[Detection ofmethylated genes related to allergic rhinitis and establishment of methylation profile].

Objective:The aim of this study is to detect differentially methylated genes to allergic rhinitis (AR) based on methylation chip, and to analyze the relationship between DNA methylation and AR.Method:Illumina methylation chip were made by normal inferior turbinate mucous tissue obtained from patients(n=19) and healthy individuals(n=11). Detection of differential the sites of methylated genes, Gene Ontology enrichment, KEGG pathway enrichment database and literature search were used to analysis.Result:There were 94 aberrant methylation sites in patients with AR, including 51 hypermethylation sites (e.g. ST7,LCE2D,ATRIP genes) and 43 hypomethylation sites (e.g. PIK3CG, TLR6, IL-4 genes). The results of Gene Ontology enrichment and KEGG pathway enrichment indicates the DNA methylation has relative trend with AR, and DNA methylation of ST7, LCE2D, PIK3CG genes may be associated with AR, but the results of GO analysis and KEGG analysis were statistically significant. Moreover, literature search prompts that DNA methylation of TLR6 gene and IL-4 gene may be associated with AR.Conclusion:Varying degrees of methylated genes from inferior turbinate mucous tissue based on high-flux methylation chip hint gene methylation is an important cause of AR. The relationship between them needs further verification.

[Screening of differentially expressed genes of allergic rhinitis with asthma].

Objective:To detect the differentially expressed genes of allergic rhinitis(AR) with asthma and screen the pathogenic genes. Method: Eight nasal mucosa tissue samples from patients with nasal septum deviation (healthy control group), eight nasal mucosa tissue samples from patients with allergic rhinitis（AR） and eight nasal mucosa tissue samples from patients with AR and asthma were collected. Allergy & Asthma PCR Array was used to analyze allergy related genes expression level. Result: Compared to the control group, there are 84 related genes were found and 15 genes were up-regulated, 69 genes were down-regulated. Furthermore, there are 17 genes（ADAM33, BCL6, IFNGR2, IL12A, IL12B, IL13RA1, IL17A, IL31, IL4R, IL5, KIT, LTB4R, MS4A2, RORC, STAT5A, STAT6, TBX21） differentially expressed. Compared AR with asthma group to the AR group, there was 1 gene differentially expressed(RORC). Conclusion: ADAM33, BCL6, IFNGR2, IL12A, IL12B, IL13RA1, IL17A, IL31, IL4R, IL5, KIT, LTB4R, MS4A2, RORC, STAT5A, STAT6, TBX21 are the possible pathogenic genes of AR with asthma. RORC may be the specific marker gene in asthma induced by allergic rhinitis.

[Clinical efficacy of endoscopic nasopharyngectomy for initially diagnosed advanced nasopharyngeal carcinoma].

Objective: To explore the clinical efficacy in patients who underwent endoscopic nasopharyngectomy for primary advanced nasopharyngeal carcinoma (NPC). Methods: Forty-five patients who underwent endoscopic nasopharyngectomy for primary advanced NPC encountered between Aug. 2007 and Sep. 2015 were retrospectively reviewed. Twenty-seven patients were male (60.0%), and 18 patients were female (40.0%), the ratio of male to female was 3∶2. The median age was 53 years old (ranged from 13 to 75 years old). The median onset time was 5 months (ranged from 1 to 72 months). TNM stage: 16 cases were at stage Ⅲ (35.6%), 29 at stage Ⅳ (64.4%); T3 16 cases (35.6%), T4 29 cases (64.4%); N0 38 cases (84.4%), N2 7 cases (15.6%). No patients were found to have distance metastasis. All patients underwent endoscopic resection of lesions. Postoperatively all the patients were treated with radiotherapy or chemoradiotherapy. Using SPSS 19.0 software, Kaplan-Meier and Log-rank test were done for the assessmen of survival rate; Cox proportional hazards model was used for the univariate analysis of prognostic factors. Results: The median follow-up was 36 months (ranged from 6 to 97 months), with 36 cases surviving (80.0%), 9 cases died (20.0%); 15 cases relapsed (33.3%). The overall 1 year survival rates (SR), 3 year SR, 5 year SR was 90.6%, 81.0%, 76.0%, respectively. The survival univariate analysis indicated the recurrence and metastasis were correlated with the survival (χ(2) value was 16.644, 6.451, respectively, all P<0.05). Conclusion: The patients who undergo endoscopic nasopharyngectomy for primary advanced NPC have better survival rate with lower recurrent rate and metastatic rate.

