Correlation analysis between Dx-pH monitoring and proton pump inhibitor test in the diagnosis of laryngopharyngeal reflux disease / 中华耳鼻咽喉头颈外科杂志

Objective@#The consistency of 24-hour oropharyngeal Dx-pH monitoring and proton pump inhibitor(PPI) test in the diagnosis of laryngopharyngeal reflux disease (LPRD) was investigated.@*Methods@#Sixty patients with laryngopharyngeal reflux (LPR) related symptoms who had never received PPI treatment were assessed by reflux symptom index (RSI) and reflux finding score (RFS) between October 2017 and October 2018, including 28 males and 38 females, aged from 16 to 72 years, with a medium age of 38 years. Prior to treatment, all patients were evaluated with 24 hours oropharyngeal Dx-pH monitoring(Restech). After empiric therapy with PPI twice-daily for 8 weeks, the efficacy was evaluated according to posttreatment RSI score.The data was analysed with Kruskal-Wallis test, Student Newman Keuls test and consistency check.@*Results@#(1)Among all 60 patients,13 patients (21.7%) had pathologic Ryan score and all resulted responsive to PPI;27 patients (45.0%) with a negative Ryan score were unresponsive to PPI; 20 patients (33.3%) despite a negative Ryan score resulted responsive to PPI therapy. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of Ryan score were 39.4%, 100%, 100% and 57.4% respectively. The Kappa value was 0.369 (P<0.01). (2)Among 34 patients (56.7%) with positive Dx-pH results (24-hour oropharyngeal acid reflux events≥ 3 times), 29 patients were positive and 5 patients were negative in PPI test. Among 26 patients with negative Dx-pH results (24-hour oropharyngeal acid reflux events<3 times), 4 patients were positive and 22 patients were negative in PPI test. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of 24-hour oropharyngeal acid reflux events were 87.9%, 81.5%, 85.3% and 84.6% respectively. The Kappa value was 0.696(P<0.01).@*Conclusions@#There is a positive correlation between 24-hour oropharyngeal Dx-pH monitoring positive results (24-hour oropharyngeal acid reflux events≥3 times) and PPI test in the diagnosis of LPRD. The 24-hour oropharyngeal Dx-pH monitoring can be a promising tool for the diagnosis of suspected LPRD patients, and more sensitive and accurate Dx-pH diagnostic index will be required in the clinic.

Expression and clinical significance of CK4, CK13 in sinonasal squamous cell carcinoma / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo investigate the expression of cytokeratin (CK) 4 and 13 in sinonasal squamous cell carcinoma (SNSCC) and their pathobiological implications for tumor angiogenesis and metastasis. METHODSThe expression of CK4 and CK13 was detected by immunohistochemistry in normal and cancerous tissues in 42 cases of SNSCC, integral optical density (A) was measured by computer analysis of images and analyzed by SPSS13.0.RESULTSCK4 and CK13 were expressed significantly higher in normal tissues than in cancerous tissues of SNSCC. Moreover, the expression level of CK4 and CK13 was related to the differentiation of SNSCC, which was higher in the well/middle differentiated ones than in poor ones. The expression of CK4 was significantly associated with the tumor size, clinical stage and cervical lymphatic metastasis in SNSCC. While CK13 had no relationship with these three factors.CONCLUSIONThe detection of CK-4 and CK-13 might play an important role in the prognostic evaluation of SNSCC.

