[Mechanism of VPS26 gene promoting implant osseointegration through Wnt/β-catenin pathway in hyperlipidemia rats]

Objective: To investigate the mechanism of VPS26 effect on osteogenesis and adipogenesis differentiation of rat bone marrow mesenchymal stem cells (BMSC) in high fat environment, and to explore the effect of VPS26 on implants osseointegration of high fat rats and ectopic osteogenesis in nude mice. Methods: BMSC were cultured under normal osteogenic induction (osteogenic group) and high-fat osteogenic induction (high-fat group).High-fat group was transfected with VPS26 enhancer and inhibitor, and the expression levels of osteogenesis related genes and adipogenesis related genes were examined. Osteogenesis and adipogenesis of BMSC were detected by alkaline phosphatase (ALP) staining and oil red O staining after 7 and 14 days of induction.In osteogenic group,the binding of VPS26 to β-catenin was detected by immunofluorescence staining and immunoprecipitation, and dual luciferase reporter assay (TOP Flash) was used to analyze the TOP/FOP ratio. Eighteen male 12-week hyperlipidemic Wista rats (160-200 g) were implanted with implants, and six in each group were injected with VPS26 overexpression lentivirus (LV-VPS26 group), negative control lentivirus (LV-nc group) and saline (blank control group).Micro-CT analysis , HE and oil red O staining were used to evaluate the osseointegration of the implants and lipid droplets formation of the femur samples. Twenty female 6-week nude mice (30-40 g) were divided into five groups and subcutaneously implanted with osteogenic BMSC non-transfected and transfected LV-VPS26, LV-nc, shVPS26, and shscr lentivirus on the back. Samples were used to observe ectopic osteogenesis. Results: The mRNA expression levels of ALP in the high-fat group BMSC after overexpression of VPS26 (1.56±0.09) were significantly higher than those of the negative control (1.01±0.03) (t=10.09, P<0.001), while those of peroxisome proliferator-activated receptor-γ (PPAR-γ) (t=6.44, P<0.001) and fatty acid-binding protein4 (FABP4) (t=10.01, P<0.001) were lower than those of the negative control. Western blotting results showed that compared with the negative control, protein expression of ALP and Runt-related transcription gene 2 was enhanced in the high-fat group BMSC after overexpression of VPS26 while PPAR-γ and FABP4 were inhibited. ALP activity of BMSC in the high-fat group was stronger after overexpression of VPS26, and the formation of lipid droplets was weaker than that in negative control. The results of immunofluorescence, immunoprecipitation and dual luciferase reporter assays showed co-localization and interaction of VPS26 with β-catenin and a significant 43.10% increase in the TOP/FOP ratio (t=-3.17, P=0.034). VPS26 overexpression enhanced osseointegration and decreased the number of lipid droplets in high-fat rat and enhanced ectopic osteogenesis of nude mice. Conclusions: VPS26 activated osteogenesis differentiation and inhibited adipogenic differentiation of BMSCs through Wnt/β-catenin pathway, promoting osseointegration of high-fat rat implants and ectopic osteogenesis of nude mice.

[Association of sleep with anxiety in the elderly aged 60 years and older in China]

Objective: To investigate the relationship of sleep duration and sleep quality with anxiety in the elderly aged 60 years and older in China. Methods: The elderly aged 60 years and older were selected from the China Short-term Health Effects of Air Pollution Study conducted between July 18, 2017 and February 7, 2018. Multivariate logistic regression models were used to analyze the association of sleep duration and sleep quality with anxiety. Results: A total of 3 897 elderly aged 60 years and older were included in the study. The age of the elderly was (73.4±8.0) years old. Among the elderly surveyed, 6.5% were defined with anxiety, and 18.7% reported poor sleep quality. Multivariate logistic regression models showed shorter sleep duration was the risk factor for anxiety in the elderly that after adjusting for factors such as general demographics, socioeconomic factors, lifestyle, health status, social support and ambient fine particulates exposure. Compared with the elderly with 7 hours of sleep duration daily, the OR (95%CI) of anxiety for those with sleep duration ≤ 6 hours was 2.09 (1.49-2.93). Compared with those with good sleep quality, the OR (95%CI) of anxiety for those with poor sleep quality was 5.12 (3.88-6.77). We also found statistically significant correlations of the scores of subscales of Pittsburgh sleep quality index with anxiety, in which the effects of sleep disturbance, subjective sleep quality and daytime dysfunction scores were most obvious, the ORs (95%CI) were 4.63 (3.55-6.04), 2.75 (2.33-3.23) and 2.50 (2.19-2.86), respectively. Subgroup analysis showed that the association of sleep duration and sleep quality with anxiety was more obvious in males and in those aged <80 years. Conclusion: Shorter sleep duration and poor sleep quality are associated with anxiety in the elderly in China.

[Association between food intake and the serum total cholesterol level among adults in 9 regions of China]

Objective: To analyze the association between food intake and the serum total cholesterol(TC) level in adult Chinese population. Methods: This study included apparent healthy residents aged between 20 and 70 years who participated in the eighth round of China Health and Nutrition Study (CHNS) in 9 regions of China including Liaoning, Helongjiang, Shandong, Jiangsu, Henan, Hunan, Hubei, Guizhou provinces and Guangxi Zhuang Autonomous Region in 2009. The association between the serum TC level and the diet and other related factors were analyzed. Results: (1) Linear trend test showed that age, body mass index, waist circumference, systolic and diastolic blood pressure were positively related with serum TC level in 20-45 and 46-70 years old male and female (all P<0.01), while physical activity level was negatively related with serum TC level in 20-45 and 46-70 years old male and 46-70 years old female (all P<0.01). (2) Multivariate linear regression analysis showed that livestock meat intake was positively related with serum TC level in following populations: 20-45 years old male, β=0.133, P<0.001; 46-70 years old male, β=0.102, P=0.001; 20-45 years old male, β=0.065, P=0.041; years old female, β=0.059, P=0.045. Vegetable oil intake was negatively related with serum TC level in 20-45 years old male (β=-0.071, P=0.021). Saturated fat intake was positively related with serum TC level in 46-70 years old female (β=0.084, P=0.019). Total dietary cholesterol intake was positively related with serum TC level in male (20-45 years old, β=0.067, P=0.021; 46-70 years old, β=0.070, P=0.012), but not in female (20-45 years old, β=0.007, P=0.809; 46-70 years old, β=0.038, P=0.144). Cholesterol intake from livestock meat was positively related with serum TC level in male (20-45 years old, β=0.156, P<0.001; 46-70 years old, β=0.099, P=0.001), and positively related with serum TC level in 46-70 years old female (β=0.063, P=0.028). Cholesterol intake from egg was positively related with serum TC level in 46-70 years old male (β=0.056, P=0.032). Conclusions: Age, body mass index, waist circumference, blood pressure, blood pressure, and physical activity level are related with serum TC level. Cholesterol intake from livestock meat was the main food source that related with serum TC level, and the serum TC increases at a relatively small level after intake of total dietary cholesterol.

