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To evaluate the role of transcription factor GATA-3 in the pathogenesis of nasal polyps.The expression of GATA-3 was detected by immunohistochemistry and reverse transcriptase polymerase chain reaction (RT-PCR) in 28 cases of nasal polyps and 17 specimens of normal nasal epithelium. The expression of interleukin-5 (IL-5) in these specimens was detected by enzyme-linked immunosorbent assay (ELISA) meanwhile.Immunohistochemistry showed, as confirmed by RT-PCR, a positive rate of GATA-3 of 89.3% in the nasal polyp (25/28) and 29.4% in the normal nasal mucosa (5/17), P0.05. GATA-3 was mainly distributed in submucous inflammatory cells. The relative density ratio of GATA-3 to GAPDH was 0.618 +/- 0.137 in nasal polyp and 0.21 +/- 0.11 in normal nasal mucosa (P0.05) as indicated by RT-PCR and agarose electrophoresis. The concentrations of IL-5 were 69.4 +/- 15.1 pg/ml and 25.7 +/- 13.0 pg/mg in the two groups respectively. The expression of GATA-3 was positively correlated to the expression of IL-5 in the nasal polyp.Contributing to the overexpression of such cytokines as IL-5, GATA-3 may play an important role in the pathogenesis of nasal polyps.

To describe the clinical experiences with multi-channel cochlear implantation in the children with enlargement of vestibular aqueduct.Fifteen patients were diagnosed with enlargement of vestibular aqueduct and received multi-channel cochlear implantation at Beijing Tongren Hospital. A cochleostomy was performed for all patients by a standard facial recess approach to anterior inferior to the round window niche.(1) Most of the electrodes were totally inserted in the cochlear, and gusher appeared in 6 implantations. (2) No serious complications occurred after implantation. (3) All patients have auditory sensations after implantations. (4) The hearing threshold in this series were similar to that of the normal cochlear implantation (the average threshold was 30 dB). (5) The rehabilitation concept was developed by Rehabilitation Research Center for Deaf Children in Beijing and Beijing Tongren Hospital. The training sessions included sound detection, word discrimination, auditory comprehension and spoken language skill development. The abilities of speech discrimination and spoken language were improved comparing with that of pre-operation. Two of the patients could go to the normal school after implantations.The outcome of hearing rehabilitation for children with enlargement of vestibular aqueduct were similar to those children with "normal" cochlear structure followed the multi-channel cochlear implantation.

To evaluate the role of chloride channel ClC-3 in perennial allergic rhinitis.The nasal mucosa from 19 patients with perennial allergic rhinitis were studied by immunohistochemistric staining and reverse transcriptase polymerase chain reaction (RT-PCR) for the expression of ClC-3.ClC-3 was positively stained in 17 cases of 19 patients, with a rate of 89.6%. It mainly distributed in cytoplasm of epithelium and submucosal gland. All tissues displayed expected DNA length after PCR. The relative density of ClC-3 in mucosa with allergic rhinitis was 0.685 +/- 0.114 and 0.140 +/- 0.075 in normal.ClC-3 played an important role in the over-secretion of liquor in allergic rhinitis.

To explore the clinical experience of multi-channel cochlear implantation in patients with bilateral inner ear malformations.Multi-channel cochlear implantation was conducted among 180 patients from 1997 to 2001. Twenty-five of them, being with inner ear malformations, were given hearing and speech rehabilitation including sound detection, word discrimination, auditory comprehension and spoken language skill development. A follow-up lasting 4 - 24 months was conducted after the operation. A retrospective analysis was performed among these 25 patients to observe the surgical outcomes and mapping characteristics after surgery.(1) All patients restored their auditory sensations after the operation. (2) Stapedial gusher was found in 13 cases with inner ear malformations, especially those with Mondini malformation, much more frequently than among the patients with other malformations. (3) Most of the action electrodes were inserted in the "cochleostomy" in full length, only 2 pairs of them remained outside of the "cochleostomy". (4) No serious complications occurred after implantation. (5) The impedance of the electrodes, T level and C level were higher in the 25 cases than in the normal cochlear implantation, however, with the hearing similar hearing threshold. (6) After training, the abilities of speech discrimination and spoken language were improved in comparison with those before operation.The cochlear implantation can be performed safely in patients with bilateral inner ear malformations. The primary outcome of cochlear implantation in hearing rehabilitation is similar for both the patients with inner ear malformations and those with normal cochlear structure.

