[Metagenomic data-analysis reveals enrichment of lipopolysaccharide synthesis in the gut microbiota of atrial fibrillation patients].

Objective: To investigate the functional changes of key gut microbiota (GM) that produce lipopolysaccharide (LPS) in atrial fibrillation (AF) patients and to explore their potential role in the pathogenesis of AF. Methods: This was a prospective cross-sectional study. Patients with AF admitted to Beijing Chaoyang Hospital of Capital Medical University were enrolled from March 2016 to December 2018. Subjects with matched genetic backgrounds undergoing physical examination during the same period were selected as controls. Clinical baseline data and fecal samples were collected. Bacterial DNA was extracted and metagenomic sequencing was performed by using Illumina Novaseq. Based on metagenomic data, the relative abundances of KEGG Orthology (KO), enzymatic genes and species that harbored enzymatic genes were acquired. The key features were selected via the least absolute shrinkage and selection operator (LASSO) analysis. The role of GM-derived LPS biosynthetic feature in the development of AF was assessed by receiver operating characteristic (ROC) curve, partial least squares structural equation modeling (PLS-SEM) and logistic regression analysis. Results: Fifty nonvalvular AF patients (mean age: 66.0 (57.0, 71.3), 32 males(64%)) were enrolled as AF group. Fifty individuals (mean age 55.0 (50.5, 57.5), 41 males(82%)) were recruited as controls. Compared with the controls, AF patients showed a marked difference in the GM genes underlying LPS-biosynthesis, including 20 potential LPS-synthesis KO, 7 LPS-biosynthesis enzymatic genes and 89 species that were assigned as taxa harbored nine LPS-enzymatic genes. LASSO regression analysis showed that 5 KO, 3 enzymatic genes and 9 species could be selected to construct the KO, enzyme and species scoring system. Genes enriched in AF group included 2 KO (K02851 and K00972), 3 enzymatic genes (LpxH, LpxC and LpxK) and 7 species (Intestinibacter bartlettii、Ruminococcus sp. JC304、Coprococcus catus、uncultured Eubacterium sp.、Eubacterium sp. CAG:251、Anaerostipes hadrus、Dorea longicatena). ROC curve analysis revealed the predictive capacity of differential GM-derived LPS signatures to distinguish AF patients in terms of above KO, enzymatic and species scores: area under curve (AUC)=0.957, 95%CI: 0.918-0.995, AUC=0.940, 95%CI 0.889-0.991, AUC=0.972, 95%CI 0.948-0.997. PLS-SEM showed that changes in lipopolysaccharide-producing bacteria could be involved in the pathogenesis of AF. The key KO mediated 35.17% of the total effect of key bacteria on AF. After incorporating the clinical factors of AF, the KO score was positively associated with the significantly increased risk of AF (OR<0.001, 95%CI:<0.001-0.021, P<0.001). Conclusion: Microbes involved in LPS synthesis are enriched in the gut of AF patients, accompanied with up-regulated LPS synthesis function by encoding the LPS-enzymatic biosynthesis gene.

Decreased platelet-to-lymphocyte ratio as predictor of thrombogenesis in nonvalvular atrial fibrillation.

BACKGROUND: Inflammation plays a key role in the progression of atrial fibrillation and its related prothrombotic state. The platelet-to-lymphocyte ratio (PLR) is an easily obtainable biomarker of inflammatory burden. Decreased left atrial appendage flow velocity (LAA-FV) reflects blood stasis, and left atrial strain is a manifestation of atrial remodeling. This study examined the role of PLR in reflecting decreased LAA-FV and its correlation with impaired left atrial strain. METHODS: In 54 patients with nonvalvular atrial fibrillation, LAA-FV and left atrial strain were measured by echocardiography. The PLR was calculated from a complete blood count. RESULTS: The PLR was lower in the group of patients with decreased LAA-FV (84.22 [IQR, 69.87-98.17 cm/s] vs. 103.27 [IQR, 90.37-127.16 cm/s]; p = 0.018). PLR was predictive of decreased LAA-FV with a sensitivity of 66.7% and a specificity of 83.3%. In a receiver operator characteristic curve analysis, using a cut-off value of 88.16, the area under the curve for PLR as a predictor of decreased LAA-FV was 0.726 (p = 0.018). Furthermore, the patients with a PLR of < 88.16 had a lower left atrial strain than those with a PLR of > 88.16 (0.38 vs. 0.77, p = 0.02). CONCLUSION: The PLR was lower in patients with nonvalvular atrial fibrillation and with a decreased LAA-FV. Its correlation with left atrial strain might indicate the role of inflammation in the progression of atrial remodeling and in the prothrombotic state.

