Application of two noninvasive scores in predicting the risk of respiratory failure in full-term neonates: a comparative analysis / 中国当代儿科杂志

OBJECTIVES@#To study the value of Silverman-Anderson score versus Downes score in predicting respiratory failure in full-term neonates.@*METHODS@#The convenience sampling method was used to select the full-term neonates with lung diseases who were hospitalized in the neonatal intensive care unit from July 2020 to July 2021. According to the diagnostic criteria for neonatal respiratory failure, they were divided into a respiratory failure group (65 neonates) and a non-respiratory failure group (363 neonates). Silverman-Anderson score and Downes score were used for evaluation. The receiver operating characteristic analysis was used to compare the value of the two noninvasive scores in predicting respiratory failure in full-term neonates.@*RESULTS@#Among the 428 full-term neonates, 65 (15.2%) had respiratory failure. The Silverman-Anderson score had a significantly shorter average time spent on evaluation than the Downes score [(90±8) seconds vs (150±13) seconds; P<0.001]. The respiratory failure group had significantly higher points in both the Silverman-Anderson and Downes scores than the non-respiratory failure group (P<0.001). The Silverman-Anderson score had an AUC of 0.876 for predicting respiratory failure, with a sensitivity of 0.908, a specificity of 0.694, and a Youden index of 0.602 at the optimal cut-off value of 4.50 points. The Downes score had an AUC of 0.918 for predicting respiratory failure, with a sensitivity of 0.723, a specificity of 0.953, and a Youden index of 0.676 at the optimal cut-off value of 6.00 points. The Downes score had significantly higher AUC for predicting respiratory failure than the Silverman-Anderson score (P=0.026).@*CONCLUSIONS@#Both Silverman-Anderson and Downes scores can predict the risk of respiratory failure in full-term neonates. The Silverman-Anderson score requires a shorter time for evaluation, while the Downes score has higher prediction efficiency. It is recommended to use Downes score with higher prediction efficiency in general evaluation, and the Silverman-Anderson score requiring a shorter time for evaluation can be used in emergency.

Laryngeal reconstruction by complex hyoid bone flap after frontal partial laryngectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The aim of this study was to describe a new technique of combined hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction after tumor resection, and to evaluate outcome.</p><p><b>METHODS</b>Six patients requiring an frontal partial laryngectomy for cancer were enrolled between September 2008 and August 2012.</p><p><b>RESULTS</b>Nasogastric feeding was initiated within 24 hours. The mean times to swallow batter, ability to drink water and removal of the nasogastric tube were 2.6, 5.5 and 6.3 days. All patients had good respiratory function. There were no deaths, and no reports of postoperative dyspnea or dysphagia. The vocal quality was satisfactory, slightly deeper and raspy, and the volume was weak when calling. The final follow-up assessment was in August 2012, and the overall mean follow-up period was 29.5months, range 14 to 47 months. Case two subsequently underwent total laryngectomy for recurrence in the paraglottic space, but there was no evidence of further tumor recurrence at the final assessment.</p><p><b>CONCLUSIONS</b>The combined muscle-pedicle hyoid bone and thyrohyoid membrane flap is a reliable graft for one-stage repair of laryngotracheal defects, providing effective repair of the mucosa and cartilage support. Vocal quality, swallowing function and ventilation after the procedure were favorable.</p>

