Epidemiological features of allergic rhinitis in four major cities in Western China

Allergic rhinitis (AR), with an increasing uptrend of the prevalence in many developed and developing countries, is a global health problem that affects people of all ages and ethnic groups. However, data on the prevalence of self-reported AR in western China are rare. This study investigated the epidemiological features of self-reported AR in western China. In the cross-sectional, population-based study, a validated questionnaire survey on self-reported AR was carried out in 4 major cities in western China by multistage, stratified and cluster sampling, from January to December 2008. The total prevalence rate was 34.3%, with 32.3% (Chongqing), 34.3% (Chengdu), 37.9% (Urumqi), 30.3% (Nanning), respectively. The prevalence presented to increase with age before 30 years old while decrease with age after 30 years old, and the highest prevalence was in 19-30 years group in Chongqing, Chengdu and Nanning which significantly showed "persistent and moderate-severe" type (P<0.0001); In Urumqi, there wasn't a significant increasing or decreasing trend of prevalence rate with age but with an "intermittent and mild"predominance (P<0.0001). There were no distinct sexual differences in prevalence rates in the 4 cities. The morbidity was positively related to monthly average temperature and sunshine (r=0.76645, P=0.0036; r=0.67303, P=0.0165), but negatively associated with relative humidity (r=-0.64391, P=0.0238) in Urumqi. Interestingly, the monthly morbidity was negatively associate with average temperature, sunshine and precipitation in Nanning (r=-0.81997, P=0.0011; r=-0.60787, P=0.0360; r=-0.59443, P=0.0415). Self-reported AR is becoming common in western China with a rapid development in recent years, affecting about three persons out of ten. The climatic factors may have an indirect impact on the prevalence rate through the effects on the local allergens.

[Clinical evaluation of acute low-tone sensorineural hearing loss]

OBJECTIVE

To assess the effect of treatment on acute low-tone sensorineural hearing loss and the related factors on the prognosis.

METHOD

A total of 398 inpatients with sudden deafness were retrospectively analyzed. Among them, 41 cases were diagnosed as acute low-tone hearing loss and then subjected to combined treatment with glucocorticoids. The relativity between patients' gender, disease duration and age of onset and curative effect were analyzed.

RESULT

The acute low-tone sensorineural hearing loss accounted for 10.30% of sudden deafness. Among which, female cases were significantly more than men, accounting for 70.73% of the total. At the first diagnosis, the average hearing threshold of three low tones was (48.43 +/- 11.67) dB against (18.86 +/- 9.40) dB of three high tones. After treatment, those two values were (27.07 +/- 11. 52) dB and (17.60 +/- 9.15) dB, respectively. There was statistical difference between three low tones and three high tones before treatment (t = 15.42, P < 0.01). There was statistical difference for three low tones before and after treatment (t = 10.69, P < 0.01) while there was no difference for the high ones before and after treatment(t = 1.93, P > 0.05). No obvious difference of the cure rate and effectiveness was found between male and female patients (P > 0.05). The incidence of acute low-tone sensorineural hearing loss was high in the age range of 21-40 years, accounting for 68.29% of the total. The cure rates were statistically different between patients less than 40 years old and 41-60 years old (chi2 = 6.662, P < 0.05), but the effectiveness had no difference (P > 0.05). There was no difference of cure rate and effectiveness between those with duration less than or equal to 7 days and those with more than 7 days (P > 0.05).

CONCLUSION

The combined therapy with glucocorticoids shows good effects on treating acute low-tone sensorineural hearing loss. Neither gender nor duration affect the prognosis. Age of onset is related to the prognosis.

Developmental expression of ACRV1 in humans and mice

To identify the developmental expression of the ACRV1 gene in humans and mice, testes cDNA samples were collected at different post-natal days (days 4, 9, 18, 35, 54, and 6 months) from Balb/c mice and were hybridised to the mouse whole genome 430 2.0 Array (Affymetrix Inc.) chip. The characteristics of ACRV1 were analysed using various cellular and molecular biotechnologies. The results showed that the expression of mouse ACRV1 was not detected in mouse testes on days 4, 9, and 18 but was present on days 35, 54, and 6 months. Using RT-PCR analysis of mouse ACRV1, we determined that mouse ACRV1 was expressed specifically in the mouse testis, and its expression began at days 35. Western blot analysis demonstrated that human ACRV1 was primarily expressed in human testes, and immunofluorescent and immunohistochemistry staining showed that human ACRV1 protein was predominantly located in round and elongated spermatids in human testes, indicating that ACRV1 may play an important role in mammalian spermatogenesis and may be a target of a contraceptive vaccine.

