Evaluation of CK19 and VEGF gene expression, ki67 antigen, p53 protein, C-erb-B2, and their relationship in oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is one of the ten most common malignant tumors globally. This study aimed to evaluate the expression changes of Cytokeratin 19 (CK19), vascular endothelial growth factor (VEGF), P53, ki67, and c-ert-B2 in OSCC patients. For this purpose, 30 patients were selected as the case group and 30 healthy individuals as the control group. The expression of CK19 and VEGF genes in their blood serum was measured. Also, the expression of ki67, P53, and c-ert-B2 markers in squamous cell carcinoma was evaluated using immunohistochemistry. T-test was used to analyze the data. The results showed that the presence of CK19 marker in people with OSCC was positive in 17 out of 30 patients and VEGF marker in 23 out of 30 patients. The mean of ki67 positive, P53 positive, and Cerb-B2 positive cells were 399.4, 221.4, and 26.8, respectively. The correlation test between the indices showed a statistical correlation between the incidence of ki67 and P53 (r = 91.5% and p = 0.02). While statistical correlation was not seen between the incidence of ki67 and Cerb-B2 index (r = -1.7% and p = 0.97) and P53 and C-erb-B2 index (r = -13% and p = 0.8) (p <0.05). In general, the expression of VEGF and CK19 genes is higher in patients with OSCC than in healthy individuals. Therefore, examining the expression level of these two biomarkers in the blood of OSCC patients can be considered as a diagnostic screening method in the early stages of the disease. The immunohistochemical study of squamous cell carcinoma can also be used as a diagnostic screening test in the early stages of the disease.

Clinical efficacy of low-temperature radiofrequency ablation of pharyngolaryngeal cyst in 84 Chinese infants.

The aim of the study is to investigate the advantages and disadvantages of low-temperature radiofrequency ablation of pharyngolaryngeal cyst.The study population was composed of 84 children diagnosed with pharyngolaryngeal cyst who underwent surgical treatment at the Department of Otolaryngology, Wuhan Children's Hospital, Wuhan, China, between January 1984 and December 2013. All patients were operated using a self-retaining laryngoscope and were divided into 3 groups: traditional cystectomy group (N = 9), dynamic cutting system group (N = 18), and low-temperature radiofrequency ablation group (N = 57). Clinical outcomes were analyzed to assess the efficacy of low-temperature radiofrequency ablation in treatment of pharyngolaryngeal cyst.Compared with traditional cystectomy group or dynamic cutting system group, operation time was shorter, bleeding was less and one-year recurrence rate was much lower in low-temperature radiofrequency ablation group. However, operation time and bleeding was not statistically different between traditional cystectomy and dynamic cutting system group.Low-temperature radiofrequency ablation may be an effective substitute for treating pharyngolaryngeal cyst.

[Operational Characteristics of the Simultaneous Nitrogen and Phosphorus Removal and Removal of Phthalate Esters by Three-dimensional Biofilm-electrode Coupled with Iron/Sulfur Reactor].

In order to explore the technological characteristics of the simultaneous removal of phthalate esters (PAEs) as well as nitrogen and phosphorus by the novel technology of three-dimensional biofilm-electrode coupled with iron/sulfur reactor (3DBER-S-Fe), the changes of the total nitrogen (TN),total phosphorus (TP),DBP,DEHP,NO3--N, SO42- and pH value were analyzed under the hydraulic retention time (HRT) of 8 h, 6 h and 4 h respectively. The results showed that 3DBER-S-Fe could remove nitrogen, phosphorus and PAEs effectively. Under the HRT of 8 h, 6 h and 4 h, the removal rates of TN were 80.99%, 78.85% and 64.76%; TP were 65.18%, 67.17% and 43.44%; DBP were 96.72%, 97.32% and 96.53%; DEHP were 91.89%, 81.57% and 74.30%, respectively. There were heterotrophic denitrification, hydrogen autotrophic denitrification and sulfur autotrophic denitrification processes in the 3DBER-S-Fe, the elemental sulfur could compensate for the relative shortage of denitrification electron donor caused by the increase of NO3--N load in the influent as a result of maintaining a high efficiency of the denitrification system when the HRT was shortened from 8h to 4h; the iron ions produced by the corrosion of the sponge iron filler in the system had a sustainable and efficient function of removing phosphorus by precipitation; the 3DBER-S-Fe process combined the interactions of physical adsorption, biological degradation and electrochemical processes which supported its high removal rates of DBP and DEHP under the different HRT conditions.

