Objective:To determine the effectiveness of individualized voice therapy in persistent pediatric voice disorders. Methods:Thirty-eight children who were admitted to the Department of Pediatric Otolaryngology Shenzhen Hospital, Southern Medical University due to persistent voice disorder from November 2021 to October 2022 were included. All children were evaluated by dynamic laryngoscopy before voice therapy. Two voice doctors performed GRBAS score and acoustic analysis on the children's voice samples to obtain the relevant parameters including F0, Jitter, Shimmer, and MPT; All children were given personalized voice therapy for 8 weeks. Results:Among 38 children with voice disorders, 75.8%（29 cases） were diagnosed with vocal nodules, 20.6%（8 cases） were vocal polyps, and 3.4%（1 case） were vocal cysts. And in all children. And 51.7%（20 cases） had the sign of supraglottic extrusion under dynamic laryngoscopy. GRBAS scores decreased from 1.93 ± 0.62, 1.82 ± 0.55, 0.98 ± 0.54, 0.65 ± 0.48, 1.05 ± 0.52 to 0.62 ± 0.60, 0.58 ± 0.53, 0.32 ± 0.40, 0.22 ± 0.36, 0.37 ± 0.36. F0, Jitter, Shimmer decreased from（243.11±39.73） Hz, （0.85±0.99）%, （9.96±3.78）% to（225.43±43.20） Hz, （0.33±0.57）%, （7.72±4.32）%, respectively MPT was prolonged from（5.82±2.30） s to（7.87±3.21） s after treatment. All parameters changes had statistical significance. Conclusion:Voice therapy can solve children's voice problems, improve their voice quality and effectively treat children's voice disorders.
Humans ; Child ; Voice Disorders/diagnosis* ; Voice ; Voice Quality ; Acoustics ; Speech Acoustics ; Vocal Cords/surgery*

Inflammatory myofibroblastic tumor （IMT） is a rare mesenchymal soft tissue tumor characterized by borderline or low-grade malignancy. It is rare childhood tumor with an average age of onset of 10 years old. It is even rarer in infants and toddlers, and the etiology and pathogenesis of this tumor are still unclear. The clinical presentation of IMT is non-specific and are related to the location of the tumor. When the tumor compresses adjacent organs, it can cause pain and functional impairment. According to the current literature, IMT is most commonly found in the digestive and respiratory systems, but also occasionally occur in the genitourinary system, head and neck, and limbs. At present, there have been no reports of nasopharyngeal IMT involving nasal cavity of infants and toddlers at home and abroad.This article reports a case of a massive inflammatory myofibroblastic tumor involving the nasal cavity and nasopharynx in an infant. Plasma-assisted minimally invasive surgery was performed through multiple surgical approaches and achieved satisfactory therapeutic results. This case report may provide valuable reference for the treatment of similar diseases.
Humans ; Infant ; Granuloma, Plasma Cell/pathology* ; Nasopharynx/pathology* ; Neoplasms, Muscle Tissue ; Soft Tissue Neoplasms

Objective To observe the efficacy of intravitreal injection of ranibizumab (IVR) for different patterns of optical coherence tomography (OCT) of diabetic macular edema and the relationship between integrity of ellipsoidal zone and visual acuity outcomes.Methods Eighty-five IVR treated eyes were enrolled.The examination of BCVA was according to Early Treatment Diabetic Retinopathy Study,and the results were recorded as logarithm of the minimum angle of resolution (logMAR).Frequency-domain OCT was used to measure the central foveal thickness (CFT) and the integrity of ellipsoidal zone.All eyes were classified as diffuse macular edema (DRT group,31 eyes),cystoid macular edema (CME group,29 eyes),and serous retinal detachment (SRD group,25 eyes).All the patients were treated with intravitreal injection of 0.05 ml (0.5 mg) ranibizumab.The mean follow-up time was (9.21+3.56) months after IVR treatment.The changes of BCVA and CFT in 3 groups were compared and analyzed after 3,6 and 12 months.According to visual acuity at different ranges,the relationship between integrity of ellipsoidal zone and BCVA was analyzed.Results Compared with the average logMAR BCVA before treatment,except for 12 months after treatment in group SRD (t=2.104,P=0.053),the average logMAR BCVA after IVR at 3 months,6 months and 12 months improved in DRT group (t=7.847,6.771,6.426;P=0.000,0.000,0.000),CME group (t=8.560,6.680,5.082;P=0.000,0.000,0.000) and SRD group (t=5.161,3.968,2.104;P=0.000,0.001,0.053).The average logMAR BCVA of the DRT group was lesser than that in CME and SRD group after 12 months treatment (t=-2.043,-3.434;P=0.030,0.001).The average CFT after IVR at 3 months,6 months and 12 months reduced significantly in DRT group (t=12.746,10.687,9.425;P=0.000,0.000,0.000),CME group (t=13.400,11.460,10.169;P=0.000,0.000,0.000),and SRD group (t=1 1.755,10.100,9.173;P=0.000,0.000,0.000).After 12 months of treatment,the average CFT of the SRD group was thicker than that in DRT group and CME group (t=-3.251,-1.227;P=0.003,0.025);there was significant difference in the integrity of ellipsoidal zone among 3 groups (x2=1.267,P=0.531).The results showed that there were significant differences in the integrity of ellipsoidal zone with different ranges of BCVA before and after 12 months treatment (x2=20.145,41.035;P=0.000,0.000).Conclusions IVR could significantly improve the visual acuity of different patterns of DME,reduced the CFT,and had the best efficacy in the DRT group.There was relationship between the integrity of ellipsoidal zone and the visual acuity outcomes.

