BACKGROUND Gastric cancer(GC)and head and neck squamous cell carcinoma(HNSCC)are common malignancies with high morbidity and mortality rates.Traditional treatments often yield limited efficacy,especially in advanced c...BACKGROUND Gastric cancer(GC)and head and neck squamous cell carcinoma(HNSCC)are common malignancies with high morbidity and mortality rates.Traditional treatments often yield limited efficacy,especially in advanced cases.Recent advancements in immunotherapy,particularly immune checkpoint inhibitors targeting programmed death-ligand 1(PD-L1),have shown promise.However,the expression and interaction of pescadillo ribosomal biogenesis factor 1(PES1)and PD-L1 in these cancers remain unclear.Understanding their roles could provide new insights into tumor biology and improve therapeutic strategies.AIM To investigate the expression levels of PES1 and PD-L1 in tumor tissues of patients with GC and HNSCC.METHODS A total of 58 cases of GC and HNSCC undergoing surgical resection were selected from January 2022 to January 2024.Paraffin specimens of GC and HNSCC tissues were taken from the patients,and the sections were subjected to staining with immunohistochemistry and hematoxylin-eosin staining,and the protein expression of PES1 and PD-L1 was observed microscopically.RESULTS Among 58 GC and HNSCC tissues,30 cases were positive and 28 cases were negative for PES1 expression,and 34 cases were positive and 24 cases were negative for PD-L1 expression.The positive expression rates of PES1 and PDL1 were 51.72% and 58.62%,respectively.PES1 expression was correlated with the TNM stage,lymph node metastasis,and the depth of infiltration(P<0.05),and PD-L1 expression was correlated with the differentiation degree,lymph node metastasis,and infiltration depth(P<0.05).CONCLUSION PES1 and PD-L1 were positively expressed in GC and HNSCC tissues and correlated with clinical features.They may serve as potential biomarkers for immune-targeted therapies.展开更多
Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can ...Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can serve as a tumor biomarker,the underlying mechanism in modulating head and neck squamous cell carcinoma(HNSCC)remains unclear.In this study,the aimed was to investigate the CXCL16 expression in HNSCC and to uncover the potential underlying mechanism.Hereby,we determined the high expression of CXCL16 in The Cancer Genome Atlas(TCGA)database,as well as in tissue samples from patients with HNSCC at our central hospital and from HNSCC cell lines.The results showed that CXCL16 knockdown inhibited the proliferation,migration,and invasion of HNSCC cells.Mechanistically,transcriptome sequencing revealed that CXCL16 may affect HNSCC cell growth by regulating the antioxidant pathway of glutathione peroxidase 1(GPX1).The reactive oxygen species(ROS)levels were elevated in small interfering CXCL16(si-CXCL16)cells,which may contribute to the inhibition of cell proliferation,migration,and invasion.Moreover,treatment of cells with the GPX1 inhibitor eldecalcitol(ED-71)revealed that HNSCC cell growth was significantly inhibited in the synergistic group of si-CXCL16 and GPX1 inhibitor compared to the si-CXCL16 group.In conclusion,CXCL16 contributed to the development of HNSCC cells by modulating the GPX1-mediated antioxidant pathway.Thus,targeting cellular CXCL16 expression seems to be a promising strategy for treating HNSCC.展开更多
BACKGROUND Patients with head and neck cancer often develop depressive symptoms during radiochemotherapy due to changes in saliva secretion,radiation-induced oral mucositis,and dysphagia.These symptoms significantly a...BACKGROUND Patients with head and neck cancer often develop depressive symptoms during radiochemotherapy due to changes in saliva secretion,radiation-induced oral mucositis,and dysphagia.These symptoms significantly affect quality of life.Although existing nursing interventions provide some relief,they have limitations in improving swallowing function and developing coping strategies.AIM To evaluate the effectiveness of tongue pressure resistance feedback training combined with empowerment education in improving depressive symptoms and swallowing function in patients with head and neck cancer undergoing radiochemotherapy.METHODS This study included 110 patients with head and neck cancer who exhibited depressive symptoms and underwent radiochemotherapy at the Affiliated Hospital of Jiangnan University between January 2021 and December 2023.Patients were randomly assigned to either a reference group or an experimental group,each comprising 55 patients.The reference group received routine care,whereas the experimental group received tongue pressure resistance feedback training and empowerment education.After 6 weeks of continuous intervention,comparisons were made between the two groups regarding depressive symptom scores,swallowing function,coping strategies,and quality of life,both pre-and post-intervention.RESULTS Following the intervention,both groups demonstrated decreased scores for depressive symptoms and swallowing function,with the experimental group showing a significantly greater reduction than the reference group(P<0.05).The experimental group also demonstrated higher confrontation scores and lower avoidance and submission scores for coping strategies than the reference group(P<0.05).Quality of life scores improved in both groups after the intervention,with the experimental group showing markedly higher scores than the reference group(P<0.05).CONCLUSION The combination of tongue pressure resistance feedback training and empowerment education is effective in alleviating depressive symptoms,enhancing swallowing function,optimizing coping strategies,and significantly improving the quality of life of patients with head and neck cancer undergoing radiochemotherapy.This approach shows promise for clinical applications and promotion.展开更多
Intra-tumoral bacteria are pivotal in the initiation and progression of head and neck squamous cell carcinoma(HNSCC),exerting a significant influence on tumor cell biology,immune responses,and the tumor microenvironme...Intra-tumoral bacteria are pivotal in the initiation and progression of head and neck squamous cell carcinoma(HNSCC),exerting a significant influence on tumor cell biology,immune responses,and the tumor microenvironment(TME).Different types and distribution of bacteria threaten the balance of metabolism and the immune environment of tumor cells.Taking advantage of this disrupted homeostasis,intra-tumoral bacteria stimulate the secretion of metabolites or influence specific immune cell types to produce inflammatory or chemokines,thereby influencing the anti-tumor immune response while regulating the level of inflammation and immunosuppression within the TME.Some intra-tumoral bacteria are used as diagnostic and prognostic markers in clinical practice.Based on the unique characteristics of bacteria,the use of engineered bacteria and outer membrane vesicles for drug delivery and biological intervention is a promising new therapeutic strategy.The presence of intra-tumoral bacteria also makes chemoradiotherapy tolerable,resulting in a poor treatment effect.However,due to the immune-related complexity of intra-tumoral bacteria,there may be unexpected effects in immunotherapy.In this review the patterns of intra-tumoral bacteria involvement in HNSCC are discussed,elucidating the dual roles,while exploring the relevance to anti-tumor immune responses in the clinical context and the prospects and limitations of the use of bacteria in targeted therapy.展开更多
