Infants with laryngotracheal anomalies are clinically manifested as stridor or noisy breathing, choking, hoarseness, feeding difficulties, and cyanotic spells, followed by developmental and growth retardation and other health issues; in severe cases, patients may present with severe dyspnea, which is associated with high mortality. A timely diagnosis as well as appropriate strategy for laryngotracheal anomalies is still challenging for pediatric otolaryngologists. This consensus statement, evolved from expert opinion by the members of the Pediatric Otorhinolaryngology Professional Committee of the Pediatrician Branch of the Chinese Medical Doctor Association, provides comprehensive recommendations and standardized guidance for otolaryngologists who manage infants and young children with laryngotracheal anomalies in evaluation and treatment based on symptomatology, physical and laboratory examinations.
Humans ; Child ; Infant ; Child, Preschool ; Laryngostenosis/surgery* ; Airway Obstruction/complications* ; Hoarseness/complications* ; Consensus ; Respiratory Sounds

Objective To study the effects of multi frequency tympanometry and acoustic stapedius reflexes on the diagnosis of the middle ear functions of infants.Methods Tympanometries with 226,678 and 1 000 Hz probe tones and 500 and 1 000 Hz acoustic stapedius reflexes were performed on infants at age 0~1 year.128 normal infants(256 ears) and 104 abnormal infants(168 ears) were tested with GSI Tympstar middle ear analyzer.Results The patterns of 226 Hz tympanograms were non-peaked,single-peaked and W-shaped.There were no significant differences between two groups of infants aged 0～6 months.The patterns of 678 Hz and 1 000 Hz tympanograms showed significant differences between two groups of infants aged 0～1 year.The outcomes of 500 Hz and 1 000 Hz acoustic stapedius reflexes showed no differences between the same age groups.There were significant differences between normal group and abnormal group.Conclusion Tympanometry with 678 Hz and 1 000 Hz probe tones can yield accurate diagnostic results in the assessment of the middle ear functions for infants younger than six months.The tympanometry with three frequency probe tones is sensitive to infants aged 6～12 months.The outcomes of acoustic stapedius reflexes at 500 and 1 000 Hz show no differences between the same age groups,but presences become more noticeable as a function of ages.

0.05).②For the neonates passed DPOAE screening,the ASSR thresholds at 250,500 and 1 000 Hz and the ABR thresholds were not correlated,but there were significant correlations at 2 000 and 4 000 Hz.For the neonates whose DPOAE screening results were abnormal,the ASSR thresholds and the ABR thresholds were significantly correlated at all the carrier frequencies.Conclusion Reliable and frequency specific results could be obtained by ASSR,so it could be a promising audiometry to evaluate the hearing of neonates.

Objective The aim of the study was to analyse the middle ear function of one hundred and twenty-five newborns using 226,678,1 000 Hz tympanometry. Methods Tympanometries with 226,678,1 000 Hz probe tones were obtained from 125 newborns (250 ears) by means of GSI Tympstar middle ear analyzer. The newborns with abnormal tympanograms were referred for temporale CT. Results One case of 226 Hz tympanograms was type "As" while others were all type "A",of which single-peaked tympanograms was 43.2%(108/250),W-shaped tympanograms was 56.8%(142/250). The abnormal pattern of 678 Hz tympanograms were 74 ears,and the abnormal pattern of 1 000 Hz tympanograms were 35 ears. 43 newborns (86 ears) have accepted temporale CT and results showed 30 middle ears with effusion. Conclusion 226 Hz probe tone tympanometry couldn't reflect the middle ear function of newborns. The sensitivity of 678 Hz probe tone tympanometry in the diagnosis of middle ear function of newborns was good,but specificity was worse. The sensitivity and specificity of 1 000 Hz probe tone tympanometry were the best.

Objective To explore the use of auditory steady-state response (ASSR) for threshold evaluation in neonates. Methods 30 neonates 60 ears) were included in the study who passed distortion product otoacoustic emission (DPOAE) screening and 45 neonates (78 ears) who failed DPOAE. The ASSR thresholds were evaluated screening, the significant difference was found between the ASSR thresholds at 250 Hz and the ABR thresholds (P ＜0.05), however the ASSR thresholds at 4 000 Hz and average thresholds were not different from the ABR thresholds (P＞0.05). For the neonates whose DPOAE screening results were abnormal, the ASSR thresholds from 250 to 4 000 Hz and average thresholds were not significant different from the ABR thresholds respectively (P＞0.05). olds were not correlated, but there were significant correlations at 2 000 and 4 000 Hz. For the neonates whose DPOAE screening results were abnormal, the ASSR thresholds and the ABR thresholds were significantly correlated at all the carrier frequencies. Conclusion Reliable and frequency specific results could be obtained by ASSR,so it could be a promising audiometry to evaluate the hearing of neonates.

