Altered intestinal microbiota enhances adenoid hypertrophy by disrupting the immune balance.

Introduction: Adenoid hypertrophy (AH) is a common upper respiratory disorder in children. Disturbances of gut microbiota have been implicated in AH. However, the interplay of alteration of gut microbiome and enlarged adenoids remains elusive. Methods: 119 AH children and 100 healthy controls were recruited, and microbiome profiling of fecal samples in participants was performed using 16S rRNA gene sequencing. Fecal microbiome transplantation (FMT) was conducted to verify the effects of gut microbiota on immune response in mice. Results: In AH individuals, only a slight decrease of diversity in bacterial community was found, while significant changes of microbial composition were observed between these two groups. Compared with HCs, decreased abundances of Akkermansia, Oscillospiraceae and Eubacterium coprostanoligenes genera and increased abundances of Bacteroides, Faecalibacterium, Ruminococcus gnavus genera were revealed in AH patients. The abundance of Bacteroides remained stable with age in AH children. Notably, a microbial marker panel of 8 OTUs were identified, which discriminated AH from HC individuals with an area under the curve (AUC) of 0.9851 in the discovery set, and verified in the geographically different validation set, achieving an AUC of 0.9782. Furthermore, transfer of mice with fecal microbiota from AH patients dramatically reduced the proportion of Treg subsets within peripheral blood and nasal-associated lymphoid tissue (NALT) and promoted the expansion of Th2 cells in NALT. Conclusion: These findings highlight the effect of the altered gut microbiota in the AH pathogenesis.

[The airway management and treatment of newborns with micrognathia and laryngomalacia].

Objective:To explore the perioperative airway management and treatment of newborns with micrognathia and laryngomalacia. Methods:From January to December 2022, a total of 6 newborns with micrognathia and laryngomalacia were included. Preoperative laryngoscopy revealed concomitant laryngomalacia. These micrognathia were diagnosed as Pierre Robin sequences. All patients had grade Ⅱ or higher symptoms of laryngeal obstruction and required oxygen therapy or non-invasive ventilatory support. All patients underwent simultaneous laryngomalacia surgery and mandibular distraction osteogenesis. The shortened aryepiglottic folds were ablated using a low-temperature plasma radiofrequency during the operation. Tracheal intubation was maintained for 3-5 days postoperatively. Polysomnography（PSG） and airway CT examination were performed before and 3 months after the surgery. Results:Among the 6 patients, 4 required oxygen therapy preoperatively and 2 required non-invasiveventilatory support. The mean age of patients was 40 days at surgery. The inferior alveolar nerve bundle was not damaged during the operation, and there were no signs of mandibular branch injury such as facial asymmetry after the surgery. Laryngomalacia presented as mixed type: type Ⅱ+ type Ⅲ. The maximum mandibular distraction distance was 20 mm, the minimum was 12 mm, and the mean was 16 mm. The posterior airway space increased from a preoperative average of 3.5 mm to a postoperative average of 9.5 mm. The AHI decreased from a mean of 5.65 to 0.85, and the lowest oxygen saturation increased from a mean of 78% to 95%. All patients were successfully extubated after the surgery, and symptoms of laryngeal obstruction such as hypoxia and feeding difficulties disappeared. Conclusion:Newborns with micrognathia and laryngomalacia have multi-planar airway obstruction. Simultaneous laryngomalacia surgery and mandibular distraction osteogenesis are safe and feasible, and can effectively alleviate symptoms of laryngeal obstruction such as hypoxia and feeding difficulties, while significantly improving the appearance of micrognathia.

Adenoid lymphocyte heterogeneity in pediatric adenoid hypertrophy and obstructive sleep apnea.

