Objective:To observe and analysis the clinical presentations and high resolution computed tomography (HRCT) features of patients with eosinophilic granulomatosis with polyangiitis (EGPA), and to provide support for clinical diagnosis and treatment decision.Methods:Clinical characteristics, relevant laboratory data, HRCT features, treatment and prognosis of 15 clinically confirmed EGPA patients were analyzed retrospectively. Statistical Program for Social Sciences (SPSS) 21.0 software was used for statistical analysis of the data.Results:Among the 15 patients, there were 8 males and 7 females, with a midian age of 48. Four cases (27%) were misdiagnosed as refractory asthma for the first time. The most common clinical manifestation was paranasal sinus inflammation in 14 cases (93%), followed by cough and wheeze in 13 cases (87%). In the laboratory examination, eosinophilia was found in 13 cases (87%) and ANCA positive in 5 cases (39%). The common chest HRCT signs were: fiber stripes in 13 cases (87%), patch ground glass opacities in 12 cases (80%), interlobular septal thickening in 10 cases (67%), and nodules in 9 cases (60%). The five-factor score (FFS) was used to score the patients, and FFS were 5(33%) with score 0 and 6(40%) with score1. Finally, 12 patients (80%) were discharged after remission.Conclusion:The EGPA has a low incidence and no spefic clinical manifestations and chest HRCT features, so it hasto be diagnosed by combination of paranasal sinus examination, electromyography and laboratory tests.

This paper presented the hereditary pattern of otosclerosis in families. Among 1500 cases there were 13 patients, belonging to 6 families, and 20 ears were surgically treated. There was often a marked similarity in clinical features of affected siblings within the same family.The clinical characteristics are as following: (1) The age at inset of hearing loss seems similar. There is a difference of 1 or 2 years in two families znc 3 to 10 years in the other four. (2) The side of first hearing loss is the same in affected individuals of 6 families. (3) The propositi are females in 5 families (83.3%). (4) Auditory curve of hearing loss is similar in 4 familiers, and different in the other two. (5) The footplate lesions are similar in macroscopic features, thin footplate in two fimalies and thick footplate in the other four.

OBJECTIVE: To discuss the complication and the prevention of transnasal endoscopic adenoidectomy in children. METHODS: A total of 215 children patients with adenoid hypertrophy were treated with transnasal endoscopic adenoidectomy and were followed up for 1-6 months postoperatively. We summarized the complication and their management. RESULTS: The children had a disappearance or relief of their clinical symptoms and manifestations after endoscopic adenoidectomy. Involved complication included 10 nose bleedings, 30 nasal synechia, 1 adenoidal regrowth. CONCLUSION Endoscopic adenoidectomy is performed under direct and clear view that allows surgeons to operate conveniently and shorten surgical time. Surgeons still have to be alert to these complications and try to avoid them.
Adenoidectomy ; methods ; Adenoids ; pathology ; surgery ; Child ; Child, Preschool ; Endoscopy ; methods ; Female ; Humans ; Hypertrophy ; surgery ; Male ; Nose ; surgery ; Postoperative Complications ; prevention & control

OBJECTIVE: To observed the prevention efficacy of secretory otitis media after radiation therapy by the Myrtol Standardized Enteric Coated Soft Capsules. METHOD: Sixty patients with nasopharyngeal carcinoma who Diagnosis without secretory otitis media before radiation therapy were divided into experimental group and control group, 30 cases in each group. After the start of radiation therapy ,the experimental group patients oral the Myrtol Standardized Enteric Coated Soft Capsules, each 0.3 g, 3 times a day, 7 days a course of treatment, oral the medication three months, the patients in the control group received no treatment. 3 months and 6 months after the end of radiation therapy, whether there is a difference comparison of experimental group and the control group in symptoms, signs, pure tone audiometry and tympanogram change. RESULT: Seventeen patients (18 ears) (56.67%, 17/30) in the control group were suffering from secretory otitis media, 7 patients (7 ears) (23.33%, 7/30) in the experimental group were suffering from secretory otitis media. The difference between the two groups was statistically significant (P < 0.01). 17 patients (17 ears) in the control group and 7 patients (7 ears) in the experimental group were suffering from tinnitus. 20 patients(20 ears) in the control group and 9 patients (10 ears) in the experimental group have ear choking feeling. The difference between the two groups was statistically significant (P < 0.01). The air conduction hearing threshold of the experimental group before radiation therapy is (7.5 +/- 2.0) dB HL and the air conduction hearing threshold of the control group patients is (8.3 +/- 4.0) dB HL. The difference between the two groups was not statistically significant (P > 0.05). 3 months after radiation therapy,the gas conductive hearing threshold of the experimental group is (25.6 +/- 3.0) dB HL, but the data in the control group is (40.7 +/- 5.0) dB HL. The difference between the two groups was statistically significant (P < 0.01). CONCLUSION Patients with nasopharyngeal carcinoma oral the the Myrtol Standardized Enteric Coated Soft Capsules before radiation therapy can effectively reduce the incidence of secretory otitis media after radiotherapy, it can prevent the occurrence of secretory otitis media.
Adult ; Aged ; Aged, 80 and over ; Carcinoma ; Drug Combinations ; Female ; Humans ; Male ; Middle Aged ; Monoterpenes ; therapeutic use ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Otitis Media with Effusion ; etiology ; prevention & control ; Radiotherapy ; adverse effects

