New metal-free one-pot synthesis of α-2-deoxy-Ulosides by microwave-assisted double Michael Addition of ß-enamino ketones.

New metal-free one-pot synthesis of α-2-deoxy-ulosides in moderate to good yields by microwave-assisted double Michael addition of various O-nucleophiles to ß-enamino ketones in the presence of 12 N HCl. These glycosyl additions occurred with high α-stereoselectivity and were complete in 10-25 min in 51-93% yield. In addition, high α-stereoselectivity was also observed when S-nucleophiles were examined.

[Analysis of efficacy of coblation assisted endoscope system for the treatment of parapharyngeal space tumors with transoral approach].

Objective:To summarize and analyze the feasibility, safety and efficacy of parapharyngeal space surgery assisted by coblation and endoscopic system with transoral approach. Methods:The data of 20 patients with parapharyngeal space tumors were retrospectively analyzed. All the patients underwent CT and/or MRI examination before surgery, and all underwent transoral approach assisted by coblation and endoscopic systems. The patients were followed up strictly after the operation, with a follow-up time of 8-56 months and the median follow-up time of 28 months. Results:Among the 20 patients, 18 （90%） were pathologically benign tumors and 2 （10%） were malignant tumors. The maximum tumor diameter was （4.4±1.6） cm, the operative time was （79.00±30.03） min, the intraoperative blood loss was （23.63±22.20） mL, and the postoperative pain VAS score was 2.8±1.4. There were 17 cases complete resection, and 3 cases of relapse, including 1 patient who died after distant metastasis of synovial sarcoma postoperative complications occurred in 2 cases, hoarseness in 1 case of neurofibroma and tongue extension deflection in 1 case of schwannoma. Conclusion:Coblation assisted endoscopic system for the treatment of parapharyngeal space tumors with transoral approach has no cervical scar, which is a satisfaction for the patients, less intraoperative bleeding, short operative time, mild postoperative reaction and quick recovery. However, external approach is still recommended for primary malignant lesions, extensive or highly vascularized lesions, tumors located on the lateral side of the internal carotid artery, less than 2 cm from the skull base, or lateral invasion of the deep lobe of the parotid gland, or a pleomorphic adenoma is considered or is found to be too large to be completely resected preoperatively or intraoperatively.

Serum levels of specific IgE to Staphylococcus aureus enterotoxins in patients with chronic rhinosinusitis.

The aim of this study was to determine the prevalence of Staphylococcus aureus enterotoxins (SEs) in the serum from patients with chronic rhinosinusitis (CRS) and its involvement in the condition. Thirty CRS patients without nasal polyps (CRSsNP), 40 CRS patients with nasal polyps (CRSwNP), and 30 healthy controls were enrolled in this study. Peripheral blood was obtained and analyzed to measure the serum levels of total IgE, specific IgE to SEA, SEB and SEC, and eosinophil cationic protein (ECP) using ImmunoCAP assays. The positive rate and level of serum specific IgE to SEB, but not to SEA or SEC, were significantly higher in CRSwNP patients compared with the controls (P=0.027 and P=0.021, respectively). No significant differences were found between CRSsNP patients and controls, or between CRSsNP and CRSwNP patients. Serum total IgE was significantly elevated and positively correlated with SEB-specific IgE in the CRSsNP (P<0.001; r=0.393, P=0.032) and CRSwNP (P<0.001; r=0.581, P<0.001) groups. ECP was also significantly increased in the CRSsNP (P=0.002) and CRSwNP (P<0.001) groups, but not correlated with specific IgE to SEs in either CRS group. The results suggest that SEB may play a role in the pathogenesis of CRSwNP.

Applied anatomy of the submental island flap and its clinical application in the repair of defects following hypopharyngeal carcinoma resection.

OBJECTIVE: To explore the feasibility of the submental island flap in the repair of hypopharyngeal defects. METHODS: We collected wet specimens of fresh cadaveric heads from the Han Chinese adult population for applied anatomy of the submental island flap, and followed five patients with pyriform sinus carcinoma after reconstruction surgery using submental island flaps. RESULTS: We found that the average length and width of the submental island flaps were (65.20 ± 11.69) mm and (46.70 ± 6.59) mm, respectively. The skin flap in all five patients survived after surgery, and tracheal tubes and gastric tubes were removed 7-36 days after surgery. Patients were followed up for 24-42 months, pharyngeal flaps grew well, and speech and swallowing functions were satisfactory. CONCLUSION: The submental island flap is a preferred material for the repair of hypopharyngeal defects after hypopharyngeal carcinoma resection, because of good blood supply, easy harvesting, and high survival rate.

Increased expression of toll-like receptors 2 and 4 and related cytokines in persistent allergic rhinitis.

