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    20 July 2019 Volume 33 Issue 4
      
    Editorial
    History, current status and future of laryngeal function retention in laryngeal cancer treatment
    Xiaoming LI
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  1-5.  doi:10.6040/j.issn.1673-3770.1.2019.030
    Abstract ( 1591 )   HTML ( 27 )   PDF (603KB) ( 346 )   Save
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    Invited Review
    Transoral laser microsurgery for early glottic neoplasms
    Ming LIU
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  6-9.  doi:10.6040/j.issn.1673-3770.1.2019.037
    Abstract ( 1721 )   HTML ( 10 )   PDF (565KB) ( 254 )   Save
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    With the development of minimally invasive technology, most of early glottic carcinoma is treated by endoscopic surgery. Since CO2 laser was introduced into the treatment of early laryngeal carcinoma in the 1970s, it is widely due to its advantages. It does not require an neck incision and tracheotomy, and it is associated with less postoperative complications, shorter hospital stay, faster rapid recovery of patients, better preservation of laryngeal function and so on. Surgery with CO2 is recognized as the preferred endoscopic surgery for treating glottic cancers. The indications, complications, limitations and surgical classification of oral CO2 laser in the treatment of early vocal cord carcinoma are discussed in this paper. In addition, the history and development of endoscopic treatment of early glottic carcinoma are reviewed, and the importance of the oncological principles during the surgery of malignant tumor are emphasized.

    Significance of induction chemotherapy in late treatment of locally advanced hypo-pharyngeal cancer
    Xiaobo CUI
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  10-17.  doi:10.6040/j.issn.1673-3770.1.2019.027
    Abstract ( 2935 )   HTML ( 36 )   PDF (17739KB) ( 566 )   Save
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    Early symptoms of hypopharyngeal cancer were not obvious because tumorigenesis in concealed areas. Almost 2/3 of hypopharyngeal cancer were diagnosed as middle and advanced stage, when first seeing a doctor.It is a malignant tumor with poor prognosis in head and neck tumors. In recent years, in order to improve the prognosis, we advocate a comprehensive treatment model combining surgery, radiotherapy and chemotherapy. Value of induction chemotherapy has been noticed in organ preservation and metastasis rate reduction. But in the actual clinical work, the role of induction chemotherapy (IC) in the treatment of locally advanced hypopharyngeal cancer has been disputed because every physicians′ understanding of the advantages and disadvantages of the guidelines and treatment methods and differences in clinical experience. How to choose the most reasonable one based on the patients′general and local conditions from many different treatment methods is an issue that has been explored in during treatment of hypopharyngeal cancer. This paper points out the author′s individual experience the induction chemotherapy in treatment of locally advanced hypopharyngeal cancer by literature review and case analyses.

    Reseach Progress
    Progress in clinical research on circulating tumor cells in squamous cell carcinoma of the head and neck
    Kun LIU,Xinxin ZHANG
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  18-24.  doi:10.6040/j.issn.1673-3770.1.2019.039
    Abstract ( 1158 )   HTML ( 6 )   PDF (627KB) ( 457 )   Save
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    Circulating tumor cells (CTCs), as one of the materials of "liquid biopsy, " have important guiding roles in the early diagnosis of head and neck squamous cell carcinoma, judgment of prognosis and therapeutic response, and monitoring of tumor recurrence and metastasis. In this paper, the progress in research on CTCs in recent years and their clinical application in head and neck squamous cell carcinoma are reviewed

    Etiology, molecular mechanisms, and treatment strategies of precancerous laryngeal lesions
    Yupeng SHEN,Qi SONG,Xiaoming LI
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  25-30.  doi:10.6040/j.issn.1673-3770.1.2019.029
    Abstract ( 1695 )   HTML ( 10 )   PDF (419KB) ( 234 )   Save
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    Laryngeal precancerous lesions refer to several types of laryngeal lesions with malignant potential, which present with similar clinical manifestations, pathological features, and biological characteristics. Common laryngeal precancerous lesions include laryngeal keratosis, chronic hypertrophic laryngitis, papilloma of larynx, etc. There are many pathogenic factors associated with laryngeal precancerous lesions. The prognosis is dependent on where the lesion occurs and how it develops, as there are various molecular mechanisms involved in the regulative progress. The clinical treatment strategy for laryngeal precancerous lesions depends on an individualized surgical plan. Future clinical research will focus on efforts to prevent and block the pathogenic factors of laryngeal precancerous lesions.

    Clinical Research
    Effects of dihydroartemisinin on endoreticulum stress pathway in FaDu hypopharyngeal carcinoma cells
    Zelei HUANG,Qi SONG,Xiuying LU,Lanzhen CUI,Xiaoming LI
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  31-35.  doi:10.6040/j.issn.1673-3770.1.2019.031
    Abstract ( 1144 )   HTML ( 8 )   PDF (1795KB) ( 280 )   Save
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    Objective

    To investigate the mechanism of inhibition by dihydroartemisinin (DHA) of the proliferation of FaDu cells in hypopharyngeal cancer, and provide a theoretical basis for its clinical application in anti-tumor therapy.

    Methods

    FaDu cells were cultured in different concentrations of glucose (5.5, 10, 15, 25, 50, 100 mM) for 36 h, then the expression of p-STAT3 and endoplasmic reticulum stress-related protein GRP78 were detected by western blot. FaDu cells of hypopharyngeal carcinoma were treated with DHA at different concentrations (10, 20, 40, 80, 160 M) in a culture medium with 25 mM glucose, and the effect on cell proliferation was detected by MTT assay 24 h later. Western blot was used to detect the expression of p-STAT3 and GRP78.

    Results

    DHA inhibited the proliferation of FaDu hypopharyngeal carcinoma cells in a concentration-dependent manner. Low-glucose concentration medium reduced the expression of p-STAT3 and increased the expression of GRP78. DHA inhibited the expression of p-STAT3; GRP78 expression was stimulated at low DHA concentrations, but was inhibited as the DHA concentration increased.

    Conclusions

    DHA significantly inhibits the proliferation of FaDu hypopharyngeal carcinoma cells, inhibits the expression of p-STAT3, and induces endoplasmic reticulum stress, which may be closely related to the interference of cellular glucose metabolism.

    Clinical Report
    Recurrent laryngeal cancer
    Ruofei HUANG,Lixiao CHEN,Xinwei CHEN,Ziwei YU,Bin JIN,Jiangcai ZHU,Pin DONG
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  36-39.  doi:10.6040/j.issn.1673-3770.1.2019.032
    Abstract ( 1173 )   HTML ( 2 )   PDF (364KB) ( 185 )   Save
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    目的

    分析喉癌术后无瘤生存5年以上,喉重复癌病例的临床特征与治疗。

    方法

    收集近20年来符合以上条件的喉癌患者对初发和再发肿瘤的时间间隔、再发后治疗方式及生存情况进行分析。

    结果

    1997至2018年患者9例,其中T1N0M0 3例,T2N0M0 5例,T3N0M0 1例。喉癌治疗后喉部重复癌发生最短60个月,最长190个月。喉部重复癌(同侧3例,对侧3例,声门下3例)9例,8例进行了不同方式的二次手术治疗。喉部重复癌确诊后2例死亡,已生存时间15~87个月;其中再手术后生存时间超过3年者5例。

    结论

    喉癌术后远期治愈后仍有肿瘤再发局部重复癌可能,需坚持长期有效的随访,尽早发现再发病灶并进行处理,仍能延长患者生存期。

    Interpretation of Foreign Clinical Guidelines
    Application of laryngeal retention strategy in the treatment of laryngeal cancer - introduction to the clinical practice guide of the American Society of Clinical Oncology (2017)
    Xiaohan SUN,Na LI
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  40-42.  doi:10.6040/j.issn.1673-3770.1.2019.042
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    美国临床肿瘤学会2017年对喉保留策略在喉癌治疗中的应用——美国临床肿瘤学会临床实践指南进行更新。对适当的患者采用保喉方法治疗并不影响生存率。对T1、T2期患者应采用内镜手术切除病灶或放疗。对于T3、T4期患者应行喉保留手术、联合放化疗或单纯放疗。对广泛受累的T3或T4a期或治疗前已有严重喉功能不全的患者应行全喉切除术以提高生存率及生活质量。治疗前患者应接受喉语音及吞咽功能的基础评估。指南推荐了评价喉发声及吞咽功能的最佳方案。

    Original Article
    Treatment and outcome of tinnitus in sudden deafness
    Xiaosheng ZHONG,Haidi YANG,Yiqing ZHENG
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  43-46.  doi:10.6040/j.issn.1673-3770.0.2018.393
    Abstract ( 1790 )   HTML ( 1 )   PDF (415KB) ( 254 )   Save
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    Objective

    To study and analyze the treatment and outcome of tinnitus in sudden deafness with tinnitus.