Introduction: Adenoid hypertrophy is the main cause of obstructive sleep apnea in children. Previous studies have suggested that pathogenic infections and local immune system disorders in the adenoids are associated with adenoid hypertrophy. The abnormalities in the number and function of various lymphocyte subsets in the adenoids may play a role in this association. However, changes in the proportion of lymphocyte subsets in hypertrophic adenoids remain unclear. Methods: To identify patterns of lymphocyte subsets in hypertrophic adenoids, we used multicolor flow cytometry to analyze the lymphocyte subset composition in two groups of children: the mild to moderate hypertrophy group (n = 10) and the severe hypertrophy group (n = 5). Results: A significant increase in naïve lymphocytes and a decrease in effector lymphocytes were found in severe hypertrophic adenoids. Discussion: This finding suggests that abnormal lymphocyte differentiation or migration may contribute to the development of adenoid hypertrophy. Our study provides valuable insights and clues into the immunological mechanism underlying adenoid hypertrophy.

Changes in the oral and nasal microbiota in pediatric obstructive sleep apnea.

Background: Several clinical studies have demonstrated that pediatric obstructive sleep apnea (OSA) is associated with dysbiosis of airway mucosal microbiota. However, how oral and nasal microbial diversity, composition, and structure are altered in pediatric OSA has not been systemically explored. Methods: 30 polysomnography-confirmed OSA patients with adenoid hypertrophy, and 30 controls who did not have adenoid hypertrophy, were enrolled. Swabs from four surface oral tissue sites (tongue base, soft palate, both palatine tonsils, and adenoid) and one nasal swab from both anterior nares were collected. The 16S ribosomal RNA (rRNA) V3-V4 region was sequenced to identify the microbial communities. Results: The beta diversity and microbial profiles were significantly different between pediatric OSA patients and controls at the five upper airway sites. The abundances of Haemophilus, Fusobacterium, and Porphyromonas were higher at adenoid and tonsils sites of pediatric patients with OSA. Functional analysis revealed that the differential pathway between the pediatric OSA patients and controls involved glycerophospholipids and amino acid metabolism. Conclusions: In this study, the oral and nasal microbiome of pediatric OSA patients exhibited certain differences in composition compared with the controls. However, the microbiota data could be useful as a reference for studies on the upper airway microbiome.

Association of Hypertriglyceridemic Waist Phenotype with Obstructive Sleep Apnea: A Cross-Sectional Study.

OBJECTIVE: Hypertriglyceridemic waist (HTGW) phenotype is an independent risk factor for metabolic disorders. Although obstructive sleep apnea (OSA) is associated with metabolic disorders, it is unclear whether there is an association between HTGW phenotype and OSA. METHODS: We enrolled consecutive participants presenting to a sleep center in Shanghai, China. Full-night polysomnography was performed, and serum triglyceride (TG) levels and waist circumference (WC) were calculated. HTGW phenotype was defined as increased WC (men > 90 cm, women > 80 cm) and elevated TG levels (> 1.7 mmol/L). Participants were classified into four groups: normal TG with normal WC (NTNW); normal TG with increased WC (NTGW); elevated TG with normal WC (HTNW); and elevated TG with enlarged WC, namely HTGW. The relationships between HTGW phenotypes and OSA were assessed using binary (apnea hypopnea index, [AHI]≥5/hr) and multinomial logistic regression analyses (clinical AHI severity categories). RESULTS: We included 3190 participants in this cross-sectional study. Compared to the NTNW phenotype, participants with NTGW and HTGW phenotypes had the significantly higher risk of OSA (AHI ≥5/hr, odds ratio [OR] = 2.51, 95% confidence interval [CI] = 1.91-3.31; OR = 3.76, 95% CI = 2.67-5.31, respectively), after adjustment for confounders. In subgroup analyses categorised by age, sex, and BMI, the aforementioned associations remained significant. The association between the NTGW, HTGW phenotype and OSA risk remained significant across the OSA severity groups. Multinomial logistic regression also revealed that the mild (OR = 1.63, 95% CI = 1.07-2.50), moderate (OR = 1.875, 95% CI = 1.22-2.88), and severe OSA (OR = 3.18, 95% CI = 2.14-4.73) were associated with HTGW phenotype. CONCLUSION: Both NTGW and HTGW phenotype were positively associated with OSA risk in all subgroups. Further longitudinal follow-up studies are needed to determine the causal link and prognostic role of these metabolic factors.

Pediatric temporal fistula: Report of three cases.

