[Current issues for treating laryngotracheal diseases].
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Humans↗
Biomedical subjects
Shui-fang Xiao
Publications and source records attributed to Shui-fang Xiao.
[Percutaneous dilational tracheostomy].
OBJECTIVE: To describe and introduce a new technique for percutaneous dilational tracheostomy without the aid of a bronchoscope. METHODS: Ten patients who underwent rotating dilation tracheostomy with percutwist set were prospectively studied. The time needed for the procedure, the grading of the difficulty, the amount of bleeding, and the complications for the procedure were evaluated. All procedures were performed without the aid of a bronchoscope. RESULTS: During the operations, blood pressure, ECG parameters were stable. One patient had short period of intraoperative oxygen desaturation. The mean operating time was 6.2 minutes with a range of 3 to 10 minutes. Eight procedures were performed without any difficulty, 2 procedures were performed with some difficulties which could be managed by the surgeon. Six patients had been examined under fibrobronchoscopy within one week postoperatively, no posterior tracheal wall injuries were found. One patient had peristomal bleeding after the operation, one patient had mild infection of the tracheostoma. There were no life threatening complications attributable to this technique. CONCLUSIONS: Controlled rotating dilation is a simple, rapid and safe bedside procedure. In the absence of bronchoscopic guidance, the procedure can be safely performed with precautions.
Aged↗
[Expression of adrenomedullin in the tissue with laryngeal carcinoma].
OBJECTIVE: To observe the expression of adrenomedullin (AM) in the patients with laryngeal carcinoma. METHODS: Two-step immunohistochemistry method was used to examine the expression of AM in the patients with laryngeal carcinoma. Radioimmunoassay was applied to determine the concentration of AM in the laryngeal carcinoma tissues, adjacent laryngeal mucosa of carcinoma tissues and in the plasma of patients and controls. RESULTS: Positive stainings for AM were found in all 21 specimen examined,distributed mainly in the cytoplasm of the laryngeal carcinoma cells. Positive stainings were more stronger in the circumference than in the center of tumor tissue for the highly and moderately differentiated tumors. While the stainings were distributed homogeneously for poorly and moderately differentiated tumors. The concentration of AM in the laryngeal carcinoma tissues (n = 44) and the adjacent mucosa (n = 44) were (49.67 +/- 28.33) pg/ml and (14.71 +/- 7.17) pg/ml (x +/- s) respectively and laryngeal tumor showed much higher concentration of AM than the adjacent mucosa (u = 135.00, P < 0.01). The concentration of AM in patients with laryngeal carcinoma of T2, T3 and T4 stage were (31.52 +/- 15.22), (56.63 +/- 18.51) and (96.12 +/- 18.22) pg/ml (x + s) respectively,and there were statistically significant difference among them. In the N stage, patients with higher stages were found to express significantly higher AM concentration, but there was not statistically significant difference between NO stage and N1 stage. In the M stage,patients with M1 stage were found to express significantly higher AM concentration (u = 31.00, P < 0.01). But there was not statistically significant difference between AM plasma concentration of laryngeal carcinoma patients and that of healthy controls. CONCLUSIONS: The results suggested that high expression of AM in tissues of laryngeal carcinoma was related with the TNM stage of laryngeal carcinoma, AM may play an important role in the development of the laryngeal neoplasma.
Adrenomedullin↗
[Heterogeneous mutations of Wolfram syndrome I gene responsible for low frequency nonsyndromic hearing loss].
OBJECTIVE: To explore the mutations of Wolfram syndrome I gene (WFS1) in families affected by non-syndromic low frequency sensorineural hearing loss (NS-LFSNHL). METHODS: Twenty eight individuals from 6 pedigrees with hereditary non-syndromic low frequency sensorineural hearing loss as a dominant trait and cases of control were collected in the present study. The coding sequence of WFS1 gene was amplified by polymerase chain reaction (PCR), and direct DNA sequencing was performed to screen the entire coding region of the WFS1 gene for mutations in the WFS1. RESULTS: Three heterozygous missense mutations (2016 G-->T, 2379 G-->4A, 2766 G-->A) in the WFS1 gene were found in two families. Mutations in WFS1 were identified in all patients tested of the two pedigrees. None of the mutations was found in at least 280 control chromosomes and normal individuals of the families. These missense mutations affecting conserved amino acids in two pedigrees. CONCLUSIONS: Mutations in WFS1 are one of causes of non-syndromic low frequency sensorineural hearing loss, and the majority of mutations are missense mutations. Genetic counseling and genetic testing may be useful in the management of patients with this type of hearing loss.
Adolescent↗
[Reporter genes transfer into human squamous cell carcinoma of larynx factor receptor mediated non-viral GE7 polypeptide delivery system with a new epidermal growth].
OBJECTIVE: To evaluate the efficiency of marker gene and reporter gene transfection into human squamous cell carcinoma of larynx implanted in nude mice with a new EGFR mediated non-viral polypeptide gene delivery system. METHODS: Labeled streptavidin biotin (LSAB) was applied to examine over-expression of epidermal growth factor receptor (EGFR) on the squamous cell carcinoma of larynx. The complex of marker gene or reporter gene and gene delivery system was prepared and subsequently inoculated with Hep 2 cells or injected into laryngeal carcinoma implanted on nude mice. RESULTS: Over-expression of EGFR was observed on inoculated Hep 2 cells and on 65% of laryngeal carcinoma specimen examined (15/23). Positive staining was located on the surface of the cells and some of them in the cytoplasma. Green fluorescence was observed on Hep 2 cells under fluorescent microscope 48 hrs after PEGFP-C1 gene transfection and became the strongest 72 hrs after transfection. The rate of transfection was 80% (78/97). Blue staining was noticed 12 hrs after beta-gal gene transfer and it became more remarkable 24 hrs after gene transfection with X-gal staining on the implanted human laryngeal carcinoma on nude mice. CONCLUSIONS: Squamous cell carcinoma of head and neck over-expressed EGFR and a non-viral GE7 polypeptide gene delivery system could transfer exogenous genes into laryngeal carcinoma cells and tissues with high efficiency and targeting both in vitro and in vivo suggesting that GE7 would be applicable as a new targeted, high efficient gene delivery system to the gene therapy of squamous cell carcinoma of head and neck.
