Journal of Otolaryngology and Ophthalmology of Shandong University

Changes of serum myocardial enzymes and uric acid in patients with severe obstructive sleep apnea hypopnea syndrome complicated with hypertension

ZOU Juanjuan, WANG Yan, LI Yanzhong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 1-5. doi:10.6040/j.issn.1673-3770.0.2015.221

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Objective To explore the levels of creatine kinase (CK), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH) and uric acid (UA) in patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with hypertension. Methods A total of 140 OSAHS cases were divided into simple OSAHS group (n=67) and OSAHS complicated with hypertension group (n=23, OSAHS+HT group), 30 patients with simple hypertension were included into the hypertension group, and 20 healthy people served as controls. The levels of CK, CK-MB, LDH and UA of the 4 groups were measured. The rates of abnormal cardiac structure and function in OSAHS group and OSAHS+HT group were analyzed. Results Compared with the control group, the levels of CK, CK-MB, LDH and UA in the other 3 groups were higher (P<0.05, or P<0.01). Compared with simple OSAHS group, the levels of CK, LDH and UA in OSAHS+HT group were higher (P<0.05), but the level of CK-MB had no significant difference (P>0.05). The incidence of left ventricular hypertrophy, ventricular septal thickening, left atrial enlargement, aortic valve regurgitation and E/A<1 was higher in OSAHS+HT group than in OSAHS group (P<0.05, or P<0.01). The levels of serum CK, LDH and UA in OSAHS patients were positively correlated with AHI, but negatively correlated with SpO₂. There was no significant correlation between CK-MB and AHI, and SpO₂. Conclusion Severe OSAHS patients have increased serum myocardial enzymes and uric acid level. For OSAHS patients complicatedwith hypertension, uric acid and myocardial enzymes will increase more significantly. Patients with severe OSAHS may have abnormal cardiac structure and function, and hypertension may increase this probability. UA, CK and LDH are associated with the severity of OSAHS and degree of hypoxia.

Short-term efficacy of surgical treatment of moderate to severe obstructive sleep apnea syndrome

XIA Cui, GAO Tianxi, HOU Jin, WANG Ting, ZHENG Guoxi

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 6-10. doi:10.6040/j.issn.1673-3770.0.2015.231

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Objective To evaluate the surgical treatment efficacy and change of quality of life of patients with moderate or severe obstructive sleep apnea syndrome (OSAHS). Methods Clinical data of 48 patients with OSAHS confirmed by polysomnography (PSG) were collected. Preoperative and postoperative apnea hyponea Index (AHI), lowest oxyhemoglobin saturation (LaSO₂), mean oxyhemoglobin saturation (MSaO₂), sleep efficiency and quality of life (determined by Quebec sleep questionnaire) were compared. Results ① After surgical treatment, AHI reduced from (56.3±18.2) to (28.4±20.8), and LaSO₂ rose from (64.2±12.8) to (75.1±13.4). There were statistically significant differences (P<0.05). ② After surgical treatment, patients' quality of life was improved, especially the daytime sleepiness. ③ According to objective indicators, the cure rate was 5.5%, effectual rate was 25.0%, effective rate was 44.5%, ineffective rate was 25.0%, and the total effective rate was 75.0%. According to subjective symptoms, the total effective rate was 88.9%, of which daytime sleepiness was 61.1%, daytime symptom was 80.6%, nighttime symptom was 38.9%, emotion was 69.4%, social interaction was 61.1%. Conclusion To develop multi-plane individualized treatment programs based on different blocking plane is key to the success of surgical treatment of OSAHS, and can significantly improve patients' quality of life. To evaluate the surgical efficacy, both subjective and objective indicators should be considered.