Background:Head and neck squamous cell carcinoma(HNSCC)is a prevalent form of cancer globally,with chemoresistance posing a major challenge in treatment outcomes.The efficacy of the commonly used chemotherapeutic agent...Background:Head and neck squamous cell carcinoma(HNSCC)is a prevalent form of cancer globally,with chemoresistance posing a major challenge in treatment outcomes.The efficacy of the commonly used chemotherapeutic agent,cisplatin,is diminished in patients with poor prognoses.Methods:Various bioinformatics databases were utilized to examine Carboxylesterase 1(CES1)gene expression,clinicopathologic features,patient survival analysis,and gene function.An organoid model of HNSCC was established,along with the induction of drug-resistant HNSCC in the organoid model.CES1 expression was assessed using qRT-PCR and Western Blot,and differential markers were identified through transcriptome sequencing.Knockdown and overexpression models of CES1 were created in SCC-9 and patient-derived organoid(PDO)cells using shRNA and lentivirus to investigate the tumor biology and cisplatin resistance associated with CES1.Results:Research in bioinformatics has uncovered a strong correlation between the expression level of CES1 and the prognosis of HNSCC.The data suggests a significant link between CES1 expression and tobacco smoking.RNA-sequencing revealed a notable increase in CES1 expression in HNSCC-PDOcis-R cells compared to the parental PDO cells.Subsequently,we performed in vitro studies by HNSCC-PDO and SCC-9 and found that CES1-overexpressing cells exhibited reduced sensitivity to cisplatin and stronger tumor malignant biological behavior compared with CES1-knockdown cells.Conclusion:The observed association between CES1 expression and tobacco smoking implies a potential influence of smoking on the efficacy of cisplatin-based chemotherapy in HNSCC through the regulation of CES1 expression.展开更多
Introduction: Head and neck cancers represent a significant burden of cancer, collectively ranking fourth for cancer incidence and second for cancer mortality worldwide. Objective: To study the epidemiological and his...Introduction: Head and neck cancers represent a significant burden of cancer, collectively ranking fourth for cancer incidence and second for cancer mortality worldwide. Objective: To study the epidemiological and histopathological aspects of head and neck cancers in the ENT-CCF department of Ignace Deen National Hospital. Materials and Methods: This was a descriptive retrospective study covering a period of 5 years from September 1, 2016, to September 30, 2021. Results: We collected 43 cases of head and neck cancers, representing a hospital frequency of 1.85%. The mean age was 45.21 ± 13.23 years. Males predominated, accounting for 65.12%, compared to 34.88% for females, with a male-to-female ratio of 1.87. Housewives accounted for 27.90%, followed by farmers at 23.26% and traders/merchants at 18.60%, with 41.86% being uneducated. The main risk factors were tobacco (37.21%) and alcohol (34.88%). Pain (53.49%), dysphonia (51.16%), and dyspnea (39.53%) were the main presenting symptoms. Squamous cell carcinoma (74.42%) and large cell lymphoma (18.60%) were the most commonly cited histological types. Conclusion: Head and neck cancers remain relatively common in our country. Improving prognosis depends on early diagnosis of the condition, resuscitation resources, and prompt management.展开更多
Head and neck cancer is a significant threat to human health and is charac-terized by high 5-year morbidity and mortality rates.Addressing this challenge requires the application of precision medicine,but the inherent...Head and neck cancer is a significant threat to human health and is charac-terized by high 5-year morbidity and mortality rates.Addressing this challenge requires the application of precision medicine,but the inherent heterogeneity of head and neck cancer complicates its treatment.Radiogenomics,an inter-disciplinary field at the intersection of genomics and radiology,may represent a solution.Radiogenomics offers the potential to revolutionize the diagnosis and treatment of this complex and diverse disease.By comprehensively analyzing the genetic information and radiological features of tumors,clini-cians can gain a profound understanding of patients'conditions.Gaining such in-depth insight facilitates early detection and implementation of personalized treatment strategies,both of which are integral components of precision medicine.Tailored treatments,including surgical interventions and targeted therapies,provide improved outcomes and reduced side effects.Radio-genomics represents a groundbreaking advancement that has the potential to significantly enhance the quality of care and outcomes of patients with head and neck cancer.To shed light on this transformative approach,we performed a comprehensive overview of radiomics and radiogenomics-based diagnostic methods tailored to the unique characteristics of head and neck cancer.展开更多
Objective:This study aimed to develop and evaluate a novel software tool for robust analysis of the Visually Enhanced Vestibular-Ocular Reflex(VVOR)and video head impulse test(vHIT)saccades.Methods:A retrospective stu...Objective:This study aimed to develop and evaluate a novel software tool for robust analysis of the Visually Enhanced Vestibular-Ocular Reflex(VVOR)and video head impulse test(vHIT)saccades.Methods:A retrospective study was conducted on 94 patients with Meniere’s Disease(MD),unilateral vestibular hypofunction(UVH),and vestibular migraine(VM).The MATLAB-based VVOR Analysis System and Saccades All in One software were utilized for data processing.New techniques,VVOR_diff and VVOR_cycle,were deployed for saccade parameter extraction.Results:Saccade incidence rates,examined through vHIT,VVOR_diff,and VVOR_cycle,exhibited distinct patterns in MD,UVH,and VM patients.Frequent instances of multiple saccades within a single cycle were noted on the affected side in MD and UVH patients.Statistically significant differences in saccade gain and incidence rates between the affected and unaffected sides were evident in MD and UVH patients.Notably,high inter-method and intra-method correlations suggested consistency across different methods and potential interactions within one.Conclusion:The software proved effective in extracting saccades and reducing noise in VVOR data,thereby enhancing the evaluation of vestibular function and potentially improving diagnostic accuracy for vestibular disorders.展开更多
Background:Traditional Chinese medicine is promising for managing challenging and complex disorders,including cancer,and in particular,saffron is applied in treating various cancer types.However,its potential therapeu...Background:Traditional Chinese medicine is promising for managing challenging and complex disorders,including cancer,and in particular,saffron is applied in treating various cancer types.However,its potential therapeutic efficacy and active components in managing squamous cell carcinoma of the head and neck(HNSCC)remain unclear yet.Methods:Using network pharmacology approaches,active ingredients of saffron,their target genes,and HNSCC-related genes were identified.Enrichment analyses were conducted for determining molecular functions and pathways enriched by genes that overlapped between the saffron target gene set and the HNSCC gene set.Among the four known active ingredients of saffron,crocetin was found to have the strongest inhibitory impact on HNSCC,based on the findings of cell viability and migration assays.Therefore,the potential target genes of crocetin in HNSCC cells were examined using molecular docking experiments and were confirmed by qPCR.Result s:Four active ingredients of saffron and 184 of their target genes were identified.Further,a total of 34 overlapping saffron-/HNSCC-associated targets related to the four active ingredients were screened,and crocetin was chosen for further investigation because it had the strongest inhibitory effect on HNSCC cells.Molecular docking experiments indicated that ESR1 and CCND1 were the target genes of crocetin.These results were confirmed through qPCR analysis,in which crocetin was found to lower the expression of the ESR1 and CCND1 genes in AMC-HN-8 and FaDu cells.Conclusion:According to our results,crocetin is a primary active anti-cancer component of saffron that may have potential in the development of novel HNSCC-treating medications.However,more thorough molecular research is necessary for confirming these results and elucidating the anti-cancer mechanism underlying saffron.展开更多
