[Measuring laryngotracheal stenosis by extracting centerline based on CT 3D reconstruction].

Objective: To compare the accuracy of the centerline extracted based on CT 3D reconstruction and conventional CT 3D reconstruction in measuring the length and degree of laryngotracheal stenosis. Methods: A retrospective analysis was performed on 35 patients with laryngotracheal stenosis (including 19 cases without tracheotomy and 16 cases with tracheotomy) treated in the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Guangxi Medical University from March 2006 to March 2016, including 20 males and 15 females, whose ages ranged from 1 to 73 years, with a median age of 40.5 years. And CT data of 20 normal subjects were included in the same period, including 10 males and 10 females, whose ages ranged from 20 to 63 years, with a median age of 37.0 years. The continuous cross-sectional area of the airway perpendicular to the centerline was obtained by Mimics software. The area was compared with the discontinuous cross-sectional areas reconstructed by conventional CT 3D reconstruction software advantage workstation, also the length of cervical trachea, the length of stenosis, and the minimum airway area were compared. Multi-factor linear stepwise regression method was used to analyze the factors influencing the measuring difference between the two methods. Three patients with laryngotracheal stenosis were selected, and the measured stenosis length was compared with the surgical specimens to evaluate the accuracy of the two methods. SPSS 26.0 software was used for statistical analysis. Results: In normal people, the areas of thyroid cartilage notch, glottis, inferio thyroid cartilage margin, inferio cricoid cartilage margin, and suprasternal notch planes measured by Mimics centerline method were smaller than those measured by conventional CT 3D reconstruction (t thyroid cartilage notch=4.685, tglottis=3.791, tlower thyroid cartilage margin=5.621, tlower cricoid cartilage margin=6.312, tsuprasternal notch plane=6.436, P<0.05). And the airway length measured by Mimics centerline method from the inferior thyroid cartilage to the superior sternal notch was longer (t=9.79, P<0.001). In laryngotracheal stenosis, in the non-tracheotomy group, the minimum airway area measured by Mimics centerline method was smaller and the stenosis length was longer than those measured by the conventional CT 3D reconstruction, and the difference was statistically significant (tminimum airway area=2.562, tstenosis length=5.240, P<0.05). In the tracheotomy group, the stenosis length measured by Mimics centerline method was longer than that measured by conventional CT 3D reconstruction, and the difference was statistically significant (tstenosis length=2.854, P<0.05). Multi-factor linear regression analysis showed that different CT thickness had a statistically significant effect on the difference in the length of stenosis measured by the two methods (b=-5.370, t=-3.306, P=0.004), and different tracheal forward angle had a statistically significant effect on the difference in the minimum airway area measured by the two methods (b=-0.419, t=-2.208, P=0.04). The difference between the measured length of the Mimics centerline method and the intraoperative specimens was less than 0.5 mm. Conclusion: The centerline extracted based on CT 3D reconstruction can precisely reflect the laryngotracheal morphology and measure laryngotracheal stenosis more accurately.

The impact of sample storage on molecular-based detection of Mycoplasma genitalium.

AIMS: Mycoplasma genitalium causes a common, sexually transmitted bacterial infection. This study assessed the detection of M. genitalium in stored urine samples to understand the impact of sample storage on M. genitalium detection. METHODS: Aliquots of M. genitalium-positive urine (n = 20 patients) were stored at either room temperature (22°C) or 4°C, without a preservative. At weekly intervals, samples were tested using the commercial test ResistancePlus MG® (SpeeDx® , Australia). We report the analysis at 1 week, an acceptable collection-to-test turnaround time, with further analysis over 5 weeks to illustrate degradation trends. RESULTS: After storing at 4°C, the proportion of specimens that remained positive for M. genitalium was 100% after 1 week and 95% after 4 weeks. Storage at 22°C led to more rapid decline in detection in the first 4 weeks, with 95% detected after 1 week and 85% at 2 weeks onwards. At 5 weeks, samples stored at both temperatures had an 85% M. genitalium detection rate, with increase in crossing points (Cq) of 0·72 (95% confidence interval (CI) 0·01-1·43; P-trend = 0·027) at 4°C, and 1·75 ((95% CI 0·79-2·71), P-trend <0·001) at 22°C. CONCLUSIONS: Urine samples stored without preservative, and unfrozen, retained high M. genitalium detection levels over the short term (up to 5 weeks). To minimize degradation, storing at 4°C is recommended. SIGNIFICANCE AND IMPACT OF THE STUDY: There is little known about the stability of clinical samples for M. genitalium detection. This study found that a high proportion (85-100%) of samples are still suitable for M. genitalium detection after storage for up to 5 weeks.

