The Possible Role of Sclerostin in the Pathogenesis of Tympanosclerosis.

OBJECTIVE: The aim of this study was to investigate sclerostin (SOST) expression in a rat model of experimental tympanosclerosis (TS) and its possible role in the formation of TS. MATERIALS AND METHODS: Thirty-four SD rats were randomly divided into 2 groups: experimental group (n = 17) and normal group (n = 17). The left tympanic cavities in the experimental group were inoculated with methicillin-resistant Staphylococcus aureus. The changes of tympanic membranes were examined and recorded under otoendoscope. Haematoxylin-eosin staining was adopted to detect the morphological changes in the tympanic membrane and middle ear mucosa. Immunohistochemistry and Western blot analysis were used to observe the expression of SOST, Wnt3a, ß-catenin, and P-ERK1/2. RESULTS: In the experimental group, sclerotic lesions were observed in 54.5% ears in the end of 6 weeks. Morphological changes such as mucosa incrassation, inflammatory cells infiltration, fibrous tissue proliferation, and interstitial tissue incrassation prominently appeared in the tympanic membrane and middle ear mucosa. SOST protein was mainly distributed in the cytoplasm of epithelial cells and gland cells, the expression of which increased significantly in the calcified experimental ears. In addition, expression levels of Wnt3a, ß-catenin, and P-ERK1/2 increased significantly in the calcified group too. CONCLUSION: The upregulated expression level of SOST may be involved in the formation of TS, first, through the pro-phosphorylation of ERK1/2 in the inflammatory stage, and then through the enhancement of Wnt3a in the osteogenic stage.

The Issue of Recurrently Positive Patients Who Recovered From COVID-19 According to the Current Discharge Criteria: Investigation of Patients from Multiple Medical Institutions in Wuhan, China.

The current discharge criteria for COVID-19 require that patients have 2 consecutive negative results for reverse transcription polymerase chain reaction (RT-PCR) detection. Here, we observed that recurrent positive RT-PCR test results in patients with 3 consecutive negative results (5.4%) were significantly decreased compared with those in patients with 2 consecutive negative results (20.6%); such patients reported positive RT-PCR test results within 1 to 12 days after meeting the discharge criteria. These results confirmed that many recovered patients could show a positive RT-PCR test result, and most of these patients could be identified by an additional RT-PCR test prior to discharge.

The activation and function of IL-36γ in neutrophilic inflammation in chronic rhinosinusitis.

BACKGROUND: Although increased accumulation of neutrophils has been noted in chronic rhinosinusitis (CRS), the function and regulation of neutrophils in CRS are largely unknown. IL-36 family cytokines may play an important role in neutrophilic inflammation. OBJECTIVE: This study sought to investigate the expression and function of IL-36 cytokines in CRS. METHODS: Quantitative RT-PCR, immunohistochemistry, immunofluorescence, and ELISA were used to investigate the expression of IL-36 cytokines and IL-36 receptor (IL-36R) in sinonasal mucosa. The expression of IL-36R on neutrophils in polyps and blood was measured by flow cytometry. Purified blood neutrophils were cultured to investigate the regulation of IL-36R expression. The cleavage of IL-36γ was detected by Western blotting. Dispersed nasal polyp cells were treated with IL-36γ with or without elastase inhibitor and dexamethasone. RESULTS: Neutrophil infiltration and expression of IL-36 cytokines and IL-36R were upregulated in both CRS with and without nasal polyps. IL-36γ was the most abundant isoform and mainly expressed by epithelial cells in CRS. Neutrophils were the principal IL-36R+ cell type in polyps. IL-36R expression was almost absent in blood neutrophils and upregulated by IL-6, IL-1ß, and Dermatophagoides pteronyssinus group 1. Elastase activity was increased in polyps and degraded full-length IL-36γ. Consistently, the levels of cleaved IL-36γ were increased in polyps. Full-length IL-36γ promoted the production of matrix metalloproteinase 9; IL-17A; and chemokine (C-X-C motif) ligands 1, 2, and 8 from dispersed nasal polyp cells, which was abolished by elastase inhibitor. The proinflammatory effect of IL-36γ was not suppressed by dexamethasone. CONCLUSIONS: Increased production and activation of IL-36γ may act on neutrophils and further exaggerate neutrophilic inflammation in CRS.