Traditional open head and neck surgery often leaves permanent scars,significantly affecting appearance.The emergence of surgical robots has introduced a new era for minimally invasive surgery.However,the complex anato...Traditional open head and neck surgery often leaves permanent scars,significantly affecting appearance.The emergence of surgical robots has introduced a new era for minimally invasive surgery.However,the complex anatomy of the head and neck region,particularly the oral and maxillofacial areas,combined with the high costs associated with established systems such as the da Vinci,has limited the widespread adoption of surgical robots in this field.Recently,surgical robotic platform in China has developed rapidly,exemplified by the promise shown by the KangDuo Surgical Robot(KD-SR).Although the KD-SR has achieved some results comparable to the da Vinci surgical robot in urology and colorectal surgery,its performance in complex head and neck regions remains untested.This study evaluated the feasibility,effectiveness,and safety of the newly developed KD-SR-01,comparing it with standard endoscopic systems in head and neck procedures on porcine models.We performed parotidectomy,submandibular gland resection,and neck dissection,collected baseline characteristics,perioperative data,and specifically assessed cognitive workload using the NASA-TLX.None of the robotic procedures were converted to endoscopic or open surgery.The results showed no significant difference in operation time between the two groups(P=0.126),better intraoperative bleeding control(P=0.001),and a significant reduction in cognitive workload(P<0.001)in the robotic group.In conclusion,the KD-SR-01 is feasible,effective,and safe for head and neck surgery.Further investigation through well-designed clinical trials with long-term follow-up is necessary to establish the full potential of this emerging robotic platform.展开更多
The head and neck region encompasses structures from the base of the skull to the clavicles which include nasopharynx,oropharynx,hypopharynx,larynx and oral cavity.Tobacco,alcohol,and human papilloma virus(HPV)infecti...The head and neck region encompasses structures from the base of the skull to the clavicles which include nasopharynx,oropharynx,hypopharynx,larynx and oral cavity.Tobacco,alcohol,and human papilloma virus(HPV)infection are the three major risk factors for head and neck squamous cell carcinoma(HNSCC)in different countries.展开更多
The most dreaded complication in head and neck surgery is the development of fistula. Fistulas are common and devastating. The prevalence and the risk factors that contribute to fistula formation after head and neck p...The most dreaded complication in head and neck surgery is the development of fistula. Fistulas are common and devastating. The prevalence and the risk factors that contribute to fistula formation after head and neck procedures were discussed briefly. The main goal of this manuscript is to discuss current management of head and neck fistula. We believed that the best management strategy for head and neck fistulas is prevention. We recommend a holistic preventive approach during the perioperative period. The roles of different types of wound products and hyperbaric oxygen therapy were also discussed and highlighted. We also discussed the operative repair of fistulas, which relies on the tenet of providing well-vascularized tissue to an area of poor wound healing. Most often, the surgeon’s preference and range of operative skills dictate the timing and the type of repair. We highlighted the use of the pectoralis major, a well-known fap, as well as a novel technique in the surgical repair of complex, diffcult-to-heal head and neck fstula.展开更多
BACKGROUND Odontogenic infection is one of the common infectious diseases in oral and maxillofacial head and neck regions.Clinically,if early odontogenic infections such as acute periapical periodontitis,alveolar absc...BACKGROUND Odontogenic infection is one of the common infectious diseases in oral and maxillofacial head and neck regions.Clinically,if early odontogenic infections such as acute periapical periodontitis,alveolar abscess,and pericoronitis of wisdom teeth are not treated timely,effectively and correctly,the infected tissue may spread up to the skull and brain,down to the thoracic cavity,abdominal cavity and other areas through the natural potential fascial space in the oral and maxillofacial head and neck.Severe multi-space infections are formed and can eventually lead to life-threatening complications(LTCs),such as intracranial infection,pleural effusion,empyema,sepsis and even death.CASE SUMMARY We report a rare case of death in a 41-year-old man with severe odontogenic multi-space infections in the oral and maxillofacial head and neck regions.One week before admission,due to pain in the right lower posterior teeth,the patient placed a cigarette butt dipped in the pesticide"Miehailin"into the"dental cavity"to relieve the pain.Within a week,the infection gradually spread bilaterally to the floor of the mouth,submandibular space,neck,chest,waist,back,temporal and other areas.The patient had difficulty breathing,swallowing and eating,and was transferred to our hospital as an emergency admission.Following admission,oral and maxillofacial surgeons immediately organized consultations with doctors in otolaryngology,thoracic surgery,general surgery,hematology,anesthesia and the intensive care unit to assist with treatment.The patient was treated with the highest level of antibiotics(vancomycin)and extensive abscess incision and drainage in the oral,maxillofacial,head and neck,chest and back regions.Unfortunately,the patient died of septic shock and multiple organ failure on the third day after admission.CONCLUSION Odontogenic infection can cause serious multi-space infections in the oral and maxillofacial head and neck regions,which can result in multiple LTCs.The management and treatment of LTCs such as multi-space infections should be multidisciplinary led by oral and maxillofacial surgeons.展开更多
Tumor resection causes damage in the head and neck which creates problems in swallowing,chewing,articulation,and vision,all of which seriously affect patients'quality of life.In this work,we evaluated the applicat...Tumor resection causes damage in the head and neck which creates problems in swallowing,chewing,articulation,and vision,all of which seriously affect patients'quality of life.In this work,we evaluated the application of a free medial tibial flap in reconstruction of head and neck defects after tumor resection.We discussed the anatomy,surgical technique,and the advantages and disadvantages of the flap.We found several benefits for the flap,such as,it is especially effective for the defects that require thin-layer epithelium to cover or the separated soft tissue defect;a two-team approach can be used because the donor site is far away from the head and neck;and the flap is easy to integrate because of the subcutaneous fat layer of the free medial tibial flap is thin and the flap is soft.Thus,the medial tibial flap could replace the forearm flap for certain applications.展开更多
OBJECTIVE: To investigate the efficacy and safety of intravenous cervus and cucumis polypeptides for treating avascular necrosis of the femoral head(ANFH) in regard to pain and hip function in a randomized clinical tr...OBJECTIVE: To investigate the efficacy and safety of intravenous cervus and cucumis polypeptides for treating avascular necrosis of the femoral head(ANFH) in regard to pain and hip function in a randomized clinical trial.METHODS: A total of 96 subjects with ANFH who were recruited at the Orthopaedic Hospital Affiliated with Hebei United University and Qian Hai Femoral Head Hospital of Beijing were assigned by lottery to an intervention group(n = 48) or a control group(n = 48). All subjects underwent physical therapy and rehabilitation exercises. In addition,subjects in the intervention group were given intravenous infusions of cervus and cucumis polypeptides. Visual analogue scale(VAS), Harris hip score,and radiography or magnetic resonance imaging were applied to assess all subjects at the beginning of treatment and 3, 6, and 9 months afterward. All the subjects were followed up for 2 years.RESULTS: At the beginning of treatment, there were no statistically significant differences between the two groups in terms of the general condition of patients or the VAS and Harris hip scores(all P > 0.05). At 3, 6, and 9 months after treatment,however, the VAS score decreased and the Harris hip score increased in all patients, with the improvement of intervention group significantly greater than that of the control group(P < 0.05).The total effectiveness rates for the intervention and control groups were 89.58% and 70.83%, respectively, with the difference being statistically significant(P < 0.05). There was no statistically significant difference between the two groups in terms of the safety of the injections(P > 0.05).CONCLUSION: Intravenous infusion of cervus and cucumis polypeptides relieved pain and improved hip function of subjects with ANFH.Thus, the intravenous infusion of cervus and cucumis polypeptides was a safe, effective treatment for ANFH.展开更多
