New progress in the surgical treatment of laryngeal cyst in infants and children / 临床耳鼻咽喉头颈外科杂志

Laryngeal cyst is a cystic lesion occurring in the laryngeal cavity. Large laryngeal cyst in infants and young children can cause laryngeal wheezing and other upper airway obstruction symptoms. In severe cases, it can be even life-threatening and requires timely surgical treatment. Currently, there is a lack of unified clinical treatment strategy for this disease.This article summarizes the surgical methods, the advantages and disadvantages of various surgical methods for laryngeal cysts in recent years. It is recommended that needle aspiration, partial cyst wall resection, radical cyst dissection, transoral robotic surgery or external approach cyst resection should be selected through full communication and evaluation to clarify the extent of the lesion scope and the advantages and disadvantages of surgery.

Clinical analysis of 102 cases of pediatric vocal fold nodules / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the impact of vocal fold nodules on the quality of life of children, and to compare the efficacy between conservative management（voice hygiene education, etc.） and laryngeal microsurgery. Methods:A retrospective study was performed on 102 children with vocal fold nodules, who received treatment in Children's Hospital of Fudan University during the period from January 2020 to December 2022. According to the regime, the patients were divided into conservative management group and surgical treatment group; Cases are divided into pre-school age group （2-5 years old） and school-age group （6-12 years old） based on age. The pediatric voice-related quality of life （pVRQOL） was used to evaluate the impact of vocal fold nodules on the quality of life of children and differences in efficacy between two treatment regimens. Results:The pVRQOL scores of vocal fold nodule grades 1, 2, and 3 were 91.58±8.17, 78.87±12.49, 72.50±12.08, respectively. There were statistical differences between grade 1 and grade 2, and between grade 2 and grade 3. There were statistical differences between grade 1 grade 2, grade 2 and grade 3 （P<0.001）, suggesting that the higher the rating of vocal cord nodules, the lower the pVRQOL score of patients was. The pVRQOL score of the school-age group was 69.83±11.11, which is lower than that of the preschool group（87.59±8.63）, and the difference was statistically significant （P=0.042）. Vocal fold nodules had a significant impact on the pVRQOL score of school-age children. In the conservative management group, the pVRQOL scores before and after treatment were 83.99±12.66 and 87.26±9.58, respectively, and there was significant difference between the two groups（P=0.046）. Indirect voice therapy such as voice hygiene education could improve children's pVRQOL scores and was more effective for school-age children（P<0.001）. The microsurgical treatment had a more significant improvement in the pVRQOL score of children. Conclusion:The higher the rating of vocal fold nodules, the greater the impact on the quality of life of patients. Vocal fold nodules had a greater impact on the quality of life of school-age children than that of preschool children. Voice hygiene education could improve the quality of life of children, which was more evident in the school-age group. Compared with voice hygiene therapy, laryngeal microsurgery had a more significant effect on improving the pVRQOL score of patients. It is recommended to undergo laryngeal microsurgery for the treatment of vocal fold nodules for the requirement of improving the quality of life related to voice. During the 6-month follow-up period after surgery in this study, the short-term efficacy of laryngeal microsurgery in treating vocal cord nodules in children is clear, but the long-term efficacy needs further research.

Diagnosis and treatment of disorders of laryngeal airway in children and prospect / 临床耳鼻咽喉头颈外科杂志

