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Laryngopharyngeal reflux disease (LPRD) is an inflammatory condition in the laryngopharynx and upper aerodigestive tract mucosa caused by reflux of stomach contents beyond the esophagus. LPRD commonly presents with sym-ptoms such as hoarseness, cough, sore throat, a feeling of throat obstruction, excessive throat mucus. This complex condition is thought to involve both reflux and reflex mechanisms, but a clear understanding of its molecular mechanisms is still lacking. Currently, there is no standardized diagnosis or treatment protocol. Therapeutic strategies for LPRD mainly include lifestyle modifications, proton pump inhibitors and endoscopic surgery. This paper seeks to provide a comprehensive overview of the existing literature regarding the mechanisms, patho-physiology and treatment of LPRD. We also provide an in-depth exploration of the association between LPRD and gastroesophageal reflux disease., Competing Interests: Conflict-of-interest statement: The authors have no conflicts of interest to declare., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: This cross-sectional study aimed to determine the epidemiology of olfactory and gustatory dysfunctions related to COVID-19 in China., Methods: This study was conducted by 45 tertiary Grade-A hospitals in China. Online and offline questionnaire data were obtained from patients infected with COVID-19 between December 28, 2022, and February 21, 2023. The collected information included basic demographics, medical history, smoking and drinking history, vaccination history, changes in olfactory and gustatory functions before and after infection, and other postinfection symptoms, as well as the duration and improvement status of olfactory and gustatory disorders., Results: Complete questionnaires were obtained from 35,566 subjects. The overall incidence of olfactory and taste dysfunction was 67.75%. Being female or being a cigarette smoker increased the likelihood of developing olfactory and taste dysfunction. Having received four doses of the vaccine or having good oral health or being a alcohol drinker decreased the risk of such dysfunction. Before infection, the average olfactory and taste VAS scores were 8.41 and 8.51, respectively; after infection, they decreased to 3.69 and 4.29 and recovered to 5.83 and 6.55 by the time of the survey. The median duration of dysosmia and dysgeusia was 15 and 12 days, respectively, with 0.5% of patients having symptoms lasting for more than 28 days. The overall self-reported improvement rate was 59.16%. Recovery was higher in males, never smokers, those who received two or three vaccine doses, and those that had never experienced dental health issues, or chronic accompanying symptoms., Conclusions: The incidence of dysosmia and dysgeusia following infection with the SARS-CoV-2 virus is high in China. Incidence and prognosis are influenced by several factors, including sex, SARS-CoV-2 vaccination, history of head-facial trauma, nasal and oral health status, smoking and drinking history, and the persistence of accompanying symptoms., Competing Interests: Professor Lei Cheng, Hua‐Bin Li, Jian‐Feng Liu, Zhen‐Lin Wang, Chang‐Qing Zhao and Dong‐Dong Zhu are the members of World Journal of Otorhinolaryngology ‐ Head and Neck Surgery editorial board and are not involved in the peer review process of this article. The other authors declare no conflict of interest., (© 2024 The Authors. World Journal of Otorhinolaryngology ‐ Head and Neck Surgery published by John Wiley & Sons Ltd on behalf of Chinese Medical Association.)

Objective: Acute kidney injury (AKI) seriously affects the health of both pregnant women and fetuses. This study aimed to investigate the clinical characteristics and prognosis of pregnancy-related AKI (PR-AKI)., Methods: This case series study enrolled pregnant women with PR-AKI admitted to the surgical intensive care unit of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine between January 2010 and December 2020., Results: Thirty-one PR-AKI patients were enrolled with a mean age of 29.16 ± 4.97 years. Seventeen pregnant women (54.84%) had complete recovery of renal function, 5 (16.13%) had partial recovery of renal function, 2 (6.45%) patients had no renal function improvement, and 7 (22.58%) died. Among the 31 patients with 35 fetuses, 25 (80.6%) pregnant women had poor fetal outcomes, including 5 cases of stillbirths, 5 neonatal asphyxia, 18 premature births, 10 low birth weight, and 8 deficient birth weight infants. Compared to cases with good fetal outcomes, cases with poor fetal outcomes had significantly shorter gestational weeks (39.26 ± 1.53 vs. 31.62 ± 5.50, P = 0.002), lower platelet count (217.13 ± 122.87 vs. 90.24 ± 84.88, P = 0.005), lower hemoglobin (94.19 ± 13.21 vs. 74.48 ± 20.78, P = 0.036), higher blood urea nitrogen (11.87 ± 4.28 vs. 19.47 ± 10.98, P = 0.013), and higher uric acid (262.41 ± 167.00 vs. 586.87 ± 144.52, P < 0.001)., Conclusions: The maternal renal function of women with PR-AKI might improve after treatment, but occurrence rates of adverse fetal outcomes were still high., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: A higher compliance with clinical guidelines helps improve treatment outcomes. But the clinical practice of otolaryngologists is not always consistent with guidelines., Objective: To describe otolaryngologists' compliance with guidelines about allergic rhinitis (AR) management and identify factors responsible for the discordance between clinical practice and guideline recommendations in China., Methods: A cross-sectional nationwide survey was designed and conducted via an online platform. Recruitment was done by emailing otolaryngologists registered in the Chinese Society of Otorhinolaryngology-Head and Neck Surgery or by inviting otolaryngologists to scan a Quick Respond (QR) code that linked to the questionnaire at various academic meetings., Results: A total of 2142 otolaryngologists were eligible and completed the survey. Of them, 64.7% had over 10 years work experience and 97.4% had a bachelor's degree or higher. About 18.3% of the participants strictly copied the guideline in clinical practice, while 73.7% used the guideline that had been adjusted according to their clinical experience. Otolaryngologists were most concerned about the efficacy, safety, and minimum age of AR medications, and least concerned about patient preferences. Regarding the use of intranasal steroids (INS), leukotriene receptor antagonists (LTRA), and H1-antihistamines, 86.8%, 55.7% and 51.2% of otolaryngologists complied with the guideline recommendations, respectively. Educational background was a factor affecting the compliance with guidelines and acceptance of INS., Conclusion: A vast majority of Chinese otolaryngologists complied with the current Chinese AR guidelines. A difference still existed between the otolaryngologists' real-world and guideline-recommended management. The otolaryngologists should pay more attention to patient preferences. A higher education could improve otolaryngologists' adherence to the guidelines., Competing Interests: All authors declare that they do not have any conflicts of interest within the scope of the submitted work., (© 2021 The Authors.)

