Application of rigid bronchoscopy for emergent removal of tracheobronchial foreign body in paediatric cases: a learning curve study.

OBJECTIVES: To explore the factors associated with the operative duration for paediatric tracheobronchial foreign body removal by rigid bronchoscopy, and to analyse the learning curve for mastery of the rigid bronchoscopy skill. METHODS: A retrospective study was performed of paediatric cases of tracheobronchial foreign body removal by rigid bronchoscopy in our department from January 2007 to July 2019. Multivariate Cox regression analysis was used to analyse the factors associated with the operative duration. In addition, the learning curves for two doctors were evaluated by curve-fitting regression analysis. RESULTS: A total of 410 paediatric cases of tracheobronchial foreign body removal by rigid bronchoscopy were evaluated. The operative duration was significantly influenced by the skill of the doctor. The learning curves for both doctor A and doctor B demonstrated two typical phases: an initially rapidly changing learning phase followed by a steady consolidation phase. CONCLUSION: The operative duration for paediatric tracheobronchial foreign body removal by rigid bronchoscopy was associated with the skill of the doctor. In order to fully master the rigid bronchoscopy technique, doctors should perform a minimum number of procedures to pass the learning phase and reach the consolidation phase.

Nomogram Based on Clinical and Radiomics Data for Predicting Radiation-induced Temporal Lobe Injury in Patients with Non-metastatic Stage T4 Nasopharyngeal Carcinoma.

AIMS: To use pre-treatment magnetic resonance imaging-based radiomics data with clinical data to predict radiation-induced temporal lobe injury (RTLI) in nasopharyngeal carcinoma (NPC) patients with stage T4/N0-3/M0 within 5 years after radiotherapy. MATERIALS AND METHODS: This study retrospectively examined 98 patients (198 temporal lobes) with stage T4/N0-3/M0 NPC. Participants were enrolled into a training cohort or a validation cohort in a ratio of 7:3. Radiomics features were extracted from pre-treatment magnetic resonance imaging that were T1-and T2-weighted. Spearman rank correlation, the t-test and the least absolute shrinkage and selection operator (LASSO) algorithm were used to select significant radiomics features; machine-learning models were used to generate radiomics signatures (Rad-Scores). Rad-Scores and clinical factors were integrated into a nomogram for prediction of RTLI. Nomogram discrimination was evaluated using receiver operating characteristic analysis and clinical benefits were evaluated using decision curve analysis. RESULTS: Participants were enrolled into a training cohort (n = 139) or a validation cohort (n = 59). In total, 3568 radiomics features were initially extracted from T1-and T2-weighted images. Age, Dmax, D1cc and 16 stable radiomics features (six from T1-weighted and 10 from T2-weighted images) were identified as independent predictive factors. A greater Rad-Score was associated with a greater risk of RTLI. The nomogram showed good discrimination, with a C-index of 0.85 (95% confidence interval 0.79-0.92) in the training cohort and 0.82 (95% confidence interval 0.71-0.92) in the validation cohort. CONCLUSION: We developed models for the prediction of RTLI in patients with stage T4/N0-3/M0 NPC using pre-treatment radiomics data and clinical data. Nomograms from these pre-treatment data improved the prediction of RTLI. These results may allow the selection of patients for earlier clinical interventions.

Surgical anatomy of the submental artery perforator flap and assessment for application in postoperative reconstruction following oral cancer surgery: a prospective clinical study.

The submental artery perforator flap (SMAPF) has an elongated pedicle, allowing good cosmetic outcomes to be achieved following oral reconstruction surgery. The improper dissection of perforators often leads to a vascular flap crisis. To avoid this, some surgeons choose to carry amounts of connective tissue around the pedicle. However the inclusion of connective tissue on the pedicle raises concerns about oncological safety. A surgical anatomical study of the submental vessel patterns and subdivisions of the cervical level I lymph nodes was conducted on 33 patients with primary oral cancer who underwent reconstruction with a SMAPF after tumour resection. The variations in vessels and cervical level I lymph nodes observed during SMAPF harvesting were recorded and analyzed. Two patterns of submental artery perforators and three patterns of submental veins were identified. The different characteristics of the lymph node distribution were elucidated for five subdivisions. All SMAPFs survived (n=33, 100%); however, two SMAPFs exhibited partial losses. The 3-year survival rate of patients was 84.5±6.4%, and there were no suspected flap-related recurrences. With detailed anatomical information on the vascular system and lymph node subdivision, SMAPFs are a reliable choice for postoperative reconstruction following oral cancer surgery, meeting the standards for oncological safety.

