BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emoti...BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emotional states is imperative.AIM To evaluate the efficacy of cognitive behavioral therapy(CBT)-based psychological interventions in improving the psychological well-being and quality of life(QoL)of patients with laryngeal carcinoma.METHODS This study enrolled 120 patients admitted from February 2022 to February 2024.The control group,comprising 50 participants,received standard supportive psychological care,while the research group,consisting 70 participants,underwent CBT-based interventions.Several clinical outcomes were systematically assessed that included postoperative recovery metrics(duration of tracheostomy and nasogastric tube dependence and length of hospitalization),psychological status(Self-Rating Anxiety Scale and Self-Rating Depression Scale),nutritional markers(serum albumin and hemoglobin levels),sleep quality(Self-Rating Scale of Sleep and Athens Insomnia Scale),and QoL(Functional Assessment of Cancer Therapy-Head and Neck).RESULTS The results demonstrated that the research group experienced superior outcomes,with significantly reduced durations of tracheostomy and nasogastric tube dependence,as well as shorter hospital stays,compared with the control group.Additionally,the research group exhibited markedly lower post-intervention Self-Rating Anxiety Scale,Self-Rating Depression Scale,Self-Rating Scale of Sleep,and Athens Insomnia Scale scores,along with minimal but higher change in serum albumin and hemoglobin levels compared with the control group.All five domains of Functional Assessment of Cancer Therapy-Head and Neck showed notable improvements in the research group,exceeding those observed in the control group.CONCLUSION CBT-based psychological support positively affects the mental well-being and QoL of patients with laryngeal carcinoma,highlighting its potential for broader clinical application.展开更多
BACKGROUND Oral and pharyngolaryngeal papillomas are occasionally detected during esophagogastroduodenoscopy.However,their endoscopic features have not been sufficiently investigated.AIM To distinguish oral and pharyn...BACKGROUND Oral and pharyngolaryngeal papillomas are occasionally detected during esophagogastroduodenoscopy.However,their endoscopic features have not been sufficiently investigated.AIM To distinguish oral and pharyngolaryngeal papillomas from elevated squamous carcinomas,this study examined their endoscopic features.METHODS Forty-seven patients with oral or pharyngeal papilloma participated in this study.The endoscopic characteristics of papillomas were identified by focusing on narrowband and blue laser imaging representations.RESULTS Papillomas were classified into three patterns based on their endoscopic features:Salmon roe-like polyps,polyps without capillary transparency,and pinecone-like polyps,with salmon roe-like polyps most prevalent(48.9%).We subsequently analyzed features differentiating papillomas and squamous cell carcinomas in the same region and found that squamous cell carcinomas exhibited at least one of the following three features:Uneven or absent lobulated structure,irregular morphology of capillaries,and coexistence of flat lesions.In contrast,papillomas displayed a uniform lobulated structure,homogeneous or non-visible capillaries,and an absence of flat components.When any of these characteristics were present,two endoscopic specialists evaluated the lesions for the diagnosis of squamous cell carcinoma,with sensitivities of 100%and 97.6%and specificities of 68.9%and 93.3%.CONCLUSION Understanding distinct endoscopic patterns of oropharyngeal papillomas and squamous cell carcinomas provides valuable guidance to endoscopists performing esophagogastroduodenoscopy.展开更多
BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of sali...BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of salivary fistula remains a major complication.This study aims to compare the stapler and hand-sewn techniques for esophageal closure and evaluate their impact on fistula formation.AIM To compare stapler-assisted and hand-sewn esophageal closure techniques after laryngectomy regarding their impact on salivary fistula formation.METHODS A total of 52 patients(44 men,8 women),aged 43 to 77 years,underwent total laryngectomy.Esophageal reconstruction was performed using either a stapler(29 patients)or a hand-sewn technique(23 patients).A surgical stapler TA was used for esophageal closure in the stapler group.Patients were clinically monitored for fistula formation during the first 7 days postoperatively and again two weeks after discharge using fiberoptic examination.RESULTS A total of 22 salivary fistulas were recorded:17(77.3%)occurred following the hand-sewn technique,while 5(22.7%)developed in the stapler group.Addi-tionally,preoperative radiotherapy was identified as a statistically significant risk factor for fistula formation.No technical complications related to the stapler device were observed.CONCLUSION Although hand-sewn closure is commonly used after total laryngectomy,stapler-assisted closure shows lower fistula rates and is a viable esophageal reconstruction alternative.展开更多
