Objective:To analyze the clinical characteristics of malignant lymphoma of the head and neck in children, and to improve the understanding and diagnosis and treatment of this type of disease by otolaryngologists. Methods:Clinical data of 49 children with malignant lymphoma of the head and neck hospitalized in the Department of Otorhinolaryngology, Head and Neck Surgery of Kunming Children's Hospital from 2013-2021 were retrospectively analyzed and statistically analyzed according to gender, age distribution, duration of the disease, site of onset, type of pathology and survival status. Results:A total of 49 cases of malignant lymphoma of the head and neck in children were collected, of which, 39 were male and 10 female. The minimum age was 3 years, the maximum was 14 years and 4 months, the median age of onset was 7 years, and the largest percentage （51.02%） of children was in the school age（6-12 years）. The duration of the disease ranged from 5 days to 2 years, with a median of 1 month, and the site of the lesion was located in the neck in the majority of cases, 41（83.67%）. The pathologic types of hodgkin lymphoma（HL） were 25 cases（51.02%） and non-hodgkin lymphoma（NHL） were 24 cases（48.98%）, and among hodgkin lymphomas, mixed-cell classical hodgkin lymphoma was the most common, with 9 cases（18.37%）; among non-hodgkin lymphomas,originated from B-cells in 16 cases （32.65%） and from T-cells in 7 cases （14.29%）, with Burkitt's lymphoma being the most numerous of B-cell origin in 13 cases （26.53%）, and T-cell lymphoblastoid lymphoma being the most common of T-cell origin in 4 cases （8.16%）. The follow-up period was from 22 days to 6 years and 10 months, with 3 cases losing, 43 cases surviving, 3 cases dying, with a survival rate of 93 5%, and 3 cases relapsing, with a relapse rate of 6 5%. Conclusion:Children's head and neck malignant lymphoma has its own characteristics in terms of age of onset, gender distribution, site of onset, pathological type and treatment prognosis, which should be comprehensively assessed, diagnosed as early as possible, and multidisciplinary joint treatment actively carried out to propose personalized treatment plans.
Humans ; Male ; Female ; Child ; Head and Neck Neoplasms/therapy* ; Child, Preschool ; Retrospective Studies ; Adolescent ; Lymphoma/therapy* ; Survival Rate ; Hodgkin Disease ; Prognosis ; Infant ; Lymphoma, Non-Hodgkin

OBJECTIVE To provide reference for better implementation of the priority review system for generic drugs of encouraged generic drug catalogues. METHODS Based on literature research， practical status of the priority review system for generic drugs in two batches of encouraged generic drug catalogues in China was analyzed， and the problems existing in the application of the system were compared to propose corresponding solutions. RESULTS & CONCLUSIONS China has issued two batches of encouraged generic drug catalogues， and there were 49 varieties of generic drugs included in the catalogues. In the implementation of the priority review system for generic drugs of encouraged generic drug catalogues， there were some problems in legislation， incentive system for the first generic drug， post-marketing re-evaluation system， and cross-departmental coordination and linkage mechanism. It is suggested to strengthen legislation， improve the “first generic market exclusivity period” system， perfect the post-marketing re-evaluation system and form a normalized cross-departmental coordination mechanism so as to ensure the safety， effectiveness and accessibility of generic drugs in China.

Objective To summarize the experience of general anesthesia management in pregnant women with pulmonary hypertension who had to undergo cesarean section. Methods Clinical data, anesthesia methods and outcome of 6 pregnant women with pulmonary hypertension were analyzed. Among them, 1 case of patent ductus arteriosus had to undergo cesarean section twice, because the interval time of twice cesarean section was longer (2 years), and the number of pregnant women was counted to 7 cases. Results Seven patients had to undergo cesarean section with general anesthesia, and all the pregnant women′s hemodynamic were stable during the operation. After operation, 1 pregnant woman discharged from hospital against the doctor′s advices because of massive brain infarction, and the others were all rehabilitated. Seven newborns status:preterm in 3 cases, cardiopulmonary resuscitation in 2 cases, the Apgar score of the others newborns was 9-10 scores. Conclusions Pregnant women with pulmonary hypertension have high peri-operative risk, especially those who undergo general anesthesia. To improve the survival rate, anesthetist should reinforce the perioperative care, maintain oxygen supply, reduce the stress response, maintain the preload and blood pressure, and avoid the increasing of pulmonary pressure.