Quality of life of patients with scabies.

BACKGROUND: Scabies is a highly contagious disease caused by the mite Sarcoptes scabiei, and the disease is still a major public health problem in many resource-poor regions. Apart from the skin lesions or substantial morbidity, scabies also leads to social stigma. However, quality of life (QoL) has not been investigated in patients with scabies. OBJECTIVES: The aim of this study was to assess the impact of scabies on patients' QoL using the Dermatology Life Quality Index (DLQI) questionnaire, and assess its feasibility and internal consistency. METHODS: One hundred consecutive outpatients seeking treatment for scabies in the Department of Dermatology, the Second Hospital of Xi'an Jiaotong University, were assessed for eligibility for this prospective study from 8 August 2008 to 20 December 2008. Sulphur (10%) was selected in the treatment of scabies. RESULTS: A total of 96 patients completed the study. Among them, 78 (81.25%) of patients were considered cured at the end of the study. The mean ± SD DLQI score in our study was 10.09 ± 5.96. QoL of most of (71.9%) our patients has moderately affected. Questions 1 (symptoms), 2 (embarrassment), 7 (work or study) and 9 (sexual difficulties) had the most impact on patients with scabies. Domain 1 (symptoms and feelings) and 5 (personal relationships) scored higher than other domains. There was significant progress of QoL after treatment in our patients. No strong relationship between disease-related characteristics and QoL could be found. CONCLUSION: Scabies moderately affected the QoL of the patients. Sulphur could be considered as an effective treatment for patients with scabies.

Treatment Strategy for Unruptured Intracranial Aneurysm in Elderly Patients: Coiling, Clipping, or Conservative?

An increasing number of unruptured intracranial aneurysms (UIAs) has been discovered in elderly patients in recent years, but the optimal treatment strategy for these patients remains controversial. We report our six-year experience treating UIAs in elderly patients (≥ 70 years old). A retrospective review was conducted of elderly patients who harbored UIAs treated by conservative observation, microsurgical clipping, or endovascular coiling between January 2009 and December 2014. The patients' clinical and imaging information was recorded. Treating methods, procedure-related complications, imaging results, and clinical outcomes were analyzed. A total of 141 consecutive elderly patients with 166 UIAs were enrolled in our study. In all, 64 patients with 79 aneurysms were treated with coiling, and 14 patients with 14 aneurysms were treated with clipping. The remaining 63 patients with 73 aneurysms were placed under conservative observation. The average modified Rankin scale was 0.99 (range 0-6) in the full cohort after a mean follow-up of 50.4 months (range 0-70 months). There was no significant difference of modified Rankin scale in patients with UIAs treated by different methods. Multivariate analysis showed that age (p=0.030) and aneurysm size (p=0.011) were independent risk factors for unfavorable outcome of UIAs in the elderly. Patient age (p=0.010) and aneurysm size (p=0.020) were also significantly associated with unfavorable outcome of UIAs managed with observation initially. Our results indicated that endovascular coil embolization and clipping were both safe and effective treatment methods for UIAs in the elderly. Aggressive treatment for UIAs in elderly patients with risk factors of aneurysm rupture should be considered positively.

[Variation trend and significance of adult tonsil size and tongue position].

Objective:The aim of this study is to explore the changing trend and significance of adult tonsil size and tongue position by observing adults in different age groups. Method:Oropharyngeal cavities of 1 060 adults who undergoing health examination and had no history of tonsil surgery were observed. Friedman tongue position (FTP) and tonsil size (TS) were scored according to Friedman's criteria and results were statistic analyzed to evaluate their changing law and significance. Result: Mean FTP scores increased with age significantly（P <0.01）; FTP score in male was lower than that in female（P <0.01）. TS score significantly decreased with age（P <0.05）.The average score of TS had no statistical significance in different gender. Although there was no statistical significance, total score of FTP show an increasing trend with age（P >0.05）;Total scores of FTP were different between sexes（male 4.12±0.67，female 4.23±0.68，P <0.05）.BMI was not found to be statistically different when FTP scores, TS scores and total scores changed (P >0.05); but it showed an increasing trend with age（P <0.01）. Conclusion:Width of pharyngeal cavity in normal adults is always kept in certain stability, while it proves to be narrower in obese people. TS score and FTP score, which appear the opposite trend with age, can be thought as a major factor to keep a stable width of oral pharyngeal cavity.

The Myb DNA-binding domain is highly conserved in Dictyostelium discoideum.