BACKGROUND Cardiac myxoma is a benign neoplasm and one of the most common types of primary cardiac tumors.Synchronous cardiac myxoma and other malignancies are extremely rare,and only limited cases have been reported....BACKGROUND Cardiac myxoma is a benign neoplasm and one of the most common types of primary cardiac tumors.Synchronous cardiac myxoma and other malignancies are extremely rare,and only limited cases have been reported.CASE SUMMARY We describe a young patient with newly diagnosed locally advanced laryngeal cancer,with a synchronous cardiac tumor detected on staging scans.An echocar-diogram showed the typical appearance of myxoma in the left atrium.Early cardiac surgery was performed in view of its obstructive features and post cardiac surgery recovery was uneventful.The patient was scheduled for subsequent oncological treatment for the laryngeal cancer.However,due to rapid progression of the advanced laryngeal malignancy,he was placed on supportive care.CONCLUSION To our knowledge,this is the first reported case of synchronous cardiac myxoma with laryngeal malignancy.Individualized treatment strategy should be adopted to manage synchronous tumors in a multidisciplinary approach.The most life-threatening condition needs be treated first.Single resection,staged operations or simultaneous resection of both tumors have been reported with good outcomes.展开更多
The laryngeal muscle evoked potential(LMEP)is a neurophysiological outcome parameter that guarantees integrity of the nerve-electrode interface during experiments with vagus nerve stimulation(VNS).This paper discusses...The laryngeal muscle evoked potential(LMEP)is a neurophysiological outcome parameter that guarantees integrity of the nerve-electrode interface during experiments with vagus nerve stimulation(VNS).This paper discusses a large series of minimally invasive LMEP recordings in 46 female Lewis rats,implanted with a custom-made VNS electrode around the left cervical vagus nerve.After a 3-week recovery,LMEPs were recorded twice in each animal,with swapping the anode and cathode positions of the VNS electrode(polarity inversion).A VNS-induced LMEP was identified as the initial negative peak wave post-stimulation artifact,consistently recorded in all sweeps at a given stimulation output current.Latency was defined as the time from stimulation onset to this negative peak,and stimulation threshold as the lowest current showing a clear and reproducible LMEP.An LMEP response was shown by 37/46 animals(80.4%),with stimulation intensity threshold of 0.37±0.27 mA and latency of 2.39±0.45 ms.Administering the cathodic pulse phase first at the caudal electrode contact resulted in the shortest LMEP latencies(MWU:p=0.049.2.36±0.43 ms vs.2.41±0.47 ms).Minimally invasive LMEP recording provides a feasible and reliable means for checking electrode functioning and correct implantation.展开更多
Suboptimal treatment of laryngeal squamous cell carcinoma(LSCC)provides poor survival rate.The poor bioavailability,resistance to cetuximab(Cet),and the instability of small interfering RNA(siRNA)limit their efficacy ...Suboptimal treatment of laryngeal squamous cell carcinoma(LSCC)provides poor survival rate.The poor bioavailability,resistance to cetuximab(Cet),and the instability of small interfering RNA(siRNA)limit their efficacy in LSCC therapy.The present study has been aimed to develop a Cet and focal adhesion kinase(FAK)siRNA(siFAK)co-delivery nanosystem.Zeolitic imidazolate framework-8(ZIF-8),with its large specific surface area and pH-responsive properties,is an ideal delivery carrier allowing controlled drug release in the acidic tumor microenvironment.Therefore,Cet was loaded onto ZIF-8 and encapsulated in a TU177 cell membrane(TCM)after the electrostatic adsorption of siFAK.Fourier transform infrared(FTIR)spectroscopy,transmission electron microscopy(TEM),scanning electron microscopy(SEM),zeta potential,X-ray diffraction,and particle size analyses were deployed to characterize Cet/siFAK@ZIF-8@TCM.TU177 cells and subcutaneously transplanted tumor-bearing nude mice were used to