Analysis of allergen screening results in 2413 children with allergic rhinitis in Children's Hospital of Fudan University / 中国实用儿科杂志

OBJECTIVE: To analyse the allergens in children with allergic rhinitis and provide evidence for the prevention and treatment of allergic rhinitis in children. METHODS: Allergens were detected in 2413 children with allergic rhinitis by immunoblotting from January 2013 to July 2018 in Department of Otolaryngology Head and Neck Surgery,Children's Hospital of Fudan University. RESULTS: The first four inhaled allergens were house dust mites,mixed mold,dog hair and house dust,each accounting for 49.52%,23.62%,17.99%,and 15.54%. The first four food-borne allergens were milk,eggs,cashews,and crabs,each accounting for 46.54%,22.92%,19.10%,and 9.45%. Most patients with allergic rhinitis(46.33%)have both inhaled and ingestive allergies.There was a statistically significant difference in the positive rate of allergens between male and female children(P<0.05). With age increasing,the positive rate of inhaled allergens in children gradually increased,and the positive rate of ingestive allergens gradually decreased. CONCLUSION: The inhaled allergens in Shanghai are mainly dust mites and mixed molds. The food-borne allergens are mainly milk and eggs. The detection of allergens can help to understand the allergic state of children.

Clinical application of H_1 antihistamines in children with allergic rhinitis / 中国实用儿科杂志

The incidence of allergic rhinitis in children increases year by year,and H_1 antihistamines play a role in the control of allergic diseases by blocking the binding of histamine and H_1 receptor. The second-generation H_1 antihistamines have more stable binding,better specificity,lower central inhibitory effect and longer action time,and can effectively improve the symptoms of the nose and eyes,which is the firstline drug for the treatment of allergic rhinitis in children. At present,there aren't objective testing methods to evaluate the effectiveness and safety of antihistamines. Therefore,the dosage for children should be adjusted according to body weight,appropriate dosage forms should be selected,age limit should be paid attention to,dosage varieties should be individualized as far as possible,and reasonable course of treatment should be applied.

Analysis of the causes of 117 infants with persistent hoarseness / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the causes of persistent hoarseness in infants.</p><p><b>METHODS</b>One hundred and seventeen infants with persistent hoarseness treated in the department of otorhinolaryngology in Children's Hospital of Fudan University between June 2008 and July 2010 were retrospectively analyzed (all patients received antibiotic therapy for 2 weeks and the symptoms were not relieved after that). The patients were divided into three groups according to the age at first visit: 22 newborns, < 6 months old in 60 cases, < 12 months old in 35 cases. All patients had video laryngoscope examinations. Some of them received CT scan, cardiac ultrasonography and pathological examination in additional. The diagnosis was established by clinical history and imaging modalities, and the causes were analyzed subsequently.</p><p><b>RESULTS</b>Among the 117 patients, 45 cases were vocal hypertrophy and hyperplasia (37.81%), 39 cases were vocal cord paralyses (32.78%), 7 cases were laryngeal hemangiomas (5.89%), 4 cases were laryngeal webs and cyst (3.36%), 2 cases were vocal cord polyps (1.68%), 2 cases were glottic incompetence (1.68%), 1 case was laryngeal papillomas(0.84%), 1 case was vocal code granulomas (0.84%), 1 case was glottis restricted by neck lymphangioma (0.84%); 4 cases were undetermined and 13 cases were no abnormalities. The percentage of patients with congenital heart diseases (19 cases) in vocal cord paralysis was 48.72%. The proportion of vocal cord paralysis in younger group was higher than that in elder one, their percentage were 50.00%, 36.67% and 17.14% respectively (χ(2) = 7.18, P < 0.05).</p><p><b>CONCLUSIONS</b>A variety of causes can lead to persistent hoarseness in infants. The majority of them are vocal hypertrophy and hyperplasia, followed by vocal cord paralyze. Vocal cord paralysis is more common in younger infants than in elder ones, and the main causes are post-cardiac surgery and congenital heart disease.</p>

Establishment of the multiplex quantitative ligase chain reaction for detecting mutations of deafness genes / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To establish a low-cost, convenient and accurate multiplex quantitative ligase chain reaction (MQ-LCR) technique to detect the five common mutations in Chinese patients with deafness.</p><p><b>METHODS</b>Primers and probes for 5 common mutations of deafness genes, i.e., GJB2 gene 235delC and 299-300delAT, mtDNA A1555G, SLC26A4 gene IVS7-2 A>G and 2168A>G, were designed and synthesized. The technique for those mutations was established, and the reliability of the technique was tested in 98 patients with impaired hearing and 30 children with normal hearing, who were randomly selected from the ENT in Children's Hospital of Fudan University. The subjects were detected by MQ-LCR and direct DNA sequencing of PCR products, following a double-blind approach. Finally the results from the two methods were compared.</p><p><b>RESULTS</b>The results revealed 48 cases carried two mutations, 31 cases carried heterozygous mutations in the 98 deaf children, and 3 had heterozygous mutation in 30 normal controls. These results were consistent with that from DNA sequencing. No false positive and false negative result was obtained.</p><p><b>CONCLUSION</b>The MQ-LCR technique established in this study is of low-cost, convenience, accuracy, high sensitivity and high specificity. It is suitable for large-scale detection and preventive diagnosis of mutations in deafness.</p>

