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Vocal cord paralysis is a common condition that significantly impairs laryngeal function and can even be life-threatening. Over nearly a century, researchers have conducted extensive animal and clinical studies to achieve accurate diagnosis and restore laryngeal function, making significant progress. Approaches have evolved from mechanically narrowing the glottis to restore phonation, to enlarging the glottis to relieve breathing difficulties, and ultimately to the development of surgical techniques aimed at restoring vocal cord mobility, significantly advancing the field. The publication of expert consensus guidelines on the diagnosis and treatment of vocal cord paralysis has standardized the principles and technical standards for managing this condition. However, a vast amount of related knowledge-including the disease's pathogenesis, diagnostic criteria, surgical principles, and techniques-still requires broader dissemination and further refinement. Advancing this knowledge will guide clinical practice and further enhance the diagnosis and treatment of this condition in China.
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Paralisia das Pregas Vocais , Paralisia das Pregas Vocais/diagnóstico , Paralisia das Pregas Vocais/terapia , Humanos , Prega Vocal/fisiopatologiaRESUMO
Objective:Comparing the primary tumor control, vocal function recovery, postoperative adhesion rate and degree of adhesion in early glottic cancer involving the anterior commissure treated with CO2 laser staged and lateral surgery, one-stage surgery combined with laryngeal stent placement, and simple CO2 laser excision. Methods:This study focuses on 83 patients with T1-2N0M0 stage glottic squamous cell carcinoma involving the anterior commissure who underwent CO2 laser treatment. The study was divided into three groups: Group A with 15 cases, treated with staged resection surgery; Group B with 18 cases, treated with one-stage surgery combined with the placement of a silicone laryngeal stent; and Group C with 50 cases, treated with simple CO2 laser excision. The Voice Handicap Index-10ï¼VHI-10ï¼, the GRBAS auditory-perceptual assessment, and the maximum phonation timeï¼MPTï¼ were used to evaluate the vocal function of the patients before and six months after surgery. The degree of vocal cord adhesion was assessed using the Cohen classification of vocal cord adhesion. Statistical analysis was performed to determine the differences in each indicator before and after surgery, and the primary tumor control rates among the three groups. Results:Local recurrence occurred in 1 case each in Groups A and B, and in 4 cases in Group C, with no distant metastasis observed. Postoperative vocal cord adhesion of varying degrees occurred in a total of 77 cases, with an adhesion rate of 73.3%ï¼11/15ï¼ in Group A, 88.9%ï¼16/18ï¼ in Group B, and 100%ï¼50/50ï¼ in Group C. The postoperative vocal cord adhesion rate and degree in Group C were significantly higher than in Groups A and B. The postoperative VHI-10 scores in all three groups were significantly increased compared to preoperative scoresï¼P<0.05ï¼, and when compared between groups postoperatively, Group C was significantly worse than Groups A and B ï¼P<0.05ï¼. The postoperative maximum phonation timeï¼MPTï¼ in Group C was significantly reduced compared to preoperative and was markedly shorter than that of Groups A and B postoperativelyï¼P<0.05ï¼. The postoperative grades of Gï¼Gradeï¼ and Rï¼roughnessï¼ in Group C were significantly higher than preoperatively, indicating a noticeable deterioration in voice quality, and were also significantly worse than those postoperatively in Groups A and B, with all differencesï¼P<0.05ï¼. Conclusion:For early glottic cancer involving the anterior commissure, choosing staged surgery or one-stage surgery combined with the placement of a silicone anterior commissure laryngeal stent were better than simple laser tumor excision in terms of secondary vocal cord adhesion and voice function preservation.