This paper focuses on the diagnosis and treatment of disorders of laryngeal airway in children, including congenital anomalies, infection, and tumor of the larynx to provide a new technology for managing these diseases. Based on the characteristic of them, the pediatric upper airway is dedicated to the clinical evaluation of airway obstruction and the assessment of the compromised pediatric airway, including clinical evaluation of symptoms, diagnostic endoscopy, and imaging examination. Information on endoscopic techniques used for dealing with different degrees of pediatric airway comprised is provided, also this techniques could diagnose what kinds of airway disorder. For example, determining the a particular laryngeal cleft at the initial otolaryngology encounter, flexible laryngoscopy should be performed. In order to define the extent of any identified cleft, the rigid bronchoscopy should be completed to evaluate for classification of laryngeal cleft including typeⅠ, Ⅱ, Ⅲa, Ⅲb, Ⅳa, Ⅳb under general anesthesia. The decision to pursue any therapy for the disorders of laryngeal airway in children should be based on the severity of the patient's symptoms, endoscopic and imaging examination. There are two medical treatments including nonsurgical therapy and surgical therapy. For example the laryngeal cleft, approximately half of type 1 and select type 2 patients can be managed entirely with nonsurgical therapy. Medical management is multifaceted. Under recommendations from the feeding team, a modified diet with thickened feeds and possibly altered feeding position should be initiated. Endoscopic surgical repair is the current gold standard for definitive repair of type 1, the majority of type 2, and selected type 3 clefts. Finally, information on new techniques used into the future for dealing with the diagnosis and treatment of disorders of laryngeal airway in children in this paper.

The consensus among experts on the diagnosis and treatment of pediatric vocal cord paralysis / 临床耳鼻咽喉头颈外科杂志

Pediatric vocal ford paralysis is a vocal cord movement disorder caused by damage to the pediatric laryngeal motor nerves.It is mainly characterized by voice, breathing,and swallowing difficulties,and in severe cases,it can lead to choking in affected children. Currently, the diagnosis and treatment of this condition pose a significant challenge for pediatric otolaryngologists, as the goal is to minimize damage to the vocal folds and laryngeal framework.In order to standardize the diagnosis and treatment of pediatric vocal cord paralysis, the Pediatric Otolaryngology Committee of the Chinese Medical Association,in collaboration with multiple children's medical centers nationwide, have formulated this consensus document.

Consensus recommendations on the evaluation and treatment of congenital laryngeal clefts / 临床耳鼻咽喉头颈外科杂志

Congenital laryngeal cleft is a rare airway malformation, mainly manifested as choking, feeding difficulties, which affects the growth and development of children. Patients with a severe laryngeal cleft may have recurrent aspiration, leading to cyanotic spells, or even death. Advances in development of endoscopic techniques have made early diagnosis possible. Depending on the degree of cleft, management may involve a variety of approaches ranging from medical management alone to open repair. Therefore, it is important for pediatric ENT doctors to diagnose and evaluate in clinical practice. This consensus statement, developed by the Pediatric otorhinolaryngology Professional Committee of the Pediatrician Branch of the Chinese Medical Doctor Association, provides comprehensive recommendations and standardized guidance on diagnosis and management of laryngeal cleft, based on symptomatology, physical examinations, and laboratory tests.

Consensus recommendations on the evaluation and treatment of laryngotracheal anomalies in infants and young children / 临床耳鼻咽喉头颈外科杂志

Infants with laryngotracheal anomalies are clinically manifested as stridor or noisy breathing, choking, hoarseness, feeding difficulties, and cyanotic spells, followed by developmental and growth retardation and other health issues; in severe cases, patients may present with severe dyspnea, which is associated with high mortality. A timely diagnosis as well as appropriate strategy for laryngotracheal anomalies is still challenging for pediatric otolaryngologists. This consensus statement, evolved from expert opinion by the members of the Pediatric Otorhinolaryngology Professional Committee of the Pediatrician Branch of the Chinese Medical Doctor Association, provides comprehensive recommendations and standardized guidance for otolaryngologists who manage infants and young children with laryngotracheal anomalies in evaluation and treatment based on symptomatology, physical and laboratory examinations.

Clinical evaluation of vocal fold paralysis in 207 children / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the etiology and clinical characteristics of vocal fold paralysis in children. To provide useful information for diagnosis, management and prognosis in the clinical work.@*Methods@#Two hundred and seven children with vocal fold paralysis in Children′s Hospital of Fudan University were retrospectively studied, and followed-up.@*Results@#All the patients had hoarseness.151 cases had vocal paralysis in the left side and the main etiology was pulmonary arterial hypertension.43 cases had bilateral vocal paralysis and all of them had respiratory problems.The main etiology were congenital tracheoesophageal malformations.13 cases had vocal paralysis in the right side.In terms of etiology, 8 cases were related to intracranial lesions, 2 cases were idiopathic.@*Conclusions@#The main etiologies of left vocal fold paralysis were cardiovascular diseases, and bilateral vocal paralysis were congenital tracheoesophageal malformations.The main etiologies of right vocal fold paralysis were neoplastic and central lesion.The prognosis of bilateral vocal fold paralysis and right vocal fold paralysis was poor.

