Objective To study the relationship between voice acoustic analysis(VAA) and voice handicap index (VHI) in patients with vocal cord polyps,and to investigate the characteristic of the VHI.Methods 35 subjects with normal voice and 35 patients with vocal cord polyps underwent VHI,were tested by VAA.Results The parameters such as APQ、jitter、shimmer、NHR in patients with vocal cord polys were much higher than those in the normal voice group.The average score of VHI was 43.32?4.66,while the average score of the normal voice group was 12.51?1.88.There was no correlation between VHI and VAA.Conclusion Since there is no correlation between VHI and VAA in patients with vocal cord polys.One can not speculate the VHI score by the voice acoustic analysis.

Objective To investigate the voice recovery by means of observing the changes of the acoustic parameters in the patients after vocal cord polyp operation by microlaryngoscope.Methods Follow up on the voice changes by means of morphology evaluations and voice analysis applied to 30 cases of patient with vocal cord polyp before the operation and in each week for 4 weeks after the operation.Results 86.67% patients were observed to have improved external appearance of their vocal cords 2 weeks after surgery.There is statistically significant difference in 2-,3-,4-week respectively after the operation compared with the preoperative group(P0.05).Conclusion 2 weeks is needed for the patients with vocal cord polyp to have improved vocal cords and one month needed at least to have the voicing functions recovered.Therefore the resting time should be proposed to patients with vocal cord polyp as a resting guideline.

Objective: To explore the clinical value of the treatment of bilateral vocal cord paralysis by tenoto-my and vocal process resection with CO_2 laser. Method: Eighteen cases of bilateral vocal cord paralysis after thy-roidectomy from March 2004 to June 2006 were retrospectively analyzed. Preoperative tracheotomy and CO_2 laser tenotomy and vocal process resection were performed. Result: All patients were able to breathe through the mouth and nose immediately after the operation. Fifteen patients were extubated within 8 weeks. Three patients were op-erated again after 4-6 weeks because of granulation hyperblastosis. All patients were followed up for 1. 6 years to 2. 3 years without breathing difficulties, aspiration and with satisfactory voice. Conclusion: The approach of CO_2 la-ser tenotomy and vocal process resection can effectively relieve breathing difficulty resulted from bilateral vocal cord paralysis, achieve satisfactory voice and avoid aspiration.

BACKGROUND: The mechanism of spasmodic dysphonia(SD) is still unclear and lacks of confirmed diagnostic standards. Limited reports on the treatment mainly focused on botulinum toxin infiltration; recurrent laryngeal nerve section, and voice training, amongst which voice training has been considered as one of the ideal complementary therapeutic means for SD because of less side effects and complications.OBJECTIVE: To investigate the significance of voice training in the treatment of SD and provide a method for the clinical treatment.DESIGN: Clinical case analysis and retrospective study based on patients.SETTING: Department of otolaryngology and cerebral surgery in a university hospital.PARTICIPANTS: Thirty-six confirmed SD patients in Wuhan College affiliated Renmin Hospital from February 1985 to December 2002.METHODS: Psychological consultation combined with breathing and voice training was adopted to make patients breathe freely and coordinately, with breath pattern changed from deep chest breathing and reversal breathing to normal chest-abdominal combined breathing, which helped decreasing larynx muscle straining. All patients were followed up for one to two years and their therapeutic effects were assessed by normal phonation, improvement, and ineffectiveness.MAIN OUTCOME MEASURES: Assessment of therapeutic effects.RESULTS: All 36 SD patients achieved satisfactory outcomes after voice training, with SD completely recovered in 30 cases and obviously improved in 6 cases.CONCLUSION: Psychological consultation combined with voice training is an ideal approach for the rehabilitation of SD.

Objective To investigate the characteristics of voice changes by multi-dimensional acoustic analysis in patients who underwent thyroid gland lobectomy without laryngeal nerve injury.Methods To observe vocal cord movement and evaluate voice quality,32 patients with unilateral thyroid adenoma received the examinations of fiberlaryngscopy and Multi-Dimensional Voice Program before and after operation,respectively.Forty subjects with normal voice were used as cantrol group.Results Fiberlaryngscopy examinations were normal in all patients before and after surgery.In thyroid group,the preoperative acoustic parameters in male patients showed no significant difference(P＞0.05) compared with the control group.There was no significant difference between preoperative and postoperative acoustic parameters(P＞0.05).While the postoperative acoustic parameters of female patients was significantly lower than those of preoperative and in control group(P＜0.05).There was significant improvement 3 months after the operation compared with that of preoperative group(P＜0.05).Fhi of 3 months after operation was still lower than those of preoperation and in control group in male and female patients that continues to be significant after 3 months.Conclusion Voice changes may occur after unilateral thyroid gland lobectomy without any laryngeal nerve injury,and there is little voice change in male patients,while in female patients,voice improvement is observed after operation.Fhi still remaines lower level for a certain of time.

Objective To study the voice rest treatment after laryngomicrosurgery in patients with vocal fold polyps .Methods Eighty -five patients with vocal fold polyps were divided into two groups randomly :Group A (48 cases) and Group B ( 37 cases) ,receiving 1 or 2 weeks voice rest postoperation ,respectively .Vocal acoustic analy-sis and fiberlaryngoscopy were performed in all patients before the surgery and 1 ,2 ,3 and 4 weeks after surgery . Results When compared with the preoperative data ,there were no significant differences in jitter ,shimmer and NHR 1 week after surgery in patients of two groups (P>0 .05) .Two weeks after surgery ,all the parameters im-proved significantly in Group B(P<0 .05) ,but only jitter improved in Group A (P<0 .05) .All the data in two groups returned to normal 4 weeks after surgery .Laryngoscopic examination showed varying degrees of vocal fold hyperemia and edema one week after surgery ,which then gradually subsided and gone .At 4 weeks after surgery , the appearance of the operative vocal fold completely returned to normal .Conclusion Patients with vocal fold polyps should be treated with complete voice rest for 2 weeks after surgery ,followed by 2 weeks of relative voice rest .This is beneficial to the voice recovering and the wound healing .