evaluate the intracellular uptake,cytotoxicity,in vivo biocompatibility,biodistribution,biosafety,pH responsiveness,and anti-LSCC efficacy of Cet/siFAK@ZIF-8@TCM.After ZIF-8@TCM were loaded with Cet and siFAK,alterations in their physical and crystal structures,particle size,and zeta potential were observed.Meanwhile,the co-delivery system increased the loading of Cet through the electrostatic adsorption of siFAK to Cet-loaded ZIF-8.The intracellular uptake of Cet/siFAK@ZIF-8@TCM also protected siFAK from degradation,effectively decreasing the messenger RNA(mRNA)and protein expression levels of FAK in LSCC cells.The ZIF-8@TCM nanosystem for co-delivery of Cet and siFAK exhibited pH-responsiveness and tumor-targeting capabilities,thereby exerting anti-LSCC effects.Co-delivery of Cet and siFAK via the pH-responsive ZIF-8@TCM system enabled the targeted release of the chemotherapeutic and gene,in turn maximizing their anti-LSCC effect while ensuring biosafety.展开更多
Hereditary angioedema (HAE) is a rare,autosomal dominant inherited disorder with an incidence of approximately 1 in 50,000.Among its various tapes,HAE with normal C1 inhibitor levels (HAE-nC1-INH)is exceptionally rare...Hereditary angioedema (HAE) is a rare,autosomal dominant inherited disorder with an incidence of approximately 1 in 50,000.Among its various tapes,HAE with normal C1 inhibitor levels (HAE-nC1-INH)is exceptionally rare.^([1]) HAE symptoms include recurrent episodes of skin and mucosal edema that can occur anywhere in the body.^([1-4]) Laryngeal edema is life-threatening,as it can lead to airway obstruction and potentially fatal suffocation.^([1-3])Edema of the gastrointestinal mucosa may cause abdominal pain,vomiting,and symptoms that are often misdiagnosed as acute abdomen.^([1-4]) This study included four patients,including one with HAE-nC1-INH (genetic testing revealed a heterozygous mutation in the KNG1 gene (c.1404G>C:p.Q468H)) and three with HAE due to C1 inhibitor deficiency (HAE-C1-INH).This case series aims to increase knowledge of HAE by illustrating its diverse clinical presentations and emphasizing features that may prompt clinical suspicion and facilitate timely diagnosis.展开更多
BACKGROUND Laryngeal squamous cell carcinoma(LSCC)is a prevalent head and neck malignancy with suboptimal survival rates due to late detection and therapeutic resistance.AIM To investigate chaperonin-containing TCP1 s...BACKGROUND Laryngeal squamous cell carcinoma(LSCC)is a prevalent head and neck malignancy with suboptimal survival rates due to late detection and therapeutic resistance.AIM To investigate chaperonin-containing TCP1 subunit 3(CCT3)expression and its clinical implications,and its effects on LSCC cell growth.METHODS Systematic data on CCT3 mRNA expression were collected from biomedical databases,and integrated further based on the standardized mean difference and the summary receiver operating characteristic curve.Single-cell RNA-seq data were mined to validate the expression level of CCT3 mRNA.In-house immunohistochemistry was performed to explore the CCT3 protein levels of clinical LSCC samples and their relationship with clinical parameters.The growth function of LSCC cell was analyzed using CRISPR knockout screening.CCT3-related signaling pathway analyses were conducted using gene set enrichment analysis.Protein-protein interaction network construction was performed to identify hub genes.RESULTS CCT3 mRNA was significantly overexpressed in 269 LSCC tissues cases across multiple independent datasets(standardized mean difference=32,area under the curve=0.93);At the translational level,the in-house immunohistochemical analysis further demonstrated the consistent upregulation of CCT3 protein in 88 cases of LSCC samples(58 non-LSCC samples vs 30 LSCC samples,P=1.4e^(-14)).Analysis of clinical parameters showed no significant differences among subgroup.Functional characterization with clustered regularly interspaced short palindromic repeats--mediated gene knockout revealed that depletion of CCT3 potently suppressed LSCC cell viability in vitro.Gene set enrichment analysis indicated that CCT3 was markedly associated with several key oncogenic pathways,including extracellular matrix receptor interaction and cell cycle regulation pathways.CONCLUSION CCT3 upregulation in LSCC may influence cellular growth by regulating related pathways,indicating its potential as a biomarker and therapeutic target for LSCC.展开更多