Proteomic and gene expression analyses during bolting-related leaf color change in Brassica rapa

Bolting and flowering are key processes during the growth and development of Chinese cabbage (Brassica rapa L. ssp pekinensis). Understanding the molecular mechanisms underlying bolting and flowering is of significance for improving production of the vegetable. A leaf-color change from bright green to gray-green has been observed following differentiation of the flowering stem and before bolting in the vegetable, and is considered to be a signal for bolting. Proteomics in meristem tissues of an inbred line (C30) were analyzed by two-dimensional electrophoresis during the transition period. We found that some proteins were specifically expressed while others were differentially expressed. Among these, 17 proteins were specifically expressed before the color change, 18 were specifically expressed after the color change, 21 were downregulated during the color change, and 29 were upregulated. Mass spectrometric analysis (MALDI-TOF-TOF/MS) was used to analyze 17 protein spots, and four proteins (subunit E1 of vacuolar-type H+ transporter ATPase, the large subunit of Rubicon, S-adenosylmethionine synthetase, and tubulin α-2) were identified. qPCR analysis was conducted to quantify the expression of genes encoding these proteins during the transitional period. The expression of BrVHA-E1, BrSAMS, BrrbcL, and BrTUA6 was significantly different before and after the leaf-color change, suggesting that these genes might be involved in regulating flower differentiation and bolting.

Association between interleukin-10 gene polymorphisms and susceptibility to diabetic nephropathy in a Chinese population

In this study, we investigated the association between the interleukin (IL)-10 -592C/A, -819C/T, and -1082G/A genetic variations and susceptibility to diabetic nephropathy in a Chinese population. The IL-10 -592C/A, -819C/T, and -1082G/A polymorphisms were genotyped in diabetic nephropathy patient and control samples by polymerase chain reaction-restriction fragment length polymorphism. The results were then statistically analyzed using SPSS 17.0. The results of the χ(2) test revealed a significant difference in the frequencies of the GG, GA, and AA genotypes of IL-10 -1082G/A between patients with diabetic nephropathy and control subjects (χ(2) = 10.03, P = 0.007). Unconditional logistic regression analysis revealed that the AA genotype of IL-10 -1082G/A significantly increased the susceptibility to diabetic nephropathy [adjusted odds ratio (OR) = 2.52, 95% confidence interval (CI) = 1.31-4.82] compared to the wild-type genotype. Moreover, the A allele of this polymorphism was associated with an increased risk of diabetic nephropathy compared to the G allele (adjusted OR = 1.51, 95%CI = 1.15-1.99). However, the IL-10 -819T/C and -592A/C genetic polymorphisms did not increase the risk of diabetic nephropathy. In conclusion, the IL-10 -1082G/A polymorphism was found to be correlated with the development of diabetic nephropathy.

Regulation of bolting and identification of the α-tubulin gene family in Brassica rapa L. ssp pekinensis

Microtubules are important components of eukaryotic cells, and they play vital roles in cell morphogenesis, carrying of signaling molecules, transport of materials, and establishing the cell polarity. During bolting of biennial plants, cell division and elongation are involved, and cell elongation inevitably involves the microtubules arrangement and expression of related genes. So we deduce that it is of great significance to figure out the mechanism of bolting and flowering in which TUA genes are involved. In the present study, bioinformatic methods were used to predict and identify the α-tubulin gene family (BrTUAs) in Brassica rapa L. ssp pekinensis (Chinese cabbage) through the alignment of AtTUA gene sequence from Arabidopsis thaliana with the B. rapa genome database (http://brassicadb.org/brad/) using the basic local alignment search tool. The change in the structure and functions of BrTUAs during the process of evolution, cis-acting elements in the promoter sequences of BrTUAs, and the expression of the identified genes was also analyzed. Twelve members of the α-tubulin gene family were identified from Chinese cabbage. The gene length, intron, exon, and promoter regions were determined to have changed significantly during the genome evolution. Only five of the 12 members were encoded completely and were observed to differ in their spatial and temporal expression. The five BrTUA promoter sequences contained different numbers of cis-elements responsive to light and low-temperature response, cis-elements responsive among which hormonal responses were significantly different. We also report that the BrTUAs were involved in the regulation of the bolting in Chinese cabbage, and propose that this process could be controlled by regulating the expression of BrTUAs.

ANALYSIS OF GENOMIC DNA METHYLATION AND GENE EXPRESSION IN CHINESE CABBAGE (Brassica rapa L. ssp. pekinensis) AFTER CONTINUOUS SEEDLING BREEDING

Vernalization plays a key role in the bolting and flowering of Chinese cabbage (Brassica rapa L. ssp. pekinensis). Plants can switch from vegetative to reproductive growth and then bolt and flower under low temperature induction. The economic benefits of Chinese cabbage will decline significantly when the bolting happens before the vegetative body fully grows due to a lack of the edible value. It was found that continuous seedling breeding reduced the heading of Chinese cabbage and led to bolt and flower more easily. In the present study, two inbred lines, termed A161 and A105, were used as experiment materials. These two lines were subjected to vernalization and formed four types: seeds-seedling breeding once, seedling breeding twice, seedling breeding thrice and normal type. Differences in plant phenotype were compared. DNA methylation analysis was performed based on MSAP method. The differential fragments were cloned and analyzed by qPCR. Results showed that plants after seedling breeding thrice had a loosen heading leaves, elongated center axis and were easier to bolt and flower. It is suggested that continuous seedling breeding had a weaker winterness. It was observed that genome methylation level decreased with increasing generation. Four differential genes were identified, short for BraAPC1, BraEMP3, BraUBC26, and BraAL5. Fluorescent qPCR analysis showed that expression of four genes varied at different reproduction modes and different vernalization time. It is indicated that these genes might be involve in the development and regulation of bolting and flowering of plants. Herein, the molecular mechanism that continuous seedling breeding caused weaker winterness was analyzed preliminarily. It plays an important guiding significance for Chinese cabbage breeding.