    Methods

    Seventy-six cases of sudden deafness with tinnitus were selected and treated according to the Guidelines for Diagnosis and Treatment of Sudden Deafness (2015). After 2 weeks, the tinnitus disability scale (THI) and visual analog scale (VAS) scores were analyzed. All patients were provided psychological counseling at discharge. Individualized short-term medication, masking therapy, acclimatization therapy, and hearing aid therapy were provided to those who could not adapt to tinnitus. At the 1-year follow-up, patients who still experienced tinnitus were treated with masking therapy or acclimatization.

    Result

    Before and after 2 weeks of routine treatment, the THI scores of the 76 patients were 49.71±2.69 and 41.04±2.84, respectively (t=3.935, P < 0.001); VAS scores were 5.17±0.20 and 4.22±0.25, respectively (t=5.010, P < 0.001). Hearing was good in 53 cases and poor in 23 cases. The difference in THI before and after routine treatment in the good and poor hearing groups was 13.57±2.27 and -2.60±4.28, respectively (t=3.339, P=0.002); the VAS difference before and after routine treatment in the good and poor hearing groups was 1.35±0.17 and 0±0.43, respectively (t=2.953, P=0.006). After psychological counseling, patients were followed up for 1 year by telephone. Of these, 53 patients had adapted to tinnitus, accounting for 69.7% of patients. Twenty-three patients returned to hospital due to tinnitus, accounting for 30.3% of patients. The THI scores ranged between 18 and 92 with an average of 56.6, a mean mostly driven by scores in 3-4 patients with severe tinnitus. The VAS scores at 2 weeks and 1 year were 4.22±0.25 and 3.39±0.18, respectively. There was a significant difference in VAS scores between the two time periods (t=6.362, P < 0.001). After treatment for 2 weeks, tinnitus resolved in four patients and was significantly alleviated in seven patients, alleviated in 11 patients, unchanged in 49 patients, and aggravated in five patients. Tinnitus was reduced by 28.9%. After one year of treatment, tinnitus resolved in six patients and was significantly alleviated in 10 patients, alleviated in 14 patients, unchanged in 42 patients, and aggravated in four patients. In total, for 39.5% of patients, tinnitus was alleviated. After treatment for 2 weeks and 1 year later, there was a significant difference in the rate of tinnitus relief, (χ2=43.978, P < 0.001). After 1 year, 31 patients were completely adapted to tinnitus, and 40 patients were largely adapted; the total adaptation rate was 92.1%. Six patients found it difficult to adapt.

    Conclusion

    Routine treatment, psychological counseling, masking therapy, and acclimatization therapy for sudden deafness have positive effects on tinnitus. Patients with tinnitus recovered well after individualized treatment.