[Efficacy of sublingual immunotherapy with Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis].

OBJECTIVE: To evaluate the efficacy of sublingual immunotherapy (SLIT) with standardized Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis. METHOD: The clinical data of 162 patients treated with standardized Dermatophagoides farina drops were analyzed retrospectively. These patients were divided into the monoallergen sensitized group and polyallergen sensitized group according to the results of skin prick tests. The total nasal symptoms score (TNSS), the total medication score (TMS) and adverse effects (AEs) were evaluated before treatment, 2 year after SLIT treatment and 3 year after drug discontinuance. Result:After SLIT treatment for 2 years and drug discontinuance for 3 years, the TNSS (3. 14[2. 47; 3. 65], 3. 45 [2. 76; 3. 92], respectively) and TMS (0. 42[0. 36; 0. 57],0. 35[0. 26; 0. 44], respectively) in the monoallergen sensitized group were lower than that before the treatment (TNSS: 9. 00 [8. 00; 10. 00], TMS: 2. 16 [1. 88; 2. 37]), which have showed a statistically significant difference(P<0. 05). Similarly, after SLIT treatment for 2 years and drug discontinuance for 3 years, the TNSS (3. 14[2. 46; 3. 63], 4. 23[3. 65; 4. 96], respectively) and TMS (0. 42[0. 36; 0. 58], 0. 50[0. 34; 0. 72], respectively) in the polyallergen sensitized group were lower than that before the treatment (TNSS: 9. 00[8. 00; 10. 00], TMS: 2. 18[1. 95; 2. 37]), which have showed a statistically significant difference(P<0. 05). No statistically significant finding could be observed in monoallergen and polyallergen sensitized group before the treatment and 2 years after treatment, respectively. However, a statistically significant finding could be observed between two groups in the drug discontinuance for 3 years (P<0. 05). Eleven patients suffered local adverse effects, and the incidence of adverse effects showed no significantly difference (P>0. 05). CONCLUSION: SLIT with standardized Dermatophagoides farina drops has a long-term efficacy in monosensitized and polysensitized patients with allergic rhinitis. Moreover, a longer SLIT treatment (>2 years) may be necessary to consolidate its efficacy.

[The clinical characters and surgical management of nasopharyngeal teratoma in infants].

OBJECTIVE: To describe and analyze the clinical characteristics of nasopharyngeal teratoma in infants and improve the levels of diagnosis and treatment to reduce misdiagnosis. METHOD: The clinical data of 11 cases of nasopharyngeal teratoma in infants were reviewed retrospectively and summarized the clinical features. After the preoperative examination of nasopharyngeal endoscopy and imaging (CT or MRI), all patients were under general anesthesia of nasopharyngeal teratoma surgical resection. Of them, 8 cases were used radiofrequency ablation, 3 cases used conventional power systems. RESULT: Eleven cases with neoformation were completely removed, the operation time was 5-15 min, blood loss was 1-5 ml, patients had no significant nasal obstruction, bleeding, eating nasopharyngeal regurgitation, breathing difficulties or other complications. No recurrence was found after 10 months to 9 years followed up. CONCLUSION: The nasopharyngeal mass must be kept in mind in the differential diagnosis of breathing difficulties in infants, especially when it exists together with upper airway obstruction symptoms; The low-temperature radiofrequency ablation with endoscopic had the advantages of short time, precise control, less bleeding, clear operative field, little injury and pain, low recurrence, providing a new clinical treatments.

[Clinical analysis of 49 cases of special airway foreign bodies in children].

OBJECTIVE: To explore the clinical characteristics and treatment skills of children with respiratory special foreign body. METHOD: To retrospectively analyze the clinical characteristics of 49 cases of special airway foreign bodies in children during 2013. 5.1-2014. 5.1 in our hospital, and the treatment methods were summarized. RESULT: Fourty-seven cases with rigid bronchoscopy foreign body cured, 1 case turned Department of thoracic sur- gery chest to remove foreign body, 1 case of death. CONCLUSION: The clinical characteristics of special airway foreign bodies in children is different from ordinary foreign body, treatment of preoperative, intraoperative and postoperative is not fully equivalent to the ordinary foreign body.

