A glimpse into the psychological status of E.N.T inpatients in China: A cross-sectional survey of three hospitals in different regions.

OBJECTIVE: To determine whether E.N.T inpatients have a higher prevalence of mental illness than the general population and whether certain diseases are more likely to be associated with mental illness than other diseases. METHODS: This cross-sectional survey was conducted in the E.N.T departments of three hospitals in different cities in China. The psychological status of all consecutive adult inpatients was assessed within 1-2 days following hospital admission using the Symptom Checklist-90 (SCL-90), Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS). Inpatients from the general surgery and pneumology departments at the same hospital were enrolled and surveyed as control groups. RESULTS: The 439 patients enrolled in the final analysis accounted for 88.0% of all E.N.T inpatients during the study period. Of these patients, 16.4% were in an anxious state and 79.5% were in a depressive state. The overall anxiety (41.7 ± 9.7) and depression (55.9 ± 29.2) scores were much higher than Chinese norm (29.8 ± 10.0 and 33.5 ± 8.6, respectively), and significant differences were observed (t = 20.89, P < 0.01 and t = 13.12, P < 0.01, respectively). Although 18.7% of the E.N.T patients were psychiatric distress, these patients scored lower on the SCL-90 than the Chinese norm. Furthermore, the patients in the E.N.T department had a higher prevalence of anxiety and depression than those in the general surgery department but a similar prevalence to those in the respiratory department. CONCLUSION: Psychological distress, particularly anxiety and depression, are widespread in patients with otolaryngological diseases. Therefore, the identification and treatment of co-occurring psychiatric disorders in this high risk and clinically challenging group of patients are urgent in China.

Phase II clinical trial of whole-brain irradiation plus three-dimensional conformal boost with concurrent topotecan for brain metastases from lung cancer.

BACKGROUND: Patients with brain metastases from lung cancer have poor prognoses and short survival time, and they are often excluded from clinical trials. Whole-cranial irradiation is considered to be the standard treatment, but its efficacy is not satisfactory. The purpose of this phase II clinical trial was to evaluate the preliminary efficacy and safety of the treatment of whole-brain irradiation plus three-dimensional conformal boost combined with concurrent topotecan for the patients with brain metastases from lung cancer. METHODS: Patients with brain metastasis from lung cancer received concurrent chemotherapy and radiotherapy: conventional fractionated whole-brain irradiation, 2 fields/time, 1 fraction/day, 2 Gy/fraction, 5 times/week, and DT 40 Gy/20 fractions; for the patients with ≤ 3 lesions with diameter ≥ 2 cm, a three-dimensional (3-D) conformal localised boost was given to increase the dosage to 56-60 Gy; and during radiotherapy, concurrent chemotherapy with topotecan was given (the chemoradiotherapy group, CRT). The patients with brain metastasis from lung cancer during the same period who received radiotherapy only were selected as the controls (the radiotherapy-alone group, RT). RESULTS: From March 2009 to March 2012, both 38 patients were enrolled into two groups. The median progression-free survival(PFS) time , the 1- and 2-year PFS rates of CRT group and RT group were 6 months, 42.8%, 21.6% and 3 months, 11.6%, 8.7% (χ2 = 6.02, p = 0.014), respectively. The 1- and 2-year intracranial lesion control rates of CRT and RT were 75.9% , 65.2% and 41.6% , 31.2% (χ2 = 3.892, p = 0.049), respectively. The 1- and 2-year overall survival rates (OS) of CRT and RT were 50.8% , 37.9% and 40.4% , 16.5% (χ2 = 1.811, p = 0.178), respectively. The major side effects were myelosuppression and digestive toxicities, but no differences were observed between the two groups. CONCLUSION: Compared with radiotherapy alone, whole-brain irradiation plus 3-D conformal boost irradiation and concurrent topotecan chemotherapy significantly improved the PFS rate and the intracranial lesion control rate of patients with brain metastases from lung cancer, and no significant increases in side effects were observed. Based on these results, this treatment method is recommended for phase III clinical trial.

[Clinical observation of isolated congenital anosmia].

OBJECTIVE: To introduce 8 patients with isolated congenital anosmia and to discuss the clinical manifestations, imaging characteristics and family characteristics of this rarely seen disorder. METHODS: Eight patients with isolated congenital anosmia treated between April 2007 and April 2012 were reviewed retrospectively. There were 4 males and 4 females. A detailed medical history collection, physical examination, nasal endoscopy, T&T and Sniffin'Sticks subjective olfactory function tests, olfactory event-related potentials sinonasal computed tomography scan and sex hormones level monitoring were performed in all patients. Seven cases underwent magnetic resonance image of olfactory pathway examination. RESULTS: All patients were anosmia without evidence of other defects. ENT physical examination, nasal endoscopy and computed tomography scan were normal except 4 cases with obvious nasal septum deviation, 2 cases with concha bullosa. Subjective olfactory test indicated all of them were anosmia. Olfactory event-related potentials were obtained in only 1 patient. Magnetic resonance imaging revealed the smaller or atrophy olfactory bulb and olfactory tract in five cases, the absence of olfactory bulbs and tracts in two case. A female patient did not have MRI examination because of wearing IUDs. Detection of 8 patients of sex hormones were normal. Family characteristics: 3 patients showed family inheritance pattern. CONCLUSIONS: The diagnosis of isolated congenital anosmia should be based on chief complaint, medical history, physical examination, olfactory test, nasal endoscopy, olfactory testing, olfactory imaging and olfactory event-related potentials. Magnetic resonance image of olfactory pathway and olfactory event-related potentials have important value for the diagnosis. More attention should be paid to the genetic susceptibility of the family.