    Correlation between unilateral sudden deafness and imaging features of vertebrobasilar artery
    ZHAO Junying, WANG Jianming
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  47-51.  doi:10.6040/j.issn.1673-3770.0.2018.573
    Abstract ( 1646 )   PDF (405KB) ( 276 )   Save
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    Objective To investigate the correlation between unilateral sudden deafness and the imaging features of vertebrobasilar artery. Methods This study included 175 patients diagnosed with unilateral sudden deafness in our hospital between 2014 and 2018, who had complete laboratory and imaging data. Data were analyzed in order to determine the relationship between the side and degree of hearing loss and the imaging characteristics of vertebral and basilar arteries. Results A stenosis/tortuosity of vertebral(χ2=8.031, P=0.045)and basilar arteries(χ2=5.091, P=0.034)was found to be related to hearing loss side. The univariate analysis results of hearing loss predictors demonstrated that left-sided hearing loss in patients is related to right-sided(odds ratio [OR]=2.89, 95% confidence interval [CI]: 1.77-2.77, P=0.036)and bilateral vertebral artery stenosis/tortuosity(OR=4.43, 95% CI: 1.49-13.23, P=0.008). Basilar artery stenosis/tortuosity on neither side is related to right-sided hearing loss in patients(OR=0.31, 95% CI: 0.11-0.90, P=0.030). Other evaluated factors were not statistically significant. Multivariate analysis matched by age and sex demonstrated that stenosis/tortuosity of the right vertebral artery was related to left-sided hearing loss(OR=2.83, 95% CI: 1.05-7.67, P=0.040), whereas no statistically significant difference was observed for the relationship between stenosis/tortuosity of basilar artery and hearing loss(χ2 = 3.339, P=0.068). The degree of hearing loss in patients with sudden deafness is not related with the imaging features of the vertebral(χ2 = 3.897, P=0.273)and basilar arteries(χ2 = 3.339, P=0.068). Conclusion In patients with sudden deafness, the lateral nature of hearing loss is influenced by stenosis/tortuosity of the vertebrobasilar artery, whereas stenosis/tortuosity of the right vertebral artery is related to hearing loss in the left ear.
    Clinical efficacy and safety of different methods of administration of glucocorticoids in the treatment of sudden deafness
    ZHANG Junjun, LIU Haili, LIU Jiafu, QIN Xiaofeng, DU Hongming, WANG Houhui
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  52-55.  doi:10.6040/j.issn.1673-3770.0.2018.408
    Abstract ( 1951 )   PDF (421KB) ( 307 )   Save
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    Objective The aim of the study was to investigate the clinical efficacy and safety of different methods of glucocorticoid administration in the treatment of sudden deafness. Methods One hundred and fifty patients with sudden deafness admitted in our hospital from January 2017 to March 2018 were randomly divided into three groups according to the hospitalization order. Based on the application of improved microcirculation methods, nutritional neuropharmacology, and tympanostomy, the groups were classified as tympanic glucocorticoid injection group, intravenous drip and intravenous infusion of glucocorticoid group, and postauricular mastoid group with postauricular mastoid injection of glucocorticoids. The improvement in hearing and adverse reactions of the three groups were compared after the completion of treatment. Results A comparison of the three groups before and after 2-weeks of hearing improvement treatment suggests that the effect of glucocorticoid injection in the postauricular mastoid region was better than intravenous infusion or tympanic injection of glucocorticoids, and the difference was observed to be statistically significant (P<0.05). However, no significant differences were observed in the rate of adverse reactions and complications among the three groups (P>0.05). Conclusion Glucocorticoid injection in the posterior mastoid area was found to be better for the treatment of sudden deafness. The incidence of adverse reactions is low, and, hence, the treatment can be deemed reliable and safe.
    Expression of immunological markers in middle ear effusion in children with secretory otitis media
    NI Jing, LEI Fei, BAI Dan, ZHOU Yun, MA Jianmei, HUANG Wei, WANG Chunyang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  56-59.  doi:10.6040/j.issn.1673-3770.0.2018.230
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    Objective To evaluate the expression of immunological markers in middle ear effusion in children with secretory otitis media. Methods The research group included 30 patients with secretory otitis media, who were treated in our hospital from December 2016 to December 2017, while 30 healthy children were selected as the control group. The percentages of CD4+T and CD8+T cells and the CD4+/CD8+ ratio in the peripheral blood of the two groups were compared. The levels of IL-2, IL-4, and IL-6 in the middle ear effusion and plasma between the two groups were compared. The correlation of CD4+T and CD8+T cell values and IL-2, IL-4, and IL-6 in middle ear effusion was analyzed. Results The percentages of CD4+T and CD8+T cells in peripheral blood of the study group were significantly higher than that in the control group, and the CD4+/CD8+ ratio was significantly lower than that in the control group with a statistically significant difference(P<0.01). The levels of IL-2, IL-4, and IL-6 in the middle ear effusion of the group were significantly higher than that in the plasma, and the difference was statistically significant(P<0.01). The levels of IL-2, IL-4, and IL-6 in the study group were significantly higher than those in the control group, and the difference was statistically significant(P<0.01). Pearson linear correlation analysis showed that the levels of IL-2, IL-4, and IL-6 in the middle ear effusion of the group had a significantly positive correlation with CD4+T and CD8+T cell values in peripheral blood(P<0.01). Conclusion Secretory otitis media is closely related to the strong immune response and the phenomenon of significant rise in the CD4+T and CD8+T cell subgroup. Additionally, IL-2, IL-4, IL-6 showed a certain clinical significance in diagnosing and managing secretory otitis media in children.
    Evaluation of clinical effects of sublingual immunotherapy with Dermatophagoides farinae drops in patients of different age groups with allergic rhinitis
    ZHANG Guiyang, HUANG He, XIAN Zhi, ZHANG Hanwen, XIE Guicai
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  60-65.  doi:10.6040/j.issn.1673-3770.0.2018.267
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    ObjectiveTo explore the clinical effects of sublingual immunotherapy with Dermatophagoides farinae drops in patients of different age groups with allergic rhinitis(AR). Methods A total of 240 patients with AR admitted to the hospital from March to August 2016 were divided into six groups based on their age(3-6 years old, preschool group; 7-12 years old, school group; 13-20 years old, puberty group; 21-40 years old, adolescent group; 41-60 years old, middle-age group; older than 60 years, old-age group), with 40 patients in each group. The patients were treated with sublingual administration of Dermatophagoides farinae drops. The desensitization therapy of Dermatophagoides farinae drops included two stages: increasing dose and maintenance dose. The desensitization therapy was combined with symptomatic drug treatment based on the patient's condition. Scores of symptoms, drugs, physical signs, and visual analog scale(VAS)were compared between the two groups after 6 months. The effective and incidence rates of adverse events were statistically analyzed in each group. Results After 6 months of treatment, the scores of symptoms(3.20±0.79, 3.58±0.81, 3.92±0.70, 4.25±0.72, 4.59±0.75, and 4.96±0.80 points), drugs(0.84±0.32, 0.98±0.30, 1.14±0.41, 1.33±0.44, 1.52±0.40, and 1.72±0.48 points), physical signs(0.18±0.02, 0.21±0.05, 0.24±0.06, 0.27±0.07, 0.31±0.06, and 0.35±0.07 points), and VAS(1.82±0.39, 2.08±0.51, 2.31±0.50, 2.54±0.53, 2.78±0.52, and 3.00±0.46 points)significantly improved in the preschool, school, puberty, adolescent, middle-age, and old-age groups. The lower the age of the patient, more obvious were effects of score improvement(F=28.111, 28.111, 48.241, 32.607; P<0.001). The effective rates of efficacy in the preschool, school, puberty, adolescent, middle-age, and old-age groups were 95.00%, 95.00%, 90.00%, 87.50%, 87.50%, and 82.50%, respectively(χ2=20.293, P=0.161). The incidence rates of adverse events in the adolescent, middle-age, and old-age groups(30.00%, 25.00%, and 25.00%, respectively)were lower than those in the preschool, school, and puberty groups(7.50%, 5.00%, and 7.50%, respectively)(χ2=6.646, 4.501, 4.501, 8.658, 6.275, 6.275, 6.646, 4.501, 4.501; P=0.010, 0.034, 0.034, 0.003, 0.012, 0.012, 0.010, 0.034, 0.034). Conclusion Sublingual immunotherapy with Dermatophagoides farinae drops is effective in treating patients with AR. The titer lowers with age, while the safety increases.
    Effects of lncRNA CTB-147C22.8 and mRNA KLK6 on the invasion of recurrent respiratory papilloma cells
    PAN Xiaofei, WANG Jun, XIAO Yang, MA Lijing
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  66-70.  doi:10.6040/j.issn.1673-3770.0.2018.409