Diagnosis in infants with hearing loss using auditory steady-state evoked potentials / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the correlation between the auditory steady-state response (ASSR) thresholds and the vision reinforcement audiometry (VRA) thresholds in infants with auditory neuropathy.</p><p><b>METHODS</b>Ten cases in control group were measured by the ASSR and VRA. Based upon the ABR, DPOAE, and impedance data, as well as the aetiology (infection of the early pregnancy, defect of oxygen in birth and jaundice after birth), the 16 cases with hearing losses were divided into three groups (I , II and III). ASSR and VRA were examined.</p><p><b>RESULTS</b>From the analysis of ABR, DPOAE, and impedance data, the patients with the infection of early pregnancy in group I (5 cases/8 ears) had that the DPOAE were absent (5 cases/8 ears), the latency of wave I of ABR was delay and the interpeak latency of wave I - V of ABR was short (4 cases/6 ears), as well as the acoustic reflect thresholds in 500 Hz and 1000 Hz were normal (3 cases/6 ears) and high (2 cases/2 ears). They were deduced in cochlear lesion. The patients of group II with defect of oxygen in birth (5 cases/10 ears) showed that the DPOAEs were absent, the wave I of ABR was absent (3 cases/5 ears), and the interpeak latency of wave I - III of ABR was delay (2 cases/3 ears) They were deduced in auditory neuropathy (lesion from the cochlea to the brain-stem). The patients of group III had that the DPOAEs were present (6 cases/8 ears), the wave I/III/V of ABR and acoustic reflect were absent(4 cases/5 ears), and the interpeak latency of wave I -V of ABR was delay (2 cases/3 ears) who were deduced in auditory neuropathy(from the brain-stem to the subcortical lesion). Our results showed that the correlation coefficient-ranges between the ASSR thresholds and the VRA thresholds were the 0. 95 - 0. 98 in group I, the 0. 72 - 0. 84 in group II, and the 0.43 - 0.64 in group III. Comparison of the mean threshold-differences between the ASSR VRA thresholds for group I, group II, and group III for each frequency revealed significant difference (F test, P < 0.05, P < 0.01, P < 0.01, P < 0.05, P < 0.05).</p><p><b>CONCLUSIONS</b>The correlation technique between the ASSR thresholds and the VRA thresholds could provide the auditory neuropathy diagnosis and differential diagnosis in infants.</p>

Early detection of hearing impairment in high-risk infants of NICU / 中华儿科杂志

<p><b>OBJECTIVE</b>Hearing impairment or loss is a common disorder at birth. Many perinatal conditions may also cause hearing impairment. The present study aimed at investigating the incidence and morbidity of hearing impairment in critically ill neonates with high risk factors in neonatal intensive care unit (NICU).</p><p><b>METHODS</b>Patients were evaluated using the auditory brain-stem response (ABR) to detect hearing impairment or loss in 248 neonates stabilized or before discharge from the NICU during the period from Dec. 1999 to Aug. 2001 in SCMC. In this article, high risk factors of hearing loss included severe asphyxia, hyperbilirubinemia and very low birth weight, persistent pulmonary hypertension or on a ventilator, exposed to ototoxic medications such as aminoglycosides and diuretics, a family history of hearing loss, meningitis and craniofacial anomalies, etc. Screening test was performed with a 70 dB (SPL) hearing level click stimulus to each ear.</p><p><b>RESULTS</b>Seventy-two newborns had detectable hearing impairment in all the patients studied, the incidence of hearing impairment was 29.03%. Among them 3 cases had serious hearing loss. Twenty cases were among the 50 asphyxiated newborns (40.0%); 24 were from the 91 neonates with hyperbilirubinemia (26.37%); 15 were from the 44 premature infant group (34.09%), three of 4 premature cases with birth weight less than 1 500 g had hearing impairment. Six cases were among the 15 newborns who used mechanical ventilation (40.0%); 19 cases were among the 46 newborns who received ototoxic agents (41.30%).</p><p><b>CONCLUSIONS</b>Critically ill neonates with some specific high risk factors had a significantly high incidence of hearing impairment. Early hearing screening is necessary for neonates who are discharged from NICU.</p>

The parents' opinions on screening program regarding newborn hearing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate opinions on screening of newborn hearing from parent's and its influence to parents and their families.</p><p><b>METHODS</b>Parents were divided into two groups and were given the same questionnaire. Those parents whose babies had passed the first test were in the first group, and those parents whose babies failed the test were in the second group.</p><p><b>RESULTS</b>Most of the parents showed their ignorance to hearing screening with about 97.5% of parents admitted they had little knowledge of hearing screening. 93.06% of the parents showed positive attitude to the screening after being informed of the test. 59.73% of the parents thought the test results were reliable. 73.12% of the parents whose babies showed negative result at the first-test, thought the results were accurate. There were only 38.19% of the parents whose babies failed the first test held the same opinion. We also found that there were some disagreement among 78% of the parents who believed that the positive screening results might cause additional psychological stress on them and therefore affecting their normal family life.</p><p><b>CONCLUSIONS</b>Being informed of the screening, parents showed awareness of the test and were willing to cooperate. They believed the test was beneficial to their babies. Some parents whose babies did not pass the first screening test were often doubtful to the results and refused to be followed up. Therefore, we should improve our diagnostic technology to reduce the negative effects of the test. The results of our investigation suggested that the newborn hearing screening was applicable in our country.</p>