[Correlation between androgen receptor expression and surrogate molecular subtypes in invasive breast carcinoma].

Objective: To investigate androgen receptor(AR)expression in invasive breast carcinoma and the correlation with surrogate molecular breast carcinoma subtypes. Methods: Immunohistochemical staining of AR and other biomarkers was performed in a cohort of 870 cases of primary invasive breast carcinomas collected from August to December, 2016. The association of AR expression with different histological and surrogate molecular subtypes was analyzed. Results: The positive expression rate of AR in the immunohistochemistry-based surrogate subtypes was 96.3%(207/215) for Luminal A, 89.8%(378/421) for Luminal B, 82.4%(75/91) for HER2 overexpression and 37.1%(53/143) for triple negative breast carcinoma, with significant differences among the four groups (P<0.01). AR correlated positively with the expression of ER(P<0.01), PR(P<0.01), HER2(P=0.007), GATA3(P<0.01), GCDFP15(P<0.01)and mammaglobin(P<0.01), while negatively with the expression of Ki-67(P<0.01), CK5/6(P<0.01)and CK14(P<0.01). Conclusions: AR exhibits a high expression in invasive breast carcinoma, which is mainly correlated with ER-positive breast carcinoma. Regardless of the relatively low expression rate, AR is a potential therapeutic target in triple negative breast carcinoma.

[Effects of ligustilide on the extracellular recombinant human heat shock protein 60 induced inflammatory reactions in the THP-1 cells and the related mechanisms].

Objective: To investigate the effects of ligustilide(LIG) on extracellular recombinant human heat shock protein 60 (HSP60) induced inflammatory reactions in the THP-1 cells and the related mechanisms. Methods: THP-1 cells were differentiated to macrophages by incubation with phorbol-12-myristate-13-acetate (PMA). The immunofluorescence method was used to screen the optimum transfection concentration of MyD88 siRNA.The macrophages were divided into six groups(n=3), including blank control(siRNA transfection reagent), model(siRNA transfection reagent+ HSP60 10 mg/L), negative control(MyD88 negative control+ HSP60 10 mg/L), LIG group(siRNA transfection reagent+ HSP60 10 mg/L+ LIG 20 mg/L), RNA interfering(RNAi) group(MyD88 siRNA+ HSP60 10 mg/L) and RNAi+ LIG group(MyD88 siRNA+ HSP60 10 mg/L+ LIG 20 mg/L). The protein expression level of MyD88 and phospho-nuclear factor-κB(p-NF-κB) in macrophages and the level of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in the culture supernatant were assessed by Western blot analyses or ELISA, respectively. Results: (1)The protein expression levels of MyD88 (1.196±0.125 vs. 0.341±0.063, P<0.01) and p-NF-κB(0.817±0.034 vs. 0.312±0.046, P<0.01) were significantly higher in the model group than those in the blank control group.The protein expression levels of MyD88(0.554±0.043) and p-NF-κB(0.538±0.063) in the RNAi group were significantly lower than those in the model group (all P<0.01) but significantly higher than those in the blank control group (all P<0.05). The protein expression levels of MyD88(0.694±0.087, P<0.05) and p-NF-κB(0.669±0.043, P<0.01)in the LIG group were markedly lower than those in the model group, but higher than those in the RNAi group (P<0.05) and the blank control group (P<0.01). The protein expression levels of MyD88(0.409±0.069) and p-NF-κB(0.395±0.046) in the RNAi+ LIG group were significantly lower than in the model group (all P<0.01) and in the LIG group(P<0.05 or 0.01), and were similar to the blank control group(P>0.05). The expression level of p-NF-κB in the RNAi+ LIG group was significantly lower than in the RNAi group (P<0.05). (2) The contents of TNF-α((312.24±28.69) ng/L vs. (5.99±1.03) ng/L, P<0.01) and IL-6((233.45±57.77) ng/L vs. (2.25±0.67) ng/L, P<0.01) were significantly higher in the model group than in the blank control group. The contents of TNF-α((235.66±25.12) ng/L) and IL-6((131.59±13.99) ng/L) were significantly lower in the RNAi group than in the model group (P<0.01). The contents of TNF-α((258.13±44.80) ng/L) and IL-6((175.92±28.27) ng/L) were also significantly lower in the LIG group than in the model group(P<0.05) while the content of IL-6 was significantly higher in the LIG group than in the RNAi group(P<0.01). The contents of TNF-α((88.57±16.10) ng/L) and IL-6((59.99±10.31) ng/L) were significantly lower in the RNAi+ LIG group than those in the model group, the RNAi group and the LIG group(P<0.05 or 0.01). Conclusions: The MyD88/NF-κB signaling pathway is one of the key signaling pathways of human HSP60 induced inflammation in THP-1 cells. Ligustilide could exhibit the anti-inflammatory effect probably by inhibiting the MyD88/NF-κB signaling pathway.

