Objective:To obtain the prevalence laryngopharyngeal reflux disease (LPRD), anxiety and depression in otorhinolaryngology outpatients and to explore the role of mental and psychological factors (anxiety and depression) in their pathogenesis.Methods:A questionnaire survey of reflux symptom index(RSI) scale and hospital anxiety and depression (HAD) scale were used to report 1 111 cases of outpatients in Department of Otorhinolaryngology Head and Neck Surgery, Peking University People′s Hospital, from July 2017 to June 2018 (486 males, 625 females, age of 18-96 years old, median age of 38[30,53] years old) and to obtain the prevalence of LPRD, anxiety and depression. RSI-positive patients were selected in the case group, and RSI-negative patients were selected in the control group. The differences in HAD scores between the two groups were compared, and the risk factors of laryngopharyngeal reflux were analyzed. Statistical analysis was performed using SPSS 20.0 software.Results:There were 151 cases in the case group and 960 cases in the control group. The prevalence of LPRD was 13.59% (151/1 111).There was no significant difference in the prevalence of LPRD between different genders ( P>0.05). The prevalence rate was the highest in the 18-40 age group, and the difference in the prevalence of all age groups (18~ 40 years old; 41-65 years old; >65 years old) was statistically significant ( P<0.05). The prevalence of LPRD among smokers and non-drinkers was higher than that of non-smokers and non-drinkers and the prevalence of the two groups was statistically significant ( P<0.05). The most common symptoms of the RSI scale were pharyngeal foreign body sensation (92.72%,140/151), persistent clearing throat (88.74%,124/151), excessive sputum or nasal reflux (82.12%, 124/151). There were significant statistical differences between the two groups ( P<0.05). Ninty-one patients with anxiety, the prevalence was 8.19%(91/1 111); 76 patients with depression, the prevalence was 6.84%(76/1 111).Among the LPRD patients, the hospital anxiety scale scored 29.14% (44/151), and the hospital depression scale scored 17.22% (26/151). The scores of anxiety symptoms and depressive symptoms in the LPRD group were higher than those in the non-LPRD group. The above scores were statistically significant ( P<0.05). Logistic regression analysis showed that smoking, anxiety and symptoms of gastroesophageal reflux disease were independent risk factors for laryngopharyngeal reflux. Conclusions:The prevalences of LPRD, anxiety and depression in the otorhinolaryngology clinic are 13.59%, 8.19% and 6.84%, respectively. Among patients with laryngopharyngeal reflux, the prevalence of anxiety is 29.14%, and the prevalence of depression is 17.22%. Age, smoking, drinking, alcohol consumption, education level, course of disease, symptoms of gastroesophageal reflux disease, pharyngeal foreign body sensation, etc. are related to LPRD. Mental factors (anxiety and depression) may play a role in LPRD. Smoking, anxiety symptoms and symptoms of gastroesophageal reflux disease are closely related to the incidence of LPRD.

Objective: To establish a New Zealand rabbit animal model of laryngopharyngeal reflux disease (LPRD) using esophageal balloon together with metal internal stent dilation and to investigate the changes of mucosa. Methods: 20 New Zealand rabbits were randomly divided into experimental group and control group, with 10 in each group. Balloon dilatation and metal internal stent dilation were carried out in experimental group to reproduce the animal model of LPRD.The middle of balloon was placed at the lower esophageal sphincter (LES) while the stent was placed at the upper esophageal sphincter (UES). The guide wire was placed in the control group, but the balloon was not expanded and the stent was not placed. The general condition, pH value of hypopharynx, laryngeal histopathology and changes of pepsin content of New Zealand rabbits were observed regularly. The difference between experimental group and control group was compared. Results: The 24-hour Dx-pH monitoring results showed that the number of reflux episodes(20.0[9.5, 35.0], 13.0[6.5, 22.0]), and the percent time below pH 5.5 (1.36%[0.60%, 4.57%], 1.36%[0.43%, 2.77%]) in the experimental group at the 2nd and 4th week were significantly different from those in the control group (0[0,3.0], 1.0[0.5, 3.8]; 0[0, 0.01%], 0[0, 0], respectively, all P<0.01), suggesting that the experimental group New Zealand rabbits developed LPRD. Compared with the control group under microscope, lymphocytes infiltration and submucosal gland hyperplasia increased in the mucosa of the throat of the experimental group. The results of pepsin immunohistochemical staining between the two groups were statistically significant (P=0.014). Conclusion The use of balloon dilatation of the LES combined with metal stent dilatation of the UES can successfully establish a laryngopharyngeal reflux model, and lesions in the throat tissue can be observed.