Onset time and efficacy of sublingual immunotherapy with Dermatophagoides farinae drops in children with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the onset time and efficacy of sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops in children with house dust mites (HDM)-induced allergic rhinitis (AR).</p><p><b>METHODS</b>One hundred and forty three children with perennial moderate to severe HDM-induced AR were treated by SLIT with standardized Dermatophagoides farinae extract. One hundred children who finally completed two years treatment were divided into two groups according to the age: younger children group (aged 4-8 years, n = 52) and older children group (aged 9-14 years, n = 48). Respectively, Each children was assessed before and after 1st, 2nd, 3rd, 6th, 12th, 24th months of the treatment. Total nasal symptom score (TNSS), total medication score (TMS) and visual analogue scale (VAS) were evaluated at each visit. All clinical data were analyzed retrospectively with the SPSS 19.0 software.</p><p><b>RESULTS</b>TNSS, TMS and VAS of two groups decreased significantly after three months of the treatment compared with before (younger children group: Z value was -3.843, -3.534, -3.940, older children group: Z value was -3.938, -3.405, -3.953, all P < 0.05). TNSS and VAS of younger children group decreased significantly after two months of the treatment compared with before (6.4 ± 1.6, 5.3 ± 1.4 vs 8.6 ± 1.2, 7.9 ± 1.6, Z value was -3.843, -3.940, both P < 0.05). Five children (5%) experienced local adverse events and 2 children (2%) experienced mild systemic adverse events. No severe adverse events happened during the treatment.</p><p><b>CONCLUSIONS</b>SLIT with Dermatophagoides farinae drops is an efficient and safe treatment for children with HDM-induced AR. Its onset of action can be observed as early as 3 months after treatment.</p>

Clinical analysis of 26 neonatal pneumonia patients complicated with pneumothorax / 中国基层医药

Objective To explore the clinical features and prevention measures of neonatal pneumonia complicated with pneumothorax.Methods Clinical data of 26 neonatal pneumonia patients complicated with pneumothorax were retrospectively analyzed.Results In 26 cases of neonatal pneumonia complicated with pneumothorax,16 cases(61.4％) were aspiration pneumonia,10 cases(38.5％) were infectious pneumonia.2 cases of not obvious mild cyanosis and dyspnea were given conservative treatment,24 cases were shortness of breath cyanosis,groan,face pale,difficulty in breathing,restlessness,irritability.Breath sounds were reduced or disappear,sound shift,cyanosis to oxygen can not be sustained remission.Blood oxygen saturation were lower grade.One side or both sides of the chest profile were apparent uplift with thoracic puncture exhaust or thoracic closed drainage.24 cases(92.5％) suffered from pneumothorax were cured.2 cases (7.7％) gave up the treatment,including 1 case died and 1 case loss prevention.Conclusion Pneumonia of newborn pneumothorax is secondary to inhalation of most inappropriate,infection,airway pressure,suction.Once found,timely treatment is important.Mild cyanosis can spontaneous remission,cyanosis having oxygen can not be sustained remission.The prognosis of it by thoracic puncture exhaust or closed thoracic drainage is good.Actively control influence during pregnancy,birth and postpartum.Preventing meconium inhalation can reduce the occurrence of neonatal pneumonia complicated with pneumothorax.

Clinical characteristics of benign paroxysmal positional vertigo secondary to sudden deafness / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To retrospectively analyze the clinical characteristics of the benign paroxysmal positional vertigo (BPPV) secondary to the sudden deafness (SD) and to explore pathogenetic mechanism.@*METHOD@#One hundred and seventy-eight cases of the SD in our department were retrospectively analyzed. They were all treated under the guidance of clinical guidelines.@*RESULT@#(1) In all these patient's with SD, there were 31 cases with BPPV secondary to the SD. There were 26 cases of BPPV of posterior semicircular canal and 5 cases of BPPV of lateral BPPV semicircular canal. All patients with BPPV were diagnosed as the same ears as the SD, including 16 cases on left sides and 15 on right sides. (2) The interval between the onset of SD and BPPV was less than one week in 27 cases, between one week and one month in 3 cases, and between one and three months in 1 case. (3) All patients with BPPV secondary to the SD were cured with Epley maneuver or Barbecue roll maneuver.@*CONCLUSION@#The occurrence of BPPV may follow SD, and the major of BPPV secondary to the SD occurs in the posterior semicircular canal. The canalith repositioning is an effective therapy to the secondary BPPV.

