Table of Content

16 April 2015 Volume 29 Issue 2

  

Clinical investigation of sleep disorders and related factors in Alzheimer's disease

HE Ying-xue, CONG Lin, DU Yi-feng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  1-8.  doi:10.6040/j.issn.1673-3770.0.2014.236

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Objective To describe the characteristic of sleep disorders in patients with Alzheimer's disease and discuss the relationships between sleep disorder and cognitive function, psychiatric symptoms, living abilities and the caregiver burden. Methods 33 patients with Alzheimer's disease were recruited from clinics of Shandong Provincial Hospital. MMSE was used to measure the cognitive function and the degree of dementia. PSQI and ESS were used to evaluate the sleep disorders of the patients. The data were analyzed with software SPSS version 21.0. Results All items in PSQI occured in AD patients. The most common symptoms were sleep disturbance (57.6%), followed by reduction of sleep efficiency (54.5%) and daytime dysfunction (51.5%), most of which were of mild impairment. The least common item is the using of hypnotic drugs (9.1%). In PSQI, the sleep quality, difficulty falling asleep, sleep time, sleep efficiency were negatively related to MMSE score. In MMSE, orientation, immediate memory, drawing were negatively related to PSQI score. NPI and CSDD scores were both possitively related to PSQI score. Delusion, apathy, sleep/behavior at night and depression were more related to sleep disorders. Patients with sleep disorders had higher ADL and ZBI scores than patients without sleep disorder. Conclusion Various kinds of sleep disorders can occur in the process of Alzheimer's disease. The sleep disorders are closely related to the degree of dementia, cognitive function, living ability and psychiatric symptoms. Also, sleep disorders aggravate the patients' caregiver burden.

Meta analysis of nasal corticosteroid treatment in the children with obstructive sleep apnea hypopnea syndrome

CHEN Xi, LI Jin-rang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  9-11.  doi:10.6040/j.issn.1673-3770.0.2014.347

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Objective To investigate the effectiveness of nasal corticosteroids to treat the children with obstructive sleep apnea hypopnea syndrome (OSAHS) using meta-analysis. Methods The published articles were searched from PubMed, Chinese Biomedical Literature CD-ROM databases, and China Academic Journals Full-text database bases on the inclusion and exclusion criteria. The results of the found studies were analyzed. Results 3 English articles and 88 cases were finally included. The results of Meta analysis showed that application of nasal corticosteroids significantly reduced the weighted mean AHI[weighted mean difference (WMD)=4.07, 95% CI(0.00, 8.14), P<0.000 01]. Conclusion Nasal corticosteroids may be helpful in ameliorating children with OSAHS.

Optimal time of fistulectomy in treatment of congenital preauricular fistula

WANG De-qing, TU Yong, GAO Xia

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  12-14.  doi:10.6040/j.issn.1673-3770.0.2014.310

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Objective To explore the optimal time of surgery in the treatment of congenital preauricular fistula. Methods A total of 78 cases diagnosed as congenital preauricular fistula were studied, including 35 cases of local infection and 43 cases out. All preauricular fistula were removed with the aid of microscopy. For the cases of local infection, additional antibiotics treatment before surgery was applied. Results After a median follow up period of more than one year, 76 cases achieved full recovery, while 1 case in each group was to be recurrent. Conclusion Congenital preauricular fistula can be surgically removed under microscope when local infection has been resolved.

Advance flap in repairing marginal perforation of tympanic membrane in 27 cases

WANG Jian, GE Qian-jin, KANG Li-ping

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  15-16.  doi:10.6040/j.issn.1673-3770.0.2014.331

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Objective To investigate the therapeutic effects of advance flap to repair marginal perforation of tympanic membrane. Methods Twenty-seven ears with marginal perforations of tympanic membrane were enrolled. The epithelial ring, from the edge of perforation, was removed. Then, the epithelial and underneath fibrous layer were separated and the former was advanced to the center to close the perforation. Results 26 cases of tympanic membrane's perforations were completely repaired. The healing rate was 96.3% during 3-6 months follow-up. Conclusion Advance flap is effective in repairing marginal perforation of tympanic membrane.