Objective: To investigate the pathogenic factors of vocal leukoplakia and its clinical and pathological features. Methods: Eighty-one patients with vocal cord leukoplakia who underwent surgery between February 2010 and December 2016 and 160 volunteers without pharyngeal symptoms designed as controls were included in this case control study. The clinicopathological characteristics of 81 patients were summarized and analyzed synthetically. Results: There was statistical significance in reflux symptom index(RSI), reflux finding score(RFS), smoking index, and drinking index between case group and control group(Z=-5.35, -4.82, -4.76, -2.44, P<0.05). The voice-using duration per day in case group was significantly longer than that of control group.There was no statistical significance in hospital anxiety and depression scale for anxiety(HADA) scores、hospital anxiety and depression scale for depression(HADD) scores between case group and control group(P>0.05). In 42 patients who received 24-hour dual probe pH monitoring the prevalence of pathologic LPR was 42.8%. In 81 patients, 39(48%)patients were pathologically diagnosed as squamous cell hyperplasia, 18(22%)patients as mild dysplasia, 12(15%)sides as moderate dysplasia , 10(12%)patients as severe dysplasia and 2(2%)patients as carcinoma in-situ. The average age of high-risk pathological vocal leukoplakia was significantly higher than that of low-risk leukoplakia(t=-2.73, P<0.01). The propotion of speckled leukoplakia in high-risk leukoplakia was significantly higher than that of low-risk leukoplakia(χ²=23.81, P<0.01). There was no statistical significance between high-risk leukoplakia and low-risk leukoplakia in the prevalence of pathologic LPR(P>0.05). The bilateral lesions, speckled leukoplakia were more likely to relapse(χ²=4.27, 12.17, P<0.05). The more serious the pathology, the more likely it was to relapse (Z=-2.168, P=0.03). There was no statistical significance between recurrence group and non-recurrence group in the prevalence of pathologic LPR(P>0.05). Conclusions LPR, smoke constitute the risk factors of vocal cord leukoplakia. Drinking, voice abuse are related to vocal cord leukoplakia. Senile, speckled leukoplakia are more likely to be malignancy. A speckled leukoplakia, bilateral leukoplakia, severe pathological degree are important factors to predict recurrence.

Objective To simulate the process of hypoxic?ischemic brain injury at high altitude in a simulated cabin with plateau low pressure environment, and to prepare a rat model of cerebral injuries at different high altitudes. Method Thirty?two 0?day?old neonatal SD rats were divided into four groups, namely group A ( control group) and three test groups:group B (2000 m group), group C (4000 m group), and group D (6000 m group). The rats of control group were reared in a barrier environment. The rats of test groups were placed in a simulated cabin with plateau low pressure environment, and to prepare neonatal cerebral ischemia?hypoxia model by sport activities. The sport movements were carried out in the cabin in a swimming groove 60 min/d, and not less than 20 hours a day at high altitude low pressure environment. Zea Longa 5 point scale standard was used to determine the behavioral scores at the 3 th 7 th 11 th 15 th days, and samples were collected on the 15th day to observe red blood cell morphology using HE and 2, 3, 5?triphenyltetrazolium chloride ( TTC ) staining and ultrastructure by scanning electron microscopy. Result ( 1 ) The neurological scores of the test groups A, B, C were significantly different from that of the control group (P<0?05), and the scores of test group D and control group were very significantly different ( P <0?01 ) . ( 2 ) The histopathological examination using HE staining showed inflammatory cell infiltration in all rats of the test groups, and the extent of inflammatory cell infiltration was positively correlated with the increase of altitude. ( 3 ) The histopathology with TTC staining revealed prominent ischemia in the cerebral cortex of rats in the plateau hypoxic environment. ( 4 ) Scanning electron microscopy showed that the rat erythrocytes were cap?like in the group B, irregular in the group C, and zigzag shape in the group D. Conclusions In this study, a rat model of neonatal hypoxic?ischemic encephalopathy ( HIE) is successfully established by hypoxic cabin combined with sport activity. This model is stable, reliable, more closely mimicking the pathogenesis and clinical manifestation of neonatal HIE than models prepared with other methods, therefore, may be used in related research.

