Clinical efficacy of Dermatophagoides farina drops on allergic rhinitis in children sensitized by dust mites combined with different allergens.

OBJECTIVE: This study aimed to investigate the clinical efficacy and safety of sublingual immunotherapy (SLIT) using standardized dermatophagoides farina drops for the treatment of allergic rhinitis (AR) in children sensitized to dust mites combined with different allergens. The findings contribute to establishing a preliminary foundation for future in-depth studies on AR treatment. METHODS: A total of 152 AR children undergoing SLIT were categorized into two groups based on serological test results: the inhalation group (dust mite combined with inhalation allergy) and the ingestion group (dust mite combined with ingestion allergy). The clinical efficacy and safety were evaluated by assessing the total nasal symptoms score (TNSS), total medication scores (TMS), visual analog scale scores (VAS scores), and the incidence of adverse reactions before treatment and after two years of treatment. RESULTS: After two years of treatment, TNSS, TMS, and VAS scores significantly improved compared to pre-treatment values in both the inhalation and ingestion groups (p < 0.05). However, there were no significant differences in efficacy between the two groups after two years of treatment (p > 0.05). During the treatment period, only 15 cases (10.9 %, 9 cases in the inhalation group and 6 cases in the ingestion group) experienced mild adverse reactions. There was no significant difference in the incidence of adverse reactions between the two groups (p > 0.05). CONCLUSION: SLIT using standardized dermatophagoides farina drops demonstrates long-term efficacy in children with AR, regardless of whether they belong to the inhalation or ingestion group, without significant differences in treatment outcomes.

[Evaluation the curative effect of supracricoid partial laryngectomy for laryngeal cancer].

OBJECTIVE: To analyze the oncological outcomes, functional outcomes in patients undergoing supracricoid partial laryngectomy (SCPL). Provide clinical experience for application of SCPL. METHOD: A retrospective analysis of the 115 cases with laryngeal carcinoma accepted SCPL in our department from Jan 1996 to Dec 2004. Use the Kaplan-Meier method to analyze the patients'survival rate. Evaluate the value of reserve larynx function. RESULT: The 5-years survival rates and the decannulation rate was 80.8%, 99.1% respectively; and the average decannulation time was 22.25 days. The mean time of removal of gastric tube was 9.57 days. The function of CHEP was superior to CHP. The vocal function of 115 cases were all achieved in general communication. CONCLUSION: SCPL get better oncological and functional outcomes and allows the preservation of the basic function of the larynx. It's a safe, effective technique and deserved to generalization.

[Resection of invasive head and neck neoplasms involving skull base].

OBJECTIVE: To investigate the operative methods of invasive head and neck neoplasms involving skull base. METHOD: Thirty-two cases with invasive head and neck neoplasms involving anterior and lateral skull base, from 1997 to 2005, were treated with surgical resection. Nine surgical approaches including endoscopic transnasal approach for five cases, combined craniofacial approach for three cases, maxillary resection approach for 15 cases, transpalatal approach for one case, transmandibular approach for one case, lateral neck-mandibular incision approach for two cases, combined retroauricular and neck approach for one case, frontotemporal approach for two cases, and facial translocation approach for two cases were used to resect the tumors. RESULT: Four cases with nasal sinus mucocele were only applied drainage and one case with chordoma was subtotally resected. The tumors of the rest 27 cases were totally removed. Although one case complicated with cerebrospinal fluid leak and recovered within one week, no one died from the operation and no serious cranium-cerebrum complication occurred. Eight cases with benign tumor were followed up for six months to eight years without recurrence and no one died. For 24 cases with malignant tumor, survival rates of three and five years were 63.2% (12/19), 41.7% (5/12) respectively. CONCLUSION: Surgical approach must be designed according to the pathological change's characters, site and invasive range. Favorable curative effect could be achieved by resecting tumors totally as possible, protecting important constitutions, and adopting proper reparative techniques.

[Expressions and correlation with radiotherapy's effect of five kinds of genes in nasopharyngeal carcinoma].

OBJECTIVE: To investigate the expressions of E-cadherin, CD44H, matrix metalloproteinase-3 (MMP-3), nm23H1 and vascular endothelial growth factor (VEGF) in nasopharyngeal carcinoma and its relationship to the effect of radiotherapy. Furthermore, to analyze the predict value of radiotherapy effect. METHODS: The expressions of E-cadherin, CD44H, MMP-3, nm23H1 and VEGF in 62 patients with nasopharyngeal carcinoma were determined by immunohistochemical SP method. There were 62 patients (17 to 70 years old) with nasopharyngeal carcinoma which were treated by radiotherapy from March 1995 to October 1995 and the period of follow-up had full 10 years. RESULTS: The expressions of CD44H (chi2 = 18.739, P = 0.028) and VEGF (chi2 = 18.523, P = 0.030) were closely related with short-term effect after radiotherapy in nasopharyngeal carcinoma. The short-term effect was descent along with enhancement of their expressions. In the group of low expressions in CD44H and nm23H1, 3-year overall survival rate were 65.5% and 45.5%, and 5-year overall survival rate were 47.3% and 22.7%. In the group of high expressions in CD44H and nm23H1, 3-year overall survival rate were 54.6% and 75.9%, and 5-year overall survival rate were 27.8% and 53.2%. There were respectively significant difference between two group of expressions in CD44H (chi2 = 7.31, P = 0.0069) and nm23H1 (chi2 = 15.64, P = 0.0001). CONCLUSIONS: These findings indicated that to detect the expressions of CD44H and VEGF gene may predict short-term effect of radiotherapy. Furthermore, to detect the expressions of CD44H and nm23H1 gene may predict long-term effect of radiotherapy in nasopharyngeal carcinoma.