[Clinical analysis of cochlear implants related inflammatory reaction]

OBJECTIVE

This article discusses the clinical features and treatment methods of the inflammatory reaction associated with cochlear implants, and analyzes the possible pathogenesis and related factors.

METHOD

We retrospectively analyzed postoperative inflammation cases from February 2002 to October 2013 among 825 cochlear implantation patients. Their symptoms, signs and treatment processes and outcomes were described and summarized.

RESULT

Incidence of implants related inflammatory reaction was 1.58%. The onset time ranged from 2 months to 11 years post-operatively. There were 6 cases of implants related non-infectious inflammation, with an incidence of 0.73% (6 of 825). Post auricular swelling and subcutaneous non-infectious discharge were found in all these 6 cases. Pressure dressing with bandage and steroid, antihistamine medications was effective. There were 7 cases of post auricular infection, with an incidence of 0.85%, resulted from flap trauma or acute otitis media. Antibiotics and drainage was used for them to treat the infection, and rotation scalp flaps were used to cover the exposed device. Five of these cases were cured but cochlear implants had to be removed out in the other 2 cases of staphylococcus aureus infection.

CONCLUSION

Cochlear implantation surgery is safe and effective for profound deafness. However, the implants-related non-infectious and infectious inflammatory reaction impacts the effect of cochlear implants, even lead to removal of the implants.

[The impact of malleus processing in ossicular chain reconstruction on the therapeutic effect in patients with tympanosclerosis]

OBJECTIVE

To investigate the effect of different malleus treatments on the postoperative efficacy in the tympanosclerosis patients receiving ossicular chain reconstruction.

METHOD

Fifty-nine patients (62 ears) with tympanosclerosis were treated by ossicular chain reconstruction. All the patients were divided into three groups, including malleus removal group (A, 24 ears), retaining only the malleus handle group (B, 18 ears) and the intact malleus group (C, 20 ears). All the patients were followed up 3 months pre-operation, 3 months and 1 year post-operation by audiometric measurement (the average hearing threshold at 0.5, 1.0, 2.0 kHz HI). Tympanic membrane was examined by ear endoscope.

RESULT

The pre-operation mean air bone gap (ABG) in these groups were 40.07 +/- 77.56 dB, 37.31 +/- 76.45 dB, and 36.75 +/- 76.72 dB, among which the difference had no statistical significance (P > 0.05). At 3 months after operation, the ABG in all cases was improved at 0.5, 1 and 2 kHz. The difference of ABG improvement among these three groups had no statistical significance (P > 0.05). One year after surgery, the ABG of the three groups were decreased by 17.92 +/- 9.28 dB, 16.76 +/- 5.19 dB and 10.58 +/- 7.38 dB respectively. The hearing improvement in group C is less than the other two groups (P = 0.03, P = 0.016). The difference of hearing improvement between group A and group B had no statistical significance(P > 0.05). Group A and group B each have one case of tympanic membrane perforation and artificial ossicle falling off.

CONCLUSION

The operating processes of malleus in ossicular chain reconstruction of patients with tympanosclerosis were introduced. In terms of short-term efficacy, the three groups showed no significant difference. However, the long-term efficacy of the patients in the group A and group B were better compared with the group C.

[Normal anatomy of aditus of antrum and antrum on high-resolution CT and three-dimensional reconstruction]

OBJECTIVE

To study the normal anatomy of aditus of antrum and antrum on the high-resolution CT (HRCT) and the three-dimensional reconstruction, testing the normal range. And comparison was carried out according to the age, sex and side.

METHOD

Ninety cases were randomly selected without ear lesions. Scanning were taken in sagittal, transverse and coronal planes on HRCT respectively. The structure of aditus and antrum was displayed by three-dimensional reconstruction. The left-right distances and up-down distances, antero-posterior distances were measured and analyzed.

RESULT

The image of antrum varied with age, while aditus remained constant on the HRCT and the three-dimensional reconstruction. The average of left-right distance of aditus was (5.19 +/- 1.39) mm, and the average of up-down distance of aditus was (5.74 +/- 1.16) mm. The average of left-right distance of antrum was (8.27 +/- 1.41) mm (<6 years old) and (5.41 +/- 1.32) mm (> or = 6 years old). The average of up-down distance of antrum was (11.78 +/- 1.65) mm (<6 years old) and (9.91 +/- 2.04) mm (> or = 6 years old). The average of antero-posterior distance of antrum was (12.25 +/- 1.23) mm (<6 years old) and (10.05 +/- 1.69) mm (> or = 6 years old). No statistically significant differences were seen in left-right distance of aditus by age, sex and side (P > 0.05). Significant differences in up-down distance of aditus was found between male and female, and the distance in male was greater than that in female (P < 0.05). Statistically significant differences were seen in left-right distance and up-down distance, antero-posterior distance of antrum by age (P < 0.05), but no statistically significant differences by sex or side (P > 0.05).

CONCLUSION

Imaging of aditus ad antrum is relatively constant in the normal persons, while the aditus is more diverse. Significant gender differences were seen in up-down distance. There were significant differences in left-right distance, up-down distance, and antero-posterior distance of aditus among all age groups.

[Applied anatomy of scala tympani inlet related to cochlear implantation]

OBJECTIVE

To investigate the related parameters of the temporal bone structure for determining the position of implanting electrode into the scala tympani in cochlear implantation surgery through the facial recess and epitympanum approach.

METHODS

In a surgical simulation experiment, 20 human temporal bones were studied and measured to determine the related parameters of the temporal bone structure.