文摘BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emotional states is imperative.AIM To evaluate the efficacy of cognitive behavioral therapy(CBT)-based psychological interventions in improving the psychological well-being and quality of life(QoL)of patients with laryngeal carcinoma.METHODS This study enrolled 120 patients admitted from February 2022 to February 2024.The control group,comprising 50 participants,received standard supportive psychological care,while the research group,consisting 70 participants,underwent CBT-based interventions.Several clinical outcomes were systematically assessed that included postoperative recovery metrics(duration of tracheostomy and nasogastric tube dependence and length of hospitalization),psychological status(Self-Rating Anxiety Scale and Self-Rating Depression Scale),nutritional markers(serum albumin and hemoglobin levels),sleep quality(Self-Rating Scale of Sleep and Athens Insomnia Scale),and QoL(Functional Assessment of Cancer Therapy-Head and Neck).RESULTS The results demonstrated that the research group experienced superior outcomes,with significantly reduced durations of tracheostomy and nasogastric tube dependence,as well as shorter hospital stays,compared with the control group.Additionally,the research group exhibited markedly lower post-intervention Self-Rating Anxiety Scale,Self-Rating Depression Scale,Self-Rating Scale of Sleep,and Athens Insomnia Scale scores,along with minimal but higher change in serum albumin and hemoglobin levels compared with the control group.All five domains of Functional Assessment of Cancer Therapy-Head and Neck showed notable improvements in the research group,exceeding those observed in the control group.CONCLUSION CBT-based psychological support positively affects the mental well-being and QoL of patients with laryngeal carcinoma,highlighting its potential for broader clinical application.
文摘BACKGROUND Oral and pharyngolaryngeal papillomas are occasionally detected during esophagogastroduodenoscopy.However,their endoscopic features have not been sufficiently investigated.AIM To distinguish oral and pharyngolaryngeal papillomas from elevated squamous carcinomas,this study examined their endoscopic features.METHODS Forty-seven patients with oral or pharyngeal papilloma participated in this study.The endoscopic characteristics of papillomas were identified by focusing on narrowband and blue laser imaging representations.RESULTS Papillomas were classified into three patterns based on their endoscopic features:Salmon roe-like polyps,polyps without capillary transparency,and pinecone-like polyps,with salmon roe-like polyps most prevalent(48.9%).We subsequently analyzed features differentiating papillomas and squamous cell carcinomas in the same region and found that squamous cell carcinomas exhibited at least one of the following three features:Uneven or absent lobulated structure,irregular morphology of capillaries,and coexistence of flat lesions.In contrast,papillomas displayed a uniform lobulated structure,homogeneous or non-visible capillaries,and an absence of flat components.When any of these characteristics were present,two endoscopic specialists evaluated the lesions for the diagnosis of squamous cell carcinoma,with sensitivities of 100%and 97.6%and specificities of 68.9%and 93.3%.CONCLUSION Understanding distinct endoscopic patterns of oropharyngeal papillomas and squamous cell carcinomas provides valuable guidance to endoscopists performing esophagogastroduodenoscopy.
文摘BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of salivary fistula remains a major complication.This study aims to compare the stapler and hand-sewn techniques for esophageal closure and evaluate their impact on fistula formation.AIM To compare stapler-assisted and hand-sewn esophageal closure techniques after laryngectomy regarding their impact on salivary fistula formation.METHODS A total of 52 patients(44 men,8 women),aged 43 to 77 years,underwent total laryngectomy.Esophageal reconstruction was performed using either a stapler(29 patients)or a hand-sewn technique(23 patients).A surgical stapler TA was used for esophageal closure in the stapler group.Patients were clinically monitored for fistula formation during the first 7 days postoperatively and again two weeks after discharge using fiberoptic examination.RESULTS A total of 22 salivary fistulas were recorded:17(77.3%)occurred following the hand-sewn technique,while 5(22.7%)developed in the stapler group.Addi-tionally,preoperative radiotherapy was identified as a statistically significant risk factor for fistula formation.No technical complications related to the stapler device were observed.CONCLUSION Although hand-sewn closure is commonly used after total laryngectomy,stapler-assisted closure shows lower fistula rates and is a viable esophageal reconstruction alternative.