[The clinical characters and surgical managements of congenital laryngeal cysts in infants].

OBJECTIVE: To classify congenital laryngeal cysts in 62 newborn or infants, and to discuss the characteristics of different operation mode. METHOD: The clinical data of 62 infants with laryngeal cysts treated were reviewed retrospectively. After the examination of neck palpation, laryngoscope and imaging (CT or MRI), all patients were under general anesthesia of laryngeal cyst excision. we select operation mode according to the classification. Classification include: 61 cases of cysts were confined to the larynx, 1 case was beyond the larynx. Surgical managements include: an excision through external carotid approach in 1 case beyond the larynx, 61 cases had endoscopic excision under general anesthesia (12 cases with traditional bite exception, 12 cases with powered system and 37 cases with low-temperature radiofrequency ablation). RESULT: The operations was successful. No recurrence was found after 0.5 to 7 years follow-up. CONCLUSION: To chose surgical management after classification and preoperative assessment, which could avoid unnecessary opening surgical approaches, reducing the recurrence, and preventing repeated endoscopic treatment or tracheotomy. The low-temperature radiofrequency ablation had the advantages of short operation time, less bleeding, little injury, low recurrence rate and light postoperative reaction. It is worthy of clinical promotion.

[Efficacy and safety of sublingual immunotherapy of allergic rhinitis in children between 4 and 5 years age group and 11 and 12 years age group].

OBJECTIVE: To evaluate the efficacy and safety of the sublingual immunotherapy with Dermatophagoides fannie drops on children with allergic rhinitis of different age groups (4 - 5 years old group and 11 - 12 years old group). METHODS: Sixty-two children aged 4 - 5 years, and 71 children aged 11 - 12 years, who suffered from dust mite induced allergic rhinitis, was randomly divided into the sublingual immunotherapy (SLIT) + drug group and drug group. SLIT + drug group was treated with a standardized sublingual immunotherapy drops of Dermatophagoides fannie and combined with symptomatic therapy, drug group was treated with mometasone furoate nasal spray and desloratadine tablets as symptomatic treatment. These children were followed up for 2 years with one visit in every 3 months, then visited at the end of the study and 2-years after the treatment ended. Symptom scores and medication scores were recorded at each visit. Comprehensive evaluation of symptoms, medication, and patients' degree of satisfaction were used. RESULTS: Two years after SLIT finished, symptom scores (SLIT + drug group: 1.13 ± 1.05; drug group: 4.68 ± 3.09), medication scores (SLIT + drug group: 0.07 ± 0.04; drug group: 0.36 ± 0.25) of SLIT + drug group were significantly lower than those in drug group (t value were -8.43, -8.87, respectively, all P < 0.01). Also, the subjective assessment of patients' symptoms, medication, and treatment satisfaction in SLIT + drug group was significantly lower than those in drug group. Subjective assessment symptoms, medication, and treatment satisfaction in age group 4 - 5 was the same as in age group 11 - 12. After SLIT ended for 2 years, subjective assessment and treatment satisfaction in age 11 - 12 group was better than those in age 4-5 group in medication score. CONCLUSIONS: SLIT demonstrated clinical improvement in children of different ages during 2 years treatment. Two years after withdrawal, the symptom scores, medication score and subjective satisfaction in 11 years old group are better than those in 4-5 years old group.

[The clinical analysis of tympanoplasty in treating children's chronic otitis media].