The c-myb proto-oncogene encodes a protein that is highly conserved among birds and mammals. The amino-terminal domain of c-Myb contains three imperfect tandem repeats of approximately 50 amino acids each. This domain is required for DNA binding and has also been conserved to varying degrees in invertebrates, plants and yeast. Given that myb-related genes appear to control cellular differentiation in a variety of eucaryotic systems, the presence of a myb gene in the cellular slime mold Dictyostelium discoideum might provide a tractable system for studying the role of myb in differentiation. Degenerate oligonucleotide primers encoding regions that are highly conserved in the vertebrate and Drosophila Myb DNA-binding domains were used to amplify a related domain from Dictyostelium genomic DNA, which was then used to isolate a genomic clone. The putative DNA-binding domain of Dictyostelium Myb is as closely related to vertebrate c-Myb as is Drosophila Myb (65% identity), whereas the known Myb-related proteins of plants and yeast are more distantly related. The conserved domain of Dictyostelium Myb is capable of binding to the same DNA sequence as the vertebrate and Drosophila Myb proteins. The remainder of the deduced amino acid sequence of Dictyostelium Myb shows no homology to the divergent domains of the known animal, plant and yeast Myb-related proteins. Evolutionary analysis implies that the duplications that generated the repeats of the Myb DNA-binding domain began prior to the divergence of animals, plants, cellular slime molds and yeast.

Fractionation of Corynebacterium pekinense AS 1.299 phage subtypes by anion-exchange chromatography.

A novel method to fractionate phage into its subtypes while fully retaining biological function is reported. Corynebacterium pekinense AS 1.299 phage samples, purified by either conventional ultracentrifugation or gel chromatography on a Superose(R) 6 Prep column (0.78 x 30 cm), were fractionated further into four fractions by anion-exchange chromatography on a Toyopearl SuperQ 650C column (0.5 x 20 cm) with a linear gradient of NaCl concentration from 0.2 to 1.0 M in 0.02 M carbonate-biocarbonate buffer, pH 10.0. Two peaks were identified to be C. pekinense AS 1.299 phages by their ability to infect the host bacteria when inoculated into the culture media, and when examined by electron microscopy. These two types of the phage were found to be morphologically the same except for the difference in the length of their non-contractile tails. Both possessed an isometric head with a diameter of 50 +/- 3 nm, while their tails were 170 +/- 10 and 210 +/- 10 nm, respectively. This simple technique provides a convenient method for phage isolation not only to its species homogeneity, but also to determine its subtype or variant homogeneity.

[Treatment of soil-transmitted helminth infections by anthelmintics in current use].

The efficacy of broad-spectrum anthelmintics in current use was studied in Hengshan County, Hunan Province. The vermicides under study include albendazole (400mg, single dose), mebendazole composite (mebendazole 100 mg and levamisole 25mg bid x 3d), oxantel pyrantel pamoate composite (pyrantel pamoate 150 mg and oxantel pamoate 150 mg bid x 2d), and pyrantel pamoate composite (base 10 mg/kg, single dose). Therapeutic effect assessed 2 weeks after medication revealed Ascaris egg negative rates or cure rates (CR) of 97.5-100% for the former 3 regimens, and 80.9% for the latter one; while CR for hookworm infection were 95.4%, 78.6-100%, 96.7% and 83.3%, respectively. A follow-up survey pursued 4 weeks post treatment showed no significant difference in CR for the above regimens. Judging from CR in Trichuris trichiura infection, pyrantel pamoate composite was recommended as the drug of choice (89.3%), which was followed by mebendazole composite (64.6-83.8%) and albendazole (28.2-42.6%), whereas pyrantel pamoate was inefficacious. Obvious egg reduction rates were evidenced post application of the above drugs in trichuriasis treatment except pyrantel pamoate at single dose.

Electrochemical and PM-IRRAS a glycolipid-containing biomimetic membrane prepared using Langmuir-Blodgett/Langmuir-Schaefer deposition.

Differential capacitance, chronocoulometry, and polarization modulation infrared reflection absorption spectroscopy (PM-IRRAS) measurements were used to characterize the structure and orientation of a DMPC + cholesterol + GM 1 (60:30:10 mol %) bilayer supported at a Au(111) electrode surface prepared using combined Langmuir-Blodgett/Langmuir-Schaefer (LB/LS) deposition. The electrochemical measurements indicate that the incorporation of ganglioside GM 1 into the membrane significantly improves the quality of the bilayer, reflected in the very low capacitance value of approximately 0.8 microF cm (-2). An analysis of the infrared data suggests that the incorporation of the glycolipid into the membrane changes both the orientation of the lipid acyl chains in the membrane and the hydration of the membrane, particularly with respect to the interfacial region of the lipids.