Correlation between chronic hypoxia caused by obstructive sleep apnea syndrome and nonalcoholic fatty liver disease

MEI Xubin, ZOU Xinbo, ZHAO Limin, ZOU Huizhong, CHEN Zhengang, LIU Wenjun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 11-13. doi:10.6040/j.issn.1673-3770.0.2015.175

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Objective To investigate the correlation between chronic hypoxia caused by obstructive sleep apnea hypopnea syndrome (OSAHS) and nonalcoholic fatty liver disease (NAFLD). Methods A total of 927 OSAHS patients were divided into simple sleep apnea group (n=63), mild hypoxemia OSAHS group (n=202), moderate hypoxemia OSAHS group (n=332), and severe hypoxemia OSAHS group (n=330), according to the lowest oxygen saturation (LSaO₂) and apnea hyponea index (AHI) collected by polysomnography (PSG). The low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TG), total cholesterol (TC) level of all patients were examined, and abdominal ultrasound was conducted. Results ① As anoxia aggravated, the detection rate of OSAHS with NAFLD increased. In severe hypoxemia, the detection rate of OSAHS with NAFLD was higher than that of simple sleep apnea, mild and moderate hypoxemia. ② There were significant differences in BMI, TC, TG, HDL-C, LDL-C in OSAHS patients with NAFLD and without NAFLD (all P<0.05). ③ The BMI, TC, TG, LDL-C, moderate and severe hypoxemia were independent risk factors for OSAHS with NAFLD. Conclusion OSAHS patients with long-term chronic hypoxia are susceptible to NAFLD. To improve patients' long-term anoxic state, weight loss and control of triglyceride levels may effectively prevent the occurrence of NAFLD.

An investigation on the test of bone mineral density in middle-aged men with obstructive sleep apnea hypopnea syndrome

LI Jufen, MU Chao, WANG Yan, LI Yanzhong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 14-18. doi:10.6040/j.issn.1673-3770.0.2015.172

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Objective To investigate the changes of bone mineral density (BMD) in middle-aged men with obstructive sleep apnea hypopnea syndrome (OSAHS), in order to explore the correlation between OSASH and BMD. Methods A total of 48 OSASH cases were enrolled as the OSAHS group, and 28 healthy male served as the control group. All subjects were monitored with PSG. Blood biochemical and other indexes were tested. BMD was measured with DXA. Patients in the OSAHS group were subdivided according to values of AHI and LSaO₂. The changes of different indexes in different subgroups were compared, and the correlation between OSAHS BMD was analyzed. Results ① There was no statistical difference in BMD between the OSAHS group and control group (χ²=0.262, P>0.05), and between mild-to-moderate OSAHS subgroup and severe OSAHS subgroup (χ²=2.508, P>0.05), but there was difference between mild-to-moderate hypoxia subgroup and severe hypoxia subgroup (χ²=5.073, P<0.05). ② There were statistical differences in body weight index (BMI) and triglyceride (TG) between the control group and OSASH group (both P<0.05). There was statistical difference in TG between the mild-to-moderate hypoxia and severe hypoxia subgroups (P<0.05). ③ In the OSAHS group, 13 cases were complicated with dyslipidemia, 5 cases with high blood pressure, 1 case with type II diabetes, 7 cases with abnormal glucose tolerance. Conclusion The change of bone mass density is not correlated with OSASH in middle-aged male. LSaO₂ has larger effects than AHI on the change of bone mass density.

Reducing the volume of soft palate and tongue with low-temperature plasma combined with pharyngeal mucosal relaxation suture in patients with obstructive sleep apnea hypopnea syndrome

ZHANG Baolin, GUO Rui, GONG Weixi, MA Jianling, LI Xianlong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 19-22. doi:10.6040/j.issn.1673-3770.0.2015.319

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Objective To explore the efficacy of low-temperature plasma combined with pharyngeal mucosal relaxation suture to reduce the volume of soft palate and tongue in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of 38 moderate and 42 severe OSAHS cases underwent low-temperature plasma ablation of the soft palate and tongue, combined with relaxation suture of posterior arch in the fossa. Their sleep was monitored, Epworth Sleepiness Scale (ESS) was filled and pharyngeal cavities were measured before operation and 6 months after operation. Results All patients' sleep was significantly improved. The diameters of the pharyngeal cavity were enlarged. Conclusion Pharyngeal mucosal relaxation tension suture can effectively prevent tear and collapse. Combined with low-temperature plasma ablation in the soft palate and tongue, it is one of the effective methods in the treatment of OSASH.

