Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder. Here, we report a rare case of multi-system LCH in a 20-month-old children presenting nasal congestion, fever, abnormal liver function, anemia, and skin damage. The radiograph computed tomography showed an osteolytic lesion in the lateral skull base with tumor extension. Pathological biopsy was performed, and the histopathologic diagnosis was LCH. A general review of LCH, including clinical manifestations, diagnosis, treatment, and prgognosis, is presented.
Histiocytosis, Langerhans-Cell ; diagnosis ; Humans ; Infant ; Rare Diseases

Objective An epitope in E1 region of hepatitis C virus (HCV) was constructed and highly expressed in a foreign epitope presenting vector based on an insect virus, flock house virus capsule protein encoding gene as a vector. Methods Using genetic engineering techniques, an epitope in E1 region of HCV was constructed in a foreign epitope presenting vector based on an insect virus, flock house virus capsule protein encoding gene as a vector and lastly constructed a chimeric gene. The chimeric gene can be put into an expressing plasmid, and expressed in either eukaryotic or prokaryotic system. The foreign epitope can be expressed in this system on the surface of the vector stereotic structure with its native conformation, and which can improve its immunogenecity. Results An epitope in E1 region of HCV was successfully cloned in three positions (aa106、aa153、aa305) of a foreign epitope presenting system based on an insect virus, flock house virus capsule protein encoding gene as a vector.The recombinant epitope in this system could be highly expressed more than 40% of total cell protein in E.coli.BL21 cell in somewhat strict conditions without IPTG inducing. Conclusions We have made this chimeric gene highly expressed in E.coli.BL21, by the way different from routine method. The results suggest that the expression method and this epitope presenting system can be used in studying immunological and biological properties of HCV and developing diagnostic reagents as well as epitope-based subunit vaccines for controlling HCV infection.

OBJECTIVE: To investigate clinical application of head impulse test with video recording eye movements in the diagnosis of vertigo. METHOD: The video head impulse test(vHIT) was used to measure the eye saccades and velocity gain in 95 patients with vertigo which were divided into two groups, peripheral vertigo (47 cases) and central vertigo(48 cases); the characteristics of eye saccades and velocity gain of six semicircular canals in different patients with vertigo were analyzed, and were compared between the two groups. RESULT: The vHIT result in patients with peripheral vertigo: in 22 patients (23 affected ears) with Meniere's disease, 21 ears were abnormal (91. 3%); the vHIT results in 4 patients with vestibular schwannoma, 2 patients with vestibular neuritis, 5 patients with delayed endolymphatic hydrops, 6 patients with sudden hearing loss accompanied vertigo, and 8 patients with vestibular dysfunction, were abnormal with correct saccades and/or lower velocity gain of vHIT. The abnormal vHIT results were also found in 35 of 48 patients (72. 9%) with central vertigo, which including posterior cerebral circulation ischemia(7 patients), cerebral infarction/stroke(6 patients), and dizziness with vertigo(17 patients) and others(18 patients). Abnormal rate of vHIT in patients with peripheral vertigo was 95. 7% (45/47), which was significantly higher than that (72. 9%) in patients with central vertigo. CONCLUSION It is easy to perform the vHIT which without adverse reactions. We can record high-frequency characteristics of vestibular-ocular reflex among six semicircular canals through vHIT. The vHIT results which show the function of vestibular ocular reflex in different diseases with vertigo, can help discriminate peripheral vertigo from central vertigo, and it is a practical assessment method for vertigo.
Dizziness ; Endolymphatic Hydrops ; diagnosis ; Head Impulse Test ; Humans ; Meniere Disease ; diagnosis ; Neuroma, Acoustic ; diagnosis ; Reflex, Vestibulo-Ocular ; Saccades ; Semicircular Canals ; Vertigo ; diagnosis ; Vestibular Neuronitis ; diagnosis ; Video Recording

