Epstein-Barr Virus-encoded RNAs (EBERs) as a Survival Predictor in Nasopharyngeal Carcinoma

Objective: The aim of this study was to analyze the role of EBV latency by detecting the EBV-associated latent small nuclear RNAs (EBERs) in the clinical management of nasopharyngeal carcinoma (NPC). Methods: RNA in situ hybridization (ISH) for the detection of EBERs was carried out on 908 NPC tumor tissues. Overall survival (OS) curve were analyzed with the Kaplan-Meier method and Cox proportional hazards regression models. Results: The median follow-up time was 70 months (1-120 months). 816 cases (89.9%) of a total of 908 consecutive cases of NPC were found to be EBV-EBER positive. EBERs-ISH staining revealed nucleus localization in NPC cells. In Kaplan-Meier analysis for OS, high level of EBERs expression for NPC patients was statistically significant positive prognostic factors on survival (log-rank, P = 0.022), especially in adults aged 17-40 years (P = 0.023) and the advanced stage disease (log-rank, P = 0.002). Cox proportional hazards regression model analysis showed that the level of EBERs expression was an independent risk factor for OS (hazard ratio [HR] = 0.724, P = 0.005). Conclusion: EBERs appears to be a predictor for OS of NPC patients. This is the first detailed investigation of relationship between the EBERs expression and prognosis in Guangzhou, where NPC is endemic.     

阻塞性睡眠呼吸暂停低通气综合征患者日间嗜睡相关因素研究及其机制的探讨

目的分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者多道睡眠监测(PSG)结果,寻找OSAHS患者日间嗜睡的预测因素,并探讨其发生机制。方法分析319例疑为OSAHS患者(单纯鼾症组39例、轻度组71例、中度组63例、重度组146例;无低血氧症34例、轻度低血氧症55例、中度低血氧症163例、重度低血氧症67例)的Epworth嗜睡量表(Epworth sleepiness score,ESS)评分及PSG数据,比较各组间ESS评分,并对ESS与各因素进行相关分析;按ESS分组(无嗜睡235例,嗜睡84例),对各调查项目进行多元logistic回归分析。结果组间ESS差异均有统计学意义;ESS与最低动脉血氧饱和度(lowest SaO2,LSaO2)水平成负相关,与夜间氧饱和度低于90%时间百分比(SLT90%)、微觉醒指数、低氧指数成正相关;Logistic回归分析得OSAHS患者日间嗜睡与呼吸暂停低通气指数(AHI)、LSaO2、体块指数(BMI)相关。结论 OSAHS患者日间嗜睡的相关因素为AHI、LSaO2及BMI,可预测OSAHS患者日间嗜睡程度。     

小儿可疑呼吸道异物诊断方法的敏感度及特异度比较

目的　拟从病史、体征及影像学检查等方面对小儿呼吸道异物的诊断方法进行敏感度和特异度的比较。方法　回顾性分析340例患儿的病历资料,根据文献及临 床经验制定出病史、体征及影像学检查的阳性标准,支气管镜检查的结果为“金标准”,分别计算上述各指标的灵敏度、特异度、阳性预测值及阴性预测值。对同时接受X线和CT检查的患儿进行两种检查方法的符合率和吻合度比较。结果　病史、体征、X线检查及CT检查的灵敏度及阳性预测值都较高,特异度和阴性预测值较低;CT和X线检查与术中所见的符合率比较差异无统计学意义。结论　当患儿出现以上指标中单一指标阳性时,可以选择支气管镜探查。对于可疑呼吸道异物的患儿,可以首选包括透视在内的X线检查。     

儿童呼吸道梭形磁铁异物经支气管镜成功取出一例

患儿男,6岁,因误吸磁铁3d于2013年7月10日收入院.患儿3d前玩耍梭形磁铁时将磁铁掷出,磁铁撞击瓷砖墙壁后弹回飞入患儿口中并误吸,当即出现呼吸困难、喘气表现,无神志不清,拍背后缓解,偶有喘气、咳嗽,无呼吸困难、发绀等.外院X线片示右侧支气管异物(图1).查体:右肺呼吸音明显减低,未闻及哕音.诊断:右支气管异物.