Chemical constituents from Neo-Taraxacum siphonathum / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents from the antioxidant fraction of Neo-Taraxacum siphonathum.</p><p><b>METHOD</b>Various chromatographic techniques were used to isolate and purify the constituents. The structures were elucidated on the basis of chemical evidence and spectral analysis.</p><p><b>RESULT</b>Ten compounds were isolated and identified from Neo-T. siphonathum, caffeic acid (1), chlorogenic acid (2), quercetin (3), luteolin (4), quercetin-3-O-beta-D-glucopyranoside (5), quercetin-3-O-alpha-D-arabinofuranoside (6), quercetin-3-O-alpha-D-arabinopyranoside (7), luteolin-7-O-beta-D-glucopyranoside (8), beta-sitosterol (9) and daucosterol (10).</p><p><b>CONCLUSION</b>Compounds 1-10 were isolated from this plant for the first time.</p>

Meningeal malignant melanosis:3 cases report with clinicopathological and neuroimaging / 中华神经科杂志

Objective To investigate clinicopathological and neuroimaging features of meninheal malignant melanosis.Methods The cytologic study of cerebrospinal fluid(CSF)and neuroimaging examination and meningeal histochemistry were performed in 3 cases of meningeal malignant melanosis. Results Three patients were found to have initial onsets of headache.followed by meningeal irritation.One case had huge malignant melanoma on skin.The second patient had diabrotic malignant melanoma on her face,which did not healed for a long time.The third patient had no malignant melanoma on skin and viscera.The MRI enhanced scanning of all 3 cases showed abnormal enhancement of meninge.There were a large number of abnormal shape cells in CSF.The meninxes were blackbrown or brown.The tumor cells were in various shapes with big and round irregular nucleus and rich cytoplasm.There were a great quantitv of melanosomes.The tumor cells were disarranged. Immunohistochemistry analyses found S-100 protein and Vim and HMB-45 were positive reaction. Conclusions The patients with meningeal malignant melanosis have an initial onset of headache,followed by meningeal irritation,and MRI enhanced scanning plays a valueble role in the diagnosis.A lage number of tumor cells in abnormal shape have been found in CSF.Thetumour cells of meninx presents different shapes with big and round or irregular nucleus.There are a great quantity of mellanosomes,and the tumour cells are arranged in a state of chaos.

Expression of MMP-2, c-erbB-2 and clinical significance in non-small cell lung cancer / 肿瘤研究与临床

Objective To investigate the expression of MMP-2 and c-erbB-2 and evaluate the correlation of clinical pathological parameters in non-small cell lung cancer. Methods Forty-five paraffin-embedded specimens of radical postoperative non-small cell lung cancer was detective for MMP-2 and c-erbB-2 using immunohistochemical method. Results The positive rates of MMP-2 and c-erbB-2 are 57.8 %, 75.6 %, there is a significance between the expression of MMP-2 and lymph node metastases(P =0.006), the expression of c-erbB-2 is related to clinical stage and lymph node metastases (P =0.015, P =0.032), The expression of MMP-2 and c-erbB-2 are related to 5-year survival rate (P =0.002, P =0.003). Conclusion The expression of MMP-2 and c-erbB-2 is significantly related to some clinical parameters and 5-year survival rate.

To Stress Innovation and Improve the Quality and Effect of Medical Chemistry Experiment Teaching / 中华医学教育探索杂志

Medical chemistry is one of the important basic medicines.Faced with the rapid development of education,Medical chemical education reform or innovation should also keep vigorous.In this paper,we discuss how to innovate and improve the quality and effect of experiment in the process of medical chemistry experiment and lay a solid foundation for continued study.

Tuina and External Application for Cervical Spondylopathy / 针灸推拿医学（英文版）

Objective: To explore the clinical efficacy and characteristics of Tuina and herbal and magnetic application in the treatment of cervical spondylopathy, Method: 302 subjects were treated with above methods and their efficacy were assessed according to the patterns. Results: Among the 302 cases, 153 cases were cured, 131 got marked effects, 14 cases were improved and 4 cases failed; the total effective rate was 98.7%. Conclusion: Tuina in combination with herbal and magnetic application has good effects on various pattern of cervical spondylopathy.