OBJECTIVE To explore validity and reliability of proton pump inhibitors (PPI) in adult patients with laryngopharyngeal reflux disease(LPRD). METHODS Randomized and placebo-controlled clinical trials regarding the effectiveness of PPIs on LPRD patients were systematically extracted from PubMed, Cochrane Library, and EMBASE, Web of Science, CNKI, CBM, VIP and WANFANG from the beginning of indexing to August 2017. After selection and quality assessment, data were extracted from eligible studies meeting the exclusion and inclusion criteria. The Review Manager software(version 5.2, The Cochrane Collaboration) was performed for all of the statistical analysis in this meta-analysis. The level of evidence was assessed by the GRADE (Grades of Recommendation, Assessment, Development and Evaluation). RESULTS The sample comprised 14 RCTs including a pooled total of 821 LPRD patients were eligible for this meta-analysis, of which 447 and 374 patients took PPIs and placebo, respectively. Pooled results demonstrated that total RSI significantly improved for patients who received PPI therapy by comparing with those receiving placebo [SDM=2.12, 95％CI(0.80; 3.45), P<0.05]. PPI treatment group showed effective in response rate [OR=1.62, 95％CI (0.89, 2.95), P>0.05], but the differences between PPIs and placebo groups was not statistically significant. CONCLUSION PPI treatment could significantly improve reflux symptoms in LPRD patients, therefore, should be taken into consideration for LPRD management with other strategies, such as lifestyle modification.

[Abstract] Objective: To explore the expression and regulation mechanism of Dickkopf-1 (DKK1) in head and neck squamous cell carcinoma (HNSCC) tissues. Methods: Based on the TCGA database, the relationship of DKK1 expression in HNSCC tissues and its methylation site with patients’prognosis was analyzed. GO and KEGG gene enrichment method were used to analyze the signaling pathways of DKK1 enrichment. STRING was used to analyze the interaction between DKK1 protein and other proteins. TargetScan was used to analyze the miRNAs that regulate the expression of DKK1, and the transcription factors of DKK1 were analyzed with the TRRUST website. Results: DKK1 gene was highly expressed in HNSCC tissues (P<0.01), and its expression level was significantly correlated with the HPV status, age, pathological grade, and clinical stage of patients (all P<0.05); the prognosis of HNSCC patients with high DKK1 expression was poorer than those with low DKK1 expression (P<0.01). There were 19 methylation sites in DKK1, 12 of which were significantly different between cancer tissues and normal tissues (P<0.05), and 11 sites were significantly related to the prognosis of HNSCC (P<0.05). In addition, miRNA, circRNA, lincRNA and transcription factors, etc. also participated in the regulation of DKK1. A total of 5 DKK1-related PPI networks that may involve in the occurrence, development, invasion and metastasis of HNSCC were obtained. Conclusion: DKK1 is highly expressed in HNSCC tissues and is a risk factor for poor prognosis of HNSCC patients. DKK1 plays an important role in the pathogenesis of HNSCC and is expected to become a potential target for HNSCC treatment.

OBJECTIVE: To analyze the influence of signal transducers and activators of transcription 2(STAT2) on the apoptosis of oxidative stress-induced HEI-OC1 hair cells. METHODS: With random number table method,HEI-OC1 hair cells were divided into interference group and non-interference group. The artificial synthesis design targeted STAT2 small interfering RNA(siRNA) and opti-modified Eagle medium(opti-MEM) were added into the interference group, and only the opti-MEM was added into the non-interfere group. The 0, 20, 40, 60 μmol/L of tertiary butyl peroxide hydrogen(t-BHP) was added into the interference and non-interference group. Western blotting was used to detect the relative expression of STAT2 and cysteine protease(caspase)-3. The apoptotic rate of hair cells was detected by flow cytometry. RESULTS: In the interference group and non-interference group, the apoptotic rate of HEI-OC1 cells and the relative expression level of STAT2, Caspase-3 increased with the dose of t-BHP(P<0.01). The apoptotic rate of HEI-OC1 cells and the relative expression level of Caspase-3 in the interference group with 20, 40, 60 μmol/L of t-BHP were higher than that of the 20, 40 μmol/L group(P<0.01). The apoptotic rate of HEI-OC1 cells in the interference group was higher than those in the non-interference group with the same dose(P<0.01), while the relative expression level of STAT2 was lower than those in the non-interference group with the same dose(P<0.01). CONCLUSION: Inhibiting oxidative stress and STAT2 expression in hair cells can lead to aggravation of apoptosis. STAT2 has anti-apoptotic effect.

Objective:To explore the effects of dexmedetomidine (DEX) on postoperative pain, oxidative stress and adverse reactions in patients undergoing radical mastectomy.Methods:A total of 90 patients with breast cancer who received radical surgical treatment in our hospital from Jun. 2022 to Jun. 2023 were prospectively included as research objects and randomly divided into 3 groups with 30 patients in each group. DEX group was applied before, during and after surgery, respectively. The levels of pain visual analogue scale (VAS), Richmonation sedation score (RASS), superoxide dismu-tase (SOD) and malondialdehyde (MDA) were recorded.Results:The recovery time and extubation time in preoperative and intraoperative DEX group were significantly lower than those in postoperative DEX group, and the awakening time and extubation time in preoperative DEX group were significantly lower than those in intraoperative DEX group ( F value was 48.62 and 53.98, respectively, P<0.001). At 1 h, 6 h and 12 h after surgery, the VAS and RASS scores of patients in the preoperative and intraoperative DEX group were significantly lower than those in the postoperative DEX group, compared with those in the intraoperative DEX group. The VAS and RASS scores in the DEX group were significantly decreased ( F value: 62.34, 55.24, 69.26, 36.82, 24.20, 39.97, P<0.001). At 24h after surgery, there was no significant difference in VAS and RASS scores among the three groups ( F value was 0.45 and 0.81, respectively, P value was 0.613 and 0.418). Immediately after surgery, 24 h after surgery, 72 h after surgery, the SOD level of DEX group was significantly higher than that of DEX group before and during surgery ( F value was 29.37, 33.24, 10.35, P<0.001). MDA levels were significantly lower than those in postoperative DEX group ( F value was 30.52, 41.27, 8.26, P<0.001). There was no significant difference in the incidence of postoperative adverse reactions among all groups ( P>0.05) . Conclusion:Preoperative and intraoperative application of DEX can reduce postoperative pain and oxidative stress in breast cancer patients, help patients recover quickly after surgery, and preoperative application is superior to intraoperative application.