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BACKGROUND AND PURPOSE: This study aimed to investigate the risk factors for recurrent laryngeal nerve (RLN) injury after microwave ablation (MWA) of thyroid nodules and to identify factors influencing the recovery time of post-procedure hoarseness. MATERIALS AND METHODS: We retrospectively analyzed data from patients who underwent MWA for thyroid nodules at five hospitals between November 2018 and July 2022. Patients were divided into malignant and benign nodule groups. Variables analyzed included nodule size and location, the shortest distance from nodules to the thyroid capsule and tracheoesophageal groove (TEG-D), and ablation parameters. Univariate and multivariate analyses were performed to identify risk factors. Kaplan-Meier and Cox analyses were used to evaluate the recovery time of hoarseness after MWA. RESULTS: The study included 1,216 patients (mean age 44 ± 12 [SD] years; 901 women) with 602 malignant nodules and 614 benign nodules. The posterior capsule distance (PCD) and TEG-D were identified as independent influencing factors for hoarseness in all patients (P = 0.014, OR = 0.068; P < 0.001, OR = 0.005; AUC = 0.869). TEG-D was a significant risk factor for hoarseness, with safe thresholds identified at 4.9 mm for malignant nodules and 2.2 mm for benign nodules. Among patients who developed hoarseness, those in the close-distance group (TEG-D≤2 mm) had a longer recovery time compared to the distant-distance group. TEG-D was an independent factor influencing recovery time (P = 0.008, HR = 11.204). CONCLUSION: Clinicians should consider several factors, particularly TEG-D and PCD, when assessing the risk of RLN injury before MWA. TEG-D was a vital independent factor influencing recovery time. SUMMARY: Clinicians should pay attention to several influencing factors for RLN injury before MWA and TEG-D was an independent influencing factor for recovery time of hoarseness after MWA.
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Hearing loss is the third most prevalent physical condition affecting communication, well-being, and healthcare costs. Sensorineural hearing loss often occurs first in the high-frequency region (basal turn), then towards the low-frequency region (apical turn). However, the mechanism is still unclear. Supporting cells play a critical role in the maintenance of normal cochlear function. The function and supporting capacity of these cells may be different from different frequency regions. Hensen's cells are one of the unique supporting cell types characterized by lipid droplets (LDs) in the cytoplasm. Here, we investigated the morphological and gene expression differences of Hensen's cells along the cochlear axis. We observed a gradient change in the morphological characteristics of Hensen's cells along the cochlear tonotopic axis, with larger and more abundant LDs observed in apical Hensen's cells. Smart-seq2 RNA-seq revealed differentially expressed genes (DEGs) between apical and basal Hensen's cells that clustered in several pathways, including unsaturated fatty acid biosynthesis, cholesterol metabolism, and fatty acid catabolism, which are associated with different energy storage capacities and metabolic potential. These findings suggest potential differences in lipid metabolism and oxidative energy supply between apical and basal Hensen's cells, which is consistent with the morphological differences of Hensen's cells. We also found differential expression patterns of candidate genes associated with hereditary hearing loss (HHL), noise-induced hearing loss (NIHL), and age-related hearing loss (ARHL). These findings indicate functional heterogeneity of SCs along the cochlear axis, contribute to our understanding of cochlear physiology and provide molecular basis evidence for future studies of hearing loss.
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Análise de Sequência de RNA , Animais , Perda Auditiva Neurossensorial/genética , Perda Auditiva Neurossensorial/patologia , Metabolismo dos Lipídeos/genética , Cóclea/patologia , Cóclea/metabolismo , Gotículas Lipídicas/metabolismo , HumanosRESUMO
BACKGROUND: Sinonasal adenoid cystic carcinomas (SNACCs) are aggressive tumors that show massive expansion and are challenging to treat when locally advanced. AIMS: To report our experiences with endoscopic endonasal surgery (EES) - centered comprehensive treatment and discuss the associated outcomes of these patients. MATERIAL AND METHODS: A retrospective review of primary locally advanced SNACCs patients was conducted in a single center. EES combined with postoperative radiotherapy (PORT) was used as a comprehensive surgery-centered approach to treat these patients. RESULTS: The study included 44 patients with Stage III/IV tumors. The median follow-up duration was 43 months (4-161 months). Forty-two patients underwent PORT. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 61.2% and 46%, respectively. Local recurrence occurred in 7 patients, and 19 patients had distant metastasis. No significant relationship was found between OS and postoperative local recurrence. The OS of patients with Stage IV or exhibiting distant postoperative metastases was shorter than that of other patients. CONCLUSIONS AND SIGNIFICANCE: Locally advanced SNACCs are not a contraindication for EES. EES-centered comprehensive treatment can ensure satisfactory survival rates and reasonable local control. Function-preserving surgery using EES and PORT may represent an alternative strategy when vital structures are involved.