Evaluation and treatment of children′s laryngeal clefts / 中华耳鼻咽喉头颈外科杂志

Objectives@#To provide the experience about the diagnostic process and following management, and to discuss the outcome and predictors in children with laryngeal cleft (LC).@*Methods@#A retrospective case study was conducted at an academic children′s hospital. Thirty children were diagnosed as laryngeal cleft between January 2016 and April 2017.Airway evaluations were performed using both flexible and rigid endoscopy, and swallowing evaluations were performed using fiberoptic endoscopic examination of swallowing or modified barium swallow.@*Results@#Of 30 cases, 18 were male and 12 were female, ranging in age from birth to 8 years. Two cases were diagnosed as type 0 LC, and they were offered thickened liquid without medication. Throughout follow-up, they remained asymptomatic and showed no respiratory complications. Nineteen children were diagnosed as type Ⅰ LC. Six of them were significantly improved by anti-reflux therapy and feeding instructions. Four children were concomitant with swallowing dysfunction and/or neuromuscular disorders, and they were given a tracheotomy and routine management. Another 4 children were submitted surgical repair when routine treatment failed, and their symptoms were relieved. Five children were concomitant with larygomalacia, and their symptoms were totally ameliorated by supraglottoplasty. Three children were diagnosed as type Ⅱ LC. Two of them received surgical repair and clinically improved, and the rest one was treated by anti-reflux therapy and still under follow-up. Three children were diagnosed as type Ⅲ LC. One of them was underwent surgical repair and clinically improved. Two children were tracheotomized and treated by anti-reflux therapy. Three cases were diagnosed as type Ⅳ LC at birth and no one survived.@*Conclusions@#Laryngeal cleft is a rare congenital anomaly manifesting with a variety of symptoms, including swallowing disorder, aspirations, dyspnea, stridor and hoarseness. Diagnosis and treatment of laryngeal clefts is a challenge. The best way to evaluate the LC is FEES by laryngeal endoscopy combined with MLB. Cases with type 0-Ⅰ mostly were significantly improved by anti-reflux therapy and feeding instructions. When routine treatment failed, surgical repair is needed. All the cases with LC type Ⅱ-Ⅲ need surgical repair as soon as possible. For type Ⅳ cases, early diagnosis, appropriate treatment and management help to reduce mortality and morbidity.

Study in air-conducted and bone-conducted auditory brainstem responses in children with congenital external auditory canal atresia / 中华全科医师杂志

Objective To study the clinical value of air-and hone-conduction auditory brainstem responses(ABRs) in children with congenital aural atresia.Methods Air-and bone-conduction clickevoked ABRs in 38 children with congenital external auditory canal atresia were compared to those in 34 normal-hearing children.Results ABR threshold were (65.0 ± 8.7) dBnHL for air conduction and (10.6 ±7.0) dBnHL for bone conduction in children with congenital external auditory canal atresia;and (25.6 ± 1.7) dBnHL and (9.7 ± 6.7) dBnHL respectively in normal hearing children.There was statistically difference between the two groups in air-conduction ABR threshold(t' =21.59,P ＜ 0.01).There was no significance between the two groups in bone-conduction ABR (P ＞ 0.05).While the air-bone ABR threshold gap was greater in children with external auditory canal atresia than in normal hearing children (t' =13.78,P ＜ 0.01),bone-conduction ABR wave latencies were not statistically different between the two groups(all P ＞ 0.05).Conclusion Bone conduction ABR is valuable in assessing fuuction of cochlea,auditory nerve and brainstem in individuals with congenital external auditory canal atresia.It has important clinical value in objective differential diagnosis of conductive deafness with combined application of air-and bone-conduction ABRs.

