Objective: To investigate the characteristics of the time-point distribution of the occurrence of laryngopharyngeal reflux (LPR) by 24-hour multichannel intraluminal impedance-pH monitoring (24 h MII-pH) and to provide guidance for the development of individualized anti-reflux strategies for LPR patients. Methods: We conducted a retrospective analysis of 24 h MII-pH data from 408 patients [339 males and 69 females, aged 23-84 (55.08±11.08) years] attending the Department of Otorhinolaryngology Head and Neck Surgery at the Sixth Medical Center of the PLA General Hospital from January 2013 to March 2020. The number of gas acid/weak-acid reflux, mixed gas-liquid acid/weak-acid reflux, liquid acid/weak-acid reflux and alkaline reflux events at different time points were recorded and statistically analyzed through SPSS 26.0 software. Results: A total of 408 patients were included. Based on the 24 h MII-pH, the total positive rate of LPR was 77.45% (316/408). The type of positive gaseous weak-acid reflux was significantly higher than the remaining types of LPR (χ²=297.12,P<0.001). Except the gaseous weak-acid reflux, the occurrence of the remaining types of LPR showed a tendency to increase after meals, especially after dinner. Liquid acid reflux events occurred mainly between after dinner and the following morning, and 47.11% (57/121) of them occurred within 3 h after dinner. There was a significant positive association between Reflux Symptom Index scores and gaseous weak-acid reflux(r=0.127,P<0.01), liquid acid reflux(r=0.205,P<0.01) and liquid weak-acid reflux(r=0.103,P<0.05)events. Conclusions: With the exception of gaseous weak-acid reflux events, the occurrence of the remaining types of LPR events has a tendency to increase after meals, especially after dinner. Gaseous weak-acid reflux events accounts for the largest proportion of all types of LPR events, but the pathogenic mechanisms of gaseous weak-acid reflux are needed to further investigate.
Male ; Female ; Humans ; Laryngopharyngeal Reflux/diagnosis* ; Retrospective Studies ; Esophageal pH Monitoring ; Otolaryngology ; Software ; Electric Impedance

Aim To explore the mechanism of action of the active ingredients of Callerya nitida var.hirsutissima corresponding to the target gene in the treatment of triple-negative breast cancer(TNBC), using network pharmacology, molecular docking technology and in vitro experimental verification.Methods Based on literature research and combined with database screening, the main active components of Callerya nitida var.hirsutissima and the related targets of TNBC were obtained.Intersection genes were found to construct a protein interaction(PPI)network diagram, and core targets were screened according to the size of the correlation.A core target interaction network model of "Traditional Chinese Medicine-Ingredients-Targets-Disease" was constructed.The intersection targets were analyzed for gene GO function and KEGG pathway enrichment analysis.Finally, molecular docking and in vitro experimental verification of the selected components and the target were carried out.Results A total of 38 active components of Callerya nitida var.hirsutissima were collected, as well as 388 related potential targets, 3 919 TNBC targets, and 277 Callerya nitida var.hirsutissima therapeutic targets for TNBC.It mainly acted on multiple targets such as PIK3R1, PIK3CA, MAPK1, AKT1, SRC, etc.In in vitro experiments, it could be seen that the chloroform fraction of Callerya nitida var.hirsutissima and the monomer compounds luteolin and betulin had certain inhibitory effects on cell proliferation.All groups could inhibit the expression of VEGFA, AKT, PIK3CA, CDK1, CDK4 within the range of administration concentration.Conclusions Based on network pharmacology and molecular docking methods, this study explores the possible targets and signaling pathways of Callerya nitida var.hirsutissima in the treatment of TNBC, and conducts in vitro verification experiments to further verify the prediction of network pharmacology.