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Carcinoma Adenoide Cístico , Neoplasias dos Seios Paranasais , Humanos , Nariz , Intervalo Livre de Doença , Endoscopia , Estudos Retrospectivos , Recidiva Local de NeoplasiaRESUMO
Three zeolitic imidazolate frameworks (ZIFs) materials including ZIF-8 (H2O), ZIF-8 (methanol) and ZIF-L were synthesized and applied to the adsorption and detoxification of gossypol in cottonseed oil. The characterization results showed three ZIFs materials had good crystal structure, thermal stability and high specific surface area. The ZIFs materials had also good adsorption performance for gossypol and their adsorption processes can be described by the pseudo-second-order adsorption kinetic models. Adsorption isotherm analysis indicated that Langmuir model expressed a better conformity than Freundlich model, suggesting that the adsorption was the single-layer adsorption on a uniform site. Furthermore, the spiked experiment showed that the detoxification rate of ZIFs materials in vegetable oil was 72-86 %. A satisfied detoxification rate of 50-70 % was found in the detoxification experiment of real cottonseed oil samples. Therefore, these results demonstrate the great potential of using ZIFs materials as detoxification in cottonseed oil.
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Gossipol , Nanopartículas , Zeolitas , Imidazóis/química , Óleo de Sementes de Algodão , Zeolitas/química , AdsorçãoRESUMO
Due to the lack of an assessment approach, the image of in vivo nasal ciliary motion of allergic rhinitis (AR) has never been captured and analyzed to date. Here, we have used an optimized approach to analyze the nasal ciliary function in vivo in AR rats. The digital microscopy system, a method for direct observation of ciliary motion in a living AR rat model, was applied to visualize and measure ciliary motion in vivo, including ciliary beat frequency (CBF) and ciliary beat distance (CBD). The AR rat model was established by ovalbumin sensitization. Comparisons of nasal ciliary motion in vivo between the experimental group (ovalbumin sensitization, allergen, or histamine) and the control group were analyzed. In the living rat model of allergic rhinitis, CBF and CBD decreased to 57.8 and 73.1% of the control group, respectively, but were restored after administration of chlorpheniramine maleate. Ovalbumin (OVA) significantly inhibited the ciliary motion of normal mucosa in vivo. However, responding to the OVA challenge, the ciliary motion of OVA-sensitized mucosa would not decrease further and stay at a stable level. Histamine stimulated in vivo ciliary motion quickly within 30 min, but afterward, the ciliary motion gradually decreased below the baseline. These results have clarified that in vivo ciliary motion was impaired by nasal mucosal sensitization, and this impairment was most likely related to allergen challenge and histamine. In addition, the short-term stimulation and long-term inhibition effects of histamine on in vivo ciliary motion were first reported in this study.
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Histamina , Rinite Alérgica , Alérgenos , Animais , Citocinas , Modelos Animais de Doenças , Histamina/farmacologia , Camundongos , Camundongos Endogâmicos BALB C , Mucosa Nasal , Ovalbumina/farmacologia , RatosRESUMO
Introduction: With the spread of the epidemic worldwide, an increasing number of doctors abroad have observed the following atypical symptoms of coronavirus disease 2019 (COVID-19): olfactory or taste disorders. Therefore, clarifying the incidence and clinical characteristics of olfactory and taste disorders in Chinese COVID-19 patients is of great significance and urgency. Materials and Methods: A retrospective study was conducted, which included 229 severe acute respiratory syndrome coronavirus 2 confirmed patients, through face-to-face interviews and telephone follow-up. Following the completion of questionnaires, the patients participating in the study, were categorized according to the degree of olfactory and taste disorders experienced, and the proportion of each clinical type of patient with olfactory and taste disorders and the time when symptoms appeared were recorded. Results: Among the 229 patients, 31 (13.54%) had olfactory dysfunction, and 44 (19.21%) had gustatory dysfunction. For the patients with olfactory dysfunction, 6 (19.35%) developed severe disease and became critically ill. Olfactory dysfunction appeared before the other symptoms in 21.43% of cases. The proportion of females with olfactory and gustatory dysfunction was higher than that of males (P < 0.001). Conclusions: The incidence of olfactory and gustatory dysfunction was much lower than that reported abroad; the prognosis of patients with olfactory dysfunction is relatively favorable; olfactory and gustatory dysfunction can be used as a sign for early screening; females are more prone to olfactory and gustatory dysfunction.