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Carcinoma de Células Escamosas , Glote , Neoplasias Laríngeas , Terapia a Laser , Prega Vocal , Humanos , Neoplasias Laríngeas/cirurgia , Prega Vocal/cirurgia , Terapia a Laser/métodos , Carcinoma de Células Escamosas/cirurgia , Masculino , Feminino , Lasers de Gás/uso terapêutico , Pessoa de Meia-Idade , Resultado do Tratamento , Idoso , Recidiva Local de Neoplasia/prevenção & controleRESUMO
Objective:To analyze the efficacy of endoscopic CO2 laser arytenoidectomy in treating bilateral vocal cord paralysis. Methods:Ninety-five patients who underwent endoscopic CO2 laser arytenoidectomy for bilateral vocal cord paralysis at the First Affiliated Hospital of Naval Medical Universityï¼Changhai Hospitalï¼ of Shanghai from January 2009 to December 2022 were included in this study. Among them, 59 patients underwent endoscopic CO2 laser arytenoidectomy as their first glottic enlargement surgeryï¼Group Aï¼, while 36 patients, who had previously undergone two unsuccessful CO2 laser-assisted posterior cordotomies, underwent endoscopic CO2 laser arytenoidectomy as a subsequent surgeryï¼Group Bï¼. Swallowing function, electronic laryngoscopy, perceptual voice evaluation, and objective voice analysis indicators were statistically analyzed before and after surgery to evaluate clinical efficacy. Results:The extubation rate after the first surgery was 84.75% in Group A and 86.11% in Group B, with total extubation rates of 94.92% and 94.44%, respectively. There were no significant differences between the two groups in preoperative and postoperative swallowing function, glottic size, or various voice evaluation indicatorsï¼P>0.05ï¼. Within-group comparisons showed that postoperative swallowing function, glottic closure during phonation, perceptual evaluations of Gï¼grade of hoarsenessï¼, Aï¼astheniaï¼, and Bï¼breathinessï¼ significantly worsened, with increased grades. The maximum transverse diameter of the posterior glottis during inspiration significantly increased, and the VHI-10 score was significantly higher postoperatively. Jitter, shimmer, and the harmonics-to-noise ratio significantly deteriorated, and maximum phonation time significantly shortenedï¼P<0.05ï¼. No significant differences were observed in postoperative Rï¼roughnessï¼ and Sï¼strainï¼ compared to preoperative valuesï¼P>0.05ï¼. Conclusion:Endoscopic CO2 laser arytenoidectomy can impair voice quality to some extent but effectively alleviates breathing difficulties in patients with bilateral vocal cord paralysis. For patients who did not achieve successful extubation with CO2 laser-assisted posterior cordotomy, endoscopic CO2laser arytenoidectomy is an effective reoperative method, ensuring a high extubation rate while preserving certain voice functions.
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Cartilagem Aritenoide , Lasers de Gás , Paralisia das Pregas Vocais , Humanos , Cartilagem Aritenoide/cirurgia , Lasers de Gás/uso terapêutico , Paralisia das Pregas Vocais/cirurgia , Masculino , Terapia a Laser/métodos , Laringoscopia/métodos , Feminino , Pessoa de Meia-Idade , Cordotomia/métodos , Reoperação , Resultado do Tratamento , Endoscopia/métodos , AdultoRESUMO
Objective:Investigates the application and clinical efficacy of ansa cervicalis anterior root-recurrent laryngeal nerveï¼RLNï¼ anastomosis in the treatment of unilateral vocal fold paralysisï¼UVFPï¼. Methods:A prospective study was conducted with 92 UVFP patients admitted to our department from January 2018 to January 2022 who received ansa cervicalis anterior root-RLN anastomosis. The course of nerve injury ranged from 6 to 24 months. Videostroboscopy, voice subjective auditory perceptual assessmentï¼GRBASï¼, Voice Handicap Indexï¼VHI-10ï¼, voice objective acoustic analysis and laryngeal electromyographyï¼EMGï¼ were used to evaluate the efficacy of the operation. Results:Videostroboscopy showed that although the movement of vocal cords did not return to normal 12 months after operation, their volume and muscle tension were significantly improved and their positions were adducted to the median or near-median. Also the glottic closure, vocal cord position, vocal cord edge, symmetry and regularity of vocal cord vibration were significantly improved than pre-operationï¼P<0.01ï¼. The five indexes of GRBASï¼Grade, Roughness, Breathiness, Asthenia, Strainï¼ and VHI-10, as well as voice acoustic parametersï¼Jitter, Shimmer, NHRï¼ post-operation were significantly reduced, while the maximum phonation timeï¼MPTï¼ was significantly longerï¼P<0.01ï¼. The results of laryngeal EMG indicated that the maximum voluntary motor unit recruitmentï¼VMURï¼ post-operation was significantly recoveredï¼P<0.01ï¼, which confirmed that the affected laryngeal muscle obtained effective nerve reinnervation. Conclusion:Ansa cervicalis anterior root-RLN anastomosis can effectively improve the voice function of patients which is safe and satisfactory. It is an ideal method for the treatment of unilateral RLN injury.