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    Objective To investigate the effect of lncRNA CTB-147C22.8 on the invasion of recurrent respiratory papilloma cells. Methods A high-throughput genome expression profile chip was used for early stage analysis. To establish a human nasopharyngeal epithelial cell line(NP69 - SV40T), cells were incubated with Lipofectamine TM2000 for transfection; the transfected nasopharyngeal epithelial cells contained the exogenous gene recombinant plasmid pcDNA3.1/zeo+-CTB-147C22.8. Based on the transfection carrier, cells were divided into three groups: NP69 blank group, NP69 H145 group, and NP69-H6373 group. NP69 indicates untransfected plasmid cell blank group, NP69 H145 group refers to the cells transfected with a blank plasmid, and NP69 H6373 group refers to the cells transfected with the target gene CTB-147C22.8. KLK6 expression in human nasopharyngeal epithelial cells before and after transfection of lncRNA CTB-147C22.8 was detected by qrt-pcr. Flow cytometry was performed on the epithelial cells transfected with lncRNA CTB-147C22.8, and cell cycle analysis was performed by using FlowJo software. Transwell assay was used to determine the effect of lncRNA CTB-147C22.8 on cell invasion. Results KLK6 gene expression levels in the NP69-blank, NP69-H145, and NP69 H6373 groups were 1.005 771 107±0.008 724 979, 1.591 421 113±0.311 999 127, and 1.880 766 963±0.109 759 031, respectively. Compared with NP69-blank and NP69-H145 groups, the duration of cells in S stage in the NP69 H6373 group was significantly longer(F=8.763, P=0.017). The number of cells migrating in the NP69 H6373, NP69-H145, and NP69 H6373 groups was 6.889±2.261, 8.222±3.114, and 39.556±18.228, respectively. The differences in these numbers were statistically significant between the NP69 H6373 group, and the NP69-blank group and NP69-H145 group(F=3.038, P=0.034). Conclusion lncRNA CTB-147C22.8 promotes the invasion of recurrent respiratory papilloma cells.
    Panitan single resistance and taxol as the first-line treatment of recurrent or metastatic head and neck cancer: a phase Ⅱ study
    LUO Tongyong, YANG Huaqing, YUE Shengqing, JIA Quanfan, YUAN Long
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  71-75.  doi:10.6040/j.issn.1673-3770.0.2018.207
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    Objective To investigate the clinical effects of panitumumab and paclitaxel as the first-line treatment in patients with stage II recurrent or metastatic head and neck cancer. Methods Eighty-six patients with stage II recurrent or metastatic head and neck cancer were enrolled in this study. According to the different treatment methods, the patients were divided into the control group and the study group, respectively. The control group was administered paclitaxel injection in combination with chemotherapy by continuous intravenous infusion at a dose of 70-100 mg/m2 twice daily for 3 days. The study group was treated with paclitaxel alone along with panitumumab injection on the fourth day by intravenous drip at a dose of 80-85 mg/m2 once daily. Both the groups were treated for one month. The short-term efficacy, adverse reactions, survival rate, and quality of life before and after the treatment were compared. Results The effective response rates in the study group and the control group were 83.7% and 60.5%, respectively, which were significantly different(χ2=15.472, P<0.001). The incidence of adverse reactions in the study group and the control group were 7.0% and 27.9%, respectively, which were significantly different(χ2=12.648, P<0.001). The severity of adverse reactions in the study group were Grade Ⅰ(1.3%), Ⅱ(1.3%), and Ⅲ(1.3%), and control group(5.6%)(11.6%). There were 3 cases(7.0%)of grade Ⅲ and 1 case(2.3%)of grade Ⅳ adverse reactions. There was a statistically significant difference in the severity of adverse reactions between the two groups(χ2 were 5.394, 6.391, 5.125, and 4.935 respectively; P were all< 0.001). The 3 years-OS and RS in the study group were 93.0% and 95.3%, respectively, which were significantly higher than those in the control group(88.4% and 86.0%)(χ2 were 9.26 and 8.89, respectively, P were all< 0.001). The scores were 60.5% and 65.1%, which were significantly higher than those in the control group(55.8% and 58.1%)(P were all< 0.001 ). The quality of life scores in the two groups before treatment were: control group, 66.3±5.1, 63.2±3.5, 64.1±4.2, and 64.3±3.1 points; and study group, 67.1±4.6), 62.2±4.3, 63.9±4.8, and 62.9±4.2 points, which were not significantly different(P=0.46, 0.49, 0.39, and 0.50). After treatment, the quality of life scores in the study group(80.5±4.8, 80.3±3.8, 81.5±5.1, and 80.6±4.8 min)was significantly better than that in the control group(74.2±4.8, 71.2±3.3, 71.6±3.8, and 74.3±3.5 min)(P<0.001). Conclusions The therapeutic effects of panitumumab combined with paclitaxel in patients with stage II recurrent or metastatic head and neck cancer were good, and the incidence of various adverse reactions was less. The patients had high long-term survival rate, long survival time, and good quality of life.
    Survey of overall sleep quality in 142 patients with laryngectomy
    DING Jie, SUN Yan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  76-81.  doi:10.6040/j.issn.1673-3770.0.2018.244
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    Objective To investigate sleep quality in post-laryngectomy patients. Methods In total, 142 post-laryngectomy patients and 48 healthy controls were recruited into this study between May 2015 and February 2016 from the Department of Otorhinolaryngology & Head and Neck Surgery of the Affiliated Hospital of Qingdao University. The Pittsburgh Sleep Quality Index(PSQI)and SRSS were used to evaluate sleep quality and the results of these measures were statistically analyzed. Results Both the average PSQI score and the average SRSS score were higher in the experimental group(7.20±3.84, and 24.92±5.80, respectively)than the control group(4.42±1.61, 18.27±3.39, respectively, P<0.01). The average PSQI score in patients who received chemoradiotherapy after laryngectomy(7.65±4.39), did not significantly differ from the score of those who did not(6.92±3.45, P=0.295). Similarly, the average SRSS score in patients who received chemoradiotherapy after laryngectomy(25.56±6.11)did not significantly differ from the score of those who did not(24.52±5.60, P=0.297). The average PSQI scores of patients who underwent extubation after partial laryngectomy, non-extubation after partial laryngectomy, or total laryngectomy(6.90±3.33, 8.80±5.44, 7.20±3.98, respectively)were not significantly different from one another(P=0.215). There were similarly no significant differences between the average SRSS scores of patients who underwent extubation after partial laryngectomy, non-extubation after partial laryngectomy, or total laryngectomy(24.05±4.92, 27.80±8.00, 25.40±6.10, respectively, P=0.055). In 142 cases of post-laryngectomy, 92 cases(64.79%)had differing degrees of pain and discomfort, 135 patients(95.07%)reported dry mouth and using the toilet at night, and 112 patients(78.87%)had difficulty falling asleep after waking up. Conclusion The overall sleep quality of post-laryngectomy patients is poor. The main causes of poor sleep quality are physical pain, psychological disorders caused by the disease itself, and sequelae and complications caused by treatment.
    Risk factors and prognosis of esophageal cancer with hypopharyngeal carcinoma
    HUANG He, OUYANG Hui
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  82-86.  doi:10.6040/j.issn.1673-3770.0.2018.234
    Abstract ( 2438 )   PDF (386KB) ( 405 )   Save
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    Objective To investigate the risk factors and prognosis of hypopharyngeal carcinoma patients with esophageal cancer. Methods This study included 200 patients with esophageal cancer in our hospital from January 2011 to March 2014. General data, tumor information, and follow-up of patients were retrospectively analyzed. First, the risk factors of esophageal cancer with hypopharyngeal carcinoma were analyzed by univariate analysis with comparisons between groups using the chi square test(2). Logistic regression analysis was then performed for factors with statistical differences. The Kaplan-Meier method was used to analyze the survival rate. Results Single-factor analysis revealed that age(<55 years), male gender, severe smoking history, severe alcohol consumption history, and >3 tumor invasion sites were high risk factors for comorbidity of esophageal cancer in hypopharyngeal cancer patients(P<0.05). The results of the multifactor analysis showed that age(<55 years), severe smoking history, severe alcohol consumption history, and >3 tumor invasion sites were independent risk factors for comorbidity of hypopharyngeal carcinoma(P<0.05). The median survival time of the 200 hypopharyngeal cancer patients was 37.5 months, and the 5-year survival rate was 36.7%. The median survival time of 56 patients with concurrent hypopharyngeal carcinoma and concurrent esophageal cancer was 24.8 months, which was significantly lower than that in patients with hypopharyngeal carcinoma without concurrent esophageal cancer(P<0.05). The median survival time in patients with early-stage esophageal carcinoma(0+Ⅰ stage)was 29.2 months, which was significantly higher than that in patients with advanced esophageal carcinoma(Ⅱ+Ⅲ stage), and the difference was statistically significant(P<0.05). Conclusion The survival time in hypopharyngeal cancer patients with concurrent esophageal cancer is relatively low. Age(<55 years), severe smoking history, severe alcohol consumption history, and >3 tumor invasion sites are independent risk factors for comorbidity of hypopharyngeal cancer, and early interventions should be implemented in clinical practice.
