Objective:To investigate the expression of EIF3B and its role in the development of laryngeal carcinoma. Methods:Immunohistochemistry, cell culture, cell transfection, qRT-PCR, Western Blot and other techniques were used to determine the expression difference of EIF3B in laryngeal cancer and adjacent tissues, and analyze the relationship between EIF3B and the size and TNM stage of laryngeal cancer. By constructing a laryngeal carcinoma cell model with EIF3B knocked down, the cell function was studied, and the regulatory effect of EIF3B on laryngeal carcinoma cells was proved in vitro. Finally, the effect of EIF3B on laryngeal carcinoma growth in vivo was studied by subcutaneous xenograft tumor model in nude mice. Results:The signal intensity of EIF3B in laryngeal carcinoma tissues was significantly stronger than that in adjacent tissues, and the expression level of EIF3B was positively correlated with patient age, TNM stage, lymph node metastasis, tumor size and clinical stage. Knocking down EIF3B can significantly inhibit the proliferation, migration and aggregation of cancer cells, and promote apoptosis. In vivo experiments with nude mice also showed that down-regulating EIF3B expression could inhibit tumor formation in vivo. Conclusion:The expression of EIF3B in laryngeal cancer is significantly increased, and it is closely related to the pathological characteristics of laryngeal cancer, which can be used as a diagnostic index of laryngeal cancer. In terms of function, EIF3B knockdown can inhibit the proliferation, migration and tumor formation of laryngeal cancer cells in vitro and in vivo, and may become a candidate target for targeted therapy of laryngeal cancer in the future.
Laryngeal Neoplasms/pathology* ; Humans ; Eukaryotic Initiation Factor-3/metabolism* ; Animals ; Mice, Nude ; Mice ; Cell Line, Tumor ; Cell Proliferation ; Apoptosis ; Cell Movement ; Neoplasm Staging ; Male ; Transfection ; Female ; Middle Aged ; Gene Expression Regulation, Neoplastic

Pure-tone audiometry can be performed to evaluate the type and degree of hearing loss， whose results can be divided into four types including low-frequency descending， high-frequency descending， flat descending and total deafness. The low-frequency descending type of sudden hearing loss （SHL） is more likely to be spleen deficiency and dampness exuberance， the high-frequency descending type is often due to yin deficiency of liver and kidney， the flat descending type is commonly associated with qi and blood depletion， and the type of total deafness is often linked to blood stasis. Our team has further developed a comprehensive diagnostic and therapeutic approach for SHL， emphasizing "the integration of disease and syndrome， the combination of acupuncture and herbal medicine， and dynamically administering treatment". Firstly， it advocates integrating disease diagnosis with syndrome differentiation. Secondly， it recommends combining acupuncture and herbal medicine， with local acupoints such as Ermen （TE 21）， Tinggong （SI 19）， Tinghui （GB 2）， and Yifeng （TE 17） used to unblock the auditory orifice， and herbal prescriptions tailored to the hearing curve patterns. For the low-frequency descending type， it is recommended to fortify the spleen and percolate dampness by taking distal points of spleen channel and stomach channel and using Shenling Baizhu Powder （参苓白术散）. For the high-frequency descending type， the method of nourishing kidney and calming liver is recommended， using distal points of kidney and liver channels and taking Erlong Zuoci Pills （耳聋左慈丸）. Regarding the flat descending type， tonifying qi and nourishing blood is advised， for which acupoints of Conception Vessel， spleen， stomach and large intestine channels can be needled， and Yiqi Congming Decoction （益气聪明汤） can be administered. For the total deafness type， it is recommended to activate blood and dissipate stasis， often with Xuehai （SP 10） and Geshu （BL 17） needled and Tongqiao Huoxue Decoction （通窍活血汤） administered. All these are conducted to treat the root and branch simultaneously. At the same time， it emphasizes the need to consider complex syndrome presentations and disease progression， dynamically analyze the disease causes and mechanisms， and adjust treatment according to the changing syndromes. In conclusion， this article is expected to inspire clinical diagnosis and treatment of SHL.