OBJECTIVE: To examine the microsatellite instability and loss of heterozygosity in the pathogenic mechanism of laryngeal squamous cell carcinomas. METHOD: Forty cases squamous cell carcinomas of larynx were analyzed by comparing tumorous tissues and normal tissues around with 3 microsatellite markers from chromosome 3, 5 and 11, using PCR and PGE-AgNO3 staining. RESULT: Among the 40 cases of laryngeal squamous cell carcinomas, 87.5% (35/40) of samples showed microsatellite instability or loss of heterozygosity in one to three microsatellite markers. High frequent microsatellite abnormal occurred at D5S592, it was 70% (28/40). Then the mutation rate of D3s1228 was 52.5% (21/40). CONCLUSION Our study revealed that tumor suppressor genes nearby chromosome 3p14 and 5q23 regions related to the pathogenesis of squamous cell carcinomas of larynx. A correlation between microsatellite alternation and stage of the tumor were found in D3s1228 and D5s592 chromosome regions.
Carcinoma, Squamous Cell ; genetics ; pathology ; Genes, Tumor Suppressor ; Humans ; Laryngeal Neoplasms ; genetics ; pathology ; Loss of Heterozygosity ; Microsatellite Instability ; Neoplasm Staging

Objective: To preliminarily evaluate the clinical effect of the three-dimensional (3D) printing individualized titanium mesh combined with guided bone regeneration technology for repairing alveolar bone defects. Methods: Six patients with alveolar bone defects (4 males and 2 females, aged 18-27 years, mean 23.3 years) were selected from the Department of Oral Implantology, Stomatological Hospital of Chongqing Medical University from January to June 2018. The patients′ cone-beam CT (CBCT) data was imported into the digital design software, and the individualized titanium meshes were designed based on the ideal bone mass around the implant, alveolar bone morphology and soft tissue condition. Then, the ".stl" files were output and the meshes were fabricated by 3D printing technology. The individualized titanium meshes combined with the mixture of autogenous bone and bone substitute materials were used to augmentation during operation. All patients were reviewed at 1, 3 and 6 months after surgery to observe the complications and evaluate the effect of bone augmentation. After taking out the titanium mesh, the CBCT was compared with the preoperative CBCT. The increased bone height and bone width were measured and the bone incremental volume was calculated. Results: Titanium mesh exposure occurred in 2 patients with no obvious infection, and no early removal. In 6 patients, the bone width increased by 1.75-7.54 mm (mean 3.58 mm), the bone height increased by 0.91-11.80 mm (mean 3.37 mm), and bone incremental volume increased by 247-676 mm³ (mean 503 mm³). All of the cases showed sufficiently grafted volume for implant placement. Conclusions The individualized 3D printing titanium meshes combined with guided bone regeneration could repair alveolar bone defects with excellent clinical effect, but a better design needed to be explored in the future to solve or delay the exposure of titanium mesh.

Objective:To evaluate the clinical effect of three-dimensional (3D) printing individualized titanium mesh for ridge augmentation in the esthetic zone.Methods:Forty-three patients were treated with personalized titanium mesh bone augmentation from Department of Oral Implantology, Stomatological Hospital of Chongqing Medical University from January, 2018 to June, 2020. According to the preoperative cone-beam CT (CBCT) data, the 43 patients [male: 21, female: 22, aged (30.1±5.8) years] were divided into three groups according to the Seibert classification as horizontal, vertical and horizontal-vertical classes (sample size: 14, 15, 14). Then, comprehensively the bone mass and esthetic requirements were taken into account to design and accordingly fabricate the 3D printing individualized titanium mesh. During the surgical process, autologous bone and xenogeneic bone substitutes were mixed at a 1∶1 ratio, combined with injectable platelet-rich fibrin (i-PRF) and individualized titanium mesh for ridge augmentation. All patients were recalled at 1, 3, and 6 months post-operation to observe the mesh exposure; the clinical effect of ridge augmentation was evaluated 6 months post-operation. After the implant placement and final restoration, the pink esthetic score (PES)/white esthetic score (WES) were evaluated.Results:Only one patient experienced early mesh exposure, and no obvious infection was observed. The bone gain regarding three types of bone defects was significantly higher immediately post-operation compared to pre-operation (horizontal, vertical and horizontal-vertical bone defect measured as (3.27±0.13), (17.41±0.46), (3.76±0.24), (14.37±0.89) mm pre-operation, respectively; and (5.25±0.15), (26.10±0.55), (6.35±0.29), (22.52±0.90) mm immediately post-operation, P<0.01). There was no obvious bone resorption 6 months post-operation [outcomes for horizontal, vertical and horizontal-vertical bone defect measured as (5.14±0.14), (25.67±0.52), (6.13±0.26), (22.35±0.89) mm, P>0.05]. The PES/WES scores of all patients were interpreted as "excellent". Conclusions:The 3D printing individualized titanium mesh is effective in repairing bone defects in the esthetic zone, and produces credible esthetic outcomes after implantation and final restoration.