Surface-Modified LDH Nanosheets with High Dispersibility in Oil for Friction and Wear Reduction.

Surface and interfacial engineering of nanomaterials is essential for improving dispersion stability in liquids. In this study, we report that oleic acid (OA)- and stearic acid (SA)-functionalized layered double hydroxide (LDH) nanosheets as lubricant additives can achieve high dispersion and reduce friction and wear. LDH is a typical layered structure, and OA and SA are long-chain organic molecules that are not only compatible with base oils but also act as friction-reducing agents. The OA and SA molecules were branched onto ZnMgAl LDH nanosheets using dehydration condensation between the exposed OH groups on the surface of LDH and the COOH groups on the OA and SA molecules. Compared with that of the pristine ZnMgAl LDH, the dispersion of OA-ZnMgAl LDH and SA-ZnMgAl LDH was significantly improved. The surface-modified LDH exhibited superior tribological properties and great stability due to the synergistic lubrication effect between OA, SA, and LDH. Even at an ultralow concentration (0.15 wt %), the coefficient of friction and wear volume were reduced by ∼65 and ∼99%, respectively, compared to those of the base oil. Due to the green and simple synthesis method and excellent tribological properties, surface-functionalized LDH has enormous possibilities for future industrial applications.

A General Survey of Pharynlaryngeal Diseases and Voice Disorders Among Basic Education Teachers in Tianjin.

OBJECTIVE: In this study, we created a city-wide database of pharynlaryngeal diseases and voice disorders among basic education teachers to analyze the incidence, distribution, and risk factors of pharynlaryngeal diseases and voice disorders. METHODS: A total of 47,823 teachers in primary and secondary schools and kindergartens of Tianjin were enrolled in this study and underwent questionnaires and throat examinations. In addition, the data were subjected to descriptive statistics, chi-square analysis, and univariate and multivariate logistic regression analyses. RESULTS: Pharynlaryngeal diseases and voice disorders had an overall prevalence of 69.42% among basic education teachers in Tianjin, wherein the prevalence of chronic pharyngitis, chronic hyperplastic laryngitis, and chronic simple laryngitis were the highest at 39.45%, 19.80%, and 15.59%, respectively. The results of multivariate logistic regression analysis suggest that pharynlaryngeal diseases and voice disorders were statistically correlated with gender (P < 0.001), years of teaching (P < 0.001), school district (P < 0.001), class size (P < 0.001), subjective assessment of teachers on vocal loudness (P < 0.001), neck and shoulder discomfort (P < 0.001), smoking (P < 0.001), psychological stress (P = 0.002), and frequent habitual throat clearing (P < 0.001). Furthermore, the risk factors for pharynlaryngeal diseases and voice disorders were age (P = 0.002), school district (P < 0.001), class size (P = 0.008), neck and shoulder discomfort (P = 0.038), smoking (P < 0.001), water intake habits during class (P = 0.023), and frequent habitual throat clearing (P = 0.001) for male teachers, and for female teachers, it was age (P < 0.001), school district (P < 0.001), daily teaching hours (P = 0.005), class size (P < 0.001), subjective assessment of teachers on vocal loudness (P < 0.001), neck and shoulder discomfort (P < 0.001), smoking (P = 0.033), psychological stress (P = 0.003), and frequent habitual throat clearing (P < 0.001). CONCLUSION: Due to the high prevalence of pharynlaryngeal diseases and voice disorders among basic education teachers, throat and voice health education-related activities should be conducted for teachers to intervene in the occurrence of pharynlaryngeal diseases and voice disorders at an early stage.

HAGLROS knockdown restrained cell proliferation, migration and invasion and facilitated apoptosis in laryngeal cancer via miR-138-5p/CLN5 axis.