RESULTS

The distance 5.91∓0.29 mm between the short process of the incus and the round window niche, 2.11∓0.18 mm between the stapes and the round window niche, 6.70∓0.19 mm between the facial nerve in the perpendicular paragraph and the round window niche, 2.22∓0.21 mm from the pyramidal eminence to the round window, and 2.16∓0.14 mm between the stapes and the round window. The minimal distance between the implanting electrode and the vestibular window was 2.12∓0.19 mm. The distance between the cochleariform process and the round window niche was 3.79∓0.17 mm. The position of the cochlear electrode array insertion into the second cochlear turn was 2.25∓0.13 mm under the stapes. The location of the cochlear electrode array insertion into the second cochlear turn was 2.28∓0.20 mm inferior to the pyramidal eminence.

CONCLUSION

These parameters provide a reference value to determine the different positions of cochlear electrode array insertion into the scale tympani in different patients.

[Applied anatomy of facial recess and posterior tympanum related to cochlear implantation]

OBJECTIVE

To investigate the related parameters of temporal bone structure in the surgery of cochlear implantation through facial recess approach so as to offer a theoretical reference for the avoidance of facial nerve injury and the accurate localization.

METHOD

In a surgical simulation experiment, twenty human temporal bones were studied. The correlation parameters were measured under surgical microscope.

RESULT

Distance between suprameatal spine and short process of incus was (12.44 +/- 0.51) mm. Width from crotch of chorda tympani nerve to stylomastoid foramen was (2.67 +/- 0.51) mm. Distance between short process of incus and crotch of chorda tympani nerve was (15.22 +/- 0.83) mm. The location of maximal width of the facial recess into short process of incus, crotch of chorda tympani nerve were (6.28 +/- 0.41) mm, (9.81 +/- 0.71) mm, respectively. The maximal width of the facial recess was (2.73 +/- 0.20) mm. The value at level of stapes and round window were (2.48 +/- 0.20 mm) and (2.24 +/- 0.18) mm, respectively. Distance between pyramidalis eminence and anterior round window was (2.22 +/- 0.21) mm. Width from stapes to underneath round window was (2.16 +/- 0.14) mm.

CONCLUSION

These parameters provide a reference value to determine the position of cochlear inserting the electrode array into the scale tympani and opening facial recess firstly to avoid potential damage to facial nerve in surgery.

[Cochlear implantation and rehabilitation in prelingually deafened adolescents and young adults]

OBJECTIVE

To investigate the outcomes of prelingually deafened adolescents and young adults receiving cochlear implantation (CI).

METHODS

Thirty-three patients with prelingual deafness aged 7-33 years at the time of CI were followed up for 4 years. The Speech Discrimination Score (SDS) was tested using disyllabic words and short sentences with close-set and open-set, respectively.

RESULTS

After appropriate mapping, sound field audiometry with warble tone showed that the warble tone threshold average (WTA) of the patients reached 25-41 dBHL, with a mean threshold of 28.62∓2.37 dBHL. At 1 year after the operation, the mean value of SDS was 70.03% in close-set word list with lip-reading and 61.18% without lip-reading, and was improved to 82.12% and 72.67% at 4 years, respectively. In open-set word list, the mean value of SDS was 77.94% with lip-reading and 67.85% without lip-reading. The safety and the benefits-cost evaluation of CI for prelingually deafened school age children and adolescents had been recognized by 90.9% of the families involved.

CONCLUSION

These patients can obtain appropriate speech discrimination scores with improved quality of life after CI.

[The expressions of alpha-enolase in the nasopharyngeal cancer tissue]

OBJECTIVE

To study the meaning of expressions of ENO1 in the nasopharyngeal cancer tissue.

METHOD

By using SP immunohistochemical methods.

RESULT

The positive expressions for ENO1 were 60.0% in the nasopharyngeal cancer tissues,significantly higher than that (27.5%, 11/40) of in inflammatory nasopharyngeal mucosa (P<0.05). The positive expression rate of ENO1 protein in stage T1 + T2 + T3 was higher than that of in patients with T4 (chi2 = 11.424, P<0.05). But there was no significant relationship between expression of ENO1 and lymph node metastasis and postradiotherapy distant metastasis (P>0.05).

CONCLUSION

The results show that ENO1 over expression may play a important role in cell proliferation and canceration of nasopharyngeal cancer.

[Therapeutic effect of ossicular reconstruction with bioceramic or porous macromolecular polyethylene partial ossicular replacement prosthesis in patients with tympanosclerosis]

OBJECTIVE

To evaluate the effect of ossicular reconstruction with partial ossicular replacement prosthesis (PORP) in patients with tympanosclerosis.

METHODS

The data of 31 cases of tympanosclerosis treated between 1992 and 2009 were reviewed. Of the 31 patients, 17 (17 ears) underwent ossicular reconstruction with porous macromolecular polyethylene PORP, and 14 (14 ears) with bioceramic PORP. All the patients were followed up for 3-24 months.

RESULTS

Significant improvement was found in postoperative speech frequency (500, 1000, 2000 Hz) pure tone average (PTA) and air-bone gap (ABG) (P < 0.05) after the treatments without statistically significant differences between the two groups (P > 0.05).

CONCLUSION

Porous macromolecular polyethylene and bioceramic are valuable ossicular prosthesis for tympanosclerosis.

[Study of three-dimensional speech chart by time-frequency analysis in Chinese Mandarin Monosyllabic word phonemes]

OBJECTIVE

To investigate the physical characteristic of Chinese Mandarin Monosyllabic word phonemes by the time-frequency analysis.

METHODS

Manufactured and study the three-dimensional speech chart which was on the basic of information of the time-frequency analysis in 40 monosyllabic words with the SigmaPlot 9.0 and Matlab 7.0 software.

RESULTS

The mean value of basic frequency in 40 monosyllabic words was between 220 to 320 Hz area, and the mean value of four groups has significant difference by t-test. It is indicated by time-frequency analysis that the characteristics vary according to the tone of monosyllabic words. With the change of time, the various frequencies and its intensity of tone first remain basically unchanged, the curve is horizontal type; the different frequencies of tone second gradually tend to high-frequency direction, the graph is upward-type, additionally, the intensity of some tone drops little; the divers frequencies of tone third firstly deflect to low-frequency areas, then increasingly deviate to high-frequency direction of bias after maintaining a period of time, the figure is v-type, intensity changes are concave-shaped; The various frequencies of tone fourth deviate from high-frequency to low-frequency areas, and its intensity drops sharply, the graph is decreased type.