Background:Benign paroxysmal positional vertigo(BPPV)is characterized by vertigo lasting from seconds to minutes,induced by head movements.Objectives:Our study aimed to investigate the clinical significance of the cal...Background:Benign paroxysmal positional vertigo(BPPV)is characterized by vertigo lasting from seconds to minutes,induced by head movements.Objectives:Our study aimed to investigate the clinical significance of the caloric vestibular and video head-impulse tests(vHIT)diagnosing the disorder.Methods:68 patients suffering from posterior canal BPPV(25 male,43 females,mean age±SD,54.5±13.2 years)and 56 patients with a normal functioning vestibular system as control were investigated.Bithermal caloric test and vHIT was performed during the same medical check-up.Canal paresis(CP%),gain(GA)and asymmetry(GA%)parameters were calculated.Results:The Dix-Hallpike manoeuvre was only positive in 4%of this population.The CP%parameter was only pathologic in two patients,and there was no significant difference between control and BPPV patients(p=0.76).The GA value was never under 0.8 in this population,but GA%was abnormal in 63.2%.A significant difference comparing the GA%values to the control group was seen(p=0.034).There was no correlation detected between the CP%and GA%values in BPPV.Regarding the GA%value,61%sensitivity and 76%specificity was seen.Conclusion:The Dix-Hallpike manoeuvre was not often positive in the non-acute phase of BPPV;therefore,objective testing is essential.The caloric test does not have clinical significance in BPPV,but vHIT can be helpful based on the GA%parameter。展开更多
To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).METHODSSince 2006, we introduced the surveillance...To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).METHODSSince 2006, we introduced the surveillance for HN region using NBI for all patients with ESCC before treatment, and each follow-up. The patients with newly diagnosed stage I to III ESCC were enrolled and classified into two groups as follows: Group A (no surveillance for HN region); between 1992 and 2000), and Group B (surveillance for HN region with NBI; between 2006 and 2008). We comparatively evaluated the detection rate of superficial head and neck squamous cell carcinoma (HNSCC), and the serious events due to metachronous advanced HNSCC during the follow-up.RESULTSA total 561 patients (group A: 254, group B: 307) were enrolled. Synchronous superficial HNSCC was detected in 1 patient (0.3%) in group A, and in 12 (3.9%) in group B (P = 0.008). During the follow up period, metachronous HNSCC were detected in 10 patients (3.9%) in group A and in 30 patients (9.8%) in group B (P = 0.008). All metachronous lesions in group B were early stage, and 26 patients underwent local resection, however, 6 of 10 patients (60%) in group A lost their laryngeal function and died with metachronous HNSCC.CONCLUSIONSurveillance for the HN region by using NBI endoscopy increase the detection rate of early HNSCC in patients with ESCC, and led to decrease serious events related to advanced metachronous HNSCC.展开更多
Head and neck cancer(HNC) ranks as the 6th most common cancer worldwide, with the vast majority being head and neck squamous cell carcinoma(HNSCC). The majority of patients present with complicated locally advanced di...Head and neck cancer(HNC) ranks as the 6th most common cancer worldwide, with the vast majority being head and neck squamous cell carcinoma(HNSCC). The majority of patients present with complicated locally advanced disease(typically stage Ⅲ and Ⅳ) requiring multidisciplinary treatment plans with combinations of surgery, radiation therapy and chemotherapy. Tumor staging is critical to decide therapeutic planning. Multiple challenges include accurate tumor localization with precise delineation of tumor volume, cervical lymph node staging, detection of distant metastasis as well as ruling out synchronous second primary tumors. Somepatients present with cervical lymph node metastasis without obvious primary tumors on clinical examination or conventional cross sectional imaging. Treatment planning includes surgery, radiation, chemotherapy or combinations that could significantly alter the anatomy and physiology of this complex head and neck region, making assessment of treatment response and detection of residual/ recurrent tumor very difficult by clinical evaluation and computed tomography(CT) or magnetic resonance imaging(MRI). 18F-2-fluoro-2-deoxyD-glucose positron emission tomography/CT(18F-FDG PET/CT) has been widely used to assess HNC for more than a decade with high diagnostic accuracy especially in detection of initial distant metastasis and evaluation of treatment response. There are some limitations that are unique to PET/CT including artifacts, lower soft tissue contrast and resolution as compared to MRI, false positivity in post-treatment phase due to inflammation and granulation tissues, etc. The aim of this article is to review the roles of PET/CT in both pre and post treatment management of HNSCC including its limitations that radiologists must know. Accurate PET/CT interpretation is the crucial initial step that leads to appropriate tumor staging and treatment planning.展开更多
Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their uti...Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their utility in diagnosing VM.To better understand clinical features of VM,it is necessary to understand raw saccades data.Methods:Fourteen patients with confirmed VM,45 patients with probable VM(p-VM)and 14 agematched healthy volunteers were included in this study.Clinical findings related to spontaneous nystagmus(SN),positional nystagmus(PN),head-shaking nystagmus(HSN),caloric test and vHIT were recorded.Raw saccades data were exported and numbered by their sequences,and their features analyzed.Results:VM patients showed no SN,PN or HSN,and less than half of them showed unilateral weakness(UW)on caloric test.The first saccades from lateral semicircular canal stimulation were the most predominant for both left and right sides.Neither velocity nor time parameters were significantly different when compared between the two sides.Most VM patients(86%)exhibited small saccades,around 35%of the head peak velocity,with a latency of 200e400 ms.Characteristics of saccades were similar in patients with p-VM.Only four normal subjects showed saccades,all unilateral and seemingly random.Conclusions:Small saccades involving bilateral semicircular canals with a scattered distribution pattern are common in patients with VM and p-VM.展开更多
AIM: To determine swallowing outcomes and hyolaryngeal mechanics associated with post radiation therapy head and neck cancer(rt HNC) patients using videofluoroscopic swallow studies. METHODS: In this retrospective coh...AIM: To determine swallowing outcomes and hyolaryngeal mechanics associated with post radiation therapy head and neck cancer(rt HNC) patients using videofluoroscopic swallow studies. METHODS: In this retrospective cohort study, video-fluoroscopic images of rt HNC patients(n = 21) were compared with age and gender matched controls(n = 21). Penetration-aspiration of the bolus and bolus residue were measured as swallowing outcome variables. Timing and displacement measurements of the anterior and posterior muscular slings elevating the hyolaryngeal complex were acquired. Coordinate data of anatomical landmarks mapping the action of the anterior muscles(suprahyoid muscles) and posterior muscles(long pharyngeal muscles) were used to calculate the distance measurements, and slice numbers were used to calculate time intervals. Canonical variate analysis with post-hoc discriminant function analysis was performed on coordinate data to determine multivariate mechanics of swallowing associated with treatment. Pharyngeal constriction ratio(PCR) was also measured to determine if weak pharyngeal constriction is associated with post radiation therapy.RESULTS: The rt HNC group was characterized by poor swallowing outcomes compared to the control group in regards to: Penetration-aspiration scale(P < 0.0001), normalized residue ratio scale(NRRS) for the valleculae(P = 0.002) and NRRS for the piriform sinuses(P = 0.003). Timing and distance measurements of the anterior muscular sling were not significantly different in the two groups, whereas for the PMS time of displacement was abbreviated(P = 0.002) and distance of excursion was reduced(P = 0.02) in the rt HNC group. A canonical variate analysis shows a significant reduction in pharyngeal mechanics in the rt HNC group(P < 0.0001). The PCR was significantly higher in the test group than the control group(P = 0.0001) indicating reduced efficiency in pharyngeal clearance. CONCLUSION: Using videofluoroscopy, this study shows rt HNC patients have worse swallowing outcomes associated with reduced hyolaryngeal mechanics and pharyngeal constriction compared with controls.展开更多
