Minimally invasive procedure for diagnosis and treatment of vallecular cysts in children: review of 156 cases.

PURPOSE: Vallecular cyst is an uncommon but potentially life-threatening disease. The aim of this study was to review the presentation, evaluation, and treatment of vallecular cysts in children. METHODS: Medical records of 156 patients treated for vallecular cysts between 2013 and 2016 were retrospectively reviewed. The patients were divided into four age groups for comparison of clinical data: A, < 1 month; B, 1-6 months; C, 7-12 months; and D, > 1 year. RESULTS: The median age of all patients (98 males and 58 females) was 12.1 months (range 1 day-11 years), including 21, 86, 21, and 28 patients in group A, B, C, and D, respectively. A diagnosis of vallecular cysts was made for 135 patients using a combination of flexible laryngoscopy and ultrasound, and ten patients (all in group A) required pre-surgery ventilation support. The most common symptoms were wheezing (59.6%) and stridor (36.5%). Ten patients experienced difficulty with intubation. Endoscopic-assisted transoral coblation marsupialization was performed for all patients, combined with supraglottoplasty for 41 out of 68 patients with concurrent laryngomalacia. Patients in group D had a longer operation time and higher incidence of intraoperative bleeding, two of whom experienced post-operation recurrence, and symptoms resolved after a second operation in both cases. CONCLUSIONS: Flexible laryngoscopy and ultrasound are recommended for a diagnosis in suspected cases of vallecular cysts. Coblation marsupialization has advantages of minor damage, low recurrence rate, and suitability for all age groups.

ChIP-cloning analysis uncovers centromere-specific retrotransposons in Brassica nigra and reveals their rapid diversification in Brassica allotetraploids.

Centromeres are indispensable functional units of chromosomes. The evolutionary mechanisms underlying the rapid evolution of centromeric repeats, especially those following polyploidy, remain unknown. In this study, we isolated centromeric sequences of Brassica nigra, a model diploid progenitor (B genome) of the allopolyploid species B. juncea (AB genome) and B. carinata (BC genome) by chromatin immunoprecipitation of nucleosomes containing the centromere-specific histone CENH3. Sequence analysis detected no centromeric satellite DNAs, and most B. nigra centromeric repeats were found to originate from Tyl/copia-class retrotransposons. In cytological analyses, six of the seven analyzed repeat clusters had no FISH signals in A or C genomes of the related diploid species B. rapa and B. oleracea. Notably, five repeat clusters had FISH signals in both A and B subgenomes in the tetraploid B. juncea. In the tetraploid B. carinata, only CL23 displayed three pairs of signals in terminal or interstitial regions of the C-derived chromosome, and no evidence of colonization of CLs onto C-subgenome centromeres was found in B. carinata. This observation suggests that centromeric repeats spread and proliferated between genomes after polyploidization. CL3 and CRB are likely ancient centromeric sequences arising prior to the divergence of diploid Brassica which have detected signals across the genus. And in allotetraploids B. juncea and B. carinata, the FISH signal intensity of CL3 and CRB differed among subgenomes. We discussed possible mechanisms for centromeric repeat divergence during Brassica speciation and polyploid evolution, thus providing insights into centromeric repeat establishment and targeting.

Effects of berberine on tumor growth and intestinal permeability in HCT116 tumor-bearing mice using polyamines as targets.

The prognosis of colorectal cancer (CRC) is seriously affected by high intestinal mucosal permeability accompanied by increasing tumor load. Berberine, a natural plant-derived product, can protect the intestinal mucosal barrier and suppress tumor growth, but its effects on the intestinal mucosal barrier dysfunction of CRC have not yet been evaluated. Herein, we assessed the effects of berberine on the intestinal mucosal permeability of HCT116 tumor-bearing mice and the underlying mechanism. Berberine (6.25, 12.5, 25 mg/kg) was administered to tumor-bearing mice for 3 weeks by intraperitoneal injection, and saline was given to controls and models. Compared with the control group, tumor-bearing mice had increased intestinal mucosal permeability in the third week. Meanwhile, the body weight decreased by 4%-7%, the concentration of D-lactic acid in plasma increased, and the expressions of ZO1 and Occludin were down-regulated. The intestinal mucosa was impaired. Compared with the model group, berberine inhibited tumor growth in a dose-dependent manner (6.25, 12.5, 25 mg/kg), reduced the permeability of intestinal mucosa, and alleviated intestinal mucosal damage. HPLC showed that berberine decreased the content of polyamines in tumor tissue, whereas increased that in intestinal mucosa tissue. Western blot showed that berberine inhibited the expressions of ODC, C-MYC and HIF-1α, but up-regulated those of OAZ1 and SSAT. In short, berberine may exert antitumor effects by suppressing tumor growth and elevating the intestinal mucosal permeability.