Obstructive sleep apnea syndrome combined with marfan's syndrome in 1 case

MEI Xubin, ZOU Xinbo, ZHAO Limin, LIU Wenjun

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 23-24. doi:10.6040/j.issn.1673-3770.0.2015.176

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Complications of cochlear implantation in children and adults

CHEN Shiqin, HU Jinwang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 25-28. doi:10.6040/j.issn.1673-3770.0.2015.180

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Objective To compare the characteristics of complications after cochlear implantation in children and adults, and to explore the management of these complications. Methods A total of 170 cases of cochlear implantation were retrospectively analyzed. These patients were divided into children group (n=147) and adult group (n=63) according to their age. The characteristics of complication and management were summarized. Results The success rate of implantation was 100%. Three days after operation, 13 children (8.84%) and 2 adults (8.69%) developed fever, and there was no significant difference in the incidence of fever between children and adults(P>0.05). Among those with normal inner ear, 10 children (10.20%) and 11 adults (52.38%) had postoperative vertigo, and the incidence of vertigo was lower in children than that in adults (P<0.05). Scalp hematoma occurred in 1 adult and healed after extraction. External ear canal skin perforation was observed in 1 child which was cured with surgical repair. The cochlear implant was damaged 18 months after implantation in 1 child and was re-implanted. Conclusion Different complications may occur in different periods after cochlear implantation in various age groups, which need clinicians' close attention.

Intratympanic injection of dexamethasone for otitis media with effusion by two different methods

LIANG Dongyong, HE Zhongyang, LI Qu, ZOU Xiuyuan, HUANG Yue, WANG Juxin, ZHUO Yongzhi

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 29-31. doi:10.6040/j.issn.1673-3770.0.2015.144

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Objective To evaluate the efficacy and safety of intratympanic injection of dexamethasone to treat otitis media with effusion (OME) by two different methods, namely, through Eustachian tube under electronic laryngoscope, and auripuncture and intratympanic injection. Methods A total of 65 OME cases (69 ears) with poor curative effect after conventional medical therapy for 1-4 weeks were randomly divided into two groups. The treatment group (n=32, 33 ears) were treated with intratympanic dexamethasone injection through eustachian tube under electronic laryngoscope, and the control group (n=33, 36 ears) were treated with auripuncture and intratympanic dexamethasone injection. These injections were repeated once every 2-3 days for 3 times. The clinical efficacy and complications were compared between the two group after a followed-up of 10~12 months. Results The total effective rate in the treatment group and control group was 93.9% (31/33) and 83.3% (30/36), respectively, and the recurrence rate was 15.2% (5/33) and 33.3% (12/36). The total effective rate was higher in the treatment group than in the control group while the recurrence rate was lower in the treatment group. But the differences had no statistical significance (both P>0.05). No complications occurred in both groups. Conclusion Two methods about intratympanic dexamethasone injection have the same efficacy. Intratympanic dexamethasone through eustachian tube under electronic laryngoscope can be used as a new way for the treatment of OME.

Otogenic cerebellar abscess: report of 2 cases and literature review

LI Zhaosheng, HONG Bin, HUANG Qianjin, PU Weimin, XU Zhenyue

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 32-37. doi:10.6040/j.issn.1673-3770.0.2015.178

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Objective To explore the clinical features of otogenic cerebellar abscess in order to improve the diagnosis and treatment of this disease. Methods Clinical data of 2 cases of otogenic cerebellar abscess were retrospectively analyzed and relevant literature was reviewed. Results Both patients were adult, who had symptoms of chronic otorrhea and cholesteatoma in middle ear. On admission, both cases were apathy, having no signs of central nervous system. Case one was cured by aspiration of cerebellar abscess through transmastoid approach after a radical mastoidectomy. Case two was cured by resection of cerebellar abscess in the cerebellopontine angle through trans-retrosigmoid approach first, and then by modified radical mastoidectomy after half a month. During the follow-up of 3-6 years, no recurrence was observed. Conclusion Otogenic cerebellar abscess is rare, which can easily miss diagnosis and lead to death if improperly managed. The diagnosis is based on enhanced CT and MRI scans. For the treatment, based on positive anti-infection, increased intracranial pressure should be prevented, radical debridement on the original lesion in the mastoid should be performed timely to keep drainage smooth, and aspiration of cerebellar abscess in transmastoid cavity should be carried out. If the patient is in critical condition, aspiration by cranial drilling and incision drainage on mastoid must be performed to improve the effect of antibiotics. If the patient suffers from multiple cerebellar abscesses, craniotomy or simultaneous radical mastoidectomy should be conducted. If the antibiotics are sensitive and the abscess is small, the patient may be cured by strengthening anti-infectives, followed by radical resection of mastoid lesions and regular follow-up MRI examinations. Complete removal of the mastoid lesions and selection of sensitive antibiotics are essential to cure otogenous cerebellar abscess.