Background: The activation of the nuclear factor-κB (NF-κB) signaling pathway gives rise to inflammation in the pathogenesis of lupus nephritis (LN), with A20 serving as a negative feedback regulator and ubiquitin C‑terminal hydrolase L1 (UCH-L1) acting as a downstream target protein. However, their roles in the mechanism of LN remain undetermined., Methods: In the present study, the expression of A20 and UCH-L1, the activity of NF-κB and ubiquitin-proteasome system (UPS) were measured in MRL/lpr mice and A20 gene silenced podocytes. The severity of podocyte injury and immune complex deposits were detected by transmission electron microscopy., Results: The in vivo experiments revealed that A20 failed to terminate the activation of NF-κB, which was accompanied by UCH-L1 overexpression, ubiquitin accumulation, and glomerular injury in LN mice. Immunosuppression therapy did improve LN progression by attenuating A20 deficiency. In vitro experiments confirmed that tumor necrosis factor-α induced NF-κB activation, which led to UCH-L1 overexpression, UPS impairment, the upregulation of desmin and the downregulation of synaptopodin in A20 gene silenced podocytes., Conclusion: Thus, the results of the present study suggest that A20 regulates UCH-L1 expression via the NF-κB signaling pathway and A20 deficiency might play an important role in LN pathogenesis. Therefore, the A20 protein may serve as a promising therapeutic target for LN.

Lupus nephritis (LN), an autoimmune kidney disease caused by systemic lupus erythematosus (SLE), is the inflammation of the kidney. Although the treatment of LN is still a therapeutic challenge for many practitioners, the present study aims to provide a new insight for the treatment and management. The study aims to explore the effect of A20 on LN in relation to the nuclear factor-kappa B (NF-κB) signaling pathway. MRL/lpr mice were used as the LN mouse model. Next, A20, UCH-L1, and NF-κB expression in LN patients and MRL/lpr mice was determined. A20 was upregulated in podocytes to assess biological functions of A20 in LN. Furthermore, to further investigate the pivotal role of the NF-κB pathway in LN, the NF-κB pathway was blocked in podocytes. Next, UCH-L1 was downregulated in MRL/lpr mice to assess biological functions of UCH-L1 in LN. A20 was downregulated, whereas UCH-L1 was upregulated in LN. Overexpressed A20 declined NF-κB, UCH-L1 expression, and the extent of p65 phosphorylation. A20 overexpression or UCH-L1 inhibition increased expression of synaptoporin and nephrin but decreased desmin expression and ubiquitin accumulation level in podocytes. Moreover, A20 overexpression or UCH-L1 inhibition increased the podocyte number but decreased protein level of cleaved caspase-3, podocyte lesion improvement, decreased foot process width, glomerulus basement membrane, and foot process fusion rate. In addition, urine protein, blood urea nitrogen, serum creatinine, and ds-DNA antibody levels decreased with elevated A20 or depleted UCH-L1. Collectively, it could be concluded that A20 protects against podocyte injury in LN via UCH-L1 by inactivating the NF-κB signaling pathway., (© 2019 Wiley Periodicals, Inc.)

Background: Type 1 diabetes mellitus (DM) is associated with severe osteoporosis, which is still a great challenge in the clinic. This work aimed to investigate the skeletal effects of FK506 in a rat model of streptozocin induced type 1 DM., Methods: Rats were divided into three groups: control (CTL), DM rats and DM rats treated with FK506. Dual energy X-ray absorption, micro-computed tomography, bone mechanics and bone histology were used for skeletal analysis. Bone marrow adipocytes infiltrations were detected by oil red O stain and H&E stain. In addition, the protein expression of adipocyte-specific makers (PPAR-γ, C/EBP-αβ), osteoblast-specific markers (Runx2, Osterix) and nuclear translocation of β-catenin in femurs were determined by western blot., Results: In the study, bone mineral density of femurs and lumbar vertebras in diabetic rats were increased after FK506 administration. FK506 treatment resulted in higher cancellous bone volume but had no significant effect on cortical bones in diabetic rats. The ultimate force and work to failure were increased in DM+FK506 group, while they were reduced in the DM group. Compared with the CTL, the infiltration of bone marrow adipocytes was significantly increased in the DM group, which was reduced after the treatment of FK506. Besides, the expression levels of Runx2 and Osterix were up-regulated, and that of PPAR-γ and C/EBP-α were down-regulated in diabetic rats after FK506 treatment. In addition, the nuclear translocation of β-catenin protein levels were increased in diabetic rats after the treatment of FK506., Conclusions: Our study indicated that FK506 could alleviate bone loss in diabetic rats. This effects could be due to the results of enhancing osteogenesis and inhibiting adipogenesis, which might be regulated by activation the nuclear translocation of β-catenin., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

Background/aims: Nephrolithiasis plagues a great number of patients all over the world. Increasing evidence shows that the extracellular signal-regulated kinase (ERK) signaling pathway and renal tubular epithelial cell (RTEC) dysfunction and attrition are central to the pathogenesis of kidney diseases. Mucin 4 (MUC4) is reported as an activator of ERK signaling pathway in epithelial cells. In this study, using rat models of calcium oxalate (CaOx) nephrolithiasis, the present study aims to define the roles of MUC4 and ERK signaling pathway as contributors to oxidative stress and CaOx crystal formation in RTEC., Methods: Data sets of nephrolithiasis were searched using GEO database and a heat flow map was drawn. Then MUC4 function was predicted. Wistar rats were prepared for the purpose of model establishment of ethylene glycol and ammonium chloride induced CaOx nephrolithiasis. In order to assess the detailed regulatory mechanism of MUC4 silencing on the ERK signaling pathway and RTEC, we used recombinant plasmid to downregulate MUC4 expression in Wistar rat-based models. Samples from rat urine, serum and kidney tissues were reviewed to identify oxalic acid and calcium contents, BUN, Cr, Ca2+ and P3+ levels, calcium crystal formation in renal tubules and MUC4 positive expression rate. Finally, RT-qPCR, Western blot analysis, and ELISA were employed to access oxidative stress state and CaOx crystal formation in RTEC., Results: Initially, MUC4 was found to have an influence on the process of nephrolithiasis. MUC4 was upregulated in the CaOx nephrolithiasis model rats. We proved that the silencing of MUC4 triggered the inactivation of ERK signaling pathway. Following the silencing of MUC4 or the inhibition of ERK signaling pathway, the oxalic acid and calcium contents in rat urine, BUN, Cr, Ca2+ and P3+ levels in rat serum, p-ERK1/2, MCP-1 and OPN expressions in RTEC and H2O2 and MDA levels in the cultured supernatant were downregulated, but the GSH-Px, CAT and SOD levels in the cultured supernatant were increased. Moreover, MUC4 silencing or ERK signaling pathway inactivation may decrease the formation of CaOx crystals., Conclusion: Taken together, silencing of MUC4 can inactivate the ERK signaling pathway and further restrain oxidative stress and CaOx crystal formation in RTEC. Thus, MUC4 represents a potential investigative focus target in nephrolithiasis., (© 2018 The Author(s). Published by S. Karger AG, Basel.)