Effects of Typhae pollen Decoction on Isolated Uterine Smooth Muscle Contraction of Rats at Postconceptu-al Stage / 中国药房

OBJECTIVE:To study the effect of Typhae pollen decoction on isolated uterine smooth muscle(USM)contraction of rats at postconceptual stage. METHODS:16 Wistar rats at postconceptual stage were selected and USM strips were isolated. T. pollen decoction 0(blank control),2,4,8 and 12 mg(medicinal material)/ml were added respectively;the effects of T. pollen de-coction on USM strips contraction were observed,and mean tension,duration of contraction and frequency were measured and re-corded. The effects of T. pollen decoction on USM strips contraction were investigated after pretreatment of prostaglandin synthase inhibitor indometacin(1×10-7 mol/ml)and calcium channel blocker verapamil(1×10-7 mol/ml);USM tension,duration of contrac-tion and frequency were measured and recorded. RESULTS:Compared with blank control group,T. pollen decoction 4,8 and 12 mg(medicinal material)/ml could increase USM tension,duration of contraction and frequency(P<0.05);after added verapamil and indometacin,T. pollen decoction decreased USM tension,shortened duration of contraction and decreased frequency (P<0.05). CONCLUSIONS:T. pollen decoction can strengthen USM strips contraction,and the effect is inhibited by prostaglandin syn-thase inhibitor and calcium channel blocker.

Different roles of total flavonoids of astragalus on human normal mesenchymal stem cells and hepatoma cells in radiation protection / 中华放射医学与防护杂志

Objective To investigate the different radioprotective effects of total flavonoids of Astragalus (TFA) on human normal mesenchymal stem cells(hMSCs) and hepatoma cells injured by 60 Coγ-ray radiation.Methods hMSCs and HepG-2 cells were cultured and randomly divided into TFA-treated and untreated groups.The cells of different groups were irradiated with 60 Co γ-rays at the dose of 6 Gy.MTT method was utilized to detect the survival rates of the hMSCs and HepG-2 cells pretreated or untreated with TFA before irradiation.Cell clone formation test was used to measure the cellular radiosensitivity.The apoptosis rates of different groups were determined by flow cytometer assay.The expression rates of the apoptosis-promoting proteins Fas and Bax and the apoptosis-inhibiting protein Bcl-2 were analyzed by Western blotting.Results MTT showed that the survival rates of hMSCs pretreated by TFA were 1.15-1.95 times higher than that of the pure irradiation group.On the contrary,the survival rates of the TFA pretreated HepG-2 cells were only 0.53-0.23 times that of the pure irradiation group.There was a good dose-effect relationship between the cell survival rate and the TFA concentration.Cell clone formation rate indicated that combined treatment of TFA and radiation inhibited the cell proliferation more effectively than single TFA or pure radiation.Flow cytometry showed that 6,24 and,48 h post-irradiation to 6 Gy,the apoptosis rates of the hMSCs were 23.3% ,11.2% ,and 2.9% ,respectively in the TFA pretreated group and were 29.3% ,24.9% ,and 13.6% in the pure radiation group.However,the apoptosis rates of the HepG-2 cells at 6,24,and 48 h post-irradiation to 6 Gy were 11.6% ,17.3% ,and 20.1% ,respectively in the TFA pretreated group and were 6.9% ,9.3% ,and 15.8% ,respectively in the direct radiation group.Western blotting showed that the expression levels of Fas and Bax proteins in the HepG-2 cells were significantly higher in the TFA pretreated group than in the pure radiation group.On the contrary,the expression level of the apoptosis inhibiting protein Bcl-2 was significantly lower in the TFA pretreated group than in the pure radiation group.Conclusions TFA has obvious effects of radiological protection on human hMSCs and has no effects of radiological protection but effects of apoptosis enhancement on hepatoma cells.The promotion of apoptosis of TFA on hepatoma cells is primarily through increasing the expression of apoptotic proteins such as Fas and Bax and reducing the expression of anti-apoptotic protein Bcl-2.