OBJECTIVE: To study the effectiveness of tympanoplasty for treatment of chronic otitis media and cholesteatoma in children. METHOD: Twenty-three cases with chronic otitis media and cholesteatoma treated by tympanoplasty were retrospectively studied, among which 15 cases had complete clinical data. The condition of surgical cavities, the duration of getting dry ears, the hearing improvements, the growth of new ear drums and whether the recurrence of cholesteatomas occurred or not were observed. RESULTS: In all patients, the chief complains were ear discharging and hearing loss. The tympanum membranes(pars flaccid or pars tensa) became retracted or perforated and CT scan showed mastoid processes were poor developed in some cases with lesions mainly located at attic, middle tympanum cavity and/or petrous parts. The duration of getting dry ear was (6.0 +/- 1.5) weeks after surgery. The effective rate was 80%. The hearing of 12 cases has been improved, that of 2 cases has no changed, that of 1 case has been descended, and 1 case exhibited recurrent cholesteatoma after surgery. CONCLUSION: This study demonstrated that children's chronic otitis media and cholesteatoma have their own clinic features of wide erosiveness and strong aggressiveness, and tympanoplasty has been proved to treat this disease effectively, also been proved to improve these patients' hearing cognitions and eventually improve their life qualities.

[Clinical analysis of foreign body ingestion of button cell in children].

OBJECTIVE: To improve diagnosis and treatment level of foreign body ingestion of button cell in children. METHOD: Among the 14 cases with foreign bodies ingestion of button cell, 6 cases in esophageal, 7 cases in stomach and lower gastrointestinal tract, 1 case with multiple foreign bodies both in esophagus and stomach. Seven cases in stomach and lower gastrointestinal tract were closely observed without special treatment, 6 cases in esophageal, underwent esophagoscopy and removal of foreign body under general anesthesia, 1 case with multiple foreign bodies in esophagus and stomach underwent esophagoscopy and electronic gastroscopy and then removal of foreign body. All patients had symptomatic treatments after removal of foreign body. The average age is 2 years and 1 month. RESULT: After the removal of button cell, Foreign bodies in stomach and lower gastrointestinal tract in 7 cases were all discharged spontaneously. For the 6 cases in esophagus, 4 cases were cured, 1 case had esophageal stricture, 1 cased died. 1 case with multiple foreign bodies in both esophagus and stomach was cured. CONCLUSION: Esophageal foreign body has strong corrosiveness and would cause serious damages even to threaten children's life. It also may lead to esophageal stricture. The key point to cure this disease is to diagnose timely and to operate as soon as possible. Because neutralize of digestive juices and low probability of incarceration, with close observation, the foreign bodies of stomach and lower gastrointestinal tract can discharge spontaneously.

[CT and MRI study in severe sensorineural hearing loss in children].

OBJECTIVE: To investigate the value of CT and MRI in diagnosing the children with sensorineural hearing loss. METHOD: Ninety-six cases suspected as severe sensorineural hearing loss were examined by CT/MRI system and 3D reconstruction. RESULT: Of 96 cases, 15 cases were found malformation these malformation included Michel, cochlear hypoplasia, commun cavity, Mondini, inner canal straitness, cochlear nerve undeveloped and vestibular aqueduct enlargements. CONCLUSION: There are 15.63% inner ear malformation occurred in sensorineural hearing loss children. CT and MRI of inner ear have a great clinical value in diagnosing children sensorineural hearing loss by learning the anatomy.

[Follow-up examination for high risk infants with auditory neuropathy spectrum disorder].

OBJECTIVE: The goal was to know more about the characteristic of auditory neuropathy spectrum disorder (ANSD) for high risk infants. METHOD: The newborn hearing screening was performed with automatic auditory brainstem response (AABR) and transient evoked otoacoustic emission(TEOAE) for the infants in the NICUs from August 2007 to January 2011. After subsequent rescreening, children with AABR test referred were perform hearing test set including high frequency (1000 Hz) tympanometry, ABR, DPOAE and/or Cochlear Microphonics (CMs) in 3 months old. Only infants demonstrated severely abnormal ABRs along with preserved DPOAEs and/or CMs were scheduled for re-examination in 6-8 months old and Behavior audiometry in 8-12 months old. RESULT: Eighteen infants (14 cases were bilateral and 4 cases were unilateral) considered as suffering from AN in 3 months old. All of them showed ABR thresholds > or = 80 dB nHL or absent at maximum test intensity. Follow-up examination revealed 9 cases (18 ears) with restoration of ABR to normal or a lower ABR thresholds and a resolution of ANSI) in 11 out of 18 infants retested in 6-8 months old. CMs were present in all ears but DPOAE were not present in 4 ears with middle ear pathology in 3 months test. Behavioral hearing of 10 cases ranged from mild (n = 2), moderate(n = 4) to severe and profound loss (n = 4). CONCLUSION: ANSD in high risk neonates could show the temporary character. It was too difficult to forecast the prognosis, they would be to follow up to at least 3 years old for newborn ANSD.

