Objective:To investigate the prognosis and influencing factors of endoscopic surgery for early glottic carcinoma.Methods:In this retrospective study, we applied the Cox proportional hazards regression model and the random survival forest model to analyze the clinical characteristics of 385 patients [362 males, 23 females, age ranging from 33 to 91 years (62.0±9.6)] who visited the Sixth Medical Center of the General Hospital of the People's Liberation Army from January 2009, to December 2022 and diagnosed with early glottic carcinoma, encompassing variables such as age, gender, T stage, surgical approach, pathological typing, etc. The primary evaluation indicators were overall survival(OS) and disease-free survival rates (DFS). The follow-up duration ranged from 30 to 5,557 days (with a median follow-up time of 1,596 days).Results:After a three-year follow-up, the OS rate for the 385 patients was 95.83%, while the DSF rate was 82.98%. The Cox proportional hazards regression analysis revealed age ( HR=2.35, 95% CI: 1.75 to 3.15, P<0.001) and T staging ( HR=1.59, 95% CI: 1.13 to 2.23, P=0.019) as predominant factors affecting the OS and DFS. The random survival forest model identified poor tumor differentiation, and high expression of P53 and Ki-67 as predictors of inferior prognosis. Conclusion:Endoscopic surgery for early glottic carcinoma yields favorable short-term OS and reduces short-term recurrence rates, with T-stage emerging as a pivotal factor influencing recurrence. Tumors with poor differentiation and elevated expression of P53 may be indicative of an increased risk of recurrence.

Objective:To observe the efficacy of vocal cord botulinum toxin type A injection in the treatment of refractory laryngeal contact granuloma and to analyze the factors affecting the curative effect.Methods:Fifty-two patients with refractory laryngeal contact granuloma who received vocal cord botulinum toxin type A injection under topical anesthesia from May 2021 to May 2023 were analyzed retrospectively. Among them, 51 were males and 1 was female, aged 22-66 (48.98±8.87)years old. All patients were followed up for a minimum of 12 months. Outcome measures in terms of patient cure rate, total effective rate, complications and recurrence rate were calculated. The median [ M ( Q1, Q3)] was used to represent non-normally distributed measurement data, and Logistic regression analysis was used to determine independent risk factors affecting efficacy. Results:The cure rate of 52 patients with refractory laryngeal contact granuloma treated by vocal cord botulinum toxin type A injection was 78.8% (41/52), and the total effective rate (including cure, marked and effective) was 90.4% (47/52). The median number of injections was 1[1,2]. Following a single injection, the cure rate was 69.2% (36/52), and the median treatment duration for cured patients was 3 [3,3] months. Hoarseness occurred in 88.5% (46/52) of patients, with recovery within 3 months in all cases. Additionally, 21.2% (11/52) of the patients experienced cough, sore throat, dyspnea, all of whom recovered within 3 months. One patient among the 41 cured cases was lost to follow-up, and the recurrence rate at the 12th month was 17.5% (7/40). Multivariate regression analysis indicated that age, granuloma size, history of PPI treatment, previous corticosteroid injections, prior surgical excision, pharyngeal reflux, chronic cough, pharyngeal reflux, chronic cough and vocal overuse were not independent risk factors for cure and recurrence.Conclusion:Vocal cord botulinum toxin type A injection is an alternative for the treatment of refractory laryngeal contact granuloma, which offers benefits such ashigh cure rate, short treatment cycle and less injection times.

Objective:To explore effects of intervention based on story theory on self-management behavior and emotional state of patients with rectal cancer undergoing anus-preserving surgery.Methods:Using the convenient sampling method, a total of 80 patients with rectal cancer who underwent anus preserving surgery in Henan Provincial People's Hospital from January to September 2019 were selected as the research objects. The patients were randomly divided into 42 cases in the control group and 38 cases in the observation group. The patients in the control group adopted perioperative routine nursing methods for patients with rectal cancer, while patients in the observation group adopted an intervention program based on story theory at basis of the control group. Profile of Mood States-Short Form (POMS-SF) and Bowel Symptoms Self-Management Behaviors Questionnaire For Rectal Cancer Patients After Anus Preservation were used for evaluation.Results:In the end, the control group recovered 40 valid questionnaires and the observation group recovered 38 valid questionnaires. After intervention, scores of all dimensions of POMS-SF of the two groups were compared and the differences were statistically significant ( P<0.05) . In the observation group, scores of dimensions of stress-anxiety, depression-depression, anger-hostility, fatigue-dullness and bewilderment-disorder were lower than those of the control group, and the score of energy-vitality was higher than that of the control group. After intervention, there was no statistically significant difference in the score of treatment management dimension in Bowel Symptoms Self-Management Behaviors Questionnaire For Rectal Cancer Patients After Anus Preservation between the two groups ( P>0.05) . The scores of diet management, perianal skin management, seeking help from others and self-emotional adjustment in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Intervention based on story theory can effectively improve the emotional state of patients with rectal cancer undergoing anus-preserving surgery and improve dietary management, perianal skin management, seeking others' help and self-emotional regulation behaviors in patients' intestinal self-management behaviors, which has good clinical application values.

