IRF4 Knockdown Inhibits the Chronic Rhinosinusitis Without Nasal Polyps Development by Regulating NLRP3/Caspase-1/GSDMD-Mediated Pyroptosis.

Chronic rhinosinusitis without nasal polyps (CRSsNP) is a CRS phenotype. However, the mechanisms of CRSsNP remains unclear. Differentially expressed genes (DEGs) were obtained from the GSE36830 and GSE198950 datasets through the GEO2R tool. The six hub genes were screened by the protein-protein interaction (PPI) network analysis and Cytoscape software. Then we constructed the mouse models of CRS and verified the expression levels of hub genes by reverse transcription quantitative PCR (RT-qPCR). Hematoxylin-eosin (HE) staining was employed to observe pathological alterations in mouse tissues. Casepase-3 expression was detected by immunohistochemistry (IHC). The levels of TNF-α, IL-12, IL-6, IL-1ß, LDH, and IL-18 were evaluated using enzyme-linked immunosorbent assay (ELISA). Pyroptosis-related protein expressions were measured by western blotting. Cell counting kit-8 (CCK-8) and flow cytometry were performed to assess the proliferation and apoptosis of lipopolysaccharide (LPS)-induced NP69 cells. Six hub DEGs were identified. The expression levels of IRF4, IKZF1, and CD79A were obviously increased in CRSsNP, while those of ADH6, ADH1A, and LDHC were significantly decreased. IRF4 knockdown attenuated the pathologic features of CRSsNP. IRF4 knockdown reduced levels of the TNF-α, IL-12, IL-6 IL-1ß, LDH, and IL-18 as well as the proteins expression of Casepase-1, GSDMD, and NLRP3 both in vivo and in vitro, implying that inflammation and pyroptosis were inhibited. IRF4 knockdown hinders the development of CRSsNP by inhibiting the inflammatory response and NLRP3/Caspase-1/GSDMD-mediated pyroptosis, which offers novel promising treatment strategies for clinical intervention.

Comparison of the postoperative in-hospital versus at-home recovery quality and circadian rhythm status in preschool kids after adenotonsillectomy: a cohort and observational study.

Background: At present, minimally invasive surgery is often used in paediatric patients as a day surgery to promote rapid post-operative recovery. Obstructive Sleep Apnea Syndrome (OSAS) Patients recovery in the hospital or at home after surgery may differ in terms of recovery quality and circadian rhythm status because of sleep disruption; however, this remains unknown. Pediatric patients usually unable to explain their feelings effectively, and objective indicators to measure recovery situation in different environments are promising. This study was conducted to compare the impact of in-hospital and at-home postoperative recovery quality (primary outcome) and circadian rhythm (as measured via the salivary melatonin level) (secondary outcome) in preschool-age patients. Methods: This was a cohort, non-randomized and exploratory observational study. A total of 61 children aged 4 to 6 years who were scheduled to receive adenotonsillectomy were recruited and assigned to recover either in the hospital (Hospital group) or at home (Home group) after surgery. There were no differences in the patient characteristics and perioperative variables between the Hospital and Home groups at baseline. They received the treatment and anesthesia in the same way. The patients' preoperative and up to 28 days post-surgery OSA-18 questionnaires were harvested. Moreover, their pre- and post-surgery salivary melatonin concentrations, body temperature, three-night postoperative sleep diaries, pain scales, emergence agitation, and other adverse effects were recorded. Results: There were no significant differences in the postoperative recovery quality, as assessed by the OSA-18 questionnaire, body temperature, sleep quality, pain scales, and other adverse events (such as respiratory depression, sinus bradycardia, sinus tachycardia, hypertension, hypotension, nausea, and vomiting) between the two groups. The preoperative morning saliva melatonin secretion was decreased in both groups on the first postoperative morning (P<0.05), while a significantly greater decrease was found in the Home group on postoperative day 1 (P<0.05) and day 2 (P<0.05). Conclusions: The postoperative recovery quality of preschool kids in the hospital is as good as at home based on OSA-18 evaluation scale. However, the clinical importance of the significant decrease in morning saliva melatonin levels with at-home postoperative recovery remains unknown and warrants further study.