CONCLUSION

Through time-frequency analysis and three-dimensional speech chart observation, we consider that the physical characteristic of Chinese Mandarin Monosyllabic word phonemes mainly reflects the frequencies and intensity change with time.

[Cochlear implantation in patients with Waardenburg syndrome type II]

OBJECTIVE

To describe the multi-channel cochlear implantation in patients with Waardenburg syndrome including surgeries, pre and postoperative hearing assessments as well as outcomes of speech recognition.

METHOD

Multi-channel cochlear implantation surgeries have been performed in 12 cases with Waardenburg syndrome type II in our department from 2000 to 2008. All the patients received multi-channel cochlear implantation through transmastoid facial recess approach. The postoperative outcomes of 12 cases were compared with 12 cases with no inner ear malformation as a control group.

RESULT

The electrodes were totally inserted into the cochlear successfully, there was no facial paralysis and cerebrospinal fluid leakage occurred after operation. The hearing threshold in this series were similar to that of the normal cochlear implantation. After more than half a year of speech rehabilitation, the abilities of speech discrimination and spoken language of all the patients were improved compared with that of preoperation.

CONCLUSION

Multi-channel cochlear implantation could be performed in the cases with Waardenburg syndrome, preoperative hearing and images assessments should be done.

[Tumor-targeted human telomerase reverse transcriptase promoter/tk gene therapy against human nasopharyngeal carcinoma cells in vitro]

OBJECTIVE

To investigate the targeted killing effect of human telomerase reverse transcriptase promoter (hTERTp)/tk gene on human nasopharyngeal carcinoma (NPC) cells.

METHODS

The recombinant plasmid hTERTp/tk/pGL3 was transfected into human NPC HNE1 cells and the expressions of TK and telomerase were investigated. The targeted killing effect induced by hTERTp/tk on HNE1 cells was assessed using RT-PCR and MTT assay.

RESULTS

TK gene expression was detected in HNE1 cells transfected by hTERTp/tk/pGL3, and the cells showed reduced telomerase and hTERT expression as compared with the control cells. hTERTp/tk/pGL3 resulted in target killing of HNE1 cells but not of the normal control cells. The tumor cell-killing effect of hTERTp/tk/pGL3 was slightly milder than that of the positive control CMV/tk/pGL3 that produced nonselective cell killing.

CONCLUSION

hTERTp/tk, a tumor-specific expression system, allows targeted tumor cell killing and reduces the activity of telomerase in NPC cells in vitro.

[Clinical analysis of 118 patients with tympanosclerosis]

OBJECTIVE

To study the incidence of tympanosclerosis (TS) and the major risk factors of hearing loss.

METHODS

A total of 118 TS patients (137 ears) were compared with 265 patients with chronic otitis media (COM) (311 ears) for gender, age and course of disease. The disease regions and hearing loss of the TS patients were analyzed.

RESULTS

TS showed higher prevalence in women of older ages. Sclerosis was seen most frequently in the tympanic membrane, followed by the malleus, incus, incudomalleolar joint, other regions, ariticulus incudostapedius and stapes. The patients with sclerosis or deterioration in the ossicular chain had worse hearing loss than the other patients. Carhart notch occurred in 45 ears (32.85%), an incidence similar to that of inverted "V"-shaped curve of air-conduction audiometry near 2 kHz (47 ears, 34.31%). The factors contributing to the hearing loss, listed in the order of their importance, included pathologies in the incus, malleus, incudomalleolar joint, ariticulus incudostapedius, stapes, other regions, tympanic membrane, and gender.

CONCLUSIONS

Female patients may had increased risk of TS. The presence of Carhart notch and inverted "V"-shaped curve in air-conduction audiograph may indicate myringosclerosis or ossicular chain sclerosis. Abnormal ossicular chain is the leading factor contributing to hearing loss.

Electrically evoked auditory nerve responses in the cochlea with normal outer hair cells

As hybrid cochlear implant devices are increasingly used for restoring hearing in patients with residual hearing it is important to understand electrically evoked responses in cochleae having functional hair cells. To test the hypothesis that extracochlear electrical stimulation (EES) from sinusoidal current can provoke an auditory nerve response with normal frequency selectivity, the EES-evoked compound action potential (ECAP) was investigated in this study. Brief sinusoidal electrical currents, delivered via a round window electrode, were used to evoke ECAP. The ECAP waveform was observed to be the same as the acoustically evoked CAP (ACAP), except for a shorter latency. The input/output and intensity/latency functions of ACAPs and ECAPs were also similar. The maximum acoustic masking for both ACAP and ECAP occurred near probe frequencies. Since the masked tuning curve of a CAP reflects the frequency selectivity of neural excitation, these data demonstrate a highly specific activation of the auditory nerve, which would result in high degree of frequency selectivity. This frequency selectivity likely results from the cochlear traveling wave caused by electrically stimulated outer hair cells.

[Long-term results of endolymphatic sac decompression and endolymphatic-mastoid shunting for Meniere's disease]

OBJECTIVE

To investigate the efficacy of endolymphatic sac surgery for Meniere's disease, and compare the effects of endolymphatic sac decompression with endolymphatic-mastoid shunting.

METHOD

Twelve patients(13 ears) undergoing endolymphatic-mastoid shunting and eleven patients (11 ears) undergoing endolymphatic sac decompression were retrospectively compared for hearing results and vertigo controlled rates. All of them have been followed up for more than two years after surgery.

RESULT

According to Chinese Meniere's disease diagnosis and curative effect standard evaluation criteria published in 2006, for vertigo symptom of endolymphatic mastoid shunting group, 9 cases (69.2%) achieved grade A(completely controlled), 4 cases (30.8%) achieved grade B (fundamentally controlled). There were 8 cases (72.7%) with grade A, 2 cases (18.2%) with grade B and one case (9%) with grade C among 11 patients who received endolymphatic sac decompression. There was not statistically significant differences in postoperative speech pure tone average and vertigo controlled rate between the two groups.

CONCLUSION

Endolymphatic sac decompression and endolymphatic-mastoid shunting are effective management with less complication for intractable Meniere's disease. Particularly, the vertigo symptoms were controlled significantly. Patients with Meniere's disease in advanced clinical stages may also be relieved.