Objective To investigate the epidemiological and clinical characteristics of measles in patients of different age groups in Northeast China in 2014.Methods The clinical data of patients with measles in ten hospitals of infectious diseases in Northeast China from January 2014 to June 2014 were collected.Patients were divided into <16 age group and ≥16 age group, and the epidemiology , clinical characteristics, treatment and prognosis of all patients were retrospectively reviewed .SPSS 17.0 was used for data analysis.Results There were 1 401 patients with measles, in which 402 were <16-year old, and 999 were ≥16-year old.Clinical manifestations were mainly maculopapule (100.0%), fever (84.58%), cough (85.80%), Koplik’ s spot (73.23%), pharyngeal hyperemia (71.23%), diarrhea (43.97%), expectoration (40.97%), tears (39.40%) and runny nose (30.55%).The incidences of Koplik’s spot, sputum, pharyngeal hyperemia and diarrhea in <16 age group were lower than those in ≥16 age group (χ2 =8.364, 29.768, 10.953 and 6.701, P<0.05 or <0.01); while the incidence of runny nose was higher than that in ≥16 age group (χ2 =6.703, P<0.05).Abnormalities were found in blood routine examination, C-reactive protein (CRP), liver and kidney function, serum electrolyte levels, myocardial enzymes, and so on.Increasing in WBC, PLT and creatine kinase isoenzyme (CKMB), and decreasing in WBC were observed in 38(9.45%), 122(30.35%), 279(69.40%) and 105(26.12%), patients in <16 age group, which were higher than those in ≥16 age group [45(4.5%), 14(1.40%), 347(34.73%) and 202(20.22%)], and the differences were of statistical significance (χ2 =12.593, 274.033, 139.385 and 5.830, P<0.05 or P<0.01).Increasing in alanine aminotransferase (ALT), CRP, total bilirubin level (TBil), creatine kinase (CK), and decreasing in albumin (Alb), K+, Na+, Cl-were observed in 70(17.41%), 7(1.74%), 38(9.45%), 7(1.74%), and 214(53.23%), 59(14.68%), 45(11.19%), 94(23.38%) patients in <16 age group, which were lower than those in ≥16 age group [668(66.87%), 89(8.91%), 277(27.73%), 714(71.47), and 268(26.83%), 339(33.93%), 642(64.26%), 450 (45.05%)], and the differences were of statistical significance (χ2 =281.230, 23.073, 50.687, 159.740, and 14.674,114.286, 44.268, 271.546, P<0.01).Laryngitis and pneumonia were the most common complications.The incidence of laryngitis in <16 age group was 12.69% (51/402), which was higher than that in ≥16 years group (93/999, 9.31%,χ2 =3.545, P<0.05);while the incidence of spot shadows demonstrated by X-ray in <16 years group ( 72.89%, 121/166 ) was higher than that in ≥16 years group (265/445, 59.55%,χ2 =9.249, P<0.01).Conclusions There are differences in clinical features of measles in patients between <16 age group and ≥16 age group.Basic immunization in children and revaccination in adults should be enhanced to control the epidemics of measles .

Objective To explore the morbidity of laryngopharyngeal reflux in patients with dysphonic diseases and to investigate the influence of LPR on the patients.Methods One hundred and twenty-seven patients with dysphonic diseases were encountered in Peking University of the People Hospital.Under the agreement, the patients were asked to fill in the scales of RSI, RFS, VHI and SF-36.24-hour ambulatory double pH monitoring was applied to diagnose LPR definitely.2 643 volunteers were recruited to fill in the RSI scale through physical examination, outpatient , the ward and web survey.Results 46.46％ (59/127) patients were diagnosed with LPR definitely.1 241 of 2 643 volunteer, who filled in the RSI, score more than zero in the first entry of hoarseness or dysphonia, 65.0％ (807/1 241) of them, scoring 13 points or higher, were diagnosed with clinically suspected LPR.Based on the 24-hour ambulatory double pH monitoring, VHI total scores and subscores in the emotional domains were higher in positive group than in negative group.There was no statistical difference (P ＞ 0.05) in functional and physical domains.The SF-36 scale was used to evaluate the quality of life of the patients.The difference of 6 dimensionality, scoreshad statistical significance(P ＜ 0.05) , including role-physical, general health, validity, social function, role-emotional and mental health.There was no statistical difference in dimensionalities of rolephysical and bodily pain.Conclusions The volunteers who were diagnosed with hoarseness or dysphonia had the higher morbidity rate of LPR.At the time of treatment, more attention should be paid to the quality of life.