Phase II trial of capecitabine combined with docetaxel in previously treated patients with non-small cell lung cancer: A randomized controlled study.

Docetaxel alone has been confirmed to be beneficial to patients with advanced previously treated non-small cell lung cancer (NSCLC). However, the duration and survival time is short. The study of two-agent combination regimens has important clinical significance. We conducted this randomized controlled phase II trial to comparatively evaluate the efficacy and side effects of capecitabine combined with docetaxel in previously treated patients with NSCLC. Patients with previously treated NSCLC who failed first-line chemotherapy were randomized into two groups; one received capecitabine combined with docetaxel (XT group) and the other received docetaxel alone (T group). Patients in the XT group received chemotherapy as follows: capecitabine 625 mg/m(2), p.o. bid, days 5-18; and docetaxel 30 mg/m(2), days 1 and 8, while patients in the T group received docetaxel 35 mg/m(2) on days 1 and 8. The primary endpoint was time to progression (TTP), and secondary endpoints were overall survival (OS), response rate (RR) and disease control rate (DCR). Forty-eight patients were recruited (23 in the XT group and 25 in the T group). TTP, median survival time (MST) and 1-year OS rate in the XT group and the T group were 7 months, 12 months, 47.6% and 3 months, 12 months, 39.6%, respectively. The TTP in the XT group was significantly longer compared to that in the T group (χ(2)=4.763, p=0.029). The RR and DCR in the XT group and T group were 13.0% (3/23), 78.3% (18/23) and 12.0% (3/25), 76% (19/25), respectively. The difference was not significant (p>0.05). The major side effects observed in the two groups were neutropenia, fatigue and nausea, and toxicities were mild to modest. No severe cases of hand-foot syndrome were observed in the XT group. In conclusion, compared with docetaxel alone, capecitabine combined with docetaxel for patients with previously treated NSCLC achieved a significantly longer TTP and this regimen was well tolerated. The relatively high median TTP, 1-year OS rate and DCR encourage further evaluation of this regimen in a randomized phase III trial.

Costs of screening children for hearing disorders and delivery of hearing aids in China.

BACKGROUND: The burden of disease of hearing disorders among children is high, but a large part goes undetected. School-based screening programs in combination with the delivery of hearing aids can alleviate this situation, but the costs of such programs are unknown. AIM: To evaluate the costs of a school-based screening program for hearing disorders, among approximately 216,000 school children, and the delivery of hearing aids to 206 children at three different care levels in China. METHODS: In a prospective study design, screening and hearing aid delivery costs were estimated on the basis of program records and an empirical assessment of health personnel time input. Household costs for seeking and undergoing hearing health care were collected with a questionnaire, administered to the parents of the child. Data were collected at three study sites representing primary, secondary and tertiary care levels. RESULTS: Total screening and hearing aid delivery costs ranged between RMB70,000 (US$9,000) and RMB133,000 (US$17,000) in the three study sites. Health care cost per child fitted ranged from RMB5,900 (US$760) at the primary care level, RMB7,200 (US$940) at the secondary care level, to RMB8,600 (US$1,120) at the tertiary care level. Household costs were only a small fraction of the overall costs. Cost per child fitted ranged between RMB1,608 and RMB2,812 (US$209-US$365), depending on perspective of analysis and study site. The program was always least costly in the primary care setting. CONCLUSION: Hearing screening and the delivery of hearing aids in China is least costly in a primary care setting. Important questions remain concerning its implementation.

[Primary investigation of central auditory function in patients with temporal lobe epilepsy].

