The role of environmental tobacco exposure and Helicobacter pylori infection in the risk of chronic tonsillitis in children / O papel da exposição ambiental do tabaco e infecção pelo Helicobacter pylori no risco de amigdalite crônica em crianças

ABSTRACT CONTEXT AND OBJECTIVE: Helicobacter pylori (H. pylori) is a chronic infectious pathogen with high prevalence. This study investigated the interaction between environmental tobacco exposure and H. pylori infection on the incidence of chronic tonsillitis in Chinese children. DESIGN AND SETTING: Cross-sectional study performed in an outpatient clinic in China. METHODS: Pediatric patients with chronic tonsillitis were enrolled. H. pylori infection was determined according to the presence of H. pylori CagA IgG antibodies. Serum cotinine levels and environmental tobacco smoke (ETS) exposure were determined for all participants. RESULTS: There was no significant difference in H. pylori infection between the children with chronic tonsillitis and children free of disease, but there was a significant difference in ETS between the two groups (P = 0.011). We next studied the association between ETS and chronic tonsillitis based on H. pylori infection status. In the patients with H. pylori infection, there was a significant difference in ETS distribution between the chronic tonsillitis and control groups (P = 0.022). Taking the participants without ETS as the reference, multivariate logistic regression analysis showed that those with high ETS had higher susceptibility to chronic tonsillitis (adjusted OR = 2.33; 95% CI: 1.67-3.25; adjusted P < 0.001). However, among those without H. pylori infection, ETS did not predispose towards chronic tonsillitis. CONCLUSION: Our findings suggest that tobacco exposure should be a putative mediator risk factor to chronic tonsillitis among children with H. pylori infection.

RESUMO CONTEXTO E OBJETIVO: Helicobacter pylori (H. pylori) é um patógeno infeccioso crônico com alta prevalência. Este estudo investigou a interação entre exposição à fumaça ambiental do tabaco (FAT) e infecção pelo H. pylori sobre a incidência de amigdalite crônica em crianças chinesas. TIPO DE ESTUDO E LOCAL: Estudo transversal desenvolvido num ambulatório na China. MÉTODOS: Pacientes pediátricos com amigdalite crônica foram recrutados. A infecção por H. pylori foi determinada segundo a presença de anticorpos H. pylori CagA IgG. Foi determinado o nível de cotinina sérica e exposição à FAT de todos os participantes. RESULTADOS: Não houve diferença significativa entre crianças com amigdalite crônica na infecção por H. pylori e sem amidalite, mas existia diferença significativa na FAT entre os dois grupos (P = 0,011). Em seguida, estudamos a associação entre FAT e amigdalite crônica com base no status de infecção por H. pylori. Nos pacientes com infecção por H. pylori, houve diferença significativa na distribuição de FAT entre os grupos de amigdalite crônica e controle (P = 0,022). Tomando os participantes sem FAT como referência, a análise de regressão logística multivariada mostrou que aqueles com alta FAT tinha maior susceptibilidade à amigdalite crônica (OR ajustado IC = 2,33, 95%: 1,67-3,25, ajustado P < 0,001). No entanto, naqueles sem infecção por H. pylori, a FAT não predispôs a amigdalite crônica. CONCLUSÃO: Nossos achados sugerem que a exposição ao tabaco é um fator de risco para amigdalite crônica em crianças com infecção por H. pylori.