Objective: Asthma is one of the most common chronic diseases and associated with significant morbidity and mortality. However, few data on occupational and environmental risk factors of asthma are available, particularly in Asian adults. Based on a national cross-sectional survey, we assessed the prevalence and risk factors of asthma in Chinese adults., Methods: A total of 9974 participants aged 15 years and over in seven Chinese cities were selected using a stratified four-stage random sampling. All participants were interviewed face-to-face in their homes using a standardized self-administered questionnaire. Multivariate logistic regression analyses were adopted to determine various risk factors for asthma., Results: The prevalence of self-reported lifetime asthma was 2.46% among the entire adult population, 3.02% among males and 1.93% among females. The prevalence varied by age group, ethnicity, marital status, education, and floor space per person ( p < 0.05). After adjusting for socio-demographic variables and smoking, we found independent occupational and environmental determinants of asthma, including a clearance-related job (OR = 2.28, 95%CI: 1.07-4.89), occupational exposure to industrial or occupational poisonous gas (OR = 4.21, 95%CI: 2.43-7.30), having large amounts of carpet in the workplace (OR = 2.61, 95%CI: 1.20-5.69) and using coal for cooking (OR = 2.65, 95%CI: 1.26-5.57)., Conclusions: Asthma is a serious public health problem in China. Our study provides important updated information on the prevalence of asthma and its associated risk factors, which may help us better understand the epidemiology of asthma and prevent this disorder., Competing Interests: The authors declare no conflict of interests.

Background: Chronic rhinosinusitis (CRS) is defined as a condition of inflammation in the paranasal sinus mucosa persisting for more than 12 weeks. We previously reported that the prevalence of CRS was about 8 % in China. Here, we aim to investigate the occupational and environmental risk factors associated with CRS., Methods: Data were collected from seven Chinese cities: Urumqi, Changchun, Beijing, Wuhan, Chengdu, Huaian and Guangzhou. CRS was diagnosed according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EP(3)OS) document. Participants were asked to complete a standardized questionnaire, which was developed by the Global Allergy and Asthma European Network (GA(2)LEN) project and covered sociodemographic characteristics, CRS-related symptoms and occupational and environmental exposures. We evaluated the association between CRS and various occupational and environmental factors using odds ratios (ORs) and 95 % confidence intervals (95 % CIs)., Results: The total study population consisted of 10,633 subjects, 850 (7.99 %) of whom were defined as having CRS according to the EP(3)OS criteria. We found that there were significant associations between occupational and environmental factors and CRS. Specifically, having a clearance-related job, occupational exposure to dust, occupational exposure to poisonous gas, a pet at home or carpet at home or at the workplace were risk factors for CRS. Additionally, the method used to keep warm in winter, the duration of time spent using air conditioning in summer and the frequency of exposure to mouldy or damp environments were significantly different in subjects with and without CRS., Conclusions: Our data showed that some occupational and environmental exposures are strongly associated with CRS, which aids in understanding the epidemiology of CRS.

In view of the climate changes caused by the continuously rising levels of atmospheric CO2 , advanced technologies associated with CO2 conversion are highly desirable. In recent decades, electrochemical reduction of CO2 has been extensively studied since it can reduce CO2 to value-added chemicals and fuels. Considering the sluggish reaction kinetics of the CO2 molecule, efficient and robust electrocatalysts are required to promote this conversion reaction. Here, recent progress and opportunities in inorganic heterogeneous electrocatalysts for CO2 reduction are discussed, from the viewpoint of both experimental and computational aspects. Based on elemental composition, the inorganic catalysts presented here are classified into four groups: metals, transition-metal oxides, transition-metal chalcogenides, and carbon-based materials. However, despite encouraging accomplishments made in this area, substantial advances in CO2 electrolysis are still needed to meet the criteria for practical applications. Therefore, in the last part, several promising strategies, including surface engineering, chemical modification, nanostructured catalysts, and composite materials, are proposed to facilitate the future development of CO2 electroreduction., (© 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Background: Previous studies have shown that high glucose (HG) induced endothelial cell (EC) damage via a phenotypic transition of EC. There is increasing evidence suggesting the role of inflammatory cytokines in mediated HG-induced EC damage. However, little is known about the potential role of interleukin-1β (IL-1β) in the process. The aim of present study was to investigate whether IL-1β mediated HG-induced phenotypic transition in human aortic endothelial cells (HAECs) and to determine the possible underlying mechanism., Methods: Primary HAECs were exposed to normal glucose (NG, 5.5 nM), high glucose (HG,30 nM), IL-1β (10 ng/ml), HG + IL-1β (10 ng/ml) and HG + anti-IL-1β antibodies (1000 ng/ml) or HG + IL-1β small interfering RNA (siRNA). Pathological changes were investigated using confocal microscopy and electron microscopy. Confocal microscopy was performed to detect the co-expression of CD31 and fibroblast specific protein 1 (FSP1). To study the effect of protein kinase C-β (PKCβ) activation on IL-1β in HAECs, HAECs were stimulated with 30 nM PMA (PKCβ activator) and 0.3 μM PKCβ inhibition (LY317615) for 48 h in the NG or HG group. The expressions of PKCβ and IL-1β were detected by RT-PCR and Western blot. And the concentration of IL-1β in the supernatant of HAECs was measured by ELISA. The expressions of FSP1, a-SMA and CD31 were detected by Western blot., Results: It was shown that the HG resulted in significant increase in the expressions of PKCβ and IL-1β in dose-and time-dependent manners. The HG or exogenous IL-1β alone inhibited the expression of CD31 and markly increased the expressions of FSP1 and α-SMA. Furthermore, we observed that the HG and IL-1β synergistically increased FSP1 and a-SMA expressions compared with the HG or IL-1β alone group (P < 0.05). Confocal microscopy revealed a colocalization of CD31 and FSP1 and that some cells acquired spindle-shaped morphologies and a loss of CD31 staining. Electron microscopy showed that the HG resulted in the increased microfilamentation and a roughened endoplasmic reticulum structure in the cytoplasm. However, the changes above were attenuated by the intervention of anti-IL-1β antibodies or IL-1β siRNA (P < 0.05). In addition, the PMA induced the expressions of PKCβ and IL-1β in HAECs. The PKCβ activation may mediate the effect of the HG on IL-1β production, which could be attenuated by the PKCβ selective inhibitor (LY317615) (P < 0.05)., Conclusions: Our findings suggested that HG-induced phenotypic transition of HAECs might require IL-β activation via the PKCβ pathway.