BACKGROUND: Pediatric temporal fistulae are rarely reported in the literature. Dissemination of these cases can help inform future diagnosis and effective treatment. CASE SUMMARY: Three pediatric patients came to the clinic due to repeated infections of the skin and soft tissue of the temporal area. One patient presented with a temporal fistula that penetrated the temporal bone and reached the dura mater. Another patient presented with a temporal fistula that penetrated into the temporal muscle fascia. The third patient presented with a fistula that penetrated the lateral wall of the orbit and entered the orbit. All patients underwent surgical fistula resection informed by preoperative computed tomography (CT) evaluation. Histopathological evaluation was also performed. All three patients were surgically treated successfully. Histopathological evaluations confirmed the fistula diagnoses in all three cases. CONCLUSION: For patients who have temporal fistulae with repeated infections, surgical treatment should be performed as soon as possible to prevent serious complications. CT can be very useful for preoperative evaluation. B-mode ultrasound examination and evaluation also have a certain auxiliary role.

The Associations Between Sleep Architecture and Metabolic Parameters in Patients With Obstructive Sleep Apnea: A Hospital-Based Cohort Study.

Background and Objectives: The associations between objective sleep architecture and metabolic parameters have been rarely studied in patients with obstructive sleep apnea (OSA). Here, we evaluated the associations between objective sleep measures derived via polysomnography (PSG) and metabolic parameters. Methods: A total of 2,308 subjects with suspected OSA were included. We measured common metabolic parameters such as body mass index (BMI) and glucose, insulin, blood pressure, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels. All subjects underwent full-night PSG. PSG sleep parameters included total sleep time (TST), time spent in slow-wave sleep (SWS) and rapid eye movement (REM) sleep, sleep efficiency, and the microarousal index (MAI). Results: The TST correlated with the BMI, glucose level, and systolic blood pressure. The SWS/TST ratio correlated with BMI and glucose, TC, and TG levels. The REM/TST ratio correlated with BMI, glucose, insulin, and TG levels, and diastolic blood pressure. We found significant relationships between sleep efficiency and BMI, glucose levels, and TG levels. The MAI was significantly correlated with all metabolic parameters. After adjustment for age, gender, smoking status, alcohol use, apnea hypopnea index, and oxygen desaturation index (ODI), multiple linear regression analysis showed that the MAI was independently associated with glucose level, TC, HDL, and LDL. REM/TST ratio was positively associated with diastolic blood pressure but negatively associated with glucose metabolism. Conclusions: Though some independent correlation between sleep and metabolic parameters was confirmed, only weak associations were observed, suggesting a clinically negligible influence of sleep structure. Further prospective studies are warranted to confirm our findings.

Interaction between obstructive sleep apnea and short sleep duration on insulin resistance: a large-scale study : OSA, short sleep duration and insulin resistance.

OBJECTIVES: Both short sleep duration and obstructive sleep apnea (OSA) seem to be associated with insulin resistance. We aimed to explore whether short sleep duration modifies the relationship between OSA and insulin resistance. METHODS: Participants were consecutively enrolled from our sleep center during the period from 2007 to 2017. The index of homeostasis model assessment insulin resistance (HOMA-IR) was calculated from insulin and glucose. Sleep duration was determined by standard polysomnography. The associations between sleep duration and insulin resistance were estimated by logistic regression analyses. RESULTS: A total of 5447 participants (4507 OSA and 940 primary snorers) were included in the study. OSA was independently correlated with insulin resistance after adjusting for all potential confounders (OR, 1.319; 95% CI, 1.088-1.599), but not short sleep duration. In stratified analysis by sleep duration, compared with primary snorers, in the OSA group only extremely short sleep duration (< 5 h) was significantly associated with insulin resistance after adjusting for all covariates (OR, 2.229; 95% CI, 1.283-3.874). Rapid eye movement predominant OSA was significantly associated with insulin resistance (OR = 1.355, 95% CI: 1.019-1.802) after adjustment for confounding factors including age, sex and body mass index. CONCLUSIONS: OSA, but not short sleep duration, was independently associated with insulin resistance. It is worth noting that OSA combined with extremely short sleep duration showed a greater detrimental effect than OSA itself with regard to insulin resistance.