Study on effect of four traditional Chinese medicines distributed along lung meridian on TLR2 and NF-κB expressions in mice with lung heat syndrome / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effect of four traditional Chinese medicines distributed along lung meridian, namely Ephedrae Hebra, Zingiberis Rhizoma, Scutellariae Radix and Mori Cortex, on TLR2 and NF-κB expressions in mice with lung heat syndrome, in order to study the intervention effect of the four traditional Chinese medicines (TCMs) on the lung heat syndrome.</p><p><b>METHOD</b>One hundred KM mice were randomly divided into the normal control group, the model group, the Ephedrae Hebra group, the Zingiberis Rhizoma group, the Scutellariae Radix group and the Mori Cortex group (20, 10 g x kg(-1)), nasally dripped with streptococcus pneumoniae to establish the mouse lung heat syndrome model, and then administered with different TCMs. The expressions of TLR2, NF-κB p65 proteins in lung tissues were analyzed by the immunohistochemical method. The expressions of TLR2, NF-κB p65 mRNA were measured by real time PCR.</p><p><b>RESULT</b>Compared with the normal control group, the expressions of TLR2 and NF-κB p65 proteins in lung tissues in the model group were higher (P < 0.01), and the expressions of TLR2 and NF-κB p65 mRNA in lung tissues were up-regulated (P < 0.01 or P < 0.05). Compared with the model group, Ephedrae Hebra high and low dose groups, the Zingiberis Rhizoma low dose group and the Scutellariae Radix high dose group showed decreased expression of TLR2 protein (P < 0.05 or P < 0.01); Ephedrae Hebra high and low dose groups, the Zingiberis Rhizoma low dose group, Scutellariae Radix high and low dose groups and Mori Cortex high and low dose groups showed reduced expression of NF-κB p65 protein (P < 0.05 or P < 0.01). Ephedrae Hebra high and low dose groups, Zingiberis Rhizoma high and low dose groups, Scutellariae Radix high dose group and Mori Cortex high dose group showed down-regulated expression of TLR2 mRNA (P < 0.01 or P < 0.05).</p><p><b>CONCLUSION</b>Ephedrae Hebra, Zingiberis Rhizoma, Scutellariae Radix and Mori Cortex can induce the TLR2/NF-κB inflammatory signal pathways by down-regulating the expressions of TLR2 and NF-κB p65 in protein and mRNA, so as to alleviate the lung tissue injury in mice with lung heat syndrome.</p>

Prognostic analysis of 450 patients with lung squamous cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To study the treatment strategy and prognosis and its affected factors of lung squamous cancer according retrospective analysis.</p><p><b>METHODS</b>Clinic data of 450 lung squamous cancer inpatient cases who were performed complete resection from January 2004 to January 2007, was retrospectively reviewed. There were 363 male and 87 female patients, aged from 31 to 82 years, with a mean of 60.5 years and a median of 62 years.</p><p><b>RESULTS</b>The overall 5-year survival rate was 52.4%. Cox Regression suggested that preoperative N status (χ(2) = 18.969, P = 0.000), N stage (χ(2) = 44.069, P = 0.000) and TNM stage (χ(2) = 63.025, P = 0.000) are independent factors affecting the prognosis. Adjuvant chemotherapy affects the prognosis of stage II-IIIA lung squamous cancer (5-year survival rate: 48.9% vs. 37.7%, χ(2) = 3.946, P = 0.047). Studying the combined therapy of stage IIIA, the chemoradiotherapy group achieved the best survival (48.8%), then single chemotherapy group (35.9%) and no treatment group (28.5%), and the single radiotherapy group achieved the poorest survival rate (11.1%), and there were statistically significant differences among them (χ(2) = 8.397, P = 0.038).</p><p><b>CONCLUSIONS</b>The 5-year survival rate of lung squamous cancer has significantly increased through promoting the standard of operation, especially increasing the standard of lymph node dissection. Adjuvant chemotherapy is benefit for stage II-IIIA patients and combined chemoradiotherapy is the best choice for stage IIIA patients. If preoperative examination suggests mediastinal lymph node's enlargement and fusion, the operation should not be performed.</p>

Relationship and expression of hepatocyte growth factor and vascular endothelial growth factor in serum preoperative and postoperative patients with laryngeal squamous cell cancer / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the role and clinical value of the serum level of hepatocyte growth factor (HGF) and vascular endothelial growth factor(VEGF) in laryngeal squamous cell cancer and the relationship between HGF, VEGF and clinicopathological factors.@*METHOD@#We measured serum HGF and VEGF level in 54 laryngeal squamous cell cancer patients using ELISA to demonstrate the variation of HGF, VEGF level before operation and at day 1, 3, 7, 14 post-surgery. The concentration of the serum HGF, VEGF content in 35 normal healthy people and in 30 vocal cords polyps patients were measured by the quantitative sandwich enzyme linked immunoassay technique.@*RESULT@#(1) The level of serum HGF and VEGF in the patients with laryngeal squamous cell cancer was significantly higher than that of normal healthy people and vocal cord polyps patients (P 0.05). (3) There was a significantly positive correlation between preoperative serum VEGF and HGF levels (r = 0.7667, P < 0.01). (4) Post-operational serum HGF levels in 54 laryngeal squamous cell cancer patients who underwent surgical intervention increased significantly, peaked at day 3 after operation. Serum HGF levels of survivors during follow-up period gradually decreased at day 7 and day 14 after operation. The postoperative serum levels of VEGF were decreased significantly than that of preoperation.@*CONCLUSION@#HGF and VEGF may play an important role in the development and progression of human laryngeal cancer. Elevated serum HGF and VEGF levels predict a more aggressive biological behavior in laryngeal squamous cell cancer.