SP1-induced AFAP1-AS1 contributes to proliferation and invasion by regulating miR-497-5p/CELF1 pathway in nasopharyngeal carcinoma.

Nasopharyngeal carcinoma is a type of otolaryngological malignancy with high incidence. Long non-coding RNAs (lncRNAs) are closely related to nasopharyngeal carcinoma. LncRNA AFAP1-AS1 (AFAP1-AS1) has been found to play important roles in nasopharyngeal carcinoma progression and poor prognosis. However, the mechanism underlying AFAP1-AS1 in regulating nasopharyngeal carcinoma is still unclear. In current study, AFAP1-AS1 was found to be up-regulated in nasopharyngeal carcinoma tissues and cells. AFAP1-AS1 overexpression and knockdown were conducted in nasopharyngeal carcinoma cells. The results proved that AFAP1-AS1 promoted the survival and migration of nasopharyngeal carcinoma cells. Additionally, specificity protein 1 (SP1) was enhanced in nasopharyngeal carcinoma tissues and cells, and induced AFAP1-AS1 expression. The interaction between AFAP1-AS1 and miR-497-5p was confirmed. AFAP1-AS1 was demonstrated to regulate CELF1, a target gene of miR-497-5p. Further functional analysis revealed that AFAP1-AS1 knockdown attenuated SP1-induced nasopharyngeal carcinoma progression. These results indicate that SP1-induced AFAP1-AS1 facilitates nasopharyngeal carcinoma progression by regulating miR-497-5p/CELF1 pathway, which provides a new target for nasopharyngeal carcinoma treatment.

Factors affecting recurrent positive RT-PCR results in clinically cured COVID-19 patients: a multicenter study.

The aim of this study was to evaluate factors affecting the recurrence of positive RT-PCR results. By performing a retrospective analysis, we evaluated the clinical data of recurrent positive coronavirus disease 2019 (COVID-19) patients in multiple medical institutions in Wuhan. We recruited COVID-19 patients who were hospitalized from January 1 to March 10, 2020, in three tertiary hospitals in Wuhan, met the discharge criteria and received at least one additional nucleic acid test before leaving the hospital. According to the RT-PCR results, patients were split into a recurrent positive group (RPos group) and a nonrecurrent positive group (non-RPos group). Clinical characteristics, therapeutic schedules and antibody titers were compared between the two groups. AI-assisted chest high-resolution computed tomography (HRCT) technology was applied to investigate pulmonary inflammatory exudation and compare the extent of lung areas with different densities. This study involved 122 COVID-19 patients. There were no significant differences in age, sex, preexisting diseases, clinical symptoms, clinical classification, course of disease, therapeutic schedules or serum-specific antibodies between the two groups. A higher proportion of patients who showed pulmonary inflammatory exudation on HRCT scans were recurrent positive at the time of discharge than other patients (81.6% vs 13.7%, P < 0.01). In addition, the degree of pulmonary fibrosis was higher in the RPos group than in the non-RPos group (P < 0.05). Subpleural exudation at the peripheral edge of the lung and extensive pulmonary fibrosis at the time of discharge represent risk factors for the recurrence of COVID-19.

The association between vitamin deficiency and otolaryngologic diseases: A therapeutic target.

Vitamins are indispensable nutrients for metabolism. Adequate vitamin intake plays vital role in physiological processes including embryonic development, cellular and immunity proliferation and differentiation, DNA synthesis and oxidative response. In contrast, insufficient vitamin levels usually lead to a large number of clinical manifestations including xerophthalmia, nyctalopia, hyperpigmentation, vitiligo, jaundice, megaloblastic anemia, glossitis, scurvy, stroke, cancer, coronary heart disease, Alzheimer's disease, multiple sclerosis and Parkinson's disease. In recent years, more and more researches have focused on the relationship between vitamin family and otorhinolaryngologic diseases. This review will summarize the current knowledge of vitamin family and vitamin-mediated regulating role in those related otorhinolaryngologic diseases.