BACKGROUND: This work investigated the role of HAGLROS in laryngeal cancer (LC). METHODS: HAGLROS expression in the head and neck squamous cell carcinoma (HNSC), target miRNAs of HAGLROS, target mRNAs of miR-138-5p, and the binding sites of HAGLROS and miR-138-5p or CLN5 and miR-138-5p were predicted through bioinformatics. HAGLROS, miR-138-5p, CLN5, Bcl-2, and Bax levels were detected by qRT-PCR and Western blot. The biological functions of LC cells were assessed through CCK-8, colony formation assays, transwell assay, and flow cytometry assay. The targeting relationship between HAGLROS and miR-138-5p or CLN5 and miR-138-5p was confirmed by dual luciferase gene reporter analysis. RESULTS: HAGLROS was upregulated in LC. HAGLROS-specific small interfering RNA (Si-HAGLROS) inhibited the viability, proliferation, migration, and invasion while increased the apoptosis in LC cells. MiR-138-5p was a target of HAGLROS and the miR-138-5p inhibitor reversed the effects of si-HAGLROS on LC cells. CLN5 was a target of miR-138-5p. MiR-138-5p inhibitor raised the viability, migration and invasion, and Bcl-2 expression while declined Bax expression in LC cells, with si-CLN5 performing the opposite effects and reversing the effects of miR-138-5p inhibitor. CONCLUSION: Silenced HAGLROS restrained the LC cells' abilities to proliferate, migrate, and invade as well as facilitated apoptosis in LC via miR-138-5p/CLN5 axis.

Awareness about laryngopharyngeal reflux disease among Chinese otolaryngologists: a nationwide survey.

OBJECTIVES: This study aimed to investigate the status of the current knowledge about laryngopharyngeal reflux disease (LPRD) among Chinese otolaryngologists. DESIGN: Multi-centre cross-sectional survey. SETTING: 220 medical centres in different regions of China. PARTICIPANTS: A total of 2254 otolaryngologists from 220 medical centres in China who were successfully on-site surveyed between November 2019 and December 2020. MAIN OUTCOME MEASURES: Awareness about LPRD included knowledge about risk factors, symptoms, laryngoscope signs, related diseases, current diagnostic methods and treatments. RESULTS: The percentage of participants who had heard of LPRD was 96.4%, with academic conferences as the most common source of information (73.3%). The most commonly known risk factor, symptom, laryngoscope sign, related disease, diagnostic method and treatment were alcohol consumption (44.0%), pharyngeal foreign body sensation (66.9%), hyperaemia (52.4%), pharyngolaryngitis (54.8%), pH monitoring (47.6%) and medication (82.1%), respectively. Only 28.3% of all participants knew that 24 h pH or multichannel intraluminal impedance pH monitoring was the most accurate diagnostic test. As many as 73.1% of all participants knew that proton pump inhibitors were the first-line treatment drugs. An analysis of the overall status of awareness using a scoring system suggested that otolaryngologists were better aware owing to more access, working at 3A hospitals, and postgraduate or above educational background (all p<0.05). CONCLUSION: Although the majority of Chinese otolaryngologists had heard of LPRD, their overall awareness about the disease was not encouraging. More efforts are needed to increase the knowledge about LPRD among this group of physicians. TRIAL REGISTRATION NUMBER: ChiCTR1900025581.

Chaos Behavior Analysis of Alaryngeal Voices Including Esophageal and Tracheoesophageal Voices.

HYPOTHESIS/OBJECTIVES: This study's objective was to develop a method to evaluate the chaotic characteristic of alaryngeal speech. The proposed method will be capable of distinguishing between normal and alaryngeal voices, including esophageal (SE) and tracheoesophageal (TE) voices. It has been previously shown that alaryngeal voices exhibit chaotic characteristics due to the aperiodicity of their signals. The proposed method will be applied for future use to quantify both chaos behavior (CB) and the difference between SE and TE voices. STUDY DESIGN: A total of 74 voice recordings including 34 normal and 40 alaryngeal (26 SE and 14 TE) were used in the study. Voice samples were analyzed to distinguish alaryngeal voices from normal voices and to investigate different chaotic characteristics of SE and TE speech. METHODS: A chaotic distribution detection-based method was used to investigate the CB of alaryngeal voices. This CB was used to detect the difference between SE and TE voice types. Quantification of the CB parameter was performed. Statistical analyses were used to compare the results of the CB analysis for both the SE and TE voices. RESULTS: Statistical analysis revealed that CB effectively differentiated between all normal and alaryngeal voice types (p < 0.01). Subsequent multiclass receiver operating characteristic (ROC) analysis demonstrated that CB (area under the curve) possessed the greatest classification accuracy relative to correlation dimension (D2). CONCLUSIONS: The CB metric shows strong promise as an accurate, useful metric for objective differentiation between all normal and alaryngaeal, SE and TE voice types. The CB calculations showed expected results, as SE voices have significantly more CB than TE voices, constituting substantial improvement over previous methods and becoming the first SE and TE classification method. This metric can help clinicians obtain additional acoustic information when monitoring the efficacy of treatment for patients undergoing total laryngectomies.