Modified two-flaps palatoplasty with lateral mucus relaxing incision in cleft repair: A STROBE-compliant retrospective study.

STUDY DESIGN: clinical results of A STROBE-compliant retrospective study OBJECTIVE:: To achieving adequate pharyngeal closure and improve the pharyngeal function by a modified two-flap palatoplasty. SUMMARY OF BACKGROUND: Excessive tension in soft palate is the main factor causing the dysphonia after cleft palate. The tension-free suture of the soft palate is the key to achieving adequate pharyngeal closure. In this paper, a modified two-flap palatoplasty improved the pharyngeal function METHODS:: From August 2016 to December 2017, 20 patients with cleft palate were treated with a modified two-flap palatoplasty of the posterolateral symmetrical mucosal relaxation incision. The mucosal relaxation incision was performed on both posterolateral sides of the soft palate. RESULTS: All cases had good healing of mucosal flap and the palate. All patients underwent endoscopic examination at 6 months after operation. The postoperative results were satisfactory, with no complications. Twelve patients had bilateral exudative otitis media before operation, 4 patients returned to normal postoperatively, and 8 patients underwent bilateral tympanic membrane catheterization; 2 patients had abnormal function of bilateral eustachian tube before operation and returned to normal postoperatively; 3 patients had unilateral exudative otitis media before operation, and all of them returned to normal; the acoustic impedance test was normal in 3 children before operation. Most children begin to learn to speak, parents are satisfied with their pronunciation, and 3 children are in speech rehabilitation due to unclear pronunciation. CONCLUSIONS: We propose a technique to improve the function of the velopharyngeal closure which effectively reduces the incidence of pharyngeal insufficiency and occurrence of operative correction of pharyngeal closure dysfunction. The modifed two-flap palatoplasty with posterior lateral symmetric mucosal relaxation incision is beneficial for better velopharyngeal closure.

Diagnosis and treatment of the pharyngeal glial choristoma accompanied with incomplete cleft palate: A case report.

INTRODUCTION: A choristoma formed by heterotopic tissue rarely occurs in the throat, especially one accompanied with cleft palate in a new-born baby. PATIENT CONCERNS: An 18-month-old female patient was admitted to the hospital for apparent snoring symptoms accompanied by mouth breathing and sleep apnea. In addition, the patient presented with weak aspiration and nasal leakage during fluid intake. DIAGNOSIS: The patient received routine physical examination and endoscopy showing that there was a wide fissure which split from the palate vertical anterior cleft to 1/3 of the hard palate. Meanwhile, we found an unclear-bordered uplift in the left palate and a soft mass. The radiographs revealed a mass with inhomogeneous density convex to the pharyngeal cavity. INTERVENTIONS: The patient was subsequently referred for surgical resection and tissue diagnosis of choristoma was confirmed by pathological examination. H&E staining showed well demarcated mature brain tissue with scattered sand-like calcification. OUTCOMES: According to the diagnosis, the patient suffered from pharyngeal glial choristoma and incomplete cleft palate. The surgical resection and repair were performed together. The postoperative recovery was very good. LESSONS: Choristoma rarely occurs in the head and neck, especially if accompanied by cleft palate. Early diagnosis for choristoma relies heavily on clinical examination and radiological imaging. Complete resection of choristoma remains the gold standard for treatment of these patients.

Correlation of VEGF and EGFR in peripheral blood with clinical stage and pathological grade of renal cell carcinoma and analysis of prognosis.