High-resolution CT findings of scutum in cholesteatoma of middle ears

GUO Yan-hong, PAN Yan, WANG Ji-sheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  17-19.  doi:10.6040/j.issn.1673-3770.0.2014.307

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Objective To evaluate erosion of scutum in the diagnosis of middle ear cholesteatoma by high-resolution CT scan(HRCT). Methods HRCT findings of 38 patients(in 42 ears)with middle ear cholesteatoma in our department were reviewed. The condition of the scutum was observed with CT scanning and surgical findings. Result There are 37 ears with erosion of scutum, 4 ears with marginal/central perforation and 1 ear with intact tympanic membrane. Conclusion Scutum erosion demonstrates an important role in the diagnosis of cholesteatoma of middle ear, however, this sign cannot be found in some patienas with cholesteatoma.

Fufanghuangbai Liquid combined with triamcinolone acetonide acetate treating eczema of external auditory canal (40 cases report)

YANG Mei-yan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  20-23.  doi:10.6040/j.issn.1673-3770.0.2014.254

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Objective To investigate the clinical effect of Fufanghuangbai liquid combined with triamcinolone acetonide acetate treating eczema of external auditory canal. Methods In the Juye County People's Hospital otolaryngology from January 2012 to April 2014, 80 cases of eczema were randomly divided into control group and observation group, the control group of 40 patients were given triamcinolone acetonide acetate, 40 patients were given Fufanghuangbai liquid combined with triamcinolone acetonide acetate treatment, compared two groups of patients with clinical treatment effect and adverse reaction. Results After 1 weeks of treatment, the observation group efficiency was 45%, although slightly higher than that of the control group was 40%, but the two groups had no statistical difference (P>0.05). In observed group, the total efficiency of 75%, it was slightly higher than 72.5% of the control group, but the two groups had no statistical difference (P>0.05). After 2 weeks treatment, the observed group was 77.5%, significantly higher than the control group of 40%, a significant difference between two groups (P<0.05). Total effective rate of observation group was 92.5%, significantly higher than the control group of 72.5%, with a significant difference between two groups (P<0.05). Patients in the two groups after treatment had no significant adverse reactions. Conclusion Fufanghuangbai liquid combined with triamcinolone acetonide acetate treating eczema of external auditory canal has satisfied effect, it can significantly improve the patient's clinical symptoms with less adverse reaction.

Three different routes of administration in the treatment of sudden sensorineural hearing loss

LU Na

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  24-27.  doi:10.6040/j.issn.1673-3770.0.2014.316

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Objective To explore the best route of administration in the treatment of sudden sensorineural hearing loss. Methods According to the best route of administration. 210 sudden sensorineural hearing loss patients were divided into the venous group(70 patients injected dexamethasone via vein), the tympanic group(70 patients injected methylprednisolone into tympanic cavity), and the retroauricular group (70 patients injected methylprednisolone subperiosteally in the mastoid). Results The cure and effective rates of the three groups were 29.58%, 64.79%, 35.21%, 80.28%, and 64.79%, 83.10%, respectively. As for thecure rate,there were significant differences between the vein group and the retroauricular group(P<0.01), the tympanic group and the retroauricular group(P<0.01), but there were not significant differences between the vein group and the tympanic group(P>0.05). For the effective rates, there were significant differences between the vein group and the retroauricular group(P<0.01), the vein group and the tympanic group(P<0.01), but there were not significant differences between the tympanic group and the retroauricular group(P>0.05). Conclusion injecting methylprednisolone subperiosteally in the mastoid shows a high cure rate and stable effective rate sudden sensorineural hearing loss.

Preliminary evaluation of predicative performance of BAHA softband in the conductive or mixed hearing loss patients

ZHOU Xiao-wei, YU You-jun, ZHAO Yuan-xin, LIU Zhen, ZHENG Li-gang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  28-30.  doi:10.6040/j.issn.1673-3770.0.2014.247

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Objective To investigate the hearing improvement of BAHA softband in the conductive or mixed hearing loss patients. Methods Sixty-two conductive or mixed hearing loss patients participated in the study. Pure-tone threshold in the acoustic field was compared before and after the application of BAHA softband to evaluate the patients' hearing capability. A questionnaire was filled up to understand subjective feelings after wearing the BAHA softband. Results Air conduction in 0.25 k to 4 kHz was improved in different degrees, and sense of direction and communication in the noise environment were improved. Conclusion BAHA can improve the hearing loss in the conductive deafness or mixed deafness.