Objective:To investigate clinical and imaging parameters to predict blood loss and cranial nerve injury (CNI) following carotid body paraganglioma (CBP) resection.Methods:A retrospective examination of clinical and imaging data was conducted on 63 patients who underwent CBP resection at Xiangya Hospital of Central South University from January 2016 to December 2022, including 23 males and 40 females, aged 26-87 years old. Three imaging parameters including tumor volume, the angle of contact with the internal carotid artery (ICA), and the distance to the base of skull (DTBOS) were gauged using the IMEDPACS software on CTA and MR imaging. The predictive efficacies of age, gender, Shamblin classification, and three imaging parameters for blood loss and CNI following surgery were analysed. Logistic composite parameter models were constructed and their predictive validity was assessed.Results:Multivariate logistic regression analysis underscored that only tumor volume ( OR=1.381,95% CI:1.167-1.507, P=0.001) showed significant statistical correlations with blood loss following surgery. Area under curve (AUC) values of 0.910 for receiver operating characteristic (ROC) curves showed a sensitivity of 1.000 and a specificity of 0.694. Tumor volume ( OR=1.126,95% CI:1.030-1.231, P=0.002) and DTBOS ( OR=0.225,95% CI:0.081-0.630, P=0.005) were significantly associated with postoperative CNI. The analysis of logistic composite model showed AUC values for tumor volume, DTBOS and combination of the two parameters were 0.858, 0.788, and 0.872, respectively. The model for combination of tumor volume and DTBOS also proved superior in predicting postoperative CNI ( Z=3.106, P<0.001), with a sensitivity of 0.833 and a specificity of 0.769. Conclusions:Tumor volume and DTBOS emerged as effective predictors for blood loss and/or CNI in patients with CBP resection. Moreover, the logistic composite parameter model outclassed single-parameter models in terms of their predictive clinical value.

Objective:To construct and purify four respiratory syncytial virus (RSV) PreF proteins through gene sequence design and optimization and evaluate their immunogenicity.Methods:Coronin-1A and T4 trimer protein gene sequences were optimized with Human and CHO codons, and then added to RSV F protein sequence. The above plasmids were transfected into Expi293F cells for protein expression. After purification by nickel column, four trimer proteins were prepared. SDS-PAGE and Western blot were performed for protein identification. BALB/c mice were immunized at week 0 and week 3, and blood samples were collected to measure the activities of binding and neutralizing antibodies in serum.Results:SDS-PAGE and Western blot showed that the four proteins had stable trimer structure. Antigen-antibody affinity test showed that the four trimer proteins had strong affinity with RSV-specific monoclonal antibodies 8897, D25, Motavizumab, AM14 and Palivizumab. The titers of antibodies induced by the two T4 trimers were higher after the initial immunization, while there was a substantial increase in the titers of antibodies induced by Human codon-optimized trimer protein after the second immunization.Conclusions:PreF trimer protein can be prepared by adding any of the two different heterotrimer motifs, and induce effective binding and neutralizing antibodies in mice.

Objective:To compare the immunogenicity of the prefusion (PreF) and postfusion (PostF) conformations of the respiratory syncytial virus (RSV) F protein.Methods:The expression of PreF and PostF recombinant proteins was analyzed by SDS-PAGE and Western blot. The binding affinity between F protein and its specific antibodies was detected by Octet. The binding antibodies and neutralizing antibodies in immune serum were detected after immunizing mice with PreF or PostF recombinant protein.Results:PreF protein was stable in the form of a trimer after modification with higher binding affinity with monoclonal antibodies such as D25, 8897, AM14, Palivizumab and Motavizumab. PostF protein lacked the antigenic site ? and showed a monomer conformation. Besides, it was unable to bind to D25, 8897 and AM14 antibodies. Animal experiments showed that AS01 adjuvant was better than aluminum adjuvant in inducing binding antibodies and neutralizing antibodies against RSV Long strains. The binding antibodies induced by PreF and PostF recombinant proteins had similar binding ability to PreF protein, while the binding antibodies induced by PostF recombinant protein showed stronger binding ability to PostF than to PreF.Conclusions:PreF has more epitopes and the trimer form of PreF recombinant protein after modification is more stable and can induce stronger neutralizing antibodies. Moreover, the immunopotentiating effect of AS01 adjuvant is better than that of aluminum adjuvant. Therefore, stabilization-based trimer structure modification of PreF and the development of adjuvants are crucial for the development of RSV vaccines.