Lipid-Polymer Hybrid Nanoparticle-Based Combination Treatment with Cisplatin and EGFR/HER2 Receptor-Targeting Afatinib to Enhance the Treatment of Nasopharyngeal Carcinoma.

PURPOSE: Nasopharyngeal carcinoma (NPC) is one of the most prevalent carcinomas among the Cantonese population of South China and Southeast Asia (responsible for 8% of all cancers in China alone). Although concurrent platinum-based chemotherapy and radiotherapy have been successful, metastatic NPC remains difficult to treat, and the failure rate is high. METHODS: Thus, we developed stable lipid-polymer hybrid nanoparticles (NPs) containing cisplatin (CDDP) and afatinib (AFT); these drugs act synergistically to counter NPC. The formulated nanoparticles were subjected to detailed in vitro and in vivo analysis. RESULTS: We found that CDDP and AFT exhibited synergistic anticancer efficacy at a specific molar ratio. NPs were more effective than a free drug cocktail (a combination) in reducing cell viability, enhancing apoptosis, inhibiting cell migration, and blocking cell cycling. Cell viability after CDDP monotherapy was as high as 85.1%, but CDDP+AFT (1/1 w/w) significantly reduced viability to 39.5%. At 1 µg/mL, AFT/CDDP-loaded lipid-polymer hybrid NPs (ACD-LP) were significantly more cytotoxic than the CDDP+AFT cocktail, indicating the superiority of the NP system. CONCLUSION: The NPs significantly delayed tumor growth compared with either CDDP or AFT monotherapy and were not obviously toxic. Overall, the results suggest that AFT/CDDP-loaded lipid-polymer hybrid NPs exhibit great potential as a treatment for NPC.

Bencycloquidium bromide nasal spray is effective and safe for persistent allergic rhinitis: a phase III, multicenter, randomized, double-blinded, placebo-controlled clinical trial.

PURPOSE: To investigate the efficacy and safety of bencycloquidium bromide nasal spray (BCQB) in patients with persistent allergic rhinitis (PAR). METHODS: We enrolled 720 patients from 15 hospitals across China and randomly assigned them into BCQB group or placebo group (90 µg per nostril qid) to receive a 4-week treatment. Visual analog scale (VAS) for rhinorrhea, sneezing, nasal congestion, itching and overall symptoms were recorded by patients every day. Anterior rhinoscopy scoring was completed by doctors on every visit. Adverse events were recorded in detail. RESULTS: A total of 354 and 351 patients were included in BCQB group and in placebo group. Baseline information was comparable. At the end of the trial, the decrease of VAS for rhinorrhea from baseline was 4.83 ± 2.35 and 2.46 ± 2.34 in BCQB group and placebo group, respectively (P < 0.001). The change ratio from baseline of VAS for rhinorrhea in BCQB group was 72.32%, higher than 31.03% in placebo group (P < 0.001). VAS for other symptoms and overall symptoms also improved significantly in the BCQB group, while no inter-group difference was found in anterior rhinoscopy scoring. The incidence of adverse reaction was similar between the two groups. Most reactions were mild and no severe reactions happened. CONCLUSION: 90 µg BCQB per nostril four times daily is effective and safe in the treatment of rhinorrhea as well as sneezing, nasal congestion and itching for patients with PAR. RETROSPECTIVELY REGISTERED: ChiCTR2000030924, 2020/3/17.