Objective To explore the different changes of the adult cerebral blood flow with ages,different weight and gender,to summarize the changing characteristics of cerebral blood flow.Methods 360 cases of examination were divided into two groups according to gender,and were divided into five groups at different ages,and were divided into four groups according to body mass index,using TCD detector blood flow velocity.Results 196 cases of male physical examination,the mean cerebral blood flow was (969.37 ± 117.54)ml/min;the 164 females physical examination,the average cerebral blood flow was (987.76 ± 114.34)ml/min,there was no statistically significant difference (P ＞ 0.05).Different ages cerebral blood flow velocity were different,20 to 29-year-old group and the 30 to 39-year-old group had no significant difference (P ＞ 0.05) ;40 to 49-year-old group,50 to 59 years,60 to 69 years old ＞ 70 age group significantly declined compoued with the first two groups,there was significant difference (P ＜ 0.05) ;there were significant difference between the four groups (P ＜ 0.05).Overweight and obese group were significantly lower than the light and the normal group,there was a statistically significant difference (P ＜ 0.05).Conclusion TCDcan be a sensitive and accurate hemodynamic changes in the human brain,and is very important in the early diagnosis,prevention,treatment,and follow-up of cerebrovascular disease.

Objective To compare the clinical results of endovenous laser treatment(EVLT),radiofrequency endovenous occlusion(RFO)and conventional stripping combined with transilluminated powered phlebectomy(TIPP)for lower extremity varicose vein.Methods From Jun 2004 to Jan 2007,200 cases(232 limbs)were treated by EVLT with TIPP,80 cases(88 limbs)by RFO with TIPP,and 180 cases(202 limbs)by conventional stripping with TIPP.Operation time,number of the incision made,intraoperative bleeding,postoperative hospital stay,complications,and one-year recurrence rate were compared with each other. Results Operation time was longer(41±8)min in RFO group than that in other two groups.Postoperative hospital stay was shorter in EVLT group(1.2±0.4 d)and RFO group (2.1±0.8 d)than that in stripping and TIPP group(P＜0.05).Patients in stripping group also suffered from more intra-operative bleeding more often incidental nervus saphenus injury and more incision numbers when compared with other two groups(P＜0.05).There was no significant difierence in one-year recurrence rate among patients in the three groups. Conclusions The clinical efficacy is almost the same among the three groups in terms of eradication of the varicose veins.EVLT and RFO are safe and minimal invasive for the treatment of lower extremity varicose vein.

Objective To explore the morbidity,the diagnosis and the method of therapy of accidental prostatic carcinoma. Methods From Jan of 1984 to May of 2004, 19 cases of prostatic accidental carcinoma were confirmed on pathological examination after prostatectomy for BPH. Bilateral orchiectomy and Estrogen treatment were performed in 6 cases and Bilateral orchiectomy in 7 cases alone but no treatment in 6 cases. Results 5 of the patients wereA1 stage and 14 A2 stage. 12 of them were followed up for 3 to 120 months. 14 of them survived and one untreated died of metastasis to pubis and vertebra after one year. Conclusions Most patients of prostatic accidental carcinoma are A1 and have a better prognosis. Bilateral orchiectomy and Estrogen treatment might improve the patients’s survival rate.

BACKGROUNDTo study the effect and safety of tissue specific gene therapy of suicide gene for lung adenocarcinoma.

METHODSRetroviral vector of G1CEACDNa contained a carcinoembryonic antigen (CEA) promoter regulated cytosine deaminase expression cassete (CEA/CD). By means of infection of virus, tissue specific expressing vectors and non-specific expressing vectors were transfected into A549 cell, which was CEA-producing lung adenocarcinoma cell line and then xenografted in nude mice, and the anti-tumor effect was evaluated. Then the retrovirus was injected directly into the tumor mass on nude mice, and the sensitivity of the xenograft to G1CEACDNa/5-fluorocytosine (5-FC) and the side effects were observed.

RESULTS(1) After transfected and untransfected A549 cells were implanted into nude mice, there was no difference in tumor formation among all the groups. (2) After 5-FC administration, the tumor transfected with tissue-specific gene displayed a higher sensitivity to the drug than those treated with non-specific in vitro gene-therapy. (3) The tumor-bearing nude mice were randomized in a blind manner based on comparable size to receive the supernatant of recombinant retrovirus G1CEACDNa followed by 5-FC, and significant growth suppression could be observed. (4) Comparing to the group with injection of 5-fluorouracil (5-FU) alone, tissue-specific suicide gene therapy showed lower suppression to bone marrow.

CONCLUSIONSThe results suggest that tissue-specific suicide gene therapy may play an important role in individual treatment of lung cancer.