Background The scarring of conjunctival filtering blebs after glaucomatous surgery is a leading cause of operation failure.Exploring the balance between matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) in conjunctival filtering bleb is very important for the study on pathogenesis of postoperative scarring.Objective This study was to evaluate the role of MMP-2 and TIMP-2 in wounding healing of subconjunctival tissue after filtering surgery in rats.Methods Sixty-three clean male SD rats were divided into normal control group and postoperative 1-day,3-day,5-day,7-day,14-day and 28-day group.The drainage tube was monocularly implanted into the anterior chamber of the rats to establish the filtering surgery models,and the operative response of the eyes was examined under the slit lamp microscope.The animals were sacrificed in corresponding time points,and the frozen sections of eyeballs were prepared,and the expressions of MMP-2 and TIMP-2 in conjunctival and subconjunctival tissues were detected using immunofluorescence technique.Western blot was employed to assay the dynamic expressions of MMP-2 and TIMP-2 proteins in conjunctival and subconjunctival tissues in different groups.The use and care of the rats complied with the Instruction Notions with Respect to Care for Laboratory by State Ministry of Science and Technology.Results Filtering blebs were formed in all the operated eyes 1 day after surgery and remained for 7-17 days,with the average survival time of 12 days.Western blot assay revealed that the expression levels of MMP-2 protein in the filtering blebs of the normal control group were 121.67 ±4.37,and the expressions were gradually elevated from the postoperative 3-day group (183.67±5.61) until the postoperative 7-day group (230.50±8.48) and then gradually declined till the postoperative 28-day group (172.33 ± 8.43),showing a significant difference among the groups (F=280.18,P＜0.05).In addition,the expression levels of TIMP-2 protein in filtering blebs of the normal control group were 102.50 ±6.25.The expression levels were gradually raised in postoperative 3-day group (162.67±7.00) and peaked in the postoperative 5-day group (232.00± 11.03),and then the levels gradually reduced till the postoperative 28-day group (150.50±6.41),with a significant difference among the groups (F =145.34,P ＜ 0.05).Immunofluorescent staining showed that MMP-2 and TIMP-2 were weakly expressed in the conjunctival epithelium of the normal rats,while in the operated rats,strong fluorescence for MMP-2 and TIMP-2 was seen in both conjunctival epithelium and subconjunctival tissues of filtering blebs.Conclusions The expression trends of MMP-2 and TIMP-2 in the filtering blebs are consistent to the fibrosis process of conjunctival tissue,indicating that MMP-2 and TIMP-2 participate in the scar formation of conjunctival filtering bleb after glaucoma filtering surgery.

Background Myopia is one of the main blinding diseases worldwide.At present,a lot of studies on ocular structure focus on the changes of corneal curvature(CC),central corneal thickness (CCT),anterior chamber depth (ACD),ocular axial length (AL) and choroid and retina,but the research of anterior chamber angle section structure form and ciliary body shape is lack.Objective This study was to measure and analyze the changes of the anterior chamber angle and related tissue structure in myopic eyes.Methods One hundred and forty-nine eyes of 149 subjects were included from May 2008 to May 2010 in Eighth Hospital of Qingdao City with the ages of 18-40years old under the informed consent.The subjects were assigned to the emmetropia group (30 eyes) ([0.02±0.18] D),low myopia group(46 eyes) ([-1.64±0.69] D),moderate myopia group (35 eyes) ([-4.56±0.66] D) and high myopia group (38 eyes) ([-7.04 ± 1.02] D).Conventional indexes including intraocular pressure (IOP),CCT,CC,AL and ACD were measured,and the indexes including chamber angel open distance (AOD),iris thickness (IT1,IT2,IT3),the position of ciliary body such as A-angel,B-angel,trabecular ciliary process distance (TCPD),irisciliary process distance (ICPD) and ciliary body thickness (CBT1,CBT2,CBT3) were measured by ultrasound biomicroscope(UBM).Results The IOP,CC and CCT values showed slight change in different groups without remarkable difference among them (all at P＞0.05).As the increase of myopic degree,AL was extended and ACD was deepened,showing significant differences among the groups (both at P＜0.05).There were no significant differences in IT1,IT2 and IT3 among the four groups (all at P＞0.05).However,the measuring values of angle opening degree (TIA and AOD500),ciliary position (A-angle,B-angle,TCPD,ICPD) and CBT (CBT1,CBT2,CBT3) elevated with the increase of myopic degree (all at P＜0.05).Positive correlations were found between AOD500 and ACD,A-angle,CBT1,CBT2,AL,negative correlations was found between AOD500 and myopic degree (r =0.573,0.513,0.325,0.398,0.542,-0.435,all at P＜0.01);Positive correlations were found between TIA and ACD,A-angle,CBT1,CBT2,AL,negative correlations was found between AOD500 and myopic degree (r =0.573,0.464,0.276,0.410,0.539,-0.435,all at P ＜ 0.01).Conclusions Within certain limits,as the increase of myopic degree,ACD deepens,the anterior chamber angle widens,ciliary process thickens and ciliary body backward shifts.