Expressions of EGF and EGFR in nasal polyps epithelium

DUAN Chen, XU Xin, SHI Li

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  31-35.  doi:10.6040/j.issn.1673-3770.0.2014.352

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Objective To investigate the expressions of epidermal growth factor (EGF) and epidermal growth factor receptor(EGFR) in nasal polyps (NPs) as well as their potential roles in polyp epithelium. Methods Polyp biopsies were collected from 25 patients with NPs. Inferior turbinates were obtained from 10 subjects with septal deviation, which were served as the control group. EGF and EGFR expression levels were assessed by using immunohistochemistry and real-time quantitative PCR. Results Staining results revealed that EGF and EGFR mainly localized in basal epithelial cells, and their protein levels were significantly lower in NP than in the control. Down-regulation of both EGF and EGFR mRNA levels were further confirmed in NP as compared with control samples. Conclusion Lower expression of EGF and EGFR in epithelium may be involved in the defect of epithelial repair process in NP.

Nasal endoscopic surgery for fibrous dysplasia involving rhino-orbito-skull base: a report of 4 cases

LI An, LI Na, JIANG Yan, YU Long-gang, LIU Hui, XU Tong, KONG Xiang-bin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  36-40.  doi:10.6040/j.issn.1673-3770.0.2014.409

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Objective To investigate the treatment method and prognosis of fibrous dysplasia involving rhino-orbito-skull base. Methods The clinical data of 4 cases of fibrous dysplasia involving rhino-orbito-skull base treated with nasal endoscopic surgery were retrospectively analyzed. There was 1 male and 3 females aging from 5 to 17 years with a median age 13 years. Their clinical manifestations included headache, rhinorrhea, hyposmia and nasal obstruction, except of visual deterioration in 1 case. The primary sinus involved was the ethmoid (4), sphenoid (2), frontal (2), maxillary (2), and skull (1). Results All the patients were followed up of 13-123 months. The symptoms such as headache, rhinorrhea and nasal obstruction disappeared after the operation, olfactory dysfunction was better, and the nasal cavity epithelization was well. The case of visual deterioration was re-operated 4 years later because of recurrence. All the patients had no complications and had satisfied outcome. Conclusion The nasal endoscopic surgery is safe, effective and results in less injury for fibrous dysplasia involving rhino-orbito-skull base. It not only can repristinate nasal sinuses physiological function and improve clinical symptoms, but also has positive effect on prevention and treatment of complications.

Effect of steroid nasal spray on pediatric allergic rhinitis in children with adenoidal hypertrophy

WEI Yi, WANG De-le, WANG Shao-jian, ZENG Li

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  41-43.  doi:10.6040/j.issn.1673-3770.0.2014.360

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Objective To evaluate the curative effect of steroid nasal spray on pediatric allergic rhinitis with adenoidal hypertrophy. Methods A total of 261 children with adenoids served as the control group, of them, 190 children(72.7%) were with adenoid hypertrophy. A total of 162 children with allergic rhinitis and adenoids served as the experimental group, of them, 110 children(67.2%) were with adenoid hypertrophy. The two groups were both treated by Fluticasone propionate nasal spray (50 μg per nostril a day) for 3 months. Results Adenoidal hypertrophy incidence was 72.7% in the control group and 67.2% in the experimental group (χ²=1.16, P>0.05). 112 (58.9%) patients in the control group and 89 (80.9%) patients in the experimental group had the adenoidal volume decreased (χ²=19.04, P<0.01). Conclusion After steroid nasal spray treatment, the adenoidal volume is much more decreased in the experimental group than in the experimental group. Steroid nasal spray is the first choice for children with allergic rhinitis and adenoidal hypertrophy.

