Higher radiation doses after partial laryngectomy may raise the incidence of pneumonia: A retrospective cohort study.

Background: Currently, studies have shown that a high dose of radiotherapy to the throat have various harmful and adverse effects on the patients' laryngeal function, resulting in the development of pneumonia. This study aimed to explore how radiotherapy dose affected the probability of pneumonia following laryngeal cancer surgery. Materials and methods: A retrospective analysis was done on patients diagnosed with laryngeal cancer between 2010 and 2020 and were treated surgically and with postoperative radiotherapy in the same institution. This study included 108 patients in total, 51 of who were in the low-dose group and 57 of whom were in the high-dose group. Age, gender, the location of laryngeal cancer, the presence or absence of lymph node metastasis, and other demographic and clinical characteristics were collected, and the prevalence of postoperative pneumonia was compared between the two groups. Results: The total prevalence of postoperative pneumonia was 59.3%, but there was a significant difference between the two groups(high-dose group 71.9% VS low-dose group 45.1%; p=0.005). A total of 9.3% (10/108) of the patients had readmission due to severe pneumonia, and the rate of readmission due to pneumonia was significantly different between the two groups (high-dose group 15.8% VS low-dose group 2.0%, p=0.032). Additionally, the high-dose group's prevalence of Dysphagia was significantly higher than the low-dose group's. According to multivariate logistic modeling, high-dose radiation was a risk factor for pneumonia (OR=4.224, 95%CI =1.603-11.131, p=0.004). Conclusion: Pneumonia risk could increase with radiotherapy doses > 50 Gy in the treatment of laryngeal cancer. Therefore, we recommend that when the radiation dose surpasses 50Gy, doctors should pay particular attention to the lung health of patients with laryngeal cancer.

Application Value of Flexible Endoscopic Examination of Swallowing in Acute Stoke Patients With Dysphagia.

BACKGROUND: The aim was to study the application value of flexible endoscopic examination of swallowing (FEES) for the aspiration screening, the diagnosis of dysphagia and evaluation of the therapeutic effect in acute stoke patients with dysphagia. METHODS: A total of 525 patients with acute stoke who were hospitalized from October 2015 to January 2021 in the Rehabilitation Medicine Department of our hospital underwent FEES for analyzing the characteristic performance. Twenty-one cases of them were examined by video fluoroscopic swallow study and compared with the results of FEES for evaluating the reliability of the FEES, the reliability of diagnosis of dysphagia, and the consistency of the 2 methods. The effect of rehabilitation was evaluated by comparing the FEES test results before and after treatment. RESULTS: In 525 patients, the FEES revealed 378 cases of aspiration (139 cases were silent aspiration), showing a higher detection rate than water swallow test. Patients with potential cricopharyngeus achalasia got the same results through both of examinations. FEES can provide more positive indicators, guide clinical rehabilitation treatment and objectively assess the effect of rehabilitation. CONCLUSIONS: Acute stoke patients with dysphagia have characteristic pharyngeal and laryngeal performance. FEES is simple to operate and has high application value in the diagnosis and treatment of dysphagia.

Experience of low-temperature plasma radiofrequency treatment of 53 patients with tongue hemangioma.

BACKGROUND: The main treatments of hemangioma of the tongueare are injection of sclerotherapy, freezing, surgical resection or combined application of the above methods. It is extremely difficult to remove it completely. Even if combined with multiple methods, it is often unable to control its continued growth, and many important physiological functions of the tongue will be affected, resulting in poor quality of life for patients. OBJECTIVE: To probe into the therapeutic effect of low-temperature plasma on hemangioma of the tongue. METHODS: The clinical data of 53 patients with hemangioma of the tongue admitted to our department from July 2013 to July 2019 were retrospectively analyzed and studied. RESULTS: Low-temperature plasma radiofrequency to treat hemangioma of the tongue might have advantages of simple operation, wide vision, fewer postoperative complications and quick recovery. SIGNIFICANCE: The low-temperature plasma system possesses advantages of precise location, light collateral damage, non­carbonization of the wound surface, light postoperative response, fewer complications and faster recovery. Combined with the endoscopic system with different angles, it can fully expose the surgical field and is especially suitable for the surgical treatment of patients with tumor of the tongue, which is worth popularizing application in clinic.

The Neutralizing Antibody Response Elicited by Tembusu Virus Is Affected Dramatically by a Single Mutation in the Stem Region of the Envelope Protein.