Hsa_circ_0057481 promotes laryngeal cancer proliferation and migration by modulating the miR-200c/ZEB1 axis.

As a new type of non-coding RNA, circular RNAs (circRNAs) have been reported to be important regulators of tumor initiation and progression. By using the high-throughput microarray, a recent study demonstrated that the expression of hsa_circ_0057481 is upregulated in human laryngeal cancer. In the present study, we aimed to elucidate the role of hsa_circ_0057481 in laryngeal cancer. We found that hsa_circ_0057481 was significantly upregulated in laryngeal cancer tissues compared with healthy normal specimens. Silencing of hsa_circ_0057481 by siRNAs suppressed cell growth, cell cycle progression, invasive and migration potential, and promoted cell apoptosis in laryngeal cancer HEP-2 and TU212 cells. Mechanistically, hsa_circ_0057481 directly sponges miR-200c in HEP-2 cells. Knockdown of hsa_circ_0057481 suppressed the expression of ZEB1, a best-known target of miR-200c. Moreover, the oncogenic effects of hsa_circ_0057481 were partly dependent on its inhibition on miR-200c. Taken together, our findings showed that hsa_circ_0057481 might act as a novel therapeutic target in laryngeal cancer.

MiR-154 inhibits the growth of laryngeal squamous cell carcinoma by targeting GALNT7.

MicroRNAs are critical regulators of the development and progression of laryngeal squamous cell carcinoma (LSCC). However, the role of microRNA-154 (miR-154) in the development and progression of LSCC has not been clarified. We found that down-regulated miR-154 expression in LSCC tissues was associated with poorer prognosis in LSCC patients. MiR-154 over-expression inhibited the proliferation, clonogenicity, and migration of LSCC cells and induced cell cycle arrest, which were reversed by miR-154 inhibition. MiR-154 targeted GALNT7 expression by reducing GALNT7-regulated luciferase activity in LSCC cells while up-regulating GALNT7 mRNA transcription in LSCC tissues and cells. GALNT7 silencing significantly attenuated the proliferation, clonogenicity, and migration of LSCC cells and induced cell cycle arrest. Finally, intravenous treatment with lentivirus for miR-154, but not scrambled control miRNA, significantly restrained the growth of implanted LSCC Hep-2 tumors and decreased the tumor mass by reducing GALNT7 expression in mice. Therefore, miR-154 may serve as a novel prognostic marker and therapeutic target for LSCC.

Expression of DCUN1D1 in laryngeal squamous cell carcinoma and its inhibiting effect on TU-177 cells after interfered by RNA.

Expression of DCUN1D1 in laryngeal squamous cell carcinoma (LSCC) and its inhibition by small interfering RNA (siRNA) target in the TU-177 cells was investigated. Immunohistochemistry was used to detect the expression level of DCUN1D1 in LSCC tissue in 140 cases and to analyze its relationship with clinical pathological characteristics. siRNA expression plasmid targeting DCUN1D1 was constructed and transferred into TU-177 cells. The effect of siRNA target DCUN1D1 gene silencing on proliferation, invasion and migration of TU-177 cells were observed by MTS assay and Transwell experiment. The expression levels of focal adhesion kinase (FAK) and matrix metalloproteinase-2(MMP-2) were detected by western blot. Expression level of DCUN1D1 protein increased significantly in T3 + T4, N+, and III + IV stages of LSCC patients (P < .05). After DCUN1D1 was targeted by siRNA, the DCUN1D1 protein level decreased 67% in siRNA-3 group, where average absorbance value was lower than the control and blank group with significant difference(F = 6.076, P < .05) in MTS assay, meantime migration, and invasion cells in each vision were the same (F = 19.851, F = 25.454, P < .01) in the Transwell experiment. The expression level of FAK and MMP-2 was significantly down-regulated in siRNA-3 group (F = 28.896, F = 40.240, P < .01). DCUN1D1 is associated with progression and prognosis of LSCC. After siRNA based target on DCUN1D1, TU-177 cells growth was inhibited and invasion of malignant tumour was diminished by reducing the expression of FAK and MMP-2. DCUN1D1 is could become a potential new target for the treatment of LSCC.

