[Impact of blood eosinophils on clinical effect of endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps]

Objective: To investigate the effect of blood eosinophils on clinical effect of endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: From March 2011 to March 2016, 72 cases with CRSwNP were treated by endoscopic sinus surgery in Department of Otorhinolaryngology Head and Neck Surgery, Peking University People's Hospital. The clinical records were retrospectively reviewed, and the cases were divided into eosinophilia elevated and non-elevated group according to blood eosinophils, and nasal polyps were evaluated for histopathology eosinophil count. Statistical analysis was performed to compare two groups' pre- and post-operative symptoms of VAS score, sinus computed tomography (CT) scans scores according to the Lund-Mackay system and the outcome of surgery. Both groups' factors that might have affected their outcome were analyzed by t-test, Chi square, Pearson Correlation Coefficient and Willcoxon rank sum test. Results: Seventy two cases were followed up from 24 to 78 months.The average follow-up time was 56 months. The VAS score in the eosinophilia elevated group (n=16) was higher than that in the non-elevated group(n=56), and the difference was statistically significant (11.44±7.13 vs 4.98±5.64, t=3.726, P<0.05). The control of symptoms in the peripheral blood eosinophilia elevated group was less than that in the non-elevated group, and the difference was statistically significant (Z=-1.979, P<0.05). There was a positive correlation between eosinophil counts in peripheral blood and tissues of 72 cases (r=0.429, P<0.05). Conclusion: There is a significant correlation between tissue and blood eosinophil counts, and eosinophilia group has poorer outcomes.

[Clinical evaluation about rhinoplasty of nasal cavity improving nasal obstruction in patients with structural variation]

Objective:To explore the long-term effect of rhinoplasty of nasal cavity improving nasal obstruction in patients with structural variation. Method:One hundred and six patients with structural rhinitis included this study whose assessment of nasal obstruction were achieved by visual analogue scale(VAS), and were divided into two groups: group1(n=56,VAS score >5), group 2(n=48,VAS score <5).They were measured by rhinomanometry and acoustic rhinometry recording the minimum cross-sectional area of nasal cavity(MCA), the distances from the nostrils(MD) and the nasal volume of 5 cm,2-5 cm,5-7 cm from the nostril(V5,V2-5,V5-7),then we calculated the ratio of the parameters of the two sides of the nasal cavity respectively, recorded nasal resistance and calculated Rlr. All patients were performed endoscopic rhinoplasty of nasal cavity and re-evaluated one-year later. Two groups were compared with statistical test.Result: The symptoms of twogroup patients improved satisfactorily after surgery. VAS scores and ratio of pre-operation of two groups had statistical differences except MD,V5-7,and group1 had more structural abnormalities compared with group 2.VAS scores and ratio of pre- and post-operation of group1 had statistically difference. Conclusion:Severity of nasal obstruction is related to structural variation of nasal cavity and the nasal plasty has certain clinical application value as its good long-term curative effects,the purpose of surgery is to restore symmetry of nasal cavity.

[Rosenmüller valve during endoscopic dacryocystorhinostomy in treating refractory nasolacrimal duct obstruction]

OBJECTIVE

The objective of this study was to assess the efficacy of exposing Rosenmüller valve during endonasal endoscopic dacryocystorhinostomy (EES-DCR) in treating refractory nasolacrimal duct obstruction.

METHODS

Thirty six patients (47 eyes) with refractory nasolacrimal duct obstruction were entered into this study, including 13 patients (15 eyes) underwent nasal lacrimal duct intubation before, 18 patients (26 eyes) with small lacrimal sac, 2 patients underwent DCR before, 1 patient with functional nasal lacrimal duct obstruction, 1 patient with lacrimal mucocele, 1 patient with nasal trauma. During the DCR, the bone window was enlarged as wide as possible and the valve of Rosenmüller was exposed. The intubation of the lacrimal apparatus was performed if the lacrimal sac was very small and the Rosenmüller valve was tight. Functional endoscopic sinus surgery and septoplasty were performed simultaneously if necessary. Postoperatively, each patient was assessed by the symptom and nasal endoscopy.

RESULTS

The postoperative follow-up period ranged from 3 to 36 months. Thirty two patients(89.4%, 42/47 eyes) were cured, which presented as the disappearance of symptoms, the patency of the lacrimal ostium and the lacrimal duct irrigation was clear. One patient (2.1%, 1/47 eyes) was improved, which presented as the improvement of symptoms, a few hypertrophic scar around the lacrimal ostium and the lacrimal duct irrigation was clear. Four cases failed (8.5%, 4/47), which presented as symptomatic and obstruction of the lacrimal ostium. The total effective rate reached to 91.5%. No serious postoperative complications were found in all cases.

CONCLUSIONS

To expose Rosenmüller valve during endoscopic DCR in treating patients with refractory nasolacrimal duct obstruction could obviously increase the operative success rate, fewer complications, with no facial surgical scar. It is an ideal way to treat the refractory nasolacrimal duct obstruction.

Effect of inhaled MgSO4 on FEV1 and PEF in children with asthma induced by acetylcholine: a randomized controlled clinical trail of 330 cases

OBJECTIVES

To determine the response of nebulized magnesium sulfate on the lung function of acetylcholine-induced asthma children.

