Tonsillectomy versus Tonsillotomy for Sleep-Disordered Breathing in Children: A Meta Analysis

Objectives

Tonsillotomy has gained popular acceptance as an alternative to the traditional tonsillectomy in the management of sleep-disordered breathing in children. Many studies have evaluated the outcomes of the two techniques, but uncertainty remains with regard to the efficacy and complications of tonsillotomy versus a traditional tonsillectomy. This study was designed to investigate the efficacy and complications of tonsillotomy versus tonsillectomy, in terms of the short- and long-term results.

Methods

We collected data from electronic databases including MEDLINE, EMBASE, and the Cochrane Library. The following inclusion criteria were applied: English language, children, and prospective studies that directly compared tonsillotomy and tonsillectomy in the management of sleep disordered breathing. Subgroup analysis was then performed.

Results

In total, 10 eligible studies with 1029 participants were included. Tonsillotomy was shown to be advantageous over tonsillectomy in short-term measures, such as a lower hemorrhage rate, shorter operation time, and faster pain relief. In long-term follow-up, there was no significant difference in resolution of upper-airway obstructive symptoms, the quality of life, or postoperative immune function between the tonsillotomy and tonsillectomy groups. The risk ratio of SDB recurrence was 3.33 (95% confidence interval = 1.62 6.82, P = 0.001), favoring tonsillectomy at an average follow-up of 31 months.

Conclusions

Tonsillotomy may be advantageous over tonsillectomy in the short term measures and there are no significant difference of resolving obstructive symptoms, quality of life and postoperative immune function. For the long run, the dominance of tonsillotomy may be less than tonsillectomy with regard to the rate of sleep-disordered breathing recurrence.     

G6PD Deficiency and Hemoglobinopathies: Molecular Epidemiological Characteristics and Healthy Effects on Malaria Endemic Bioko Island,Equatorial Guinea

Background

Glucose-6-phosphate dehydrogenase (G6PD) deficiency and hemoglobinopathies were the inherited conditions found mostly in African. However, few epidemiological data of these disorders was reported in Equatorial Guinea (EQG). This study aimed to assess the prevalence and healthy effects of G6PD deficiency and hemoglobinopathies among the people on malaria endemic Bioko Island, EQG.

Materials and Methods

Blood samples from 4,144 unrelated subjects were analyzed for G6PD deficieny by fluorescence spot test (FST), high-resolution melting assay and PCR-DNA sequencing. In addition, 1,186 samples were randomly selected from the 4,144 subjects for detection of hemoglobin S (HbS), HbC, and α-thalassemia deletion by complete blood count, PCR-DNA sequencing and reverse dot blot (RDB).

Results

The prevalence of malaria and anemia was 12.6% (522/4,144) and 32.8% (389/1,186), respectively. Overall, 8.7% subjects (359/4,144) were G6PD-deficient by FST, including 9.0% (249/2,758) males and 7.9% (110/1,386) females. Among the 359 G6PD-deficient individuals molecularly studied, the G6PD A^- (G202A/A376G) were detected in 356 cases (99.2%), G6PD Betica (T968C/A376G) in 3 cases. Among the 1,186 subjects, 201 cases were HbS heterozygotes, 35 cases were HbC heterozygotes, and 2 cases were HbCS double heterozygotes; 452 cases showed heterozygous α-thalassemia 3.7 kb deletion (-α^3.7 kb deletion) and 85 homozygous - α^3.7 kb deletion. The overall allele frequencies were HbS 17.1% (203/1186); HbC, 3.1% (37/1186); and –α^3.7 kb deletion 52.4% (622/1186), respectively.

Conclusions

High G6PD deficiency in this population indicate that diagnosis and management of G6PD deficiency is necessary on Bioko Island. Obligatory newborn screening, prenatal screening and counseling for these genetic disorders, especially HbS, are needed on the island.     

Atrophic Patterns of the Frontal-Subcortical Circuits in Patients with Mild Cognitive Impairment and Alzheimer’s Disease

Atrophy of the cortical thickness and gray matter volume are regarded as sensitive markers for the early clinical diagnosis of Alzheimer’s disease (AD). This study aimed to investigate differences in atrophy patterns in the frontal-subcortical circuits between MCI and AD, assess whether these differences were essential for the pathologic basis of cognitive impairment. A total of 131 individuals were recruited, including 45 with cognitively normal controls (CN), 46 with MCI, and 40 with AD. FreeSurfer software was used to perform volumetric measurements of the frontal-subcortical circuits from 3.0T magnetic resonance (MR) scans. Data revealed that both MCI and AD subjects had a thinner cortex in the left caudal middle frontal gyrus and the left lateral orbitofrontal gyrus compared with CN individuals. The left lateral orbitofrontal gyrus was also thinner in AD compared with MCI patients. There were no statistically significant differences in the cortical mean curvature among the three groups. Both MCI and AD subjects exhibited smaller bilateral hippocampus volumes compared with CN individuals. The volumes of the bilateral hippocampus and the right putamen were also smaller in AD compared with MCI patients. Logistic regression analyses revealed that the left lateral orbitofrontal gyrus and bilateral hippocampus were risk factors for cognitive impairment. These current results suggest that atrophy was heterogeneous in subregions of the frontal-subcortical circuits in MCI and AD patients. Among these subregions, the reduced thickness of the left lateral orbitofrontal and the smaller volume of the bilateral hippocampus seemed to be markers for predicting cognitive impairment.     