    Analysis of risk factors that increase the risk for requirement of surgical incision for a mediastinal abscess after a cervical abscess
    TANG Sucheng, WANG Yuejian, CHEN Weixiong
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  87-91.  doi:10.6040/j.issn.1673-3770.0.2018.354
    Abstract ( 1802 )   PDF (417KB) ( 222 )   Save
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    Objective To discuss the clinical factors related to an increased risk for the requirement of surgical drainage and a prolonged length of hospital stay in cases of a deep-space neck abscess with a mediastinal abscess and to better determine the surgical treatment options. Methods The clinical data of 61 consecutive patients with mediastinal abscesses between January 2008 and August 2017 were reviewed retrospectively. The Wilcoxon rank-sum test was adopted for the analysis. Logistic regression analysis was used to study the clinical risk factors by stepwise forward regression. Results The mortality rate of the mediastinal abscess reached 16.4%. At an ɑ level of 0.05, the factors that delayed hospitalization duration included diabetes, maximum abscess dimension ≥3 cm, and surgery(W test: P=0.002, P=0.047, and P=0.042). Age sex, white blood cell count, fever, dyspnea, and timely surgery did not prolong hospitalization duration. Dyspnea increased the risk for requirement of surgical drainage(β=3.001; odds ratio [OR]=20.099). Diabetes and maximum abscess dimension ≥3 cm increased the likelihood of not only surgical treatment(β=1.942, OR=2.565; β=2.369,OR=10.979)but also medical therapy failure(β=2.889,OR=18.147; β=4.048, OR= 57.303). Conclusion Active preoperative preparation and surgical intervention should be performed as soon as possible in patients with diabetes, dyspnea, and maximum abscess dimension ≥3 cm. However, patients without diabetes, dyspnea, and maximum abscess dimension ≥3 cm may recover without surgical incision and drainage under sufficient and effective intravenous antibiotic treatment alone with close surveillance. The result of treatment was satisfactory with surgical incision and drainage. A double-chamber tube should be a good choice. Abstraction of pus was effective and reduced surgical injury.
    Clinical efficacy of the pharyngopalatine arch muscle mucosal flap for tonsillectomy wound closure after plasma surgery
    HUANG Jiyi, LI Baizi, WU Shunong, LÜ Zhenghua
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  92-95.  doi:10.6040/j.issn.1673-3770.0.2018.400
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    Objective We aimed to improve the procedure of tonsillectomy by plasma resection and analyze the improvement of the curative effect after tonsil plasma surgery with wound closure using the pharyngopalatine arch muscle mucosal flap. Methods Patients who underwent tonsillectomy were randomly divided into two groups. Conventional tonsillectomy was performed in 105 cases, whereas partially separated pharyngopalatine arch muscle mucosal flap placement was performed after tonsillectomy in 94 cases to close the tonsillar fossa. Data on postoperative pain, wound healing, and bleeding were analyzed and compared between the two groups. Results During the first 7 days after operation, pain severity was significantly less in the experiment group than in the control group. The differences in wound healing and postoperative bleeding rates between the experiment and control groups were also statistically significant. Conclusion Operation using a pharyngeal muscle mucosal flap to close the tonsil plasma is easy and can reduce postoperative pain, promote wound healing, and reduce the risk of surgical wound bleeding.
    Airway management and anesthesia method of children with tracheobronchial foreign bodies
    ZHAO Haitao, SHI Lei, WANG Junxia, WANG Yafang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  96-98.  doi:10.6040/j.issn.1673-3770.0.2018.332
    Abstract ( 1592 )   PDF (391KB) ( 365 )   Save
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    Objective To investigate feasible airway management and anesthesia protocols during rigid bronchoscopy for critical children with tracheobronchial foreign bodies. Methods We selected 134 critical children with tracheobronchial foreign bodies. After the children entered the operating room, they were supplied oxygen via a face mask or underwent endotracheal intubation. Preoperative medication was usually administered intravenously and included penehyclidine hydrochloride(0.03 mg/kg)and dexamethasone(0.4~0.5 mg/kg). Among the patients, 119 without respiratory distress syndrome were administered low doses of rocuronium together with intravenous anesthesia; 13 with respiratory distress were administered intravenous anesthesia to preserve spontaneous breathing; and two with severe respiratory distress and unconsciousness underwent rigid bronchoscopy performed by an otolaryngologist. High-frequency jet ventilation was discontinuously implemented based on the intraoperative blood oxygen level, with a ventilation frequency of 60-80 times per minute, an I/E ratio of 1∶1.5, and a drive pressure not exceeding 60 kPa. After completion of the surgery, we ensured the recovery of spontaneous respiration; no significant postoperative vomiting and respiratory depression occurred. Thereafter, the children were transferred to either the postoperative care room for otolaryngology patients or the PICU for further observation. Results The foreign bodies in each of the children were successfully removed through a single operation. No serious laryngospasm or bronchospasm, forced withdrawal of the mirror due to breath holding or coughing, or anesthesia accident occurred during the operations. Owing to prolonged hypoxia, one patient died of multiple organ failure 8 hours after the operation. The remaining patients recovered with stable postoperative vital signs and were discharged after 3-8 days of treatment. Conclusion Anesthesiologists should adopt different anesthetic protocols during rigid bronchoscopy, based on the degree of dyspnea, to ensure adequate oxygen supply, to avoid false aspiration of gastric contents, and to prevent airway spasms, and should assist otolaryngologists in relieving airway obstruction as soon as possible.
    Relationship between carotid elasticity and oxidative stress in patients with obstructive sleep apnea syndrome
    SONG Fan, HUANG Weijun, XU Huajun, GUAN Jian, YI Hongliang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  99-104.  doi:10.6040/j.issn.1673-3770.0.2018.578
    Abstract ( 1559 )   PDF (447KB) ( 251 )   Save
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    Objective This study aimed to investigate the relationship between carotid elasticity and oxidative stress in patients with obstructive sleep apnea syndrome(OSAS). Methods Patients with suspected OSAS, and healthy volunteers were recruited. According to the apnea-hypopnea index, 36 patients each were enrolled in the OSAS group and control group. The sex, age, and body mass index(BMI)of the two groups were matched. Serum malondialdehyde(MDA)and glutathione(GSH)levels were estimated using enzyme-linked immunosorbent assay. Quality intima-media thickness(QIMT)and quality arterial stiffness(QAS)techniques were used to detect the bilateral carotid intima-media thickness(IMT), distensibility coefficient, compliance coefficient, pulse wave velocity, and stiffness coefficients α and β. The correlation factors between oxidative stress and arterial elasticity were analyzed by correlation analysis. Multiple linear regression analysis was used to analyze the independent risk factors of IMT. Results There was no difference in sex, age, BMI, high-density lipoprotein, urinary microalbumin, cystatin C, and diastolic blood pressure between the OSAS group and the control group (P>0.05). Triglyceride, total cholesterol, low-density lipoprotein, high-sensitivity C-reactive protein, insulin resistance, blood glucose, systolic blood pressure, and sleep parameters of the two groups were significantly different (P<0.05). Serum MDA and GSH levels were higher in the OSAS group than in the control group (P<0.05). There was no significant difference in carotid IMT and arterial elasticity between the groups. Carotid IMT and arterial elasticity were not correlated with MDA and GSH levels. Linear regression showed that age and low-density lipoprotein were independent risk factors for carotid IMT. Conclusion The increased oxidative stress response in patients with OSAS is insufficient to affect carotid elasticity. Age and low-density lipoprotein are independent risk factors for carotid IMT.
    Inhibitory effect of miR-204 and the molecular mechanism of RB via endoplasmic reticulum stress
    SU Jie, MA Chunmei, ZHAO Lili, LIU Yan, SHAO Hongchao
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  105-108.  doi:10.6040/j.issn.1673-3770.0.2018.132