Tembusu virus (TMUV) is a mosquito-borne flavivirus that most commonly affects adult breeder and layer ducks. However, a TMUV-caused neurological disease has also been found in ducklings below 7 weeks of age, highlighting the need to develop a safe vaccine for young ducklings. In this study, a plaque-purified PS TMUV strain was attenuated by serial passage in BHK-21 cells. Using 1-day-old Pekin ducklings as a model, the virus was confirmed to be attenuated sufficiently after 180 passages, whereas the neutralizing antibody response elicited by the 180th passage virus (PS180) was substantially impaired compared with PS. The findings suggest that sufficient attenuation results in loss of immunogenicity in the development of the live-attenuated TMUV vaccine. Comparative sequence analysis revealed that PS180 acquired one mutation (V41M) in prM and four mutations (T70A, Y176H, K313R, and F408L) in the envelope (E) protein. To identify the amino acid substitution(s) associated with loss of immunogenicity of PS180, we rescued parental viruses, rPS and rPS180, and produced mutant viruses, rPS180-M41V, rPS180-A70T, rPS180-H176Y, rPS180-R313K, rPS180-L408F, and rPS180-M5, which contained residue 41V in prM, residues 70T, 176Y, 313K, and 408F in E, and combination of the five residues, respectively, of PS in the backbone of the rPS180 genome. The neutralizing antibody response elicited by rPS180-L408F and rPS180-M5 was significantly higher than those by other mutant viruses and comparable to that by rPS. Furthermore, we produced mutant virus rPS-F408L, which contained residue 408L of PS180 in the backbone of the rPS genome. The F408L mutation conferred significantly decreased neutralizing antibody response to rPS-F408L, which was comparable to that elicited by rPS180. Based on homologous modeling, residue 408 was predicted to be located within the first helical domain of the stem region of the E protein (EH1). Together, these data demonstrate that a single mutation within the EH1 domain exerts a dramatical impact on the TMUV neutralizing antibody response. The present work may enhance our understanding of molecular basis of the TMUV neutralizing antibody response, and provides an important step for the development of a safe and efficient live-attenuated TMUV vaccine.

Generation of a reliable full-length cDNA of infectiousTembusu virus using a PCR-based protocol.

Full-length cDNA of Tembusu virus (TMUV) cloned in a plasmid has been found instable in bacterial hosts. Using a PCR-based protocol, we generated a stable full-length cDNA of TMUV. Different cDNA fragments of TMUV were amplified by reverse transcription (RT)-PCR, and cloned into plasmids. Fragmented cDNAs were amplified and assembled by fusion PCR to produce a full-length cDNA using the recombinant plasmids as templates. Subsequently, a full-length RNA was transcribed from the full-length cDNA in vitro and transfected into BHK-21 cells; infectious viral particles were rescued successfully. Following several passages in BKH-21 cells, the rescued virus was compared with the parental virus by genetic marker checks, growth curve determinations and animal experiments. These assays clearly demonstrated the genetic and biological stabilities of the rescued virus. The present work will be useful for future investigations on the molecular mechanisms involved in replication and pathogenesis of TMUV.

[Analysis of monitoring results of Mattress-type of sleep monitoring system in elderly patients with OSAHS].

OBJECTIVE: To investigate the sleep monitoring feature of the MSMS in elderly patients with OSAHS. METHOD: One hundred and ninety patients diagnosed with OSAHS were divided into elderly group and non elderly group according to age, then the results of MSMS were analyzed. RESULT: Majority elderly patients were with mild to moderate OSAHS. The nocturnal mean blood oxygen and the lowest oxygen were higher than non elderly group, coupled with higher percentage of the total oxygen saturation < 90% monitoring time (TS90). There was no significant difference in sleep structure between two groups, but the total sleep time of elderly group is lower than the non elderly group, the difference is statistically significant. CONCLUSION: The elderly patients with OSAHS were less severe in nature, but the nocturnal hypoxia last longer in the elderly group. There is no significant difference in the sleep structure between the two groups. But the total sleep time decrease in elderly group. With smaller interference, the MSMS is closer to the natural sleep stustus of the subjects.

[Nasal mucosa recovery after endoscopic surgery using the plasma radiofrequency ablation at low temperature for treatment of nasal inverted papilloma].

OBJECTIVE: To assess the therapeutic effect and study the role of nasal mucosa epithelization after endoscopic surgery using the plasma radiofrequency ablation at low temperature in patients with nasal inverted papilloma. METHOD: The clinical data of 104 patients with nasal inverted papilloma underwent endoscopic surgery u sing the plasma radiofrequency ablation at low temperature from July, 2008 to July, 2012 were analyzed,and the recovery of mucosa was observed under nasal endoscope. RESULT: The mucosa recovery extent showed a decreasing trend from mucosa pattern degree I to III, where the difference was statistically significant by chi-square test between groups (P < 0.05). The average epithelialization time was 2.7 months. It showed a significantly decreasing trend among average epithelialization time of different degrees of mucosa (P < 0.05). The nasal mucosa of most patients completed epithelialization 2.9 months after surgery. CONCLUSION: It is safe and effective to treat nasal inverted papilloma with plasma radiofrequency ablation at low temperature. The patients should be followed up with regular reexamination for at least three months after surgery.

[Preliminary investigation of coblation for early glottic carcinoma].

OBJECTIVE: To establish whether Coblation is a suitable modality for removal of early glottic carcinoma. METHODS: Fourteen patients with early glottic carcinoma (Tis-T2) without lymph node metastasis underwent resection of laryngeal cancer lesions using transoral endoscopic coblation (TEC), without pre- or post-operative radiotherapy and chemotherapy. RESULTS: No severe complication such as bleeding and dyspnea occurred in the cases. Only mild postoperative pain happened to the patients. All patients could eat and pronounce on the surgery day. With following-up of 25 - 37 months, no recurrence was observed in 13 cases. One case, with poorly differentiated squamous cell lesion in the anterior commissure invading subglottic, recurred 3 months postoperatively. The patient received the re-resection of laryngeal lesion by coblation, but another recurrence happened to the patient 6 months postoperatively, and then was cured by partial laryngectomy, with recurrence-free survival 21 months postoperatively. CONCLUSION: The observation suggests that transoral endoscopic coblation is a reliable and safe modality for the resection of early glottic carcinoma.