Objective To study the objective changes and effects of speech characteristics in patients with nasal endoscopic surgery,and to analyze the relationship between surgery and changes in vocal tract structure.Methods A prospective study was conducted on 45 patients who underwent nasal endoscopic surgery from June 2023 to December 2023.Among them,13 patients underwent nasal septum deviation correction surgery and/or nasal polypectomy and/or turbinate shaping surgery group(G1 group),11 patients underwent simple sinus opening surgery group(G2 group),and 21 patients underwent nasal sinus opening+nasal septum deviation correction surgery and/or nasal polypectomy and/or nasal turbinate shaping surgery group(G3 group).Spectrogram detection was completed before and 1 month after surgery.Nasal resistance(Refft value),acoustic indicators resonance peak frequency(F1-F4),bandwidth(B1-B4),difference between F1 amplitude and nasal murmur resonance peak amplitude(A1-P0),and difference between F1 and nasal murmur resonance peak amplitude(A1-P1)under different sound tasks(oral vowels,nasal vowels,and phrases and short sentences containing nasal vowels)were analyzed.Results After surgery,there was no significant change in the acoustic indicators in any of the groups,and the Refft value significantly decreased.The change in the resonance peak of oral vowels was not significant,but the bandwidth significantly decreased.A1-P1 in each group showed an upward trend after surgery,while A1-P0 showed a downward trend after surgery.Among them,A1-P1 in G1 group showed a significant increase compared to preoperative levels in/ma/,/na/,/mi/,and/ni/,and A1-P0 showed a significant decrease in/ma/and/na/compared to preoperative levels.There were statisti-cally significant differences in A1-P0 between G2 group and preoperative group in both/ma/and/na/.The A1-P1 levels in G3 group showed significant differences compared to preoperative levels in/mi/and/ni/,and A1-P0 showed significant differences compared to preoperative levels in/ma/and/na/.Conclusion Nasal endoscopic surgery may have a measurable impact on the patient's speech.The spectrogram can be used to evaluate the postoperative pronuncia-tion characteristics of nasal endoscopy,with A1-P1 being a better measurement indicator for high vowels/i/and A1-P0 being a better measurement indicator for non high vowels/a/.

Objective To investigate the spatiotemporal expression pattern of metabotropic glutamate receptor 4(mGluR4)in the mouse cochlear basilar membrane and its dynamic changes during postnatal development until hair cell synaptic maturation.Methods Ten healthy 3-month-old C57BL/6L wild-type mice(5 males,5 females,25～35 g)were bred to obtain offspring.Cochlear samples from postnatal days 1～30(P1～P30)were analyzed.Frequency-specific auditory brainstem response(ABR)thresholds were measured at 45.2,32.0,22.6,16.0,11.3,8.0,5.6,and 4.0 kHz in P12,P14,P16,P21,and P30 mice.Immunofluorescence assay combined with confocal laser scanning microscopy was used to scan cochlear whole-mount preparations.Spatiotemporal co-localization profiling of mGluR4 and synaptic markers Ctbp2 and Snap25 was observed,and quantitative comparisons of fluorescent puncta density were performed.Results ABR testing revealed undifferentiated waveforms in all P12 mice,while 70%of P14 mice exhibited well-defined Wave I.In P14,P16,P21 and P30,mice undergoing ABR testing,50%failed to exhibit ABR waveforms when stimulated by 45.2 kHz tones,and 87.5%showed no response to 32.0 kHz stimuli.Auditory response thresholds for other frequencies progressively decreased with increasing postnatal age.Immunolocalization demonstrated stronger mGluR4 expression in inner hair cells(IHCs)versus outer hair cells(OHCs).Distinct mGluR4 puncta were observed at IHC presynaptic active zones(co-localized with Snap25)as early as P11,but showed minimal overlap with CtBP2-labeled ribbons.Quantitative analysis revealed significantly higher mGluR4 puncta density at P30 compared to P14 synapses(P<0.05).Conclusion Postnatal upregulation of mGluR4 at IHC synaptic regions correlates with functional maturation.These findings suggest mGluR4 may modulate vesicular exocytosis regulation and exert pharmacological inhibition on glutamate release,potentially influencing synaptic plasticity during auditory pathway refinement.