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    Objective To evaluate miR-204 expression in human retinoblastoma and to investigate the effect of latter's growth and molecular mechanism. Methods RT-PCR was performed to detect the expression of miR-204 in retinoblastoma(Y79)and the normal retinal(ARPE-19)cell lines. The mimic(s)and inhibitor(s)of miR-204 were transiently transfected into Y79 cells. CCK-8 and flow cytometry aided the detection of the survival and apoptosis of Y79 cells. The expression level of GRP78 protein was determined by Western blot. Results The expression of miR-204 in Y79 cells was significantly lower than that in ARPE-19. It was observed that the over-expressed miR-204 in Y79 cells could significantly inhibit the proliferation of retinoblastoma. Moreover, it promoted apoptosis, increased GRP78 protein's expression, and could activate the endoplasmic reticulum stress pathway. Conclusion miR-204 expression in retinoblastoma cells was significantly lower than that in the normal retinal cells. In addition, miR-204 might induce retinoblastoma cell(s)apoptosis by activating the endoplasmic reticulum stress pathway.
    Visual quality research on a custom selection of aspheric intraocular lenses in cataract patients
    LIN Jia, LIAO Xuan, LAN Changjun, TAN Qingqing, WEN Baiwei, TIAN Jing
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  109-114.  doi:10.6040/j.issn.1673-3770.0.2018.357
    Abstract ( 2081 )   PDF (451KB) ( 303 )   Save
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    ObjectiveTo compare the visual quality after implanting aspheric and spherical intraocular lenses(IOLs)in cataract patients, to influence selectability of the better lens. Methods A prospective, non-random, controlled study was conducted on 59 age-related cataract patients(91 eyes)after phacoemulsification and IOL implantation. They were sorted into two groups; group A received aspheric IOLs and group B received spherical IOLs. Corneal, internal, and ocular high order aberrations(HOAs)including spherical aberration(SA), coma and trefoil, and total high order aberration(tHOA), were measured at 3 months postoperatively at pupil diameters(PD)of 4 mm and 6 mm using Topcon KR-1W. Objective scatter index(OSI), strehl ratio(SR), modulation transfer function(MTF)cut off, contrast visual acuity OV100%, OV20%, and OV9% were measured by OQASTMⅡ and the CSV-1 000. The independent samples t-test was used to analyze the data. Results There were no statistically significant differences between group A and B in uncorrected visual acuity and best corrected visual acuity. There was no statistically significant difference between the two groups in corneal tHOA, SA, coma, and trefoil at 4 mm and 6 mm PD. There was a statistically significant difference between the two groups in internal SA, but no significant difference in internal tHOA, coma, or trefoil at 4 mm and 6 mm PD. There was a statistically significant difference between the two groups in ocular SA but no significant difference in coma and trefoil at 4 mm PD. There was a statistically significant difference between the two groups in ocular tHOA, SA, but no significant difference in ocular tHOA, coma, and trefoil at 6 mm PD. There was a statistically significant difference between the two groups in OSI, MTF cut off, SR, OV100%, OV20%, and OV9%. With respect to CS, no significant difference was found at a spatial frequency of 3 cpd, but significant differences at 6 cpd, 12 cpd, and 18 cpd were observed between aspheric and spherical IOL groups. Conclusion The ocular tHOA, SA and internal SA in aspheric IOL group were lower than the spherical group at 4 mm and 6 mm PD; which demontrates that the visual quality parameters from the Optical Quality Analysis System and the middle and high frequency(6 cpd, 12 cpd, 18 cpd)in the aspheric IOL group were better than those of the spherical IOL group. Visual quality in aspheric IOL groups was better than spherical IOL groups.
    Refractive study of children with spontaneous regression of retinopathy of prematurity
    YUAN Haiqin, CHEN Miaohong, ZHAO Jinfeng, ZHANG Guoming
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  115-118.  doi:10.6040/j.issn.1673-3770.0.2019.010
    Abstract ( 1449 )   PDF (355KB) ( 371 )   Save
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    Objective To study the refractive status of children with spontaneous regression of retinopathy of prematurity(ROP). Methods This was a retrospective case-control study on 72 children(144 eyes)with spontaneous regression of ROP in the observation group, which was further divided into 3 groups based on the age of children at the time of the refraction test: Group 1, corrected gestational age(CGA)≤ 1 year; Group 2, 1 year < CGA ≤ 2 years; Group 3, 2 years < CGA ≤ 3 years. Simultaneously, 180 preterm children(360 eyes)without ROP were included in the control group, which was also divided into 3 groups according to the age of children at the time of the refraction test: Group 4, CGA ≤ 1 year; Group 5, 1 year < CGA ≤ 2 years; Group 6: 2 years < CGA ≤ 3 years. Refractive states of the children's eyes were measured and compared between the observation and control groups. Chi-squared and Fisher's exact tests were used for the counting data. A t-test was used for the measurement data. Results The average equivalent sphericity, average astigmatism, myopia ratio, high myopia ratio, hyperopia ratio, and astigmatism ratio had no statistical differences between groups 1 and 4, 2 and 5, and 3 and 6. Conclusion There were no significant differences in the refractive state between children with spontaneous regression of ROP and preterm children without ROP before 3 years of age. Most children had envisage and farsightedness, some had myopia, and a very few children had high myopia.
    Clinical and imaging characteristics in patients with ocular ischemic syndrome
    YANG Xiufen, LI Hongyang, ZHAO Lu,WEI Ying, HU Xiangdong, CHEN Jun, WANG Yanling
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  119-123.  doi:10.6040/j.issn.1673-3770.0.2018.526
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    Objective To describe the clinical and imaging features of ocular ischemic syndrome in a patient visiting the ophthalmology department. Methods This study was a retrospective case series. Consecutive patients suspected of having ocular ischemic syndrome from 2015 to 2017 were retrospectively studied. Results The study included 20 patients(24 eyes)with ocular ischemic syndrome; of these, 16 were men and 4 were women. The patients were 59 to 88 years old(mean age: 71.68 years). The ocular ischemic syndrome involved 13 right eyes and 11 left eyes; in 4 patients, the involvement was bilateral. The symptoms reported by the patients were decreased vision in 13 eyes(54.17%)and ocular or periocular pain in 6 eyes(25%). A history of transient monocular vision loss was noted in 13 eyes(58.33%). The best-corrected visual acuity(BCVA)was <0.05 in 4 eyes(16.67%), 0.05 to <0.3 in 9 eyes(37.5%), 0.3 to <0.7 in 8 eyes(33.33%), and >0.7 in 3 eyes(12.5%). Retinal examination typically revealed midperipheral retinal hemorrhages, arteriolar narrowing, and venous dilation. Fundus fluorescein angiography showed that the retinal arteriovenous passage time was prolonged(20.3 to 90.2 s). At the end of the angiography, incomplete filling of the veins was seen in 1 eye(4.17%)and the “front” phenomenon of arteries in 9 eyes(37.5%). Hyperfluorescent dots indicating microaneurysms could be seen in 18 eyes(75%). Arteriovenous shunts were found in 2 eyes and retinal neovascularization in 1 eye(4.17%). Non-perfused areas were observed in 10 eyes(41.67%). The arterial and venous walls could be stained in 18 eyes(75%). Color Doppler imaging was performed on 13 patients and transcranial Doppler imaging on 7 patients. The color Doppler imaging showed that the intima and/or media at the origin and/or bifurcation of the internal carotid artery(ICA)were thickened, the thickest of which was about 1.3 mm. ICA was totally occluded or severely narrow in 3 cases, and no blood flow was found. The other cases showed abnormal peaks of systolic velocity, ranging from 73 to 484 cm/s(median: 295 cm/s). Transcranial Doppler ultrasonography detected different degrees of stenosis or occlusion of cerebral vessels and ICA. Conclusions Ocular ischemic syndrome is usually found in the older population and more commonly in men.The clinical manifestations are complex and variable. Fundus fluorescein angiography and Doppler ultrasonography of the carotid artery are reliable methods to diagnose ocular ischemic syndrome.
    Soft palate surgeries with hyoid bone suspension for obstructive sleep apnea hypopnea syndrome with glossoptosis: a meta-analysis
    JI Di, CHEN Xiang, YU Lin
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  124-130.  doi:10.6040/j.issn.1673-3770.0.2018.517
    Abstract ( 1407 )   PDF (1339KB) ( 201 )   Save