Determination of Pork Meat Storage Time Using Near-Infrared Spectroscopy Combined with Fuzzy Clustering Algorithms.

The identification of pork meat quality is a significant issue in food safety. In this paper, a novel strategy was proposed for identifying pork meat samples at different storage times via Fourier transform near-infrared (FT-NIR) spectroscopy and fuzzy clustering algorithms. Firstly, the FT-NIR spectra of pork meat samples were collected by an Antaris II spectrometer. Secondly, after spectra preprocessing with multiplicative scatter correction (MSC), the orthogonal linear discriminant analysis (OLDA) method was applied to reduce the dimensionality of the FT-NIR spectra to obtain the discriminant information. Finally, fuzzy C-means (FCM) clustering, K-harmonic means (KHM) clustering, and Gustafson-Kessel (GK) clustering were performed to establish the recognition model and classify the feature information. The highest clustering accuracies of FCM and KHM were both 93.18%, and GK achieved a clustering accuracy of 65.90%. KHM performed the best in the FT-NIR data of pork meat considering the clustering accuracy and computation. The overall experiment results demonstrated that the combination of FT-NIR spectroscopy and fuzzy clustering algorithms is an effective method for distinguishing pork meat storage times and has great application potential in quality evaluation of other kinds of meat.

Effect of IL-35 on apoptosis, adhesion, migration, and activation of eosinophils in allergic rhinitis.

BACKGROUND: Eosinophils play critical roles in the development of allergic rhinitis (AR) by releasing toxic substance. Interleukin-35 (IL-35), a newly identified anti-inflammatory cytokine, had potent inhibitive role for eosinophil infiltration in allergic disease. However, the direct effect of IL-35 on eosinophil was not clear. METHODS: Twenty AR children and sixteen controls were recruited. The correlation between IL-35 protein expression and blood eosinophil counts and activation was analyzed. The effect of IL-35 on eosinophil apoptosis and adhesion was analyzed by flow cytometry. Transwell system was used for the migration assay. The eosinophil cationic protein (ECP) from supernatant of eosinophils after IL-35 stimulation was detected by enzyme-linked immunosorbent assay kits. RESULTS: The IL-35 protein levels were negatively correlated with eosinophil counts (p < .01) and ECP concentration (p < .01) in AR children. IL-35 promotes apoptosis and inhibits adhesion, migration, and activation of eosinophils. Moreover, the mRNA expression of IL-12 receptor ß2 and glycoprotein 130 were significantly enhanced by eosinophils after IL-35 stimulation. The apoptosis induced by IL-35 was mediated by phosphoinositide 3-kinase (PI3K) pathway. IL-35 inhibits adhesion of eosinophils through extracellular regulated protein kinases (ERK) and PI3K pathways. The eosinophil chemotaxis and activation affected by IL-35 were mediated by PI3K and p38 mitogen-activated protein kinase (MAPK) pathways. CONCLUSION: Our results confirmed that IL-35 played inhibitive roles in apoptosis, adhesion, migration, and activation of eosinophils in AR, implying that IL-35 may be used as treatment target in future.

[Evaluation of application of nasal nitric oxide on specific allergen immunotherapy in children with allergic rhinitis].

Objective:To evaluate the short-term efficacy of nasal nitric oxide（nNO） on specific allergen subcutaneous immunotherapy in children with allergic rhinitis. Methods:The data of 87 children with allergic rhinitis treated in the otolaryngology clinic of Guangzhou Women and Children's Medical Center from January 2018 to January 2019（case group） and 80 healthy children who received physical examination in the hospital during the same time period（control group） were retrospectively analyzed. The case group was treated with specific allergen subcutaneous immunotherapy. Compare the nNO and symptom score changes of the control group and the case group at different time points. Describe the treatment effect of children in the case group after 1 years of treatment. Analyze the changes of nNO and TNSS（nNO, TNSS） in the case group of patients with different treatment effects during treatment, and calculate the evaluation value of nNOand TNSSon the treatment effect of children. Results:The nNO and TNSS in the case group decreased significantly with the prolonged treatment time（both P<0.05）. The nNO and TNSS of the case group at different treatment time points were higher than those of the control group（all P<0.05）. There was a positive correlation between nNO and TNSS in the control group and case group at all information collection time points（r=0.870, P<0.05）. After 1 year of treatment, the effective rate of treatment in the case group was 78.16%（68/87）. There was a statistically significant difference in nNO and TNSS of children with different treatment effects in the case group（P<0.05）. Using the nNO and TNSS to infer the therapeutic effect of children, the best cut-off values were 457.78µg/L and 3.95（points）. The Youden Index was 0.821, 0.639. Conclusion:Specific allergen subcutaneous immunotherapy has a good therapeutic effect on children with allergic rhinitis, and it is of good value to evaluate the therapeutic effect by using the changes of nNO values before and after treatment in children.

