A review of the risk factors associated with juvenile-onset recurrent respiratory papillomatosis: genetic, immune and clinical aspects.

BACKGROUND: Juvenile-onset recurrent respiratory papillomatosis (JoRRP) is one of the most common benign lesions of hyperplastic respiratory epithelial tissue in children and is predominantly caused by human papillomaviruses (HPVs) 6 and 11. The clinical course of the disease is variable, and some patients even develop a malignancy. The purpose of this review was to summarize the related factors affecting the disease course in patients with JoRRP. DATA SOURCES: We used databases, including PubMed and Google Scholar, to search for publications on factors associated with the genetic, immune, and clinical aspects of JoRRP. The most relevant articles to the scope of this review were chosen for analysis. RESULTS: Mother-to-child transmission is the most important mode of disease transmission; other factors, such as immune condition or genetic susceptibility, may be important determinants of JoRRP occurrence. Genetically, the presence of DRB1*0301 and HPV 6/11 E6/E7 is associated with a more severe disease. Immunewise, patients have an enhanced T helper 2-like response. In addition, regulatory T cells are enriched in tumors and may become one of the effective prognostic indicators. For clinical characteristics, patients infected with HPV-11 have more aggressive disease. However, compared with HPV type, age at first onset is a more important factor related to the aggressiveness of JoRRP. Furthermore, socioeconomic status may also affect the course. CONCLUSIONS: Genetic, immune, and some clinical factors have been noted to play an important role in the course of JoRRP. Exploring definite influencing factors will be an important direction of research in the future.

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.

[Proportion and prevention of venous thromboembolism among hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease in Beijing].

OBJECTIVE: To explore the proportion and prevention status of venous thromboembolism (VTE) among hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing. METHODS: Based on a multi-center retrospective study, a total of 636 hospitalized AECOPD patients from 17 class 2/3 hospitals in Beijing were examined from September 1, 2011 to March 31, 2012. They fulfilled one of the following criteria: respiratory failure type II, on invasive or non-invasive mechanical ventilation, hospitalization for pulmonary infection, bedridden duration ≥ 3 days and congestive heart failure. All investigators received standardized training and used a standardized questionnaire to collect data on VTE risk factors, the diagnosis of VTE and the utilization of VTE prophylaxis. According to Caprini score, they were categorized into 3 groups of lower risk (Caprini score ≤ 3), moderate risk (Caprini score 4-6) and high risk ( ≥ 7) to compare the intergroup differences in the VTE proportion and the utilization of VTE prophylaxis. RESULTS: A total of 636 patients were assessed. There were 416 males and 220 females with a mean (SD) age of 74.9 ± 9.3 years. Among them, 133 patients received lower extremity venous ultrasonic examination and 92 were diagnosed with deep venous thrombosis (DVT) including 2 patients with pulmonary thromboembolism (PTE). Thus the overall incidence of VTE was 14.5% (92/636) and increased with age (Ptrend = 0.044). The proportion of VTE in asymptomatic patients was higher in those symptomatic ones (21.1% vs 8.0%, P = 0.000). And it was the highest in high risk group, followed by lower risk and moderate risk groups at 17.9% (14/78), 16.0% (26/163) and 13.2% (52/395) respectively, There was no statistical significance (P = 0.450 for group difference, Ptrend = 0.946). Among 544 patients without VTE, only 19.1% (104/544) employed the pharmacologic and/or mechanical methods for preventing VTE. The prevention proportion gradually increased with rising Caprini score, i.e. 17.5%, 18.4% and 26.6% for lower, moderate and higher risk group respectively. There was no statistical significance (P = 0.266 for group difference, Ptrend = 0.201). CONCLUSIONS: The proportion of VTE is relatively higher. However, the preventive methods are significantly underutilized among hospitalized AECOPD patients in Beijing.

Expression and purification of recombinant human serum albumin from selectively terminable transgenic rice.