Objectives: Hydrogen sulphide (H2 S) has been found to be involved in cardiovascular diseases, but the exact mechanism has not been clarified. The purpose of this study was to investigate whether sodium hydrogen sulphide (NaHS), the donor of H2 S, can improve diabetic cardiomyopathy by reversing disordered calcium-handling system in sarcoplasmic reticulum (SR)., Methods: Sprague Dawley rats were injected with streptozotocin (STZ, 60 mg/kg, i.p.) to build diabetic model. Treatment groups included: aminoguanidine group (AG, 100 mg/kg, p.o.) and NaHS group (5 mg/kg per day, s.c.)., Key Findings: Cardiac dysfunction and myocardial hypertrophy were found in diabetic model (DM) group, along with increased ROS levels and upregulated mRNA and protein expressions of NADPH p22(phox) , endothelin A receptor (ETA ) and protein kinase Cε (PKCε). Expressions of calcium-handling proteins in SR including FK506-binding proteins (FKBP12.6), sarcoplasmic reticulum Ca(2+) ATPase (SERCA2a) and calsequestrin 2 (CASQ2) were downregulated in DM group, accompanied by elevated concentration of diastolic free calcium in high glucose-incubated cardiomyocytes, indicating of calcium leak. After treated by NaHS, these abnormalities were attenuated significantly., Conclusions: Exogenous H2 S played a protective role in diabetic cardiomyopathy by inhibiting abnormal calcium-handling system in SR and ET-NADPH oxidase-PKCε pathway., (© 2016 Royal Pharmaceutical Society.)

Pro-opiomelancortin (POMC) plays important roles in the regulation of food intake and energy expenditure. The sheep exon 3 of gene POMC was amplified and sequenced by screening the DNA pools to select single nuclear polymorphisms and analyze the association with the growth traits. Two silent SNP mutations (g.273 T/C and g.456 G/A) in Hu sheep were identified. PCR-restriction fragment length polymorphism (RFLP) was used to test the g.273 T/C and the association between the g.273 T/C polymorphism and some growth traits was analyzed in Hu sheep (n = 162) and East Friesian x Hu crossbred sheep (n=130). The results showed that three genotypes, TT, TC and CC, were detected in Hu sheep with the frequencies of 0.469, 0.438 and 0.093, respectively. Two genotypes, TT and TC, were detected in East Friesian x Hu crossbred sheep with the frequencies of 0.754 and 0.246, respectively. The association analysis showed that in Hu sheep the two-month weaning weight, four-month rump height of genotype CC and the four-month body length, cannon circumference of genotype TC were significantly higher than those of genotype TT (P < 0.05); the four- and six-month weight of genotype CC were significantly higher than those of genotypes TT and TC (P < 0.01); the four-month body height and body length of genotype CC were significantly higher than those of genotypes TT (P < 0.01) and TC (P < 0.05); the four-month cannon circumference of CC genotype was significantly higher than that of TT genotype (P < 0.01). In East Friesian x Hu crossbred sheep the two-month weaning weight, four-month weight, body height, body length, chest depth and cannon circumference of genotype TC were significantly higher than those of genotype TT (P < 0.05); the six-month weight of genotype TC was significantly higher than that of genotype CC (P < 0.01). In conclusion, the exon 3 of gene POMC was associated with growth traits, and C allele was beneficial to the increase of body weight and body size traits of sheep, which potentially afford a good foundation for further study on POMC gene as aided breeding markers for growth traits in sheep.

Objective: To test the immunoglobulin free light chain (FLC) from nasal secretion(s) and serum of patients with allergic rhinitis and non-allergic rhinitis for the purpose of exploring the possible immunological mechanism., Methods: Sixty consecutive patients were selected between September and December in 2009, involving 30 patients with allergic rhinitis and 30 patients with non-allergic rhinitis, diagnosed by symptoms, signs, SPT and sIgE. Thirty volunteers was chosen as health control (HC). ELISA was used to detect the total IgE, eosinophil cationic protein (ECP), mast cell tryptase (MCT), κFLC, λFLC in nasal secretion and serum. The data was statistically analyzed by SPSS 17.0 software., Results: According to the VAS scores, the nasal symptoms of AR and NAR, including sneeze, nasal discharge, nasal obstruction and nasal itching were compared. There was no statistical difference (t value was 1.189, 0.741, 0.758, 0.797, respectively, P < 0.5); In serum, κFLC, λFLC, IgE, ECP & MCT were increased in NAR compared to HC (P < 0.05); λFLC was increased in NAR compared to AR group (P < 0.05), κFLC and ECP were increased in AR. There was no significant difference between AR and NAR (P < 0.05); In nasal secretion, κFLC, λFLC, IgE, ECP and MCT were increased in AR and NAR compared to HC, and the ECP and IgE were significantly increased in AR compared to NAR (P < 0.05). ; In nasal secretion, the FLCs revealed a significantly higher correlation with MCT (r value was 0.518 and 0.484, P < 0.01), and in serum revealed a significant correlation with ECP (r value was 0.343 and 0.342, P < 0.01)., Conclusions: Immunoglobulin free light chain takes part in the path of physiological process of allergic rhinitis and non-allergic rhinitis with the immunological mechanism.

Objective: To evaluate the three-year efficacy and safety with standardized dust mite subcutaneous immunotherapy in patients with allergic rhinitis., Methods: Ninety patients who were diagnosed as allergic to mite by skin prick test and serum IgE were include in the standardized allergen-specific dose-escalation regimen. Nasal symptom score (0-3) were collected before treatment and three years after treatment; VAS (visual analogue scale, 0-10) of all nasal symptoms and drug use score were collected every four months; frequency of local and systemic reactions were recorded in the duration of dose escalation and maintenance., Results: Nasal blocking, sneeze, rhinorrhea and nasal itch were significantly improved after 3 years treatment (before treatment: 2[2;3], 2[2;3], 2[2;3], 2[1;2] ; after treatment: all were 0[0;0]; Z value were -8.310, -8.408, -8.377, -8.287, all P were 0.000). VAS of all nasal symptoms and drug use score decreased dramatically after escalation period (before treatment: 8.00[7.00;8.85], 2.00[1.50;2.00]; after treatment: 1.00[1.00;1.50], 0 [0;0]; Z value were -8.287, -8.248, P value 0.086, 0.744), and maintained afterwards (F value were 2.483, 0.296; P value were 0.086, 0.744). Ninety-eight case times (64.47%) local reactions mainly happened in maintenance period; the frequency of systemic reactions was 2.54%., Conclusion: The standardized specific allergen immunotherapy for allergic rhinitis is safe and effective.