Novel histone deacetylase inhibitor N25 exerts anti-tumor effects and induces autophagy in human glioma cells by inhibiting HDAC3.

N25, a novel histone deacetylase inhibitor, was created through structural modification of suberoylanilide hydroxamic acid. To evaluate the anti-tumor activity of N25 and clarify its molecular mechanism of inducing autophagy in glioma cells, we investigated its in vitro anti-proliferative effect and in vivo anticancer effect. Moreover, we detected whether N25 induces autophagy in glioma cells by transmission electron microscope and analyzed the protein expression level of HDAC3, Tip60, LC3 in glioma samples by western blot. We additionally analyzed the protein expression level of HDAC3, Tip60, ULK1 (Atg1), and Beclin-1 (Atg6) after treatment with N25 in glioma cells. Our results showed that the anti-tumor activity of N25 in glioma cells is slightly stronger than SAHA both in vitro and in vivo. We found that N25 induced autophagy, and HDAC3 was significantly elevated and Tip60 and LC3 significantly decreased in glioma samples compared with normal brain tissues. Nevertheless, N25 inhibited HDAC3 and up-regulated the protein expression of Tip60, ULK1 (Atg1), and Beclin-1 (Atg6) after treatment of glioma cells with N25. In conclusion, these data suggest that N25 has striking anti-tumor activity in part due to inhibition of HDAC3. Additionally, N25 may induce autophagy through inhibiting HDAC3.

Absorption mechanism of oxymatrine in cultured Madin-Darby canine kidney cell monolayers.

Context Oxymatrine (OMT) is beneficial to human health by exerting various biological effects. Objective To investigate the absorption mechanism of OMT and discover absorption enhancers using Madin-Darby canine kidney (MDCK) cell monolayers. Materials and methods Concentration effects on the transport of OMT were measured in the range of 1.0 × 10(-5)-1.0 × 10(-3) M in 2 h. Then, the effect of time, direction, temperature and pH on the transport of OMT at 10(-4) M was studied. Moreover, Papp of OMT was determined in the absence/presence of cyclosporine and surfactants at 100 µM to further confirm the relative transport mechanism. Results The Papp AP→BL ranged from (3.040 ± 0.23) × 10(-6) to (3.697 ± 0.19) × 10(-6 )cm/s as the concentration varied from 10(-5) to 10(-3) M. OMT showed similar Papp at 4 and 37 °C (p > 0.05). Increasing the apical pH 7.4 and 8.0 resulted in Papp versus pH 5.0 (p < 0.01). Furthermore, in the presence of cyclosporine and surfactants including sodium citrate, sodium dodecyl sulphate (SDS) and deoxysodium cholate, Papp was (0.318 ± 0.033) × 10(-5), (0.464 ± 0.048) × 10(-5), (0.897 ± 0.115) × 10(-5) and (1.341 ± 0.122) × 10(-5 )cm/s, respectively. In the presence of surfactants, Papp significantly increased up to 1.5-4.3-fold (p < 0.05). Discussion and conclusion OMT transport across MDCK cell monolayers was by passive diffusion. Sodium citrate, SDS and deoxysodium cholate serve as excellent absorption enhancers which are useful for the related research improving the oral bioavailability of OMT.

Expression and function of GSTA1 in lung cancer cells.

Glutathione S-transferase A1 (GSTA1) appears to be primarily involved in detoxification processes, but possible roles in lung cancer remain unclear. The objective of this study was to investigate the expression and function of GSTA1 in lung cancer cells. Real-time PCR and Western blotting were performed to assess expression in cancer cell lines and the normal lung cells, then verify the A549 cells line with stable overexpression. Localization of GSTA1 proteins was assessed by cytoimmunofluorescence. Three double-strand DNA oligoRNAs (SiRNAs) were synthesized prior to being transfected into A549 cells with Lipofectamine 2000, and then the most efficient SiRNA was selected. Expression of the GSTA1 gene in the transfected cells was determined by real-time PCR and Western blotting. The viability of the transfected cells were assessed by MTT. Results showed that the mRNA and protein expression of A549 cancer cells was higher than in MRC-5 normal cells. Cytoimmunofluorescence demonstrated GSTA1 localization in the cell cytoplasm and/or membranes. Transfection into A549 cells demonstrated that down-regulated expression could inhibit cell viability. Our data indicated that GSTA1 expression may be a target molecule in early diagnosis and treatment of lung cancer.

[Treatment of infantile subglottic hemangioma with oral propranolol].