OBJECTIVES: Toll-like receptors (TLRs) are the crucial components of host defenses and supposed to play a role in nasal inflammation such as chronic rhinosinusitis and seasonal allergic rhinitis. This study was performed to investigate the expression patterns of TLRs and related cytokines in persistent allergic rhinitis (PER). STUDY DESIGN: Experimental study of human nasal tissue. SETTING: Academic medical center. SUBJECTS AND METHODS: Nasal biopsy specimens were obtained from 21 patients with PER and 21 controls from December 2012 to September 2013. Messenger RNA (mRNA) expression of TLR1-9, interleukin (IL)-1, IL-6, IL-8, IL-12, interferon (IFN)-α, and tumor necrosis factor (TNF)-α was determined by quantitative reverse transcription polymerase chain reaction. The cellular localizations as well as protein expression of TLR2 and TLR4 were further detected by immunohistochemistry and Western blotting, respectively. RESULTS: TLR1-9 mRNA could be determined in nasal mucosa. Compared with the controls, mRNA expression of only TLR2 and TLR4 was significant higher in patients with PER (P < .05). In addition, mRNA expression of IL-6 and IL-8, but not IL-1, IL-12, IFN-α, and TNF-α, was upregulated in patients with PER vs control subjects (P < .05). However, these increased cytokines were not correlated with either TLR2 or TLR4 in patients with PER. Protein expression of TLR2 and TLR4 was consistent with mRNA levels (P < .05). The cellular distributions of TLR2 and TLR4 were localized in nasal epithelium, subepithelial glands and capillary endothelial cells, and immune cells. CONCLUSION: TLR2 and TLR4 are increased in patients with PER and may be one of the major contributors to the persistence and aggravation of allergic inflammation in PER.

Liver tumor detection and segmentation using kernel-based Extreme Learning Machine.

This paper presents an approach to detection and segmentation of liver tumors in 3D computed tomography (CT) images. The automatic detection of tumor can be formulized as novelty detection or two-class classification issue. The method can also be used for tumor segmentation, where each voxel is to be assigned with a correct label, either a tumor class or nontumor class. A voxel is represented with a rich feature vector that distinguishes itself from voxels in different classes. A fast learning algorithm Extreme Learning Machine (ELM) is trained as a voxel classifier. In automatic liver tumor detection, we propose and show that ELM can be trained as a one-class classifier with only healthy liver samples in training. It results in a method of tumor detection based on novelty detection. We compare it with two-class ELM. To extract the boundary of a tumor, we adopt the semi-automatic approach by randomly selecting samples in 3D space within a limited region of interest (ROI) for classifier training. Our approach is validated on a group of patients' CT data and the experiment shows good detection and encouraging segmentation results.

[The application of mitomycin C in treatment of airway scarring stenosis].

OBJECTIVE: To explore the feasibility and efficacy of mitomycin C(MMC) in the treatment of airway scarring stenosis. METHOD: The clinical materials of 11 patients with airway stenosis treated with MMC from 2008 to 2012 were analyzed retrospectively,including atresiaofnasopharynx/choanal atresia (2 cases), pharyngostenosis (1 case), and laryngotracheal stenosis (8 cases). All were treated with endoscopic surgery under general anesthesia. Patients received topical application of MMC (0.4 mg/ml) to the lesion for 5 minutes after the scar tissue removed and repeated five times. RESULT: No patients occurred restenosis in 2 months' follow-up postoperative. Two patients with atresiaofnasopharynx/choanal atresia achieved satisfactory ventilation outcome, 8 patients with laryngotracheal stenosis decannulated successfully, 1 patients with pharyngostenosis achieved near normal deglutition. CONCLUSION: MMC in endoscopic airway surgery is safe and effective in the treatment of airway stenosis and offers a high success rate for patients with grade 1-2 stenosis. It should be used as a first method in the treatment of airway stenosis.

[Treatment of allergic rhinitis with nasal mometasone furoate].

OBJECTIVE: To evaluate the effects of nasal mometasone furoate on moderate to severe allergic rhinitis. METHODS: Patients with moderate to severe allergic rhinitis were enrolled and received mometasone furoate nasal spray 200 microg once daily for four weeks. Four hundreds and sixty-three patients completed the study. We weekly interviewed the patients to evaluate the symptoms, and the affection of disease on night sleep and daily life. Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ) and Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ) were used to evaluate the quality of life. RESULTS: The individual and total symptomatic scores of week 1, week 2 and week 4 decreased compared with baseline. The scores of Mini-RQLQ and NRQLQ of week 1, week 2 and week 4 decreased compared with baseline too. The scores of the next visit were significantly lower than those of the previous visit (P < 0.01). CONCLUSIONS: A four-week administration of mometasone furoate nasal spray can effectively treat allergic rhinitis.

Mometasone furoate nasal spray reduces symptoms and improves quality of life in Chinese patients with moderate to severe allergic rhinitis: a multicenter open-label study.

CONCLUSION: Mometasone furoate nasal spray (MFNS) can reduce the symptoms and improve quality of life in Chinese patients with moderate to severe allergic rhinitis (AR). OBJECTIVE: To evaluate the effects of MF on symptoms and quality of life in Chinese patients with moderate to severe AR. PATIENTS AND METHODS: In a multicenter and open-label study, 500 patients with moderate to severe AR were enrolled and received MFNS 200 microg once daily. We visited the patients four times (at baseline, and week 1, 2, and 4) to record symptom scores and the influence of AR on daytime activities and quality of sleep. The Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ) and the Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ) were used in this study. RESULTS: Compared with the baseline, MFNS significantly reduced the total and individual symptom scores and nocturnal sleep and daytime activities scores at week 1, 2, and 4 according to the Mini-RQLQ and NRQLQ.