Risk factors of recurrence and canceration for premalignant vocal fold lesions after surgery / 临床耳鼻咽喉头颈外科杂志

Objective:To analyze the risk factors of recurrence and canceration for premalignant vocal fold lesions after surgery, and to provide a reasonable basis for preoperative evaluation and postoperative follow-up. Methods:This study retrospective analyzed the relationship between clinicopathological factors and clinical outcome（recurrence, canceration, recurrence-free survival, and canceration-free survival） in 148 patients undergoing surgical treatment in Chongqing General Hospital from 2014 to 2017. Results:The five-year overall recurrence rate was 14.86% and the overall recurrence rate was 8.78%. Univariate analysis showed that smoking index, laryngopharyngeal reflux and lesion range were significantly associated with recurrence（P<0.05）, and smoking index and lesion range were significantly associated with canceration（P<0.05）. Multivariate logistic regression analysis showed that smoking index ≥600 and laryngopharyngeal reflux were independent risk factors for recurrence（P<0.05）, and smoking index ≥600 and lesion range ≥1/2 vocal cord were independent risk factors for canceration（P<0.05）. The mean carcinogenesis interval for the postoperative smoking cessation group was significantly longer（P<0.05）. Conclusion:Excessive smoking, laryngopharyngeal reflux and a wide range of lesions may be related to postoperative recurrence or malignant progression of precancerous lesions in the vocal cord, and further large-scale multi-center prospective randomized controlled studies are needed to clarify the effects of the above factors on recurrence and malignant changes in the future.

The mediating effect of hope between psychological distress and quality of life in radiotherapy patients with cervical cancer / 中国实用护理杂志

Objective@#To investigate the relationship between hope, mental suffering and quality of life in radiotherapy patients with cervical cancer, to provide the basis for the cancer patient′s psychological intervention.@*Methods@#A cross-sectional study of 120 cases of radiotherapy cervical cancer patients was conducted, using the psychological distress thermometer, Herth Hope Scale, Life Quality Measurement Scale for patients with cervical cancer to evaluate patients′ hope, quality of life and psychological distress.@*Results@#Radiotherapy cervical cancer patients′ psychological distress and hope were negatively correlated (r=-0.385, P <0.01), psychological distress and quality of life were negatively correlated (r=-0.602, P <0.01), hope and quality of life were positive correlation (r=0.711, P <0.01). Patients′ hope played partially mediated effect between psychological distress and quality of life, emotional status, functional status, played fully mediated effect between psychological distress and social family status. The Mediated effect sizes were 35.9%, 36.3%, 55.9% and 100.0%.@*Conclusions@#Psychological distress has not only a direct negative effect on the quality of life of cancer patients, but also an indirect negative effect through hope. During the Medical care, we should accurately assess of patient's psychological distress and hope, and take measures to help improve patients' hope and alleviate psychological distress, so as to improve patients′ quality of life.

Observation of clinical effect of glucocorticoid and hyperbaric oxygen therapy on thehigh-frequency and diminishing sudden deafness / 重庆医学

Objective To investigate the curative effect of glucocorticoid and hyperbaric oxygen therapy on the high-frequency and diminishing sudden deafness.Methods A total of 260 patients with high-frequency and diminishing sudden deafness were divided into hormone group(n=110),hyperbaric oxygen group(n=80) and routing group(n=70,ginaton 87.5 mg+5% GS 250 mL static drops static drops,intramuscular injection of vitamin B1 1.5 mg+cobamamide 0.1 g and 2% lidocaine 10 mL+5% GS 250 mL static drops).The first two groups were added oral prednison and hyperbaric oxygen therapy on the basis of therapy of routing group.The effect of comparison analysis was conducted after 10 days of treatment according to the course of disease which was less than that of or equal to 7 days or greater than 7 days.Results The overall curative effect of hormone group and hyperbaric oxygen group was better than that of routing group,and the difference was statistically significant (P<0.05).During the whole course of disease,the difference of therapeutic effect between routing group and the other two groups was statistically significant(P<0.05).Conclusion The glucocorticoid and hyperbaric oxygen therapy both have really curative effect on high-frequency and diminishing sudden deafness.