PURPOSE: To detect the expression of VEGF and EGFR in peripheral blood and cancer tissues of patients with renal cell carcinoma (RCC), and to explore the correlations with clinical stage, pathological grade and prognosis of disease. METHODS: A total of 64 patients with RCC who were diagnosed and treated from June 2016 to August 2017 in our hospital were enrolled. Patients were divided into different clinical stages and pathological grades, and ELISA and immunohistochemistry were used to detect the expression of VEGF and EGFR in peripheral blood. Peripheral blood was also taken from 24 healthy individuals to serve as control group. Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expression of VEGF and EGFR in RCC tissues and paracancer tissues. All patients were followed up after discharge to record their survival. RESULTS: Significant differences in the expression levels of VEGF and EGFR were found between stage III and IV (p<0.05), but not between stage I and II. Expressions level of VEGF and EGFR in serum of well-differentiated, moderatelydifferentiated, and poorly-differentiated RCC were all higher than those in the healthy control group, and significant differences were found between different pathological grades (p<0.05). Patients with higher expression levels of VEGF and EGFR showed shorter survival compared to patients with lower expression levels (p<0.05). CONCLUSION: VEGF and EGFR in peripheral blood can be used as one of the effective indicators of prognosis of RCC. Our study provided reference for clinical treatment and prediction of prognosis of RCC.

Pediatric Obstructive Sleep Apnea is Associated With Changes in the Oral Microbiome and Urinary Metabolomics Profile: A Pilot Study.

STUDY OBJECTIVES: Several cross-sectional studies have reported associations between oral diseases and obstructive sleep apnea (OSA). However, there have been no reports regarding the structure and composition of the oral microbiota with simultaneous evaluation of potential associations with perturbed metabolic profiles in pediatric OSA. METHODS: An integrated approach, combining metagenomics based on high-throughput 16S rRNA gene sequencing, and metabolomics based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry and gas chromatography coupled with time-of-flight mass spectrometry, was used to evaluate the oral microbiome and the urinary metabolome. RESULTS: 16S rRNA gene sequencing indicated that the oral microbiome composition was significantly perturbed in pediatric OSA compared with normal controls, especially with regard to Firmicutes, Proteobacteria, Bacteroidetes, Fusobacteria, and Actinobacteria. Moreover, metabolomics profiling indicated that 57 metabolites, 5 of which were metabolites related to the microflora of the digestive tract, were differentially present in the urine of pediatric patients with OSA and controls. Co-inertia and correlation analyses revealed that several oral microbiome changes were correlated with urinary metabolite perturbations in pediatric OSA. However, this correlation relationship does not imply causality. CONCLUSIONS: High-throughput sequencing revealed that the oral microbiome composition and function were significantly altered in pediatric OSA. Further studies are needed to confirm and determine the mechanisms underlying these findings.

[Establishment of pharyngeal 3-dimensional finite element model of patients with isolated cleft palate].

PURPOSE: The aim of this study was to provide basis for future design and selection of cleft palate surgery through establishing finite element model of pharyngeal cavity which was suitable for biomechanical analysis. METHODS: One patient with isolated cleft palate and 1 normal child underwent multilayer head CT examination. The scanned data of pharyngeal cavity were imported into Mimics software for a 3-D geometric model reconstruction. The model was divided into a grid, so it can be further processed for subsequent finite element analysis. RESULTS: After applying 5cm water column pressure load of 0.0005 MPa at the back edge of the soft palate in the two models respectively, the results showed that the maximum stress of the abnormal nasopharyngeal cavity model was 0.025 MPa, greater than the normal model (0.017 MPa). The same pressure loading was applied to different parts of the two models, the stress change area in the posterior margin of the soft palate and the middle of the palate was the same, and the stress in the front of the hard palate was smaller. CONCLUSIONS: Finite element model has good biomechanical characteristics and geometric similarity. It can be used in isolated cleft palate with preoperative biomechanical analysis, for repairing and functional reconstructive surgery to provide ideal biomechanical model predicts.

Factors related to pediatric obstructive sleep apnea-hypopnea syndrome in children with attention deficit hyperactivity disorder in different age groups.