Human serum albumin (HSA) is widely utilized for medical purposes and biochemical research. Transgenic rice has proved to be an attractive bioreactor for mass production of recombinant HSA (rHSA). However, transgene spread is a major environmental and food safety concern for transgenic rice expressing proteins of medical value. This study aimed to develop a selectively terminable transgenic rice line expressing HSA in rice seeds, and a simple process for recovery and purification of rHSA for economical manufacture. An HSA expression cassette was inserted into a T-DNA vector encoding an RNA interference (RNAi) cassette suppressing the CYP81A6 gene. This gene detoxifies the herbicide bentazon and is linked to the 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) cassette which confers glyphosate tolerance. ANX Sepharose Fast Flow (ANX FF) anion exchange chromatography coupled with Butyl Sepharose High Performance (Butyl HP) hydrophobic interaction chromatography was used to purify rHSA. A transgenic rice line, HSA-84, was obtained with stable expression of rHSA of up to 0.72% of the total dry weight of the dehusked rice seeds. This line also demonstrated high sensitivity to bentazon, and thus could be killed selectively by a spray of bentazon. A two-step chromatography purification scheme was established to purify the rHSA from rice seeds to a purity of 99% with a recovery of 62.4%. Results from mass spectrometry and N-terminus sequencing suggested that the purified rHSA was identical to natural plasma-derived HSA. This study provides an alternative strategy for large-scale production of HSA with a built-in transgene safety control mechanism.

[Relationship between idiopathic epilepsy and sleep macrostructure in children].

OBJECTIVE: To evaluate the relationship between epilepsy and sleep macrostructure in children. METHODS: Totally 31 children with idiopathic epilepsy aged 6-13 (mean 9.5) years were enrolled in this study, including 18 with idiopathic focal epilepsy and 13 with idiopathic generalized epilepsy. Sixteen age-and gender-matched children were also included as the control group. Polysomnogram (PSG) was recorded in all the children for analysis. RESULTS: Children with idiopathic partial epilepsy had increased total recording time (P<0.05) and those with idiopathic generalized epilepsy exhibited reduced non-rapid eye movement sleep in comparison with the control group. The efficiency of the different phases in the total sleep was also lowered in children with idiopathic generalized epilepsy (P<0.05), whose total sleep time had also been significantly reduced (P<0.05). CONCLUSIONS: Significant changes occur in the sleep macrostrcture of children with idiopathic epilepsy. Children with idiopathic generalized epilepsy presents poorer sleep quality, whereas those with idiopathic partial epilepsy tend to require excessive time for sleep.

[Clinical observation on effect of combination of zhuanyindan and hormone in treating male infertility with positive antisperm antibody].

OBJECTIVE: To explore the therapeutic effect of combination of Zhuanyindan (ZYD, a self-made Chinese herbal preparation) and hormone in treating male infertility with positive antisperm antibody and its influence on nitric oxide (NO) level. METHODS: Eighty-two patients were randomly divided (according to the digital list) into the WM group (n = 20, treated with prednisone), the TCM group (n = 28, treated with ZYD) and the ICWM group (n = 34, treated with prednisone plus ZYD). The clinical effect, negative converting rate of antisperm antibody, changes of NO level in semen and various parameters of sperm motion before and after treatment were observed. RESULTS: The total effective rate in the ICWM group was 88.2%, that in the TCM group 75.0% and in the WM group 65.0%. Significant difference was seen in the ICWM and TCM group before and after treatment in NO level, sperm motion parameters, including linear motion speed, linearity, propulsion, whip frequency, sperm vitality and mean moving angle, and quality of semen (P < 0.05 or P < 0.01). In the WM group, significant difference in comparison before and after treatment was seen in NO level, propulsion, whip frequency, mean moving angle and quality of semen, including vitality and survival rate (P < 0.01). CONCLUSION: Combination of Chinese herbs and hormone could lower the NO level in semen and improve the quality of sperm.