Objective To study the clinical value of stroboscopic laryngoscope combined with narrow band imaging endoscope in the diagnosis of benign and malignant glottic lesions.Methods A total of 60 patients(84 sides of vocal cord)who visited our department from June 2022 to January 2023 with hoarseness as the main complaint and were found to have glottic lesions by electronic nasopharyngoscopy were selected.In all 60 patients with 84 sides of vocal cord degenerative lesions,stroboscopic laryngoscopy and narrow band imaging(NBI)endoscopy were com-pleted.The examination results were evaluated and graded separately.The same operative group performed the re-section biopsy of vocal cord lesions under general anesthesia and laryngoscope respectively,and the pathological re-sults were used as the diagnostic gold standard.With sensitivity,specificity,accuracy,false negative rate,and false positive rate as the main evaluation indexes,the differences in diagnostic accuracy between single test technique and combined application of the two techniques were analyzed.Results Pathological results showed squamous cell carci-noma on 18 sides,carcinoma in situ on 4 sides,severe dysplasia on 4 sides,mild and moderate dysplasia on 13 sides,and papilloma,chronic,mucosal,nflammation,hyperplasia,hypokeratosis,hyperkeratosis on 45 sides.The sensitivity of strobe laryngoscopy detection was 53.06％and specificity was 60.34％.The sensitivity of NBI endo-scopic detection was 88.46％,and the specificity was 89.66％.The sensitivity of strobe laryngoscopy combined with NBI endoscopy was 96.15％,and the specificity was 94.83％.The areas under the ROC curve of strobe laryn-goscopy,NBI endoscopy and white light imaging combined with narrowband imaging were 0.888(95％CI:0.820～0.957),0.943(95％CI:0.885～1),0.970(95％CI:0.942～0.999),respectively.The area under the curve of the combined method was higher than that of the single method,and the difference was statistically significant(P＜0.05).Conclusion Stroboscopic laryngoscope combined with NBI endoscope can improve the diagnostic accuracy of benign and malignant glottic lesions.

Objective To study the objective changes and effects of speech characteristics in patients with nasal endoscopic surgery,and to analyze the relationship between surgery and changes in vocal tract structure.Methods A prospective study was conducted on 45 patients who underwent nasal endoscopic surgery from June 2023 to December 2023.Among them,13 patients underwent nasal septum deviation correction surgery and/or nasal polypectomy and/or turbinate shaping surgery group(G1 group),11 patients underwent simple sinus opening surgery group(G2 group),and 21 patients underwent nasal sinus opening+nasal septum deviation correction surgery and/or nasal polypectomy and/or nasal turbinate shaping surgery group(G3 group).Spectrogram detection was completed before and 1 month after surgery.Nasal resistance(Refft value),acoustic indicators resonance peak frequency(F1-F4),bandwidth(B1-B4),difference between F1 amplitude and nasal murmur resonance peak amplitude(A1-P0),and difference between F1 and nasal murmur resonance peak amplitude(A1-P1)under different sound tasks(oral vowels,nasal vowels,and phrases and short sentences containing nasal vowels)were analyzed.Results After surgery,there was no significant change in the acoustic indicators in any of the groups,and the Refft value significantly decreased.The change in the resonance peak of oral vowels was not significant,but the bandwidth significantly decreased.A1-P1 in each group showed an upward trend after surgery,while A1-P0 showed a downward trend after surgery.Among them,A1-P1 in G1 group showed a significant increase compared to preoperative levels in/ma/,/na/,/mi/,and/ni/,and A1-P0 showed a significant decrease in/ma/and/na/compared to preoperative levels.There were statisti-cally significant differences in A1-P0 between G2 group and preoperative group in both/ma/and/na/.The A1-P1 levels in G3 group showed significant differences compared to preoperative levels in/mi/and/ni/,and A1-P0 showed significant differences compared to preoperative levels in/ma/and/na/.Conclusion Nasal endoscopic surgery may have a measurable impact on the patient's speech.The spectrogram can be used to evaluate the postoperative pronuncia-tion characteristics of nasal endoscopy,with A1-P1 being a better measurement indicator for high vowels/i/and A1-P0 being a better measurement indicator for non high vowels/a/.

Objective To study the clinical value of stroboscopic laryngoscope combined with narrow band imaging endoscope in the diagnosis of benign and malignant glottic lesions.Methods A total of 60 patients(84 sides of vocal cord)who visited our department from June 2022 to January 2023 with hoarseness as the main complaint and were found to have glottic lesions by electronic nasopharyngoscopy were selected.In all 60 patients with 84 sides of vocal cord degenerative lesions,stroboscopic laryngoscopy and narrow band imaging(NBI)endoscopy were com-pleted.The examination results were evaluated and graded separately.The same operative group performed the re-section biopsy of vocal cord lesions under general anesthesia and laryngoscope respectively,and the pathological re-sults were used as the diagnostic gold standard.With sensitivity,specificity,accuracy,false negative rate,and false positive rate as the main evaluation indexes,the differences in diagnostic accuracy between single test technique and combined application of the two techniques were analyzed.Results Pathological results showed squamous cell carci-noma on 18 sides,carcinoma in situ on 4 sides,severe dysplasia on 4 sides,mild and moderate dysplasia on 13 sides,and papilloma,chronic,mucosal,nflammation,hyperplasia,hypokeratosis,hyperkeratosis on 45 sides.The sensitivity of strobe laryngoscopy detection was 53.06％and specificity was 60.34％.The sensitivity of NBI endo-scopic detection was 88.46％,and the specificity was 89.66％.The sensitivity of strobe laryngoscopy combined with NBI endoscopy was 96.15％,and the specificity was 94.83％.The areas under the ROC curve of strobe laryn-goscopy,NBI endoscopy and white light imaging combined with narrowband imaging were 0.888(95％CI:0.820～0.957),0.943(95％CI:0.885～1),0.970(95％CI:0.942～0.999),respectively.The area under the curve of the combined method was higher than that of the single method,and the difference was statistically significant(P＜0.05).Conclusion Stroboscopic laryngoscope combined with NBI endoscope can improve the diagnostic accuracy of benign and malignant glottic lesions.