文摘BACKGROUND Gastric cancer(GC)and head and neck squamous cell carcinoma(HNSCC)are common malignancies with high morbidity and mortality rates.Traditional treatments often yield limited efficacy,especially in advanced cases.Recent advancements in immunotherapy,particularly immune checkpoint inhibitors targeting programmed death-ligand 1(PD-L1),have shown promise.However,the expression and interaction of pescadillo ribosomal biogenesis factor 1(PES1)and PD-L1 in these cancers remain unclear.Understanding their roles could provide new insights into tumor biology and improve therapeutic strategies.AIM To investigate the expression levels of PES1 and PD-L1 in tumor tissues of patients with GC and HNSCC.METHODS A total of 58 cases of GC and HNSCC undergoing surgical resection were selected from January 2022 to January 2024.Paraffin specimens of GC and HNSCC tissues were taken from the patients,and the sections were subjected to staining with immunohistochemistry and hematoxylin-eosin staining,and the protein expression of PES1 and PD-L1 was observed microscopically.RESULTS Among 58 GC and HNSCC tissues,30 cases were positive and 28 cases were negative for PES1 expression,and 34 cases were positive and 24 cases were negative for PD-L1 expression.The positive expression rates of PES1 and PDL1 were 51.72% and 58.62%,respectively.PES1 expression was correlated with the TNM stage,lymph node metastasis,and the depth of infiltration(P<0.05),and PD-L1 expression was correlated with the differentiation degree,lymph node metastasis,and infiltration depth(P<0.05).CONCLUSION PES1 and PD-L1 were positively expressed in GC and HNSCC tissues and correlated with clinical features.They may serve as potential biomarkers for immune-targeted therapies.
基金supported by the Scientific Research Fund of the National Health Commission-Zhejiang Provincial Health Major Science and Technology Plan Project(No.WKJ-ZJ-2415)the Key Research and Development Program of Zhejiang Province(No.2024C03166)+1 种基金the Traditional Chinese Medicine Science and Technology Project of Zhejiang Province(No.2022ZB020)the Zhejiang Provincial Natural Science Foundation of China(No.LY21H160049).
文摘Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can serve as a tumor biomarker,the underlying mechanism in modulating head and neck squamous cell carcinoma(HNSCC)remains unclear.In this study,the aimed was to investigate the CXCL16 expression in HNSCC and to uncover the potential underlying mechanism.Hereby,we determined the high expression of CXCL16 in The Cancer Genome Atlas(TCGA)database,as well as in tissue samples from patients with HNSCC at our central hospital and from HNSCC cell lines.The results showed that CXCL16 knockdown inhibited the proliferation,migration,and invasion of HNSCC cells.Mechanistically,transcriptome sequencing revealed that CXCL16 may affect HNSCC cell growth by regulating the antioxidant pathway of glutathione peroxidase 1(GPX1).The reactive oxygen species(ROS)levels were elevated in small interfering CXCL16(si-CXCL16)cells,which may contribute to the inhibition of cell proliferation,migration,and invasion.Moreover,treatment of cells with the GPX1 inhibitor eldecalcitol(ED-71)revealed that HNSCC cell growth was significantly inhibited in the synergistic group of si-CXCL16 and GPX1 inhibitor compared to the si-CXCL16 group.In conclusion,CXCL16 contributed to the development of HNSCC cells by modulating the GPX1-mediated antioxidant pathway.Thus,targeting cellular CXCL16 expression seems to be a promising strategy for treating HNSCC.
文摘BACKGROUND Patients with head and neck cancer often develop depressive symptoms during radiochemotherapy due to changes in saliva secretion,radiation-induced oral mucositis,and dysphagia.These symptoms significantly affect quality of life.Although existing nursing interventions provide some relief,they have limitations in improving swallowing function and developing coping strategies.AIM To evaluate the effectiveness of tongue pressure resistance feedback training combined with empowerment education in improving depressive symptoms and swallowing function in patients with head and neck cancer undergoing radiochemotherapy.METHODS This study included 110 patients with head and neck cancer who exhibited depressive symptoms and underwent radiochemotherapy at the Affiliated Hospital of Jiangnan University between January 2021 and December 2023.Patients were randomly assigned to either a reference group or an experimental group,each comprising 55 patients.The reference group received routine care,whereas the experimental group received tongue pressure resistance feedback training and empowerment education.After 6 weeks of continuous intervention,comparisons were made between the two groups regarding depressive symptom scores,swallowing function,coping strategies,and quality of life,both pre-and post-intervention.RESULTS Following the intervention,both groups demonstrated decreased scores for depressive symptoms and swallowing function,with the experimental group showing a significantly greater reduction than the reference group(P<0.05).The experimental group also demonstrated higher confrontation scores and lower avoidance and submission scores for coping strategies than the reference group(P<0.05).Quality of life scores improved in both groups after the intervention,with the experimental group showing markedly higher scores than the reference group(P<0.05).CONCLUSION The combination of tongue pressure resistance feedback training and empowerment education is effective in alleviating depressive symptoms,enhancing swallowing function,optimizing coping strategies,and significantly improving the quality of life of patients with head and neck cancer undergoing radiochemotherapy.This approach shows promise for clinical applications and promotion.
基金supported by grants from the National Natural Science Foundation of China(Grant nos.82472818 and 82103336)the Fundamental Research Funds for the Central Universities(Grant nos.2042024kf0021 and 2042022dx0003)the Natural Science Foundation of Wuhan(Grant no.2023020201020515)。
文摘Intra-tumoral bacteria are pivotal in the initiation and progression of head and neck squamous cell carcinoma(HNSCC),exerting a significant influence on tumor cell biology,immune responses,and the tumor microenvironment(TME).Different types and distribution of bacteria threaten the balance of metabolism and the immune environment of tumor cells.Taking advantage of this disrupted homeostasis,intra-tumoral bacteria stimulate the secretion of metabolites or influence specific immune cell types to produce inflammatory or chemokines,thereby influencing the anti-tumor immune response while regulating the level of inflammation and immunosuppression within the TME.Some intra-tumoral bacteria are used as diagnostic and prognostic markers in clinical practice.Based on the unique characteristics of bacteria,the use of engineered bacteria and outer membrane vesicles for drug delivery and biological intervention is a promising new therapeutic strategy.The presence of intra-tumoral bacteria also makes chemoradiotherapy tolerable,resulting in a poor treatment effect.However,due to the immune-related complexity of intra-tumoral bacteria,there may be unexpected effects in immunotherapy.In this review the patterns of intra-tumoral bacteria involvement in HNSCC are discussed,elucidating the dual roles,while exploring the relevance to anti-tumor immune responses in the clinical context and the prospects and limitations of the use of bacteria in targeted therapy.