[Experience in the removal of difficult and high risk tracheobronchial foreign body by bronchoscopy].

OBJECTIVE: To explore the best methods and skill for the removal of difficult and high risk tracheobronchial foreign body under bronchoscope. METHODS: A retrospective review was performed between August 1995 to August 2012. There were 4217 children with tracheobronchial foreign body, among them, 272 were diagnosed as high-risk, highly difficult tracheobronchial foreign bodies confirmed by clinical manifestations, foreign body type and bronchoscopy. RESULTS: In 271 children, the tracheobronchial foreign body was removed under bronchoscope, the success rate was 99.6%; only one child with a pen cap blocking the left lower lobe bronchus was transferred to the department of thoracic surgery, and the foreign body was finally removed by thoracotomy. Eighty-five children (among them, 82 children were under 1 year of age) had II-II degree laryngeal obstruction, the emergency surgery was performed to remove the foreign body and to relieve the laryngeal obstruction. Twenty-six children had lung infection and 27 children had failed foreign body removal surgery before, in all these children, the foreign body was removed after infection control. There were 17 children with the pen cap as the tracheobronchial foreign body, direct removal was successful in 12 children with the history less than two weeks; in 4 children, the foreign body was removed after 0.1% epinephrine saline flush, and 1 case with the homemade bronchial foreign body hook remove. There were 26 children with the whistle as the foreign body, and 32 children had large and sharp foreign bodies. In these cases, the foreign bodies were removed together with the bronchoscope. Forty-two children had multiple or fragile foreign bodies, and 16 children had subsegmental bronchial foreign bodies. In these cases, the foreign bodies were removed with forceps under direct vision and intraoperative bronchial lavage.In This series, 129 children received intraoperative bronchial lavage, among them, 127 children showed normal X-ray changes one week after operation. Two children with a history of more than 1 month complicated with pulmonary consolidation. After bronchial lavage, pneumothorax and subcutaneous emphysema occurred, which recovered after treatment. No glottic edema, asphyxia, and other complications were found, the complication rate of surgery was 0.7%. CONCLUSION: For the removal of highly difficult and high risk tracheobronchial foreign bodies, preoperative analysis and discussion should be sufficient, appropriate surgical skill and surgical instruments may improve the success rate of the surgery and prevent the operation complications.

[The analyse of telephone follow-up affecting the compliance of sublingual desensitization treatment to allergic rhinitis patients].

OBJECTIVE: To analyze the compliance of sublingual desensitization used in allergic rhinitis patients by telephone follow up, and to discuss the influencing factor associate with medicine pause. METHOD: One hundred and thirty-two patients of allergic rhinitis were randomly divided into two groups, 53 cases was in the control group, 79 cases was in telephone follow up group for a period of 6 months of observation. RESULT: Sublingual desensitization treatment for 6 months, 28/53 cases of control group were compliance, 25/53 cases were loss, and compliance rate was 52.8%; 17/27 cases of follow-up group A were compliance, 10/27 cases were loss, and compliance rate was 63.0%; 21/28 cases of follow-up group B were compliance, 7/28 cases were loss, and compliance rate was 75.0%; 22/24 of follow-up group C were compliance, 2/24 cases were loss, and compliance rate was 91.7% (P < 0.05). Significant difference was found in the 4th month after treatment (P < 0.01). Long-term treatment and cure were the main impact factors for compliance. CONCLUSION: Timely telephone follow-up education and guidance to patients could improve compliance of patients with sublingual desensitization.

[Clinical analysis of esophageal foreign bodies of button cell in childhood].