Let-7a microRNA functions as a potential tumor suppressor in human laryngeal cancer.

MicroRNAs (miRNAs) are endogenously expressed non-coding RNAs, which are involved in the gene expression regulation. Lethal-7a (let-7a) is a founding member of miRNA family and recently it was found to be associated with several cancers, such as lung and colon cancers. In the present study, we found that let-7a miRNA expression was significantly downregulated both in human laryngeal squamous cancer tissues and in Hep-2 cells, a laryngeal cancer cell line, as compared with adjacent normal tissues and BEAS-2B cells, respectively. Moreover, we found that let-7a expression levels were significantly further decreased in non-differentiated (G3) cancer tissues as compared with moderately and well differentiated cancer tissues (G2 and G1), although no significant difference in let-7a expression levels between the cancer specimens with different T stages or specimens from patients with different lymph node metastasis status was revealed. In Hep-2 cells, let-7a mimics transfection markedly suppressed proliferation and induced apoptosis of Hep-2 cells under the treatment of diamminedichloroplatinum or not and downregulated RAS and c-MYC protein expression without affecting the mRNA levels. In parallel, RAS and c-MYC protein levels were found significantly upregulated only in cancer tissues with downregulated let-7a expression. Thus, we propose that let-7a may be a tumor suppressor in laryngeal cancer by inhibiting cell growth, inducing cell apoptosis and downregulating the oncogenes expression.

Carbon Dioxide Laser Microsurgery versus Low-Temperature Plasma Radiofrequency Ablation for T1a Glottic Cancer: A Single-Blind Randomized Clinical Trial.

BACKGROUND: Very few studies have been conducted to compare carbon dioxide laser microsurgery (CO2-LS) with low-temperature plasma radiofrequency ablation (LTP-RFA) in treating T1a glottic cancer. Therefore, we conducted this study to compare the efficacy of CO2-LS and LTP-RFA to define a superior therapeutic modality for T1a glottic cancer. METHODS: Patients (n=131) with T1a glottic cancer were recruited between January 2010 and September 2014. The included patients were randomly assigned to either receive CO2-LS (n=65) or LTP-RFA (n=66). We conducted the following multidimensional vocal assessments: (i) videostroboscopic evaluation; (ii) auditory-perceptual evaluation; (iii) aerodynamics/ efficiency; (iv) acoustics; and (v) self-assessment questionnaires. Meanwhile, the surgery time and three-year overall survival rates in two groups were recorded. The predefined primary endpoint was overall survival, and the minimum follow-up time was set to six months. RESULTS: After treatment, we found that the structure and vibration of vocal cord might recover more quickly in patients receiving LTP-RFA than in patients receiving CO2-LS, and moreover, the patients in the LTP-RFA group had the better vocal functions. Meanwhile, the surgery time was significantly less in the LTP-RFA group (8.83±1.59 minutes) than in the CO2-LS group (12.49±1.40 minutes) (p<0.00001). In addition, the two intervention methods had the similar three-year overall survival rates (94% versus 96%, p=0.58). CONCLUSION: These results indicated that both LTP-RFA and CO2-LS could effectively treat T1a glottic cancer, and LTP-RFA might have some advantages in voice function. Limited by the relatively small sample size, future studies were needed to validate our conclusion.

[Experimental studies for botulinum toxin type A to antagonist the VIP/PACAP expression on nasal mucosa in allergic rhinitis rat].