BACKGROUNDEpstein-Barr virus (EBV) infection is one of the most important factors of nasopharyngeal carcinoma (NPC) endemic areas. Transcription of EBV-encoded non-polyadenylated RNAs (EBERs) are presented in most of NPC tumors. Exploring EBERs as a prognostic marker for NPC might further be informative about the biology and the progression of the disease. The aim of this study was to analyze the role of EBV latency in the clinical management of nasopharyngeal carcinoma (NPC), by detecting EBERs.

METHODSRNA in situ hybridization (ISH) for detecting EBERs was carried out on 908 NPC tumor tissues. Overall survival (OS) curves were analyzed with the Kaplan-Meier method and the Cox proportional-hazards regression models.

RESULTSThe median follow-up time was 70 months (1-120 months). Eight hundred and sixteen (89.9%) from a total of 908 consecutive NPC cases were found to be EBV-EBER positive. EBER-ISH staining revealed nuclear localization in NPC cells. In the Kaplan-Meier analysis for OS, high EBER expression levels in NPC patients were statistically significant positive prognostic factors for survival (log-rank, P = 0.022), especially in adults aged 17-40 years (P = 0.023) and in those with advanced stage disease (log-rank, P = 0.002). Cox proportional-hazards regression model analysis showed that the EBER expression level was an independent risk factor for OS (hazard ratio 0.724, P = 0.005).

CONCLUSIONSEBERs were frequently detected in NPC tumor tissues, and high-level EBER expression correlated with good prognosis in NPC patients, especially in adult patients and in those with advanced stage disease. EBER may serve as a potential prognostic predictor in NPC.

Adolescent ; Adult ; Aged ; Carcinoma ; Epstein-Barr Virus Infections ; virology ; Female ; Herpesvirus 4, Human ; genetics ; pathogenicity ; Humans ; In Situ Hybridization ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; mortality ; virology ; RNA, Viral ; genetics ; Young Adult

Background Dynamic observation in morphology and histology of conjunctival filtering bleb in rats can contribute to form ideal filtering blebs by interferencing the process of scarring.Objective This study was designed to observe the survival time,morphological and histopathological changes of conjunctival filtering bleb after filtering surgery.Methods Filtering surgeries were performed on 60 male adult Sprague-Dawley rats by implanting drainage tubes into the anterior chamber.The shape of filtering blebs was examined by slit lamp microscope 1 day,3,5,7,14,28 days after surgery.The filtering was typed according to the criteria of Kronfeld.Areas of the filtering bleb were measured and compared at various time points after surgery.Conjunctival and subconjunctival tissues at filtering zone were obtained 1 day,3,5,7,14,28 days after surgery,respectively,and hematoxylin and eosin staining was used for the histopathological evaluation.Results Well-elevated filtering blebs formed on the first day after surgery in 60 rat eyes.The survival time of filtering bleb was 7-17 days with the mean time of (11.93±2.23) days.Survival rate of the filtering blebs was 100％ in 1-5 days,77％ in 7 days,20％ in 14 days and 0 in 28 days after operation.The filtering blebs were functional (Ⅰ type) in 1-5 days after operation,23 eyes were functional in 7 days after operation (13 eyes were Ⅰ type,10 eyes were Ⅱ type),4 eyes were functional in 14 days after operation (2 eyes were Ⅰ type,2 eyes wereⅡtype).The filtering area shrunken from (7.50±1.08) mm2 to (1.83±0.35) mm2during the observational duration.The filtering blebs area of different days after surgery were statistically significant (F =180.056,P=0.000),and significant differences were found between any two timepionts after surgery (all at P =0.000).Histological examination showed that inflammatory finding was dominant in postoperative day 1-3,such as infiltration of inflammatory cells,vasodilatation and edema of tissue.However,proliferating manifestation became the main signs 5 days later,showing the increase of fibroblasts,neovascularization and collagen formation.Conclusions The model of conjunctival filtering blebs in rats can be successfully established by implanting silicone tube into anterior chamber.The inflammatory response,proliferation of fibroblasts and the accumulation of collagen fibers are involved in the scarring process of filtering blebs.