Therapeutic effect of uncinectomy through the anterior nasal fontanelle in endoscopic sinus surgery

LIN Xi, LIN Chang, ZHANG Rong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  44-47.  doi:10.6040/j.issn.1673-3770.0.2014.306

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Objective To observe the therapeutic effect of uncinectomy through the anterior nasal fontanelle in endoscopic sinus surgery. Methods Sixty patients diagnosed as chronic ethmomaxillary sinusitis were divided into two groups. The research group had 31 patients(52 sides) and the control group had 29 patients(50 sides). The research group received uncinectomy via the anterior nasal fontanelle while the control group received the traditional uncinectomy by Messerklinger. VAS score, Lund-Kennedy score, mucociliary transport time(MTT) and the activated charcoal powder method were used to observe the therapeutic effects. Results Twelve months after the operation, the VAS score, Lund-Kennedy score and the MTT of the two groups were statistically different (P<0.05). Activated charcoal powder was all drained out from the inferior edge in the research group, while there was powder stacked in the sinuses in 8 sides of the control group. Conclusion Uncinectomy through the anterior nasal fontanelle is a more effective method for chronic sinusitis and can achieve better recovery of the mucocilliary transport system than the uncinectomy by Messerklinger does.

Expression of TSLP and its relationship with the infiltrsting regulatory T cells in chronic rhinosinusitis

ZHU Hui-tao, CAI Xiao-lan, FENG Xin, QI Jun-jun, ZHANG Jin-ling, MA Yue, LI Xue-zhong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  48-51.  doi:10.6040/j.issn.1673-3770.0.2014.369

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Objective To determine the expression of thymic stromal lymphopoietin(TSLP)and regulatory T cells(CD4⁺CD25⁺Foxp3⁺Treg) in human chronic rhinosinusitis(CRS) and to analyze their pathogenesis in CRS. Methods The sinus mucosa from 25 patients with CRS was studied. Inferior nasal turbinate from 28 patients with nasal septum deviation served as the control. Their histological characteristics were analyzed by HE stain. The expressions of TSLP and Foxp3 mRNA were detected by Q-RT-PCR. Immunohistochemistry was used to detect CD4⁺CD25⁺Foxp3⁺Treg cells. The correlation of TSLP with the number of Tregs and the correlation of TSLP with Foxp3 mRNA were evaluated. Results The expressions of TSLP mRNA, Foxp3 mRNA and Treg cells were significant higher in CRS compared with the control group(P<0.05). There was positive correlation between TSLP and Foxp3 mRNA(r=0.977 3, P<0.000 1). At the same time, there was positive correlation between TSLP and the number of Tregs(r=0.864 6, P<0.0001). Conclusion TSLP could play an important role in CRS by inducing Treg cells.

Clinical characters of chronic sinusitis induced by radiotherapy for nasopharygeal carcinoma

TANG Jun, SHI Si-si, YU Qing-qing, XIAO Jian-xin, ZHANG Chao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  52-54.  doi:10.6040/j.issn.1673-3770.0.2014.115

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Objective To investigate the characters of chronic sinusitis induced by radiotherapy for nasopharyngeal carcinoma. Methods The clinical data of 40 chronic sinusitis patients induced by radiotherapy for nasopharyngeal carcinoma (the radiotherapy group) and 40 common chronic sinusitis patients (the control group) enrolled in our department from January 2011 to May 2013 were retrospectively analyzed. All patients were measured the symptom visual analysis scale (VAS) and took endoscopic examination and sinus CT scanning. A total of 18 patients of the radiotherapy group and 36 patients of the control group accepted endoscopic surgery, during the operation, purulent secretion in the maxillary was exacted and bacterial culture was done. Results As to the VAS, nasal secretion was significantly more severe in the experimental group (6.5±1.2) in comparison with the control group (5.3±1.0, P<0.05). As to the endoscopic finding, more dry and more curst in the postior nasal cavity and nasopharynx, the Lund-Kenndy score was 6.2±1.1 in the experimental group vs 4.7±0.7 in the control group. The main reasons laid in high CT scores and high involved rates of ostiomeatal complex, frontal sinus, maxillary sinus and anterior ethmoid sinus. Conclusion The characters of chronic rhinosinusitis caused by radiotherapy are quite different from those of the common chronic sinusitis. The mechanism of chronic sinusitis induced by radiotherapy prefers to obstruction of the ostium or dysfunction of the cilia continued with bacterial infection.