MicroRNA­503 serves an oncogenic role in laryngeal squamous cell carcinoma via targeting programmed cell death protein 4.

Laryngeal squamous cell carcinoma (LSCC), the most common form of laryngeal carcinoma, is an aggressive malignancy that demonstrates the second highest rate of morbidity of all head and neck squamous cell carcinomas. The abnormal expression of microRNAs (miRs) has been demonstrated in a number of types of human cancer, and they have been demonstrated to be oncogenes or tumour suppressor genes. miR­503 has been studied in various types of human cancer; however, the expression level, roles and underlying mechanisms in LSCC remain unknown. In the present study, it was demonstrated that miR­503 was significantly upregulated in LSCC tissues and cell lines. The level of miR­503 in LSCC tissues was correlated with thyroid cartilage invasion, lymph node metastasis, and tumour, node and metastasis stage. In addition, down­regulation of miR­503 inhibited cell proliferation and invasion in LSCC. Programmed cell death protein 4 (PDCD4) was identified to be a direct target gene of miR­503. PDCD4 overexpression could mimic the roles of miR­503 underexpression in LSCC. Furthermore, PDCD4 was down­regulated in LSCC tissues and this correlated with the miR­503 expression level. In conclusion, these results suggested that miR­503 promotes tumour growth and invasion by directly targeting PDCD4. The identification of the miR­503/PDCD4 axis may provide novel targets for LSCC treatment and improve prognosis.

MicroRNA-195 inhibits growth and invasion of laryngeal carcinoma cells by directly targeting DCUN1D1.

MicroRNAs (miRNAs) are a class of small, non-coding RNAs that regulate gene expression and are involved in cell biological processes. The aberrant expression of miR-195 has been found in various types of human cancer. However, the effect of miR­195 on the initiation and development of laryngeal squamous cell carcinoma (LSCC) remains to be elucidated. Accordingly, in the present study, we detected the expression level of miR-195 in the LSCC and the normal tissues and found that miR-195 were significantly down-regulated in the LSCC tissues. Gain-of-function or loss-of-function studies including cell proliferation, wound healing assay, Transwell assay, cell cycle and apoptosis assays were performed to investigate the biological function of miR-195. Luciferase reporter assay and the rescue study confirmed that DCUN1D1 was a target of miR-195. Furthermore, DCUN1D1 expression levels were found to be upregulated in laryngeal tissues and to have a negative correlation with miR-195. We also found that both miR-195 and DCUN1D1 siRNAs can inhibit cell invasion possibly through downregulating Matrix metalloproteinase-2 (MMP-2) and Matrix metalloproteinase-9 (MMP-9) at the post-transcriptional level, which can be attenuated by restoring the expression of DCUN1D1. In summary, these data suggest that low expression of miR-195 contributes to the poor prognosis of LSCC and miR-195 regulates the proliferation and invasion ability of LSCC cells in vitro. miR-195 may suppress growth and invasion of LSCC cells possibly through targeting DCUN1D1, which would provide a candidate target for cancer therapy.

ß-Defensin-2 is overexpressed in human vocal cord polyps.

The objective of the study is to investigate the expression of human ß-defensin-1 (hBD-1) and human ß-defensin-2 (hBD-2) in vocal cord polyps using tissue microarray. Tissue specimens from vocal cord polyps (N = 51), vocal cord nodules (N = 26), and healthy vocal cords (N = 8) were retrieved from the biobank of the Department of Pathology of Tianjin Tianhe Hospital between 2003 and 2006 and immunostained on tissue microarrays for the quantitative analysis of hBD-1 and hBD-2 expression. hBD-1 expression did not differ significantly between healthy vocal cords, vocal cord nodules, and vocal cord polyps (p = 0.904). In contrast, hBD-2 expression was significantly higher in vocal cord polyps compared to vocal cord nodules and healthy vocal cords (p < 0.001). The expression of hBD-2, but not hBD-1, is elevated in vocal cord polyp epithelium. This suggests that hBD-1 has a more constitutive role in host defense in the vocal cords, whereas hBD-2 expression may be a result of local inflammation or the presence of invading pathogens.