Fasting Plasma Insulin at 5 Years of Age Predicted Subsequent Weight Increase in Early Childhood over a 5-Year Period—The Da Qing Children Cohort Study

Background

The association between hyperinsulinemia and obesity is well known. However, it is uncertain especially in childhood obesity, if initial fasting hyperinsulinemia predicts obesity, or obesity leads to hyperinsulinemia through insulin resistance.

Objective

To investigate the predictive effect of fasting plasma insulin on subsequent weight change after a 5-year interval in childhood.

Methods

424 Children from Da Qing city, China, were recruited at 5 years of age and followed up for 5 years. Blood pressure, anthropometric measurements, fasting plasma insulin, glucose and triglycerides were measured at baseline and 5 years later.

Results

Fasting plasma insulin at 5 years of age was significantly correlated with change of weight from 5 to 10 years (ΔWeight). Children in the lowest insulin quartile had ΔWeight of 13.08±0.73 kg compare to 18.39±0.86 in the highest insulin quartile (P<0.0001) in boys, and similarly 12.03±0.71 vs 15.80±0.60 kg (P<0.0001) in girls. Multivariate analysis showed that the predictive effect of insulin at 5 years of age on subsequent weight gain over 5 years remained statistically significant even after the adjustment for age, sex, birth weight, TV-viewing time and weight (or body mass index) at baseline. By contrast, the initial weight at 5 years of age did not predict subsequent changes in insulin level 5 years later. Children who had both higher fasting insulin and weight at 5 years of age showed much higher levels of systolic blood pressures, fasting plasma glucose, the homeostasis model assessment for insulin resistance (HOMA-IR) and triglycerides at 10 years of age.

Conclusions

Fasting plasma insulin at 5 years of age predicts weight gain and cardiovascular risk factors 5 year later in Chinese children of early childhood, but the absolute weight at 5 years of age did not predict subsequent change in fasting insulin.     

Structural Basis of Specific Recognition of Non-Reducing Terminal N-Acetylglucosamine by an Agrocybe aegerita Lectin

O-linked N-acetylglucosaminylation (O-GlcNAcylation) is a reversible post-translational modification that plays essential roles in many cellular pathways. Research in this field, however, is hampered by the lack of suitable probes to identify, accumulate, and purify the O-GlcNAcylated proteins. We have previously reported the identification of a lectin from the mushroom Agrocybe aegerita, i.e., Agrocybe aegerita lectin 2, or AAL2, that could bind terminal N-acetylglucosamine with higher affinities and specificity than other currently used probes. In this paper, we report the crystal structures of AAL2 and its complexes with GlcNAc and GlcNAcβ1-3Galβ1-4GlcNAc and reveal the structural basis of GlcNAc recognition by AAL2 and residues essential for the binding of terminal N-acetylglucosamine. Study on AAL2 may enable us to design a protein probe that can be used to identify and purify O-GlcNAcylated proteins more efficiently.     

Impaired Function of CD5+CD19+CD1dhi B10 Cells on IgE Secretion in an Atopic Dermatitis-Like Mouse Model

Atopic dermatitis (AD) is a chronic inflammatory pruritic skin disease in which the pathogenic mechanism is complicated and not completely understood. Reports on the role of regulated cells in AD have recently evolved to regulate B cells, which may play a role in allergic inflammation as well. In the present study, we examined the frequency and regulatory function of CD5⁺CD19⁺CD1d^hi B10 cells in an AD-like mouse model. Our results showed that the percentage of CD5⁺CD19⁺CD1d^hi B10 cells increased while the frequency of IL-10-producing B cells in CD19⁺B cells decreased in the mice of AD group. Moreover, no difference in the percentage of B10pro+B10 cells was observed between the AD and control groups. Strikingly, B10 cells from control mice effectively inhibited IgE secretion, whereas the suppressive function of B10 cells from the AD mice was significantly decreased, which was similar to that observed in the group without B10. Altogether, these results suggest that the number of IL-10-producing B cells decreased in the AD group and these cells showed a defective regulatory function on IgE secretion.     

Material Properties and Constitutive Modeling of Infant Porcine Cerebellum Tissue in Tension at High Strain Rate

Background

The mechanical characterization of infant porcine cerebellum tissue in tension at high strain rate is crucial for modeling traumatic cerebellum injury, which is in turn helpful for understanding the biomechanics of such injuries suffered in traffic accidents.