Schisandrin B attenuates the inflammatory response, oxidative stress and apoptosis induced by traumatic spinal cord injury via inhibition of p53 signaling in adult rats.

Schisandrin B is an active monomer of the Chinese magnolia vine (Schisandra chinensis) that can reduce transaminase activity in liver cells, inhibit lipid peroxidation, enhance antioxidant status, has protective effects in the liver and has antitumor effects. The present study investigated the potential protective effects of schisandrin B on the p53 signaling pathway in attenuating the inflammatory response, oxidative stress and apoptosis induced by traumatic spinal cord injury (TSCI) in adult rats. Behavioral examination, inclined plate test and spinal cord water content were used to evaluate the protective effect of schisandrin B in TSCI rats. The expression levels of superoxide dismutase (SOD), malondialdehyde (MDA), nuclear factor (NF)­κB subunit p65 and tumor necrosis factor (TNF)­α were examined using ELISA kits. Western blot analysis was performed to analyze the protein expression of caspase­3 and phosphorylated (p)­p53 in TSCI rats. In the present study, schisandrin B improved behavioral examination results and the maximum angle of inclined plate test, and inhibited spinal cord water content in rats with TSCI. Notably, schisandrin B reduced the activation of traumatic injury­associated pathways, including SOD, MDA, NF­κB p65 and TNF­α, in TSCI rats. In addition, schisandrin B suppressed the TSCI­induced expression of caspase­3 and p­p53 in TSCI rats. These results indicated that schisandrin B may attenuate the inflammatory response, oxidative stress and apoptosis in TSCI rats by inhibiting the p53 signaling pathway in adult rats.

[Analysis and dynamic observation of inhaled and food allergens for people in Pearl River Delta].

Objective:To investigate the distribution of allergens in patients with suspected allergic diseases in Pearl River Delta, analysis the changes of allergens with seasons and years, and provide clinical references for management strategies with regional character.Method:Patients from 9 hospitals in Pearl River Delta, with suspected clinical symptoms and signs of allergic disease, were given serum specific IgE test from September 2012 to April 2016. The positive rate was compared with genders, ages, the dynamic changes of seasons, and years.Result:In 30 003 patients, the positive rate of dust mites, house dust, tree, mugwort, mold, animal dander were 39.3%, 26.1%, 16.9%, 26.1%, 9.0%, 6.0% respectively. In 22748 patients, the positive rate of egg, milk, fish, seafood, meats, fruits, nuts were 13.5%, 14.5%, 10.3%, 14.5%, 10.9%, 15.4%, 10.9%. The positive rate of female patients are higher than male patients in both inhaled and food allergens (P< 0.01). The positive rate of minor group was obviously higher than that of the adult group (P< 0.01). The highest positive rate of dust mite, mold, animal dander, egg, fish occurs in the spring, while trees, mugwort, house dust, milk, seafood, meats, fruits, nuts in summer (P< 0.01). There was an upward trend in the positive rate of dust mite, while the positive rate of house dust, mugwort, mold, egg, milk was on the decline, and positive rate of other allergens changed in volatility from 2013 to 2015 (P< 0.01).Conclusion:The dust mites, house dust, seafood and fruits were the main allergens in Pearl River Delta and should be the key for prevention and treatment of allergic diseases. More attention should be paid to the patients of allergic diseases of minors and major seasonal allergens in clinical prevention and treatment. The changes of allergens with the years and dietary habit in local area for the prevention and control of allergic diseases are also not allowed to be ignored.

[Detection of differentially expressed gene of allergic rhinitis based on RT² profiler PCR array].

Objective:The aim of this study is to detect differentially expressed gene of allergic rhinitis (AR) based on RT² profiler PCR array. Method:The real-time PCR array containing 84 genes were used to compare inferior turbinate samples obtained from AR patients (n=8) and healthy individuals (n=8). Result:The results showed that 67 genes were down regulated and 17 genes were up regulated in AR inferior turbinate after analysis of 84 genes related to allergy and asthma. STAT6 and BCL6 were recognized as differentially expressed genes. Conclusion:The real-time PCR array can provide new insight into the pathophysiological processes involved in AR.

[Skull base metastasis from differentiated thyroid carcinoma: 3 cases report and review of literature].