Effects of silencing hypoxia inducible factor-1α on the expression of cytokines in cultured human nasal epithelial cells

LI Yingying, ZHOU Han, ZHANG Weiqiang, DONG Weida

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 38-42. doi:10.6040/j.issn.1673-3770.0.2015.143

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Objective To investigate the effects of silencing hypoxia inducible factor-1α(HIF-1α) by transfecting short hairpin RNA(shRNA)into cultured human nasal epithelial cells (HNECs) and its further regulations on vascular endothelial growth factor(VEGF), transforming growth factor(TGF)β1 and basic fibroblast growth factor(bFGF). Methods HNECs were isolated from 10 inferior turbinate-cutting patients'mucosa. Two HIF-shRNA fragments were built and the best silencing shRNA sequence was used for transfection. We separated cells into three groups: the blank group, the negative control group and the ad-HIFshRNA interference group. The protein and gene expressions were detected by Western blotting and PCR. Results HNECs were transfected with GFP marketed adenovirus which carry the best silencing HIF-1α shRNA. The protein and mRNA expressions of HIF-1α were significantly reduced 40% and 39%(q=31.469, 16.590), and following, the protein and mRNA expressions of VEGF, TGF-β1 and bFGF were reduced (P<0.05). Conclusion Transfection of ad-HIFshRNA can effectively silence the expression of HIF-1α gene and protein and furthermore inhibit the expressions of VEGF, TGF-β1 and FGF-2, which suggests HIF-1α regulates the expression of VEGF, bFGF and TGF-β1 through direct or indirect ways. Thus silencing HIF-1α may provide a new way towards allergic rhiniti's treatment.

Valuation of the therapeutic effect of the nasal steroid hormone spray to detect EOS-CSF, IL-5 levels, EOS number of peripheral blood in allergic rhinitis patients

ZHANG Hui, ZHENG Chengcai, FENG Huiwei, GUO Chenghao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 43-46. doi:10.6040/j.issn.1673-3770.0.2015.290

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Objective To detect the levels of eosinophil colony stimulating factor (EOS-CSF), interleukin-5(IL-5) and eosinophil(EOS) numbers in persistent moderately and severe allergic rhinitis patients'peripheral blood and to investigate the relationship between the levels of EOS-CSF and IL-5 and the clinic symptom of AR patients after using the Mometasone Furoate Aqueous Nasal Spray. Methods The levels of EOS-CSF and IL-5 in peripheral blood serum were detected by enzyme linked immunosorbent assay (ELISA). The number of EOS of fresh blood smear were observed by stained by Wright Giemsa method. The patients' nasal symptoms were evaluated by visual analogue scale. Results The levels of IL-5 and EOS-CSF and the EOS number in the AR group were significantly higher than in the normal control group.There was significant reduction of IL-5 and EOS-CSF in the patients after therapy. The data showed that the IL-5 level and EOS-CSF were positively correlated with EOS number. Conclusion Detection EOS-CSF, IL-5 and EOS number of peripheral blood in AR patients after treatment with nasal steroid hormone can be used to monitor the efficacy of treatment and provide guidance to adjust medication.

The relationship between D-Dimer and nasopharyngeal carcinoma

CHE Juan, ZHAO Hongchun, LI Jinling, WANG Yanfei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 47-49. doi:10.6040/j.issn.1673-3770.0.2015.150

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Objective To investigate the prognostic value of plasma D-dimer for nasopharyngeal carcinoma. Method Sixty-nine nasopharyngeal carcinoma patients and their gender-and age-matched healthy individuals were prospectively enrolled, and their plasma D-Dimer on admission were compared. The association between plasma D-Dimer and clinical stage of nasopharyngeal carcinoma was analyzed. The prognostic value of D-dimer for all-cause mortality was estimated by receiver operating characteristic (ROC) curves and Kaplan-Meier approach. Results Compared with healthy individuals, nasopharyngeal patients had significantly higher plasma D-dimer. Plasma D-Dimer increased as the advance of clinical stage of nasopharyngeal carcinoma. The area under ROC curve of plasma D-Dimer for all-cause mortality was 0.72. Patients with increased D-Dimer (more than 0.55 mg/L) have higher risk of death than the patients with normal D-Dimer (less than 0.55 mg/L). Conclusion D-Dimer is a useful prognostic factor for nasopharyngeal carcinoma. Increased D-Dimer is associated with poor prognosis.