[Expression and correlation with metastasis of E-cadherin, CD44H, matrix metalloproteinase-3, nm23H1 and VEGF in nasopharyngeal carcinoma].

OBJECTIVE: To investigate the expression of E-cadherin, CD44H, matrix metalloproteinase-3, nm23H1 and VEGF in nasopharyngeal carcinoma and its relationship to the metastasis. METHOD: The expression of E-cadherin, CD44H, matrix metalloproteinase-3, nm23H1 and VEGF in 62 patients with nasopharyngeal carcinoma was detected by immunohistochemical SP method. RESULT: In the group of nasopharyngeal carcinoma with lymph node metastasis, the expression of E-cadherin and nm23H1 reduced and the expression of CD44H and MMP-3 increased, and there were respectively significant difference compared to the group of non-lymph node metastasis, but there wasn't significant difference between the two groups in VEGF. Furthermore, expression of E-cadherin was inversely correlated with that of CD44H and MMP-3, and the expression of CD44H was positively correlated with that of MMP-3. In the group of nasopharyngeal carcinoma with distant metastasis, the expression of E-cadherin and nm23H1 also increased and the expression of CD44H, MMP-3 and VEGF all increased. Compared with the group of negative distant metastasis, there were respectively significant difference. In addition, there was a positive correlation between the expression of CD44H and VEGF. CONCLUSION: E-cadherin, CD44H, matrix metalloproteinase-3 and nm23H1 genes are closely related with lymph node and distant metastasis of nasopharyngeal carcinoma, while VEGF gene only relates to lymph node metastasis. They are important factors acting on metastasis of neoplasms.

[Surgical treatment for laryngeal condyloma acuminata in children].

OBJECTIVE: To investigate the therapeutic methods of laryngeal condyloma acuminata in children. METHOD: Operative treatment was performed in 43 cases of laryngeal condyloma acuminata in children. Direct laryngoscopy with removal of laryngeal tumor under surface anesthesia was performed in 26 cases, and trachea cannula, retaining laryngoscopy with removal of laryngeal tumor under general anesthesia were performed in 17 cases, hypodermic implantation of the removal condyloma acuminata at medial upper arm and submucous injection of interferon at vocal fold were performed in 13 cases at the same time. RESULT: Cases were followed-up, 26 cases were cured, 7 cases were improved, 2 cases were dead, 7 cases needed tracheotomy, 3 cases had difficulty of decannulation. CONCLUSION: Wide affected part and high recurrence rate are characters of this disease, the tumor can be removed more accurately and the recurrence rate can be decreased when performing self-retaining laryngoscopy with removal of laryngeal tumor combined with hypodermic implantation of the removal condyloma acuminata at medial upper arm and submucous injection of interferon at vocal fold. Difficulty of decannulation can also be avoided after tracheotomy.

[Surgical treatment for patients with late-stage thyroid carcinoma].

OBJECTIVE: To explore the value of surgical treatment for patients with late-stage thyroid carcinoma. METHOD: Eleven cases of late-stage thyroid carcinoma underwent radical neck lymphnode dicission of the affected side plus functional neck lymphnode dicission on the opposite side. Three of them received lobectomy of the affected sides and excission of the isthmus. Six cases received lobectomy of affected sides, excission of isthmus and subtotal thyroidectomy of the opposite side; 2 of them received total thyroidectomy and parathyroid transpiantation. RESULT: With 9 cases followed up, 8 cases survived without recurrence and advancing. One for 6 years, 1 for 5 years, 2 for 3 years, 3 for 2 years and 1 for 1 year. The other one died, suffered from papillary adenocarcinoma combined with metastatic adenocarcinoma. CONCLUSION: For patients with late-stage thyroid carcinoma, operation should be performed as possible. Postoperative thyroid hormone administration could inhibit the development of the primary and metastatic lesions effectively. Preservation of parathyroid glands could improve the patient's life quality.

[Clinical analysis of primary head and neck non-Hodgkin's ].

OBJECTIVE: To research the clinical features of primary head and neck non-Hodgkin's lymphoms (NHL). METHOD: 62 patients with primary head and neck NHL were analyzed in the positions of focuses, clinical aspects, diagnosis and treatment. RESULT: Tonsilla palatina(25.8%), cervical lymphonodi (19.4%), nasal cavity and nasal sinuses(12.9%) were the common place of the origin of NHL which had various clinical manifestations. High-grade malignant lymphomas represented 75.8% of these cases whose I E stage and II E stage were 38.7% and 24.2% respectively. The complete response, partial response, and response rate were 75.8%, 14.5%, and 90.3%, respectively. Some patients had been long-term survival without tumor. CONCLUSION: Head and neck NHL is generally high degree malignancy. It often originates from outside lymph node and easily metastasizes to lymph node. Accurate surgical biopsy linking immunohistochemical test will be advantageous to make a definite diagnosis. Combining Chemotherapy and radiotherapy or operation should be put into practice to improve prognosis.