[Cochlear implant in patients with congenital malformation of the inner ear]

OBJECTIVE

To summarize the clinical experience with multi-channel cochlear implantation in patients with inner ear malformations and evaluate and the outcomes of speech rehabilitation.

METHODS

A retrospective study was conducted in 295 patients receiving cochlear implantation from 1998 to 2007, including 25 patients with large vestibular aqueduct syndrome (LVAS), 9 with Modini malformation, and 5 with common cavity deformity. All the patients received the Nucleus24 cochlear implants. In LVAS cases, 4 had Nucleus 24R (ST) implants, 8 had Contuor implants, 10 had Contuor Advance, and the remaining cases used Nucleus24(M) straight-electrode implants.

RESULTS

Severe gusher appeared in 3 cases of LVAS, and perilymph fluctuation were seen in other 15 cases. Four patients with Mondini malformation and 2 with common cavity malformation also experienced severe gusher, but the electrodes were inserted smoothly in all the patients without postoperative facial paralysis or cerebrospinal fluid leakage. The hearing threshold in these patients was similar to that in patients with normal cochlear structure. After speech rehabilitation for over 6 months, the abilities of speech discrimination and spoken language improved in all the cases in comparison with the preoperative lingual functions.

CONCLUSION

Multi-channel cochlear implantation can be performed in patients with inner ear malformation, but should not be attempted in patients with poor cochlear and cochlear nerve development. A comprehensive pre-operative radiographic and audiological evaluation is essential.

[Cochlear implantation in patients with large vestibular aqueduct syndrome]

OBJECTIVE

To evaluate the hearing and speech recognition in patients with large vestibular aqueduct syndrome undergoing multi-channel cochlear implantation.

METHODS

From 2005 to 2008, multi-channel cochlear implantation surgeries were performed in 22 patients with large vestibular aqueduct syndrome. All the patients received multi-channel cochlear implantation through transmastoid facial recess approach. The postoperative outcomes of the patients were compared with those of 22 patients with non-malformed cochlear.

RESULTS

Severe gusher occurred in 3 cases during the implantation, and perilymph fluctuation was found in another 15 cases, with a rate of anomalies of 81.8%. All the electrodes were totally inserted into the cochlear, and no facial paralysis or cerebrospinal fluid leakage occurred after the operation. The hearing threshold in these patients was similar to that in patients with normal cochlear receiving the implantation. After speech rehabilitation for over 6 months, all the patients showed improved hearing and verbal ability.

CONCLUSION

Multi-channel cochlear implantation can be performed in patients with large vestibular aqueduct syndrome, but preoperative hearing assessment and radiographic examinations should be performed.

[Experience of 76 cases of large vestibular aqueduct syndrome, clinical diagnosis and treatment]

OBJECTIVE

To explore the disease incidence, clinical symptoms, prevention and treatment measures of the large vestibular aqueduct syndrome (LVAS).

METHOD

Retrospective analyse the medical history, hearing, vestibular function examination and treatment of 76 LVAS patients who were diagnosed in our department of Otolaryngology from 2002 to 2008.

RESULT

Most patients (93.4%) showed sensorineural hearing loss. Part of patients (61.8%) showed air-bone conduction gap in low frequency. The hearing loss of 43 ears is > 40-60 dB HL, > 60 -80 dB HL 47 ears, > 80 dB HL 62 ears. Decline curve is the characteristic of the Audiogram. The decline in high-frequency 112 ears, flat curve in 29 ears, island hearing in 11 ears. Forty-six patients were conducted the vestibular function examination, which showed low vestibular function. Tympanogram showed that 141 ears are type A, 11 ears are type C. High-resolution CT scan revealed that vestibular aqueduct minimum diameter is 2.2 mm and the largest is 6.2 mm, with a wide opening and deep narrower, and showed the "triangle" or "flared". Forty-two cases of this group were simple dilatation of the vestibular aqueduct, and no large vestibular semicircular canal malformation or cochlear malformation. There was no intellectual and other development disorders. In accordance with the degree of hearing loss, 20 cases of patients restored hearing after drug treatment. Eleven were cases fit a suitable hearing aid and carried out the language rehabilitation training. Forty-five very severe patients were implanted the cochlear and mapping one month later.

CONCLUSION

Fluctuative and progressive hearing loss is the main clinical symptoms of large vestibular aqueduct syndrome. The patients should be examined by high resolution CT scan of the temporal bone. There is no precise and effective treatment for the disease. It is very important for the deaf children who have residual hearing to fit hearing aids and carry out the language rehabilitation training as soon as possible. As for the patients who suffer from hearing loss severely and the hearing aid cannot achieve effective compensation, the cochlear implant should be considered.

[Effect of surgical reconstruction of congenital aural atresia via the mastoid antrum approach: analysis of 48 cases]

OBJECTIVE

To assess the effect of surgical reconstruction of congenital aural atresia via the mastoid antrum approach and investigate method for preventing postoperative atresia of the reconstructed aural canal.

METHODS

From 2000 to 2008, aural canal reconstruction and tympanoplasty was performed via the mastoid antrum approach. In 48 patients with congenital aural atresia (54 ears, including 45 ears of type II, 9 ears of type III). All the patients were followed-up for 18 months to assess the therapeutic effect.

RESULTS

The mastoid antrum was located uneventfully for all the 54 ears, all showing ossicular chain anomalies involving most frequently the malleus and the incus followed by the upper structures of the stapes. Facial nerve abnormalities were seen in 23 ears (42.6%). Hearing improvement to over 20 dB was achieved in 45 ears (83.3%) and to over 25 dB in 25 ears (46.2%) one year later.

CONCLUSION

The mastoid antrum approach for surgical reconstruction of congenital aural atresia is safe and reliable. Maintenance of the width of the aural canal and prevention of lateral healing of the transplanted tympanic membrane are crucial in the treatment of congenital aural atresia.

[Therapeutic effect of insulin-like growth factor-1 injection into the inner ears through scala tympani fenestration on gentamicin-induced hearing loss in guinea pigs]

OBJECTIVE

To study the therapeutic effect of insulin-like growth factor-1 (IGF-1) injection into the inner ears through a scala tympani fenestration on sensorineural deafness in a guinea pig model of gentamicin-induced hearing loss.