Background: Interleukin-l7 (IL-17), which exerts strong pro-inflammatory effects, has emerged as an important mediator in inflammation-associated cancer. The aim of this study was to clarify the relationship between IL-17 and tumor associated macrophages (TAMs), and the correlation of the microvessel density in the development of laryngeal squamous cell carcinoma (LSCC)., Methods: Histopathological observations and immunohistochemistry staining for IL-17, CD68, and CD34 were performed on 72 specimens (32 cases of LSCC, 20 cases of adjacent tissues of carcinoma as controls, and 20 cases of chronic hypertrophic laryngitis). Double immunohistochemical staining was done to determine which cells expressed IL-17. Real-time quantitative PCR determined the mRNA expression of IL-17. ELISA was used to detect the expression of the serum level of IL-17 in the three groups., Results: The inflammation response had increased in LSCC. Overexpression of IL-17 and CD68 protein were seen in LSCC (P < 0.01). The expression of IL-17 was different between well and poorly differentiated LSCC (P < 0.01). The IL-17 expressing cells were mainly located in macrophages (CD68(+)/IL17(+)) as demonstrated by double immunohistochemical staining. IL-17 expression significantly correlated with high microvessel density (CD34(+)) in LSCC (P < 0.05). Relatively higher mRNA expression levels of IL-17 were seen in LSCC compared to the controls (P < 0.05). The serum expression of IL-17 was similar among the three groups (P > 0.05)., Conclusion: IL-17 was expressed by TAMs, and IL-17 may significantly correlate to the differentiation and angiogenesis in the development of LSCC.

Background: Interleukin (IL)-17A, mainly produced by Th17 cells, was previously described as an inflammatory cytokine that induces a profile of proinflammatory cytokines, chemokines, and metalloproteinases. Recent studies have revealed that IL-17 is correlated with inflammatory lung disorders by triggering an accumulation of neutrophils. More recently, we have shown that the expression of IL-17 may be involved in the development of nasal polyps (NPs). Here, we describe the characterization of IL-17 expression in patients with chronic rhinosinusitis with nasal polyps (CRSwNPs) from northeast China., Methods: Histopathological observations and immunohistochemical (IHC) staining for IL-17, IL-17RD, myeloperoxidase, and CD68 were performed on 52 specimens (42 NPs and 10 specimens of middle turbinate as normal control). Double IHC staining was performed to determine which cells expressed IL-17. The serum expression levels of IL-17 were determined by ELISA and the mRNA expression of IL-17 and Th17 cells transcription factor retinoid acid-related orphan receptor C (RORc) was determined by real-time quantitative polymerase chain reaction., Results: 42.9% of CRSwNP specimens presented eosinophilic inflammation; 35.7% of CRSwNP specimens presented neutrophilic inflammation. Relatively higher mRNA expression levels of IL-17 and RORc were seen in CRSwNPs compared with the controls. A marked increase of IL-17 and IL-17RD proteins (p < 0.01) were seen in CRSwNP group. The expression levels of IL-17 and RORc did not differ between eosinophilic and noneosinophilic CRSwNPs (p > 0.05). However, high expression levels of IL-17RD were seen in noneosinophilic CRSwNPs compared with eosinophilic CRSwNPs (p < 0.05). The serum expression of IL-17 in CRSwNP patients was similar to healthy controls. The IL-17 expressing cells mainly were the macrophages as shown by double IHC staining., Conclusion: Chinese CRSwNP patients showed an enhanced Th17 response regardless of eosinophilic or noneosinophilic inflammation. IL-17 may be involved in the development of NPs through its local immune modulation.

Objective: To investigate the basic clinical features of non-allergic rhinitis (NAR) in age, sex, incentives, and the effect of treatment with combined intranasal steroids and antihistamines., Methods: One hundred consecutive NAR patients were included in this study and the age, gender, predisposing factors and clinical symptoms were analyzed. Combined intranasal steroids and antihistamines used for 8 weeks, the symptoms were recorded before and after treatment with visual analogue scale(VAS) score as the assessment of treatment effects. SPSS 17.0 software was used to analyze the data., Results: Ninety-three NAR patients were adults, and the sex ratio was 1:1.2 (male:female), and the peak age incidence was between 30 - 39 years old. The main nasal symptoms were sneezing (96 cases), rhinorrhea (88 cases), nasal blockage (72 cases) and nasal itching (69 cases). The symptoms of eye and respiratory tract were always accompanied as eye itching (49 cases), tears (32 cases), congestion (22 cases), swelling (13 cases), cough (21 cases), suffocation (19 cases), chest compression (13 cases), wheezing (10 cases); Seventy-nine (79.0%) patients could indicate at least one kind of incentives, the temperature change (54 cases), dust (28 cases), irritating odor (21 cases) was the main incentive of NAR. Forty-seven patients completed the combined treatment of intranasal steroids and antihistamines, 38 (80.9%) patients were satisfied with the result with all symptoms relieved except wheezing (P < 0.05), but 36 patients had the NAR returned when they were exposed with the predisposing factors in the coming year; the remaining 9 (19.1%) patients failed the treatment., Conclusions: The clinical features of NAR were as follows: adult constituted the main patient population, women were slightly more than man but with no difference between genders; sneezing and nasal discharge were the main clinical symptoms, always more than 1 incentives. The combination of intranasal steroids and antihistamines could control the most of clinical symptoms.

Background: Skin-prick testing (SPT) is the most common screening method for allergy evaluation. The detection of serum-specific immunoglobulin E (sIgE) is also commonly used. The sensitivity and specificity of these testing methods may vary due to type of causative allergen and type of allergic manifestation. The purpose of this study was to evaluate the correlation between two methods of measuring sIgE (AllergyScreen [Mediwiss Analytic GmbH, Moers, Germany] and ImmunoCAP [Pharmacia, Uppsala, Sweden]) and SPT for the diagnosis of allergic rhinitis (AR)., Methods: All 216 patients who were referred to the allergist for suspected AR from June to October 2009 had SPT and the two serological tests. One hundred fifty-eight patients had a positive clinical history and a related positive SPT. The SPT was used as reference standard, and we selected three allergens (Dermatophagoides pteronyssinus, mugwort, and ragweed), which were common in fall in northeast China, to analyze the correlation of the two serum tests and SPT., Results: Compared with the SPT, the diagnostic indexes (accuracy, sensitivity and specificity) of the AllergyScreen system and the ImmunoCAP system were 0.819 versus 0.810, 0.780 versus 0.872, and 0.862 versus 0.741, respectively. The accuracy was similar between the two systems (p > 0.05). The ImmunoCAP system method had a higher sensitivity (p < 0.01). The AllergyScreen system had a higher specificity (p < 0.01)., Conclusion: These data support that the AllergyScreen system and ImmunoCAP system can identify potentially significant allergens in the diagnosis of AR in patients from northeastern China.