Humans ; Laryngopharyngeal Reflux ; Hypopharynx ; Respiratory System

Objective: To investigate the effect of gastroesophageal reflux disease (GERD) on the clinical characteristics of patients with laryngopharyngeal reflux disease(LPRD). Methods: The data of 141 patients with symptoms of LPRD, who were admitted to the Department of Pharyngology, Laryngology& Phonosurgery at the Sixth Medical Center of the PLA General Hospital from November 2020 to October 2021, were retrospectively analyzed.There were 118 males and 23 females, aged 28-75 (56.72±10.04) years old. The included patients underwent simultaneous 24-hour hypopharyngeal and esophageal multichannel intraluminal impedance pH monitoring (24h-HEMII-pH), salivary pepsin test at multiple times, Reflux Symptom Index (RSI), and Reflux Finding Score (RFS). One laryngopharyngeal reflux event on 24 h-HEMII-pH monitoring results was used as a diagnostic criterion for LPRD. And the duration of lower esophageal pH<4.0>4.0% at 24 h or DeMeester score>14.7 were used as diagnostic criteria for GERD. Among them, patients with both positive LPRD and GERD were classified as L&G group, patients with positive LPRD and negative GERD were classified as IL group, patients with negative LPRD and positive GERD were classified as IG group, and patients with both negative LPRD and GERD were classified as N group. The differences in the clinical characteristics of reflux and salivary pepsin assay in each group were statistically analyzed. SPSS 23.0 software was applied for statistical analysis. Results: According to the 24 h-HEMII-pH results, 116 (82.3%) patients were diagnosed with LPRD and 45 (31.9%) with GERD, including 82 (58.2%) in the IL group, 34 (24.1%) in the L&G group, 11 (7.8%) in the IG group, and 14 (9.9%) in the N group. Based on the salivary pepsin test, a total of 106 patients had positive results, and the L&G group had a significantly higher rate of positive total salivary pepsin test (94.1%) and positive morning test (70.6%) than the IL group (75.6%, 26.8%), IG group (63.6%, 27.3%) and N group (35.7%, 28.6%), with chi-square values of 19.01 and 20.81, both with P<0.001. The patients in the L&G group had a significantly higher RSI score (14.0) than the IL group (7.0), IG group (1.0) and N group (0), H=52.26,P<0.001. The difference in RFS between the L&G and IL groups was not statistically significant (Z=-0.92,P>0.05). Conclusion: Combined with GERD, LPRD patients have more obvious clinical symptoms and higher positive rate of pepsin test in saliva.
Aged ; Female ; Humans ; Male ; Middle Aged ; Esophageal pH Monitoring ; Hypopharynx ; Laryngopharyngeal Reflux ; Pepsin A ; Retrospective Studies ; Adult

Objective: To compare the clinical characteristics of patients with different type of laryngopharyngeal reflux disease in order to study the effect of non-acid reflux on laryngopharyngeal reflux disease. Methods: From January 2015 to January 2020, 349 inpatients or outpatients suspected of having laryngopharyngeal reflux underwent 24-hour multichannel intraluminal impedance pH monitoring (MII-pH). There were 303 male and 46 female patients, with an average age of 56.03 years old ranged from 25 to 81 years old. The reflux symptom index (RSI)and reflux findings score(RFS)were recorded before MII-pH monitoring. The number of acid reflux events and non-acid reflux events in hypopharynx were counted. It was defined mainly acid reflux type when the ratio of acid reflux to all reflux events was greater than 50%, mainly non-acid reflux type when the ratio of non-acid reflux to all reflux events was greater than 50%. The clinical characteristics of patients with different type of reflux were compared. SPSS 19.0 software was used for statistical analysis, and multiple independent samples were compared between groups. The quantitative data were analyzed by multivariate analysis of variance, and the counting data were analyzed by chi-square test, the difference was statistically significant when P<0.05. Results: The 24-hour MII-pH showed that there were 90 patients with no reflux events, 51 patients with mainly acid reflux type, 198 patients with mainly non-acid reflux type and 10 patients with equal acid reflux events and non-acid reflux events. Statistics showed that the RSI(10.72±4.40), RFS(7.70±2.73) and the average number of reflux events(0) in the group without reflux events were significantly lower than those in patients with mainly acid reflux type (RSI 13.16±6.62,RFS 10.08±3.03,average number of reflux events 5.33±3.15,P<0.05) and mainly non-acid reflux type(RSI 13.25±5.54,RFS 8.81±2.54,average number of reflux events 7.93±5.26, P<0.05). There was no significant difference in RSI between the mainly non-acid reflux type group and the mainly acid reflux type group, but the RFS of the mainly non-acid reflux type group was significantly lower than that of the mainly acid reflux type group. The average number of reflux events in the mainly non-acid reflux group was significantly higher than that in the mainly acid reflux type group (P<0.05). Conclusion: The results show that non-acid reflux plays a certain role in laryngopharyngeal reflux disease, but the effect of acid reflux is greater.
Adult ; Aged ; Aged, 80 and over ; Esophageal pH Monitoring ; Female ; Humans ; Hypopharynx ; Laryngopharyngeal Reflux/epidemiology* ; Male ; Middle Aged ; Respiratory System

Humans ; Hypopharynx ; Laryngopharyngeal Reflux/diagnosis* ; Respiratory System

Adolescent ; Adult ; Environmental Monitoring ; methods ; Hazardous Substances ; analysis ; Humans ; Male ; Occupational Exposure ; analysis ; prevention & control ; Sentinel Surveillance ; Young Adult