METHODS

Twenty guinea pigs with gentamicin-induced hearing loss were randomized equally into IGF-1 group and control group. In both groups, scala tympani fenestration was performed for injection of IGF-1 (10 microl) or artificial perilymphatic fluid (10 microl). Auditory brainstem responses (ABR) test was performed before and 7 and 14 days after surgery, respectively, and the cochlea was removed by decollation of 3 guinea pigs from each group after ABR test for observing the changes in the hair cells using scanning electron microscope.

RESULTS

Significant reduction in the ABR response threshold (RT) occurred in IGF-1 group 7 and 14 days after the surgery, and on day 14, ABR RT showed significant difference between IGF-1 group and the control group. Scanning electron microscopy revealed severer damages of the hair cells in the control group, and in the IGF-1 group, finger-like microvilli was detected on the surface of the damaged hair cells.

CONCLUSION

IGF-1 injection in the inner ear through the scala tympani fenestration may ameliorate the damages of the auditory function and relieve sustained toxicity of gentamicin in guinea pigs possibly by protection and partial repair of the damaged cochlea hair cells as well as protection of the afferent nerves.

[Auditory brainstem response in normal guinea pigs and those with gentamicin-induced hearing loss under awake and anesthetic conditions]

OBJECTIVE

To observe the alterations of auditory brainstem response (ABR) in guinea pigs with gentamicin-induced hearing loss under awake and anesthetic conditions.

METHODS

We recorded the ABR in 20 normal guinea pigs and 20 with gentamicin-induced hearing loss before and after anesthesia for statistical analysis.

RESULTS

No significant difference was observed in the waveform, response threshold (RT), I and III peak latencies (PL), I-III interpeak latencies (IPL) of ABR between awake and anesthetic conditions in normal guinea pigs (P>0.05), nor did gentamicin-induced hearing loss showed obvious impact on the ABR parameters (P>0.05).

CONCLUSION

No significant ABR alterations occur under awake and anesthetic conditions in either normal guinea pigs or those with hearing loss, therefore ABR test can be performed without anesthesia to ensure the success and error minimization of the experiment.

[Cat-scratch disease]

OBJECTIVE

To study the etiology, epidemiology, clinical and pathological features, diagnose and treatment of cat-scratch disease(CSD).

METHOD

The clinical information of 1 case was reported and the literatures were also reviewed.

RESULT

Bartonella henselae was the primary pathogen of CSD. Almost all patients with CSD were in contact with animals, especially cat or dog before the occurrence of the disease. All the patients had the self-limited swelling of local lymph nodes and commonly a fever. The pathological feature was necrotic granulation-like micro abscessation, and a pleomorphous argyrophil G- bacillus could be showed by Warthin-Starry or Brown-Hopp stainings in the swelling lymph nodes.

CONCLUSION

CSD is a self-limited bacterial infectious disease. And its clinical features,biopsy and special stainings of swelling lymph nodes are helpful to the final diagnosis. Gentamicin, rifadin, ciprofloxacin, clarithromycin, bactrim, mitramycin, or resection of swelling lymph nodes had good effects on treating CSD.

[Role of ciliary neurotrophic factor in regeneration of severed facial nerve of cats]

OBJECTIVE

To study the role of extrinsic (CNTF) in the regeneration of severed facial nerve in cats.

METHOD

The facial nerve in temporal bone of adult cats were severed and the severed ends were connected with CNTF or saline applied at the connection. Electrophysiological examination and immunocytochemistry were performed with immunoelectron microscope for morphological analysis at 2, 4 and 8 weeks after the operation.

RESULTS

Two weeks after operation, both CNTF and saline groups failed to exhibit muscular excitement by facial nerve stimulation, but the amount of myelinated nerve fibers had statistical difference between the two groups (P<0.05). At 4 weeks, the latency of the facial muscle excitement was 7.832+/-2.695 ms in CNTF group and 16.120+/-3.516 ms in saline group, and the average number of myelinated axons was significantly different between the two groups (1,435+/-318 vs 957+/-269, P<0.05). At the 8th weeks, the latency of facial muscle excitement was reduced to 3.125+/-0.165 ms in CNTF group and to a comparable level of 3.095+/-0.178 ms in saline group (P>0.05), and the average number of myelinated axons increased to 1,695+/-283 and 1,543+/-320 respectively in the two groups (P>0.05). Significant increase of Schwann cells was noted in both groups at this stage.

CONCLUSION

Local application of CNTF may enhance facial early-stage nerve regeneration in adult cats, but its long-term effects remain unclear.

[Subcloning of human neurotrophin-3 gene and construction of its genetically engineered cell model]

OBJECTIVE

To subclone human neurotrophin-3 gene (NT3) and transfer this gene into human bone marrow mesenchymal stem cells (BM-MSCs) to construct genetically engineered cells that produce NT3 in vitro.

METHODS

Human BM-MSCs were cultured in low-glucose DMEM supplemented with 10% fetal bovine serum and 10 ng/ml epidermal growth factor. Flow cytometry (FCM) was used to examine the phenotypes of the cells. The eukaryotic expression vector pcDNA3.1(+)/NT3 was constructed and transferred into human BM-MSCs in vitro via liposomes. The genetically engineered BM-MSCs were selected several times with G418 and the clones were obtained and then amplified, followed by extraction of the RNA for detection of NT3 gene expression by reverse transcriptional (RT) PCR. The biological activity of the genetically engineered cells was examined by the collecting the supernatant of the culture medium for incubation of guinea pig cochlea hair cells.

RESULTS

The cultured cells expressed CD13, CD29 and CD59, but no7 CD11, CD14, CD31, CD34, CD45, CD80, CD86, CD117 or HLA-DR. The BM-MSCs genetically modified with pcDNA3.1(+)/NT3 not only expressed and produced NT3, but also promoted the survival of the guinea pig cochlea hair cells in vitro.

CONCLUSION

It is possible to construct the genetically engineered BM-MSCs that excrete NT3 in vitro.

[Characteristic of distortion product otoacoustic emissions for preterm newborn]

OBJECTIVE

To investigate the characteristic of distortion product otoacoustic emissions (DPOAE) amplitude, SNR and noise in preterm newborns.

