[Analysis of clinical characteristics of children with adenoid hypertrophy and pharyngolaryngeal reflux].

Objectives: To explore the clinical characteristics of children with adenoid hypertrophy (AH) and laryngopharyngeal reflux (LPR) by detecting the expression of pepsin in adenoids as a standard for AH with LPR. Methods: A total of 190 children who were admitted for surgical treatment due to AH were included in the study. The main clinical symptoms of the patients were recorded, and the degree of adenoid hypertrophy was evaluated. Before the surgery, Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) were used to evaluate the reflux symptoms. After the surgery, pepsin immunohistochemical staining was performed on the adenoid tissue, and according to the staining results, the patients were divided into study group (pepsin staining positive) and control group (pepsin staining negative). SPSS 19.0 software was used for statistical analysis. Quantitative data conforming to normal distribution between the two groups were tested by two-independent sample t test, and quantitative data with skewed distribution were tested by Mann-Whitney U test. Results: The positive rate of pepsin staining in the 190 AH patients was 78.4% (149/190). The study group had higher levels of preoperative symptoms such as erythema and/or congestion of the pharynx(2.1±0.7 vs. 1.8±0.6,t=2.23), vocal cord edema[1.0(0, 1.0) vs. 1.0(0, 1.0), Z=2.00], diffuse laryngeal edema[0(0, 1.0) vs. 0(0, 0), Z=2.48], posterior commissure hypertrophy[(1.4±0.6 vs. 1.1±0.5), t=2.63], and a higher total score on the RFS scale than the control group(6.2±2.7 vs. 5.0±2.6, t=2.47), with statistical differences (P<0.05). The sensitivity and specificity of RFS score in diagnosing AH with LPR were 24.8% and 80.5%, respectively. When RFS>5 was used as the positive threshold, the sensitivity and specificity of RFS score in diagnosing AH with LPR were 61.1% and 58.5%, respectively. There was a statistical difference in the number of positive cases of RFS score between the study group and the control group(91 vs. 17,χ2=5.04,P=0.032). Conclusions: LPR is common in AH children. Children with AH and LPR have specific performance in electronic laryngoscopy, such as erythema with edema in the pharynx, posterior commissure hypertrophy, and vocal cord edema.

[Study on the correlation between meteorological factors and acute otitis media in outpatients of children in Beijing].

Objective: To explore the characteristics of acute otitis media(AOM) in children in Beijing and its correlation with meteorological factors. Methods: Data were collected in 2011-2013 in the Otolaryngology Department of Capital Institute of Pediatrics. AOM in children with relevant information, such as age, sex and season, with the same period of the Beijing municipal meteorological data (the average temperature, average pressure, average wind speed, humidity and PM2.5) were compared to analysis the relationship of meteorological environmental parameters and the onset of AOM in children. Results: Annual morbidity of AOM was 7 589, 8 245, 7 242 respectively, no obvious difference(P=0.761). It was noted that one peak could be seen in December, and a valley in February, followed by August. Summer was less than the other three seasons (P<0.05). The morbidity of AOM had a small peak within one year after birth, then reached peak at the age of about 4, and then reduced gradually. In different age groups, male patients were higher than those of female. The incidence of AOM was positively correlation tendency with air pressure and PM2.5 (r=0.333, 0.093, P=0.000, 0.002), which was negatively correlation tendency with daily temperature or humidity (r=-0.327, -0.195, P=0.000, 0.000). Conclusions: The incidence of AOM of children in Beijing changes with age, and has obvious seasonal variation. There may be some correlation between the meteorological factors and the incidence of AOM in children.

[Effect of treating obstructive sleep apnea-hypopnea syndrome on chronic cough in children].