An efficient cell culture system for the studies of heterogeneous astrocytes: Time gradient digestion.

BACKGROUND: Astrocytes are the most abundant glial cell type in mammal brain, but there exists a lot of unknown in cell development and cell function. We aim to establish an astrocytes culture system for obtaining highly enriched primary astrocytes from the neonatal mouse brain and separating Aldh1l1+Gfap- and Aldh1l1+Gfap+ cells. NEW METHOD: C57BL/J6 mouse pups at postnatal 1-4 days were used for cell preparation. Brain cortex was collected and digested with 0.25% trypsin followed by 0.5 mg/ml DNase. Cells were plated on PDL-coated flasks. After 8-10 days culture, cells were shaken at 260 rpm for 4 h at 37 â„ƒ to remove oligodendrocytes and microglia cells. Time gradient digestion was performed to obtain astrocyte subtypes. The digestion time was 0-2 min and 2-4 min, and 4-6 min. Flow cytometry, Immunostaining, CCK-8 assay and EdU staining was carried out to investigate the purity of the astrocytes, the ability of cell proliferation and to identify different subtypes. RESULTS: After shaking, percentage of oligodendrocytes significantly decreased from 22.6 ± 3.6% to 7.4 ± 1.4% (CNPase+ cells) and from 4.36 ± 0.6% to 0.75 ± 0.2% (Pdgfrα+ cells) while percentage of microglia cells reduced from 4.4 ± 0.2% to 0.6 ± 0.2%. Aldh1l1+Gfap- astrocytes were the dominant cell types in 0-2 min group while Aldh1l1+Gfap+ astrocytes were the dominant cell types in 2-4 min group. Moreover, compared with Aldh1l1+Gfap+ astrocytes, Aldh1l1+Gfap- astrocytes had a higher proliferative ability. COMPARISON WITH EXISTING METHODS: Aldh1l1+Gfap- and Aldh1l1+Gfap+ cells were separated. The percentage of residual Tmem119 + and Gfap+ cells showed no significant difference. However, the percentage of Pdgfrα+ cells were significant decreased, and the time consuming of the new system was lower. The astrocytes acquired possess higher viability. CONCLUSIONS: A new astrocytes culture system with time gradient digestion was established. Highly enriched primary astrocytes from the neonatal mouse brain were obtained with short shaking time. Aldh1l1+Gfap- and Aldh1l1+Gfap+ cells were separated by different digestion condition. This system has advantages of high efficiency and low cost, which deserves promising application in management of astrocytes research in central nerve system.

[Effect of general anesthesia on postoperative melatonin secretion in 4-to 6-year-old children with snoring].