[Biosafety risk of laboratory-acquired infection and countermeasures based on human factors].

Biosafety of pathogenic microbiology laboratories generally highlights the use of protective equipment, procedures, and operating practices to protect personnel and the environment from potentially hazardous biological materials. Under the current complex situation where traditional and non-traditional biosafety issues coexist, laboratory-acquired infection (LAI) of pathogenic microorganisms may cause illness, disability and even death. Pathogenic microorganisms may also be carried to the surrounding environment, causing community infection, which should be taken seriously. Analysis of LAI cases helps to understand the causes of exposure and learn lessons from post-exposure prophylaxis to be prepared and even prevent problems before they happen. Human factors cause most LAIs, laboratory activities related to aerosolization, laboratory activities related to sharps materials, low ability of personnel performing the work, and deficiencies in laboratory facilities or management are the four main factors. This study focuses on the human factors that lead to LAI, combined with confirmed cases, discusses the biosafety risks of pathogenic microorganism laboratories, reviews the development and evolution of biosafety laboratories and the current protection measures for experimenters, and accordingly puts forward countermeasures and suggestions.

Suppression of Zeeman gradients by nuclear polarization in double quantum dots.

We use electric dipole spin resonance to measure dynamic nuclear polarization in InAs nanowire quantum dots. The resonance shifts in frequency when the system transitions between metastable high and low current states, indicating the presence of nuclear polarization. We propose that the low and the high current states correspond to different total Zeeman energy gradients between the two quantum dots. In the low current state, dynamic nuclear polarization efficiently compensates the Zeeman gradient due to the g-factor mismatch, resulting in a suppressed total Zeeman gradient. We present a theoretical model of electron-nuclear feedback that demonstrates a fixed point in nuclear polarization for nearly equal Zeeman splittings in the two dots and predicts a narrowed hyperfine gradient distribution.

Spectroscopy of spin-orbit quantum bits in indium antimonide nanowires.

A double quantum dot in the few-electron regime is achieved using local gating in an InSb nanowire. The spectrum of two-electron eigenstates is investigated using electric dipole spin resonance. Singlet-triplet level repulsion caused by spin-orbit interaction is observed. The size and the anisotropy of singlet-triplet repulsion are used to determine the magnitude and the orientation of the spin-orbit effective field in an InSb nanowire double dot. The obtained results are confirmed using spin blockade leakage current anisotropy and transport spectroscopy of individual quantum dots.

[Primary experience and discussion on the treatment of esthesioneuroblastoma].

Objective: To summarize the preliminary experience in the treatment of esthesioneuroblastoma (ENB) and to explore the effect of age, chemotherapy, modified Kadish stage and pathological grade on the prognosis of ENB. Methods: The clinical data of 87 ENB patients from the First Affiliated Hospital of Sun Yat-sen University and Sun Yat-sen University Cancer Center between June 2002 and November 2017 were retrospectively analyzed. The modified Kadish stage was used to evaluate the extent of the lesions, and the Hyams grading system was used for pathological grading. The patients were followed up regularly to evaluate the recurrence and metastasis of the tumor. Cox proportional hazard model was used for univariate and multivariate analyses. Prognostic factors with P<0.05 in univariate analysis were included in multivariate analysis. After controlling the confounding factors, the model coefficients were used to calculate the hazard ratio (HR) and 95% confidence interval (CI). Results: The median follow-up time of ENB patients was 29 months, and the 5-year overall survival rate was 39.3%. In univariate analysis, age, chemotherapy, modified Kadish stage and pathology grade were independent predictors of overall survival, while gender, radiotherapy and surgery were not prognostic factors. Multivariate analysis showed that modified Kadish stage and pathology grade were independent predictors of overall survival rate after excluding confounding factors. Conclusions: Age, chemotherapy, modified Kadish stage and pathological grade are taking important role in the overall survival rate of patients with ENB. Modified Kadish stage and pathological grade are independent predictors of overall survival rate.