Skull base metastasis from differentiated thyroid carcinoma (DTC), including papillary and follicular thyroid carcinoma, is a rare manifestation and easily misdiagnosed. In this study, we reported three cases whose initial clinical presentation was skull base metastasis complaints with the presence of silent primary sites. Based on the thyroid ultrasound and histopathology (identifying skull base and primary thyroid tumor), the final diagnoses of DTC metastasis to skull base were confirmed. Two patients underwent removal of metastasizing tumors in the skull base and primary thyroid cancer, and have respectively survived 58 months and 4 months since then. Another patient underwent tumor removal of the metastasizing skull base carcinoma leaving the primary lesion intact. However, the patient died of recurrent carcinoma after 18 months. We compared the diagnosis and treatment processes of three patients with DTC metastasis to skull base, and referenced the reported cases in the literature. In conclusion, DTC metastasis to skull base is a rare occurrence and hence easy to be misdiagnosed as primary skull base carcinoma. Clinical records, imaging tests, histopathology and immunohistochemistry are mandatory for differential diagnosis and final diagnosis. Surgical resection of both the primary and metastatic lesions is the recommended treatment. In cases where tumors are removed completely via surgery, no further treatment is necessary postoperatively when meticulously following up is in place. However, in cases where tumors are postoperative residual, radiation therapy after surgery is a feasible option.

[Endoscopic surgery and reconstruction for extensive osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma].

Objective: To investigate the clinical efficacy of endoscopic surgery for extensive osteoradionecrosis (ORN) of skull base in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Methods: Seventeen patients diagnosed as ORN of skull base after radiotherapy for NPC and underwent endoscopic surgery were retrospectively studied with their clinic data. Results: Based on the CT and endoscopic examination, all patients had large skull base defects with bone defects averaged 7.02 cm2 (range, 3.60 - 14.19 cm2). Excepting for curetting the sequestra, endoscopic surgery was also used to repair the wound or to protect the internal carotid artery with flap in 12 patients. No bone reconstructions were conducted in all patients with the bone defects of skull base. CT examinations were taken after endoscopic surgery when required. The postoperative follow-up ranged from 8 months to 6 years (average, 14 months). Aside from 1 patient with delayed cerebrospinal fluid (CSF), others had no related complications. Conclusions: The patients with extensive ORN can be treated with endoscopic surgery to curette the necrotic bone of skull base, and endoscopic reconstruction provides an alternative technique. It may not be necessary to reconstruct the bone defects at skull base, however, the exposed important structures of skull base, such as internal carotid artery, need to repair with soft tissue such as flap.

[Analysis of the characteristics of salvage endoscopic surgery for residual or recurrent nasopharyngeal carcinoma with different rT grading after radiotherapy].

Objective:To understand the characteristics and the treatment methods of the Salvage endoscopic surgery for residual or recurrent nasopharyngeal carcinoma（rNPC）with different rT grading after irradiation failure, and to explore the effect of different endoscopic procedures on the prognosis of the diseases.Method:Ninety-six patients who underwent endoscopic salvage nasopharyngectomy for rNPC in our department between June 2009 and March 2015 were retrospectively reviewed.All the patients underwent the corresponding salvage endoscopic surgery under general anesthesia according to the different rT grading and the patients with cervical metastasis received the radical neck dissection at the same time.Result:The number of the patients whose lesions were completely removed was 44(Total removal rate 45.8%),and the number of subtotal removal was 52(subtotal removal rate 45.8%),respectively.Postoperative follow-up continued until April 2015，the median follow-up was 19 months(1-57 months),the number of overall survival patients was 62(64.6%),the number of death was 34（35.4%）. The overall 1 year survival rate(SR),2 year SR,3 year SR were 83%,68%,63%,respectively.The median survival time was 43 months.Conclusion:The patients who underwent salvage endoscopic surgery for rNPC could have a good survival rate,and the different rT grading made the different methods to resect the lesions by the endoscopy. The use of frozen pathological examination during the operation to determine the negative rate of the surgical margins is the key to ensure the operation curative effect.

[Imaging diagnosis and forensic appraisal of orbital fracture].

Misdiagnosis and missed diagnosis are common in forensic appraisal of orbital fracture. Now imaging technology is very important for studying the forensic features of orbital fracture and evaluating the degree of injury. This article reviews the classification, pathogenesis and imaging diagnosis of orbital fracture. It may do some help to forensic appraisal of orbital fracture.