Objective To explore the effect of vocal rehabilitation training on patients with spasmodic dys-phonia. Methods Thirty-six patients with spasmodic dysphonia were recruited, and psychotherapy, acupuncture,respiratory and vocal training were performed according to the patients condition to improve the coordination of the vo-cal organs. Interventions were also employed to convert the patients reverse or high locational pattern of respiration in-to the normal associated chest and abdomen respiration, so as to reduce the tone of the laryngeal muscle. ResultsSatisfactory effects were achieved by the rehabilitation training. 30 out of 36 cases recovered and the other 6 cases im-proved. Conclusion It indicated that the comprehensive vocal rehabilitation should be adopted for the treatment ofpatients with spasmodic dysphonia.

Since the outbreak of corona virus disease 2019 (COVID-19), viral strains have mutated and evolved. Vaccine research is the most direct and effective way to control COVID-19. According to different production mechanisms, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines included inactivated virus vaccine, live attenuated vaccine, mRNA vaccine, DNA vaccine, viral vector vaccine, virus-like particle vaccine and protein subunit vaccine. Among them, viral protein subunit vaccine has a wide application prospect due to its high safety and effectiveness. Viral nucleocapsid protein has high immunogenicity and low variability which could be a new direction for vaccine production. We summarized the current development of vaccine research by reviewing the current progress, vaccine safety and vaccine immune efficiency. It is hoped that the proposed possible development strategies could provide a reference for epidemic prevention work in future.
Humans ; SARS-CoV-2/genetics* ; COVID-19/prevention & control* ; Protein Subunits ; Vaccines, DNA ; Nucleocapsid Proteins

Objective To evaluate the efficacy and safety of proton pump inhibitor (PPI)plus prokinetic drug on the treatment of laryngopharyngeal reflex .Methods According to predetermined criteria of inclusion and exclu-sion ,Cochrane Central Register of Controlled Trails(CENTRAL) ,Embase ,Elsevier ,Pubmed ,VIP ,Wanfang Data , CNKI and CBM were searched for the randomized controlled trails of proton pump inhibitor and prokinetic drug on the treatment of laryngopharyngeal reflex diseases from the date of establishment of the datebases to November 2012 .Revman 5 .1 software and GRAED profiler 3 .6 software were applied to analysis the data ,which was extrac-ted by three independent evaluators .Results A total of 346 related articles were obtained ,7 trails were included , 614 patients in total .The results of Meta -analysis showed that :the overall effictive rate of combination therapy with proton pump inhibitors plus prokinetic drug in patients with laryngopharyngeal reflex was higher than those in the control group [RR=1 .18 ,95% CI(1 .10 ,1 .28) ,P<0 .0001] .The rate of improvement of laryngeal signs exam-ined by fiberoptic laryngoscope was higher than those in the control group [RR= 1 .38 ,95% CI(1 .16 ,1 .65) ,P<0 .001] .The average relief time of dysphonia symptoms was shorter than those in the control group [MD = -1 .70 , 95 CI (-2 .95 ,-0 .45) ,P<0 .001] .Conclusion The effect of proton pump inhibitor plus prokinetic drug on the treatment of laryngopharyngeal reflex is superior to those of proton pump inhibitors or prokinetic drug only ,but in terms of safety ,more large-sample ,high-quality randomized controlled trails are required .

[摘 要] 目的：探究细胞焦亡相关基因GSDME在鼻咽癌组织中的表达及其对肿瘤微环境（TME）和患者预后的影响。方法：从TCGA数据库获得548例鼻咽癌患者的基因表达数据及临床资料，运用R语言对GSDME进行差异表达分析、GO-KEGG富集分析；从人类蛋白质图谱（HPA）数据库中获取GSDME蛋白在鼻咽癌组织和相应癌旁组织中的表达数据，通过STRING数据库探究与GSDME相互作用的蛋白质网络；应用ssGSEA算法分析GSDME在鼻咽癌组织中的表达及其与24种免疫细胞浸润的相关性，运用Spearman法分析GSDME与免疫检查点分子的相关性，通过TISIDB数据库分析GSDME表达与细胞因子基因表达的相关性。单因素和多因素COX回归分析筛选预后风险因素，基于风险因素GSDME绘制预后预测列线图和校准图，根据GSDME的表达水平对鼻咽癌患者进行生存分析和风险分析。qPCR法验证中国人鼻咽癌组织中GSDME及4种趋化因子mRNA的表达。结果：数据库数据分析显示，与癌旁组织相比，鼻咽癌组织中GSDME呈高表达（P<0.01），GO-KEGG富集分析显示GSDME参与免疫反应、细胞焦亡相关信号通路，GSDME表达与免疫细胞浸润、细胞因子及免疫检查点分子表达等相关，qPCR检查结果验证了中国人鼻咽癌组织中GSDME呈高表达。GSDME表达量、N分期和M分期是鼻咽癌患者预后的风险因素，基于风险因素建立的列线图和校正图能较好地预测鼻咽癌患者OS，鼻咽癌组织中GSDME高表达的患者预后差。结论：GSDME在鼻咽癌癌组织中呈高表达且是患者预后风险因素，基于GSDME建立的列线图预测预后效能良好；GSDME高表达与TME免疫浸润有关，其可能是免疫治疗的潜在靶点。