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Anastomose Cirúrgica , Nervo Laríngeo Recorrente , Paralisia das Pregas Vocais , Humanos , Paralisia das Pregas Vocais/cirurgia , Feminino , Masculino , Nervo Laríngeo Recorrente/cirurgia , Estudos Prospectivos , Anastomose Cirúrgica/métodos , Pessoa de Meia-Idade , Resultado do Tratamento , Eletromiografia , Prega Vocal/cirurgia , Adulto , Qualidade da VozRESUMO
The related research of nerve repair for bilateral vocal cord paralysisï¼BVCPï¼ can be traced back to a century ago. There is still no standardized surgical therapeutic schedule and the evaluation of curative effect, due to the variability and complexity of laryngeal nerve innervation. Otolaryngologists have been constantly weighing and improving the surgical plan in relieving airway obstruction, maintaining vocal function and reducing cough to protect the normal physiological function of the larynx. Different medical institutions have great differences in the treatment methods. Many studies and literatures were published on the treatment of BVCP, yet have few related works on the application of it's nerve repair technology presently. The research progress of nerve repair technology for BVCP were described, along with its developing trend, aiming to lay the foundation for the future technical exploration and development.
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Paralisia das Pregas Vocais , Humanos , Paralisia das Pregas Vocais/cirurgia , Nervos Laríngeos/cirurgiaRESUMO
Background: Antibody-drug conjugates (ADCs) have emerged as the focus and hotspots in the cancer field, yet the accompanying ocular toxicity has often been underestimated. We aimed to comprehensively and comparatively analyze the risk of ocular toxicity associated with various ADCs using the FDA Adverse Event Reporting System (FAERS) database. Methods: Data were extracted from the FAERS database from Q3 2011 to Q3 2023. We analyzed the clinical characteristics of ADCs-related ocular adverse events (AEs). These data were further mined by proportional analysis and Bayesian approach to detect signals of ADCs-induced ocular AEs. Moreover, the time to onset of ocular toxicity was also evaluated. Results: A total of 1,246 cases of ocular AEs were attributed to ADCs. Ocular toxicity signals were observed in patients treated with belantamab mafodotin, brentuximab vedotin, enfortumab vedotin, mirvetuximab soravtansine, sacituzumab govitecan, trastuzumab deruxtecan, and trastuzumab emtansine. Of these, belantamab mafodotin, trastuzumab emtansine, and mirvetuximab soravtansine, whose payloads are microtubule polymerization inhibitors, were more susceptible to ocular toxicity. The ten most common ADCs-related ocular AEs signals are keratopathy [ROR = 1,273.52, 95% CI (1,129.26-1,436.21)], visual acuity reduced [ROR = 22.83, 95% CI (21.2-24.58)], dry eye [ROR = 9.69, 95% CI (8.81-10.66)], night blindness [ROR = 259.87, 95% CI (228.23-295.89)], vision blurred [ROR = 1.78, 95% CI (1.57-2.02)], photophobia [ROR = 10.45, 95% CI (9.07-12.05)], foreign body sensation in eyes [ROR = 23.35, 95% CI (19.88-27.42)], ocular toxicity [ROR = 144.62, 95% CI (117.3-178.32)], punctate keratitis [ROR = 126.21, 95% CI (101.66-156.69)], eye disorder [ROR = 2.71, 95% CI (2.21-3.32)]. In terms of onset time, sacituzumab govitecan displayed an earlier onset of 21 days, while trastuzumab deruxtecan exhibited the latest onset of 223 days. Conclusion: ADCs may increase the risk of ocular toxicity in cancer patients, leading to serious mortality. With the widespread application of newly launched ADCs, combining the FAERS data with other data sources is crucial for monitoring the ocular toxicity of ADCs. In addition, novel ocular toxicity signals not documented in product labeling were detected. Further research will be necessary to validate our findings in the future.