ObjectiveTo evaluate the effectiveness and safety of neck seven-line method combined with periauricular acupuncture as salvage treatment for sudden hearing loss in non-acute stage. MethodsSixty-six patients with non-acute stage of sudden hearing loss with a disease duration of 15-90 days were randomly divided into 33 cases each in treatment group and control group. The treatment group was given neck seven-line method combined with acupuncture at periauricular points； the control group used sham acupuncture and sham electroacupuncture at the same points. Both groups were treated 3 times a week for 6 weeks. The pure tone average hearing threshold of impaired frequencies were examined before treatment， after treatment finish and at follow-up （week 10）， and the difference between pure tone average hearing threshold of impaired frequencies before and after treatment was calculated； calculate the proportion of patients with ≥10 dB improvement in pure tone average hearing threshold of impaired frequency after treatment and at follow-up； compare the patients' Tinnitus Evaluation Scale （TEQ） scores， Chinese Medicine Quality of Life Assessment Scale （CQ-11D） health utility values and the difference between before and after treatment， and record the occurrence of adverse events. ResultsThe pure tone average of impaired frequency in the treatment group were （50.57±18.07） dB and （47.70±17.42） dB at post-treatment and follow-up respectively， and （54.38±21.77） dB and （53.36±20.99） dB in the control group at post-treatment and follow-up. Compared with the pre-treatment period， the pure tone average hearing threshold of impaired frequency in the two groups significantly decreased （P＜0.05） at post-treatment and follow-up. The difference of pure tone average hearing threshold of impaired frequency in the treatment group after treatment and at the follow-up visit compared to that before treatment was lower than those in the control group （P＜0.05）. After treatment， 13 patients （39.39%） in the treatment group and 10 patients （30.30%） in the control group showed improvement of ≥10 dB in pure tone average hearing threshold of impaired frequency； at the follow-up visit， 18 patients （54.55%） in the treatment group and 10 patients （30.30%） in the control group showed improvement of ≥10 dB in the pure tone average hearing threshold of impaired frequency， and there was no statistical significance for comparison between groups at the time of post-treatment and follow-up （P＞0.05）. The TEQ score of the treatment group significantly lower than that before treatment （P＜0.05）； the TEQ score of the treatment group and the difference between before and after treatment significantly lower than that of the control group （P＜0.05）. The difference in CQ-11D health utility values and the difference between before and after treatment were not statistically significant between the two groups （P＞0.05）. Eight cases of acupuncture-related adverse events occurred among 66 patients， including subcutaneous haematomas after needling， severe pain during needling and needle fainting， which disappeared after symptomatic treatment and did not affect the following treatment. ConclusionNeck seven-line method combined with periauricular acupuncture could be used as salvage treatment for sudden hearing loss in non-acute stage to improve the pure tone average hearing threshold of impaired frequency， alleviate tinnitus， with safety.

Objective:To establish a novel laryngopharyngeal reflux model in Bama minipigs excluding concurrent gastroesophageal reflux through endoscopic cricopharyngeal myotomy.Methods:Twelve 8-month-old male Bama minipigs were randomly assigned to three groups: Group 1 underwent cricopharyngeal myotomy alone, Group 2 underwent combined cricopharyngeal and lower esophageal sphincter myotomy, and Group 3 served as the control group. Following a one-week acclimatization period, the respective surgical procedures were performed. At 2 weeks postoperatively, laryngopharyngeal pH monitoring was conducted on all pigs. At 8 weeks, histopathological assessment using hematoxylin and eosin (HE) staining, transmission electron microscopy of the laryngopharyngeal mucosa, and quantification of pepsin in the laryngopharyngeal and distal esophageal mucosa were performed to analyze intergroup differences and to elucidate the occurrence and pathologic featuresof LPR.Results:Two weeks postoperatively, experimental groups exhibited laryngopharyngeal reflux episodes with pH<5.0, in contrast to the control group. HE staining at 8 weeks revealed inflammatory changes in the laryngopharyngeal mucosa of Groups 1 and 2, accompanied by increased intercellular spaces and decreased desmosome density under electron microscopy, indicating a pathogenic mechanism involving disruption of intercellular junctions by refluxate. Statistically significant differences in pepsin expression ofthe vocalcords mucosal were observed among groups( F=88.427, P<0.001).Group 2 exhibited elevated pepsin expression in the distal esophageal mucosa than Groups 1 and 3, suggesting concurrent GERD only occured in Group 2. Conclusion:Endoscopic cricopharyngeal myotomy induces LPRD in Bama minipigs without concurrent GERD by reducing upper esophageal sphincter pressure, thereby offering a model that closely resembles the clinical features of LPRD.