OBJECTIVE: To explore the expression and significance of vasoactive intestinal peptide and Pituitary adenylate cyclase activiting polypeptide (VIP/PACAP) of nasal mucosa in rats with allergic rhinitis (AR), and the function of botulinum toxin-A(BTX-A) to inhibit the expression of VIP/PACAP in AR. METHOD: Thirty Sprague-Dawley rats were randomly divided into 3 groups, which were the AR group, the intervention group, and the control group. In the AR group, ovalbumin was used to sensitize healthy rats. In the intervention group, BTX-A was dripped into the nasal cavity of AR rats 7 times. In the control group, only physiological saline was used to drip into the nasal cavity of AR rats. Changes of the rats' behavior were observed. ELISA were used to detected the concentration variation of serum IFN-γ and IL-4. Histopathology and immunohistochemistry were employed to observe morphology in the rats' nasal mucosal and the expression of VIP/PACAP. Statistical analysis was also made. RESULT: (1)The typical symptoms marks of nasal scratching, sneezing, nasal blockage and rhinorrhea of AR group (7.5 ± 0.50) were higher than intervention group (1 ± 0.27) and control group (0.8 ± 0.31). (2) Comparing to intervention group and control group, the serm IFN-γ of the AR group obvious reduced (P < 0.05), the serm IL-4 of the AR group obvious rose (P < 0.01), and the serm Th1/Th2 (IFN-γ/IL-4) of the AR group obvious reduced (P < 0.01). (3) Comparing to intervention group and control group, the cilium loss, inflammatory cells infiltration, and inflammatory cells exudation of nasal mucosa in AR group were more obviously (P < 0.01), and the intervention group of the 3 indexes was obviously than control group. (4) The expression of VIP in the rats' nasal mucosa of the AR group (13.27 ± 2.74) were more intense than intervention group (5.21 ± 2.18) and control group (3.56 ± 5.30) (P < 0.01), and the expression of PACAP in the rats' nasal mucosa of the AR group (20.97 ± 2.14) were more intense than intervention group (6.33 ± 3.04) and control group (4.63 ± 1.25) (P < 0.01). (5) In all the 3 groups, there was positive correlation between expression of negative in VIP/PACAP and Thl/Th2 cell infiltration(r were respectively -0.340 and -0.223, P < 0.05). CONCLUSION: The VIP/PACAP in the rats' nasal mucosa may play an important role in pathogenesis of AR, and BTX-A could improve the symptoms of AR through inhibition of the expression of VIP/ PACAP.

[The experimental study on repair of noise-induced hearing loss in guinea pigs by bone marrow NTCSCs transplantation].

OBJECTIVE: To observe the repairing effects of bone marrow transplantation with nerve tissue committed stem cell (NTCSCs) on experimental rats with injury of noise-induced hearing loss. METHOD: Guinea pigs were randomly divided into control group, noise exposure group and the transplanting group. A week after white noise exposure of 110 dB, NTCSCs and PBS were injected into guinea pigs of the noise exposure group and the transplanting group respectively. One week after noise exposure to four weeks continuous administration. ABR thresholds were measured respectively prior to the experiment, 1 week post-noise,1, 2 and 4 weeks post-drugs, The changes of cochlea hair cells were also observed by a scan electron microscope (SEM). RESULT: The ABR threshold shifts in the transplanting group were significantly fewer than that in the noise exposure group. SEM showed that hear hair of the inner and outer hair cells in noise exposure group displayed mess, fusion and imperfections. In the transplanting treatment group, the hair cells displayed slight pathological changes, there wasn't significant differents comparied with normal group. The number of OHCs were relatively stable in the normal group, while the obvious OHC loss was observed in other groups. There was significant difference among the three groups, however, the OHC loss in the transplanting group was no significantly different to that in the noise exposure (P > 0.05). CONCLUSION: The bone marrow NTCSCs which had been transplanted to rat cochlea could reduce the damage of the noise on the hair cell, and thus played a role in repairing the damage of auditory nerve.

[Correlative study of the metabolic disorder of hippocampus and cerebral cortex and cognitive impairment in moderate to severe OSAHS patients].