OBJECTIVE: To evaluate the effect of general anesthesia on postoperative melatonin secretion in 4-to 6-year-old children with snoring. METHODS: Twenty children with snoring aged 4-6 years of either gender (ASA grade Ⅰ and Ⅱ) were selected for adenoidectomy.Before, during and 3 days after the operation, salivary melatonin levels of the children were measured at 11 selected time points (T1-T11).The illumination intensity and body temperature of the children were recorded at each time point of measurement.The sleep time of the children in 3 days after the operation was recorded, and postoperative pain scores (FLACC) and Riker and Rehabilitation Quality Rating Scale-15(QoR-15) scores were assessed.Sleep Apnea Life Quality Evaluation Questionnaire (OSA-18) was used to evaluate postoperative recovery of the children at 28 days after the operation.The incidence of major adverse events of the children during hospitalization was recorded. RESULTS: No significant difference was found in baseline salivary melatonin level among the 20 children before the operation.Salivary melatonin level at 7 am after the operation (T8) was significantly lowered as compared with that before the surgery (T4)(P < 0.05) but recovered at 7 am on the second day after the surgery (T11);salivary melatonin levels at T4, T8, and T11 exceeded 3 pg/mL on the third day.No significant difference was found in illumination intensity or body temperature across the time points when melatonin level was measured.The children showed no significant changes in FLACC score, Riker score or QOR- 15 score after the operation, but the OSA-18 score was significantly lowered after the operation (P < 0.05).None of the 20 children had such adverse events as respiratory depression, sinus bradycardia, sinus tachycardia, hypertension, hypotension, nausea or vomiting during hospitalization. CONCLUSIONS: In preschool children with snoring, general anesthesia affects but does not inhibit melatonin secretion on the first night after surgery, and minor surgeries under general anesthesia in the morning do not cause significant changes in melatonin secretion to cause disturbance of the circadian rhythm in these children.

Cobalt Phosphide Nanoflake-Induced Flower-like Sulfur for High Redox Kinetics and Fast Ion Transfer in Lithium-Sulfur Batteries.

Sulfur reactivity in lithium-sulfur batteries highly depends on its distribution and morphology during cycling, which is of great significance to suppress the shuttle effect and promote conversion reaction. Herein, cobalt phosphide nanoflakes are prepared and used as a sulfur host. An improved redox kinetics from sulfur to lithium sulfide and the corresponding fast lithium-ion diffusion are observed to greatly promote the electrochemical performance of lithium-sulfur batteries. Meanwhile, for the first time, we propose "effective triple phase contact" and "insulated dead sulfur" to account for cycling performance differences of CoP@S and rGO@S batteries. The flower-like sulfur induced by CoP nanoflakes during cycling provides extra lithium-ion diffusion and electron transfer ways compared with agglomerated sulfur in the rGO@S cathode. The CoP@S battery shows good rate performance and delivers 520 mA h g-1 after 1000 cycles with an excellent Coulombic efficiency of 99%. In contrast, no conversion reaction happens after 600 cycles in the rGO@S battery, implying no existence of reactive sulfur. This research reveals the effect of morphological evolution of sulfur on the cycling performance and affords an insight for developing high-performance lithium-sulfur batteries.

Risk Factors for Safety of Allergen-Specific Sublingual Immunotherapy in Children with Allergic Rhinitis.

A good compliance often attributes to good efficacy and safety of sublingual immunotherapy (SLIT). However, few studies have been conducted on the safety of SLIT treatment in children. We aimed to confirm the pretreatment parameters to predict the safety in children who underwent SLIT. 601 children with allergic rhinitis (AR) treated with SLIT were enrolled in this study. Baseline clinical information and laboratory parameters were collected. The clinical response and adverse events (AEs) were recorded and evaluated. A multivariate logistic regression model was established to confirm the predictors for AEs. The AEs were reported in 75 children (13.8%). The serum-specific IgE (s-IgE) level was significantly correlated with the occurrence of AEs by multivariate logistic regression analysis. Our receiver operating characteristic (ROC) analysis of the serum s-IgE levels >21.6 IU/mL had the best sensitivity (83.7%) and specificity (76.7%) to predict safety. The serum s-IgE level was significantly correlated with safety of SLIT in children, which may be helpful for patient selection before SLIT.