Impact of neonatal bacillus Calmette-Guerin vaccination on lung Th17 cells and IL-17 in murine asthma model / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the impact of neonatal bacillus Calmette-Guerin(BCG) vaccination on lung Th17 cells and IL-17 in murine asthma model.</p><p><b>METHODS</b>Neonatal BALB/c mice were divided into three groups: control, OVA and BCG/OVA groups. BCG was administerd in the BCG/OVA group on postnatal day 2 or 3. Except the control group, the mice in the other two groups were sensitized and undergone OVA challenge. Inflammatory cell numbers and morphological identification of leucocytes in bronchoalveolar lavage fluid (BALF) were measured by light microscopy. Cytokine IFN-gamma and IL-17 levels in BALF were measured using ELISA. The percentage of lung Th17 cells were assayed by flow cytometry.</p><p><b>RESULTS</b>There was significantly larger number of total cells, lymphocytes, eosinophils and neutrophils in BALF in the OVA and BCG/OVA groups compared with the control group. The number or percentage of those cells in the BCG/OVA group was lower than that in the OVA group. The level of IL-17 in BALF was significantly higher in the OVA and the BCG/OVA groups compared with the control group, while the level of IFN-gamma was lower. The OVA group had higher level of IL-17 than the BCG/OVA group. The mice in the OVA and the BCG/OVA groups had a higher percentage of Th17 cells in lungs compared with the control group, but there were no significant differences in the percentage of Th17 cells between the OVA and the BCG/OVA groups.</p><p><b>CONCLUSIONS</b>Th17 cells and IL-17 play roles in the pathogenesis of asthma. BCG vaccination can reduce the level of IL-17 in BALF and the reduced IL-17 may be mainly from other IL-17-producing cells in the lungs, not Th17 cells.</p>

Concurrent chemoradiotherapy versus radiotherapy alone for locoregionally advanced nasopharyngeal carcinoma: a meta-analysis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To determine the value of concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma from the mainland of China.</p><p><b>METHODS</b>Data were extracted from randomized trials comparing chemotherapy plus radiotherapy with radiotherapy alone in locally advanced nasopharyngeal carcinoma. Actuarial rates of survival and distant metastases were calculated. The followed electronic databases were searched the Chinese Biomedicine database, Pubmed, Medline, Embase and Cochrane library; Data were extracted by tow reviewers and Review manager 4.1 software was applied for statistical analysis.</p><p><b>RESULTS</b>Eighteen trials with 1993 patients were include according to the including criterion. The 3-year overall survival rate of the chemoradiotherapy group and the radiotherapy group were 68.47% and 56.38% respectively, and the 5-year overall survival rate of the two groups above were 51.91% and 41.09% respectively, while the distant metastases rate of the chemoradiotherapy group and the radiotherapy group were 26.19% and 38.71% respectively. The result demonstrated that chemoradiotherapy increased overall survival by 12% at 3 years, and 11% at 5 years after treatment. After chemoradiotherapy, the rate of distant metastasis was reduce by 12%.</p><p><b>CONCLUSIONS</b>In patients with locoregionally advanced nasopharyngeal carcinoma, chemoradiotherapy significantly improves overall survival at 3 years, and 5 years compared with radiotherapy alone.</p>

Value of elective neck dissection in patients with clinically stage I squamous cell carcinoma of the tongue / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To determine the value of elective neck dissection in patients with clinically stage I (cT1N0M0) squamous cell carcinoma of the tongue.</p><p><b>METHODS</b>This was a retrospective study of patients with surgical treatment between November 1984 and November 1999. A total of 130 patients were included in the study, all of whom received operation of the primary site, meanwhile, 99 of whom underwent elective neck dissection simultaneously including level I -III or level I -IV neck dissection in 20 patients and level I - V neck dissection in 79 patients. Results Among all these patients, the rate of occult metastasis to the neck were 12. 0%. Local failure rate in patients with only local treatment, level I II, II, III/IV neck dissection and level I - V neck dissection were 25. 8%, 15. 0% and 7. 6% respectively. There were significant difference in regional failure between patients with only local treatment and patients with elective neck dissection (P < 0.05). Also, no significant differences were noted in the survival rate between patients with only local treatment, elective neck dissection (level I -III or level I -IV) and level I -V neck dissection (P > 0.05).</p><p><b>CONCLUSIONS</b>Elective neck dissection significantly reduced regional control failure but was not able to reduce distant metastasis or increase the overall survival. A prospective randomized study is worthwhile to further evaluate the benefit of elective neck dissection in the treatment of clinically stage I squamous cell carcinoma of the tongue.</p>