Material and Method

In this study, the infant porcine cerebellum tissue was given three loading velocities, ie, 2s^-1, 20s^-1 and 100s^-1 with up to 30% strain to investigate the tensile properties. At least six tensile tests for each strain rate were validly performed. Fung, Gent, Ogden and exponential models were applied to fit the constitutive equations, so as to obtain material parameters from the experimental data.

Results

The Lagrange stress of infant porcine cerebellum tissue in tension appeared to be no more than 3000Pa at each loading velocity. More specifically, the Lagrange stress at 30% strain was (393.7±84.4)Pa, (928.3±56.3)Pa and (2582.4±282.2)Pa at strain rates of 2s^-1, 20s^-1 and 100s^-1, respectively. Fung (0.833≤R²≤0.924), Gent (0.797≤R²≤0.875), Ogden (0.859≤R²≤0.944) and exponential (0.930≤R²≤0.972) models provided excellent fitting to experimental data up to 30% strain.

Conclusions

The infant cerebellum tissue shows a stiffer response with increase of the loading speed, indicating a strong strain-rate sensitivity. This study will enrich the knowledge on the material properties of infant brain tissue, which may augment the biofidelity of finite element model of human pediatric cerebellum.     

一株产琼胶酶细菌的分离、鉴定及其琼胶酶基本性质

【目的】分离海洋来源的琼胶酶产生菌,对其进行分类鉴定,并研究其所产琼胶酶的基本酶学性质,为琼胶酶的应用研究及开发利用奠定基础。【方法】通过以琼脂为唯一碳源的选择培养基分离产琼胶酶的菌株;利用16S rRNA基因序列分析、表型和生理生化特征对菌株进行鉴定;通过DNS-还原糖法测定琼胶酶活性;利用显色底物法测定琼胶酶的类型;对菌株所产琼胶酶粗酶的酶学性质进行初步研究。【结果】分离到一株产琼胶酶的菌株NTa,16S rRNA基因序列分析显示该菌株属于寡养单胞菌属(Stenotrophomonas sp.);该菌株主要产胞外琼胶酶,可分泌α-琼胶酶和β-琼胶酶;琼胶酶粗酶的最适反应温度和pH分别为40℃和7.0,并且琼胶酶在温度低于30℃,pH为7.0-9.0时稳定;Ca2+对琼胶酶粗酶具有促进作用,Ag+、Fe2+、Ba2+、Mn2+、Cu2+、Zn2+和Fe3+均可不同程度地抑制酶的活性;EDTA对琼胶酶粗酶活性具有抑制作用;琼胶酶粗酶对检测的抑制剂、去垢剂及变性剂有较好的抗性。【结论】海洋细菌Stenotrophomonas sp.NTa是一种新型的产琼胶酶菌株,可同时分泌α-琼胶酶和β-琼胶酶,具有潜在开发利用价值。     

结核分枝杆菌Rv1886c的原核表达及其免疫生物学特性

摘要:【目的】Rv1886c基因编码的Ag85B是结核分枝杆菌(Mycobacterium tuberculosis,M．tb)感染早期的分泌蛋白,本研究对其所诱导的免疫应答特性进行了探索。【方法】对Ag85B进行原核表达和鉴定,并通过夹心ELISA、间接ELISA及ELISPOT方法测定其诱导的细胞免疫和体液免疫应答水平。【结果】SDS-PAGE及Western blot鉴定结果表明,以包涵体形式表达的Ag85B蛋白,经变性、复性后能与结核病人的抗血清及免疫重组李斯特菌LM-Ag85B的小鼠抗血清发生特异性反应,表明His-Ag85B融合蛋白具有较好的免疫活性。将纯化的Ag85B 蛋白皮下免疫C57BL/6小鼠,夹心ELISA的测定结果表明,Ag85B蛋白免疫组诱导小鼠产生的特异性IFN-γ水平显著高于IL-4的水平(P＜0.001),呈现Th1型细胞免疫应答趋势;以结核菌素PPD作为包被抗原,通过间接ELISA测定的血清抗体效价达到1∶6400,表明Ag85B也能诱导有效的体液免疫应答。此外,以尾静脉途径初次免疫小鼠42天时,ELISPOT测定结果显示,结核分枝杆菌H37Rv诱导小鼠产生Ag85B240－259特异性的IFN-γ水平极显著高于卡介苗(BCG)免疫组(P＜0.001)。【结论】Ag85B蛋白能激发小鼠产生较强的Th1型细胞免疫应答和较好的体液免疫应答;BCG单次免疫后诱导小鼠产生的Ag85B特异的细胞免疫应答水平较低。本研究为揭示结核分枝杆菌的致病机理、新型疫苗的研制和早期诊断试剂的开发奠定了基础。