Distinct characteristics of nasal polyps with and without eosinophilia / Diferenças nas características de pólipos nasais com e sem eosinofilia

Abstract Introduction Eosinophilic and noneosinophilic Nasal polyps (NPs) are different subtypes of NPs and require different treatment methods. Objective To compare the histologic characteristics, mRNA and protein expression between Nasal Polyps with and without eosinophilia. Methods NPs tissues were obtained from eighty-six NPs patients during surgery. Eosinophilic and noneosinophilic NPs were distinguished according to immunochemical results of the specimen. The histological, mRNA and protein expression features were compared between the two groups. Results In eosinophilic NPs, we observed a significantly higher GATA-3, IL-5, IL-4, IL-13 mRNA and protein expression. In noneosinophilic NPs, IL-17, IL-23 and RORc mRNA and protein expression were increased. Immunohistochemistry tests showed, more mast cells and less neutrophils in eosinophilic NPs compared with noneosinophilic NPs. Eosinophilic NPs patient presented more severe symptom scores when compared to noneosinophilic NPs. Conclusion We demonstrate for the first time that Th2 is the predominant reaction in eosinophilic NPs while Th17 is the predominant reaction in noneosinophilic NPs. Our study may provide new treatment strategy for NPs.

Resumo Introdução Pólipos nasais (PNs) eosinofílicos e não eosinofílicos são diferentes subtipos de PNs e requerem diferentes métodos de tratamento. Objetivo Comparar as características histológicas e a expressão de mRNAs e proteínas entre PNs com e sem eosinofilia. Método Amostras de PNs foram obtidos de 86 pacientes durante a cirurgia. PNs eosinofílicos e não eosinofílicos foram diferenciados segundo os resultados imunoistoquímicos de cada amostra. As características histológicas e de expressão de mRNAs e de proteínas foram comparadas entre os dois grupos. Resultados Em PNs eosinofílicos, observamos uma expressão significativamente maior dos mRNAs e proteínas GATA-3, IL-5, IL-4 e IL-13. Nos PNs não eosinofílicos, aumentou a expressão dos mRNAs e das proteínas IL-17, IL-23 e RORc. Nos testes imunoistoquímicos, observamos maior número de mastócitos e menor número de neutrófilos nos PNs eosinofílicos, em comparação com PNs não eosinofílicos. Os pacientes com PNs eosinofílicos obtiveram escores de sintomas mais graves vs. PNs não eosinofílicos. Conclusão Demonstramos, pela primeira vez, uma reação Th2 predominante em PNs eosinofílicos e uma reação Th17 predominante em PNs não eosinofílicos. Nosso estudo pode proporcionar novas estratégias terapêuticas para a rinossinusite crônica.

Distinct characteristics of nasal polyps with and without eosinophilia.

INTRODUCTION: Eosinophilic and noneosinophilic Nasal polyps (NPs) are different subtypes of NPs and require different treatment methods. OBJECTIVE: To compare the histologic characteristics, mRNA and protein expression between Nasal Polyps with and without eosinophilia. METHODS: NPs tissues were obtained from eighty-six NPs patients during surgery. Eosinophilic and noneosinophilic NPs were distinguished according to immunochemical results of the specimen. The histological, mRNA and protein expression features were compared between the two groups. RESULTS: In eosinophilic NPs, we observed a significantly higher GATA-3, IL-5, IL-4, IL-13 mRNA and protein expression. In noneosinophilic NPs, IL-17, IL-23 and RORc mRNA and protein expression were increased. Immunohistochemistry tests showed, more mast cells and less neutrophils in eosinophilic NPs compared with noneosinophilic NPs. Eosinophilic NPs patient presented more severe symptom scores when compared to noneosinophilic NPs. CONCLUSION: We demonstrate for the first time that Th2 is the predominant reaction in eosinophilic NPs while Th17 is the predominant reaction in noneosinophilic NPs. Our study may provide new treatment strategy for NPs.

Interleukin-31 promotes helper T cell type-2 inflammation in children with allergic rhinitis.