OBJECTIVE: To improve diagnosis and treatment level of esophageal foreign bodies of button cell. METHOD: Reported 4 clinical cases of esophageal foreign bodies of button cell. RESULT: Because of different diagnosis time and different surgical time, one case died and the other were cured. CONCLUSION: Esophageal foreign bodies of button cell has been reported rarely before. Because button cell is caustically basic, drastically dangerous, it should be emphasized clinically. The key point to cure this disease is diagnosing timely and operating a surgery as soon as possible.

[The prevalence of otitis media with effusion of kindergarten children in Wuhan city].

OBJECTIVE: To investigate the prevalence of otitis media with effusion (OME) of kindergarten children in Wuhan City. METHOD: The study subjects were 3-6-year-old children in some kindergarten children in Wuhan City . All subjects were assessed with routine otorhinolaryngologic examination, otoscopic examination and tympanometry. Chi-square test were used to analyse the difference of data. RESULT: The prevalence of children of some kindergarten in Wuhan City is 6.67%. There was no statistical difference were found between sexuality. The prevalence of OME in 3 years old group is obviously higher than that in 4-6 years old group. Previous acute otitis media episodes, feeding, high-arched palate, and nasal obstruction are risk factors of OME. CONCLUSION: Children with previous acute otitis media episode and nasal obstruction should be suggested to have otorhinolaryngologic examination regularly. It is necessary to have routine otoscopic examination and tympanometry in children of kindergarten.

[Temperament of children with vocal fold nodules].

OBJECTIVE: To examine the temperament of children with vocal fold nodules. METHOD: To compare the temperament dimension and temperamental types of 42 children with vocal fold nodules with 46 vocally normal children, using Chinese children's Temperament Problem Screening system (CCTPSs). RESULT: The children with vocal fold nodules differed significantly from the comparison group in their temperament dimension's adaptability, intensity of reaction, mood value, persistency and temperamental types. CONCLUSION: There are more difficult and slow-to-warm-up children in patients with vocal fold nodules than vocally normal children.

[Risk factors for otitis media with effusion in children].

OBJECTIVE: To identify the risk factors for otitis media with effusion (OME) in some kindergarten children in Wuhan City of China and analyze the results with reference to the review of the literature. METHODS: The study subjects were 3 to 6 years old children drawn from a school screening program for OME in Wuhan. All subjects were assessed with routine otorhinolaryngologic examination, otoscopic examination and tympanometry. During the test, parents were interviewed to provide information with regard to the children's birth history, neonatal history, feeding history, family smoke history, otological history, rhinorrhea, sneeze, nasal obstruction, snoring, tonsillitis episodes history, et al. These data formed the basis in the estimation of potential risk factors for OME. RESULTS: In the univariate analysis of 144 cases and 288 controls, significantly elevated odds ratios (OR) for OME were detected on the symptoms of nasal obstruction (OR = 2.60, P = 0.002), rhinorrhoea (OR = 1.442, P = 0.003), high hard palate (OR = 4.411, P < 0.0001), and previous history of acute otitis media (OR = 1.77, P = 0.025). However, four factors were found to be significant in the multivariate logistic regression model, including feeding history (OR = 0.746, P = 0.047), nasal obstruction (OR = 2.56, P = 0.003) and previous acute otitis media episodes (OR = 1.735, P = 0.032). CONCLUSIONS: Previous acute otitis media episodes and nasal obstruction were risk factors, which was accordant with literature. In addition, breastfeeding was a protective factor for OME, but acute tonsillitis was not a factor for OME. A child who had previous acute otitis media episode and often had nasal obstruction is suggested to have otorhinolaryngologic regulatory examination.

[Pediatric sulcus vocalis].

OBJECTIVE: To observe the clinic features of the sulcus vocalis in children. METHOD: From Jan 1995 to April 2005,56 cases of pediatric sulcus vocalis were found by video-laryngoscopy. All received an operation called sulcus vocalis microdissection and vocal cord plasty with four steps: an incision along the superolateral edge of the sulcus; freeing of the mucosa adhering to the vocal ligament; detachment of the ligamentous fibers; redraping of the mucosa. RESULT: The total effective rate was 96.4% after surgical treatment. CONCLUSION: There are 5% sulcus vocalis among children referred for voice disorders. The sulci are frequently found in association with other laryngeal abnormalities. Sulcus vocalis microdissection and vocal cord plasty might be a rational and effective surgical modality.