基金supported by the National Natural Science Foundation of China(No.82160386)the Guangxi Natural Science Foundation of China(No.2024GXNSFDA010032,2023GXNSFAA026189).
文摘Background:Head and neck squamous cell carcinoma(HNSCC)is a prevalent form of cancer globally,with chemoresistance posing a major challenge in treatment outcomes.The efficacy of the commonly used chemotherapeutic agent,cisplatin,is diminished in patients with poor prognoses.Methods:Various bioinformatics databases were utilized to examine Carboxylesterase 1(CES1)gene expression,clinicopathologic features,patient survival analysis,and gene function.An organoid model of HNSCC was established,along with the induction of drug-resistant HNSCC in the organoid model.CES1 expression was assessed using qRT-PCR and Western Blot,and differential markers were identified through transcriptome sequencing.Knockdown and overexpression models of CES1 were created in SCC-9 and patient-derived organoid(PDO)cells using shRNA and lentivirus to investigate the tumor biology and cisplatin resistance associated with CES1.Results:Research in bioinformatics has uncovered a strong correlation between the expression level of CES1 and the prognosis of HNSCC.The data suggests a significant link between CES1 expression and tobacco smoking.RNA-sequencing revealed a notable increase in CES1 expression in HNSCC-PDOcis-R cells compared to the parental PDO cells.Subsequently,we performed in vitro studies by HNSCC-PDO and SCC-9 and found that CES1-overexpressing cells exhibited reduced sensitivity to cisplatin and stronger tumor malignant biological behavior compared with CES1-knockdown cells.Conclusion:The observed association between CES1 expression and tobacco smoking implies a potential influence of smoking on the efficacy of cisplatin-based chemotherapy in HNSCC through the regulation of CES1 expression.
文摘Introduction: Head and neck cancers represent a significant burden of cancer, collectively ranking fourth for cancer incidence and second for cancer mortality worldwide. Objective: To study the epidemiological and histopathological aspects of head and neck cancers in the ENT-CCF department of Ignace Deen National Hospital. Materials and Methods: This was a descriptive retrospective study covering a period of 5 years from September 1, 2016, to September 30, 2021. Results: We collected 43 cases of head and neck cancers, representing a hospital frequency of 1.85%. The mean age was 45.21 ± 13.23 years. Males predominated, accounting for 65.12%, compared to 34.88% for females, with a male-to-female ratio of 1.87. Housewives accounted for 27.90%, followed by farmers at 23.26% and traders/merchants at 18.60%, with 41.86% being uneducated. The main risk factors were tobacco (37.21%) and alcohol (34.88%). Pain (53.49%), dysphonia (51.16%), and dyspnea (39.53%) were the main presenting symptoms. Squamous cell carcinoma (74.42%) and large cell lymphoma (18.60%) were the most commonly cited histological types. Conclusion: Head and neck cancers remain relatively common in our country. Improving prognosis depends on early diagnosis of the condition, resuscitation resources, and prompt management.
基金National University of Singapore,Grant/Award Number:NUHSRO/2022/005/Startup/02NSFC,Grant/Award Number:82202231。
文摘Head and neck cancer is a significant threat to human health and is charac-terized by high 5-year morbidity and mortality rates.Addressing this challenge requires the application of precision medicine,but the inherent heterogeneity of head and neck cancer complicates its treatment.Radiogenomics,an inter-disciplinary field at the intersection of genomics and radiology,may represent a solution.Radiogenomics offers the potential to revolutionize the diagnosis and treatment of this complex and diverse disease.By comprehensively analyzing the genetic information and radiological features of tumors,clini-cians can gain a profound understanding of patients'conditions.Gaining such in-depth insight facilitates early detection and implementation of personalized treatment strategies,both of which are integral components of precision medicine.Tailored treatments,including surgical interventions and targeted therapies,provide improved outcomes and reduced side effects.Radio-genomics represents a groundbreaking advancement that has the potential to significantly enhance the quality of care and outcomes of patients with head and neck cancer.To shed light on this transformative approach,we performed a comprehensive overview of radiomics and radiogenomics-based diagnostic methods tailored to the unique characteristics of head and neck cancer.
基金supported by grants from National Science and Technology Ministry Key Research and Development Program–Project(2022YFC2402703).
文摘Objective:This study aimed to develop and evaluate a novel software tool for robust analysis of the Visually Enhanced Vestibular-Ocular Reflex(VVOR)and video head impulse test(vHIT)saccades.Methods:A retrospective study was conducted on 94 patients with Meniere’s Disease(MD),unilateral vestibular hypofunction(UVH),and vestibular migraine(VM).The MATLAB-based VVOR Analysis System and Saccades All in One software were utilized for data processing.New techniques,VVOR_diff and VVOR_cycle,were deployed for saccade parameter extraction.Results:Saccade incidence rates,examined through vHIT,VVOR_diff,and VVOR_cycle,exhibited distinct patterns in MD,UVH,and VM patients.Frequent instances of multiple saccades within a single cycle were noted on the affected side in MD and UVH patients.Statistically significant differences in saccade gain and incidence rates between the affected and unaffected sides were evident in MD and UVH patients.Notably,high inter-method and intra-method correlations suggested consistency across different methods and potential interactions within one.Conclusion:The software proved effective in extracting saccades and reducing noise in VVOR data,thereby enhancing the evaluation of vestibular function and potentially improving diagnostic accuracy for vestibular disorders.
基金the Taishan Scholar Project(No.ts20190991)the Key R&D Project of Shandong Province(2022CXPT023)。
文摘Background:Traditional Chinese medicine is promising for managing challenging and complex disorders,including cancer,and in particular,saffron is applied in treating various cancer types.However,its potential therapeutic efficacy and active components in managing squamous cell carcinoma of the head and neck(HNSCC)remain unclear yet.Methods:Using network pharmacology approaches,active ingredients of saffron,their target genes,and HNSCC-related genes were identified.Enrichment analyses were conducted for determining molecular functions and pathways enriched by genes that overlapped between the saffron target gene set and the HNSCC gene set.Among the four known active ingredients of saffron,crocetin was found to have the strongest inhibitory impact on HNSCC,based on the findings of cell viability and migration assays.Therefore,the potential target genes of crocetin in HNSCC cells were examined using molecular docking experiments and were confirmed by qPCR.Result s:Four active ingredients of saffron and 184 of their target genes were identified.Further,a total of 34 overlapping saffron-/HNSCC-associated targets related to the four active ingredients were screened,and crocetin was chosen for further investigation because it had the strongest inhibitory effect on HNSCC cells.Molecular docking experiments indicated that ESR1 and CCND1 were the target genes of crocetin.These results were confirmed through qPCR analysis,in which crocetin was found to lower the expression of the ESR1 and CCND1 genes in AMC-HN-8 and FaDu cells.Conclusion:According to our results,crocetin is a primary active anti-cancer component of saffron that may have potential in the development of novel HNSCC-treating medications.However,more thorough molecular research is necessary for confirming these results and elucidating the anti-cancer mechanism underlying saffron.