Objective:To establish a novel laryngopharyngeal reflux model in Bama minipigs excluding concurrent gastroesophageal reflux through endoscopic cricopharyngeal myotomy.Methods:Twelve 8-month-old male Bama minipigs were randomly assigned to three groups: Group 1 underwent cricopharyngeal myotomy alone, Group 2 underwent combined cricopharyngeal and lower esophageal sphincter myotomy, and Group 3 served as the control group. Following a one-week acclimatization period, the respective surgical procedures were performed. At 2 weeks postoperatively, laryngopharyngeal pH monitoring was conducted on all pigs. At 8 weeks, histopathological assessment using hematoxylin and eosin (HE) staining, transmission electron microscopy of the laryngopharyngeal mucosa, and quantification of pepsin in the laryngopharyngeal and distal esophageal mucosa were performed to analyze intergroup differences and to elucidate the occurrence and pathologic featuresof LPR.Results:Two weeks postoperatively, experimental groups exhibited laryngopharyngeal reflux episodes with pH<5.0, in contrast to the control group. HE staining at 8 weeks revealed inflammatory changes in the laryngopharyngeal mucosa of Groups 1 and 2, accompanied by increased intercellular spaces and decreased desmosome density under electron microscopy, indicating a pathogenic mechanism involving disruption of intercellular junctions by refluxate. Statistically significant differences in pepsin expression ofthe vocalcords mucosal were observed among groups( F=88.427, P<0.001).Group 2 exhibited elevated pepsin expression in the distal esophageal mucosa than Groups 1 and 3, suggesting concurrent GERD only occured in Group 2. Conclusion:Endoscopic cricopharyngeal myotomy induces LPRD in Bama minipigs without concurrent GERD by reducing upper esophageal sphincter pressure, thereby offering a model that closely resembles the clinical features of LPRD.