ObjectiveTo investigate the effect of KN93,a CaMKII inhibitor,on the spinal NR2B expression in the bone cancer pain mouse and its underlying mechanism.MethodsThirty-six male C3IL/IIeJ mice were randomly divided into 3 groups:sham group( S,n =8 ),bone cancer pain group( BP,n =8 ) and KN93 group ( K,n=20).The mouse model of bone cancer pain was established by intra-femur inoculation of osteolytie NCTC 2472 cells in BP and K groups.At 14d post operation,mice in K group received intrathecal injection of 60nmol KN93/5μl in 20％ DMSO and mice in BP group and S group received 20％ DMSD 5μl respectively.Eight mice were selected randomly from each group at (1)d before inoculation,at 1 h before administration and at 1,2,4,24h after administration( T0-5 ) to be measured the paw withdrawal threshold(PWT) stimulated by von Frey filaments.Another 3 mice were sacrificed at the corresponding time point and the spinal cord L3 -5 were obtained for determination of NR2B expression by western blot.ResultsPWT was significantly decreased in group BP( (0.50 ± 0.11 ) g) and K( (0.52 ±0.10)g),except for group K at T3(P＞0.05),and NR2B cxpression up-regulated at T2-5 in BP( 1.78± 0.34),K groups ( ( 1.11 ± 0.14),(0.73 ± 0.03 ),( 1.11 ± 0.15 ),( 1.89 ± 0.32 ) ) compared with S group ( ( 1.78 ± 0.31 ) g,(0.33 ± 0.04),P ＜ 0.05 ).Compared with group BP,PWT was increased and NR2B expression down-regulated at T2-4 in group K.In contrast to T1,PWT at T2-4 upgraded in group K(P＜0.05 ),but no significant difference was observed in other groups (P＞ 0.05 ).ConclusionIntrathecal injection of KN93 can attenuate bone cancer pain in mice through inhibiting NR2B with a time-dependent manner and spinal CaMKII-NR2B pathway may participate in the development of bone cancer pain.

ObjectiveTo investigate the effect of intrathecal injection of magnesium sulfate ( MgSO4 ) on pain behavior in mouse with bone cancer pain.Methods56 male 8-10 week old C3H/HeJ mice weighing 18-22 g were divided randomly into 7 groups ( n =8 ):sham group (S group),control group (C group) and MgSO4 plus morphine treat groups( T1-T5 group).Croup C and T mice were induced bone cancer pain models by intra-rightfemur inoculation of osteolytic NCTC2472 cells while group S were injected of only α-MEM.On the 14d after inoculation,group S and C received intrathecal injection of artificial cerebrospinal fluid 5 μl,while group T1-T5 received intrathecal injection of MgSO4 14.4 μg,43.2 μg,86.4 μg,morphine 0.36 μg,MgSO4 14.4 μg-morphine 0.36 μg,which were dissolved in 5 μl artificial cerebrospinal fluid.Micc received pain behavior tests including quantification of spontaneous flinches,paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) at 0.5h before and 0.5h,2h,4h,gh after administration.ResultsTreatment with MgSO4 (14.4 μg),morphine (0.36 μg) have no effect on bone cancer pain,while treatment with MgSO4 (43.2 μg,86.4 μg)can dose-dependently reverse quantification of spontaneous flinches,mechanical allodynia and thermal hypcralgesia which were induced by inoculation as well as MgSO4 14.4 μg-morphine 0.36 μg.At 0.5 h after administration,the quantification of spontancous flinches of the three groups( ( 10.08 ± 1.66),(7.35 ± 1.36),( 10.54 ± 1.32 ) ) were decrcased when compared with control group ( 13.05 ± 2.06 ),PWMT ( (0.81 ± 0.22 ) g; ( 1.33 ± 0.19)g; (0.93 ±0.26)g),PWTL( (10.57 ±1.53)s; (13.12 ±1.71)s; (11.46 ±1.83)s) were increased when compared with control group ( (0.42 ± 0.23 ) g,( 8.87 ± 1.27 ) s) (P ＜ 0.05 ).The effect reached maximum level at 2h,lasted for at least 4h and disappeared at 8h.ConclusionIntrathecal injection MgSO4 can effectively attenuate bone cancer pain dose-dependently.At the same time MgSO4 can amplify the analgesic effect of subliminal morphine.