OBJECTIVE: To investigate the function of central auditory, Speech-perception-in-noise test (SPIN test) was used to assess that whether temporal lobe epilepsy patients have central auditory processing disorders. METHODS: Four audiological test were performed in 9 patients with temporal lobe epilepsy and 19 age-matched normal hearing persons as controls, which include pure tone audiometry, acoustic immittance measurement, ABR (auditory brainstem response) and SPIN test. All the temporal lobe epilepsy patients were performed by CT or MRI and diagnosed by the neurologists prior to the test. The testing materials of speech and noise in SPIN test was recorded in independent tracks and the S/N was identified by -25 dB by pre-experiment. In the test, every words were read twice and both the results were recorded. RESULTS: In the ABR test, only wave V latency showed longer values in the left ear, other waves like I, III and inter-peak intervals had'nt shown significant statistical differences in both ears of temporal lobe epilepsy patients. However, in the SPIN test, there's no significant statistical differences in both left and right ears of the controls by the first-time hearing (P = 0.107), and the differences showed by the second-time hearing (P = 0.048); but in the comparison of both ears in temporal lobe epilepsy patients, both time of hearing showed no significant statistical differences with P = 0.174 and P = 0.163. In additional, the SPIN recognition score of the temporal lobe epilepsy patients, whether in the fist or second time hearing, whether in the monaural or binaural models, presented significant statistical differences compared to the controls (P = 0.000). CONCLUSIONS: There was no statistically significant difference in pure tone audiometry and ABR test for all the groups. But the speech recognition score obtained from SPIN test of tempol lobe epilepsy patients is lower than the normal persons, which has statistically significant difference. (P < 0.001) Then we can come to the conclusion that Temporal lobe epilepsy patients had central auditory dysfunctions and SPIN test is a sensitive way to assess this abnormal.

[Study on the molecular recognition of perhydroxycucurbit[6] uril with methyl orange by spectroscopic methods].

The inclusion interaction of perhydroxycucurbit[6] uril (HOCB6) with methyl orange (MO) was studied by UV spectroscopic and fluorimetric methods. Several effect factors, such as pH values, common organic solvents and surfactants on the fluorescence intensity and the stability of the complex were investigated. The results indicate that the fluorescence intensity of MO was enhanced with a blue shift as host molecules were added, showing that MO was accommodated into the hydrophobic cavities of HOCB6 and an endo-inclusion complex was formed. The hydrophobic interaction between HOCB6 and MO mainly contributed to the formation of 1 : 1 type HOCB6-MO. Its complex constant was determined to be 1.41 x 10(2) L x mol(-1). The comparative study of HOCB6 with other supramolecules, such as cucurbit[6] uril (CB6), p-(N,N-dimethyl-aminomethyl) calix [8]arene and beta-cyclodextrin, was also carried out by using MO as a guest probe. The spectra changes showed that cucurbit[6] uril (CB6) can also form 1 : 1 type endo-inclusion complex with MO, which is similar to HOCB6, but its complex constant (34.65 L x mol(-1)) is small. The spectra changes also showed that the endo-inclusion complex with 2 : 1 type was formed between beta-cyclodextrin and MO, While the exo-inclusion complex was formed between p-(N,N-dimethyl-aminomethyl) calix[8] are-ne and MO, leading to fluorescence quenching, and their complex constants were determined to be 6.14 x 10(6) L2 mol(-2) and 1.35 x 10(4) L x mol(-1), respectively.

[Study on the interaction between p-octacarboxyphenylazocalix[8]arene and norfloxacin by fluorescence spectrometry].

In the present paper, p-octacarboxyphenylazocalix[8]arene (CPAC) was used as supramolecular probe according to a reported method. The interaction of CPAC with drug norfloxacin (NFLX) was studied by fluorescence spectrometry. The results show that CPAC can strongly quench the fluorescence of NFLX because of the complex interaction between host and guest molecules in exo-inclusion complex. The spectral changes indicated that the quenching can be considered as static quenching mode. The hydrophobic interaction between the cavity of CPAC and the quinoline ring was the main force to consolidate the exo-inclusive complex CPAC-NFLX stability. The complex constant (K) and binding ratio (n) were determined to be 6. 38 X 10(5) L x mol(-1) and 1, respectively. Further experiment found that the calf thymus DNA and CPAC can combine, leading to the release of NFLX and the enhancement of fluorescence of the reaction system. It is expected that CPAC will be used as drug carrier and releaser.

[Study on the interaction of water-soluble p-(N,N-dimethylaminomethyl) calix[8] arene with DNA by fluorescent spectrometry].

The interaction of water-soluble p-(N, N-dimethylaminomethyl) calix [8] arene (CX8) with DNA was studied using adriamycin(ADM) as a probe by fluorescent spectrometry. The effect factors such as, pH of solution, salt effect and unlinking DNA on the spectra were also investigated. The interaction mechanism was proposed. The authors observed that the fluorescence of ADM was quenched by calf thymus DNA, and the fluorescence intensity of DNA-ADM enhanced with the increasing of the CX8 gradually. The result indicates that the strong electrostatic interaction between the oxyphosphate anion of DNA and the CX8 existed. According to the plot of scatchard, the results imply that the influence of CX8 on interaction of DNA-ADM belongs to mixed model, on the one hand, in the condition of neutral and acidity, the oxyphosphate anion of DNA can be neutralized by CX8 partially, which induced the contraction of DNA and the conformational change of DNA, which led to release ADM from DNA partially, on the other hand, the CX8 can also compete the electrostatic sites with ADM directly.