Opposing roles of IL-17A and IL-25 in the regulation of TSLP production in human nasal epithelial cells.

BACKGROUND: The importance of IL-17A, IL-17F, and IL-25 in allergic rhinitis (AR), as well as their possible role in regulation on thymic stromal lymphopoietin (TSLP) production in nasal epithelial cells, is not well understood. OBJECTIVE: To determine the possible regulation of IL-17A, IL-17F, and IL-25 on TSLP production in the initiation of allergic responses. METHODS: The levels of IL-17A, IL-17F, IL-25, and TSLP in nasal lavages of patients with AR were measured using an enzyme-linked immunosorbent assay (ELISA) and compared with that in normal controls. Then, primary human nasal epithelial cells (HNECs) were stimulated with dsRNA (0-75 microg/ml), as well as IL-17A (100 ng/ml), IL-17F (100 ng/ml), and IL-25(100 ng/ml). The mRNA expression of IL-17A, IL-17F, IL-25, TSLP, as well as the chemokines CCL20, IL-8, and eotaxin was analyzed using quantitative real-time PCR, and their protein levels in the supernatants of cultured HNECs were determined by ELISA. RESULTS: Both TSLP and IL-17 cytokines are significantly elevated in patients with AR. dsRNA was found to increase the production of IL-17F, IL-25, TSLP, CCL20, and IL-8 in HNECs. Furthermore, IL-25 significantly enhanced dsRNA-induced TSLP production in primary HNECs and was dominant to the inhibitory effect of IL-17A on TSLP regulation. CONCLUSIONS: Our study provides the first evidence that both IL-17F and IL-25 can be induced by dsRNA in HNECs. Despite of the opposing effects of IL-17A and IL-25 on TSLP regulation in HNECs, IL-25 was dominant to IL-17A, providing a plausible explanation for the simultaneous upregulation of IL-17 cytokines and TSLP in patients with AR.

Establishment of a paclitaxel resistant human breast cancer cell strain (MCF-7/Taxol) and intracellular paclitaxel binding protein analysis.

Multidrug resistance of tumours is one of the most important factors that leads to chemotherapy failure. A multidrug-resistant breast cancer cell line, MCF-7/Taxol, was established from the drug-sensitive parent cell line MCF-7. The biological properties of MCF-7/Taxol, including its drug resistance profile and profile of paclitaxel binding proteins, were analysed and compared with the parent cell line. A number of paclitaxel binding proteins were present in MCF-7 cells but absent from MCF-7/Taxol cells, namely heat shock protein 90, actinin and dermcidin precursor. The identification of differential paclitaxel binding proteins between the multidrug-resistant MCF-7/Taxol cell line and the parent drug-sensitive cell line MCF-7 provides insight into possible mechanisms involved in resistance to these chemotherapy drugs.

Cloning and phylogenetic analysis of hemagglutinin gene of H9N2 subtype avian influenza virus from different isolates in China during 2002 to 2009.

Forty-seven strains of H9 subtype avian influenza viruses identified by specific reverse transcription-PCR method were isolated from the chicken and duck flocks in different areas of China during the 2002 to 2009 epizootic period. Hemagglutinin (HA) genes of these strains were sequenced and analyzed with the representative strains published in GenBank. The results indicated that the HA genes of these strains and the vaccine strains displayed nucleotide homologies ranging from 91.7 to 96.6% and amino acid homologies ranging from 92.3 to 95.7%, respectively. Analysis of the mature peptide sequences of these HA genes showed that the presence of leucine at position 216 (corresponding to residue 226 in H3 numbering) indicated a preference to the binding of alpha (2-6) sialic acid receptors, which was the same as human isolates. Extra potential glycosylation sites appeared in the HA genes of most tested isolations compared with the vaccine strains. The HA cleavage sites of most of the strains were the 335PSRSSR downward arrow GLF341, but all of the strains met the characteristics of low-pathogenic avian influenza. The results of phylogenetic analysis indicated that all 47 strains and the current vaccine strains belong to the same phylogenetic lineage h9.4.2, but they had some genetic deviation in the last decade. Compared with the vaccine strains, 7 mutations were found in the antigen epitope region of the HA genes of the field strains. These results suggested that the commercial vaccine might not induce satisfactory prevention against infection of H9N2 avian influenza virus.