Exosome-derived miR-20a inhibit apoptosis of TAM by targeting BCL2L11 in nasopharyngeal carcinoma / 重庆医学

Objective To investigate whether exosome-derived microRNA of nasopharyngeal carcinoma suppresses apoptosis of tumor associated macrophage (TAM).Methods Target microRNAs and genes were determined by bioinformatics methods.Isolated exosomes were used to detect miR-20a expression by qRT-PCR.Furthermore,apoptosis index and proteins involved in apoptotic pathways were detected after miR-20a mimic and inhibitor transfection into macrophages.Results miR-20a expression was upregulated in isolated exosomes.miR-20a target gene was BCL2L11.MiR-20a overexpression could inhibit apoptosis of macrophages,meanwhile,apoptotic pathways related proteins Bim,caspase-9 and caspase-3 were significantly suppressed by miR-20a mimic(P＜0.05).Condusion miR-20a can suppress activation of Bim-caspase-9-casepase-3 and resulting in apoptotic inhibition of macrophages.

The clinical characteristics of elderly patients with obstructive sleep apnea hypopnea syndrome / 重庆医学

Objective To discuss the differences of clinical features and characteristics and features of polysomnography be‐tween elderly patients and middle‐aged patients with obstructive sleep apnea hypopnea syndrome (OSAHS) ,so as to provide refer‐ence for the diagnosis and individualized intervention of elderly OSAHS .Methods Totally 81 aged OSAHS cases and 123 youth OSAHS cases were analyzed in terms of general condition ,clinical manifestations and polysomnographic characteristics ,and the clin‐ical manifestations and polysomnographic difference indicators of the two groups were matched according to body mass index (BMI) .Results Most OSAHS patients were males in both groups ,with BMI and neck waist circumference in the aged group less than those in the middle‐aged group ,and the difference was statistically significant (P0 .05);clinical symptoms of senile groups such as drowsiness ,snoring ,morning headaches ,dry mouth and nighttime awakenings were lower than the middle‐aged group ,the difference was statistically significant (P0 .05);REM AHI was more than the middle‐aged group ,the difference was statistically significant (P0 .05) .Conclusion The incidence of typical clinical manifestations of aged OSAHS patients was lower than that in the middle‐aged group ,but high blood pressure ,diabetes and other complications prevalence were significantly higher than those in the middle‐aged group ,with similar severity of OSAHS in both groups ,there were differences PSG monitoring results with the middle‐aged group ,and the difference of REM AHI was significant .

Targeted therapy of advanced colorectal cancer / 国际肿瘤学杂志

Targeted agents for advanced colorectal cancer mainly include inhibitors of vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR).Studies show that bevacizumab and cetuximab can improve the prognosis of advanced colorectal cancer patients,but there is slight difference in the choice of chemotherapy regimens when combined with them.Bevacizumab and cetuximab can improve the overall survival of K-ras wild-type colorectal cancer patients similarly.The emergence of new targeted drugs such as aflibercept,regorafenib provides more choices for the targeted therapy of advanced colorectal cancer patients.