Referral patterns and clinical characteristics of subjects referred to substance abuse clinic of a regional hospital in Hong Kong

OBJECTIVES

To examine the clinical characteristics of subjects referred to the Substance Abuse Clinic of the Prince of Wales Hospital between 1 January 2007 and 31 December 2009 in Hong Kong.

METHODS

A chart review of 131 subjects referred to the Substance Abuse Clinic during the study period was carried out. Psychiatric diagnoses were made by a psychiatrist, according to the 10th edition of the International Classification of Diseases.

RESULTS

Social workers were increasingly a main source of referrals, accounting for 34% of referrals during the entire study period (and 43% in 2009). Another important referral source was the Hospital Authority system in Hong Kong, which accounted for 38% of referrals over the 3-year study period. Ketamine, methamphetamine, and cough mixtures were the most common drugs of primary misuse, the proportion of users being 34%, 24% and 12%, respectively. In these referals, the most common psychiatric diagnosis was substance-induced psychotic disorder, followed by depressive disorder, made in 44% and 22% of the subjects, respectively.

CONCLUSIONS

Among Hong Kong substance abusers, psychotic and depressive disorders are common, and ketamine is the most commonly misused drug.

Psychiatric morbidity at a female residential drug treatment centre in Hong Kong

OBJECTIVE

To describe the psychiatric co-morbidity of female psychotropic substance abusers treated at a residential treatment centre.

METHODS

Subjects were recruited from a female residential substance abuse treatment centre in Hong Kong--the Society for the Aid and Rehabilitation for Drug Abusers. Demographic data and substance abuse habits were recorded. Psychiatric diagnoses were established with the Structured Clinical Interview for the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders.

RESULTS

Of the 42 residents, 32 agreed to participate in the study. All of whom completed the questionnaire and the Structured Clinical Interview for the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. Concerning substance abuse, 84%, 38%, and 34% of the subjects were dependent on ketamine, methamphetamine and cocaine, respectively. The most common lifetime psychiatric diagnosis was substance-induced mood disorder (47%), followed by substance-induced psychotic disorder (16%).

CONCLUSIONS

Psychiatric disorders complicate heavy substance abuse in the majority of female patients. Regular screening of this population with standardised diagnostic instruments for psychiatric comorbidity is clearly warranted.

Radiation-induced sarcoma of head and neck: 50 years of experience at a single institution in an endemic area of nasopharyngeal carcinoma in China

Radiation-induced sarcoma in the head and neck (RISHN) is a rare condition whose clinical presentation and management remain difficult because of its low incidence. In this retrospective study, we analyzed the symptoms, diagnosis, and the treatment of 16,634 patients with head and neck disease, who received radiotherapy between 1960 and 2010 at the Affiliated Tumor Hospital and its predecessor, Guangxi Medical University, China. Among these patients, 16 with a first tumor of nasopharyngeal carcinoma (NPC) and 1 with squamous carcinoma of the tongue met the criteria of RISHN in the head and neck. Our epidemiological data showed that the incidence of RISHN rose from 0.06 to 0.17% from 1960 to 2010; the 3-year overall survival rate was 19.1%, and 3-year disease-free survival rate was 11.1%. The mean latency (SD) period was 93.2 (33) months. Based on the experiences at our institution, we suggest that RISHN is a rare complication after radiotherapy for head and neck tumors, especially NPC. Owing to its low incidence, it should not be a major factor affecting decisions about radiotherapy. Nevertheless, there may be a possibility of increasing incidence of RISHN after radiotherapy of NPC, as shown in our epidemiological results. Given the poor prognosis of RISHN, this possibility should be taken into serious consideration before determination of high-dose radiotherapy for patients with NPC and other head and neck tumors.

Using cerebral oximetry to prevent adverse outcomes during cardiac surgery

We report a case of reduced cerebral oxygenation which had the possibility of leading to an adverse outcome if it had not been detected by the routine use of cerebral oximetry. This case study illustrates that an inadvertent re-adjustment of a single-stage venous cannula within the superior vena cava resulted only in the cerebral oximetry device alerting to a potential problem. All other monitoring devices remained within standard operating parameters, with no deviation throughout the duration of the incident.

[The diagnosis and treatment of the simple congenital malformation of ossicular chain]

OBJECTIVE

To investigate the diagnosis and treatment of the simple congenital malformation of ossicular chain.

METHOD

Curative effect analysis for 4 cases of treatment of simple congenital malformation of ossicular chain were performed in our department from June 2005 to August 2009, retrospectively. 4 patients underwent middle ear exploration and ossicular chain reconstruction were followed up for 1-4 years, and air conduction threshold of speech frequency(0.5, 1.0, 2.0 kHz) were detected, 15 dB increase of which were as the standard of successful operation.

