Successful removal of metallic foreign body in the neck-mediastinum via the parapharyngeal space approach.

Neck-mediastinum foreign body (FB) is a common emergency in otorhinolaryngology head and neck surgery departments, and it can be lethal. We present a case of an uncommon foreign body in the neck-mediastinum. The FB was metallic and about 12 cm long. A 74-year-old male accidentally swallowed a metallic FB that lodged in his throat for > 3 days. The intake of the object was associated with smoking a peace pipe, and was an indication for surgery. Aerodermectasia was observed in the neck upon physical examination, and a high-density foreign body was found in the neck-mediastinum through cervicothoracic computed-tomography (CT) scan. Electronic laryngoscopy showed a white pseudo-membrane adhering to the surface of the bilateral piriform fossa in the right laryngeal vestibule, and the root of the tongue, and mucosa were swollen. Cervicothoracic CT revealed dense shadows in the neck-mediastinum. However, electronic laryngoscopy showed no FB in the larynx or piriform fossa. The metal FB was removed by surgery via the parapharyngeal space approach instead of endoscopy. After preoperative assessment and preparation, we successfully removed the metal FB from the neck-mediastinum via the parapharyngeal space approach. The patient was doing well at one-month follow-up. Neck-mediastinum FB is an emergency but rare case necessitating otorhinolaryngology head and neck surgery. It can easily lead to mediastinal and lung infection; given its location in the body, it may lead to aortic arch rupture if not handled promptly.

Increased expression of IL-1R8 and a possible immunomodulatory role of its ligand IL-37 in allergic rhinitis patients.

Allergic rhinitis (AR) is a chronic inflammatory airway disease that is caused by an abnormal T cell response. T helper (Th)-17 cells and Th2 cells are the CD4+ T cell subsets implicated in the pathogenesis of AR. The suppression of excessive responses of these Th17 and Th2 cells has been reported to be an effective therapeutic approach to treat AR patients, and continuous efforts are being undertaken to find new methods to modulate the function of these cells. Recent studies have shown that IL-1R8 and its ligand IL-37 negatively regulate the immune response. In this study, we investigated the immunomodulatory the roles of IL-37/IL-1R8 axis in AR patients. We found that IL-1R8 expression was very low on dendritic cells (DCs) and resting CD4+ T cells but increased strongly on CD4+ T cells following T cell activation. Furthermore, IL-1R8 expression on CD4+ T cells was markedly higher in AR patients than in healthy controls. The IL-1R8 ligand IL-37 could act on CD4+ T cells to inhibit IL-17 and IL-4 production but could not influence DC-induced IL-17- and IL-4-producing CD4+ T cell responses. Meanwhile, recombinant IL-37 (rIL-37) did not influence IL-6, IL-1ß, and IL-10 production by DCs and expression of co-stimulatory molecules (including CD80, CD40, CD86 and HLA-DR) in DCs. Thus, IL-37 may regulate aberrant T cell immune response of allergic rhinitis mainly through CD4+ T cells, not DCs. The immunomodulatory roles of the IL-37/IL-1R8 axis indicate the therapeutic potential of this axis in AR.

MiR-150-5p regulates EGR2 to promote the development of chronic rhinosinusitis via the DC-Th axis.

BACKGROUND AND AIMS: Accumulating studies indicate that miR-150-5p might play a significant role in dendritic cells (DCs) of peripheral blood in chronic rhinosinusitis (CRS) patients. We sought to investigate the effects and mechanism of miR-150-5p, which regulates early growth response 2 (EGR2) to promote the development of CRS via the DC-Th axis. METHODS: The upregulated expression of miR-150-5p in DCs of CRS was assayed by real-time quantitative polymerase chain reaction (qRT-PCR), and IL-17 cytokines in the supernatants of DC-naïve T cells co-cultures were analysed by enzyme-linked immunosorbent assay (ELISA). Flow cytometry was used to evaluate T cell proliferations. EGR2 was also identified as a direct target of miR-150-5p by establishing a miRNA-mRNA network, and this target was validated with a Dual-Luciferase® Reporter Assay System and Western blot. RESULTS: MiR-150-5p was up-regulated in DCs in peripheral blood from CRS patients, and this expression was down-regulated by EGR2 expression via the DC-Th axis. Up-regulated miR-150-5p Regulates DCs, and DCs Promote Naïve T Cells Proliferation. MiR-150-5p Further Regulates EGR2 and Inhibits DCs, Which Makes the DC-Th Axis Abnormal in the Peripheral Blood of Patients with CRS. CONCLUSION: MiR-150-5p and its identified target, EGR2, are involved in the development of CRS. DCs can promote T cell proliferations of peripheral blood in CRS.

Assessment of postsurgical outcomes between different implants in patients with empty nose syndrome: A meta-analysis.

Objectives The aim of this study was to evaluate the impact of surgery and different implant materials on subjective outcomes in patients with empty nose syndrome (ENS). Methods Postsurgical outcomes were assessed in a meta-analysis of patients with ENS who underwent treatment with different implants. Results We identified 122 relevant studies, and 6 were included in the meta-analysis (4 prospective trials and 2 randomized controlled trials). A significant difference was found between the preoperative and postoperative Sino-Nasal Outcome Test (SNOT) scores for different implants. With respect to implant materials, significant differences were observed between autografts/allografts (AG) and foreign material grafts (FGs). A subgroup analysis of different countries showed that more patients from China underwent surgical implant therapy than patients from other countries. Conclusions This meta-analysis suggests that surgery can improve the symptoms and SNOT scores of patients with ENS, AGs are more effective than FGs in patients with ENS, and that more patients from China undergo surgical implant therapy than patients from other countries.