Objective:To compare low temperature coblation assisted tonsillectomy with conventional dissec-tion tonsillectomy intraoperation and afteroperation. Method:Ninty-two pedia-patients were randomly divided into coblation-assisted tonsillectomy group and the control group. Arthrocare EVac 70 T&.A Wand was used for cobla-tion-assisted tonsillectomy, and the energy set was 7. Conventional dissection tonsillectomy was operated in control group. The operating time,bleeding,tonsillar fossae healing and return to normal diet and activities, intraoperative complications were recorded seperately. Postoperative pain of the pedia-patients was recorded daily using Wong Baker FACES pain scale for 10 days of afteroperation. Result: Coblation assisted group had a shorter operative time than the control group (10. 2min vs. 36. 5min, P<0. 001). The average amount of intraoperative bleeding of Coblation assisted group was(6. 83±3. 36) ml, while the control group was(30. 07±7. 04)ml. Pedia-patients of Coblation group had a better pain score on 1, 2, 3 days after operation than in control group, and there was no statistically significant difference on 4 to 10 days between the two groups. Coblation group ones returned to normal diet earlier than the control group, but both group required similar time returned to normal activities. There was one patient in control group, who required suturing to stop bleeding for active oropharyngeal bleeding on the 6th day after operation. Conclusion: Comparing with traditional dissection, Coblation assisted tonsillectomy is easy to perform with less intraoperative bleeding,shorter operation time,earlier return to normal diet, less pain on 1st to 3th day postoperatively.

OBJECTIVE: To compare low temperature coblation assisted tonsillectomy with conventional dissection tonsillectomy intra-operation and after-operation. METHOD: Ninety-two pedia-patients were randomly divided into coblation-assisted tonsillectomy group and the control group. Arthrocine EVac 70 T&A Wand was used for coblation-assisted tonsillectomy, and the energy set was 7. Conventional dissection tonsillectomy was operated in control group. The operating time,bleeding,tonsillar fossae healing and return to normal diet and activities, intraoperative complications were recorded separately. Postoperative pain of the pedia-patients was recorded daily using Wong Baker FACES pain scale for 10 days of after-operation. RESULT: Coblation assisted group had a shorter operative time than the control group (10.2 min vs. 36.5 min, P<0.001). The average amount of intraoperative bleeding of Coblation assisted group was (6.83+/-3.36) ml, while the control group was (30.07+/-7.04) ml. Pedia-patients of Coblation group had a better pain score on 1, 2, 3 days after operation than in control group, and there was no statistically significant difference on 4 to 10 days between the two groups. Coblation group ones returned to normal diet earlier than the control group, but both group required similar time returned to normal activities. There was one patient in control group,who required suturing to stop bleeding for active oropharyngeal bleeding on the 6th day after operation. CONCLUSION Comparing with traditional dissection, Coblation assisted tonsillectomy is easy to perform with less intraoperative bleeding, shorter operation time, earlier return to normal diet, less pain on 1st to 3rd day postoperatively.
Adolescent ; Child ; Child, Preschool ; Cold Temperature ; Cryosurgery ; methods ; Dissection ; methods ; Female ; Humans ; Male ; Tonsillectomy ; methods ; Tonsillitis ; surgery ; Treatment Outcome

OBJECTIVE: To investigate the characteristics of heart rate (HR) and heart rhythm in children with obstructive sleep apnea-hypopnea syndrome (OSAHS). METHOD: Ninety-five patients underwent overnight PSG for clinically suspected OSAHS. According to the apnea index (AI), the patients were assigned to control group (AI < or = 1/h, SaO2 >92%, n = 27) or OSAHS group (AI > 1/h, SaO2 < 92%, n = 68). The HR and heart rhythm were monitored and compared between the two groups. RESULT: The maximum HR during sleep was significantly higher in OSAHS group while the minimum HR was significantly lower during sleep. Bradycardia and tachycardia is a common feature of pediatric OSAHS. There was a significantly higher incidence of tachycardia in OSAHS groups than in the control group. CONCLUSION These findings suggest that pediatric OSAHS might influence HR and heart rhythm.
Child ; Child, Preschool ; Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Polysomnography ; Sleep Apnea, Obstructive ; physiopathology