This study aimed to retrospectively investigate the factors related to pediatric obstructive sleep apnea-hypopnea syndrome (OSAHS) with attention deficit hyperactivity disorder (ADHD) in children younger than 6 years and those older than 6 years.A total of 437 children who were hospitalized due to OSAHS between January 2014 and December 2014 were retrospectively reviewed. The children were further divided into OSAHS group and OSAHS + ADHD group. The general characteristics, OSA-18 quality of life, intention-hyperactivity score, and polysomnographic parameters (apnea-hypopnea index and the lowest oxygen saturation) were collected and compared between groups.There were 298 boys and 139 girls with the male to female ratio of 2.14:1. ADHD was found in 146 children including 105 boys and 41 girls with the male to female ratio of 2.56:1. Of these children, 31.62% and 35.46% had concomitant ADHD in children aged 4 to 5 years and those aged 6 to 11 years, respectively. In children aged 4 to 5 years, the incidence of allergic rhinitis was significantly higher (P = .016) and the adenoid hypertrophy was more severe (P = .001) in those with concomitant ADHD. In children aged 6 to 11 years, the tonsil hypertrophy was more severe in those with concomitant ADHD (P = .019). In children with concomitant ADHD, OSA-18 score was higher than in those with OSAHS alone (P < .001). Higher frequency of respiratory events (P < .001) and more severe hypoxia (P < .001) were found in children with concomitant ADHD than in those with OSAHS alone.As high as 30% of OSAHS children have concomitant ADHD, and the incidence of ADHD in OSAHS children is increasing over age. Boys are more likely to develop OSAHS and incidence of ADHD in OSAHS boys is higher than in OSAHS girls. In addition, risk factors of ADHD also vary between age groups. The ADHD is related to the severity of allergic rhinitis and adenoid hypertrophy in children aged 4 to 5 years, and to the severity of tonsil hypertrophy in children aged 6 to 11 years. Hypoxia may be an important factor causing ADHD. OSAHS should be treated as early as possible to reduce the incidence of ADHD in children.

Identification and Validation of Gene Expression Patterns in Cystitis Glandularis Patients and Controls.

Our aim was to investigate differences in gene expression in bladder tissues between cystitis glandularis (CG) patients and healthy controls. Subsequent RNA was isolated from urinary bladder samples from CG patients and healthy controls, followed by RNA sequencing analysis. There were 4263 differentially expressed genes in urinary bladder between CG patients and controls, and 8 genes were verified with real-time PCR, Western blot, and enzyme-linked immunosorbent assay (ELISA) analysis. Gene set enrichment analysis (GSEA) revealed that 25 signaling pathways were upregulated in CG patients, and 17 signaling pathways were found upregulated in healthy controls. The mRNA expression levels of the indicated genes, including CCND1, CCNA1, EGFR, AR, CX3CL1, CXCL6, and CXCL1, were significantly increased in urinary bladder from CG and bladder cancer (BC) patients compared with healthy controls, while TP53 was decreased. CX3CL1, CXCL6, and CXCL1 concentrations in peripheral blood from CG and BC patients were significantly increased compared with healthy controls. The protein expression levels of CCND1, EGFR, and AR were significantly increased in urinary bladder from CG and BC patients compared with healthy controls. In conclusion, the gene expression profile of CG patients has established a foundation to study the gene mechanism of CG and BC progression.

Transcriptome analysis of primary aldosteronism in adrenal glands and controls.

Primary aldosteronism (PA) is the most common form of endocrine hypertension. This study was to investigate the gene expression profile in PA adrenal glands and normal controls using RNA-Sequencing. By performing transcriptome analyses for 3 PA adrenal glands and 3 controls on Illumina platform, we identified 1,093 transcripts as significantly differently expressed genes (DEGs), which provided clues for further study of these transcript changes during PA pathogenesis. Further, Gene Set Enrichment Analysis (GSEA) identified 35 significant Kyoto Encyclopedia of Genes and Genomes (KEGG) biological pathways, including 'ribosome', 'oxidative phosphorylation', 'histidine metabolism', 'xenobiotics metabolism by Cytochrome P450', 'drug metabolism by Cytochrome P450', 'tyrosine metabolism' and 'glutathione metabolism'. In summary, we identified novel genes that are associated with PA phenotype, as well as differently regulated biological pathways relating to protein synthesis, energy acquisition and metabolism. Our study provides new candidates for further elucidation of the molecular mechanisms underlying PA pathogenesis.

A clinical analysis of 21 cases of pen sheath bronchial foreign bodies in children.