The Application of Auditory Steady - State Responses to the Neonates Hearing Evaluation / 听力学及言语疾病杂志

Objective To explore the use of auditory steady-state response (ASSR) for threshold evaluation in neonates. Methods 30 neonates 60 ears) were included in the study who passed distortion product otoacoustic emission (DPOAE) screening and 45 neonates (78 ears) who failed DPOAE. The ASSR thresholds were evaluated screening, the significant difference was found between the ASSR thresholds at 250 Hz and the ABR thresholds (P ＜0.05), however the ASSR thresholds at 4 000 Hz and average thresholds were not different from the ABR thresholds (P＞0.05). For the neonates whose DPOAE screening results were abnormal, the ASSR thresholds from 250 to 4 000 Hz and average thresholds were not significant different from the ABR thresholds respectively (P＞0.05). olds were not correlated, but there were significant correlations at 2 000 and 4 000 Hz. For the neonates whose DPOAE screening results were abnormal, the ASSR thresholds and the ABR thresholds were significantly correlated at all the carrier frequencies. Conclusion Reliable and frequency specific results could be obtained by ASSR,so it could be a promising audiometry to evaluate the hearing of neonates.

An Analysis of Tympanometry in One Hundred and Twenty-Five Newborns / 听力学及言语疾病杂志

Objective The aim of the study was to analyse the middle ear function of one hundred and twenty-five newborns using 226,678,1 000 Hz tympanometry. Methods Tympanometries with 226,678,1 000 Hz probe tones were obtained from 125 newborns (250 ears) by means of GSI Tympstar middle ear analyzer. The newborns with abnormal tympanograms were referred for temporale CT. Results One case of 226 Hz tympanograms was type "As" while others were all type "A",of which single-peaked tympanograms was 43.2%(108/250),W-shaped tympanograms was 56.8%(142/250). The abnormal pattern of 678 Hz tympanograms were 74 ears,and the abnormal pattern of 1 000 Hz tympanograms were 35 ears. 43 newborns (86 ears) have accepted temporale CT and results showed 30 middle ears with effusion. Conclusion 226 Hz probe tone tympanometry couldn't reflect the middle ear function of newborns. The sensitivity of 678 Hz probe tone tympanometry in the diagnosis of middle ear function of newborns was good,but specificity was worse. The sensitivity and specificity of 1 000 Hz probe tone tympanometry were the best.

Application of Tympanometry in Infants / 听力学及言语疾病杂志

Objective To study the effects of multi frequency tympanometry and acoustic stapedius reflexes on the diagnosis of the middle ear functions of infants.Methods Tympanometries with 226,678 and 1 000 Hz probe tones and 500 and 1 000 Hz acoustic stapedius reflexes were performed on infants at age 0~1 year.128 normal infants(256 ears) and 104 abnormal infants(168 ears) were tested with GSI Tympstar middle ear analyzer.Results The patterns of 226 Hz tympanograms were non-peaked,single-peaked and W-shaped.There were no significant differences between two groups of infants aged 0～6 months.The patterns of 678 Hz and 1 000 Hz tympanograms showed significant differences between two groups of infants aged 0～1 year.The outcomes of 500 Hz and 1 000 Hz acoustic stapedius reflexes showed no differences between the same age groups.There were significant differences between normal group and abnormal group.Conclusion Tympanometry with 678 Hz and 1 000 Hz probe tones can yield accurate diagnostic results in the assessment of the middle ear functions for infants younger than six months.The tympanometry with three frequency probe tones is sensitive to infants aged 6～12 months.The outcomes of acoustic stapedius reflexes at 500 and 1 000 Hz show no differences between the same age groups,but presences become more noticeable as a function of ages.