Objective:To explore the therapeutic effect of multi-mode sequential combination of artificial liver in the treatment of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Methods:The clinical data of HBV-ACLF patients treated with artificial liver in Wuxi Fifth People′s Hospital from January 2018 to June 2021 were retrospectively analyzed. Eighty-six patients were divided into artificial liver multi-mode sequential combination therapy group (sequential combination group) and conventional treatment group. The cytokine level changes and model for end-stage liver disease (MELD) score were analyzed at 14 days of disease duration. The survival outcome and complications of artificial liver were analyzed after 30 days of follow-up. Two independent samples t test and chi-square test were used for statistical analysis. Cox regression analysis was used to analyze the risk factors of death, and Kaplan-Meier method was used to analyze the survival rate of patients. Results:A total of 86 patients were enrolled, including 48 patients in sequential combination group with the average number of artificial liver of 4.68 times/person, and 38 patients in conventional treatment group with the average number of artificial liver of 3.17 times/person. At 14 days of disease duration, interleukin (IL)-6, IL-8, interferon γ-inducible protein (IP)-10 level and MELD score in sequential combination group decreased significantly than those in the conventional treatment group ( t=3.80, 3.62, 4.95 and 1.11, respectively, all P<0.050). After 30 days of follow-up, 63 patients survived and 23 patients died. Cox regression analysis showed that baseline international normalized ratio (hazard ratio ( HR)=0.558, 95% confidence interval ( CI) 0.193 to 0.856, P=0.027), baseline antithrombin Ⅲ activity ( HR=0.876, 95% CI 0.824 to 0.932, P<0.001), artificial liver mode ( HR=0.819, 95% CI 0.236 to 0.992, P=0.005), spontaneous peritonitis ( HR=0.170, 95% CI 0.045 to 0.647, P=0.009) and hepatic encephalopathy ( HR=0.004, 95% CI 0.001 to 0.030, P<0.001) were independent influencing factors for 30-day survival outcome. The cumulative survival rate of sequential combination group was higher than that of conventional treatment group, and the difference was statistically significant ( χ2=5.45, P=0.020). There were no significant differences in the proportions of bleeding, deep vein thrombosis, heart rate and blood pressure instability between the two groups ( χ2=0.63, 1.20 and 0.54, respectively, all P>0.050). The platelet decline of patients in sequential combination group was slighter than that in conventional treatment group, and the difference was statistically significant ( t=-4.17, P=0.002). Conclusions:Multi-mode sequential combination therapy of artificial liver could eliminate cytokines and reduce MELD score more effectively in patients with HBV-ACLF, and prolong the survival time of patients and have little effect on platelet count.

【Objective】 To investigate the effect of autologous blood transfusion(ABT) drainage system and simple drainage(using drainage bags) on the prognosis of patients after lumbar surgery. 【Methods】 The patients admitted to the Department of Orthopedics of our hospital from August 2018 to September 2020 who underwent posterior open lumbar internal fixation and fusion were divided into two groups according to different drainage methods adopted after surgery: 50 patients were randomly selected from the patients who received postoperative ABT system for drainage as ABT group, and 50 patients were randomly selected from the patients who received postoperative drainage by drainage bag as simple drainage bgroup(the control group). The postoperative drainage volume, actual postoperative drainage, total dominant blood loss, total autologous blood transfusion volume, as well as the postoperative anemia indexes, infection indexes and albumin levels in d1, d3 and d7 of the 2 groups were retrospectively analyzed. 【Results】 The gender, age, operation duration and operation segment of the 2 groups were comparable (P>0.05), and preoperative Hb, Hct, ALB, WBC, NE%, intraoperative blood loss, intraoperative autologous blood transfusion volume and actual postoperative drainage volume were similar (P>0.05). There were no significant differences in Hb, Hct, ALB, WBC, NE% and CRP in postoperative d1, d3 and d7, as well as in preoperative and postoperative Hb, Hct and ALB, and in postoperative and preoperative WBC, NE% and CRP (P>0.05). The postoperative drainage volume (mL) and total dominant blood loss (mL) in ABT group and the control group were 554.40±176.82 vs 337.80±102.43, and 1 048.40±282.87 vs 791.80±277.02, respectively (P<0.05). 【Conclusion】 The use of ABT drainage system after lumbar surgery increased the drainage volume compared with simple drainage, but the improvement of anemia, albumin and infection was not obvious. ABT system should not be used routinely for drainage after lumbar surgery.

Objective: To study the relationship between the average hearing of different frequencies and the audiometry staging in patients with Meniere′s disease. Methods: A total of 259 patients from 1996 to 2016 were collected .All patients underwent pure tone audiometry, of which 93 patients underwent 3 000 Hz audiometry. The patients were divided into five groups according to the frequencies of hearing(Ⅰ: 500, 1 000, 2 000, 3 000 Hz; Ⅱ: 250, 500, 1 000, 2 000, 3 000 Hz; Ⅲ: 250, 500, 1 000, 2 000; Ⅳ: 500, 1 000, 2 000, 4 000 Hz; Ⅴ: 500, 1 000, 2 000 Hz), then calculated the average audiometry and made the hearing staging. The obtained data were analyzed by chi-square test and Bonferroni correction was performed among the groups, P<0.05 was defined as a statistically significant criterion. Result: There were no significant difference between the five groups(P=0.441>0.05). Conclusions The choice of different pure tone audiometry frequency has no significant effect on the hearing staging. It would be more likely upstaging when plus 250 Hz. There is no statistically significant difference in staging between the latest guidelines and the 1995 guidelines.500, 1 000 and 2 000 Hz are recommended when 3 000 Hz examine is not available.