OBJECTIVE: To observe the efficacy of oral Propranolol in the treatment of infantile subglottic hemangioma. METHODS: Eleven children (6 females and 5 males) with a median age at onset of treatment being 4 months were included in this study. Propranolol was given after laryngoscopy and a CT scan with contrast of the trachea confirming the presence of a subglottic hemangioma. The starting dose of Propranolol was 0.5 mg/kg per day, given in 2 or 3 divided doses. Heart rate and blood glucose were monitored during the treatment. If no side effects occurred, the dose was increased to 1 mg/kg per day at the third day and to 2 mg/kg per day at the sixth day. Treatment was continued at home after 10 days of inpatient treatment and the children were reevaluated monthly. RESULTS: After 24 - 48 hours of treatment, all of the children had improvement in their airway obstruction which was confirmed by fibro-laryngoscopy. The diameter of the subglottic stenosis from the hemangioma decreased from 3.9 - 5.0 mm to 1.5 - 2.0 mm,and the color was also lighter than before. In 3 children with cutaneous hemangioma, there was also significant improvement in the cutaneous lesions after treatment, with the color becoming lighter. There were no significant ECG, blood pressure or blood biochemical changes during the treatment. Two of the children had hypoglycemia at the first dose, but improved after blood transfusion and changing their diet. In five children, the treatment was stopped after 6 to 11 months when the obstructive symptoms improved. None of the children in this group had any evidence of recurrence. In the 5 children who stopped treatment, the obstructing mass in the subglottis was less than 10% of the diameter. CONCLUSION: Oral propranolol is a safe and effective treatment for infantile subglottic hemangioma. It may be used as a first-line therapeutic modality.

[Study on the feasibility and related factors on semen samples from condoms, collected from sexual partners of and by the female sex workers for HIV-antibody testing].

OBJECTIVE: To explore the feasibility and related factors of using semen samples from condoms collected by their female sex workers (FSWs) for HIV-antibody testing. METHODS: FSWs were recruited by outreach workers. Semen samples from condoms of their sexual partners (paid or regular) were collected by FSWs themselves after intercourse and for HIV testing. Male partners were asked to participate in the study. Questionnaires were administered for both FSWs and heir male sexual partners. Blood samples were also collected for HIV testing. RESULTS: In total, 54 FSWs with 43 of their regular sexual partners and 57 casual clients were recruited. HIV prevalence, determined from serum samples, were 33.33% among FSWs, 29.82% and 23.26% among their clients and regular sexual partners. 40.35% and 30.23% of the semen samples from the condoms they used, were tested positive for HIV among clients and regular sexual partners of the FSWs. The sensitivity of semen samples from condoms for HIV-antibodies was 100% among both clients and regular sexual partners of the FSWs, while the rates of specificity were 85.00% and 90.91% respectively. Data from Univariate analysis indicated that among FSWs, factors as the characteristics of self-reported needle sharing and the male sexual partners who had one child, were associated with the disparity between serum and condom semen sample for HIV-antibody testing. CONCLUSION: HIV prevalence in male clients and regular sexual partners of the FSWs might be overestimated according to the HIV-antibody testing results of semen samples from condoms collected by FSWs themselves. Lower specificity indicated that FSWs with positive HIV might have contaminated the semen samples from the condom used by their HIV negative sexual partners.

[Use of noninvasive ventilation in surgical treatment of obstructive sleep apnea hypopnea syndrome in children.].

OBJECTIVE: To study the efficacy of noninvasive ventilation in the surgical treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) in children. METHODS: Since 2002.5 - 2007.12, eleven children with adenotonsillar hypertrophy and seven children with post-adenoidtonsillectomy were enrolled in the study. All children were confirmed as OSAHS by polysomnography (PSG) or portable oximetry monitor. Male:female ratio was 17:1. The age ranged from 1 to 11 years (median 3.8 years). The noninvasive ventilation treatment was carried out in all children pre- or postoperatively. PSG was the index for therapy effect. SPSS 11.5 was used to analyse the data. The parameters, x(-) +/- s, were normal distribution, and paired t-test for significancy. A P value of < 0.05 was considered statistically significant. RESULTS: Six children after adenotosillectomy, with AHI < 10/h, lowest pulse oxygen saturation (SpO2) > 0.85, did not need nasal continuous positive airway pressure (nCPAP). Eleven patients with preoperative nCPAP, did not have anesthesia comlications. Post-nCPAP, apnea and hypopnea index AHI (4.7 +/- 3.9)/h, the lowest SpO2 0.867 +/- 0.069, and the average time percents SpO2 < 0.90 during sleep (0.3% +/- 0.5%) improved significantly compared to pre-nasal continuous positive airway pressurecn (nCPAP), which were (77.6 +/- 39.8)/h, (0.535 +/- 0.151) and (46.9% +/- 34.5%), t value were 7.77, -11.62, 5.69, P < 0.001. CONCLUSIONS: Noninvasive ventilation is an effective treatment for severe OSAHS children pre- or postoperation. nCPAP could be used to treat children still with OSAHS after adenotonsillectomy, and also an effective treatment to the ones who had surgical contraindication. Regular follow-up should be done for patients with nCPAP at home.