Objective: To investigate the clinical symptom, precipitating factor, associated symptom, family history and life quality of pediatric patients with allergic rhinitis, and to analyze the characteristic of clinical symptoms., Methods: A questionnaire survey on pediatric AR patients since June 2008 to June 2010, one hundred and forty-eight pediatric AR patients were divided into 2 groups, group A (n = 43) included children aged from 3.2 to 6.0, group B (n = 105) included children aged from 6.1 to 14.8. The severity degree of clinical symptom was assessed by visual analogue scale., Results: Preschool age children had more severe rhinocleisis, more severe cough and less rhinorrhea than school age children (χ(2) value were 29.194, 12.277 and 16.904, respectively, P < 0.05). According to the classification criteria of ARIA 2008, preschool children had more mild intermittent AR and less moderate-severe persistent AR than school age children (χ(2) value were 20.370 and 24.546, P < 0.05). The precipitating factor of common cold, fitment, climate, environment factors were 22.3% (33/148), 5.4% (8/148), 16.2% (24/148), 3.4% (5/148), the others was 4.7% (7/148), no obvious precipitating factor was 48.0% (71/148). The rate of parent or parents who had allergic disease history was 11.5% (17/148). Quality of sleep that 66.2% (98/148) were upset and 62.2% (92/148) had no cathexis., Conclusions: The preschool children have different clinical symptom characteristic from the school age children, and we got some clinical data of pediatric AR patients, those were beneficial to the diagnose and therapy of pediatric AR. The clinical data obtained in this study from pediatric AR patients are beneficial to the diagnosis and therapy of pediatric AR.

Objective: To compare and analyze the clinical characteristics in patients with hyperreactive non-allergic rhinitis (HNAR) and allergic rhinitis (AR)., Methods: A questionnaire survey on AR and HNAR patients between January and August 2009 was conducted. The clinical data of 298 AR patients and 100 HNAR patients were analyzed, including gender, age distribution, seasonal, clinical symptom and induced factors., Results: The number of male patients was more than female in AR, while in NAR, the number of female patients was more than male (χ(2) = 6.415, P = 0.01). The highest morbidity age in AR was teenagers, aged between 10 - 19 (χ(2) = 12.772, P = 0.00), while in HNAR, the highest morbidity age was middle-aged and youth, aged between 30 - 39 (χ(2) = 51.533, P = 0.00). The main onset seasons in AR was autumn, while there was no seasonal diversity in HNAR. The main allergen in AR was mugwort and ragweed, consistent with the vegetative cover characteristic in Jilin province. The main classification of AR was moderate-severe persistent (χ(2) = 123.991, P = 0.00), while the main classification of HNAR was moderate-severe intermittent (χ(2) = 97.420, P = 0.00). The clinical symptoms were significantly different between AR and HNAR except rhinocnesmus (all P < 0.05). There was consistency about non-specificity induced factors in AR and HNAR (all P > 0.05)., Conclusions: There were significant differences between AR and HNAR in sex, age, classification and seasons. The severity of clinical symptoms in AR was higher than that in HNAR except sneezing and gasping. There was consistency about induced factors in AR and HNAR.

Objective: To evaluate the correlation between two serum specific IgE and skin prick test (SPT) for the diagnosis of allergic rhinitis., Methods: Two hundred and sixteen patients were referred to the allergist for a suspected allergic rhinitis between June and October in 2009. Patients were classified as positive for inhalant allergy if they had a positive clinical history and a related positive SPT for the suspected inhalant allergen. Statistical analysis was performed using SPSS13.0 software., Results: One hundred and fifty-eight patients had a positive SPT, comparing with the SPT, the diagnostic indexes (accuracy, sensitivity, specificity) of the ImmunoCAP system and the AllergyScreen system were 0.810 and 0.819, 0.872 and 0.780, 0.741 and 0.862 respectively. The accuracy was similar between the two systems (χ(2) = 0.112, P > 0.05). The ImmunoCAP system had a higher sensitivity (χ(2) = 7.361, P < 0.05). The AllergyScreen system had a higher specificity (χ(2) = 10.222, P < 0.05)., Conclusions: This data supported the use of ImmunoCAP system and AllergyScreen system to identify potentially significant individual allergens in the diagnosis of allergic rhinitis. The ImmunoCAP system had a higher sensitivity. The AllergyScreen system had a higher specificity. The AllergyScreen system can be used as a complementary with the ImmunoCAP system.

Objective: To evaluate the therapeutic effect of intranasal oligodeoxynucleotides with CpG motifs (CpG ODN) in prevention of allergic rhinitis in juvenile guinea pigs., Methods: Juvenile guinea pigs aged from 7 to 10 weeks were administrated with CpG ODN alone or combined with OVA at single dose concentration intranasally (on day 0, 5, 10, 15 in sequence) while control and blank group were administrated with saline. Both experimental and control animals were again sensitized by OVA (on day 18, 25), and 14 days after second sensitization animals were challenged by OVA intranasally (on days 39 and 46). Two hours after challenge, the animals were sacrificed. Then Hemotoxin and Eosin stain were carried out to analyze local eosinophilic reactions and nasal lesions. Local and systemic cytokines interleukin IL-5 and IFN-γ levels were examined by ELISA. Immunofluorescence was carried out with ICAM-1 antibody. Statistical analysis was performed using a SPSS 11.0 software., Results: In CpG ODN-administration or CpG ODN with OVA-administration group allergic rhinitis symptoms were not as severe as model control group (P < 0.05). Compared with the model control group, CpG ODN-administration did not increase production of OVA-specific Th1 cytokine IFN-γ but decreased productions of ovalbumin-specific Th2 cytokines IL-5 both in serum and nasal specimen (q value were 3.890 and 4.019, P < 0.05). Moreover, nasal lesions with infiltration of mean (x ± s) eosinophils (20.0 ± 9.6) in CpG group animal were prominently reduced by the CpG ODN-treatment compared with the control animals (53.5 ± 19.8) and CpG+OVA group (9.5 ± 5.7) were lower than CpG-M+OVA group (49.2 ± 18.9), the differences were significant (q value were 3.785 and 4.576, P < 0.05). Immunofluorescence results showed lower ICAM-1 expression in nasal specimen of CpG group compared with model group and CpG plus OVA group animal to CpG mimics plus OVA group (Z value were 3.697 and 3.765, P < 0.05)., Conclusions: Intranasal administration of CpG oligodeoxynucleotides with or without allergen may be an effective way to prevent the development of allergic rhinitis.

Objective: To evaluate the effect of endoscopic surgery for nasal inverted papilloma., Methods: The clinical data of 89 patients treated with endoscopic surgery in our department from May 2003 to May 2008 were retrospectively analysed. The clinical classification was assessed by preoperative endoscopy and CT or MRI. All cases were routinely followed up from 1 to 5 years., Results: The recurrence rates in group of endoscopic management and group of endoscopic plus Caldwell-Luc management were 12.5% and 11.8% respectively (chi(2) = 0.007, P > 0.05). The recurrence rates in group of grade I, grade II and group of grade III patients were 9.1% (5/55), 17.2% (5/29) and 20% (1/5) respectively (P > 0.05). The recurrence rate in the two times operation group (27.3%) was significantly higher than that in the one time group (7.5%, chi(2) = 4.311, P < 0.05). There were 70 lesions certified to be resected completely, six of these patients (8.6%) recurred. Nineteen lesions were certified to be resected uncompletely, five of these patients (26.3%) recurred. The difference was no significant (chi(2) = 2.860, P = 0.09)., Conclusions: The endoscopic surgery in nasal inverted papillomas was an effective method with minimally invasiveness, but it still had a high recurrence. The pathological examine of surgical margin could partially judge the prognosis.