Objective To retrospectively study the incidence and risk factors of thyroid disease induced by peginterferon plus ribavirin (Peg IFN/RBV) antiviral treatment in patients with chronic hepatitis C (CHC).Methods From January 2012 to December 2014,a total of 362 CHC patients were treated with Peg IFN/RBV antiviral therapy at Wuxi Fifth People's Hospital,among whom 315 patients were included in this study.Thyroid function,autoantibodies and thyroid ultrasound were measured at baseline,weeks 12,24 and 48.Comparisons between groups were performed using chi-square test for qualitative data and the unpaired t test for continuous variables.Results After treatment,thyroid dysfunction developed in 12.1％ of patients.Positive anti-thyroid peroxidase and anti-thyrobolulin antibodies were detected in 21％ of patients.The thyroid ultrasound changes developed in 14.9％ of the patients,among whom normal thyroid function and thyroid autoantibodies negative were detected in 8.7 ％ of patients.The titer of thyroid autoantibodies increased steadily from baseline to the end of treatment.Logistic regression analysis showed that positive thyroid autoantibody (OR =5.423,95％ CI:3.441 8.716),sustained virological response (OR=7.201,95％CI:6.231-10.206),female(OR=1.22,95％ CI:0.951-2.212) were the risk factors of thyroid dysfunction.Conclusions Peg IFN/RBV antiviral treatment increases the incidence of thyroid disease in CHC patients.Positive thyroid autoantibody,sustained virological response and the female gender are the risk factors of thyroid dysfunction.

Objective To investigate the effect of second generation antipsychotics (SGAs) on adiponectin (APN) and metabolic indicators and to explore the role of APN in the antipsychotic-induced weight gain (AIWG). Methods A total of 86 drug na?ve first episode schizophrenia patients and 88 sex-and age-matched healthy controls were collected. All patients received a single SGAs treatment for 8 weeks. In patient group, the level of weight, body mass index (BMI), waist-to-hip ratio (WHR), fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), APN and fasting insulin (FINS) were measured before and after 8-week treatment. While as the control group was only measured once after enroll?ment. Results The serum APN [(9.32 ± 0.76) μg/mL vs. (10.9 ± 0.66) μg/mL] was lower and FINS was higher [(20.27 ± 15.02)μIU/mL vs. (12.68±11.70)μIU/mL] in drug na?ve patients compared with healthy controls (P<0.05). After 8-weekSGAs treatment, patients showed significant increases in weight [(59.01 ± 10.56) kg vs. (63.80 ± 9.78) kg], BMI [(21.74 ± 3.57) kg/m2 vs.(23.49±3.44) kg/m2], WHR [(0.88±0.07) vs. (0.92±0.05)], TG [(0.94±0.92) mmol/L vs. (1.63±1.08) mmol/L] and FINS [(12.68 ± 11.70)μIU/mL vs. (20.27 ± 15.02)μIU/mL], and significant decreases in APN [(9.32 ± 0.76)μg/mL vs. (8.03±0.68)μg/mL] and FPG [(5.04±1.01) mmol/L vs. (4.46±0.57) mmol/L] (all P<0.05). In male patients, baseline APN levels were positively correlated with AIWG (r=0.548,P=0.005). Conclusion The serum APN levels in drug na?ve first episode schizophrenic patients are significantly lower than normal and are further decreased after SGAs treatment. Base?line APN may predict the AIWG in male patients.