OBJECTIVE To investigate the predictive value of the advanced lung cancer inflammation index(ALI)for postoperative pharyngocutaneous fistula,recurrence,metastasis,and prognosis in patients with laryngeal squamous cell carcinoma(LSCC).METHODS This retrospective study analyzed the clinical data of 114 LSCC patients treated at Huangshi Central Hospital between January 2014 and December 2023.The data included tumor staging,ALI scores,age,gender,smoking history,alcohol history,diabetes,hypertension,hyperlipidemia,coronary heart disease,tumor differentiation,HPV infection,and tumor location.Based on the occurrence of pharyngocutaneous fistula,the patients were divided into the fistula group(10 cases)and the non-fistula group(104 cases).Single-factor and multi-factor logistic regression analyses were conducted to identify independent factors associated with postoperative pharyngocutaneous fistula.Patients were also classified into recurrence and metastasis groups(22 cases)and non-recurrence groups(92 cases),and further into poor prognosis(25 cases)and good prognosis groups(89 cases)based on follow-up results.Cox regression analysis was performed to identify factors influencing recurrence,metastasis,and prognosis.RESULTS Multivariate logistic regression analysis showed that tumor stage(stage Ⅰ-Ⅱ)[HR:0.040(95％CI:0.004-0.392)]and ALI score[HR:0.885(95％CI:0.805-0.972)]were independent protective factors for the occurrence of pharyngeal fistula(P<0.05).Multivariate Cox regression analysis further confirmed that tumor stage(stage Ⅰ-Ⅱ)[OR:0.180(95％CI:0.063-0.518)]and ALI score[OR:0.970(95％CI:0.939-0.992)]were independent protective factors for recurrence,metastasis,and poor prognosis(P<0.05).ROC curve analysis revealed that the AUC for ALI in predicting pharyngeal fistula was 0.910(95％CI:0.849-0.970),with a cutoffvalue of 29.877,sensitivity of 0.827,and specificity of 1.000.The AUC for ALI in predicting recurrence and metastasis was 0.804(95％CI:0.698-0.910),with a cutoffvalue of 34.398,sensitivity of 0.920,and specificity of 0.618.CONCLUSION The ALI score is an independent protective factor for the occurrence of postoperative pharyngocutaneous fistula,recurrence,metastasis,and poor prognosis in LSCC patients.It is a valuable predictor for early warning of postoperative complications,recurrence,metastasis,and prognosis,with potential clinical utility in guiding personalized treatment strategies.

OBJECTIVE To investigate the role of glyceraldehyde-3-phosphate dehydrogenase(GAPDH)in regulating ferroptosis,malignant biological behavior,and cisplatin resistance in laryngeal squamous cell carcinoma(LSCC)under hypoxic conditions.METHODS Human laryngeal cancer Hep-2 and TU212 cell lines were cultured in vitro under hypoxic(1%O2)and normoxic(21%O2)conditions without serum.Hep-2 cells were divided into five experimental groups:DMSO control group,Erastin treatment group,Hypoxia+Erastin group,Hypoxia+Erastin+NC-GAPDH group,and Hypoxia+Erastin+Silenced GAPDH group,to study the cellular response under various experimental conditions.Quantitative polymerase chain reaction(qPCR)and Western blot(WB)techniques were employed to analyze GAPDH mRNA and protein expression levels in each cell line.Cell Counting Kit-8(CCK-8),colony formation,and Transwell invasion assays were used to assess the vitality,proliferation,and invasion capabilities of each group of laryngeal cancer cells.Additionally,CCK-8 assays were used to determine cell resistance to various concentrations of cisplatin(5,15,20 μg/ml).Kit methods were used to evaluate intracellular malondialdehyde(MDA)and glutathione(GSH)levels.WB was employed to detect the expression levels of glutathione peroxidase 4(GPX4)and 4-hydroxynonenal(4-HNE)proteins.Fe2+probes and reactive oxygen species(ROS)fluorescence probes were used to measure intracellular Fe2+content and ROS levels.Transmission electron microscopy was utilized to observe mitochondrial morphology changes to assess ferroptosis occurrence.RESULTS Compared to normoxic conditions,hypoxia significantly increased the expression of GAPDH mRNA and protein in Hep-2 and Tu212 cells(P<0.05).Under hypoxic conditions,the number of cell colonies,migration capacity,and cell viability at 15 and 20 μg/ml cisplatin treatment were significantly higher than those under normoxic conditions(P<0.05).When GAPDH was silenced,these hypoxia-induced enhancements were reversed.Under normoxic conditions,compared to the DMSO control group,Erastin treatment significantly reduced the number of colonies,migration capacity,and cell viability at 15 and 20 μg/ml cisplatin treatment(P<0.05).However,under hypoxic conditions,the inhibitory effect of Erastin was weakened.Additionally,in the hypoxia+Erastin+si-GAPDH group,the number of colonies,migration capacity,and cell viability at 15 and 20 μg/ml cisplatin treatment were significantly lower than those in the hypoxia+Erastin+NC-GAPDH group(P<0.05).CONCLUSION This study reveals that silencing GAPDH under hypoxic conditions can reverse the inhibition of ferroptosis in LSCC cells,thereby suppressing their malignant biological behavior and cisplatin resistance.