Background: Excessive expression of thymic stromal lymphopoietin (TSLP) has been demonstrated in asthmatic airway epithelia and in nasal epithelia from animal models of allergic rhinitis (AR), but the evidence of expression of TSLP in nasal epithelial cells (NECs) of patients with AR is lacking. We aimed to investigate the expression of TSLP in NECs of patients with mugwort sensitive-seasonal AR and determine whether it is associated with severity of symptoms and the number of infiltrated eosinophils in nasal mucosa., Methods: NECs specimens were obtained by scraping with plastic curettes from the nasal inferior turbinates of patients with mugwort pollen sensitive-seasonal AR (n = 22) and nonallergic controls (n = 11) during last peak mugwort pollen season. The severity of nasal symptom was assessed using a Visual Analog Scale (VAS). In addition, serum mugwort pollen IgE levels were tested from each patient. In situ hybridization (ISH) was performed to test the messenger RNA (mRNA) of TSLP in the NECs. Furthermore, immunohistochemical staining (IHC) was scored to evaluate the expression of TSLP and eosinophil cell count was made by May-Grünwald/Giemsa staining. The correlation between expression of TSLP and all other parameters was analyzed in this study., Results: The mRNA level of TSLP was significantly increased in NECs of patients with AR compared with the nonallergic control group (P < 0.05). In addition, IHC results showed that expression of TSLP in NECs from patients with AR was up-regulated which was correlated with VAS score (r = 0.598; P < 0.05) and nasal eosinophils count (r = 0.702; P < 0.05), but it was unrelated with mugwort pollen specific IgE level., Conclusions: These preliminary findings indicate a potential relationship between TSLP expression, severity of symptoms and nasal eosinophils count in pathogenesis of AR, but TSLP expression did not correlate with mugwort pollen specific IgE level. The elevated expression of TSLP might play a critical role in local atopical responses of AR. In the future, the TSLP has the potential to be one of the most important molecular markers for AR diagnoses and assessment.

Objective: To establish an animal model of minimal persistent inflammation (MPI) of allergic rhinitis in guinea pigs and to investigate the changes of nasal mucosa. The expression of transforming growth factor-beta1 (TGF-beta1) and matrix metalloproteinases-9 (MMP-9) were discussed., Methods: Thirty male Hartley guinea pigs were randomly divided into two groups: MPI model group and control group randomly, with fifteen animals in each group. Guinea pigs from MPI model group were sensitized intraperitoneally by injection of suspension of ovalbumin (OVA) and aluminum hydroxide in 0.9% physiological saline. Then, repeated local booster sensitization with low concentration of OVA suspension into the nasal cavity was performed to establish MPI models. Alcian blue-periodic acid-Schiff (AB-PAS) staining and Masson's trichrome (MT) staining were used to determine the number of goblet cells and collagen deposition within the basement membrane of epithelium. The expression and distribution of TGF-beta1 and MMP-9 in nasal mucosa were estimated by double immunofluorescence under a confocal laser scan microscopy system., Results: Compared with the control group, the increased goblet cells (t = 13.720, P < 0.05) in nasal epithelium together with the increased collagen fibrils (t = 4.542, P <0.05) within the basement membrane of epithelium were observed in the MPI model group. There was nearly no expression of TGF-beta1, in the control group and the expression of MMP-9 was only found in the epithelium cell. In contrast, there was significantly higher expression of TGF-beta1 and MMP-9 (t = 25.218, P <0.05) in nasal mucosa of MPI model group than that in control group. TGF-beta1 mainly expressed in the epithelium cell, the infiltrated inflammatory cell and extracellular matrix, while MMP-9 expressed in the epithelium cell and the infiltrated inflammatory cell., Conclusions: Long time MPI in allergic rhinitis resulted in some changes of tissue remodeling in nasal mucosa. TGF-beta1 and MMP-9 may play an important role in disease progression.

Objective: To develop an animal model of minimal persistent inflammation (MPI) in allergic rhinitis guinea pigs and to investigate its significance., Methods: Sixty male Hartley guinea pigs were divided into four groups: group A (positive control group), B (MPI model group), C (negative group) and D (bland group) respectively, with fifteen animals in each group. Guinea pigs from group A, B and C were sensitized intraperitoneally by injection of suspension of ovalbumin (OVA) and aluminum hydroxide in 0.9% physiological saline. Then, repeated local booster sensitization with different concentration of OVA suspension (1% and 0.01%) or physiological saline into the nasal cavity of those guinea pigs were performed. For group D, physiological saline was used only. Symptoms (sneezing) of guinea pigs after antigen challenge were observed and the infiltration of eosinophils (EOS) together with the expression of intercellular adhesion molecule 1 (ICAM-1) in the nasal epithelial cells were also examined., Results: When challenged with 1% OVA, the sneezing number of guinea pigs in group B was increased markedly than that in group D (P < 0.05). However, there was no difference between group B, A and C (P > 0.05). When challenged with 0.01% OVA, the symptom of sneezing almost disappeared in group B just like that in group D and there was no difference between the two groups (P > 0.05). Besides, there was still more EOS infiltrated in the nasal mucosa of guinea pigs in group B than that in group D (P < 0.05). There was no expression of ICAM-1 in nasal epithelium of guinea pigs in group D, nevertheless, ICAM-1 was found mildly expressed in group B., Conclusions: MPI models have been established successfully through long term challenge with lower density of OVA in the sensitized guinea pigs, which will provide us with a new method for further research in the mechanism and treatment of allergic rhinitis.

Objective: To investigate the role of aquaporin 1 (AQP1) in the migration of eosinophils (EOS) and to determine if AQP-1 can be viewed as the chemotactic activity marker of EOS., Methods: Asthma model of guinea pigs were developed and EOS were purified from both peripheral blood and bronchoalveolar lavage fluid (BALF). The smears of EOS were studied by in situ hybridization for determining AQP1 mRNA and immunofluorescence under laser scanning confocal microscope for determining AQP1 protein., Results: AQP1 was found expressed in EOS both from peripheral blood and from BALF. Compared with the expression of AQP1 mRNA (mean grey value 109.200 +/- 5.756, x +/- s) and protein (average fluorescence intensity 279.926 +/- 11.293) in EOS from BALF, there was stronger expression of AQP1 mRNA (92.904 +/- 3.290) and protein (425.081 +/- 17.474) in EOS from peripheral blood. The difference both of AQP1 mRNA (t = 9.519, P < 0.05) and protein(t = 27.020, P < 0.05) were considered statistically significant respectively., Conclusions: AQP1 plays a crucial role in EOS movement. It is possible that EOS produce more AQP1 protein to accelerate its migration to inflammatory tissues under allergic disease and EOS with AQP1 highly expressed are activated. AQP1 can be viewed as the chemotactic activity marker of EOS.