基金supported by the West China Hospital of Stomatology(RD-03-202309)the National Natural Science Foundation of China(U1813213)+1 种基金the Science&Technology Department of Sichuan Province(2021YFQ0036)the Postdoctoral Fellowship Program of CPSF(GZC20231787)。
文摘Traditional open head and neck surgery often leaves permanent scars,significantly affecting appearance.The emergence of surgical robots has introduced a new era for minimally invasive surgery.However,the complex anatomy of the head and neck region,particularly the oral and maxillofacial areas,combined with the high costs associated with established systems such as the da Vinci,has limited the widespread adoption of surgical robots in this field.Recently,surgical robotic platform in China has developed rapidly,exemplified by the promise shown by the KangDuo Surgical Robot(KD-SR).Although the KD-SR has achieved some results comparable to the da Vinci surgical robot in urology and colorectal surgery,its performance in complex head and neck regions remains untested.This study evaluated the feasibility,effectiveness,and safety of the newly developed KD-SR-01,comparing it with standard endoscopic systems in head and neck procedures on porcine models.We performed parotidectomy,submandibular gland resection,and neck dissection,collected baseline characteristics,perioperative data,and specifically assessed cognitive workload using the NASA-TLX.None of the robotic procedures were converted to endoscopic or open surgery.The results showed no significant difference in operation time between the two groups(P=0.126),better intraoperative bleeding control(P=0.001),and a significant reduction in cognitive workload(P<0.001)in the robotic group.In conclusion,the KD-SR-01 is feasible,effective,and safe for head and neck surgery.Further investigation through well-designed clinical trials with long-term follow-up is necessary to establish the full potential of this emerging robotic platform.
文摘The head and neck region encompasses structures from the base of the skull to the clavicles which include nasopharynx,oropharynx,hypopharynx,larynx and oral cavity.Tobacco,alcohol,and human papilloma virus(HPV)infection are the three major risk factors for head and neck squamous cell carcinoma(HNSCC)in different countries.
文摘The most dreaded complication in head and neck surgery is the development of fistula. Fistulas are common and devastating. The prevalence and the risk factors that contribute to fistula formation after head and neck procedures were discussed briefly. The main goal of this manuscript is to discuss current management of head and neck fistula. We believed that the best management strategy for head and neck fistulas is prevention. We recommend a holistic preventive approach during the perioperative period. The roles of different types of wound products and hyperbaric oxygen therapy were also discussed and highlighted. We also discussed the operative repair of fistulas, which relies on the tenet of providing well-vascularized tissue to an area of poor wound healing. Most often, the surgeon’s preference and range of operative skills dictate the timing and the type of repair. We highlighted the use of the pectoralis major, a well-known fap, as well as a novel technique in the surgical repair of complex, diffcult-to-heal head and neck fstula.
文摘BACKGROUND Odontogenic infection is one of the common infectious diseases in oral and maxillofacial head and neck regions.Clinically,if early odontogenic infections such as acute periapical periodontitis,alveolar abscess,and pericoronitis of wisdom teeth are not treated timely,effectively and correctly,the infected tissue may spread up to the skull and brain,down to the thoracic cavity,abdominal cavity and other areas through the natural potential fascial space in the oral and maxillofacial head and neck.Severe multi-space infections are formed and can eventually lead to life-threatening complications(LTCs),such as intracranial infection,pleural effusion,empyema,sepsis and even death.CASE SUMMARY We report a rare case of death in a 41-year-old man with severe odontogenic multi-space infections in the oral and maxillofacial head and neck regions.One week before admission,due to pain in the right lower posterior teeth,the patient placed a cigarette butt dipped in the pesticide"Miehailin"into the"dental cavity"to relieve the pain.Within a week,the infection gradually spread bilaterally to the floor of the mouth,submandibular space,neck,chest,waist,back,temporal and other areas.The patient had difficulty breathing,swallowing and eating,and was transferred to our hospital as an emergency admission.Following admission,oral and maxillofacial surgeons immediately organized consultations with doctors in otolaryngology,thoracic surgery,general surgery,hematology,anesthesia and the intensive care unit to assist with treatment.The patient was treated with the highest level of antibiotics(vancomycin)and extensive abscess incision and drainage in the oral,maxillofacial,head and neck,chest and back regions.Unfortunately,the patient died of septic shock and multiple organ failure on the third day after admission.CONCLUSION Odontogenic infection can cause serious multi-space infections in the oral and maxillofacial head and neck regions,which can result in multiple LTCs.The management and treatment of LTCs such as multi-space infections should be multidisciplinary led by oral and maxillofacial surgeons.
文摘Tumor resection causes damage in the head and neck which creates problems in swallowing,chewing,articulation,and vision,all of which seriously affect patients'quality of life.In this work,we evaluated the application of a free medial tibial flap in reconstruction of head and neck defects after tumor resection.We discussed the anatomy,surgical technique,and the advantages and disadvantages of the flap.We found several benefits for the flap,such as,it is especially effective for the defects that require thin-layer epithelium to cover or the separated soft tissue defect;a two-team approach can be used because the donor site is far away from the head and neck;and the flap is easy to integrate because of the subcutaneous fat layer of the free medial tibial flap is thin and the flap is soft.Thus,the medial tibial flap could replace the forearm flap for certain applications.
基金Supported by Tangshan Science and Technology Research Project(No.13130242b)
文摘OBJECTIVE: To investigate the efficacy and safety of intravenous cervus and cucumis polypeptides for treating avascular necrosis of the femoral head(ANFH) in regard to pain and hip function in a randomized clinical trial.METHODS: A total of 96 subjects with ANFH who were recruited at the Orthopaedic Hospital Affiliated with Hebei United University and Qian Hai Femoral Head Hospital of Beijing were assigned by lottery to an intervention group(n = 48) or a control group(n = 48). All subjects underwent physical therapy and rehabilitation exercises. In addition,subjects in the intervention group were given intravenous infusions of cervus and cucumis polypeptides. Visual analogue scale(VAS), Harris hip score,and radiography or magnetic resonance imaging were applied to assess all subjects at the beginning of treatment and 3, 6, and 9 months afterward. All the subjects were followed up for 2 years.RESULTS: At the beginning of treatment, there were no statistically significant differences between the two groups in terms of the general condition of patients or the VAS and Harris hip scores(all P > 0.05). At 3, 6, and 9 months after treatment,however, the VAS score decreased and the Harris hip score increased in all patients, with the improvement of intervention group significantly greater than that of the control group(P < 0.05).The total effectiveness rates for the intervention and control groups were 89.58% and 70.83%, respectively, with the difference being statistically significant(P < 0.05). There was no statistically significant difference between the two groups in terms of the safety of the injections(P > 0.05).CONCLUSION: Intravenous infusion of cervus and cucumis polypeptides relieved pain and improved hip function of subjects with ANFH.Thus, the intravenous infusion of cervus and cucumis polypeptides was a safe, effective treatment for ANFH.
基金supported by EFOP-3.6.3-VEKOP-16-2017-00009 Project and by theÚNKP-20-4-I New National Excellence Program of The Ministry for Innovation and Technology from the Source of The National Research,Development and Innovation Fund.