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    Objective To assess the efficacy of soft palate surgeries with hyoid bone suspension for obstructive sleep apnea syndrome(OSAS)with both obstructions of palatopharyngeal plane and hyopharyngeal planes obstructions. Methods An electronic search was conducted on the VIP, CNKI, and Pubmed databases and several studies were selected according to the inclusion and exclusion criteria. Subsequently, the literature quality was evaluated by MINORS and data were extracted to perform qualitative description. Data about effects were meta-analyzed by RevMan 5.3. Results A total of 13 self-controlled trials or RCTs involving 310 patients were included in the present meta-analysis. All the patients presented moderate to severe OSAHS and were followed up for more than 3 months following the surgeries. Most of the trials were self-controlled, whereas two of them were RCTs. According to the MINORS, while two studies represented a low quality research(0-12 points in total), two reported a high quality(19-24 points in total), whereas the remaining nine studies were characterized by a moderate quality(13-18 points in total). Of the 11 studies contrasting the apnea hypopnea index(AHI), 2 were asymmetric at the bottom of the funnel plots, suggesting a publication bias. Furthermore, 2 studies contrasting the respiratory disturbance index(RDI)were present, whereas 13 investigations contrasting the lowest arterial oxygen saturation(LSaO2)were found. Of them, 4 were asymmetric at the bottom of the funnel plots, indicating a publication bias. The meta-analyses described a significant improvement in AHI, RDI, LSaO2, AHI 45.61,95% CI(42.48,48.73),P<0. 001,RDI 35.26,95% CI(22.47,48.04),P<0.001,LSaO2-20.16,95% CI(-24.99,-15.33),P<0.001. A significant heterogeneity was observed in the meta-analysis, while the sensitivity analysis indicated Lin Ling’s result to be the cause. Conclusion Although most studies are moderate quality self-controlled trials, a larger sample size is needed. Soft palate surgeries with hyoid bone suspension are effective in reducing AHI and RDI and enhancing LSaO2, even though additional evidences are warranted to validate their effects.
    Effects of continuous positive airway pressure therapy on inflammatory markers in obstructive sleep apnea syndrome: a meta-analysis
    CHEN Chun, DING Jian, XIE Jin
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  131-137.  doi:10.6040/j.issn.1673-3770.0.2018.446
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    Objective In recent years, the morbidity associated with obstructive sleep apnea syndrome(OSAS)has been increasing. It could be associated with inflammatory reactions and is a risk factor for coronary artery disease(CAD). Current evidence suggests that continuous positive airway pressure(CPAP)changes the levels of inflammatory markers. We analyzed the data from published studies using a systematic meta-analysis. Methods Study eligibility criteria included full-text English studies from PubMed, Embase, and Cochrane libraries, addressing the values of at least one of the inflammatory markers before and after CPAP treatment. We used the definition of OSA as an apnea-hypopnea index(AHI)of ≥5/h and reported values as means with standard deviations. Statistical results showed that the serum C-reactive protein(CRP)levels of OSAS patients before and after CPAP treatment were significantly different(Z= 4.55; P<0.000 01; SMD=0.86; 95%CI=0.49-1.23). There were no significant differences in tumor necrosis factor-α(TNFα)levels before and after CPAP treatment(Z=1.92; P=0.05; SMD=1.08; 95%CI=0.02-2.18). Results A total of 17 studies involving 895 OSA patients were included in the meta-analysis of CRP, and 10 studies involving 290 OSA patients on TNF-α were included. Conclusion CPAP therapy partially suppresses systemic inflammation in OSA patients, and substantial differences are present among the various inflammatory markers. CPAP has been proposed to be linked with the pathogenesis of systemic inflammation to prevent cardiovascular diseases.
    Neuroprotective effects and safety of stem cell transplantation in rats with experimental glaucoma: a systematic review
    LIU Lin, ZHENG Hua, CHEN Shaolin, DUAN Xuanchu
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  138-144.  doi:10.6040/j.issn.1673-3770.0.2018.594
    Abstract ( 1532 )   PDF (538KB) ( 207 )   Save
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    Objective To systematically review the neuroprotective effects and safety of transplanted stem cells in rats with experimental glaucoma. Methods Databases including PubMed, Embase, the Cochrane Library, Ovid, CBM, CNKI, VIP, and Wanfang Data were searched to collect information on animal experiments of stem cell transplantation for glaucoma, from inception to June 10, 2018. Two reviewers independently screened the literature in accordance with the inclusion and exclusion criteria, extracted the data, and assessed the risk of bias of the included studies using SYRCLE's risk of bias tool. Subsequently, a meta-analysis was performed using the RevMan 5.3 software. Results A total of 8 studies involving 319 rats were analyzed. The results of the meta-analysis showed that: 1)on the 28th day, the intraocular pressure was lower in the experimental group that in the control group [SMD=-2.12, 95% CI:(-3.39, -0.85), Z=3.27, P=0.001; 2)on the 14th day and the 28th day, the retinal ganglion cells were more in the experimental group than in the control group [SMD=4.51, 95% CI:(3.17, 5.85), Z=6.60, P<0.001; SMD=2.96, 95% CI:(1.11, 4.80), Z=3.14, P=0.002; 3)on the 14th day, the expression of BDNF was more in the retina of the experimental group than in the control group [SMD=2.67, 95% CI:(1.46, 3.88), Z=4.32, P<0.001]; 4)on the 14th day and the 28th day, the expression of GDNF was more in the retina of the experimental group than in the control group [WMD=1.21, 95% CI:(1.05, 1.37), Z=14.75, P<0.001; WMD=0.79, 95% CI:(0.52, 1.06), Z=5.72, P<0.001; 5)on the 14th day, the expression of IGF-I was more in the retina of the experimental group than in the control group [SMD=4.31, 95% CI:(2.51, 6.11), Z=4.69, P<0.001]. Three studies showed that stem cells could survive in the eye for 4 weeks and a few cells could integrate in the host retina and express neural cell surface markers. Three studies showed no adverse reactions after transplantation. Conclusions Although the current literature shows no uniform, standardized treatment method for experimental glaucoma in rats, there is evidence that stem cell transplantation has a certain protective effect on the optic nerve of rats with glaucoma, with no adverse reactions after transplantation. Because of the limited quality and quantity of the included literature, further studies are needed to validate the results of this review.
    Correlation between endolymphatic hydrops and inner ear epithelial sodium channels and aquaporins
    HUANG Qiao,YIN Shihua
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  145-148.  doi:10.6040/j.issn.1673-3770.0.2018.301
    Abstract ( 1628 )   PDF (346KB) ( 427 )   Save
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    Endolymphatic hydrops is the main pathological disorder in Meniere's disease, although the precise mechanism is not fully understood. Studies have confirmed that endolymphatic hydrops is closely related to the inner ear ion and water transport channels. This article reviews the studies on the correlation between endolymphatic hydrops and inner ear epithelial sodium channels(ENaC)and aquaporins(AQPs)and discusses the mechanism underlying endolymphatic hydrops to provide favorable references for future studies on the pathogenesis and treatment of Meniere's disease.
    Research of the relationship between adenoid hypertrophy and the common diseases of pediatric otolaryngology
    LIU Yan, WEI Ping, KOU Wei, HU Sijie, WU Xiaofang, LIU Mengya, CHEN Cheng, YAO Hongbing
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  149-154.  doi:10.6040/j.issn.1673-3770.0.2018.266
    Abstract ( 2283 )   PDF (430KB) ( 525 )   Save
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    Adenoid hypertrophy(AH)is a common and frequently occurring disease in pediatric otorhinolaryngology. The etiology, clinical symptoms, and treatment methods of AH have been studied thoroughly and a consensus has been largely reached. However, the relationship between AH and otorhinolaryngology-related diseases has not been widely investigated. AH and allergic rhinitis(AR), acute and chronic rhinosinusitis(ARS/CRS), acute otitis media(AOM), otitis media effusion(OME), cholesteatoma otitis media(COM), acute and chronic tonsillitis(AT/CT), tonsillar hypertrophy(TH), obstructive sleep apnea syndrome(OSAS), and other pharyngeal diseases are inextricably linked. This article mainly discusses the relationship between AH and common pediatric otolaryngology diseases through the interaction and influence of AH on these diseases.
    Diagnosis and treatment of cognitive deficits in adult patients with obstructive sleep apnea hypopnea syndrome
    YAN Zhigang, ZHANG Huihui, YU Dan, LIU Yan, WEN Lianji, WANG Di
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  155-161.  doi:10.6040/j.issn.1673-3770.0.2018.561
    Abstract ( 1872 )   PDF (476KB) ( 457 )   Save
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    Sleep apnea hypopnea syndrome(OSAS)is a sleep and respiratory disorder with high incidence, which can cause damage to multiple systems and organs. Several studies have shown that OSAS mainly leads to cognitive impairment; however, the specific mechanism is not clear. Cognitive impairment may be because of chronic intermittent hypoxia, sleep disorders, etc.; this can seriously affect the quality of life. Early diagnosis and treatment of OSAS significantly improves the cognitive impairment in patients with OSAS and cognitive deficits.
    The constructive and mediating effects of knowledge/attitude/belief/practice interference on negative emotion in patients with sudden deafness
    TONG Qiaozhen, ZHAO Yan, CHENG Sihua
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  162-164.  doi:10.6040/j.issn.1673-3770.0.2018.533
    Abstract ( 1810 )   PDF (351KB) ( 282 )   Save