BACKGROUND: Interleukin-31 (IL-31) is a recently described cytokine that is involved in helper T cell type-2 (Th2)-mediated diseases. However, its regulatory effect in the pathogenesis of children allergic rhinitis (AR) needs to be further characterized. This study sought to evaluate the expression and role of IL-31 in children with AR. METHODS: Sixty children with AR and 20 normal controls were included. IL-31 and Th2 cytokines production in tissue, serum, and nasal lavage was examined by immunohistochemistry, quantitative polymerase chain reaction (qPCR), and enzyme-linked immunosorbent assay, respectively. Peripheral blood mononuclear cells (PBMCs) were purified for in vitro regulation experiment of IL-31. Nasal epithelial cells (NECs) were cultured and stimulated by recombinant IL-31. RESULTS: The IL-31 mRNA and protein levels in both serum and nasal lavage were significantly enhanced in AR compared with normal controls, especially in children with asthma. The nasal IL-31 was associated with enhanced local Th2 cytokines and mucin 5AC (MUC5AC) expression. In vitro study showed that IL-31 promotes Th2 cytokines expression and MUC5AC upregulation and thus amplified Th2 inflammation. CONCLUSION: Our results demonstrate that IL-31 expression in AR aggravated and amplified Th2 inflammation as well as mucin production, and provide a possible explanation for IL-31's regulatory role in the pathogenesis of AR.

Elevated B cell-activating factor (BAFF) in children with allergic rhinitis.

OBJECTIVE: To evaluate the possible role of B cell-activating factor (BAFF) in children with allergic rhinitis (AR). METHODS: Twenty-four AR children and 20 normal children were enrolled in this study and nasal lavage and serum were collected. The nasal and serum levels of BAFF were measured using enzyme-linked immunosorbent assay (ELISA). The relationship between serum BAFF and immunoglobulin A (IgA) was evaluated in AR children. RESULTS: Our results showed that the nasal and serum levels of BAFF were significantly increased in AR children compared with controls (p<0.05). The nasal and serum levels of BAFF in AR children were significantly associated with disease severity (p<0.05). Moreover, the level of serum BAFF was negatively related to serum IgA level (p<0.05). CONCLUSION: Our findings show BAFF expression was significantly increased and related to disease severity, indicating BAFF may be implicated in new treatment modalities for AR children.

Anti-inflammatory effect of IL-37b in children with allergic rhinitis.

BACKGROUND: Interleukin-37 (IL-37), a newly described member of IL-1family, functioned as a fundamental inhibitor of innate inflammatory and immune responses, especially its isoform IL-37b. OBJECTIVE: This study was undertaken to evaluate the expression and regulation of IL-37b in children with allergic rhinitis (AR). METHODS: Forty children with AR and twenty-five normal controls were included. The relationship between IL-37b and Th1/2 cytokines production in serum and nasal lavage was examined by enzyme-linked immunosorbent assay (ELISA). Peripheral blood mononuclear cells (PBMCs) were purified for in vitro regulation experiment of IL-37b. Intranasal mometasone furoate was given in AR children and IL-37b change after one-month treatment was detected using ELISA. RESULTS: We observed significantly decreased IL-37b expression levels in both serum and nasal lavage compared to controls. IL-37b was negatively correlated with Th2 cytokines. Our results also showed that IL-37b downregulated Th2 cytokine expressed by PBMCs and this modulation was through mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase (PI3K) pathway. We also found that intranasal mometasone furoate therapy can promote nasal IL-37b expression. CONCLUSION: IL-37b may be involved in Th2 cytokine regulation in AR and its expression was related to the efficacy of intranasal steroid therapy.

Role of BAFF in pediatric patients with allergic rhinitis during sublingual immunotherapy.