METHOD

DPAOEs at the 2f1-f2 frequency were recorded from 59 ears of 31 preterm newborns and 35 ears of 19 healthy fullterm newborns in response to equilevel primary tones at postnatal 3 days to 1 week. Detailed test included the recording of DPAOEs, SNR and noise.

RESULT

The average DPOAE audiogram of preterm newborns illustrating the frequency response of these emissions demonstrated a maximum at 1,587 Hz and a minimum around 4,000 Hz. The DPOAE response amplitude of preterm newborn was lower than that of fullterm in every frequency(P < 0.05). The SNR was higher at 4,000 Hz than that at low frequency, but was lower at 1000 Hz than that at high frequency. At 4,000, 3,175, 1,587, 1,260 and 1,000 Hz, the SNR of preterm were lower thad fullterm(P < 0.05). The noise was higher at low frequency than that at high frequency.

CONCLUSION

The characteristics of DPOAE in preterm newborn are different from fullterm newborn. These differences may indicate immaturity in cochlear function. Outer hair cell function are hypothesized sources of this immaturity, although some contribution from the immature middle ear and outer ear cannot be ruled out.

[Treatment of operation of carotid body tumor and glomus jugular tumor]

OBJECTIVE

To study the clinical characteristics and outline of surgery for carotid body tumor and glomus jugular tumor.

METHOD

Incisions of anterior border of sterno-mastoid muscle was made for simple carotid body tumor. A big S shape incisions and infratemporal fossa approach were employed which exposure the jugular foramen and apex of petrous for glomus jugular tumor or suffered carotid body tumor and glomus jugular tumor simultaneously in same side.

RESULT

Five cases of carotid body tumor were removed thoroughly and the internal carotid artery were intact reserved. In 5 cases of glomus jugular tumor 3 cases were removed thoroughly, other 2 cases of glomus jugular tumor were palliative operation, the remnant tumor have not increased in size after 1 to 3 years follow up.

CONCLUSION

Chemodectoma have some genetic characteristic. Surgical intervention is the cardinal method of treatment.

[Down-regulation of telomerase and its RNA and apoptosis in the HNE1 cell line of nasopharyngeal carcinoma induced by retinoid]

OBJECTIVE

To explore the down-regulation of telomerase as well as its RNA and apoptosis induced by retinoid acid.

METHOD

After HNE1 cell lines of NPC were incubated with 10(-5) mol of retinoid in 6 days, the expression of telomerase and its RNA and the apoptosis of HNE1 cell lines were detected respectively with TRAP PCR ELISA, RT-nested PCR, apoptosis indexes and trans-electron microscope.

RESULT

After 6 days when RA was added to the HNE1 cell line, the morphological change and suspending of HNE1 cells were found and the HNE1 cells reduced. Meanwhile, the expression of telomerase and hTR was obviously inhibited and the telomerase activity was only the 1/2 of the control with the use of ELISA indirect quantitative assay. Apoptosis indexes and apoptosis cells in RA groups were higher than those in control (P < 0.05).

CONCLUSION

The expression of telomerase and hTR are obviously inhibited and the apoptosis of HNE1 cell lines is also induced by retinoid.

In vivo micromechanical measurements of the organ of Corti in the basal cochlear turn

Cochlear mechanical measurements of organ of Corti motion are generally accomplished in the apical or basal turn as in vivo or in vitro studies. In the apex it is possible to observe and measure tectorial membrane vibration as well as vibrations of structures such as the reticular lamina or the basilar membrane (BM). However, compared to the basal turn, cochlear amplification and nonlinearity are not strong in the apex. Basal turn studies have typically been limited to point location measurements of the BM but improved technology for laser interferometry is now making possible the spatial mapping of BM motion. The 'complexity' of BM motion in the radial direction (particularly the phase variation) is important to new models of cochlear wave amplification. In future work it may be possible to learn about vibration of structures within the organ of Corti.

[Timing changes of apoptosis and proliferating cells nuclear antigen after intra-arteiral infusion chemotherapy for nasopharyngeal carcinoma]

OBJECTIVE

To investigate the timing changes of apoptosis (APO) and PCNA after intra-arterial infusion chemotherapy for nasopharyngeal carcinoma.

METHOD

Ten patients were subjected to percutaneous superficial temporal artery catheterization and infusion of anticancer drugs: 5-Fu, DDp, BLM, nicotinamide. The biopsy of nasopharyngeal tumor tissues was performed before chemotherapy and 7 days after chemotherapy. Apoptotic cells were examined by TOT-mediated DUTP-fluorescein and labeling. The expression of proliferating cells nuclear antigen (PCNA) was detected with immunohistochemical staining.

RESULT

AI of nasopharyngeal cancer cells before chemotherapy and 7 days after chemotherapy was 0.52% and 1.42%, PI was 42.4% and 51.2%.

CONCLUSION

Intra-arterial infusion chemotherapy not only induced apoptosis effectively, but also inhibited temporarily tumor cells proliferation in patients. The curative surgical treatment should be performed as soon as possible after chemotherapy.

Frequency-dependent enhancement of basilar membrane velocity during olivocochlear bundle stimulation

Basilar membrane (BM) velocity responses were measured in the presence of olivocochlear bundle (OCB) stimulation. Frequency threshold tuning curves (FTCs) were derived from tone-evoked input-output (I/O) functions. Efferent nerve activation produced decreases in velocity amplitude for frequencies around best frequency (BF) at low stimulus levels with little or no effect for stimuli well below the BF. A level-dependent efferent reduction/enhancement of BM velocity was found for certain stimulus frequencies above the BF. Efferent activation either had no effect or caused small reductions in the velocity response produced by low level sound, whereas, at higher stimulus levels, efferent activation increased the velocity response. The derived FTCs, therefore, showed criterion-dependent changes with efferent activation. For low BM criterion velocities, FTCs showed the classic desensitization of the tip region without a shift of BF. Some BM velocity criterion values showed FTCs with an expanded high-frequency response area, also without a shift of BF. The results suggest that the effect of OCB activation changes the gain of the voltage-dependent outer hair cell motility such that BM velocity response near BF is decreased while increasing the response for tones well above BF.