Circulating miR-31-5p may be a potential diagnostic biomarker in nasopharyngeal carcinoma.

Aberrant expression of miR-31-5p has been detected in various cancers and plays a significant role in tumorigenesis. Low miR-31-5p expression was present in nasopharyngeal carcinoma (NPC) tissues and cell lines and acted as a tumor suppressive miRNA. Currently, circulating miRNAs are emerging as novel biomarkers for the early diagnosis of cancers using a non-invasive method. However, circulating miR-31-5p has rarely been reported in NPC. Therefore, the aim of this study was to explore peripheral blood miR-31-5p levels as a noninvasive biomarker and evaluate its clinical value for the early diagnosis of patients with NPC. A total of 110 participants were recruited, including 55 NPC patients and 55 healthy controls. Peripheral blood samples were collected from these participants, and total RNA was extracted to quantify the relative expression of miR-31-5p by RT-qPCR. We found a significantly lower expression of miR-31-5p in the NPC patients than in the healthy controls. Furthermore, low expression of miR-31-5p was highly correlated with tumor-node-metastasis (TNM) stage (I+II vs III+IV, p=0.001), T classification (T1 vs T2+T3+T4, p=0.036) and local lymph node metastasis (N1-N3 vs N0, p=0.002), but not distant metastasis (p=0.288). Moreover, miR-31-5p showed a moderate diagnostic performance (AUC=0.866, sensitivity = 0.782, specificity = 0.818). Thus, we concluded that circulating miR-31-5p can be a potentially novel and non-invasive biomarker for the early diagnosis of NPC and an attractive therapeutic target in NPC patients.

Molecular mechanism of action of valproate acid alone or in combination with chlorpromazine in the epigenetic regulation of schizophrenia.

This study aimed to assess the molecular mechanism of the histone deacetylase inhibitor (HDACI) valproate acid (VPA) alone or in combination with the antipsychotic drug chlorpromazine in the epigenetic regulation of schizophrenia. A total of 60 perinatal CD-SD rats were divided in a control group (16 animals) and a schizophrenia model group (44 animals). For the schizophrenia model group the rats received phencyclidine (PCP) 10 mg/kg/day by intradermal injection on days 7, 9, and 11 after birth. The model was confirmed by the Morris water test in 40 rats. The control and model rats were divided into 7 groups. The Real Time PCR assay was used to detect the mRNA expression changes of GABA system gene [GABBR1 (GABA B receptor 1)], GAD1 (glutamic acid decarboxylase1), GAD2 (glutamic acid decarboxylase2), Lipase metabolic key enzyme LPL (lipoprotein lipase) gene, glutamate neurotransmitter gene GRIA2 (AMPA subtype glutamate receptors 2), inward rectifier potassium channel members KCNJ4 (potassium voltage-gated channel subfamily J member 4) and neuropeptide signal gene TAC1 (tachykinin precursor 1,TAC1) in four brain regions: the prefrontal cortex (PC), the amygdala (AM), the caudate-putamen (CPU) and the hippocampus (HIP). The platform arrival time of PMV and PMVC groups was significantly reduced compared to the PM group, the reduction being more significant in the PMV group. In the four brain regions of the epigenetic animal model of schizophrenia, the expression of GABBR1, GAD1, and GAD2 genes increased significantly. Following administration of HDACI VPA, the mRNA expression of this gene in the four brain regions decreased or approached normal levels. GABBR1 GAD1 and GAD2 are likely to be the target genes affected by the HDACI VPA.

[Advances in osteoradionecrosis of nasopharynx after radiotherapy for nasopharyngeal carcinoma].

Radiation therapy is the first choice for the treatment of nasopharyngeal carcinoma. However, it is inevitable that nasopharyngeal mucosa and tissue will be damaged after radiotherapy of nasopharyngeal carcinoma, which will cause corresponding complications. Nasopharyngeal osteonecrosis is a serious complication. Up to now, there are few reports about nasopharyngeal osteonecrosis, and the underlaying pathological mechanism remains unclear. The potential theories include radiotherapy damage, infection and trauma, but also the " three H" principle of hypoxic hypocellular hypovascular tissue, as well as the theory of radio induced fibrosis. It is controversial about the treatment of nasopharyngeal osteonecrosis. It takes comprehensive treatment, including local treatment, systemic treatment, surgical treatment and other treatments. Among them, local treatment as nasopharyngeal debridement usually is first choice. We reviewed the pathological mechanism and treatment methods of nasopharyngeal osteonecrosis, in order to provide a reference for better prevention and treatment of it.

[The morphplogical and its influencing factors research after supracricoid partial laryngectory with cricohyoidoepiglottopexy].