Molecular detection of Muscovy duck parvovirus by loop-mediated isothermal amplification assay.

Muscovy duck parvovirus (MDPV) usually causes high morbidity and mortality in 1- to 3-wk-old Muscovy ducklings due to serious infections, which is an imminent threat to the commercial duck industry in China. The objectives of this study were to develop and evaluate a simple, rapid, and inexpensive loop-mediated isothermal amplification (LAMP) method for specific detection of MDPV and to compare it with the PCR method in rapidity, sensitivity, and accuracy. The novel LAMP assay used a set of 4 specific primers to recognize 6 distinct genomic sequences of capsid protein (VP3) from MDPV, which could be completed within 50 min at 63 degrees C in a simple water bath. The diagnostic results demonstrated that the LAMP assay detected all 7 preserved MDPV isolates, had no cross-reactivity with other duck pathogens (i.e., goose parvovirus, duck plague virus, H9N2 avian influenza virus, duck hepatitis type virus I, and Muscovy duck reovirus). The LAMP assay was at least 10-fold more sensitive than the routine PCR assay and obtained more sensitivity in 61 clinical samples. Therefore, the newly developed LAMP assay provides a specific and sensitive means for detecting MDPV and can be simply applied both in field conditions and in laboratory operations in a cost-effective manner with primary care facilities.

[Establishment and test results of an artificial intelligence burn depth recognition model based on convolutional neural network].

Objective: To establish an artificial intelligence burn depth recognition model based on convolutional neural network, and to test its effectiveness. Methods: In this evaluation study on diagnostic test, 484 wound photos of 221 burn patients in Xiangya Hospital of Central South University (hereinafter referred to as the author's unit) from January 2010 to December 2019 taken within 48 hours after injury which met the inclusion criteria were collected and numbered randomly. The target wounds were delineated by image viewing software, and the burn depth was judged by 3 attending doctors with more than 5-year professional experience in Department of Burns and Plastic Surgery of the author's unit. After marking the superficial partial-thickness burn, deep partial-thickness burn, or full-thickness burn in different colors, the burn wounds were cut according to 224×224 pixels to obtain 5 637 complete wound images. The image data generator was used to expand images of each burn depth to 10 000 images, after which, images of each burn depth were divided into training set, verification set, and test set according to the ratio of 7.0∶1.5∶1.5. Under Keras 2.2.4 Python 2.8.0 version, the residual network ResNet-50 of convolutional neural network was used to establish the artificial intelligence burn depth recognition model. The training set was input for training, and the verification set was used to adjust and optimize the model. The judging accuracy rate of various burn depths by the established model was tested by the test set, and precision, recall, and F1_score were calculated. The test results were visualized to generate two-dimensional tSNE cloud chart through the dimensionality reduction tool tSNE, and the distribution of various burn depths was observed. According to the sensitivity and specificity of the model for the recognition of 3 kinds of burn depths, the corresponding receiver operator characteristics (ROC) curve was drawn, and the area under the ROC curve was calculated. Results: (1) After the testing of the test set, the precisions of the artificial intelligence burn depth recognition model for the recognition of superficial partial-thickness burn, deep partial-thickness burn, or full-thickness burn were 84% (1 095/1 301), 81% (1 215/1 499) and 82% (1 395/1 700) respectively, the recall were 73% (1 095/1 500), 81% (1 215/1 500) and 93% (1 395/1 500) respectively, and the F1_scores were 0.78, 0.81, and 0.87 respectively. (2) tSNE cloud chart showed that there was small overlapping among different burn depths in the test results for the test set of artificial intelligence burn depth recognition model, among which the overlapping between superficial partial-thickness burn and deep partial-thickness burn and that between deep partial-thickness burn and full-thickness burn were relatively more, while the overlapping between superficial partial-thickness burn and full-thickness burn was relatively less. (3) The area under the ROC curve for 3 kinds of burn depths recognized by the artificial intelligence burn depth recognition model was ≥0.94. Conclusions: The artificial intelligence burn depth recognition model established by ResNet-50 network can rather accurately identify the burn depth in the early wound photos of burn patients, especially superficial partial-thickness burn and full-thickness burn. It is expected to be used clinically to assist the diagnosis of burn depth and improve the diagnostic accuracy.