OBJECTIVE: To research the serum levels of BDNF, H2S and S-100ß as metabolic product of hippocampus and cerebral cortex in moderate to severe obstructive sleep apnea hypopnea syndrome(OSAHS) patients before and after surgery, and to analyze their correlations with cognitive impairment. METHOD: Forty-four randomly selected diagnosed OSAHS patients were divided into two groups according to Montreal Cognitive Assessment (MoCA), 19 cases in cognitively normal group and 25 cases in cognitive dysfunction group. Cases in cognitive dysfunction group underwent UPPP oriented surgery, and received 6 months follow-up, 21 cases were remained as treament group, 4 cases lost. 19 cases of healthy subjects were randomly selected as the normal control group. All groups were detected for the serum BDNF, H2S and S-100ß levels to analyze the correlations between the biochemical indexes and sleep disorders indexes, hypoxia levels and cognitive function scores. RESULT: (1) In the comparison between the treatment group and the normal control group regarding PSG monitoring results, the AHI, I + II, LA/HT and SLT90% indexes of OSAHS patients increased, and the III + IV phase, REM phase, MSaO2 and LSaO2 decreased. In the comparison between the cognitive dysfunction group and the cognitively normal group, the III + IV, REM and LSaO2 indexes of the cognitive dysfunction group decreased. (2) In the comparison between cognitive dysfunction group and cognitively normal group, and between the treatment group and the normal control group, BDNF and H2S levels increased and S-100ß levels decreased, and the MoCA total scores, attention, memory/delayed recall scores decreased. (3) The correlation between biochemical indexes with PSG indexes was as follows. The serum BNDF and H2S levels were negatively correlated with AHI index. The serum BNDF and H2S levels were positively correlated with III + IV stage, REM stage and MSaO2 indexes. The S-100ß level was positively correlated with AHI index, and S-100ß levels were negatively correlated with III + IV stage, REM stage, MSaO2 and LSaO2 indexes. (4) The correlation between biochemical indexes and MoCA scores was as follows. The serum BNDF and H2S levels were positively correlated with MoCA total scores, attention, and memory/delayed recall scores. The serum S-100ß levels were negatively correlated with MoCA total scores, attention and memory/ delayed recall scores. (5) The linear regression equation between MoCA total scores in cognitive dysfunction group of OSAHS patients and the serum BNDF, H2S and S-100ß levels was as follows: Y(MoCA) = 40.131 + 0.22 X(BDNF) + 0.012 X(H2S)-0.647X(S-100ß) (R2 = 0.461). CONCLUSION: OSAHS patients with sleep disorder and nocturnal hypoxemia might suffer from cognitive dysfunction in which attention and memory predominates. Serum BNDF, H2S and S-100ß levels, which could indirectly reflect the metabolic abnormalities degree of hippocampus and cerebral cortex, are sensitive indicators of early cognitive dysfunction in OSAHS patients.

Comparison of CO2 laser and conventional laryngomicrosurgery treatments of polyp and leukoplakia of the vocal fold.

The efficacies of CO2 laser and conventional laryngeal microsurgery for vocal cord benign (vocal cord polyp) and precancerous (vocal cord leukoplakia) lesions were compared. Patients with bilateral vocal cord polyps (n = 60) and leukoplakia (n = 30) were divided randomly into two groups. One group was treated with throat microsurgical instruments and underwent routine lesion resection (conventional group) and the other with CO2 laser (laser group). For the subjective assessment, the tools GRABS and VHI were used. The objective assessment, A multi-dimensional voice program module for voice spectrum analysis was used. The laser group was slightly worse than the conventional group 1 week post-surgery by stroboscopic findings. The subjective and objective data of the two groups pre-and post-surgery showed that the voice recovery of the laser group was significantly better than that of the conventional group (P < 0.05). CO2 laser laryngeal microsurgery for vocal cord polyp and leukoplakia can improve significantly the vocal cord morphology and pronunciation quality. The procedure is especially more effective than conventional surgery in patients with vocal cord leukoplakia.

[RAGE, NF-kappaB, p21 expressions in mouse spiral ganglion cells].