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This article introduces a new integrated scenario-based evacuation (ISE) framework to support hurricane evacuation decision making. It explicitly captures the dynamics, uncertainty, and human-natural system interactions that are fundamental to the challenge of hurricane evacuation, but have not been fully captured in previous formal evacuation models. The hazard is represented with an ensemble of probabilistic scenarios, population behavior with a dynamic decision model, and traffic with a dynamic user equilibrium model. The components are integrated in a multistage stochastic programming model that minimizes risk and travel times to provide a tree of evacuation order recommendations and an evaluation of the risk and travel time performance for that solution. The ISE framework recommendations offer an advance in the state of the art because they: (1) are based on an integrated hazard assessment (designed to ultimately include inland flooding), (2) explicitly balance the sometimes competing objectives of minimizing risk and minimizing travel time, (3) offer a well-hedged solution that is robust under the range of ways the hurricane might evolve, and (4) leverage the substantial value of increasing information (or decreasing degree of uncertainty) over the course of a hurricane event. A case study for Hurricane Isabel (2003) in eastern North Carolina is presented to demonstrate how the framework is applied, the type of results it can provide, and how it compares to available methods of a single scenario deterministic analysis and a two-stage stochastic program.
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@#Objective To investigate the feature of the angulation between left pulmonary artery (LPA) and main pulmonary artery (MPA) and its relationship to pulmonary artery development in patients with tetralogy of Fallot (TOF). Methods A total of 101 TOF patients in West China Hospital from 2014 to 2018 were enrolled in a TOF group, including 62 males and 39 females, aged 6.8 (0.3-45.8) years, and another 20 patients without basic cardiac diseases at the same stage were enrolled in a control group, including 10 males and 10 females, aged 6.9 (0.3-54.0) years. Diameters of LPA, right pulmonary artery (RPA) and MPA, the angulation between LPA and MPA (MPA-LPA), McGoon ratio, and Nakata index were measured and compared between the two groups. The relationship between the above data and MPA-LPA angulation was also analyzed. Results The average MPA-LPA angulation was smaller in the TOF group than that in the control group (113.63° vs. 128.45°, P=0.001 8). The MPA Z score was also smaller in the TOF group than that in the control group (0.46 vs. 2.75, P=0.000 4). No relationship was found by correlation analysis between the MPA-LPA angulation and MPA Z score or LPA Z score in the control group (P=0.239 6, 0.114 7) and the TOF group (P=0.759 3, 0.242 7). The McGoon ratios (2.22±0.72, 2.43±0.94, P=0.340 0) and Nakata index (359.3±294.24, 395.52±329.31, P=0.650 0) were not significantly different between the two groups. Conclusion The angulation of LPA-MPA and MPA Z score are smaller in the TOF group than those in the control group. There is no relationship between MPA-LPA angulation and pulmonary artery diameters. The LPA-MPA angulation should not be considered as an influence factor for LPA development and trans-annular patch surgery.
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BACKGROUND: The prognostic significance of preoperative plasma fibrinogen in patients with operable gastric cancer remains under debate. This study aimed to elucidate the prognostic value of fibrinogen in gastric cancer patients underwent gastrectomy. METHODS: A total of 4351 patients with gastric cancer collected from three comprehensive medical centers were retrospectively evaluated. Patients were categorized by minimum P value using X-tile, while the baseline confounders for fibrinogen was balanced through propensity score matching (PSM). The relationships between fibrinogen and other clinicopathologic features were evaluated, and nomogram was constructed to assess its prognostic improvement compared with TNM staging system. RESULTS: Fibrinogen was significantly correlated with macroscopic type, tumor differentiation, tumor size, and T and N stage. The factors, fibrinogen and T stage as well as N stage, were identified to be independent prognostic factors after PSM. Nomogram based on fibrinogen demonstrated a smaller Akaike information criterion (AIC) and a larger concordance index (C-index) than TNM staging system, illustrating that fibrinogen might be able to improve the prognostic accuracy. CONCLUSIONS: Preoperative plasma fibrinogen levels in gastric cancer patients were significantly correlated with tumor progression, which could be regarded as a reliable marker for survival prognostic prediction.