Objective: To understand the effect of treating obstructive sleep apnea hypopnea syndrome (OSAHS) on chronic cough in children. Methods: A total of 100 consecutive children with OSAHS diagnosed by polysomnography(PSG) and chronic cough were included in this study. All children underwent cough condition assessment, OSA-18 scales and MS-IOS before and after surgery, and all children were followed-up for 3 months. Children were separated into three groups according to the severity of OSAHS. Related parameters like Zr, Rf, R5, R20, X5, X35, Rc, Rp obtained from MS-IOS, OSA-18 scores and cough scores were compared between different groups using paired t-test or Wilcoxon sum test. Results: There existed significantly positive correlations between AHI and scores of OSA-18(r=0.653, P<0.01). AHI positively related to cough scores including diurnal(r=0.470, P<0.01)and nocturnal cough scores(r=0.459, P<0.01). Scores of OSA-18 had similarity in correlations with diurnal(r=0.527, P<0.01)and nocturnal cough scores(r=0.532, P<0.01). All children got improved in OSA-18 scales and cough scores after treatment. In details, the three groups were mild group(n=34), moderate group(n=37), severe group(n=29). OSA-18 scales decreased dramatically in each group after surgery, Z values were -5.014, -5.035, -4.624 respectively(P=0.000). Cough scores in day and night got reduced after treatment, Z values were -5.112, -5.102, -5.394, -5.374, -4.777, -4.770 in three groups. Rp in all children got alleviated after surgical management, Z were -3.150, -5.035, -5.374(P=0.000). Other parameters were analyzed using paired t test. Z5, R5, R20, R35 got reduced in all three groups.X5 got reduced in mild and moderate groups. Rc reduced only in the moderate group. Conclusions: OSAHS may be a trigger or inducer of chronic cough. Active treatment of OSAHS via surgery can improve the quality of children's life and alleviate the symptoms of cough in day and night.

Predicting the maturity of haemodialysis arteriovenous fistulas with colour Doppler ultrasound: a single-centre study from China.

AIM: To explore the optimal vascular diameter and blood flow measured by ultrasound to predict fistula maturity in Chinese patients. MATERIALS AND METHODS: One hundred and thirty-two patients were enrolled in the study. The blood flow and the diameters of the brachial artery, radial artery, and cephalic vein were analysed according to clinical outcomes. The performances of blood flow, cephalic vein diameter, and the two factors combined in predicting fistula maturity were evaluated and the optimal cut-off values for Chinese patients were determined. RESULTS: During a 6 month follow-up, 113 fistulas were classified as mature and 19 fistulas were classified as failure. In both groups, the diameters of the brachial and radial arteries increased gradually within 2 weeks post-surgery (p<0.05), and cephalic vein diameter and blood flow increased within 4 weeks post-surgery (p<0.05). The blood flow of the failure group was significantly lower than that of the mature group from the first day after creation. The area under the receiver operating characteristic (ROC) curve was 0.95 (529 ml/min, the optimal cut-off value) for blood flow, 0.83 (5.2 mm) for cephalic vein diameter, and 0.96 for the two factors combined in predicting fistula maturity. CONCLUSIONS: For Chinese patients, blood flow >529 ml/min could be used to predict fistula maturity and cephalic vein diameter >5.2 mm could be a supplement when necessary.

Upregulated Hoxc6 expression is associated with poor survival in gastric cancer patients.

Human Hox genes (Homeobox) have crucial roles in development and differentiation, regulating numerous processes including apoptosis, receptor signalling, differentiation, motility and angiogenesis. Aberrant expression of Hoxc6 gene has been reported in several tumor tissues and cancer cell lines. The prognostic significance of Hoxc6 in gastric cancer remains largely unknown.This study was aimed to investigate the clinical significance of Hoxc6 in gastric cancer.Total RNA of paired tissue samples (n=25) and a tissue microarray containing 161 paired tissues from patients with gastric cancers at different stages were collected. Quantitative real-time PCR and immunochemistry assay were carried out to investigate the expression of Hoxc6. Hoxc6 mRNA was increased in gastric cancer tissues ( 16 of 25) compared with the adjacent normal mucosa (P<0.05). Immunohistochemical detection showed that expression of Hoxc6 was associated with the depth of tumor invasion (P<0.05). Patients with higher expression levels of Hoxc6 had a shorter overall survival rate (P<0.05).Hoxc6 might contribute to the progression of gastric carcinogenesis and may be a significant predictor of poor survival in patients with gastric cancer after curative operations.

Secretory heat-shock protein as a dendritic cell-targeting molecule: a new strategy to enhance the potency of genetic vaccines.