Objective The aim of the study was to investigate the intraoperative EABR as a reference of beginning of fitting the cochlear implant(CI)and predicting the result.Methods Intraoperative EABR were recorded in two young children(two years,and three and half years)receiving the Digisonic DX 10 Cochlear Implant.Electrodes 15,13,10,7 and 4 were investigated using Digistim Stimulation Mode.Results During the surgery,wave Ⅲ and Ⅴ were clearly seen in the EABR.It was to demonstrate that the function of the auditory pathway of cochlear nerve and brainstem would be good.Measuring behavioral thresholds after implanted chochlea in patient was similar to predict the result.In young child the EABR thresholds were 15 ?s?60 ?V,20 ?s?60 ?V,25 ?s?60 ?V,30 ?s?60 ?V and 30 ?s?60 ?V at electrodes 15,13,10,7 and 4,whereas in another child the EABR thresholds had 15 ?s?50 ?V,20 ?s?50 ?V,25 ?s?50 ?V,20 ?s?50 ?V,and 20 ?s?50 ?V.Based upon the EABR thresholds,the amplitude for beginning of fitting was set at the 15～20 ?V differences between the Digisonic PDX10 and the EAB stimulation.Minima threshold level was set at 15 dB for starting of the number of electrode 15, and then the number of electrodes were decreased with increasing minima threshold levels(2～3 step).This was also achieved by increasing the maximum electrical thresholds.Conclusion It is confirmed that the intraoperative EABR could predict the result,and could be more precise and sensitive for beginning of fitting the cochlear implant as a reference.

OBJECTIVE:To study the effect of Typhae pollen decoction on isolated uterine smooth muscle(USM)contraction of rats at postconceptual stage. METHODS:16 Wistar rats at postconceptual stage were selected and USM strips were isolated. T. pollen decoction 0(blank control),2,4,8 and 12 mg(medicinal material)/ml were added respectively;the effects of T. pollen de-coction on USM strips contraction were observed,and mean tension,duration of contraction and frequency were measured and re-corded. The effects of T. pollen decoction on USM strips contraction were investigated after pretreatment of prostaglandin synthase inhibitor indometacin(1×10-7 mol/ml)and calcium channel blocker verapamil(1×10-7 mol/ml);USM tension,duration of contrac-tion and frequency were measured and recorded. RESULTS:Compared with blank control group,T. pollen decoction 4,8 and 12 mg(medicinal material)/ml could increase USM tension,duration of contraction and frequency(P<0.05);after added verapamil and indometacin,T. pollen decoction decreased USM tension,shortened duration of contraction and decreased frequency (P<0.05). CONCLUSIONS:T. pollen decoction can strengthen USM strips contraction,and the effect is inhibited by prostaglandin syn-thase inhibitor and calcium channel blocker.

0.05), in the sheets, quilt covers, bedsides, coats and underwear, the difference was significant (P

Objective To investigate the character 、difference and clinical meaning of distortion product otoacoustic emissions(DPOAE) and auditory brainstem respons(ABR) in high risk neonates with.Methods DPOAE and ABR were recorded with amplaid MK 22 and GSI60 in 200(400ears) high risk neonates, then compared the results.Results Of 200(400ears) newborns, the presence of DPOAE was 64%(256/400 ears), the presence of ABR was 88.25%(353/400 ears). The co-negativity and co-positivity of DPOAE and ABR were 61.50%(246/400 ears)and 9.25%(37/400 ears). The false negative and false positive of DPOAE were 3.91%(10/256 ears)and 74.31%(107/144 ears).Conclusion The DPOAE test is simple,quick,harmless,sensitive and objective. Because it only reflects the function of the cochlea and has high false positive, we can't make the diagnosis of hearing loss immediately when newborns don't pass the DPOAE test.The ABR test is a reliable method for neonatal hearing screening. The combination of DPOAE and ABR in high risk neonatal hearing screening could increase the accuracy and reliability of the test and retest results.

Objective To prepare the chitosan-potD nanoparticles and to evaluate its protective efficacy against pneumococcal nasopharyngeal colonization. Methods potD gene was amplificated from pneumococcal genome and was inserted into pVAX1 expression vectors to construct pVAX1-potD recombinant plasmid which was then transfected into 293T cell using LipofectAMINE 2000 to analyze transient potD gene expression in vitro by RT-PCR and Western blot. Chitosan-potD nanoparticles were freshly prepared by coacervation methods at each time and the characterizations of the nanoparticles were then evaluated. BALB/c mice were immunized with chitosan-potD, naked potD DNA or pVAX1 for 4 times at two-week intervals. Anti-PotD IgG, IgG1 and IgG2a levels in serum and IgA levels in nasal washes, bronchoalveolar lavage fluids (BALF) and middle ear lavages(MEL) were detected by indirect enzyme-linked immunosorbent assay (ELISA). IL-17A, IL-4 and IFN-γ levels in splenocytes were determined by double sandwich ELISA. Mice were intrannsally challenged with Streptococcus pneumoniae ATCC6303, and Pneumococci were recovered from the nasopharyngeal niche at the fifth day after challenge. Results potD gene was successfully amplificated by PCR and the sequence was confimed to be consistent with that in the Genbank. The pVAX1-potD recombinant plasmid was successfully constructed and was expressed in eukaryocytes in vitro. The mean size and zeta potential of chitosan-potD nanoparticles was 430 nm and + 20.5 mv, respectively. Chitosan-potD nanoparticles were not digested by DNase Ⅰ , while naked potD DNA was completely digested. The levels of antibodies inculding IgG, IgG1, IgG2a, IgA and cytokines including IL-17A, IL-4 and IFN-γ were significantly higher in mice immunized with chitosan-potD nanoparticles than mice with naked potD or pVAX1 ( P <0.05) only. More importantly, much less Pneumococci were recovered from mice immunized with chitosan-potD nanoparticles than the other groups(P <0.05). Conclusion Chitosan-potD nanoparticles significantly enhanced the immunogenicity and protection efficacy of DNA vaccines by intranasal immunization and could be used as a potential mucosal vaccine to prevent pneumococcal infection.