RESULT

Three cases was abnormal incus, 2 cases were absence of instruction on the stapes footplates, and stapes footplates fixed, one case was absence of the incus. Hearing level had significantly improve after hearing reconstruction in 3 patients. The averaged postoperative air conduction threshold of speech frequency had 47 dB increase, bone conduction threshold have no change, while one case of hearing level without change. Tinnitus, vertigo, facial paralysis and other complications occurred were found in all the patients.

CONCLUSION

The congenital conductive hearing loss without external ear malformations should be suspected of congenital malformation of ossicular chain, which could be diagnosed by tympanic exploration. Ossicular chain reconstruction can improve the hearing effectively.

Green tea catechins augment the antitumor activity of doxorubicin in an in vivo mouse model for chemoresistant liver cancer

Green tea catechins have been reported to have antitumor activity. The objective of this study was to examine the effect of catechins on the antitumor efficacy of doxorubicin (DOX) in a murine model for chemoresistant hepatocellular carcinoma (HCC). Epicatechin gallate (ECG) and epigallocatechin gallate (EGCG) are the most abundant polyphenolic compounds in green tea. Here, we show that ECG or EGCG at higher doses had a slight inhibitory effect on cell proliferation in the resistant human HCC cell line BEL-7404/DOX in vitro and in vivo, whereas the administration of DOX with these compounds at lower doses significantly inhibited HCC cell proliferation in vitro and hepatoma growth in a xenograft mouse model, compared with treatment with either agent alone at the same dose. Furthermore, the administration of DOX in combination with ECG or EGCG markedly enhanced intracellular DOX accumulation, which implies that the catechins inhibited P-glycoprotein (P-gp) efflux pump activity. Consistent with these results, the intracellular retention of rhodamine 123, a P-gp substrate, was increased and the level of P-gp was decreased in cells concurrently treated with DOX and ECG or EGCG. EGCG increased topo II expression, but did not alter GST protein levels in tumor xenografts. The expression of MDR1 and HIF-1alpha mRNA was obviously reduced, whereas MRP1 and LRP expression was not changed significantly. These data suggest that tea catechins at non-toxic doses can augment DOX-induced cell killing and sensitize chemoresistant HCC cells to DOX. The chemosensitizing effect of catechins may occur directly or indirectly by reversal of multidrug resistance, involving the suppression of MDR1 expression, or by enhancement of intracellular DOX accumulation, involving inhibition of P-gp function.

A survey of sexual health services in UK prisons

Sexual health services in prisons are provided without recognized national standards or commissioning guidance and surveillance data are incomplete. This original survey provides essential information on key elements of services in a large sample of UK prisons that will inform planning, development and monitoring of such services in an era of scarce NHS resources.

[Analysis on the relationship between tensor veli palatini and secretory otitis media in patients with nasopharyngeal carcinoma after radiotherapy]

OBJECTIVE

The analyze the relationship between secretory otitis media (SOM) and injury of tensor veli palatini (TVP) muscle injury after radiotherapy, then to explore the pathogenesis of SOM in patients with nasopharyngeal carcinoma (NPC) after radiotherapy.

METHOD

The cross section area (CSA) of TVP and medial pterygoid (MP) muscle were measured in MRI of 32 patients with NPC before and after radiotherapy, meanwhile the incidence of SOM were surveyed after radiotherapy, then to analyze the relationship between the change of TVP and the incidence of SOM after radiotherapy.

RESULT

Of 48 ears without SOM before radiotherapy, 27 ears developed post-irradiation SOM, including 24 ears with TVP atrophy and 3 ears without TVP atrophy, and 21 ears had no post-irradiation SOM, including 8 ears with TVP atrophy and 13 ears without TVP atrophy. chi2 test showed significant difference (P < 0.01). It indicated that post-irradiation SOM have correlation with TVP atrophy. The more possibility of TVP atrophy occurred after long time radiotherapy.

CONCLUSION

The atrophy of TVP in patients with NPC usually occurs 6 months after radiotherapy, and this may result in the post-irradiation SOM. The pathogenesis of post-irradiation SOM need further study functionally.

What happens between visits? Adverse and potential adverse events among a low-income, urban, ambulatory population with diabetes

BACKGROUND

Little is known about adverse events (AEs) that occur between physician visits for ambulatory chronic disease patients. An automated telephone self-management support programme for a diverse population of diabetes patients was implemented to capture AEs, describe the self-management domains from which they emanate and explore contributing causes.

METHODS

AEs and potential AEs (PotAEs) were identified among 111 ethnically diverse diabetes patients. An AE is an injury that results from either medical management or patient self-management; a PotAE is an unsafe state likely to lead to an event if it persists without intervention. Medical record reviews were conducted to ascertain which self-management domain was involved with the event and to explore contributing causes.