Objective:To explore the clinical and endoscopic features of patients with autoimmune gastritis (AIG) and to improve the accuracy of clinical diagnosis of AIG.Methods:From January 3, 2020 to November 25, 2021, the general information (gender, age), laboratory examination indicators and endoscopic findings of 179 AIG patients diagnosed at the Second Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. The laboratory examination indicators included hemoglobin, gastrin-17, pepsinogen (PG), anemia combination indicators (ferritin, vitamin B 12), thyroid function indicators (thyroid-stimulating hormone, thyroglobulin antibody and thyroid peroxidase antibody), Helicobacter pylori, and anti-parietal cell antibody and anti-intrinsic factor antibody. Descriptive methods were used for statistical analysis. Results:Among the 179 AIG patients, there were 42 males (23.5%) and 137 females (76.5%), with an average age of (55.23±12.04) years old. The gastrin-17 level of AIG patients was 195.31 ng/L (143.64 ng/L, 273.61 ng/L), PG Ⅰ level and PG Ⅰ/PG Ⅱ ratio were 12.40 μg/L (7.65 μg/L, 19.40 μg/L) and 1.03 (0.66, 1.52), respectively. There were 15.3% (18/118) of the AIG patients with iron deficiency anemia, and 16.1% (19/118) with megaloblastic anemia. The positive rate of anti-parietal cell antibody was 71.8% (51/71), and the positive rate of anti-intrinsic factor antibody was 25.4% (18/71). The serum thyroid-stimulating hormone level increased in 27.3% (15/55) of the patients, and the positive rates of thyroglobulin antibody and thyroid peroxidase antibody were 31.6% (12/38) and 47.4% (18/38), respectively. The positive rate of Helicobacter pylori was 29.7% (38/128). The endoscopic appearance of AIG indicated reverse atrophy, characterized by obvious atrophy in gastric fundus and gastric body mucosa, however the atrophy of gastric antrum was not obvious. Under endoscopy yellow-white turbid mucus, which was difficult to be washed, was found in 67.0% (120/179) of the patients, and under endoscopy the residual gastric fundus glands could be seen in 19.6% (35/179) of the patients. Among 179 AIG patients, 7 cases (3.9%) of neuroendocrine tumor (NET), 7 cases (3.9%) of early gastric adenocarcinoma (including 1 case of poorly differentiated adenocarcinoma), 1 case (0.6%) of adenoma, and 14 cases (7.8%) of hyperplastic polyps were found. Except for the case of poorly differentiated adenocarcinoma undergoing surgery, the others were treated with endoscopic resection. Conclusions:When unexplained iron deficiency anemia, megaloblastic anemia, or reverse atrophy is found, AIG should be considered. AIG patients are at high risk for gastric cancer and NET, and should be closely followed up, and active treatment should be given before anemia and neurological symptoms appear.

Objective To summarize the experience of clinical application of combining double suture fixation and resection of partial fat retro-orbicularis oculus in some specially difficult blepharoplasty.Methods During upper blepharoplasty,patients with heaviness and bulkiness in the both upper eyelid and lateral upper orbital region,we combined double suture fixation and resection partial fat retro-orbicularis oculus.First,partial pretarsal bulky fat was resected,and to form skin-orbicularisoculi composite below incision line.And then,some thickened fat retro-orbicularis oculus was resected,which was also named preseptal and retro-orbicularis oculus fat (ROOF).Double suture fixation techniques were applied to form dynamic and physiological double eyelid.Results 146 cases had satisfactory effectiveness,except for 2 cases with secondary operation because of some superficial double eyelid creases,and 1 case had hematoma,and 3 had transient numbness in the lateral supraorbital nerve region.They were satisfied with healthy eyelid skins,concealed incision and non-serious complications followed at 3-24 months postoperatively.Conclusions Combining double suture fixation and resection of partial fat retro-orbicularis oculus would appear to be a useful adjunct to standard blepharoplasty techniques in selected patients.