Knockdown of NFBD1/MDC1 enhances chemosensitivity to cisplatin or 5-fluorouracil in nasopharyngeal carcinoma CNE1 cells.

Nasopharyngeal carcinoma (NPC) is a rare but highly invasive cancer that is prevalent among people of southern Chinese ancestry in southern China and Southeast Asia. Radiotherapy and cisplatin (CDDP)-based chemotherapy are the main treatment options. Unfortunately, disease response to concurrent chemoradiotherapy varies among patients with NPC, and many cases are resistant to CDDP and radiotherapy. NFBD1 functions in cell cycle checkpoint activation and DNA repair following DNA damage. In this study, we identified the NFBD1 as a tractable molecular target to chemosensitize NPC cells. NFBD1 expression in NPC CNE1 cell lines was depleted using lentivirus-mediated short hairpin RNA, and the elevated sensitivity of these NFBD1-inhibited NPC cells to therapeutic reagent CDDP and 5-fluorouracil (5-FU) was evaluated using MTS assays. Flow cytometry analysis also showed that NFBD1 knockdown led to an obvious induction of apoptosis in CDDP- or 5-FU-treated CNE1 cells. Furthermore, we implicated the involvement of NFBD1 in Rad51 and DNA-PKcs foci formation following CDDP or 5-FU chemotherapy. In conclusion, NFBD1 knockdown improves the chemosensitivity of NPC cells by inhibiting cell growth and promoting apoptosis through the impairment of DNA damage repair, suggesting NFBD1 as a novel therapeutic target for NPC.

MicroRNA expression profile of mature dendritic cell in chronic rhinosinusitis.

OBJECTIVE: Chronic rhinosinusitis (CRS), which includes CRS without nasal polyposis (CRSsNP) and with nasal polyposis (CRSwNP), shows imbalance of helper T cells (Th) and regulatory T cells (Treg). The balance of Th and Treg cells is orchestrated by dendritic cells (DCs). Recent studies show functions of DCs can be regulated by microRNAs (miRNAs or miRs). This study is aimed to investigate miRNAs expression profiles of peripheral blood DCs in CRS. METHODS: Peripheral blood samples of 30 patients with CRS and 7 patients with nasal septum deviation alone were collected. CD14(+) monocytes were isolated from these samples and differentiated into dendritic cells (DCs). Small RNAs were extracted from mature DCs and reversely transcribed into cDNA by Mir-XTM miRNA First-Strand synthesis method. MiRNA microarrays were used for miRNA expression analysis. Microarray results were validated by real-time PCR performed on five top list target genes. RESULTS: MiRNA microarrays showed that DCs from different types of patients have different sets of differential expressed miRNAs when comparing with Controls; they also share 31 commonly changed miRNAs among all three groups of CRS patients. Of these 31 miRNAs, 5 miRNAs were up-regulated and 25 miRNAs were down-regulated in all three types of CRS, while MiR-1290 was down-regulated in CRSsNP but up-regulated in both atopic CRSwNP and non-atopic CRSwNP. CONCLUSIONS: By comparing miRNA gene expression patterns in 3 types of CRS patients, we have been able to identify candidate miRNAs that might mediate the core pathogenesis of CRS through regulating dendritic cells. These miRNAs could serve as potential therapeutic targets for CRS.

[Research on misdiagnosis of space occupying lesions in unilateral nasal sinus].

OBJECTIVE: By nearly 3-year retrospective analysis of cases with space-occupying lesions in unilateral nasal sinus in Guizhou Province People's Hospital, clinical diagnostic and misdiagnosis of such lesions were explored to provide references for clinicians in diagnosis and treatment of such diseases. METHOD: Combining related literatures in recent years, 213 patients with space-occupying lesions in unilateral nasal sinus were selected. The patients misdiagnosed were reviewed for its clinical manifestations, of patients had been misdiagnosed, imaging features and and pathology. RESULT: Of 213 patients, 116 cases located in the left nasal sinus and 97 in right, 65 patients were nasal polyps, 66 were sinus cyst, 20 were fungal sinusitis, 31 were benign tumor, 28 were malignant tumor and 3 were nasal foreign body. Misdiagnosis were as follow: 12 patients with malignant tumor were misdiagnosed as nasal polyps and the misdiagnosis rate 5.63%. Nasal foreign bodies were misdiagnosed as sinusitis in 2 cases and the misdiagnosis rate 0. 94%. Inserted papilloma misdiagnosed as nasal polyps in 6 cases and the misdiagnosis rate 8.45%. Fungal sinusitis misdiagnosed as purulent sinusitis in 5 cases and the misdiagnosis rate 2.35%. Sinus cyst misdiagnosed as sinusitis in 8 cases and the misdiagnosis rate 3.75%. CONCLUSION: Enquiry history, carefully specialized examination including nasal endoscopy, three-dimensional image and biopsy are crucial on the accurate diagnosis and reducing the misdiagnosis.