[Diagnostic procedures for pediatric otitis media with effusion].

OBJECTIVE: To evaluate the fluid in middle ear of otitis media with effusion (OME) by tympanometry, hearing threshold and in order to an effective and promptly way for treatment. METHODS: Forty Patients (75 ears) with OME were collected since January 2007 to June 2008. The history of hearing loss, hearing threshold, CT results and the final fluid in the middle ear during operation were analyzed. RESULTS: There were 28 males and 12 females enrolled in this study. The average age of the patients was 78 months. All the 75 ears were with type "B" according to tympanometry test. For all the patients myringotomy was performed and the ventilation tubes were placed in 23 ears. Among all the ears, there were fluid in 62 ears (82.7%) and no fluid in 13 ears (17.3%). There was correlation between the levels of hearing loss, CT results and the fluid in middle ear (P < 0.05). CONCLUSIONS: Tympanometry and hearing threshold results should have a better sensitivity and specificity rates for diagnosis of OME.

[Analysis of poor-responding sleep apnea children to adenoidtonsillectomy and further treatment].

OBJECTIVE: To analyze factors on sleep apnea children's poor responding to adenoid tonsillectomy, and discuss the further treatment. METHODS: Two hundred and forty three obstructive sleep apnea hypopnea syndrome (OSAHS) children who had adenoid tonsillectomy or adenoidectomy were reviewed, all cases had follow-up sleep study (polysomnogram, PSG) after surgery. RESULTS: According to the results obtained in 3 to 12 months after surgery with PSG, 221 cases (90.9%) were cured (apnea and hypopnea index, AHI, < 5/h), while the remaining 22 cases AHI > 5.0/h. In the latter group, 2 cases who only had adenoidectomy received tonsillectomy afterwards, 7 cases who have nasal congestion were treated with medication, 5 overweight cases and 3 cases with cerebral palsy, pectus excavatum or hyperplastic tori were treated with CPAP. CONCLUSIONS: Adenoid tonsillectomy is effective for OSAHS children. For the poor responding cases, suitable treatment should be selected accordingly.

[Clinical efficacy analysis of chemotherapy to lymph node metastasis in epithelial ovarian cancer].

BACKGROUND & OBJECTIVE: Epithelial ovarian cancer is moderate sensitivity to chemotherapy; the survival has been improved by aggressive cytoreductive surgery followed by combination chemotherapy with cisplatin-based regimen.However,there is a controversy about chemotherapeutic sensitivity of its lymph node metastasis. This study was designed to evaluate chemotherapeutic sensitivity and prognosis of lymph node metastases in epithelial ovarian cancer. METHODS: The authors retrospectively analyzed 50 cases of epithelial ovarian cancer with lymph node metastases in Cancer Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College from June 1986 to February 2001, which included 32 cases with stage III-IV, and 18 with recurrent disease. All the 50 patients were with valuable metastatic lymph nodes,and among these patients 38 were also with valuable abdominal-pelvic tumor. Forty-six patients received 1-3 courses of neoadjuvant chemotherapy,cytoreductive surgery, and postoperative chemotherapy. The response rate was evaluated by the response criteria for solid tumor. The chemotherapy included neoadjuvant chemotherapy, and chemotherapy for patients with residual tumor after operation or recurrence. Forty-five patients received platinum-based chemotherapy regimens [including CP (cyclophosphamide+cisplatin), CAP (cyclophosphamide+epirubicin+cisplatin), TC (paclitaxel+carboplatin), TP (paclitaxel+cisplatin), cisplatin+mitomycin+vincristine+etoposide+carboplatin, gemcitabine+carboplatin,IEP(ifosphamide+etoposide+cisplatin regimens) and 1 patient received melphalan, 1 patient with CF(cyclophosphamide+5-fluorouracil)regimen, 3 patients with ifosphamide+etoposide. RESULTS: The overall response rates of lymph node metastasis and abdominal-pelvic tumor were 68.0% and 71.1%, respectively (P >0.05). The response rates of lymph node metastasis and abdominal-pelvic tumor for stage III-IV were 78.1% and 76.7%, respectively (P >0.05); both were 50% for recurrent patients with epithelial ovarian cancer. CONCLUSION: Either in stage III-IV or in recurrent patients with epithelial ovarian cancer, chemotherapeutic sensitivity of lymph node metastasis was similar to that of abdominal and pelvic tumor. The prognosis was related to the optimality of cytoreductive surgery, and the intensity of chemotherapy.