Objective To investigate the effect of ifenprodil in the mice of bone cancer pain.Methods 96 male C3H/HeJ mice were divided randomly into tumor group( Group T),control group( Group C) and sham group( Group S).The α-minimal essence media(ct-MEM) with 2 × l05 osteosarcoma NCTC 2472 cells were implanted into the intramedullary space of the right femurs of mice to induce ongoing bone cancer related pain behaviors.The sham group was inoculated by α-MEM without any cells.On the 14th d after inoculation,pain ethology indexes such as the spontaneous lifting behaviors,the paw withdrawal mechanical threshold(PWMT) and the paw withdrawal thermal latency (PWTL)were observed on 1 d before inoculation and on 3 d,5 d,7 d,10 d,14 d,17 d,19 d,23 d after inoculation.Lumbar intumescentia of mice in each group were taken out to investigate the expression level of NR2B western blot after pain behaviors tests at the same time point after intrathecal injection.Results ( 1 ) At day14 after the operation,the obvious increasing of spontaneous lifting behaviors ( ( 12.88 ±1.64) ) and the expression of NR2B (2.12 ±0.13),the significant decreasing of PWMT( (0.39 ±0.17)g) and PWTL( ( 11.59 ± 1.67 ) s ) were observed in group T compared with group S and preoperative base level (P ＜ 0.05 ).(2) At day 17,day 19 and day 23 after the operation,compared with the basal level of dayl4 before administration and group C,the spontaneous lifting behaviors ( (5.13 ± 1.38),(4.70 ± 1.58),(5.64 ± 1.17) ) of group T were obviously decreased,PWMT ( ( 1.10 ± 0.65 ) g,( 0.95 ± 0.56 ) g,( 1.05 ± 0.26 ) g) and PWTL ( ( 15.17 ± 1.27) s,( 15.93 ± 2.18 ) s,( 16.28 ± 1.48 ) s ) were increased,the expression of NR2B ( ( 1.42 ± 0.17),(1.67 ±0.53),(1.14 ±0.79) ) were significantly decreased(P＜0.05).Conclusion Repeated intratheal injection of ifenprodil can efficiently relieve spontaneous lifting behaviors,mechanical hyperalgia and thermal hyperalgia and decrease the expression of lumbar intumescentia NR2B in the mouse model of bone cancer pain.

Objective To investigate the analgesic efficacy of intrathecal injection of RC-13,a competitive kinesin superfamily protein 17 antagonist,in a mouse model of bone cancer pain.Methods Forty male C3H/HeJ mice,aged 6-8 weeks,weighing 20-25 g,were randomly divided into 5 groups (n=8 each): sham operation group (group S); bone cancer pain + 5 μl dimethyl sulfoxide (DMSO) group (group R0); bone cancer pain + 2.5 μg RC-13 group (group R1); bone cancer pain + 5 μg RC-13 group (group R2) and bone cancer pain + 10 μg RC-13 group (group R3).In groups R0-3,bone cancer pain was induced by implantation of α-min-imal essence medium (α-MEM) containing osteosarcomaNCTC 2472 cells into the intramedullary space of right femur.In group S,culture medium α-MEM containing no cancer cell was injected instead.10％ DMSO 5 μl and RC-13 2.5 μg/5 μl,5μg/5μ1 and 10 μg/5 μ1 dissolved in 10％ DMSO were injected intrathecally in groups R0-3,respectively,once a day for 3 consecutive days starting from 14th day after inoculation of the tumor cells.Pain behavior was assessed by the paw withdrawal mechanical threshold (PWMT) and spontaneous lifting times (SLTs) measured at 1 day before inoculation and at 3,5,7,10,14 days after inoculation.The same tests were also performed at 1,3,5 and 7 days after administration in groups R0-3.Results Compared with group S,PWMT was significantly decreased and SLTs were increased at 7-14 days after inoculation in the other groups (P ＜ 0.05).Compared with group R0,PWMT was significantly increased and SLTs were reduced at 1 day after administration in group R1,at 1and 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R1,PWMT was significantly increased and SLTs were reduced at 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R2,PWMT was significantly increased and SLTs were reduced at 1 and 3 days after administration in group Rs (P ＜ 0.05).Conclusion Intrathecal RC-13,a competitive kinesin superfamily protein 17 antagonist,has a good analgesic efficacy in a mouse model of bone cancer pain and the efficacy is dose-dependent.