The surgical options of cervical tuberculous lymphadenitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the clinical features & variation features of cervical tuberculous lymphadenitis and to discuss its effective surgical treatment.@*METHOD@#Retrospective analysis of 27 cases of cervical tuberculous lymphadenitis patients admitted to the hospital from January 2008 to December 2013. The cervical tuberculous lymphadenitis is classified based on the enhanced CT scanning conducted before operation and the preoperative evaluation of clinical characters of patients. The lymphaden ncisional biopsy was conducted on the type I patients with cervical tuberculous lymphadenitis. The lesion resection was performed on the type II and mixed type I + II patients. The regional cervical lymph node dissection was carried on the type III, the type IV and other mixed type patients. The negative pressure drainage ball was placed after operation, and the cavity was flushed with 5% povidone iodine solution. The antituberculosis therapy was performed after wound healing.@*RESULT@#The analysis of the clinical features for 27 patients: the incidence rate on the left side, right side, both sides and middle-line is 63.0%, 25.9%, 7.4% and 3.7% respectively. The majority of patients whose lesion involving more than one region account for 62.1%; the patients whose lesion involving one region account for 37.9%. The most common is level V involved lesion (69.0%), then level IV (62.1%), level III (51.7%), level II (34.5%), level I (10.3%) and level VI (3.4%) in order. The analysis of the CT imageology features for 27 patients: the simple type is the majority (65.5%), and the most common is type III (24.1%), then the type I (17.2%), type II (13.8%) and type IV (10.3%) in order. The mixed type is minority (34.5%), but the two mixed is often (31.0%). The three mixed is only located on one side (3.4%). The recurrence never happened on the patients with resection and standard antituberculosis therapy.@*CONCLUSION@#For the cervical tuberculous lymphadenitis, the suitable surgical treatments shall be selected according to the lesion characteristics & location and CT imaging manifestations presurgical evaluation. The effective way to treat cervical tuberculous lymphadenitis is to conduct negative pressure drainage after operation, to flush the cavity with 5% povidone iodine solution and to perform antituberculosis therapy.

Investigation and analysis of otolaryngology nurses' knowledge and attitudes toward pain management in Chongqing / 中国实用护理杂志

Objective To explore otolaryngology nurses' knowledge of pain and attitude toward pain management and to provide reference for pain management.Methods A total of 102 otolaryngology nurses who participated in 2014 in Chongqing of Otolaryngology Head and Neck Surgery Symposium were surveyed by the nurses' general condition and current management situation and attitude survey regarding Chinese Knowledge and Attitude Survey Regarding Pain(KASRP).Results Average correct response rateon the KASRP from otolaryngology nurses was 45.9％,the interquartile range was 38.9％-51.0％,nurses' knowledge was relate to continuing education,P＜0.05,while irrelevant to age,work experience,education,job title,school education,clinical application of pain assessment tools,etc,P＞0.05.The proportion of nurses who accept the education of pain knowledge was 69.6％ (71/102),there was 74.5％ (76/102) nurses assess the patient by pain assessment tools in their daily work.Nurses first want to get the information of pain assessment,followed by pain medication,operational knowledge of analgesia pump and non-drug interventions for pain.Conclusions Nurses lack knowledge of pain,need to strengthen pain management training by continuing education and get knowledge of pain from academic journals,to provide reference for pain management.

The applications of the voice range profile in the polyp of vocal cord / 重庆医学

Objective To analyze the pathological voice ,normal voice range chart crowd voice characteristics through tests and analyze the differences between the two groups of test‐related parameters chart range between indicators ,so as to explore the value of the test range map in the polyp of vocal cord .Methods One hundred and twenty patients with vocal polyps according to in‐clusion and exclusion criteria were selected .Sixty cases of normal voice were randomly selected .Germany XION DIVAS system dia‐gram test mode range were recorded for both groups ,with the strongest voice of the bass were measured at different frequencies , first obtain low VRP intensity curve ,then get high‐intensity curve VRP .The maximum frequency of the vocal cord polyp group and normal control group ,the minimum frequency ,maximum intensity ,most quietly strong ,maximum phonation time ,fundamental fre‐quency perturbation and dysphonia index of the data were compared statistically .Results Compared with the control one ,the mean maximum frequency of vocal cord polyp group were lower (P= 0 .029 6) ,the average minimum frequency were significantly higher ( P= 0 .000 3) ,frequency range reduced(P= 0 .022 9) ;vocal cord polyp average loudest group was stronger(P= 0 .003 9) ,the whis‐pered strength values were significantly higher (P = 0 .000 0) ,significantly limited the average sound intensity range than normal voice group group (P= 0 .006 9) .Classification index based on objective voice disorders ,in terms of frequency ,mild voice disorders at the maximum frequency .There was no significant difference in the minimum frequency ,frequency range with a normal voice group ;and in severe voice disorders average maximum frequency lower than the normal voice group ,the smallest than normal voice frequency was significantly higher frequency range than the normal group was significantly limited .In terms of strength ,mild im‐pairment in the loudest voice is strong ,most quietly strong .There was no significant difference with the normal voice group intensi‐ty range ;and in severe voice disorders average maximum sound intensity ,most quietly strong values were higher than normal voice group .However ,the average sound intensity narrow range than normal voice group .Conclusion The range map test can be quanti‐fied assessment of voice ,and can distinguish normal voice ,clinical pathological voice and the severity of damage ,which is an impor‐tant means of voice feature detection to provide an objective basis .