Objective:To investigate the expressions of Nod-like receptor protein 3 (NLRP3), cysteine-aspartic acid protease 1 (Caspase-1), and Gasdermin D (GSDMD) in nasopharyngeal carcinoma (NPC), and their relationships with the recurrence and metastasis of NPC.Methods:A retrospective study was conducted on 421 patients diagnosed with NPC between December 2014 and January 2020. The expressions of NLRP3, Caspase-1, and GSDMD in pathological specimens were examined with immunohistochemistry and multiplex immunofluorescence staining. Univariate and multivariate Cox regression analyses were applied to identify the factors influencing NPC recurrence and metastasis. In vitro experiments with NPC cell line HNE-2 were used to explore the functional mechanisms of NLRP3, Caspase-1, and GSDMD.Results:Multivariate Cox analysis revealed that tumor staging of Ⅲ-Ⅳ( HRrecurrence=2.74, 95% CIrecurrence: 1.61-4.65; HRmetastasis=1.90, 95% CImetastasis: 1.04-3.49) and pre-treatment plasma EBV-DNA levels≥1 500 copies/ml ( HRrecurrence=1.91, 95% CIrecurrence: 1.13-3.23; HRmetastasis=2.07, 95% CImetastasis: 1.23-3.50)were independent risk factors for NPC recurrence and metastasis, while positive expression of NLRP3( HRrecurrence=0.17, 95% CIrecurrence: 0.08-0.35; HRmetastasis=0.30, 95% CImetastasis: 0.15-0.59), Caspase-1( HRrecurrence=0.32, 95% CIrecurrence: 0.18-0.59; HRmetastasis=0.43, 95% CImetastasis: 0.25-0.76), and GSDMD( HRrecurrence=0.48, 95% CIrecurrence: 0.25-0.91; HRmetastasis=0.96, 95% CImetastasis: 0.53-1.74) served as independent protective factors. Age ( HR=1.02, 95% CI: 1.01-1.04) and intensity-modulated radiotherapy ( HR=0.51, 95% CI: 0.30-0.88) were independent factors for NPC recurrence, whereas chemotherapy ( HR=0.50, 95% CI: 0.29-0.88) acted as an independent protective factor for NPC metastasis (all P<0.05). NPC patients with positive expressions of the three proteins had higher locoregional recurrence-free survival, distant metastasis-free survival, and overall survival compared to those with negative expressions (all P<0.05). In vitro experiments revealed that the overexpression of NLRP3 activated the NLRP3/Caspase-1/GSDMD signaling pathway, as evidenced by Western Blot analysis. Enzyme-linked immunosorbent assay and scanning electron microscopy demonstrated that overexpression of NLRP3 promoted pyroptosis in HNE-2 cells. Cellular functional assays further confirmed that overexpression of NLRP3 significantly inhibited the proliferation, invasion, and migration of HNE-2 cells. Conclusion:Positive expressions of NLRP3, Caspase-1, and GSDMD serves as independent protective factors for recurrence and metastasis of NPC, potentially by promoting cell pyroptosis and thus inhibiting NPC cell proliferation, invasion, and migration.

Objective To study the efficacy of voice therapy combined with Jinsangsanjie pill in patients with vocal nodule .Methods A total of 146 patients with vocal nodes were randomly divided into three groups :45 cases in group A(single Jinsangsanjie pill therapy) ,47 cases in group B(single voice therapy) and 54 cases in group C(voice therapy combined with Jinsangsanjie pill therapy) ,30 healthy adults were as a normal control group .The treatment lasted 1 month .The results were evaluated by voice handicap index ,voice acoustic analysis and electronic laryngo‐scope which were collected before and after 1 month treatments .Results The VHI ,jitter ,shimmer and NNE of all patients were reduced while the MPT was increased after the treatment .The differences were significant (P<0 .05) .VHI 3 .64 ± 2 .12 ,jitter 0 .30% ± 0 .08% ,shimmer 1 .41% ± 0 .31% ,NNE -16 .83 ± 5 .84 dB of group C were significantly lower while MPT 18 .87 ± 3 .38 s and cure rate(93 .5% ) were significantly higher than those of in groupA(7.39±2.56,0.38% ±0.12% ,1.78% ±0.41% ,-13.38±4.42dB,16.38±3.11s,80.5% )andgroupB (23.6±12.5,0.48% ±0.18% ,1.98% ±0.42% ,-9.42±3.82dB,14.98±3.28s,52.4% )(P< 0.05).The VHI ,,jitter shimmer ,NNE of group A were significantly lower .MPT and cure rate were significantly higher than those of in group B .There were no statistical differences in each vocal indicators between group C and the normal control group (P>0 .05) .Conclusion The voice therapy combined with Jinsangsanjie pill in the treatment of vocal nodules is more efficiently ,and can improve patient’s pronunciation features .