Interleukin-6 is essential for Staphylococcal exotoxin B-induced T regulatory cell insufficiency in nasal polyps.

BACKGROUND: The pathogenesis of nasal polyps is still unclear. There is increasing evidence indicating that Staphylococcal aureus (S. aureus) is associated with the formation of nasal polyps, but the mechanism has not been well documented to date. METHODS: We stimulated cultured nasal polyps and turbinate tissues with Staphylococcal exotoxin B (SEB), detected the expression of pro-inflammatory cytokines (IL-2, IL-6, and IL-8) and T cell cytokines (IFN-gamma, IL-4, IL-5, IL-10, and IL-17) in the supernatants, and evaluated mRNA expression (T-bet, GATA-3, Foxp3, and RORgammat) and frequencies of CD4+CD25+ T regulatory cells (Tregs) in nasal tissues. We also evaluated the effects of blocking IL-6 with monoclonal antibodies to T cell profiles in cultured nasal tissues stimulated by SEB. RESULTS: Levels of IL-6, IFN-gamma and IL-4 increased significantly in SEB-stimulated nasal polyps. Meanwhile, mRNA expressions of T-bet and GATA-3 were significantly up-regulated, while Foxp3 was inhibited and the frequencies of CD4+CD25+ Tregs were decreased after SEB stimulation. After blocking IL-6, the levels of IL-10 and Foxp3 mRNA, as well as the frequencies of CD4+CD25+ Tregs, were significantly increased, while IFN-gamma and IL-4 production and the mRNA expression of T-bet and GATA-3 were significantly inhibited. CONCLUSIONS: SEB is able to modulate pro-inflammatory factors, T-helper type 1/Th2 profiles and suppress Treg activity in cultured nasal polyps, which were rescued by blocking IL-6 activity. Therefore, IL-6 is essential for SEB-induced Treg insufficiency in nasal polyps.

Characterizing T-cell phenotypes in nasal polyposis in Chinese patients.

BACKGROUND: Nasal polyposis has different etiologies in Western and Eastern countries. Furthermore, its pathogenesis is still poorly understood. OBJECTIVE: To determine the T-cell phenotypes involved in nasal polyposis in Chinese patients. METHODS: Twenty-four Chinese patients with nasal polyps were studied. CD4, CD8, Foxp3, and interleukin (IL) 17 were analyzed by immunohistochemical staining. Expression of T-bet, GATA-3, Foxp3, and RORgammat mRNA was detected by real-time polymerase chain reaction. The levels of T-cell cytokines (IL-4, IL-5, interferon [IFN] gamma, IL-10, IL-17, and transforming growth factor [TGF] beta) were determined using enzyme-linked immunosorbent assay, and serum immunoglobulin (Ig) E levels were measured using the UNICAP system. RESULTS: Increased expression of CD4+ and CD8+ and decreased expression of Foxp3 and IL-17 were detected in nasal polyps compared with control tissue. Furthermore, expression of T-bet and GATA-3 mRNA was upregulated, whereas Foxp3 mRNA expression was markedly downregulated. Furthermore, increased levels of IFN-gamma, IL-4 and IL-5 and decreased levels of IL-10 and TGF-beta were found in nasal polyps. There was no association between Staphylococcus aureus exotoxin (SAE)-specific IgE and T regulatory cell (Treg) insufficiency in nasal polyps. CONCLUSIONS: Our findings demonstrate that excessive infiltration of CD4+ and CD8+ T cells in nasal polyps may be associated with expression of Foxp3+ by Tregs but not with SAEs in Chinese patients.

[New system combining Hyams grading system and modified Kadish stage to evaluate the progress of esthesioneuroblastoma].

Objective:Esthesioneuroblastoma(ENB) is a sinonasal rare tumor, and the assessment on the prognosis have not been used with on consensus, our study aims to set an accuracy indicator to predict the outcomes of ENB.Method:A retrospective review was performed on 31 ENB patients. We collected 31 patients with ENB and reviewed the clinical data and pathological slides; modified Kadish stages were evaluated by otolaryngologist and imaging specialist; Hyams grading system were confirmed by two pathologists, who reviewed and paid attention to the pathological characteristics of Hyams grading system. Finally, the relation among the clinical data, pathological features and clinical outcome of these 31 ENB were analyzed by Kaplan-Meier method.Result: The Hyams grading system and modified Kadish stage were considered together seemed to evaluate the prognosis of ENB more accurately, when the scores over 6 points, the patients had the poor prognosis with the mean median survival months of 24.67±32.22, compared with the scores under 6 and the final scores reached at 4, 5, 6, 7, 8, the tumor metastasis rates were 14.3%, 16.7%, 33.3%, 50.0%, 100.0% respectively.Conclusion:Taking the Hyams grading system and modified Kadish stage into consideration, which may evaluate the prognosis of ENB more accurately.