Objective:To study the relationship between adenoid hypertrophy, tonsillar hypertrophy and overweight or even obesity in children.Methods:A total of 799 children aged 2 to 12 years with tonsillar and adenoid hypertrophy from January 2015 to December 2019 in the Department of Otolaryngology Head Neck Surgery, the Sixth Medical Center of Chinese PLA General Hospital were selected. The body mass index (BMI) was calculated according to the height and weight measured routinely at the time of admission. The difference of BMI between children and normal children of the same age, and the correlation between adenoid, tonsil hypertrophy and obesity were compared. Chi-square test was used to compare the surgical children′s BMI of different genders with normal children of the same age, and Spearman rank correlation was used to analyze the correlation between BMI and adenoid and tonsil hypertrophy.Results:The Spearman correlation coefficient between tonsil hypertrophy and BMI was 0.078, P=0.077, the Spearman correlation coefficient between adenoid hypertrophy and BMI was -0.058( P=0.100). χ 2 test showed that the proportion of overweight and obesity in school-age children (7~12 years old) was significantly higher than that in preschool children (2~6 years old), and the difference was statistically significant (χ 2male=22.386, Pmale<0.001, χ 2female=4.478, Pfemale<0.001). Conclusion:There is no obvious correlation between adenoid hypertrophy, tonsil hypertrophy and overweight or obesity in children, but the probability of children overweight or obesity increases with age, and the proportion of obesity in children aged 7-12 years is higher.

Objective:To evaluate the efficacy of the endoscopic bilateral posterior transverse partial cordotomy in patients with upper airway obstruction due to bilateral vocal fold paralysis.Methods:A retrospective analysis of 48 cases of upper airway obstruction due to bilateral vocal fold paralysis, who were admitted to Department of Otolaryngology Head and Neck Surgery, the Sixth Medical Center of Chinese PLA General Hospital from July 2009 to July 2019, was performed, including 13 males and 35 females. Patients’ ages ranged from 27 to 83 years old. All patients underwent bilateral vocal fold posterior resection.Results:Among the 48 patients, 1 patient was lost to follow-up, and the remaining 47 patients were followed up for 5 months to 10 years . None of the 47 patients had a recurrence or severe complications. 89.58% (43/48) patients reconstructed a reliable and effective airway and 88.89% (40/45) patients were decannulated in 1-3 months postoperatively, with the median decannulation time of 1 month. Recovery rate of swallowing function and satisfactory pronunciation were 97.92% (47/48) and 95.35% (41/43) respectively.Conclusions:Endoscopic bilateral posterior transverse partial cordotomy can establish a reliable and effective airway and maximize the protection of swallowing and voice functions. At the same time, it is a safe, reliable, simple and minimally invasive treatment option.

Objective: To evaluate the feasibility of pepsin strip test in the diagnosis of laryngopharyngeal reflux. Methods: From August 2017 to September 2018,80 patients in Department of Otorhniolaryngology Head and Neck Surgery,Chinese People′s Liberation Army General Hospital-Six Medical Centre, underwent pepsin strip test and 24-hour multichannel intraluminal impedance(MII)-pH monitoring. The results of the two methods were analyzed for consistency,and 24-hour MII-pH monitoring was used as a statistical reference for the sensitivity and specificity of pepsin strip test in the diagnosis of laryngopharyngeal reflux. Data were analyzed by SPSS 19.0 software. Results: There were 57 patients with positive pepsin test strip and 23 patients with negative pepsin test strip. The score of reflux symptoms and signs, and the positive rate of laryngopharyngeal reflux events in patients with positive pepsin strip test were significantly higher than those in patients with negative pepsin test strip. If there was one or more throat reflux events (including acid reflux,weak acid reflux and alkali reflux) as the positive results of 24-hour MII-pH monitoring,the consistency between the results of pepsin strip and 24-hour MII-pH was moderate (Kappa=0.614). The sensitivity and specificity of pepsin strip were 86.9% (53/61) and 78.9% (15/19) respectively. Conclusions Pepsin strip detection has the advantages of non-invasive,cheap and easy to operate.As an objective method for early diagnosis of laryngopharyngeal reflux, pepsin strip detectionis feasible,but can not be the final diagnosis for laryngopharyngeal reflux disease.