UNLABELLED: Sublingual immunotherapy (SLIT) is the only therapeutic option for allergic rhinitis (AR) that modifies the immunological process to an allergen, rather than treating symptoms simply. However, its regulatory mechanisms are largely unknown. B-cell-activating factor of the TNF family (BAFF) plays very important roles in the development, differentiation, and proliferation of B cells and T cells. The aim of this study was to identify the role of BAFF during SLIT in pediatric patients with AR. Seventy-two house dust mite (HDM)-sensitized pediatric patients with AR were enrolled in this study. Thirty-six pediatric patients received HDM allergen extract for SLIT and 36 pediatric patients received placebo. Serum and nasal aspirate of different time points during treatment was collected and used for enzyme-linked immunosorbent assay (ELISA) of BAFF and related cytokines, respectively. Peripheral blood mononuclear cells were collected and stimulated by HDM allergen with or without rhBAFF after 12 months of treatment. Our results showed that the expression of BAFF protein decreased during the SLIT treatment compared with that in the placebo group after 6 months of therapy, and this trend lasted for 12 months. The decreased BAFF expression was positively related to Th2 cytokines and increased IL-10 expression. BAFF was also related to local production of IgA. In vitro experiments showed that BAFF can promote Th2 cytokines and inhibit IL-10 expression by PBMCs. CONCLUSION: During SLIT, BAFF expression was decreased and related to low Th2 cytokine expression and enhanced IL-10 expression. Besides, BAFF may contribute to local production of IgA. Our results suggested that BAFF may be an important biomarker during SLIT. Authors' summary. Sublingual immunotherapy (SLIT) is the only therapeutic option for allergic rhinitis (AR) that modifies the immunological process to an allergen, rather than simply treating symptoms. However, its regulatory mechanisms are largely unknown. B-cell-activating factor of the TNF family (BAFF) plays very important roles in the development, differentiation, and proliferation of B cells and T cells. Our results showed that during SLIT, BAFF expression was decreased and related to low Th2 cytokine expression and enhanced IL-10 expression. Besides, BAFF may contribute to local production of IgA. Our results suggested that BAFF may be an important biomarker during SLIT.

[The effect of low-temperature coblation under endoscopy on infantile subglottic hemangioma].

OBJECTIVE: To evaluate the effect of low-temperature coblation on subglottic hemangioma under endoscopy. METHOD: Clinical data of 5 patients whom were diagnosed as subglottic hemangioma treated with low-temperature coblation under endoscopy were retrospectively studied. Two cases of the patients were treated after tracheotomy. RESULT: Hemangioma vanished completely in the 5 patients. All patients were followed-up from 3-6 months,no recurrence was found, and the 2 cases were extubated successfully. CONCLUSION: Endoscopic surgery u sing low-temperature coblation for subglottic hemangioma after tracheotomy can relief the airway obstruction quickly, shorten the nature course of hemangioma and the period of wearing trachea,also no complication such as subglottic stenosis which is thought to be a safe and effective therapy for large size hemangioma. While for small size hemangioma, endoscopic surgery using low-temperature coblation under good total anesthesia without tracheotomy combined is effective, less injure, and suitable. Endoscopic surgery using low-temperature coblation for subglottic hemangioma has following advantages such as simplicity, minimal invasion and so on. It is a viable surgical method for the treatment of subglottic hemangioma.

Jugular vein phlebectasia in paediatric patients with vocal fold nodules.

UNLABELLED: Jugular vein phlebectasia (JVP) may often be overlooked in clinical practice and the management for JVP include surgery and a conservative approach. We have studied the relationship between JVP and vocal fold nodules in paediatric patients as well as the effects of treatment. Twenty-three cases of paediatric vocal fold nodules with JVP were studied. All patients received voice therapy. After 6 months of treatment, hoarseness, neck appearance (subjective evaluation) and the degree of dilation of the jugular vein detected by Doppler ultrasonography were analysed. The follow-up period was 6 to 84 months. The hoarseness disappeared or lessened noticeably after treatment for 1-4 months. The neck masses also lessened (pre vs. post: 2.58 ± 0.40 vs. 1.60 ± 0.19) after treatment for 1-4 months. The visual analogue score of the post-treatment symptoms decreased significantly compared with pre-treatment (p <0.05). The degree of dilation of the post-treatment jugular vein also decreased significantly (p <0.05). CONCLUSION: Paediatric vocal fold nodules may be related to JVP. Voice changes may also be observed in cases of paediatric JVP. Voice therapy may offer another conservative treatment option for JVP accompanied by vocal fold nodules, and it may offer better results than simple observation of JVP.

[Clinical features of sudden hearing loss in children].