文摘Background:Benign paroxysmal positional vertigo(BPPV)is characterized by vertigo lasting from seconds to minutes,induced by head movements.Objectives:Our study aimed to investigate the clinical significance of the caloric vestibular and video head-impulse tests(vHIT)diagnosing the disorder.Methods:68 patients suffering from posterior canal BPPV(25 male,43 females,mean age±SD,54.5±13.2 years)and 56 patients with a normal functioning vestibular system as control were investigated.Bithermal caloric test and vHIT was performed during the same medical check-up.Canal paresis(CP%),gain(GA)and asymmetry(GA%)parameters were calculated.Results:The Dix-Hallpike manoeuvre was only positive in 4%of this population.The CP%parameter was only pathologic in two patients,and there was no significant difference between control and BPPV patients(p=0.76).The GA value was never under 0.8 in this population,but GA%was abnormal in 63.2%.A significant difference comparing the GA%values to the control group was seen(p=0.034).There was no correlation detected between the CP%and GA%values in BPPV.Regarding the GA%value,61%sensitivity and 76%specificity was seen.Conclusion:The Dix-Hallpike manoeuvre was not often positive in the non-acute phase of BPPV;therefore,objective testing is essential.The caloric test does not have clinical significance in BPPV,but vHIT can be helpful based on the GA%parameter。
文摘To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).METHODSSince 2006, we introduced the surveillance for HN region using NBI for all patients with ESCC before treatment, and each follow-up. The patients with newly diagnosed stage I to III ESCC were enrolled and classified into two groups as follows: Group A (no surveillance for HN region); between 1992 and 2000), and Group B (surveillance for HN region with NBI; between 2006 and 2008). We comparatively evaluated the detection rate of superficial head and neck squamous cell carcinoma (HNSCC), and the serious events due to metachronous advanced HNSCC during the follow-up.RESULTSA total 561 patients (group A: 254, group B: 307) were enrolled. Synchronous superficial HNSCC was detected in 1 patient (0.3%) in group A, and in 12 (3.9%) in group B (P = 0.008). During the follow up period, metachronous HNSCC were detected in 10 patients (3.9%) in group A and in 30 patients (9.8%) in group B (P = 0.008). All metachronous lesions in group B were early stage, and 26 patients underwent local resection, however, 6 of 10 patients (60%) in group A lost their laryngeal function and died with metachronous HNSCC.CONCLUSIONSurveillance for the HN region by using NBI endoscopy increase the detection rate of early HNSCC in patients with ESCC, and led to decrease serious events related to advanced metachronous HNSCC.
文摘Head and neck cancer(HNC) ranks as the 6th most common cancer worldwide, with the vast majority being head and neck squamous cell carcinoma(HNSCC). The majority of patients present with complicated locally advanced disease(typically stage Ⅲ and Ⅳ) requiring multidisciplinary treatment plans with combinations of surgery, radiation therapy and chemotherapy. Tumor staging is critical to decide therapeutic planning. Multiple challenges include accurate tumor localization with precise delineation of tumor volume, cervical lymph node staging, detection of distant metastasis as well as ruling out synchronous second primary tumors. Somepatients present with cervical lymph node metastasis without obvious primary tumors on clinical examination or conventional cross sectional imaging. Treatment planning includes surgery, radiation, chemotherapy or combinations that could significantly alter the anatomy and physiology of this complex head and neck region, making assessment of treatment response and detection of residual/ recurrent tumor very difficult by clinical evaluation and computed tomography(CT) or magnetic resonance imaging(MRI). 18F-2-fluoro-2-deoxyD-glucose positron emission tomography/CT(18F-FDG PET/CT) has been widely used to assess HNC for more than a decade with high diagnostic accuracy especially in detection of initial distant metastasis and evaluation of treatment response. There are some limitations that are unique to PET/CT including artifacts, lower soft tissue contrast and resolution as compared to MRI, false positivity in post-treatment phase due to inflammation and granulation tissues, etc. The aim of this article is to review the roles of PET/CT in both pre and post treatment management of HNSCC including its limitations that radiologists must know. Accurate PET/CT interpretation is the crucial initial step that leads to appropriate tumor staging and treatment planning.
文摘Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their utility in diagnosing VM.To better understand clinical features of VM,it is necessary to understand raw saccades data.Methods:Fourteen patients with confirmed VM,45 patients with probable VM(p-VM)and 14 agematched healthy volunteers were included in this study.Clinical findings related to spontaneous nystagmus(SN),positional nystagmus(PN),head-shaking nystagmus(HSN),caloric test and vHIT were recorded.Raw saccades data were exported and numbered by their sequences,and their features analyzed.Results:VM patients showed no SN,PN or HSN,and less than half of them showed unilateral weakness(UW)on caloric test.The first saccades from lateral semicircular canal stimulation were the most predominant for both left and right sides.Neither velocity nor time parameters were significantly different when compared between the two sides.Most VM patients(86%)exhibited small saccades,around 35%of the head peak velocity,with a latency of 200e400 ms.Characteristics of saccades were similar in patients with p-VM.Only four normal subjects showed saccades,all unilateral and seemingly random.Conclusions:Small saccades involving bilateral semicircular canals with a scattered distribution pattern are common in patients with VM and p-VM.
文摘AIM: To determine swallowing outcomes and hyolaryngeal mechanics associated with post radiation therapy head and neck cancer(rt HNC) patients using videofluoroscopic swallow studies. METHODS: In this retrospective cohort study, video-fluoroscopic images of rt HNC patients(n = 21) were compared with age and gender matched controls(n = 21). Penetration-aspiration of the bolus and bolus residue were measured as swallowing outcome variables. Timing and displacement measurements of the anterior and posterior muscular slings elevating the hyolaryngeal complex were acquired. Coordinate data of anatomical landmarks mapping the action of the anterior muscles(suprahyoid muscles) and posterior muscles(long pharyngeal muscles) were used to calculate the distance measurements, and slice numbers were used to calculate time intervals. Canonical variate analysis with post-hoc discriminant function analysis was performed on coordinate data to determine multivariate mechanics of swallowing associated with treatment. Pharyngeal constriction ratio(PCR) was also measured to determine if weak pharyngeal constriction is associated with post radiation therapy.RESULTS: The rt HNC group was characterized by poor swallowing outcomes compared to the control group in regards to: Penetration-aspiration scale(P < 0.0001), normalized residue ratio scale(NRRS) for the valleculae(P = 0.002) and NRRS for the piriform sinuses(P = 0.003). Timing and distance measurements of the anterior muscular sling were not significantly different in the two groups, whereas for the PMS time of displacement was abbreviated(P = 0.002) and distance of excursion was reduced(P = 0.02) in the rt HNC group. A canonical variate analysis shows a significant reduction in pharyngeal mechanics in the rt HNC group(P < 0.0001). The PCR was significantly higher in the test group than the control group(P = 0.0001) indicating reduced efficiency in pharyngeal clearance. CONCLUSION: Using videofluoroscopy, this study shows rt HNC patients have worse swallowing outcomes associated with reduced hyolaryngeal mechanics and pharyngeal constriction compared with controls.