Outcomes of radiofrequency ablation (RFA) and CO2 laser for early glottic cancer.

OBJECTIVE: In the present study, the voice and functional outcomes of radiofrequency ablation (RFA) and CO2 laser for early glottic cancer were evaluated. METHODS: One hundred sixty eight patients with early glottic cancer from October 2007 to June 2015 were included. Ninety-seven patients underwent RFA and seventy-one patients underwent CO2 laser. The operation time and score of visual analog scale (VAS) for pain on the second day after surgery were recorded. The electronic laryngoscopy was performed at one week, one month and three months of postoperation. RESULTS: The operation time in RFA was shorter than that in CO2 laser (8.52±1.43min vs. 11.76±1.67min, P<0.05). There was no statistical difference in VAS scores between two operation methods (2.86±0.52 vs. 2.89±0.68, P>0.05). One month after operation, the mucosal recovery in RFA group was better than that in CO2 laser group (P<0.05). The alterations of acoustic parameters Jitter, Shimmer and HNR at three time points after operation showed statistical significances in both RFA and CO2 laser groups (P<0.05). The significant differences in acoustic parameters between two groups were also observed (P<0.05). There were no differences in three-year survival rate, local recurrence rate, recurrence rate with anterior commissure involvement and postoperative adhesion rate with anterior commissure between the patients with RFA and CO2 laser (P>0.05). No patient underwent tracheotomy and had symptoms of bucking, dyspnea, severe pain, hemoptysis and other serious complications. CONCLUSION: Both RFA and CO2 laser are safe and effective for the treatment of early glottic cancer. RFA has the advantage of quick voice recovery, low mucosa injury and short operation time, which is worthy for wide clinical application.

Use Videostrobokymography to Quantitatively Analyze the Vibratory Characteristics Before and After Conservative Medical Treatment of Vocal Fold Leukoplakia.

OBJECTIVES: To quantitatively analyze the vibratory characteristics of vocal folds before and after conservative treatments to evaluate the outcomes of conservative treatments for vocal fold leukoplakia using videostrobokymography (VSK). STUDY DESIGN: This is a prospective study. METHODS: Twenty patients and 20 controls were enrolled into the study. All patients received conservative treatments for 3 weeks and received VSK examination before and 3 weeks after the treatments. All controls only received VSK examination once. Vocal fold lengths of 25%, 50%, and 75% were chosen as the line-scan positions to evaluate the vocal fold vibration. Open quotient (OQ) and asymmetry index (AI) were obtained using VSK. RESULTS: Significant improvements in the main symptoms including voice hoarseness were found. Videostroboscopic findings showed that the white lesions on the vocal folds almost completely disappeared in all patients, and the vocal fold flexibility returned to normal. All OQs and AIs at each line-scan position in patients before the treatments were larger than those in controls (P < 0.017), whereas all OQs and AIs at each line-scan position decreased 3 weeks after conservative treatments (P < 0.017). No significant differences in OQs and AIs at each line-scan position were detected between patients after the treatments and controls (P > 0.017). CONCLUSIONS: VSK could quantitatively evaluate the vibratory characteristics of vocal folds before and after the treatments, and conservative treatment could improve VSK measurements to normal control values, suggesting that VSK is a tool to assess the outcomes of the conservative treatments for vocal fold leukoplakia.

CXCR4 silencing inhibits invasion and migration of human laryngeal cancer Hep-2 cells.