RESULTS

Among the 111 patients, 86% had at least one event detected over the 9-month observation period. 111 AEs and 153 PotAEs were identified. For all events, medication management was the most common domain (166 events, 63%). Only 20% of events reflected a single contributing cause; in the remaining 80%, a combination of system, clinician and patient factors contributed to their occurrence. Patient actions were implicated in 205 (77%) events, systems issues in 183 (69%) events and inadequate physician-patient communication in 155 (59%) events. Aside from communication, primary care clinician actions contributed to the occurrence of the event in only 16 cases (6%).

CONCLUSIONS

Our findings reveal a complex safety ecology, with multiple contributing causes for AEs and PotAEs among ambulatory diabetes patients. Moreover, patients themselves seem to be key drivers of safety and of AEs, suggesting that patient-level self-management support and patient-centred communication are critical to AE prevention.

[Analysis of the reason for the adhesion of vocal cord after CO2 laser laryngeal surgery]

OBJECTIVE

To investigate the reason for the adhesion of vocal cord after CO2 Laser laryngeal surgery.

METHOD

One hundred and nineteen patients who were untaken CO2 Laser laryngeal microsurgery.

RESULT

Among 119 cases, 9 cases of bilateral vocal cord paralysis, 42 cases of vocal cord polyps and 3 cases of precancerous laryngeal lesions did not show vocal cord adhesion after CO2 Laser laryngeal microsurgery. Contrarily, one of 5 cases with laryngeal stenosis, 5 of 41 cases with laryngeal papilloma and 6 of 19 cases with laryngeal carcinoma shew the adhesion of vocal cord after CO2 Laser laryngeal microsurgery.

CONCLUSION

Through selecting the appropriate patient and surgery spot, processing correctly during and after surgery, using the suitable dosage of laser and reducing the heat radiation, the adhesion of vocal cord can be avoided after CO2 Laser laryngeal surgery.

[Expression and relationship of EBV LMP1, COX-2 and VEGF-C in nasopharyngeal carcinoma]

OBJECTIVE

To evaluate the expression of vascular endothelial growth factor C (VEGF-C), Epstein-Barr virus (EBV) latent membrane protein 1 (LMP1), cyclooxygenase-2 (COX-2) in nasopharyngeal carcinoma (NPC).

METHOD

LMP1, COX-2 and VEGF-C were detects by immunohistochemical staining for 57 case NPC tissue.

RESULT

The positives rates of LMP1, COX-2 and VEGF-C detected by immunohistochemical staining were 49.1% (28/57), 75.4% (43/57) and 59.6% (34/57), respectively. The expression of LMP1, COX-2 and VEGF-C were correlated to each other in NPC (P < 0.05).

CONCLUSION

LMP1 and COX-2 may induce expression of VEGF-C directly or LMP1 induce expression of VEGF-C by induce COX-2 expression, may contribute to lymph metastasis and develop NPC.

[The exploration of TTAG method in determinating the states of eustachian tube function of healthy group]

OBJECTIVE

To explore the feasibility and validity of tubo-tymanoaerodynamicgraphy (TTAG) determinating the Eustachian tube function of health adult group.

METHOD

The ventilation function of Eustachian tube was measured by the TTAG method in health adult group (132 ears), the results and the graphs were also analyzed.

RESULT

The positive rate in health adult group using Valsalva method was 93.93% (124/132). The positive ears were divided into type I and type II, the mean value of nasopharynx press of type I and II has no significant differences (P>0.05), but the mean value of external auditory canal press had significant differences (P<0.01).

CONCLUSION

TTAG method has the clinical value in determinating the states of Eustachian tube function of health group.

Psychostimulant treatment for ADHD is modulated by prefrontal cortex manipulation

The psychostimulant amphetamine (Amph) is widely used treatments for attention-deficit hyperactivity disorder (ADHD). Chronic intermittent exposure to psychostimulants induces behavioral sensitization. The objective of this study was to investigate the role of prefrontal cortex (PFC) in the acute and chronic effect of Amph using the open-field assay. Male Sprague-Dawley rats were assigned randomly to three groups, (1) an intact control group (2) a PFC sham-operated group, and (3) a PFC lesion group. All the three groups showed increases in locomotor activity after acute amphetamine injection (P<0.05), and activity levels were especially augmented in PFC lesion group. Following chronic amphetamine, the control group and sham-operated group exhibited behavioral sensitization (P<0.05). However, the PFC lesion group failed to exhibit behavioral sensitization and the pattern of locomotion was altered, which indicated that the nature of behavioral sensitization was changed. The results suggest that PFC lesion enhance the acute effects of amphetamine on locomotor activity and is required for development of behavior sensitization.