Objective: The consistency and characteristics of 24-hour multichannel intraluminal impedance(MII)-pH monitoring and Dx-pH monitoring in the diagnosis of laryngopharyngeal reflux were investigated. Methods: Fifty-two patients with laryngopharyngeal reflux related symptoms or disease between March and October 2017 were included in this study.All patients were evaluated with 24-hour MII-pH monitoring and Dx-pH monitoring at the same time, recording each patient′s number of positive laryngopharyngeal reflux events, time of acid clearance and Ryan index.The data was analysed with Mann-Whitney U test and consistency check. Results: Among all 52 patients, 16 patients(30.7%) had a positive MII-pH monitoring result and 14 patients(26.9%) had a positive Dx-pH monitoring results.The consistency of both technique for measurement of laryngopharyngeal reflux was general(κ=0.626). With MII-pH monitoring for reference, the sensitivity and specificity of 24-hour pH monitoring were 68.8% and 91.7%.A total of 62 positive reflux events(pH<4) were measured with MII-pH monitoring, and 50 positive reflux events(upright pH<5.5 or supine pH<5.0)were detected by Dx-pH monitoring.There were 44 positive reflux events detected by both techniques, the mean time of acid clearance was 22.8[13.5; 42.6] s. Correspondingly, 18 reflux events were measured by MII-pH monitoring without positive results of Dx-pH monitoring, the mean time of acid clearance was 5.2[3.5; 6.5] s. There was significant difference in the time of acid clearance between two groups(U=858.5, P<0.05). Conclusions Dx-pH monitoring can accurately measure the change of pH value in airway, but exists the possibility of misdiagnosis especially when the time of acid clearance in laryngopharynx is short. MII-pH and Dx-pH monitoring can be complementary technique in the diagnosis of laryngopharyngeal reflux.

Objective: To observe the incidence and to determine the significance of laryngopharyngeal reflux (LPR) in laryngeal cancer and vocal leukoplakia. Methods: The patients who had been diagnosed as laryngeal cancer or vocal leukoplakia between January 2014 and June 2017 were included in this study. All of them received 24-hour multichannel intraluminal impedance-pH monitoring. The prevalence of LPR and numerous parameters from the 24-hour pH monitoring in laryngeal cancer patient and vocal leukoplakia patient groups were analyzed. The chi-square test was used for counting data, t test and Mann-Whitney U were used for measuring data. Results: In the 91 laryngeal cancer patients, the prevalence of pathologic LPR was 28.6%(26/91), the median number[P₂₅, P₇₅, P₉₅]of acid reflux events was 0[0, 3, 5], time of acid exposure was 0[0, 14, 234]s, number of weakly acidic reflux events was 3[0, 6, 11]. In the 54 vocal leukoplakia patients, the prevalence of pathologic LPR was 29.6%(16/54), the number of acid reflux events was 0[0, 3, 4], time of acid exposure was 0[0, 13, 118]s, number of weakly acidic reflux events was 1.5[0, 5, 9]. The incidence of LPR did not vary in the laryngeal cancer patient and vocal leukoplakia patient groups, but were both higher than healthy Chinese volunteers according to a report in the other literature. Furthermore, all the three patients with no history of tobacco or alcohol existed acid or weakly acidic reflux episodes. Conclusions Laryngopharyngeal reflux might play a role as an etiologic factor in laryngeal cancer and vocal leukoplakia.

OBJECTIVE To study the short term outcome of modified Semont maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV).METHODS A total of 93 patients with PSC-BPPV were diagnosed using the methods of Dix-Hallpike test and Roll test from Oct. 2015 to April 2016. All the patients were treated with the modified Semont maneuver. The 3 and 7 day outcome were recorded. RESULTS During the treatment, some patients had different degrees of vertigo and nausea, but all the patients completed the treatment successfully. The number of cured, improved and ineffective patients were 72, 16 and 5 respectively with a cure rate of 77.4% and total effective rate of 94.6% at 3 days follow up, and 84, 5 and 4 respectively with a cure rate of 90.3% and total effective rate of 95.7% at 7 days follow up.CONCLUSION Modified Semont maneuver is an effective method for management of posterior semicircular canal BPPV.

[ABSTRACT]OBJECTIVETo investigate the relationship between self-assessment of Voice Handicap Index (VHI) and objective detection of Dysphonia Severity Index (DSI) in vocal ford polyp patients.METHODSAll 104 vocal cord polyp patients assessed the Chinese version of VHI scale by themselves. The DSI was calculated by acoustic analysis of DIVAS2.5. The correlation between VHI and DSI was analyzed in Pearson test.RESULTS There was no significant difference in each index of VHI scale score by side and shape, but the Shimmer of larger or wide-base polyps was more severe. The female patients' function, physiology, and VHI total score were higher than that of male patients, but the DSI was lower than that of male patients. The physiology score was higher in bilateral vocal cord polyp patients, so as well as DSI. There was no significant correlation between each item of VHI scale score and DSI.CONCLUSIONNeither the current subjective VHI nor objective DSI in clinical assessment of voice disorders disability is ideal, further research and better evaluation methods should be further explored.