Objective:The aim of this study for observing laryngeal morphology, and motion characteristics after supracricoid partial laryngectomy with cricohyoidoepiglottopexy（SCPL-CHEP），exploring the relevant factors affecting the morphology of new laryngeal. Method:Choose 46 cases of patients with laryngeal cancer for SCPL-CHEP as the object of study, dynamic laryngoscope were performed in all the patients, to observe the movement of laryngeal pronunciation (neoglottis closure , supraglottic situation) . Combined with the patient's clinical data, the relevant factors that may affect the pronunciation and movement characteristics of the new throat were analyzed. Result:46 patients after SCPL-CHEP were included in the study. The neoglottis completely closed in 31 cases (67.4%), insufficiency closed in 15 cases (32.6%). Supraglottic vibration in 33 cases (71.7%), 13 cases (28.3%) of supraglottic structure vibration free.The Spearman 's analysis showed that, neoglottal closure status was positively correlated with age and subglottic lesions (r=0.313, P=0.034; r=0.592, P=0.000), and negatively correlated with the postoperative time (r=-0.446, P=0.002). The supraglottic vibration was negatively correlated with postoperative radiotherapy. Conclusion:The anatomy of neolarynx changes greatly,the function of neolarynx only depends on the movement of he remaining cricoarytenoid unit and arytenoid mucosa vibration. The age, tumor type, and postoperative time are related factors that affect glottic closure. Postoperative radiotherapy can reduce the occurrence of supraglottic vibration.

Effects of different degrees of depression on inflammatory response and immune function in patients with ovarian cancer.

The aim of this study was to explore the effect of depression of different degrees on inflammatory response and immune function in patients with ovarian cancer. One hundred and eight cases of ovarian cancer according to the Federation Internationale of Gynecologie and Obstetrigue (FIGO) stage II~III who visited the Gynecology Department of Affiliated HongQi Hospital of MuDanJiang Medical University between September 2015 and May 2017 were enrolled in the study. After being hospitalized, they were divided into two groups according to their Beck Depression Inventory (BDI) scores. The total score of BDI is 63, with 0~4 for the normal group (25 cases), 5~13 for the mild depression group (24 cases), 14~20 for the moderate depression group (28 cases), and 21~63 for the severe depression group (31 cases). The immune function, inflammatory reaction, tumor markers [CA125, human epididymis protein-4 (HE4), insulin-like growth factor-I (IGF-I)], platelet technology and D-dimer index were compared between the four groups. The results showed that there were different levels of depression in patients with ovarian cancer in II~III stage, and the degree of depression could stimulate the level of serum-6, and TNF -α in serum increased. The proportion of CD3+, CD4+ and NK cells in patients with severe depression decreased, and their immunity also decreased. Depression increased the levels of CA125, HE4 and IGF-I in serum and ascites of ovarian cancer patients, and increased the risk of tumor progression and recurrence. Hypercoagulability existed in patients with ovarian cancer, and tumor associated depression could increase platelet count in plasma and increase D-dimer level. To sum up, depression can affect the level of micro inflammation in patients with ovarian cancer. In particular, depression can reduce cellular immune responses, affect the progression free survival of ovarian cancer patients, and reduce their overall survival rate.

[The application status of the linear stapler device in the total laryngectomy].

Summary It is very obvious that the linear stapler can shorten the operation time, reduce the incidence of pharyngeal fistula, and shorten the oral feeding time in total laryngectomy. However the stapler was used in the total laryngectomy not as widespread as in gastrointestinal surgery. In order to further understanding the function of the linear stapler device in the total laryngectomy, the stapler's composition, working principle, classification，method to use, operation method, and application of advantages and disadvantages will be reviewed.

[The sodium salicylate affects the expression of NMDA receptor and GABAa receptor subunits in spiral ganglion neurons of the cochlea through DA receptor].