OBJECTIVE: To research advanced glycation end-product receptors (RAGE), NF-kappaB, p21 expressions in C57BL/6j mice cochlea spiral ganglion cells(SGC) ,and then to investigate the presbycusis pathogenesis. METHOD: To take C57BL/6J mice:2 month 25,and 10 month 25. Histological sections were observed the SGC. RAGE, NF-kappaB, p21 were immunohistochemical in the SGC,with IPP6 to IOD. RESULT: (1) The count SGCs of 10 month-old was obviously decreased comparing to 2 month-old, the count of 2 month SGC is 39 +/- 5, 10 month group is 20 +/- 6, P < 0.01; (2) RAGE, NF-kappaB, p21 expressed in spiral ganglion cell,different place with different age,and the means optical density in the 10 month are higher than the 2 month, respectively. The IOD of RAGE expression in 2 month SGC: 0.179 +/- 0.025, 10 month IOD: 0.308 +/- 0.050; The IOD of NF-kappaB expression in 2 month SGC: 0.181 +/- 0.045, 10 month IOD: 0.335 +/- 0.120; The IOD of p21 expression in 2 month SGC: 0.160 +/- 0.023, 10 month IOD: 0.365 +/- 0.031, compare with 2 group, respectively, P < 0.05, and the difference has statistics sense. CONCLUSION: RAGE,NF-kappaB, p21 expressions are in SGCs and increases with the aging of SGCs, suppose RAGE, NF-kappaB, p21 may participate in the process of presbycusis pathogenesis.

[Clinical analysis of 337 cases of chronic rhinosinusitis].

OBJECTIVE: To explore the clinical symptoms and signs situation of chronic rhinosinusitis, for future treatment provides the basis. METHOD: The clinical data of 337 patients with chronic sinusitis were analyzed, using SPSS 18.0 software and conducted Person chi-square test and Kruskal-Wallis test to analysis. RESULTS: VAS total score of chronic nasal sinusitis patients is 15.9 +/- 5.7. The three top of severe symptoms were: stuffy nose 56 cases (16.6%), nasal secretions or postnasal drip 23 cases (6.8%) and dizziness or headache 11 cases (3.3%), there are statistically significant differences (chi2 = 430.923, P < 0.01). Lund-Kennedy score found side with mucosa edema and secretion serious degree higher than nasal polyp, there are statistically significant difference (chi2 = 128.684, P < 0.01). Lund-Mackay score showed that the three top parts of all shadow were: maxillary sinus 314 side (46.6%), OMC 135 side (20.0%) and the former screen 112 side (16.6%), there are statistically significant differences between groups (chi2 = 803.274, P < 0.01). The pearson correlation coefficient r between VAS score and Lund-Kennedy score is 0.516, there are correlation (P < 0.05). VAS score and Lund-Mackay (r = 0.213), there are not correlation (P > 0.05). CONCLUSION: Comprehensive treatment should be proceeded according to different symptom severity and sinus lesions parts with patients, grasped the surgery procedures strictly, so as to improve the cure rate.

[Logistic regression analysis on influence factors of chronic sinusitis after endoscopic sinus surgery].

OBJECTIVE: To explore the clinical effect and the influence factors after endoscopic surgery for chronic sinusitis. METHODS: The clinical data of 337 patients with chronic sinusitis treated by endoscopic surgery were analyzed, including gender, age, culture level, course of the disease, the days of hospitalization, medical history, smoking, drinking, early surgery history, allergic rhinitis (AR) history, clinical classification, visual analogue scale (VAS) score, nasal endoscopy score, nasal polyps, CT examination score, side, nasal adhesion and postoperative follow-up compliance. The clinical effect of endoscopic sinus surgery was evaluated 6 months after operation according to the 1997 Haikou standard. SPSS 18.0 software and conducted chi-square test and logistic regression analysis were used to analyze the data. RESULTS: Three hundred and thirty-seven chronic sinusitis patients were followed up after endoscopic surgery. It was found that 298 cases (88.4%) cured, 29 cases (8.6%) improved, 10 cases (3.0%) invalid. The clinical curative effect of the patients with chronic rhinosinusitis without nasal polyp was better than that of the patients with chronic rhinosinusitis with nasal polyp, the difference was statistically significant (χ(2) = 10.932, P < 0.01). After many factors Logistic regression analysis, the most important effect factor in the clinical curative effect were clinical type, AR or not, VAS score, nasal endoscopic examination score, CT examination score, multiple nasal polyp or not, postoperative nasal adhesion or not and postoperative follow-up compliance. CONCLUSION: The clinical effective of endoscopic sinus surgery is influenced by not only surgery itself, but also by clinical classification, whether and not with AR and so on.