Comparative study with monospecific and monoclonal antibodies against a 65 K human cytomegalovirus protein.

Immunofluorescence assay using monospecific and monoclonal antibodies to the 65 K major protein of human cytomegalovirus (HCMV) was carried out to monitor the expression of this protein in infected cells. Regardless of differences in the reactivity of the monoclonal antibodies, as determined by immunoblotting and immunofluorescent staining, all stained cytoplasmic inclusion bodies localized to the site of the HCMV-induced receptor for the Fc portion of IgG, suggesting that most of the 65 K major protein of HCMV colocalizes with the HCMV-induced FcR.

Individual repeats of Drosophila Myb can function in transformation by v-Myb.

The v-Myb protein binds to specific DNA sequences and can regulate gene expression. The DNA-binding domain of v-Myb contains the second and third of the three highly conserved tandem repeats found in c-Myb. In general, the ability of mutant forms of v-Myb to transform correlates with their ability to trans activate transcription. Two mutations within the DNA-binding domain of v-Myb which preserve DNA binding in vitro but fail to trans activate or transform have been described. These results suggested that this highly conserved domain might function in specific protein-protein interactions, as well as in DNA binding. We therefore tested the ability of a related protein domain from Drosophila melanogaster to substitute functionally for the homologous region of v-Myb. We found that either the second or third repeat of Drosophila Myb, but not both, could function in trans-activation and transformation by v-Myb. The hybrid containing both the second and third repeats of Drosophila Myb bound to DNA but failed to trans activate transcription either in the context of v-Myb or as a v-Myb-VP16 fusion protein. These results demonstrate that although the protein-DNA contacts made by the Myb repeats have been conserved during the evolution of animals, the protein-protein interactions have diverged.

Effect of azithromycin plus rifampin versus amoxicillin alone on eradication and inflammation in the chronic course of Chlamydia pneumoniae pneumonitis in mice.

The effects of treatment with azithromycin plus rifampin (A+R), amoxicillin (A), or placebo (P) on the chronic course of experimental Chlamydia pneumoniae pneumonitis in mice were assessed by culture, PCR, and immunocytochemistry as well as by degree of inflammation in lung tissue. Eradication of the pathogen was significantly more frequent and inflammation in tissue was significantly reduced after treatment with A+R compared to after treatment with A or P. Combination therapy with azithromycin plus rifampin showed favorable effects in the chronic course of C. pneumoniae pneumonitis.

Voltammetric behavior of vitamin B(2) on the gold electrode modified with a self-assembled monolayer of l-cysteine and its application for the determination of vitamin B(2) using linear sweep stripping voltammetry.

The voltammetric behavior of Vitamin B(2) (VB(2)) has been studied at the gold electrode modified with a self-assembled monolayer of l-cysteine. The voltammetric responses are evaluated with respect experimental conditions, such as composition and pH of the supporting electrolyte, concentration of VB(2), accumulation potential and accumulation time. On basis of the voltammetric behavior a highly sensitive method is present for the determination of VB(2) by using linear sweep stripping volammetry. The method is suitable for the determination of VB(2) concentrations between 5.0x10(-11) and 5.0x10(-6) mol l(-1). And the detection limit can be reached to 2.5x10(-11) mol l(-1). The method is applied to determine the concentration of VB(2) in the tablets with satisfactory results.

Controlled Site-Directed Assembly of Antibodies by Their Oligosaccharide Moieties onto APTES Derivatized Surfaces.

A convenient and efficient method for the site-directed incorporation of aldehydes generated on the oligosaccharide moieties at the C-terminal of immunoglobulin (IgG) using NaIO4 oxidation reaction is explored as a means of ensuring controlled assembly of IgG antibodies onto aminopropyltriethoxylsilane (APTES) derivatized silicon wafer surfaces. The orientation and antigen binding capacity (AgBC) of site-directly assembled IgG antibodies on derivatized surfaces were investigated using atomic force microscopy (AFM) and enzyme immunoassay (EIA), respectively. A major difference in preferential orientation is observed when the incubation of derivatized surfaces with oxidized IgG molecules is compared in two different kinds of buffer solutions. We obtained the stable and homogeneous IgG layer without loss of the AgBC on the APTES derivatized surface using the controlled incubation condition. Copyright 1999 Academic Press.