Objective: To evaluate the relationship between the expression of monocyte chemotactic protein 1 (MCP-1) and vascular endothelial growth factor (VEGF) in nasal polyp (NP) tissues and the role of MCP-1 in the formation of nasal polyps., Methods: Forty nasal polyp tissues obtained from NP patients were used to detect the expression of MCP-1 and VEGF at the levels of protein and mRNA by immunohistochemical and in situ hybridization assay. Twenty-five inferior turbinate (IT) samples obtained from chronic rhinitis patients were used as control., Results: The expression of MCP-1 and VEGF was higher in NP tissue than in IT at protein and mRNA levels (P <0.01). The expression of these two cytokines was positively correlated(r = 0.871, P <0.05)., Conclusions: MCP-1 and VEGF were involved in the formation of nasal polyps.

Objective: To evaluate the effects of Staphylococcus aureus enterotoxin B (SEB) on proinflammatory cytokine/chemokine releases in primary human nasal epithelial cell (HNEC)., Methods: Epithelial cells of nasal polyps (NP) and inferior turbinate (IT) were cultured without serum under stimulus of SEB 1, 10, 100 ng/ml, IL-1beta 20 ng/ml and SEB 10 ng/ml + dexamethasone 13 ng/ml for 12,24 and 48 h, respectively. The expression of IL-5 and Granulocyte-macrophage colony stimulating factor (GM-CSF) mRNA derived from epithelial cells was detected by in situ hybridization., Results: (1) The expression of IL-5 and GM-CSF mRNA was time and dose-dependent, and reached to a peak under SEB 10 ng/ml for 24 h (P < 0.05). The mRNA expressed more intensively in epithelial cells from NP than IT (P < 0.05). (2) The expression of IL-5 and GM-CSF mRNA increased less under the stimulus of IL-1beta than SEB 10 ng/ml (P < 0.05). (3) The mRNA level of IL-5 and GM-CSF decreased under the stimulus of SEB + dexamethasone 13 ng/m when compared with the stimulus of SEB 10 ng/ml (P < 0.05)., Conclusion: SEB showed proinflammatory effects on HNEC.

Objective: To investigate surgical treatment approach of transclavicular and transsternal tumor., Methods: Twelve cases of neck-root and mediastinum thoracis tumor subjected to cervicothoracic-combined surgical treatment were retrospectively analyzed and summarized., Results: Seven cases of benign tumor survived 1-8 years after surgery. The other 5 patients were malignant tumor. Among 4 cases of metastatic squamous cell carcinoma without definite origin at neck-root site who underwent operation and routine radiotherapy, one case died of orthotopic relapse and armpit metastasis at the 16th months postoperatively; one case was lost of follow-up after surgery; another two cases showed no relapse after follow-up of 50 months and 27 months, respectively. In addition, one case of thyroid papillary carcinoma located at neck-root and mediastinum remained alive for 40 months after operation combined with radiotherapy and chemotherapy., Conclusions: The evaluation of twelve cases of transclavicular and transsternal tumor with adoption of cervicothoracic-combined surgical approach improves and develops traditional knowledge of surgical therapy of neck-root tumors.

Objective: To evaluate the effects of glucocorticoid on tissue remodeling of nasal mucosa from patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) after endoscopic surgery., Methods: Nasal mucosa obtained from 30 cases of CRSwNP during nasal endoscopic surgery were considered as preoperation group. These patients were equally divided into two groups after surgery, ie. glucocorticoid group and contrast group. Uncinate process mucosa samples from 6 patients during septoplasty were considered as normal control group. Epithelial damage and expressions of transforming growth factor-beta1 (TGF-beta1) and collagen III were studied by light microscopy and immunohistochemistry., Results: In nasal mucosa samples of preoperation group, epithelial damage showed 90% (27/30) of stage 3 and 10% (3/30) of stage 2; TGF-beta1 positive cells and collagen III positive basement membrane with more than 20 microm were seen in 87% (26/30) and 97% (29/30) of samples, respectively. No significant difference was observed in morphology of nasal mucosa and expressions of TGF-beta1 and collagen III between glucocorticoid group and contrast group at 1th month after surgery. At 3th month after surgery, epithelial damage displayed 53% (8/15) of stage 3, 33% (5/15) of stage 2 and 14% (2/15) of stage 1 in contrast group; however, 93% (14/15) of stage 0 and 7% (1/15) of stage 1 in glucocorticoid group. The difference of epithelial damage between two groups was significant (Uc = 4.481, P < 0.05). The amount of TGF-beta1 positive cell was markedly higher in contrast group than in glucocorticoid group (t = 2.32, P < 0.05). The thickness of basement membrane was above 20 microm in 67% of contrast group (10 cases) and 27% of glucocorticoid group (4 cases); the difference between the two groups was significant (P < 0.05)., Conclusions: Tissue remodeling is present in nasal mucosa of CRSwNP after endoscopic surgery. Early and appropriate administration of glucocorticoid plays an important role in inhibition of tissue remodeling and prevention of relapse. Postoperative follow-up should not be less than 3 month.

Objectives: We performed this study to investigate the expression profile of immune-associated genes and to probe the role of related genes in the immune pathogenesis of nasal polyps., Methods: Microarray analysis was used to find the expression profile of 491 immune-associated genes in nasal polyps. In validation studies, immunohistochemical staining and Western blot analysis were used to detect interleukin (IL)-17 and IL-17 receptor (IL-17R) in nasal polyps and controls., Results: Eighty-seven genes were differentially expressed in the immune-associated gene profile of nasal polyps, and 15 genes showed differential expression in both chips. In nasal polyp tissues, IL-17 was expressed mainly in the cytoplasm of plasma cells and to a lesser degree in the prickle cell layer of the epithelium and the acinus of the serous gland. In turbinates, IL-17 was also expressed in the same location, but the expression of IL-17 in nasal polyps and that in turbinates differed significantly (p < .05). Both IL-17 and IL-17R displayed specific bands in nasal polyps and turbinates, but the bands of IL-17 and IL-17R in nasal polyps were stronger than those in turbinates., Conclusions: The differentially expressed genes in immune-associated gene chips will provide clues about, and a theoretical foundation for, the pathogenesis of nasal polyps. Furthermore, IL-17 may play an important role in the occurrence of nasal polyps by overexpression.