[Correlation analysis of subjective and objective scoring of chronic rhinosinusitis with nasal polyps].

OBJECTIVE: To explore the relationship of of subjective and objective scoring chronic rhinosinusitis with nasal polyps. METHODS: The clinical data of 159 patients with chronic rhinosinusitis were analyzed. SPSS 18.0 software was used to analyze the data. Pearson regression was used to analyze the relationship. RESULTS: The Pearson correlation coefficient r between VAS score (16.380 ± 5.809)and the whole discomfort (5.070 ± 1.361) was 0.710, there were correlation (P < 0.01). The Pearson correlation coefficient r between Lund-Kennedy score (3.724 ± 1.107) and Lund-Mackay score (5.983 ± 2.984) was 0.513, there were correlation (P < 0.01). The Pearson correlation coefficient r between VAS score and Lund-Kennedy score was 0.417, there were correlation (P < 0.05). VAS score had no correlation with Lund-Mackay(r = 0.113, P > 0.05). The whole discomfort had no correlation with Lund-Kennedy score and Lund-Mackay score (r value were 0.309 and 0.022, all P > 0.05). CONCLUSIONS: The subjective and objective score of chronic rhinosinusitis with nasal polyps were contradict sometimes.

Diagnostic significance of blood eosinophil count in eosinophilic chronic rhinosinusitis with nasal polyps in Chinese adults.

OBJECTIVES/HYPOTHESIS: Over half of chronic rhinosinusitis with nasal polyps (CRSwNP) patients in China show noneosinophilic inflammation. The aim of this study was to compare the clinical characteristics of eosinophilic and noneosinophilic CRSwNP and to identify the predictors of eosinophilic CRSwNP. STUDY DESIGN: A retrospective study. METHODS: There were 155 CRSwNP patients enrolled in the Tongji cohort. Eosinophilic CRSwNP was diagnosed according to our previously published histologic criterion. The demographic and clinical features were compared between eosinophilic and noneosinophilic CRSwNP. Factors associated with eosinophilic CRSwNP were determined with regression analysis, and optimal cutoff points of the predictors were determined by a receiver operating characteristic curve. The optimal cutoff points of the predictors were validated in an independent group of 35 CRSwNP patients referred to as the Taizhou cohort. RESULTS: A male preponderance, a higher prevalence of smoking and atopy, and higher peripheral blood eosinophil absolute count and percentage and blood IgE levels were found in eosinophilic CRSwNP compared with noneosinophilic CRSwNP. Peripheral eosinophil absolute count and percentage were independently and significantly associated with eosinophilic CRSwNP. An absolute blood eosinophil count ≥ 0.215 × 10(9) /L yielded a sensitivity of 74.2% and a specificity of 86.5%, and a blood eosinophil percentage ≥ 3.05% yielded a sensitivity of 80.3% and a specificity of 75.3% for the diagnosis of eosinophilic CRSwNP in the Tongji cohort. The validation study in the Taizhou cohort revealed a lower sensitivity and specificity. CONCLUSIONS: Eosinophilic and noneosinophilic CRSwNP displayed significant differences in certain clinical features. Peripheral blood eosinophil count could distinguish eosinophilic and noneosinophilic CRSwNP in Chinese adults.

[Expression of C-erbB-2 and EGFR expression and its relationship with cell proliferation in nasopharyngeal carcinoma].