To detect the expression of urokinase-type plasminogen activator (uPA) and its inhibitors(plasminogen activator inhibitors, PAI) type-1 and type-2 in squamous cell carcinoma of human larynx and reveal the correlation of the major clinicopathologicl parameters and prognosis.uPA, PAI-1 and PAI-2 were detected from 104 cases squamous cell carcinoma of human larynx undergoing primary resection using immunohistochemistry(labeled-streptoavidin-biotin-peroxidase, SAB) method. The results were classified positive and negative. Patients were followed-up prospectively for a median of 41 months(rang 24 to 84 months). Overall survival were analyzed according to Kaplan-Meier and log-rank statistics, the prognostic relevance of uPA, PAI-1 and PAI-2 and conventional prognostic factors were analyzed by Cox analyses.uPA, PAI-1 and PAI-2 positivity were present both in neoplastic cells and in fibroblast cells and macrophages. However, depending on the histological grading and invasive capacity of the tumor, a pronounced intra- and intertumoral heterogeneity in uPA staining was observed. The total positive rate of uPA, PAI-1 and PAI-2 was 66.3%, 70.2% and 50.0% respectively. No relationship between the expression of these proteins and clinicopathological parameters except for lymph node metastasis and recurrence, P value was 0.010, 0.027 and 0.038 respectively. Univariate survival analysis revealed a high significant inverse correlation of uPA positive expression survival time. Patients with PAI-2 positive expression had a significantly longer survival time than those with PAI-2 negative expression. In different clinicopathological parameters subgroups, uPA, PAI-1 and PAI-2 added significant survival information. Multivariate analysis revealed that four independent prognostic factors for overall survival time were uPA, PAI-2, lymph node metastasis and recurrences and clinical stage, P = 0.001, 0.002, 0.035 and 0.005 respectively.These findings suggest that uPA play important role in the metastasis of human laryngeal carcinoma and PAI-2 appears to be a true inhibitor contrary to PAI-1. PAI-1 might act as an essential modulator of the plasminogen activation system or a protector of carcinoma tissue against self-degradation rather than as a simple inhibitor of system. uPA and PAI-2 could be new independent and strong biologically prognostic factors.

AIM: To summarize clinical features of probable severe acute respiratory syndrome (SARS) in Beijing. METHODS: Retrospective cases involving 801 patients admitted to hospitals in Beijing between March and June 2003, with a diagnosis of probable SARS, moderate type. The series of clinical manifestation, laboratory and radiograph data obtained from 801 cases were analyzed. RESULTS: One to three days after the onset of SARS, the major clinical symptoms were fever (in 88.14% of patients), fatigue, headache, myalgia, arthralgia (25-36%), etc. The counts of WBC (in 22.56% of patients) lymphocyte (70.25%) and CD3, CD4, CD8 positive T cells (70%) decreased. From 4-7 d, the unspecific symptoms became weak; however, the rates of low respiratory tract symptoms, such as cough (24.18%), sputum production (14.26%), chest distress (21.04%) and shortness of breath (9.23%) increased, so did the abnormal rates on chest radiograph or CT. The low counts of WBC, lymphocyte and CD3, CD4, CD8 positive T cells touched bottom. From 8 to 16 d, the patients presented progressive cough (29.96%), sputum production (13.09%), chest distress (29.96%) and shortness of breath (35.34%). All patients had infiltrates on chest radiograph or CT, some even with multi-infiltrates. Two weeks later, patients’ respiratory symptoms started to alleviate, the infiltrates on the lung began to absorb gradually, the counts of WBC, lymphocyte and CD3, CD4, CD8 positive T cells were restored to normality. CONCLUSION: The data reported here provide evidence that the course of SARS could be divided into four stages, namely the initial stage, progressive stage, fastigium and convalescent stage.

AIM: To sumarize the clinical features of patients with SARS in early stage. METHODS: The clinical data of patients with SARS who were admitted to hospitals in the periods of 1 to 7 days after onset of illness. The early stage of SARS was identified by the syndromes and signs of lungs, oxygenation index and the examination of imaging. RESULTS: The positive rates of the reference parameters were similar in the 1st day and 2nd to 3rd day, but changed obviously in the later days. The period of 1 to 3 days was therefore considered as the early stage of SARS. The study showed that 88.7 percent of patients got fever, 98.8 percent of patients had reported fever and 16.3 % patients with chilly, 4.3 percent of patients even shiver. 20 percent of patients had the unspecific syndrome, such as fatigue, headache, myalgia, and arthralgia. 16.1% patients had congestion in throat and 8.4% patients with pharyngalgia. Rhinorrhea, sneezing, skin rash and tumefaction of tonsil or lymph nodes were rare (the rates were 3.4%, 2.5%, 0.9% and 0.3% respectively). 4.3 percent of patients occurred dianrrhea, but no hematenesis and hematochezia. Nausea, vomiting and other positive signs of abdumen were not common. About one third patients presented cough, 14.6% expectoration, 7% chest distress and suffocated. The sign of lung was usually lacked, and the rate of moist rales were only 4.9%. 71.4% patients‘ artery pressure of oxygen decreased, 20.9% and 27. 8% patients oxygenation index and oxygen satureation also went down slightly. The reducing rate of WBC, lymphocyte and PLT were 22.5%, 36.4% and 13.4% respectively, but there were 6.4% patients with high WBC count. The mean counts of CD3, CD4, and CD8 cells decreased obviously and their positive rates were more than 90%. Most patients of SARS (about 80% to 90%) had inflammatory shadow in chest films, majority had one lungfield shadow and minority with multi-lungfields, but some patients had normal films of chest X-ray (19.9%) and CT (9.1%). 10-15% patients‘ liver and renal functions were abnormal. 13-16% patients with high values of creatinine kinase, but that of CK-MB was only 5.9%. CONCLUSION: In early stage of SARS (1 to 3 days), almost all the patients get fever, some have the unspecific symptom, but the sign of catarrh and tumefaction of lymph nodes are rare. About one third patients have cough and 14.6% expectoration, and present mild hypoxemia, but usually lack the sign of lung. In 22.5% and 36.4% patients WBC and lymphocyte reduce, and also the mean counts of CD3, CD4 and CD8 cells reduce significantly, the positive rates are more than 90%. About 80% (X-ray) to 90% (CT) patients show abnormal chest films in radiologic examination, but someones have the normal results of chest X-ray (19.9%) and CT (9.1%). About 10-16% patients suffer the damage of the liver, kidney and heart.