Animals↗
[Effect of immunotherapy on house dust mite allergen-specific IgG1 and igG4 antibodies in nasal secretion for patients with perennial allergic rhinitis].
OBJECTIVE: To investigate the effect of immunotherapy on allergen-specific IgG1 and IgG4 in nasal secretion for patients with nasal allergy. METHODS: Nasal secretion was collected with suction from normal subjects, patients with allergic rhinitis untreated and treated with immunotherapy. Indirect, non-competitive streptavidin-biotin ELISA was applied to analyze allergen-specific IgG1 and IgG4 in nasal secretion. RESULTS: Patients with nasal allergy both treated and untreated showed a higher concentration of IgG1 and IgG4 (Z = -3.623, -3.061, P < 0.01, respectively), treated group showed higher concentration of IgG1 and IgG4 than untreated group (Z = -2.453, -3.408, P < 0.01, respectively). IgG4 antibody specific to purified allergen Der f I in the treated group was higher than normal subjects (Z = -3.518, P < 0.01), both IgG1 and IgG4 antibodies specific to purified allergen Der f II in treated group were higher than normal subjects (Z = -2.366, -2.936, P < 0.01, respectively) and than untreated group (Z = -2.366, -2.937, P < 0.01, respectively). In the IgG subclasses of IgG1 and IgG4, there was positive correlation among crude mite extract, Der f I and Der f II. There was a positive correlation between IgG1 and IgG4 for all 3 kinds of allergens. There was a positive correlation between IgG1 in the nasal secretion and IgE in the serum and between IgG4 in the nasal secretion and IgE in the serum for crude mite extract. CONCLUSIONS: Patients with nasal allergy showed higher responsiveness to natural allergen exposure and produced higher level of IgG1 and IgG4 antibodies to specific allergens. Immunotherapy increased the concentration of IgG1 and IgG4 antibody in the nasal secretion, which might function as a blocking antibody to specific allergen.
Adult↗
[Treatment of severe subglottic laryngotracheal stenosis using hyoid graft with sternohyoid muscle flap].
OBJECTIVE: To evaluate the possibility and reliability of the hyoid-sternohyoid graft transfer in the correction of server subglottic laryngotracheal stenosis, and delineate the operation skills and clinical results. METHODS: Seven patients with severe subglottic stenosis underwent laryngotracheal reconstruction using the hyoid grafts with sternohyoid muscle flaps (HG-SHMF). Five of these patients had traumatic subglottic stenosis, one with scar tissue of unknown etiology arising in the subglottic region, another with tracheal narrowing caused by inhalation of hydrochloric acid. RESULTS: All seven patients were successfully decannulated with moderate good voice. The average time from reconstruction to decannulation was 15.4 months. The stent was endoscopically removed with a range of 3 to 22 months; the mean time required for stenting was 9.6 months. Two patients who received additional salvage reconstruction procedures because of graft or stent displacement were extubated with improved voices and satisfactory airway. CONCLUSIONS: The HG-SHMF transfer was a single-stage reconstruction, relatively simple procedure that can restore an adequate airway and a good voice. Patients undergoing laryngotracheal reconstruction with HG-SHMF must have regular, long-term follow-up since graft displacement and recurrent granulation tissue or scar reformation can cause restenosis after an initially successful surgery. This procedure should be used in a large number of patients to further test its reliability.
Adolescent↗
[CO2 laser endoscopic subtotal arytenoidectomy for bilateral median vocal cord paralysis].
OBJECTIVE: To delineate the surgical procedures and correlated techniques for endoscopic subtotal arytenoidectomy, as well as to discuss their applications and clinical outcomes. METHODS: CO2 Laser endoscopic unilateral arytenoidectomy was performed in eight cases of bilateral median vocal cord paralysis combined with one stage of mucosal micro-anastomosis. All patients suffered from dyspnea in some extent, of which 5 had the history of thyroidectomy and 2 had traumatic causes following esophagectomy and tracheal surgery respectively. One of patient had unknown cause. Six patients had undergone tracheotomy prior to operation or before their referral to our hospital. The airway was evaluated via fibro-optic laryngoscopy, and the voice quality was assessed subjectively by the patients and the surgeon before and after surgery. RESULTS: Following 5-43 months after the surgery, in all cases the function of airway as well as the acceptable voice quality was successfully restored. The tracheotomy done before operation in six patients was decannulated within the mean time of 44.2 days post-operation. CONCLUSION: The endoscopic approach for CO2 laser unilateral arytenoidectomy may lead to better restoration of an adequate airway and satisfying phonation without postoperative aspiration. Mucosal micro-anastomosis can prevent the formation of granulation or scar tissue thus promotes the healing processes. This procedure is simpler than other ordinary surgical methods, and could be a satisfactory alternation of treatment for bilateral median vocal cord paralysis.
Aged↗