CXCR4 has been reported in various types of human cancer, which is associated with cancer progression and metastasis. However, the investigation of CXCR4 in laryngeal cancer is extremely rare. In the present study, we used lentivirus-mediated shRNA targeting CXCR4 to silenced CXCR4 expression in Hep-2 cells and evaluated the effect of long-term suppression of CXCR4 on Hep-2 growth and metastasis. The Cell proliferation was analyzed by MTS assay, and the invasion and metastasis potentials were analyzed using wound healing and transwell assays, respectively. Our results showed that lentivirus-mediated shRNA effectively infected Hep-2 cells and suppressed CXCR4 expression, and inhibited cell growth of Hep-2 cells. Cell invasion and apoptosis were decreased concomitantly with the reduction in CXCR4 protein expression. Further analysis revealed that CXCR4 silencing caused the reducion of CXCR4, CXCL12, TIMP2, VEGF and MMP9, and the phosphorylation levels of IκB, AKT and MAPK, and also decreased the activity of NF-κB. These results suggested that knockdown of CXCR4 inhibits the invasion and metastasis of Hep-2 through PI3K/AKT and MAPK signaling pathways, by decreasing NF-κB activities to down-regulate VEGF, TIMP-2 and MMP-9 expression. These data demonstrate that the inhibition of CXCR4 may be an effective interventional therapeutic strategy in laryngeal cancer.

[Etiologies and clinical features of 19 cases with bilateral acute sensorineural hearing loss].

OBJECTIVE: To investigate the etiologies and clinical features for bilateral acute sensorineural hearing loss (bi-ASNHL). METHODS: The clinical data of 19 cases presenting with bi-ASNHL were retrospectively analyzed, including the clinical features, systemic examinations, laboratory examinations, audiology and radiology results, as well as the prognosis. RESULTS: There were 15 non-otologic diseases in 19 patients, accounting for 78.9% of the total cases, most of which were disorders with multisystem and multi-organ disorder. The central nervous system diseases including fungal meningitis, tuberculous meningitis, and viral encephalitis in 3 patients. The clinical features of deafness were bilateral, progressive, accompanied with fever, headache, dizziness, nausea, vomiting and change of mental status. There was a decrease in speech recognition score (SRS), and speech recognition threshold (SRT) was obviously inferior to pure tone average (PTA) disproportionally. Diseases of immune system including antineural cytoplasmic antibody (ANCA)-associated systemic vasculitis (AASV), relapsing polychondritis (RP), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE) in 5 patients. They showed the characteristics of bilateral, progressive and simultaneous autoimmune disease. Hematological and endocrine system diseases including diabetes mellitus, leukemia, and thyroid hypofunction in 5 patients. The deafness had the characteristics of symmetry and progressivity. Otologic diseases including large vestibular aqueduct syndrome (LVAS) and sudden sensorineural hearing loss (SSNHL) in 4 patients; Drug-induced sensorineural deafness happened in 2 patients. After the treatment aimed at the causes, 1 case was cured, 3 patients were markedly effective, 7 patients were effective, and 8 patients were ineffective(including dead and refusal cases), with a total effective rate of 57.9%. CONCLUSIONS: The most of bi-ASNHL cases are often associated with systemic diseases. Clinicians should analyze the history and clinical characteristics in detail, and complete specific laboratory examinations, audiology and imaging examinations in order to reveal the causative diseases. It should be treated aimed at the etiology.

[Experimental study on the impact of photodynamic therapy on the normal vocal cord injury].