Objective To study the characteristics of surface electromyography (sEMG) during swallowing in normal adults.Methods The sEMG during swallowing was carried out in 126 normal adults.There were 66 males and 60 females with their age ranged from 18 to 65 years.The recording electrodes were placed on the skin above the superior thyroid notch and the duration and amplitude of muscle activities during every deglutition were recorded.Swallowing styles were dry swallow,20 ml water swallow and 40 ml water swallow.Results The durations of sEMG at dry swallow,20 ml water swallow and 40 ml water swallow were (1.133 ± 0.209) s ((x) ± s),(1.097 ± 0.208) s,and (1.5 10 ± 0.432) s,while the amplitudes were (0.332±0.115)mV,(0.308 ±0.095)mV,and (0.399 ±0.139)mV in normal male group.The durations of sEMG at dry swallow,20 ml water swallow and 40 ml water swallow were (1.118 ± 0.170)s,(1.085 ± 0.209) s,and (1.765 ± 0.463) s,while the amplitudes were (0.292 ± 0.100) mV,(0.261 ± 0.113)mV,and (0.342 ± 0.129)mV in normal female group.The amplitudes of sEMG in male were higher than those in female (P ＜ 0.05) and the durations had no statistically significant difference between male and female (P ＞ 0.05) in all swallow styles except that the duration of 40 ml water swallow in female was longer than that in male (P ＜ 0.05).In all volunteers,the durations of sEMG at 40 ml water swallow were longer than those at dry swallow and 20 ml water swallow,and there was no statistically significant difference between dry swallow and 20 ml water swallow.The amplitude of sEMG at 40 ml water swallow was higher than that at dry swallow.The amplitude of sEMG in dry swallow was higher than that at 20 ml water swallow.There was no statistically significant difference in durations and amplitudes of sEMG among four different age groups of male.In the female groups,there was no statistically significant difference in durations and amplitudes of sEMG among four different age groups except that the duration at 40 ml water swallow was longer in younger group (＜ 30 years old) than in older groups.Conclusions Surface EMG of swallowing is a simple and noninvasive method for evaluating the swallowing function.The sEMG data of swallowing in normal adults obtained in this study may be used to provide reference for screening swallowing function in adults in the future.

Objective The consistency of reflux finding score (RFS) was studied by three different level of throat physicians.Methods One hundred and ten laryngeal photos were chosen to assess the RFS test-retest reliability on two separate occasions at least more than one week.Results The mean total RFS scores for doctor A were 9.05 ±2.54,doctor B were 8.80 ±2.20,doctor C were 8.98 ±2.21 at the initial screening,and 9.20 ±2.47,9.03 ± 2.14 and 8.91 ± 2.30 respectively at the repeat evaluation.The testretest reliability of total RFS scores of three doctors were 0.860,0.800 and 0.837 respectively,P all ＜0.001.The test-retest reliability of each item scores for doctor A were from 0.662 to 1.000,doctor B were from 0.486 to 1.000 and doctor C were from 0.613 to 1.000.There were no differences in the total RFS scores comparing among each evaluation of the three doctors (x2 =1.553,P =0.907).Total RFS scores more than 7 were considered as abnormal.The interobsever consistency was as follows:A with B was 83.6％ (K=0.617,P=0.000),A with C was 85.5％ (K =0.644,P =0.000),B with C was 89.1％ (K=0.720,P =0.000).The intraobserver consistency was 91.8％ (K =0.807,P =0.000),81.8％ (K =0.534,P =0.000),90.9％ (K =0.741,P =0.000) respectively.Conclusions The result of this study shows that the assessment of RFS is not influenced by different educational backgrounds and clinical experience.RFS can be applied widely in China.

Objective To observe the association between adiponectin and small dense low-density lipoprotein (sLDL-c) in coronary artery disease (CAD) patients.Furthermore,we sought to determine the association between single nucleotide polymorphisms (SNP) rs1501299 ( + 276G/T ), rs266729 (-11365C/G) and the incidence of CAD.Methods Consecutive subjects with chest discomfort were examined by coronary angiography and divided into non-CAD [ n =250,147 male,mean age (60.26 ±7.52) years] and CAD [n =267,153 male,mean age (60.79 ±9.63) years] groups.Blood samples were collected from all participants following an overnight fasting for at least 12 hours.Plasma adiponectin levels were measured by competitive enzyme-linked immunosorbent assay (ELISA).The serum levels of sLDL-C and oxidized low-density lipoprotein (ox-LDL) were determined by ELISA.Genotypes in rs1501299 and rs266729 of the adiponeetin were determined by polymerase chain reaetion ( PCR ).Results 1.The adiponectin levels were significantly lower [ ( 306.17 ± 74.52 ) mg/L vs.( 321.78 ± 86.28 ) mg/L ],whereas sLDL-C and ox-LDL levels were significantly higher [ ( 276.30 ± 45.55 ) ng/L vs.( 249.00 ±32.02) ng/L and (545.06 ± 115.46 ) μg/L vs.(497.74 ± 106.09 ) μg/L,P ＜ 0.05 ] in CAD group than non-CAD group.2.Adiponectin level was negatively associated with sLDL-C,whereas sLDL-C positively correlated with ox-LDL in all subjects.3.Genotype distribution and allele frequencies of rs1501299 and rs266729 were similar between CAD and non-CAD subjects and not related to the serum levels of adiponectin, sLDL-C and ox-LDL.Conclusions Reduced adiponectin and increased sLDL-C were independent risk factors for coronary artery disease.Genetic polymorphisms in rs1501299 and rs266729 were not linked with coronary artery disease.