Application of Intraoperative EABR in the Young Deaf With Cochlear Implants / 听力学及言语疾病杂志

Objective The aim of the study was to investigate the intraoperative EABR as a reference of beginning of fitting the cochlear implant(CI)and predicting the result.Methods Intraoperative EABR were recorded in two young children(two years,and three and half years)receiving the Digisonic DX 10 Cochlear Implant.Electrodes 15,13,10,7 and 4 were investigated using Digistim Stimulation Mode.Results During the surgery,wave Ⅲ and Ⅴ were clearly seen in the EABR.It was to demonstrate that the function of the auditory pathway of cochlear nerve and brainstem would be good.Measuring behavioral thresholds after implanted chochlea in patient was similar to predict the result.In young child the EABR thresholds were 15 ?s?60 ?V,20 ?s?60 ?V,25 ?s?60 ?V,30 ?s?60 ?V and 30 ?s?60 ?V at electrodes 15,13,10,7 and 4,whereas in another child the EABR thresholds had 15 ?s?50 ?V,20 ?s?50 ?V,25 ?s?50 ?V,20 ?s?50 ?V,and 20 ?s?50 ?V.Based upon the EABR thresholds,the amplitude for beginning of fitting was set at the 15～20 ?V differences between the Digisonic PDX10 and the EAB stimulation.Minima threshold level was set at 15 dB for starting of the number of electrode 15, and then the number of electrodes were decreased with increasing minima threshold levels(2～3 step).This was also achieved by increasing the maximum electrical thresholds.Conclusion It is confirmed that the intraoperative EABR could predict the result,and could be more precise and sensitive for beginning of fitting the cochlear implant as a reference.

Otoacoustic Emissions and Auditory Brainstem Response in High Risk Neonatal Hearing Screening / 听力学及言语疾病杂志

Objective To investigate the character 、difference and clinical meaning of distortion product otoacoustic emissions(DPOAE) and auditory brainstem respons(ABR) in high risk neonates with.Methods DPOAE and ABR were recorded with amplaid MK 22 and GSI60 in 200(400ears) high risk neonates, then compared the results.Results Of 200(400ears) newborns, the presence of DPOAE was 64%(256/400 ears), the presence of ABR was 88.25%(353/400 ears). The co-negativity and co-positivity of DPOAE and ABR were 61.50%(246/400 ears)and 9.25%(37/400 ears). The false negative and false positive of DPOAE were 3.91%(10/256 ears)and 74.31%(107/144 ears).Conclusion The DPOAE test is simple,quick,harmless,sensitive and objective. Because it only reflects the function of the cochlea and has high false positive, we can't make the diagnosis of hearing loss immediately when newborns don't pass the DPOAE test.The ABR test is a reliable method for neonatal hearing screening. The combination of DPOAE and ABR in high risk neonatal hearing screening could increase the accuracy and reliability of the test and retest results.

The Application of Auditory Steady-State Responses to the Neonates Hearing Evaluation / 听力学及言语疾病杂志

0.05).②For the neonates passed DPOAE screening,the ASSR thresholds at 250,500 and 1 000 Hz and the ABR thresholds were not correlated,but there were significant correlations at 2 000 and 4 000 Hz.For the neonates whose DPOAE screening results were abnormal,the ASSR thresholds and the ABR thresholds were significantly correlated at all the carrier frequencies.Conclusion Reliable and frequency specific results could be obtained by ASSR,so it could be a promising audiometry to evaluate the hearing of neonates.

Investigation of Dust Mites in Dormitories, Classrooms and Library of a College / 环境与健康杂志

0.05), in the sheets, quilt covers, bedsides, coats and underwear, the difference was significant (P

Paragonimus skrjabini Infection in Animal Reservoir Hosts and Questionnairing in Residents at a Village of Hubei Province / 中国寄生虫学与寄生虫病杂志

Freshwater crabs (Sinopotamon denticulatum) were examined for metacercariae. Cats and dogs were also examined for Paragonimus infection. Questionnairing was carried out on health knowledge and behaviors among local residents in a village of Baokang County, Hubei Province. Results showed that the infection rate of Paragonimus skrjabini metacercariae in Sinopotamon denticulatum was 20.5% (46/214), with 15.6% (20/128) in a mining area and 30.2%(26/86) for the non-mining area respectively ( ?2=6.5, P0.05). Questionnairing showed that dogs and cats were with the habit of foraging and defecating at streams and children had the habits of eating raw or under-cooked crabs. The natural and ecological environments are in favor of the life cycle of P. skrjabini.