Endoscopic endonasal dacryocystorhinostomy in treatment of chronic dacryocystitis

ZHAO Chunchen, SHAO Yuan, GONG Jitao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 50-51. doi:10.6040/j.issn.1673-3770.0.2015.159

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Objective To explore the operation skill and effect of Endoscopic endonasal dacryocystorhinostomy in treatment of chronic dacryocystitis. Methods Thirty patients with chronic dacryocystitis underwent the operation and post-operative lacrimal tract irrigation. Results All the operations were propitiously finished. Durting a follow-up of 6-12 months, no complications occurred, 28 patients were cured (93.3%)and 2 got improvement(6.6%). Conclusion The nasal lacrimal sac open operation via nasal endoscopy displayed a clear view and good treatment effect without post-operative facial scar.

Repair of tracheal defect after resection of thyroid carcinoma with acellular dermal matrix membrane

XU Zengrui, ZHANG Jianxin, SHI Jihong, CAI Xiaolan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 52-54. doi:10.6040/j.issn.1673-3770.0.2015.248

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Objective To explore the feasibility of using acellular dermal matrix membrane in tracheal defect repair after thyroid carcinoma resection. Methods Clinical data of 13 patients who suffered thyroid cancer involving trachea were retrospectively analyzed. All tracheal defects were repaired with heterogeneous acellular dermal matrix membrane. Results During the follow-up of 20 to 53 months, 11 cases removed tracheal tube smoothly, no granulation grew in trachea, and the lumen of repair site was smooth;2 cases failed to remove the tracheal tube, one of them developed infection of granulation, and the other had collapse of the repair site. Conclusion After resection of thyroid carcinoma involving the trachea, tracheal defect could be repaired by cellular dermal matrix membrane. Cases should be carefully selected in order to ensure the airway patency after operation.

The groove behind the palatovaginal canal: a landmark for identification of the palatovaginal canal

MENG Qingguo, LU Yongtian, WU Xiaoliu, LI Jianxing, SUN Huanji, ZHANG Baoying, XIE Chang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 55-61. doi:10.6040/j.issn.1673-3770.0.2015.124

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Objective To explore the groove behind the palatovaginal canal (PVC) is a critical landmark for safe identification of the PVC during endoscopic endonasal transpterygoid approaches and transfer CT scan of the pterygopalatine fossa. Methods Probes were inserted thorough the PVC of 20 dry skulls. The PVC and the groove behind it were proved on MSCT, meanwhile a comparative study was also carried out by the traditional method to identificate the PVC. Dissection of two skulls and cadaveric heads was performed to demonstrate the endoscopic anatomy of the PV canal and tbe groove. Results The grooves can be found in all 20 dry skulls and appeared as groof near the posterior opening of PV canal. 26 sids were deep while 14 sides were dimple. Mainly appeared as tube-shaped (24 sides) or ovoid dimple-shaped (16 sides). In CT scan, the average angle between PVS and the hard palate was 53.14±5.48°, while between the groove and the hard palate was 20.93±6.28°. There was also statistical difference for identification of the PVC in transfer CT between the traditional method and the method assisting with the groove. Anatomic steps and foundations for dissection of the PVC while using the groove as a landmark were described. Conclusion Anatomic investigation, radiologic studies and comparison between the methods for identification of the PVC demonstrate the important anatomic relationship of the PVC with the groove, and reveal the groove as a landmark in endoscopic endonasal transpterygoid approaches and transfer CT scan of the pterygopalatine fossa.