文摘BACKGROUND Cardiac myxoma is a benign neoplasm and one of the most common types of primary cardiac tumors.Synchronous cardiac myxoma and other malignancies are extremely rare,and only limited cases have been reported.CASE SUMMARY We describe a young patient with newly diagnosed locally advanced laryngeal cancer,with a synchronous cardiac tumor detected on staging scans.An echocar-diogram showed the typical appearance of myxoma in the left atrium.Early cardiac surgery was performed in view of its obstructive features and post cardiac surgery recovery was uneventful.The patient was scheduled for subsequent oncological treatment for the laryngeal cancer.However,due to rapid progression of the advanced laryngeal malignancy,he was placed on supportive care.CONCLUSION To our knowledge,this is the first reported case of synchronous cardiac myxoma with laryngeal malignancy.Individualized treatment strategy should be adopted to manage synchronous tumors in a multidisciplinary approach.The most life-threatening condition needs be treated first.Single resection,staged operations or simultaneous resection of both tumors have been reported with good outcomes.
基金The Research Foundation Flanders(FWO),Grant/Award Number:1S25620NThe Charcot Research Fund。
文摘The laryngeal muscle evoked potential(LMEP)is a neurophysiological outcome parameter that guarantees integrity of the nerve-electrode interface during experiments with vagus nerve stimulation(VNS).This paper discusses a large series of minimally invasive LMEP recordings in 46 female Lewis rats,implanted with a custom-made VNS electrode around the left cervical vagus nerve.After a 3-week recovery,LMEPs were recorded twice in each animal,with swapping the anode and cathode positions of the VNS electrode(polarity inversion).A VNS-induced LMEP was identified as the initial negative peak wave post-stimulation artifact,consistently recorded in all sweeps at a given stimulation output current.Latency was defined as the time from stimulation onset to this negative peak,and stimulation threshold as the lowest current showing a clear and reproducible LMEP.An LMEP response was shown by 37/46 animals(80.4%),with stimulation intensity threshold of 0.37±0.27 mA and latency of 2.39±0.45 ms.Administering the cathodic pulse phase first at the caudal electrode contact resulted in the shortest LMEP latencies(MWU:p=0.049.2.36±0.43 ms vs.2.41±0.47 ms).Minimally invasive LMEP recording provides a feasible and reliable means for checking electrode functioning and correct implantation.
文摘Suboptimal treatment of laryngeal squamous cell carcinoma(LSCC)provides poor survival rate.The poor bioavailability,resistance to cetuximab(Cet),and the instability of small interfering RNA(siRNA)limit their efficacy in LSCC therapy.The present study has been aimed to develop a Cet and focal adhesion kinase(FAK)siRNA(siFAK)co-delivery nanosystem.Zeolitic imidazolate framework-8(ZIF-8),with its large specific surface area and pH-responsive properties,is an ideal delivery carrier allowing controlled drug release in the acidic tumor microenvironment.Therefore,Cet was loaded onto ZIF-8 and encapsulated in a TU177 cell membrane(TCM)after the electrostatic adsorption of siFAK.Fourier transform infrared(FTIR)spectroscopy,transmission electron microscopy(TEM),scanning electron microscopy(SEM),zeta potential,X-ray diffraction,and particle size analyses were deployed to characterize Cet/siFAK@ZIF-8@TCM.TU177 cells and subcutaneously transplanted tumor-bearing nude mice were used to evaluate the intracellular uptake,cytotoxicity,in vivo biocompatibility,biodistribution,biosafety,pH responsiveness,and anti-LSCC efficacy of Cet/siFAK@ZIF-8@TCM.After ZIF-8@TCM were loaded with Cet and siFAK,alterations in their physical and crystal structures,particle size,and zeta potential were observed.Meanwhile,the co-delivery system increased the loading of Cet through the electrostatic adsorption of siFAK to Cet-loaded ZIF-8.The intracellular uptake of Cet/siFAK@ZIF-8@TCM also protected siFAK from degradation,effectively decreasing the messenger RNA(mRNA)and protein expression levels of FAK in LSCC cells.The ZIF-8@TCM nanosystem for co-delivery of Cet and siFAK exhibited pH-responsiveness and tumor-targeting capabilities,thereby exerting anti-LSCC effects.Co-delivery of Cet and siFAK via the pH-responsive ZIF-8@TCM system enabled the targeted release of the chemotherapeutic and gene,in turn maximizing their anti-LSCC effect while ensuring biosafety.