Objective To investigate the expression of adaptin-2(AP-2) in different stages of mouse coch‐lea and its probable role in the auditory generation and formation .Methods Mice were divided into 4 experimental groups by age (7 days old ,15 days old ,35 days old ,16 months old) ,which respectively represented the newborn mice ,developmental mice ,mature mice and old mice .Auditory brainstem response (ABR) ,laser scanning confocal microscopy (LSCM) ,immune-fluroscence histochemistry and qRT - PCR were used in this study .Results For the 15 days old ,35 days old ,16 months old groups ,ABR average threshold was 18 .67 ± 1 .21 dB nHL ,13 .83 ± 1 .47 dB nHL ,37 .83 ± 7 .68 dB nHL ,respectively ,for the 7 days old groups no responses were observed .The AP-2 im‐munoreactivity was found in all the stages of mice cochlea inner hair cell (IHC) cytoplasm ,especially in IHC basal part ,nearby the ribbon synapse .For the 7 days old ,15 days old ,35 days old ,16 months old groups ,immune-flu‐roscence histochemistry IMV(intensity mean value)were 190 .91 ± 17 .27 ,494 .06 ± 27 .63 ,838 .41 ± 38 .23 ,682 .65 ± 72 .22 ,respectively .For the 7 days old ,15 days old ,35 days old ,16 months old groups ,mRNA RQ(relative quantity)were 0 .53 ± 0 .09 ,1 .03 ± 0 .02 ,1 .00 ± 0 .09 ,1 .03 ± 0 .06 ,respectively .Developmental mice expressed significantly higher than those of the newborn in the AP -2 protein expression level which was measured by immuno -fluores‐cence histochemistry and qRT PCR(P<0 .01) .There was no significant difference between old and mature mice in the AP-2 protein expression level measured by qRT PCR (P> 0 .05) ,but mature mice had significant advantages by immuno-fluorescence histochemistry .Conclusion AP-2 protein expression level may closely related to the au‐ditory formation and maintenance because its expression gradually increases with age in mice .

OBJECTIVE: To investigate the expression of Myosin VI and Disabled-2 (Dab2) in the cochlea of mice at different ages. METHOD: Forty KM mice were divided into four groups according to age, named as postnatal 2 week (P2w), P5w, P9w, P16month. The localization of protein in the basilar membrane of mice cochlea was detected by immunofluorescence staining and laser scanning confocal microscope (LSCM). The mRNA expression level of protein in cochlear at different ages was evaluated by real-time fluorescent quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). Statistical analysis was performed by the SPSS18.0 software. RESULT: Myosin VI and Disabled-2 protein mainly expressed at the apical cytoplasm of hair cells. As for the inner hair cell, Dab2 labeling was abundant especially at the cuticular plate and nearby. Comparing four immunofluorescence staining images of Myosin VI, we found the fluorescence intensity of P2w and P16m were weaker than that of P5w and P9w. After setting P9w as the control group, qRT-PCR revealed that the mRNA expression of MyosinVI and Dab2 in P2w was less than that in the control group (P < 0.01), while no significant difference was found between P5w and the control group, nor between P16m and the control group (P > 0.05). CONCLUSION Myosin VI and Dab2, two proteins which regulated the clathrin-mediated endocytosis, expressed at hair cells of mice cochlea. In the inner hair cell, this process of endocytosis may be more efficient at the cuticular plate and nearby. The expression level of protein may change in different ages, and this probably leads to a difference of CME, it also may cause a defect of inner hair cells function.
Adaptor Proteins, Vesicular Transport ; metabolism ; Aging ; Animals ; Cochlea ; metabolism ; Endocytosis ; Hair Cells, Auditory ; metabolism ; Hair Cells, Auditory, Inner ; metabolism ; Mice ; Microscopy, Confocal ; Myosin Heavy Chains ; metabolism

OBJECTIVE: To investigate the expression of adaptin-2(AP-2) in mice cochlea and to discuss the probable role in the endocytosis of hair cells. METHOD: Laser scanning confocal microscopy and immune-fluroscence histochemistry were performed in this study. RESULT: In mature mice cochlea, the immunoreactivity for AP-2 was found in the inner hair cells cytoplasm. This protein mainly expressed in the hair cells basal part and nearby the ribbon synapse. CONCLUSION AP-2 protein mainly expressed in the hair cells synaptic activity zone , which suggested that AP-2 could play an important role in the synaptic vesicle endocytosis. This finding built the foundation for the further research involved in the physiological and pathological role of AP-2.
Adaptor Protein Complex alpha Subunits ; metabolism ; Animals ; Cochlea ; Hair Cells, Auditory ; Hair Cells, Auditory, Inner ; metabolism ; Mice ; Microscopy, Confocal ; Synapses