OBJECTIVE:To prepare Zuojin gastric-mucoadhesive tablets and evaluate their drug release properties in vitro. METHODS:Zuojin gastric-mucoadhesive tablets were prepared with hydroxypropyl methyl cellulose K15M(HPMC-K15M),car-bomer 934P and HPMC-E50 as the bioadhesive and matrix materials,and basic magnesium carbonate(foaming material),95% al-cohol solution(adhesive)and aerosil(glidant and lubricant)as the adjuvants. With the accumulative release of total alkaloids from Coptis chinensis Franch. at 2,6 and 10 h(Q2 h,Q6 h and Q10 h)as the indexes,orthogonal design test was conducted to optimize the amounts of HPMC-K15M,carbomer 934P,HPMC-E50 and basic magnesium carbonate,and verification was carried out. Drug re-lease properties in vitro of the preparation and Zuojin conventional tablets were observed and in vitro adhesion thereof determined. RESULTS:The optimal formulation was as follows as that for 50 tablets,HPMC-K15M of 0.7 g,carbomer 934P of 0.2 g, HPMC-E50 of 3.5 g and basic magnesium carbonate of 0.4 g. The Q2 h,Q6 h and Q10 h of three batches of prepared samples were 24.32%,56.10% and 77.04% respectively. 1-12 h drug release in vitro of prepared samples was in conformity with Ritger-Peppas equation. The Q2 h of Zuojin conventional tablets and Zuojin gastric-mucoadhesive tablets were 80.46% and 24.04%,Q12 h thereof 92.15% and 95.83% and gastric adhesion thereof 24.2 and 74.0 g/cm2,respectively. CONCLUSIONS:Zuojin gastric-mucoadhesive tablets which have sustained-release effect and adhesive property have been prepared successfully.

We reported a case of nasal malignant granular cell tumor. The patient was a 51 years old man who went to the hospital because of "right nasal intermittent bleeding for half a year". The pathological examination after resection showed malignant granular cell tumor. No recurrence was noted during a year after resection. The etiology and pathogenesis, clinical features, pathological features and treatments of malignant granular cell tumor were reviewed.
Epistaxis ; Granular Cell Tumor ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Nose ; Nose Neoplasms ; pathology ; surgery

OBJECTIVE: To investigate the clinical effect of nasal packing of pulmicort respules combined withnasopore after endoscopic sinus surgery. METHOD: A total of 30 CRSwNP and CRSsNP patients with bilateral functional endoscopic sinus surgery and finished following up visit were randomly choosed, conventionally select the left nasal cavity as the experimental group, the right nasal cavity as the control group. Experimental group to pack the nasal cavity with pulmicort respules union nasopore after surgery and control group to pack the nasal cavity with only nasopore after surgery. The differences were observed in patients with subjective symptoms and recovery of mucosa of operative cavity between the two groups after two weeks, one month and three months. RESULT: (1) The postoperative VAS symptoms score about nasal obstruction, nasal secretion, headache, dizziness and distending pain after two weeks,one month and three months in the experiment group were significantly better than those in the control group(P<0.05). (2) The postoperative Lund-Kennedy endoscopic mucosa morphology score after two weeks, one month and three months in the experiment group were significantly better than those in the control group(P<0.05); (3) After three months, the experiment group had 28 cases with clinic symptoms cured(93. 3%), Total effective rate was 96. 6%; The control group had 22 cases with clinic symptoms cured (73. 3%), total effective rate was 93. 3%. The cure rate of the experiment group was significantly higher than the control group(P<0.05), but there was no statistic difference between the two groups in the total effective rate (P>0.05). CONCLUSION The application of nasal packing of pulmicort respules combined with nasopore after functional endoscopic sinus surgery can effectively relieve postoperative uncomfortable symptoms, promote recovery of mucosa of perative cavity, which deserves clinical promotion.
Anti-Inflammatory Agents ; administration & dosage ; Bandages ; Budesonide ; administration & dosage ; Endoscopy ; Epistaxis ; Humans ; Nasal Cavity ; Nasal Obstruction ; Paranasal Sinuses ; surgery ; Postoperative Period