[Study on the relationship between 11ß-hydroxysteroid dehydrogenase and glucocorticoid response in nasal polyps].

Objective: To investigate the expression of 11ß-hydroxysteroid dehydrogenase (11ß-HSD) in polyps of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and its correlation with glucocorticoid sensitivity. Methods: The prospective study method was applied. Forty-three adult CRSwNP patients from Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University between April 2016 and June 2017 were enrolled in this study. There were 19 males and 24 females with the age of (37.44±7.42) years old. The endoscopic scores by nasal Polyps Grading System before and after one-week prednisone treatment (0.5 mg/(kg·d)) were evaluated. The response of glucocorticoid by the total endoscopic scores was estimated. According to the patient's reduced nasal polyp endoscopic score, patients were devided into nasal polyps insensitive to glucocorticoids treatment group (insensitive group) and nasal polyp sensitive to glucocorticoids treatment group (sensitive group). The expression of 11ß-HSD1, 11ß-HSD2 in nasal polyps were measured by Real-time PCR (RT-PCR), Western Blot and immunohistochemisty. According to the clinical data, the Logistic regression models and receiver operation characteristics (ROC) curves were used to explore the predictor for glucocorticoid response in CRSwNP. Results: The expression of 11ß-HSD1 and 11ß-HSD1/11ß-HSD2 was higher in sensitive group than that of insensitive group, while the expression of 11ß-HSD2 was lower (rank average was 26.08 vs 16.33, 27.24 vs 14.72, 18.66 vs 26.64, Z value was -2.511, 0.323, -2.059, respectively, all P<0.05). The endoscopic scores in CRSwNP group declined whereas the expression of 11ß-HSD1/11ß-HSD2 increased (r=0.528, P=0.001), while the cutoff value of the ratio of 11ß-HSD1/11ß-HSD2 was 2.290 (sensitivity was 79.17%, specificity was 88.89%). Conclusions: There is a positive correlation between the response of glucocorticoid and the ratio of 11ß-HSD1/11ß-HSD2, which could be used as a marker in predicting the level of tissue response to glucocorticoid therapy in CRSwNP.

[Clinical features, diagnosis and treatment of silent sinus syndrome].

Objective: To explore the clinical features, diagnostic methods and therapeutic strategy of silent sinus syndrome (SSS). Methods: A retrospective study was made on eight SSS patients treated during 2013-2016 in Longgang ENT Hospital and Otorhinolaryngology Hospital of the First Affiliated Hospital of SUN Yat-sen University. The following clinical data, including demographic data, symptoms, history of trauma and surgery, signs, imaging examination, endoscopic surgery and postoperative outcomes, were analyzed to summarize the diagnosis and treatment experiences. Results: Eight SSS patients showed the following clinical features: the proportions of both sexes and sinus sides were 4 to 4; seven cases (7/8) were adult, with an average of (48.1±11.8)y; seven cases (7/8) had long history of trauma or surgery, with an average of (17.9±10.5)y; seven cases (7/8) cannot recall the exact course of SSS; six cases (6/8) had no nasal symptoms; eight cases (8/8) had unilateral ocular discomforts; eight cases (8/8) had signs of unilateral enophthalmos (2-5 mm), accompanied with hypoglobus; and by CT and MRI scanning, eight cases (8/8) showed the unilateral maxillary sinus outlet obstruction, sinus full opacification, sinus wall bony rarefaction, sinus wall contraction, sinus volume loss, and the ipsilateral orbital floor bowing descent and orbital volume increase. After treated by endoscopic sinus surgery and followed-up for one year, four cases were cured, and the other four improved; no intra- or post-operative complications occurred; and no individual need a two-stage orbital plastic reconstruction. Conclusions: SSS often develops in the unilateral maxillary sinus of adult patient with long history of trauma or surgery, but the nasal symptoms and signs are silent. Diagnostic for SSS depends on characteristic ocular sign and sinus CT imaging. Endoscopic sinus surgery helps to improve ocular and nasal signs and promote orbital self-reconstruction.