Objective:To investigate mRNA expression of dopamine receptor subtypes in the rat cochlear spiral ganglion neurons (SGN) following exposure to the sodium salicylate. In addition, we observed the effect of sodium salicylate on N methyl-D-aspartic acid (NMDA) receptor subunit NR1 and gamma aminobutyric acid (GABA)a receptor subunit GABRα2 mRNA under the circumstance of DR activation or blocking. Moreover, we also focused on the the interaction between receptors mediated by SS.Method:Immunofluorescence techniques were applied to detect DR (DR1 and DR2) expression in cultured rat SGN. Moreover, RT-PCR was performed to assess NR1 and GABRα2 subunit mRNA.Result:Immunofluorescence images showed co-localization of DR1/DR2 and ßⅢ-tubulin protein in SGN bodies and axons. RT-PCR results illustrated that ①DR subtypes of DRd1-5 were detected in the SGN. ②The mRNA expression of all subtypes of DR and GABRα2, NR1 subunits were obviously upregulated except DRd3 after treatment with sodium salicylate. Among them, DRd1 expression increased 34.64%(t=-5.123,P=0.007),DRd2 expression increased 34.60%(t=-5.206,P=0.006),DRd4 expression increased 20.87%(t=-3.337,P=0.029),DRd5 expression increased 26.42%(t=-6.054,P=0.004),GABRα2 expression increased 30.41%(t=-2.839,P=0.047),NR1 expression increased 39.22%(t=-6.243,P=0.003).③After exposure to sodium salicylate (5 mmol/L), dopamine (100 µmol/L), DR1 agonist (SKF38393,20 µmol/L), DR2 agonist (Quinpirole,20 µmol/L), GABRα2 expression increased 21.78%,27.45%,33.02%,33.42% respectively (F=12.399,P=0.001),and NR1 expression increased 28.70%,26.82%,29.03%,35.05%(F=50.395,P=0.000) respectively.④Compared with the group of sodium salicylate treatment alone, both sodium salicylate + DR1 antagonist (SCH23390,20 µmol/L) group and sodium salicylate + DR2 antagonists (Eticlopride,20 µmol/L) group had a suppression on GABRα2 and NR1 mRNA expression.GABRα2 mRNA reduced 29.56%,37.10%(F=22.101,P=0.000) and NR1 mRNA expression decreased 37.62%,32.83% respectively(F=72.933,P=0.000).Conclusion:Most of the DR subtypes mRNA expression in SGN were increased following exposure to sodium salicylate. DR may be involved in the effect of sodium salicylate on GABAaR and NMDAR mRNA expression.

[Present situation of laryngotracheal stenosis' diagnosis technology].

Laryngotracheal stenosis is a complex and dangerous disease,which caused by trauma or endotracheal intubation.Accurately and clearly to show the length and area of the airway stenosis,which is of great significance for the correct qualitative and quantitative diagnosis of the disease and the development of the treatment.The relevant inspection has its advantages and disadvantages.How to use inspection accurate and reasonable,there is no unified standard.Therefore,this paper will evaluate the role and significance of different relevant inspection(pulmonary function tests,ultrasound,bronchoscopy,CT,MRI) in the diagnosis of laryngotracheal stenosis,providing reference for laryngeal and tracheal stenosis diagnosis and treatment.

Two color analysis of HLA-B27 antigen by flow cytometer--a comparative study by conventional microlymphocytotoxicity, DNA genotyping polymerase chain reaction and flow cytometric measurement.

For evaluation of specificity and sensitivity of flowcytometric determination of HLA-B27 antigen, we determined the HLA-B27 on lymphocytes using HLA-B27 monoclonal antibody by flow cytometer. Data were compared to those by conventional Terasaki microlymphocytoxicity test and DNA genotyping Polymerase Chain Reaction (PCR) method. One hundred and ninety four patients with various forms of arthritis were included in this study. Forty one of them were HLA-B27 positive, confirmed by three methods concomitantly with complete accordance. None of serological B27 negative, B7 CREG positive cells were found to be flowcytometric fluorescence positive. Furthermore, there was no significant difference of B27 intensity between different B27 DNA subtypes, nor was there any difference between primary ankylosing spondylitis (AS) and other secondary spondylitis patients as measured by mean channel of fluorescence. It is suggested that flowcytometric measurement of HLA-B27 antigen is a rapid and reliable method for HLA-B27 determination.

Differential requirement of CD28 costimulation for activation of murine CD8+ intestinal intraepithelial lymphocyte subsets and lymph node cells.

The CD8+CD4- (CD8+) murine small intestinal intraepithelial lymphocytes (IELs) contain two subpopulations, one expressing alpha alpha-CD8 homodimers and another alpha beta-CD8 heterodimers. In this study, plate-bound anti-TCR beta-chain (TCR-beta) mAb alone or combined with anti-CD28 mAb is used as a model system to study activation requirement of these two CD8+ IEL subsets. In contrast to CD8+ lymph node (LN) cells that require both TCR and CD28 triggering for activation, alpha beta-CD8+ IELs proliferate and produce IL-2 and IFN-gamma when stimulated with anti-TCR-beta mAb alone, and soluble CTLA-4 Ig has no effect on their responses. On the other hand, alpha alpha-CD8+ IELs neither make IL-2 or IFN-gamma nor proliferate even when both stimuli are provided. However, alpha alpha-CD8+ IELs are capable of proliferation in both CD8+ IEL subsets is lower than in CD8+ LN cells, which contributes to the weaker and delayed response of CD8+ IELs.