METHODS

Three hundred and thirty children of asthma with positive bronchial provocation test were randomly divided into three groups: magnesium sulfate, albuterol, and a combination of magnesium sulfate and albuterol. Lung function was compared between the three groups.

RESULTS

Forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) as percentage over predicted at 10 min and 20 min in albuterol and combination group were significantly improved when compared to magnesium group. The changes in FEV1 and PEF expressed as absolute and percentage over predicted was not statistically significant from baseline to 20 min in magnesium, albuterol, and combination of magnesium sulfate and albuterol. There was no significant adverse effect observed during the present study.

CONCLUSION

Nebulized magnesium sulfate alone has a bronchodilatory effect in Ach-induced asthmatic children. The combination of MgSO4 and albuterol did not has a synergistic effect.

Electron microscopic examination of the viromatrix of Rana grylio virus in a fish cell line

Rana grylio virus (RGV), a Ranavirus belonging to the family Iridoviridae, assembles in the viromatrix which is a factory for viral genome replication and particle assembly. Ultrastructural studies of the viromatrix will clarify the pathway of assembly. The viromatrix and quantitative changes in RGV infected epithelipma papulosum cyprini (EPC) cells, one of fish cell lines, were studied by electron microscopy. It was shown that viromatrices were adjacent to the nucleus, and the electron density was lower than that of the surrounding cytoplasm. The viromatrix contained virus particles with different forms, electron-dense materials and amorphous structures which included tubules and membranous materials. Tubules were often observed in direct continuity with empty capsids. Several bundles of intermediate filaments were seen alongside the viromatrix and crystalline aggregates. Large clusters of mitochondria occurred in proximity to viromatrix. A total of 990 cells profiles were examined. The results showed that 394 cells contained viromatrix: 89.3% contained one, and 10.7% contained two to four viromatrices. The number of viromatrices increased gradually and reached a peak at 16 h p.i. The viromatrix area at 24 h p.i. increased up to 7.4 +/- 0.69 microm(2) which was three-times lower than that at 6 h p.i. The number of empty capsids within viromatrix was generally more than that of "full" particles at different time points, and there was a strong positive correlation between them.

Gene therapy for Parkinson's disease: recent achievements and remaining challenges

Gene therapy is the use of nucleic acids as drugs. Thus, ways had to be developed to deliver this new generation of drugs to target tissues. Various viral and non-viral vectors have been engineered to carry potentially therapeutic nucleic acids into diseased organs or target cells. The brain offers a particular challenge for gene delivery to its constituent cells: it is encased by the skull, separated from the general circulation by the blood brain barrier, and made up of mostly non-dividing cells. The skull limits direct injection of vectors into the brain, the blood brain barrier inhibits the easy entry of vectors injected into the bloodstream, and post mitotic target cells restrict what type of vector can be used to deliver genes to the brain. We will discuss the main challenges faced by gene delivery to the brain, i.e. immune responses to the delivery vectors and therapeutic transgenes and length of duration of the therapy specifically as applied to Parkinson's disease. We will also discuss therapeutic strategies, which could be implemented to treat Parkinson's disease, and the models in which they have been tested.

[Intranasal endoscopic treatment of chronic sinusitis in children]

OBJECTIVE

To explore the curative effect of endoscopic sinus surgery (ESS) and the factors associated with surgery effect for treating children with chronic sinusitis.

METHOD

Thirty-one children with a median age of 10 years (range 5-14 years) who suffered from chronic sinusitis or/and nasal polyps and were operated via ESS from May 1996 to January 1999 were retrospectively analyzed.

RESULT

According to the therapeutic evaluation standard (ESS-1997, Haikou), twelve cases (38.7%) were completely cured, fifteen cases (48.4%) were improved and four children (12.9%) showed no change with a general effective rate of 87.1% without any severe operative complication.

CONCLUSION

The results suggested ESS is a safe and effective method in the treatment of children with chronic sinusitis or/and nasal polyps. Furthermore, meticulous postoperative endoscopic care and medication are also important for securing optimal long-term results.

[Distribution, content and action site of leucine-enkephalin in pulmonary artery wall of rat and rabbit]

Using immunohistochemical method to investigate the distribution of peptidergic fibers in the pulmonary artery wall of SD rat, L-enkephalin immunoreactive (L-ENK ir) fibers were easily demonstrated. The contents of L-ENK in pulmonary artery of rat and rabbit measured by radioimmunoassay were respectively 439.18 +/- 30.52 and 29.9 +/- 1.4 (pg/mg of wct tissue). Contraction of superfused strips of pulmonary artery of rabbit could be evoked by parameter I electric field stimulation. The response was blocked by alpha-receptor antagonist phentolamine. Alpha 2-receptor antagonist Yohimbine enhanced the response in small doses (0.06-0.12 mumol/L), while inhibited in large (3.2 mumol/L). The contraction could also be enhanced when the artery strips were preincubated with naloxone. After the alpha-receptors were blocked with phentolamine, stronger contraction could still be evoked by parameter II electric field stimulation and the response was not affected by naloxone. L-ENK had no effect on the contraction evoked by exogenous NE. The present experiments demonstrate that enkephalin presented in the pulmonary artery wall are released by electric field stimulation. Enkephalin may reduce the release of NE from sympathetic nerve endings via opioid receptors and inhibit the contraction response.