Pathogens of acute bacterial conjunctivitis in Nanjing area

ZHAO Taihong, LI Zhongguo

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 62-64. doi:10.6040/j.issn.1673-3770.0.2015.167

Abstract ( 1540 )

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Objective To investigate the pathogenic bacteria of acute bacterial conjunctivitis in Nanjing area and to provide reference for treatment. Methods Ninety-six eyes with acute bacterial conjunctivitis were enrolled in this study. Bacterial culture was performed on secretion specimens from conjunctival sac. Meanwhile, treatment with Gatifloxacin eye drops(4 times per day, 1 week) was carried out. After treatment, secretion specimens were re-cultivated. Results Secretion specimens of 86 eyes were successfully collected and cultivated two times. The positive rate was 81.25% in the first time. The percentages of gram positive bacteria (the top three: Staphylococcus epidermidis 52.08%, Staphylococcus aureus 7.29% and Staphylococcus saprophyticus 3.13%) and Gram negative bacteria (Escherichia coli and Klebsiella pneumoniae) in the bacteria were 65.63% and 15.63% respectively. No eye symptoms were observed after the treatment. For the second cultivation, 67 eyes(77.92%) turned to negative, 7 eyes(8.14%) were with Staphylococcus epidermidis and 4 eyes(4.65%) with Staphylococcus aureus. Conclusion The main pathogenic bacterium in acute bacterial conjunctivitis in Nanjing Area is Staphylococcus epidermidis, which should be paid attention in clinical treatment.

Analysis of simultaneous indocyanine green angiography and fundus fluorescein angiography in high myopia

ZHU Zicheng, WANG Xiaozhong, KE Genjie, WEN Yuechun, SUN Siqin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 65-68. doi:10.6040/j.issn.1673-3770.0.2015.148

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Objective To discuss the iconographic characteristics and clinical significance of synchronic examination of indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) for high myopia. Methods Thirty-two patients (58 eyes) with high myopia (>-6.00 D), selected randomly and consecutively, underwent ocular examination, fundus color photography, ICGA and FFA synchronically. The findings for the two modes of angiographies were compared. Results ICGA showed lacquer cracks in 21 eyes, while FFA showed lacquer cracks in only 15 eyes. ICGA showed choroid neovascularization (CNV) in 11 eyes, while FFA showed CNV in only 8 eyes. FFA and ICGA evenly showed multifocal choroid atrophy in 23 eyes. Conclusion ICGA can give more exact information on the lesions of choroid in high myopia. The synchronic examination of ICGA and FFA may act as a guide to the therapy for high myopia.

Outcome of artificial divergence surgery in patients with infantile nystagmus syndrome (6 cases report)

LUAN Yanan, GUO Jingli, WANG Lihua

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 69-71. doi:10.6040/j.issn.1673-3770.0.2015.146

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Objective To investigate the outcome of artificial divergence surgery in patients with infantile nystagmus syndrome. Methods Six infantile nystagmus syndrome patients with blocking convergence enrolled in out department from March 2012 to September 2014 were retrospectively evaluated. Corrected visual acuity was measured respectively. The head turn (HT) was measured when patients staring at distance fixation using a goniometer. Binocular vision function of patients was evaluated by the Titmus Stereo Test and the Worth Four Light Test in appropriate refractive correction. Prism adaptation test was used in all patients pre-operatively. The amounts of bilateral medial rectus recession was 3-4 mm. Results The average post-operative follow-up period was 9.8 months (range, 3-12 months). After surgery, the HT was eliminated in 4 patients, improved in 1 patient and ineffective in 1 patient. Monocular and binocular corrected visual acuity was improved in 3 patients and unchanged in 3 patients. Stereopsis acuity was improved in 2 patients and unchanged in 4 patients. 1 patient was consecutive exotropia. Conclusion The results of this study preliminarily showed artificial divergence surgery was effective to INS patients with blocking convergence.