Clinical study on kaino-sinus syndrome of 41 cases after nasal endoscopic surgery

WANG Yan, ZHANG Qing-quan, SONG Rui-ying, WANG Li, JIANG Shao-hong, LIU Zhong-lu

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  55-57.  doi:10.6040/j.issn.1673-3770.0.2014.399

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Objective To explore the etiological factors and treatment for Kaino-sinus syndrome. Method The clinical data of 41 cases of kaino-sinus syndrome were retrospectively analyzed. The diagnostic criteria was put forward and the treatment effect was evaluated. Results Kaino-sinus syndrome happened after nasal endoscopic surgery may due to sinus structure changes and air flow changes, temperature difference of air stimulated the sinus cavity mucous membrane and produced clinical symptom. After physical or drug treatment, the 41 patients achieved palliation or cure. Conclusion In nasal sinus operations, nasal mucosa and tissue structures of the sinus aperture should be maintained as far as possible.

Endoscopic endonasal approach to the pterygopalatine fossa: an anatomic study

SHEN Peng, SUN Zhong-wu, LI Jian-rui, YANG Li-jun, MA Liang, ZHANG Ming-sheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  58-61.  doi:10.6040/j.issn.1673-3770.0.2014.328

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Objective To investigate the related anatomy in the pterygopalatine fossa under endoscopy so as to provide anatomical data for endoscopic transnasal surgery. Methods Five (10 sides) cadaveric heads were dissected via sphenopalatine foramen approach and via the posterior wall of the maxillary sinus approach to show the pterygopalatine fossa, then the sphenoid sinus was dissected to show the optic nerve, internal carotid artery and other anatomical structures. Results Different approaches allowed for different exposure of the pterygopalatine fossa structures. All the important anatomical structures and their relations in and around the pterygopalatine fossa could be observed under endoscopy. Conclusion The endoscopic transnasal surgery in the pterygopalatine fossa is feasible and safe as if surgeons master the related anatomy and choose right cases.

Nasal endoscopy by low-temperature plasma radiofrequency for benign tumor resection

ZHU Kang, HE Ying, YAN Jing, XIA Cui, GAO Ying, ZHENG Guo-xi, HOU Jin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  62-64.  doi:10.6040/j.issn.1673-3770.0.2014.337

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Objective To evaluate the effect of nasal endoscopic surgery by low-temperature plasma radiofrequency for benign tumor resection. Methods The clinical data of 17 patients with nasal sinus benign tumor treated between January 2012 and May 2013 under nasal endoscopic surgery by the low-temperature plasma radiofrequency were retrospectively studied. All were followed up in a 1-year process. In which, 8 cases of inverted papilloma, 1 case of angiofibroma of nasopharynx, 3 cases of nasal hemangioma, and 5 cases of hermorrhagic and necrotic polyps of maxillary sinus were studied. Results The blood loss was 5 to 150 mL with an average of 30 mL. The operation time was 20 to 55 minutes with an average of 35 minutes. During the follow-up period, cavity epithelial change was good and no recurrence was found. Conclusion Endoscopic surgery by low-temperature plasma radiofrequency is a viable surgical method for benign tumor and has advantages of less bleeding, minimal invasion and short operation time.

Adenoidectomy with low-temperature plasma stripping-pushing-ablation under nasal endoscopy for children with adenoidal hypertrophy

JIN Yong-gang, LI Jian-rui, ZHANG Dong, WANG Yu, LIU Ning-ning, QIAN Hai-long

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  65-67.  doi:10.6040/j.issn.1673-3770.0.2014.348

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Objective To explore the treatment method and effect of adenoidectomy with low-temperature plasma stripping-pushing-ablation under 70° nasal endoscopy for children with adenoidal hypertrophy. Methods A total of 317 children with adenoidal hypertrophy were treated by adenoidectomy with low-temperature plasma stripping-pushing-ablation under 70° nasal endoscopy, also they were given medicine. Results During a follow-up period of 6 to 12 months, there was no recurrence. Conclusion Apparent visual fields, clear boundary lines and quick recovery are got by adenoidectomy with low-temperature plasma stripping-pushing-ablation under 70° nasal endoscopy for children with adenoidal hypertrophy.