OBJECTIVE: To explore the clinical characteristics of children pen sheath bronchial foreign body, andto conclude rigid bronchoscope and self-made foreign body hook in the value of diagnosis and treatment in childrenpen sheath bronchial foreign body and operating considerations. METHODS: 21 pen sheath bronchial foreign body cases diagnosed and treated by rigid bronchoscopy were retrospective analyzed. RESULTS: Under the assistance of self-made foreign body hook and latent speculum, 20 cases were successfully removed, 1 case was turned thoracotomy thoracic surgery. CONCLUSION: Rigid bronchoscopy is an effective method to finally diagnose and treat pen sheath bronchial foreign body. Using self-made foreign body hook can significantly improve the success rate of surgery and reduce occurrence of complications.

Correlation of ECM1 expression level with the pathogenesis and metastasis of laryngeal carcinoma.

OBJECTIVE: To investigate the expression of extracellular matrix protein 1 (ECM1) in benign laryngeal lesions, precancerous lesions and malignant laryngeal lesions and analyze the clinical significance of ECM1 changes in the pathogenesis and metastasis of laryngeal carcinoma. METHODS: A total of 46 patients with laryngeal lesions were recruited with a median age of 48.2 years (range: 33-67 years). Among these patients, 29 had laryngeal carcinoma (12 with metastasis and 17 without metastasis), 8 had benign laryngeal lesions and 9 had precancerous laryngeal lesions (laryngeal leukoplakia). Immunofluorescence staining was employed to detect the protein expression of ECM1 in benign laryngeal lesions, laryngeal leukoplakia and malignant laryngeal lesions; RT-PCR was used to measure the mRNA expression of ECM1 in laryngeal carcinoma and benign laryngeal lesions. RESULTS: ECM1 expression was detected in 25% (2/8) of patients with benign laryngeal lesions, 78% (7/9) of patients with precancerous laryngeal lesions, and 100% (29/29) of patients with laryngeal carcinoma. Among the laryngeal carcinoma patients, high ECM1 expression (+++) was found in 64.7% (11/17) of patients without lymph node metastasis and 91.7% (11/12) of patients with lymph node metastasis. Increased ECM1 expression was found in laryngeal carcinoma when compared with other laryngeal lesions and the ECM1 expression in patients with metastasis was significantly higher than that patients without metastasis (P<0.01). RT-PCR showed that the mRNA expression of ECM-1 in laryngeal carcinoma was markedly higher than that in benign laryngeal lesions. CONCLUSION: ECM1 expression is in an increasing order in benign laryngeal lesions, precancerous laryngeal lesions and malignant laryngeal lesions. Meanwhile, the metastatic laryngeal carcinoma has higher ECM1 expression than laryngeal carcinoma without metastasis. Our findings suggest that ECM1 plays promotive roles in the occurrence, development and metastasis of laryngeal carcinoma.

[Effects of antisense RNA of connective tissue growth factor expressing plasmid on rat liver fibrosis].

OBJECTIVE: To observe the effects of antisense RNA of connective tissue growth factor (CTGF) on rat liver fibrosis. METHODS: Gene recombinant techniques were used to construct a rat antisense RNA of CTGF recombinant plasmid which could be expressed in eukaryotic cells. The recombinant plasmids were encapsulated with lipofectamine and then transducted into a carbon tetrachloride (CCl4) induced rat liver fibrosis model. Expression of CTGF was assessed by RT-PCR, Western blot and immunohistochemistry. Immunohistochemistry was used to identify type I and III collagens. HE stained liver slides were used for pathological study. RESULTS: The mRNA and protein expression of CTGF in the fibrotic liver transfected with antisense-CTGF were significantly decreased compared with those of the controls (P<0.01). The depositions of type I and type III collagens were also decreased (P<0.05). Antisense-CTGF also minimized the pathological fibrosis in the rat livers (P<0.01). CONCLUSION: The results demonstrate that the antisense RNA of CTGF recombinant plasmid has certain effects in preventing liver fibrosis and makes it a possible candidate for use in future gene therapy.