Effects of rosuvastatin combined with fenofibrate therapy on vascular endothelial function retinopathy diabetic retinopathy patients

LI Junying

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 72-75. doi:10.6040/j.issn.1673-3770.0.2015.142

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Objective To investigate the effects of rosuvastatin combined with fenofibrate therapy on monocyte chemotactic factor-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), and vascular endothelial growth factor (VEGF) in elderly diabetic patients with retinopathy. Methods A total of 140 cases with diabetic retinopathy admitted during Oct. 2012 and Oct. 2014 were randomly divided into rosuvastatin group (single drug group, n=70), and rosuvastatin and fenofibrate treatment group (combined group, n=70). The single drug group received rosuvastatin calcium 10 mg/d, while the combined group were given rosuvastatin calcium 10mg/d, and Fenofibrate Capsules 100 mg once for 3 times each day. The clinical baseline levels of sex, age, body weight index, blood lipid, blood pressure and andglycated hemoglobin in the two groups had no significant differences (P<0.05). The changes of MCP-1, MMP-9 and VEGF before and after treatment were compared. Results The levels of MCP-1, MMP-9 and VEGF in the single drug group were [(2.59±0.38) vs (3.23±0.61) μg/L,t=2.697], [(47.47±5.13) vs (69.38±6.28) ng/L, t=2.868], [(125.48±8.27) vs (198.47±12.63) ng/L, t=2.846], while the levels of MCP-1, MMP-9 and VEGF in the combined group were [(1.14±0.29) vs (3.17±0.53) μg/L, t=3.217], [(34.18±4.29) vs (71.05±7.36) ng/L, t=3.163], [(87.39±10.27) vs (195.28±11.49) ng/L, t=3.352], before and after treatment, respectively. The indexes in the two groups significantly reduced after treatment. The levels of MCP-1, MMP-9 and VEGF in combined group reduced more significantly than in the single drug group, and the difference was statistically significant (P<0.05). Conclusion Rosuvastatin calcium and fenofibrate treatment contributes to the stable endothelial function in elderly diabetic retinopathy patients.

Establishment and application of model of chronic rhinosinusitis in mice

WANG Zhiyuan, ZHANG Gehua

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 76-78. doi:10.6040/j.issn.1673-3770.0.2015.184

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Chronic rhinosinusitis(CRS) is a common chronic inflammatory disease of the upper respiratory tract, which seriously affects the patients' quality of life. Because of its uncertain pathogenesis, the curative effect is not satisfactory. Animal model of CRS is the ideal means for study of the human CRS pathological mechanism and curative effect. Mice are currently common CRS animals. The main content of the review includes research progress of the mice CRS-building methods, the evaluation index and application status of the model.

Research progress of miRNA in head and neck cancers

ZHOU Juan, ZHENG Jiafa

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 79-82. doi:10.6040/j.issn.1673-3770.0.2015.170

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A microRNA, abbreviated miRNA, is a non-coding single-stranded small molecular RNA. Through incomplete or complete complementary pairing with target mRNA 3' UTR (3' end untranslated region), it plays an important role in the occurrence and development of tumors. This paper reviews the role of miRNA in the diagnosis, prognosis and treatment of head and neck cancers.

Research of eustachian tube dysfunction and the application of balloon dilation eustachian tuboplasty

ZHAO Xinxing, ZHANG Longcheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 83-86. doi:10.6040/j.issn.1673-3770.0.2015.091

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Eustachian tube dysfunction (ETD) is a major factor resulting in middle ear diseases. There are many methods for judgement and treatment of ETD in clinic. Balloon dilation eustachian tuboplasty(BET) was found to be a simple, minimally invasive and effective new method in the treatment of ETD.

Different clinical manifestations of retinitis pigmentosa and related imaging features

DU Ran, WANG Jialin, WANG Yanling

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 87-90. doi:10.6040/j.issn.1673-3770.0.2015.194

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Retinitis pigmentosa (RP) is a shared hereditary retinal disease, usually presents with night blindness, optic sallow and pigmentation. With the development of RP gene exploration and funduscopic imagines technology, researchers found that many patients do not entirely show typical symptoms. Some patients also present with untypical visual abnormals and retinal abnormalities such as macular dysfunction or anomalous retinal reflections. Modern fundus imaging techniques including visual field examination, OCT, elecreoretinogram, could provide detailed information, guide appropriate treatment and predict prognosis. Here we review the clinical manifestation of RP and related auxiliary examination performance.

The use of homemade concave shape etractor in cochlear implantation

WANG Yaning, WANG Qirong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2015, 29(5): 91-91. doi:10.6040/j.issn.1673-3770.0.2015.286

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