Treatment of laryngeal tumor with semiconductor laser and fiber laryngoscope(30 cases report)

WANG Xi, JIANG Hai-hua, DU Ji-liang, WANG Zhi-qiang, SUN Xiu-mei, SONG Li, KONG Qing-dong, HE Qing-long

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  68-69.  doi:10.6040/j.issn.1673-3770.0.2014.152

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Objective To analyze the curative effects and advantages of semiconductor laser surgery in benign throat tumor include: tumors of vocal cords and precancerous lesions. Methods With fiber laryngoscope, semiconductor laser was used to remove the polyps of vocal cords or laryngeal ventricle, vocal nodules, vocal leukoplakia, papilloma and so on under surface anesthesia. After the operation, all patients kept voice silence for 1 months, while symptomatic treatment to eliminate edema was applied at the same time. The recovery of voice was observed after one-month treatment. Result After semiconductor laser treatment, hoarseness were resolved and vocal mucosa recovered well. Conclusion With the guidance of fiber laryngoscope, semiconductor laser surgery is an effective treatment for laryngeal tumor.

CO₂ laser treatment in subglottic amyloidosis (two cases report and a literature review)

GENG Yang, WANG Hui-zhong, SUN Feng-lin, WANG Xiao, WANG Hai-peng, XU Rong, XIA Yong-jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  70-73.  doi:10.6040/j.issn.1673-3770.0.2014.299

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Objective To investigate the effectiveness of Carbon dioxide (CO₂) laser in the treatment of subglottic amyloidosis. Methods Clinical data of two cases of subglottic amyloidosis from Jan.2010 to Oct.2014 were reviewed. Results No obvious complication was found in the two patients after laser operation. Symptoms, including hoarseness and laryngeal obstruction, were relieved dramatically after the surgery. Follow-up period was 9 months and 14 months, respectively. During the follow-up, no recurrence happened on both patients. Conclusion CO₂ laser is effective to treat subglottic amyloidosis. Short-term clinical outcomes are satisfactory if complete resection is achieved, however, long-term effects need further observation.

Effect of nicotine on human RPE cells and HUVECs

ZHANG Ying-chun, DU Xiang-ge, YAN Xin, WANG Cui, ZHAO Bo-jun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  74-80.  doi:10.6040/j.issn.1673-3770.0.2014.351

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Objective To evaluate the influences of Nicotine (NT) from cigarette smoke on VEGF and PEDF expressions in retinal pigment epithelium (RPE) cells and human umbilical vein endothelial cells (HUVECs). In addition, the angiogenic behaviors of endothelial cells with NT treatment were assessed by using in vitro methods. Methods ARPE-19 cells and HUVECs were treated with different concentrations of NT for a period of times. Proliferative effect was investigated by using the method of MTT analysis. HUVECs migration and tube formation were assessed by using the wound-healing and Matrigel models. The expressions of VEGF and PEDF in both types of cells were examined by real-time PCR and Western blotting. Results There was no proliferation of ARPE-19 cells following treatment with various concentrations of NT. However, NT significantly stimulated HUVECs proliferation, migration, and tube formation. NT up-regulated the expression of VEGF but suppressed the expression of PEDF at both mRNA and protein levels in a dose- and time-dependent manner in ARPE-19 cells and HUVECs. Conclusion Our results demonstrate that NT promoted endothelial cellular proliferation, migration and angiogenesis of HUVECs in vitro. These effects might partly play through simultaneous modulation of VEGF/PEDF signaling in ARPE-19 cells and HUVECs.