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    Objective To explore the constructive and mediating effects of knowledge/attitude/belief/practice interference on negative emotion in patients with sudden deafness. Methods A total of 68 patients with sudden deafness who underwent treatment in the Otolaryngology Department of our hospital from January, 2017 to June, 2018 were selected. They were divided into two groups using a random number table: group A, those accepting nursing intervention under guidance of routine nursing mode; and group B, those accepting nursing intervention under guidance of knowledge/attitude/belief/practice mode. Scores through self-compiled scale, self-rating anxiety scale, and self-rating depression scale were acquired at baseline and after 3 months intervention. Patient care satisfaction and negative emotion were compared between groups A and B. Results After 3 months' intervention, the standard scores on self-rating anxiety scale and self-rating depression scale in the two groups were better than those at baseline(t=26.994, P<0.001; t=37.554, P<0.001); the self-rating anxiety scale score and self-rating depression scale score were lower in group B than in group A (t=12.769, P<0.001; t=10.040, P<0.001).Group B was superior to group A in terms of the nurses'ability to communicate with patients, normative nursing behavior, and ability of nurses to solve patients problems and promote and educate patients' health(t=15.285, 19.263, 15.757, and 15.096, respectively; P<0.001). Conclusion Nursing practice under the knowledge/attitude/belief/practice interference mode in patients with sudden deafness can improve the patients' negative emotion and satisfaction with nursing.
    Effects of a quality control circle-based discharge plan on rehabilitation after ear deformity reconstruction
    WANG Panpan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  165-168.  doi:10.6040/j.issn.1673-3770.0.2018.362
    Abstract ( 1601 )   PDF (408KB) ( 234 )   Save
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    Objective To explore the effects of a quality control circle-based discharge plan on the rehabilitation of patients after ear deformity reconstruction. Methods From February 2014 to January 2018, 107 patients with congenital microtia malformation who underwent ear deformity reconstruction in the First Affiliated Hospital of Harbin Medical University were enrolled in this study. Patients were divided into an observation group(n=57)and a control group(n=50), and received different nursing. All patients underwent general anesthesia during ear deformity reconstruction. The control group received routine discharge management after operation, the observation group received discharge management based on a quality control circle, and the postoperative rehabilitation of the two groups was recorded. Results The excellent and good rates of reconstructed auricles were significantly higher in the observation group(100%, 57/57)than in the control group(88.0%, 44/50)(χ2=7.246, P=0.007). The incidence of complications was significantly lower in the observation group(3.5%, 2/57)than in the control group(20.0%, 10/50)(χ2=7.275, P=0.007). Additionally, pain scores of the observation group(0.76±0.22 points)were significantly lower than those of the control group(1.72±0.44 points)(t=9.133, P=0.000). The sleep scores of the observation group and the control group were 6.49±2.85 points and 9.19±3.11 points, respectively(t=5.922, P=0.014). Compared with the control group, the observation group's self-confidence, enthusiasm, ability to solve daily and work problems, and sense of responsibility were significantly improved. Conclusion The discharge management plan based on a quality control circle can promote the recovery of patients after ear deformity reconstruction, reduce the occurrence of complications, improve the symptoms of pain and sleep disorders, and improve the quality of care.
    Effects of continuous out-of-hospital administration on the quality of life in patients with laryngeal cancer
    ZHANG Xiaoping, YANG Dengquan, WANG Shaoxin, HUANG Xiaoming
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  169-174.  doi:10.6040/j.issn.1673-3770.0.2018.369
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    Objective To discuss the effects of continuous out-of-hospital administration on the quality of life in patients with laryngeal cancer. Methods From January 2016 to June 2017, 82 patients with laryngeal cancer were selected from No.2 Hospital of Yibin and divided randomly into control and intervention groups using a stratified randomization method. Patients in the control and intervention groups underwent routine out-of-hospital follow-up and continuous out-of-hospital administration, respectively. Finally, the scores of the self-ranking anxiety scale(SAS), self-ranking depression scale(SDS), adult dispositional hope scale(ADHS), normal health status scale(SF-36), quality-of-life questionnaire for cancer patients(QLQ-C30), and functional assessment of cancer therapy-head and neck(FACT-HN)were evaluated and compared. Results The incidences of anxiety and depression were significantly different between the control and intervention groups(anxiety: 42.1% vs. 15.9% with χ2=6.933, P=0.013; depression: 39.5% vs. 9.1% with χ2=10.573, P=0.001). The scores of the SAS, SDS, and ADHS had significant differences in the two groups based on dependent t-tests(SAS: 49.2±10.3 vs. 41.3±8.7 with t=3.77, P<0.001; SDS: 47.4±9.2 vs. 40.5±7.0 with t=3.85, P<0.001; ADHS: 27.1±7.8 vs. 34.7±6.9 with t=4.68, P<0.001). In the SF-36 scale, besides general health and vitality, the other six dimensions including physical functioning, role-physical, bodily pain, social functioning, role-emotional, and mental health in the intervention group were significantly higher than those in the control group(t=2.31, 2.54, 4.15, 2.66, 3.59, and 2.59, respectively; P=0.02, =0.01, <0.001, =0.01, <0.001, and =0.01, respectively). In the QLQ-C30 scale, significant differences in overall health status, five functioning scales(including body, cognition, role, emotions, and social function), and two single items(including insomnia and anorexia)were observed between the two groups(overall health status: t=2.42, P=0.02; five functioning scales: t=3.06, 3.95, 2.27, 2.23, and 0.01, respectively; P<0.001, <0.001, =0.03, =0.03, and =0.01, respectively; two single items: t=2.69 and 2.33, respectively; P=0.01 and 0.02, respectively). The total scores of FACT-HN and three dimensions(including social/family status, emotional well-being, and additional attention)were significantly different between the two groups(FACT-HN scores: 110.3±12.2 vs. 118.6±13.6, t=2.89, P=0.01; three dimensions: t=2.55, 3.07, and 2.14, respectively, P=0.01, <0.01, and =0.04, respectively). Conclusion Continuous out-of-hospital administration has certain positive significance in correcting psychological problems and promotes a sense of gain and quality of life in patients with laryngeal cancer.
    Effects of intensive self-care on voice recovery and psychological emotions in patients undergoing laryngoscope-assisted vocal cord polypectomy
    ZHAO Yan, CHENG Sihua, TONG Qiaozhen
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  175-178.  doi:10.6040/j.issn.1673-3770.0.2018.386
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    Objective To study and analyze the effects of intensive self-care on the Hamilton anxiety scale(HAMA), a digital grading method(NRS), and the QOL scores in patients with laryngoscope-assisted vocal cord polypectomy. Methods Between March 2016 and March 2018, 94 patients who underwent laryngoscope-assisted vocal cord polypectomy at our hospital were selected as the study subjects. They were divided into the study and control groups according to a random number table, with 47 patients in each group. The control group received routine nursing intervention, while the study group received intensive self-care intervention. Voice restoration in the two groups as well as the changes in the HAMA, NRS, and QOL scores before and after intervention were compared. Results The fundamental frequency perturbation, amplitude circumference, and independent articulation ability of the study group were lower than those of the control group(t=5.181, 3.355, and 11.017, respectively; P=0.001, <0.001, and <0.001, respectively). However, the voice disturbance index was higher in the study group than in the control group (t=4.550; P<0.001). The post-intervention HAMA score of the study group was lower than the pre-intervention score of the control group(t=15.069 and 8.539, respectively; P<0.001), and the study group had a lower HAMA score than did the control group(t=6.935; P<0.001). The post-intervention NRS score of the study group was lower than the pre-intervention score of the control group(t=4.788 and 2.535, respectively; P<0.001), and the study group had a lower NRS score than did the control group(t=2.548; P=0.013). The post-intervention QOL score of the study group was higher than the pre-intervention score of the control group(t=7.292 and 2.671, respectively; P<0.001 and 0.009, respectively), and the study group had a higher QOL score than did the control group(t=4.698; P<0.001). Conclusion Intensive self-care is helpful for voice recovery in patients undergoing laryngoscope-assisted vocal cord polypectomy, while reducing the HAMA and NRS scores and improving the QOL scores.
    Thyroid adenoma misdiagnose as primary tumors of trachea: a case report and literature review
    GE Peng, JIN Chunshun, YANG Jingpu, ZHAO Xue, CHAI Guijuan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2019, 33(4):  179-182.  doi:10.6040/j.issn.1673-3770.0.2018.391
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