The application of an image guidance endoscopic system for nasal inverted papilloma and sinus osteoma / 重庆医学

Objective To evaluate the clinical effect of image guided navigation system (IGNS) and traditional methods for nasal inverted papilloma and sinus osteoma .Methods 73 cases of nasal inverted papilloma and sinus osteoma patients were divided into the navigation group and the non-navigation group ,the navigation group was given image guidance endoscopic sinus surgery ,the non-navigation group was given traditional endoscopic sinus surgery .operative time ,the anesthesia time ,amount of bleeding ,compli-cations and postoperative effects of the two groups were analyzed .Results The anesthesia time of the two groups had no significant difference(P>0 .05) ,the operative time ,blood loss had significant difference(P0 .05) ,while in stage Ⅲ ,Ⅳ ,the difference of recurrence rate had significant difference(P0 .05) ,while had significant different in stage Ⅲ ,Ⅳ(P<0 .05) .In the sinus osteoma ,the com-plications of the two grouos had significant difference(P<0 .05) .Conclusion For sinus osteoma and Ⅲ ,Ⅳ level of nasal inverted papilloma ,IGNS could work well with endoscopic system ,improve operation accuracy and reduce complications .IGNS is of a useful tool for endoscopy sinus surgery and would make a great important development in future .

Choice of image guided endoscopic sinus system in different chronic sinusitis * / 重庆医学

Objective To conduct the endoscopic sinus surgery on chronic nasosinusitis by the image guided navigation system (IGNS) and to analyze the curative effect and complication compared with traditional methods .Methods 81 cases of chronic nasosi-nusitis were randomly selected and performed endoscopic sinus surgery by using IGNS ,and compared with the other 111 cases of chronic nasosinusitis by using traditional nasal endoscopic surgery in the aspects of curative effect ,complications ,etc .Results TypeⅠ and type Ⅱ nasosinusitis had no significant difference in the effective rate between the navigation group and non-navigation group;type Ⅲ nasosinusitis had significant difference in the effective rate between navigation group and non-navigation group .The total incidence rate of complications had significant difference between the navigation group and non-navigation group(P0 .05);the incidence rate of complications in type Ⅲ nasosinusitis had significant difference be-tween the navigation group and the non-navigation group with statistical significance (P0 .05);the total effective raates of anatomical deformity of the frontal recess or the sinus area had significant difference between the naviga-tion group and the non-navigation group(P0 .05) .Conclusion For the patients with type Ⅲ chronic na-sosinusitis ,chronic frontal sinusitis ,conduct endoscopic sinus surgery by using IGNS is a reasonable choice ,can increase the opera-tive effect and accuracy ,and reduce the occurrence of complications .

Variation of Electroglottographic Parameters with Different Frequency in Chest Register of Normal People / 听力学及言语疾病杂志

Objective To study the variable orderliness of vocal fold vibration caused by the voice with different frequency in chest register of various healthy subjects having several age and sex through electroglottographic examination.Methods 120 healthy subjects were respectively evaluated with electroglottography, including the old group, the adult group, the men group and the female group. Meanwhile the parameters of vocal fold vibration, such as the contact quotient, the contact index, the contact quotient perturbation and the contact index perturbation were measured and analyzed.Results With increase of the frequency, the contact quotient was decreased in all subjects, having signification difference. The contact quotient of old group and adult group ,men and female group had also signification difference. But other parameters not represented the difference in statistics.Conclusion The closer degree of vocal fold was varied with the different frequency in chest register voice from the healthy subjects who were different in age and sex ,but the symmetry and regulation of vocal fold vibration were not related to age and sex. The results were help to study physiology of vocal fold.