Murine model of ocular toxoplasmosis and feature of fundus

LI Zhi-wei, ZHANG Han

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  81-85.  doi:10.6040/j.issn.1673-3770.0.2014.362

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Objective To establish murine model for ocular toxoplasmosis and observe the fundus and pathological changes. Methods 20 BALB/C mice were randomly divided into the control and experimental group with 10 mice per group. In the experimental group, mice were fed orally with toxoplasma type Ⅱ PRU strains cyst. Changes of fundus were observed daily and fundus photography were taken after 1 month, 2 months and 3 months, respectively. After 3 months, serum IgG of the mice was detected by ELISA assays. The mice were sacrificed and the eyes were harvested. Pathological damages of retina and choroid tissue were observed after HE staining. Results After two weeks, fundus inflammation was noticed in the experimental group, including optic disc edema, retinal angioplerosis, edema and hemorrhage along with retinal vascular, from the beginning of the optic disc area gradually expanded to the surrounding blood vessels. These changes aggravated with time. Significant titers change in serum IgG, significant higher than the control group (P<0.001), from the retinal and choroid tissue slice of the experimental group mice, we could see the retinal and choroid apparent edema, the gap between the organization was loose, lacuna was formed,inflammatory cell infiltration was found in tissue of retinal and choroid. Conclusion Infecting mice with type Ⅱ toxoplasma PRU strains via oral route could be a good way to establish animal model for ocular toxoplasmosis, which can cause inflammation of the choroid and retina.

Efficacy and safety evaluation of UVA/riboflavin crosslinking for late and thin cornea keratoconus

ZHANG Chun-xiao, LI Zhi-wei, XU Wen-wen, LI Feng-jiao, TAO Xiang-chen, MU Guo-ying

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  86-88.  doi:10.6040/j.issn.1673-3770.0.2014.338

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Objective To evaluate the efficacy and safety of UVA/riboflavin corneal crosslinking in late keratoconus cases with cornea thinner than 400 μm. Methods A total of 18 eyes of 14 keratoconus patients with corneal thickness less than 400 μm were recruited in this study. Corneal epithelium of central 8mm was removed mechanically under topical anesthesia, then hypo-osmotic riboflavin was applied until corneal thickness reached over 400 μm. Then standard UVA/riboflavin corneal crosslinking was applied. BCVA, apex K value, corneal thickness, endothelium and lens changes were examined and recorded. Results Corneal epithelium of all patients was recovered within 1 week, and it of 14 eyes within 5 days. Corneal haze was found in all patients and vanished in 2 to 6 weeks. BCVA was 4.76±0.61 before treatment and 4.83±0.46 and 4.84±0.51 on 3 and 6 months after the operation. Apex K value was 56.29±7.33D, 52.42±5.76D and 48.12±6.6D before the treatment, and 3 and 6 months after the treatment. Corneal thickness was 318±33 μm, 447±18 μm, 381±72 μm and 354±35 μm before the treatment, after swelling, and 3 and 6 months after crosslinking. Endothelium was 3 069±202/mm², 2 910±213/mm² and 2 935±215/mm² before the treatment, and 3 and 6 months after the treatment. Conclusion By using hypo-osmotic riboflavin to swell thin cornea, UVA/riboflavin corneal crosslinking is safe and effective in the treatment of late keratoconus.

Clinical observation of modified pterygium excision with limbal-conjunctival flap grafting

LI Mei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  89-90.  doi:10.6040/j.issn.1673-3770.0.2014.365

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Objective To investigate the operation method and clinical effect of modified pterygium excision with limbal-conjunctival flap grafting. Methods A total of 24 cases (24 eyes) of primary pterygium received modified excision of pterygium and limbal conjunctival autografting. Results After a follow-up of 1 month to 6 years, 22 eyes were cured and 2 eyes relapsed. Conclusion Modified pterygium excision with limbal-conjunctival flap grafting can achieve a good therapeutic effect with fewer complications and lower recurrence rate in the treatment of primary pterygium.

Etiology, mechanism of dye eye and advancement of traditional Chinese medicine in combination with western medicine for it

YANG Zi-chao, WANG Yu-liang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(2):  91-93.  doi:10.6040/j.issn.1673-3770.0.2014.394

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With the in-depth study of science and technology, people deepen the understanding about dye eye, and traditional Chinese and Western medicine treatment have greatly enhance the efficiency on dry eye. In light of the above knowledge, the present article reviews the newer theories and reports on etiology, pathogenesis and management of dry eye, and give a summary that integrated traditional Chinese and Western medicine therapy is the first treatment of choice for dry eye. TCM therapy should be performed according to the condition of patients with the viscera.