OBJECTIVE: To investigate the reactive characteristics of normal vocal cord tissues to photodynamic therapy (PDT) and the damage effects of different concentration of photosensitizer and different light on normal rabbit vocal cord. Making the preliminary research of PDT in clinical treatment of chronic inflammation of the vocal cords and precancerous lesions. METHODS: Twenty-five healthy Japanese big ear experimental rabbits were randomly divided into 5 groups: low work rate low dose group A (100 mW, 10%5-ALA), high work rate low dose group B (200 mW, 10%5-ALA), high work rate high dose group C (200 mW, 20%5-ALA), low work rate high dose group D (100 mW, 20%5-ALA) and normal control group E. The issue damage and wound recovery were observed in 1 d, 3 d, 7 d, 14 d, 28 d after intervention. RESULTS: A severe inflammation reaction was observed in group A, B, C, D after intervened with PDT compared to normal group. The reaction of group A was lighter, and the reaction of group C was the most serious. The content of collagenous fiber, hyaluronic acid and fibronectin in vocal fold lamina layer was significantly higher than that in normal group (P<0.05). Different degrees of fiber proliferation were observed in all groups. The content of each component of vocal fold lamina layer tended to be normal slightly higher level in 28 d. Observation by electron microscope showed that there were no significant differences in A, B, C, D, E in 28 d after intervention. CONCLUSION: Recoverable damage repair process can be detected in rabbit vocal after intervened with PDT, which began in 7 d and basically completed in 28 d. In a certain concentration (10%-20%) and dose range (100-200 mW). The higher of photodynamic dose, the more serious of the damage. And the damage was basically reversible.

[Experimental study on the impact of photodynamic therapy on the tissue structure of normal nasal mucosa in rabbit].

OBJECTIVE: To study the reactive changes of normal nasal mucosa in rabbit under photodynamic therapy (PDT) and to make a preliminary research for the treatment of allergic rhinitis (AR) with PDT. METHODS: Twenty-four New Zealand rabbits were divided into 2 groups, an experimental group and a control group with 12 rabbits in each group. PDT was applied to the experimental group, while the control group was given no treatment. The nasal mucosa was sampled separately from the same position of the rabbits from the 2 groups on 1st, 3rd, 7th, 14th, 21st, 28th day. Histomorphological changes of the sampled nasal mucosa were observed under light microscope and transmission electron microscope (TEM). The damage of three tachykinins: substance P (SP), neurokinin A (NKA) and neurokinin B (NKB) of nerve fibers was observed after immunohistochemical staining. RESULTS: Compared with the control group, the nasal mucosa tissues from the experimental group had serious inflammatory reaction with basal layer damaged on the 1st and 3rd day after PDT application, the epithelial cells of nasal mucosa were arranged in disorder, and part of cilium shortened and became abnormal or even disappeared, each organelles damaged obviously; on the 7th, 14th, 21st day, it could be seen that ciliated cell, columnar cell and goblet cell started regeneration, basal cell and lamina propria glands proliferated, and the glands appeared secretion phenomenon; on the 28th day, ciliated columnar epithelium took back the nasal mucosas with small amount of microvilli, and mucous granules were found in the column cells. Nasal immunohistochemical staining of the experimental group from various stages showed that three kinds of neuropeptides were not expressed. CONCLUSIONS: Normal rabbit nasal mucosas will be temporarily damaged after PDT application, the damaged nasal mucosa begin to recover in one week, and return to normal in about four weeks. Most structure and functions have recovered at the fourth week except some nerve endings.

[Clinical significance of lymph vessel density marked by D2-40 in laryngeal squamous cell carcinomas].

OBJECTIVE: To study the relationship between lymphatic vessel density and clinicopathological features of laryngeal squamous cell carcinoma. METHOD: The lymph vessels, 40 specimens of LSCC and normal mucosa, were quantitated by SABC immunohistochemistry staining with lymphatic endothelial marker oncofetal antigen M2A Monoclonal antibody (D2-40). RESULT: The density of peritumoral D2-40(+) vessels in the LSCC group was higher than that of normal mucosa one (P<0.01). The density of peritumoral D2-40(+) vessels in T3/4 group was higher than that of T1/2 group (P<0.05). The density of peritumoral D2-40(+) vessels in the neck lymph nodal metastasis group was higher than that without neck lymph nodal metastasis group (P<0.05). The density of peritumoral D2-40(+) vessels in the supraglottic group was higher than that of glottic group (P<0.01). The density of peritumoral D2-40(+) vessels among high, middle, poor differentiation group were no significant difference (P>0.05). CONCLUSION: Tumor lymph vessel mainly means peritumoral lymph vessel. The density of peritumoral lymph vessel marked with D2-40 in laryngeal carcinoma tissues was significantly correlated with progression and invasion of tumor.