基金supported by the National Social Science Fund of China (19VJX168)。
文摘Hereditary angioedema (HAE) is a rare,autosomal dominant inherited disorder with an incidence of approximately 1 in 50,000.Among its various tapes,HAE with normal C1 inhibitor levels (HAE-nC1-INH)is exceptionally rare.^([1]) HAE symptoms include recurrent episodes of skin and mucosal edema that can occur anywhere in the body.^([1-4]) Laryngeal edema is life-threatening,as it can lead to airway obstruction and potentially fatal suffocation.^([1-3])Edema of the gastrointestinal mucosa may cause abdominal pain,vomiting,and symptoms that are often misdiagnosed as acute abdomen.^([1-4]) This study included four patients,including one with HAE-nC1-INH (genetic testing revealed a heterozygous mutation in the KNG1 gene (c.1404G>C:p.Q468H)) and three with HAE due to C1 inhibitor deficiency (HAE-C1-INH).This case series aims to increase knowledge of HAE by illustrating its diverse clinical presentations and emphasizing features that may prompt clinical suspicion and facilitate timely diagnosis.
基金Supported by the National Natural Science Foundation of China,No.82160213 and No.U22A2022the Guangxi Natural Science Foundation,No.2023GXNSFAA026029,No.2024GXNSFBA010059,and No.2024GXNSFAA010079。
文摘BACKGROUND Laryngeal squamous cell carcinoma(LSCC)is a prevalent head and neck malignancy with suboptimal survival rates due to late detection and therapeutic resistance.AIM To investigate chaperonin-containing TCP1 subunit 3(CCT3)expression and its clinical implications,and its effects on LSCC cell growth.METHODS Systematic data on CCT3 mRNA expression were collected from biomedical databases,and integrated further based on the standardized mean difference and the summary receiver operating characteristic curve.Single-cell RNA-seq data were mined to validate the expression level of CCT3 mRNA.In-house immunohistochemistry was performed to explore the CCT3 protein levels of clinical LSCC samples and their relationship with clinical parameters.The growth function of LSCC cell was analyzed using CRISPR knockout screening.CCT3-related signaling pathway analyses were conducted using gene set enrichment analysis.Protein-protein interaction network construction was performed to identify hub genes.RESULTS CCT3 mRNA was significantly overexpressed in 269 LSCC tissues cases across multiple independent datasets(standardized mean difference=32,area under the curve=0.93);At the translational level,the in-house immunohistochemical analysis further demonstrated the consistent upregulation of CCT3 protein in 88 cases of LSCC samples(58 non-LSCC samples vs 30 LSCC samples,P=1.4e^(-14)).Analysis of clinical parameters showed no significant differences among subgroup.Functional characterization with clustered regularly interspaced short palindromic repeats--mediated gene knockout revealed that depletion of CCT3 potently suppressed LSCC cell viability in vitro.Gene set enrichment analysis indicated that CCT3 was markedly associated with several key oncogenic pathways,including extracellular matrix receptor interaction and cell cycle regulation pathways.CONCLUSION CCT3 upregulation in LSCC may influence cellular growth by regulating related pathways,indicating its potential as a biomarker and therapeutic target for LSCC.