OBJECTIVE: To investigate the clinical features and prognosis of sudden hearing loss in children, so that to guide clinical diagnosis and treatment. METHOD: A retrospective review of medical records of 12 hospitalized children (21 ears) suffering from sudden hearing loss was conducted. RESULT: The study comprised 8 males and 4 females with a mean age of 6.28 years old, among which 25% had a unilateral hearing loss and 75% exhibited bilateral hearing loss. The mean onset time was 5.42 days. Four children had tinnitus and 3 patients showed dizziness. For the possible etiology. 2 cases had mumps. 6 cases had definite upper respiratory infections history, one experienced trauma, and another one took ototoxic drugs. Five patients were proved to come down with the large vestibular aqua duct syndrome by the CT scan. Among the 21 ears. 7 ears were diagnosed severe hearing loss and 14 ears were diagnosed profound hearing loss. After the treatment of 7 days, 6 ears were cured, one car showed effective change. and 14 cars came out to be ineffective, with the total effective rate of 33.3%. After the 14 days' treatment, there was no improvement for 5 patients. CONCLUSION: CT scan should he performed on all of the children with hearing loss to exclude the inner ear malformation. Most of the children with sudden hearing loss underwent some clear etiology, showing more severe hearing loss and had a poorer prognosis.

[Pathogenic bacteria distribution and drug susceptibility in children with acute otitis media in Pearl River Delta].

OBJECTIVE: To investigate the pathogenic bacteria distribution and drug susceptibility in children with acute otitis media (AOM) in different age and different season in the Pearl River Delta region. METHOD: Four hundred and forty-two children diagnosed as AOM were divided into three groups by age factor and four groups by season factor. Midge ear pus collecting and culturing were used for bacteria and antimicrobial susceptibility test. RESULT: (1) Strains of bacteria were isolated from 356 children with the positive rate of 80.5%. Streptococcus pneumoniae (39.2%), staphylococcus aureus (25.9%) and haemophilus influenzae (7.4%) were the most frequently isolated pathogens. (2) Streptococcus pneumoniae was the main pathogenic bacteria in 0-1 year group and > 1-3 years group (P < 0.05), staphylococcus aureus was the most frequently isolated pathogen in >3 years group (P < 0.05); (3) In the season groups, the number of children with AOM decreased significantly in July-September group. There was no significant difference of streptococcus pneumoniae distribution among the four groups (P > 0.05). Staphylococcus aureus was the main pathogen in January-March group (P < 0.05); (4) Drug sensitivity shown that linezolid and ofloxacin were most sensitive to streptococcus pneumoniae and staphylococcus aureus, and macrolides had a good therapy effect to haemophilus influenzae. CONCLUSION: The pathogens distribution and drug susceptibility in children with AOM were varies in different age and different season. As a result, a treatment should be done based on the climate, environment, and pathogens distribution of a region.

[Comparison of the residual hearing on the profound hearing-impaired children with the hearing aids and cochlear implants].

OBJECTIVE: To compare the hearing test data of the profound hearing-impaired children with the hearing aids and with cochlear implants; to find out the useful method to measure the residual hearing. METHOD: Twenty-two profound hearing-impaired children participated in the study with complete set of hearing test and verbal rehabilitation file. Ten children fitted hearing aids and underwent verbal rehabilitation more than 3 months. Among the other 12 children with cochlear implants, 10 children fell in the same year range with the hearing aid patients. The children with hearing aids were divided into two groups according to the achievement of the verbal rehabilitation. ASSR threshold and pure- tone threshold were compared between the groups. RESULT: (1) ASSR test: 7 children (14 ears) with hearing aids achieved good verbal representation, in which ASSR threshold can be recorded on 2.71 frequency on average [(110.92 +/- 7.43) dB HL]. Among 3 children with hearing aids representing poor verbal achievement and 5 children with additional cochlear implant because of the poor verbal achievement with hearing aids, only 1.06 frequency had response of ASSR test [(110.88 +/- 48.52 ) dB HL]. (2) Pure tone audiometry: the average threshold of the 7 children with good representation was (96.11 +/- 7.81) dB HL, and the threshold on 3 frequency were less than 100 dB HL on average. The average threshold of the other 3 children with poor verbal achievement was (112.19 +/- 5.15) dB HL, and none of the frequency threshold was 100 dB HL. CONCLUSION: The number of the frequency with the response of ASSR and the threshold < or =100 dB HL of pure tone audiometry is an effective indication of the useful residual hearing.