DNA vaccines are an appealing strategy for inducing cytotoxic T-lymphocyte and antibody responses against tumor cells as well as infectious agents. Dendritic cells (DCs) play a critical role in inducing immune responses, but their potential is not fully utilized in the DNA vaccine setting since they take up only a minor fraction of the injected DNA. Here we describe a novel DNA vaccination strategy based on the targeting of a modified tumor-associated antigen, the human papilloma virus (HPV) type 16 E7 protein, to DCs by a heat-shock protein (HSP) to enhance antigen presentation and immune responses. Specifically, a chimerical HPV-E7 and HSP70 fusion gene preceded with a leader sequence was constructed. When mice were immunized with this construct, the DNA is taken up by various types of cells, which then produce and secrete an HPV-E7-HSP70 fusion protein that is targeted to DCs by the HSP70 portion of the chimerical molecule for antigen presentation. In studies to test the efficacy of this strategy, we demonstrated that DNA vaccination with this secretory HPV-E7-HSP70 construct strongly enhanced an antigen-specific CD8+ T-cell response as well as a specific B-cell response in mice. Furthermore, this immunization approach not only protected mice against lethal challenge with an HPV E7-expressing tumor line (TC-1), but also showed a therapeutic effect against established tumors. The results of this study indicate that secretory HSPs can be broadly used to target tumor-associated antigens to DCs to enhance antigen-specific immune responses.

Effects of Linomide on growth and metastasis of implanted human gastric cancer in nude mice.

AIM: To elucidate the effect of angiogenesis inhibitor, Linomide, on tumor growth and metastasis in nude mice implanted with human gastric cancer. METHODS: A metastatic model of gastric cancer was established using orthotopic implantation of histologically intact tumor tissues into the gastric wall of nude mice. Linomide (0, 80, 160 mg·kg(-1)) was given p.o. every day after the implantation, and the mice were sacrificed after 10 wk to detect tumor size and metastasis. The microvessel counts were measured by immunohistochemical staining using a monoclonal antibody against Human Factor VIII related antigen. RESULTS: Linomide treatment significantly decreased the size of the implanted tumors (control group: 1.36 ± 0.81 cm(3) vs Linomide treated group: 0.84 ± 0.51 cm(3) and 0.62 ± 0.35 cm(3), P < 0.05 and 0.01, respectively). Additionally, an antimetastatic effect of Linomide was clearly demonstrated in a dose dependent manner: mice given 80 mg·kg(-1) Linomide developed liver metastasis in 4 of 10 cases, mice given 160 mg/kg developed metastasis in only 1 of 10 mice, while it developed in 19 of 28 mice of the control group (P < 0.05 and 0.01, respectively). The number of metastatic foci was also significantly less in the treated group. Furthermore, the microvessel counts in tumors of treated mice was reduced by 33%-42% as compared with the control tumors (P < 0.01). CONCLUSION: Linomide has a strong inhibitory activity against in vivo tumor growth and metastasis of gastric cancer, effectively suppressing the growth of the primary tumor, preventing liver metastasis, and attenuating the rate of neovascularization.

A new experimental and clinical approach of combining usage of highly active tumor-infiltrating lymphocytes and highly sensitive antitumor drugs for the advanced malignant tumor.

In recent years, tumor-infiltrating lymphocytes (TILs) have been reported to be effective for tumors in experimental and clinical research. In order to increase the therapeutical effect, we modified some steps of Rosenberg's approach: a. cold digestion with collagenase at 4 degrees C for 24 hours; b. sedimentation instead of centrifugation; c. elimination of tumor cells before the cultivation procedure. Compared with the original approach, the proliferation, activity and cytotoxicity of TILs obtained by the modified procedure were much improved. TILs' expansion-fold was greater than that with the original approach. Cytotoxicity against tumor cells was more potent. Increased TILs' subsets were CD3 and CD8 cells. Meanwhile, we took tumor cells from tumor tissues to test their in vitro chemosensitivities to different drugs in order to select highly sensitive antitumor drugs for treatment of cases with advanced tumors. According to the design of using highly active TILs and highly sensitive drugs (H & H therapy), preliminary clinical results of 50 cases showed higher response rates than those in treatment with TIL/IL2, LAK/IL2 and TIL+IL2+CTX. Less toxic side effects were observed in 14 patients.

[Granule protein contents of polymorphonuclear leucocytes and serum in 30 cases of myelodysplastic syndromes].

Intracellular contents and serum levels of neutrophilic granule protein components, including myeloperoxidase (MPO), lactoferrin (LF) and lysozyme (LYZ), were investigated in 30 cases of myelodysplastic syndromes (MDS), with 59 healthy adult donors as controls. Both neutrophilic MPO and LF decreased significantly, suggesting the transformation of abnormal clones. Both serum levels of LF and LYZ exhibited a considerable fluctuation which may reflect reflect granulopoiesis in the bone marrow. We are of the opinion that measurement of intracellular MPO, LF, LYZ and their serum levels may aid in the diagnosis and prognosis of MDS and is proved to be of great clinical significance.