OBJECTIVE: To study the expression of epidermal growth factor receptor (EGFR), C-erbB-2 and its relationship with cell proliferation in nasopharyngeal carcinoma. METHOD: Expression of C-erbB-2, EGFR and proliferating cell nuclear antigen (PCNA) were detected with immunohistochemical staining in 32 nasopharyngeal carcinoma samples and 12 chronic inflammatory nasopharyngeal tissue samples. RESULT: The positive rate of EGFR,C-erbB-2, and PCNA expression in nasopharyngeal carcinoma was 65.6%, 37.5%, and (42.5 +/- 22.6)%, respectively, which was significantly higher than that in chronic inflammatory nasopharyngeal tissue (P < 0.05). There were positive correlations between the positive rate of EGFR, C-erbB-2, and PCNA expression and histopathological stage. The co-expression of C-erbB2 and EGFR was found in 62.5% (20/32) nasopharyngeal carcinoma samples. There was a positive correlation between C-erbB-2 and EGFR expression (r = 0.38, P < 0.05). The highest percentage of PCNA expression was found in carcinoma samples with co-expression of C-erbB and EGFR. CONCLUSION: C-erbB-2, EGFR might have synergetic effect in the development and progress of nasopharyngeal carcinoma. The co-expression of C-erbB-2 and EGFR closely correlates with cell proliferation status.

Transoral laser surgery for anterior commissure involvement: a study in canines.

OBJECTIVE: To present laser surgery techniques to address anterior commissure involvement and evaluate recovery. METHODS: Twelve canines were divided into three groups. In group A the right ventricular band and vocal fold, the anterior third of the left vocal fold, and anterior commissure were cauterized. In group B cauterization was extended to the thyroid cartilage and a 5 mm x 5 mm area of the anterior commissural to half the cartilage thickness. In group C the 5 mm x 5 mm window was extended through the thyroid cartilage. Surgical lesions were observed after surgery and at 1 and 4 weeks post-surgery. RESULTS: Post-operative gross examination confirmed target scopes. One week after surgery, the lesions in group A were completely covered by neo-mucosa, while group B and C wounds were only partially covered. After 4 weeks, a laryngeal web was seen at the anterior commissure and the vocal fold length was shortened. Lesions in all three groups were completely covered by neo-mucosa. Collagen proliferation was most prominent in group C with limited scarring in group A. There were no major complications. CONCLUSIONS: The three operative methods demonstrated satisfactory outcomes; the lesions recovered well over the course of 4 weeks, and no severe complications occurred. The laser surgery protocol was successfully extended into the thyroid cartilage.

[Expression of CD23 and CD19 on peripheral blood lymphocytes and its association with serum total IgE in patients with allergic rhinitis].

OBJECTIVE: To explore the expression of CD23, CD19 on peripheral blood lymphocytes as well as its association with serum total IgE levels and nasal allergic symptoms in patients with allergic rhinitis (AR). METHOD: Symptom scores were evaluated in 46 AR patients, expression of CD23, CD19 on peripheral blood lymphocytes were measured by flow cytometry, and serum total IgE levels were determined by immune chemiluminescence. Thirty two healthy individuals were enrolled as controls. RESULT: The percentage of CD23+, CD19+ and CD23+/ CD19+,on peripheral blood lymphocytes in AR patients were 11.6 +/- 1. , 22.8 +/- 3.3,10.2 +/- 1.7, respectively. Higher frequencies of CD23+, CD19+, and CD23+/CD19+ were found in AR patients compared with controls (P < 0.05). There were positive correlations between expression rates of CD23+, CD19+, CD23+/CD19+ and levels of serum total IgE, nasal allergic symptom scores, respectively. CD23+/CD19+ demonstrated greater correlations with serum total IgE and nasal allergic symptom (r = 0.65 and 0.49, P < 0.05) than CD23+ and CD19+ did. Correlation between CD23+/CD19+ and nasal allergic symptom scores was greater than the corresponding correlations of serum total IgE (r = 0.33, P < 0.05). CONCLUSION: CD23 and CD19 are important factors that associated with serum total IgE in the pathogenesis of AR, Analysis on the expression of CD23+/CD19+ on peripheral blood lymphocytes is helpful for evaluating the severity of AR.