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Introduction: We aimed to study middle ear barotrauma caused by fast compression followed by buoyant ascent escape from 200 m underwater and its effect on the auditory system, and to validate the preventive effect of tympanocentesis on middle ear barotrauma. Methods: Twenty Sprague Dawley rats were divided into two groups: rats in group A underwent a simulated fast buoyant ascent escape from a depth of 200 m, while those in group B underwent tympanocentesis before the procedure described for group A. Ear endoscopy, acoustic conductance, and auditory brainstem response (ABR) tests were conducted before and after the procedure to evaluate the severity of middle ear barotrauma and auditory function in both groups. Additionally, histopathological examination of the middle ear in both groups was conducted to evaluate the severity of middle ear barotrauma by observing submucosal haemorrhage. Results: None of the ears in either group showed any abnormalities before the experiment. In group A, middle ear barotrauma was universally observed after the simulation procedure. The tympanograms of all ears were initially type A and became type B after the procedure. Further, after the simulation, the hearing thresholds at different frequencies (4, 8, 16, 24, and 32 kHz) assessed by ABR significantly increased compared to those before the procedure. In group B, no middle ear barotrauma was observed, and the hearing threshold at each frequency did not change significantly compared with post-puncturing. After dissecting the middle ear, gross pathological observations were consistent with the above results. Microscopically, blood accumulation and submucosal haemorrhage in the middle ear cavity were observed in group A but not in group B. Conclusions: Fast buoyant ascent from 200 m underwater can cause middle ear barotrauma, resulting in hearing loss. Tympanic membrane puncture can effectively prevent middle ear barotrauma caused by the rapid buoyant ascent escape procedure.
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Barotrauma , Orelha Média , Potenciais Evocados Auditivos do Tronco Encefálico , Ratos Sprague-Dawley , Barotrauma/prevenção & controle , Barotrauma/etiologia , Animais , Orelha Média/lesões , Ratos , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Testes de Impedância Acústica/métodos , Masculino , Membrana Timpânica/lesões , Mergulho/efeitos adversos , Limiar Auditivo/fisiologiaRESUMO
OBJECTIVES: To retrospectively investigate the pathological response rate, laryngeal preservation surgery (LPS) rate and progression free survival (PFS) of neoadjuvant chemoimmunotherapy in the treatment of locally advanced hypopharyngeal cancer (LAHPC). MATERIALS AND METHODS: In this study, LAHPC patients, who were first diagnosed and underwent surgery at the First Affiliated Hospital of Naval Medical University between January 2021 and January 2024, preoperatively administered PD-1 inhibitor and TP induction regimen (albumin-bound paclitaxel 260â¯mg/m2 and cisplatin 80â¯mg/m2). The primary endpoint was major pathological response (MPR), with ORR rate, LPS rate and PFS as the secondary endpoints. Then, the correlation between MPR and overall response rate (ORR) was further validated. RESULTS: A total of 46 patients satisfied the inclusion criteria, with the median follow-up period of 10.5â¯months. After neoadjuvant chemoimmunotherapy, the ORR was observed to be 71.9â¯%, and the LPS rate reached 80.4â¯% (76.5â¯% in stage IV patients). The pathological response indicated a favorable response, with the MPR ratio at 52.2â¯% and pathological complete response (pCR) ratio at 32.6â¯%. The imaging score highly correlated with pathological response (Kappaâ¯=â¯0.058, P<0.001), while the MPR and ORR shared a strong positive linear relationship (râ¯=â¯0.753, P<0.001). The 1-year and 2-year PFS rates were 97.1â¯% and 93.8â¯% for all patients, with stage IV patients having a 1-year PFS of 92.2â¯%. Patients who achieved MPR demonstrated a significant prognostic advantage (P=0.008), with no recurrence instances or mortality reported. Grade 3 adverse events were observed in 8.7â¯% of the cohort. The most common Grade 1-2 adverse events were alopecia, reactive telangiosis and loss of appetite, and no delayed surgery occurred. CONCLUSION: Neoadjuvant therapy of PD-1 inhibitor combined with TP effectively improved the MPR and LPS rates of LAHPC patients, especially in those at clinical stage IV.
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Protocolos de Quimioterapia Combinada Antineoplásica , Cisplatino , Neoplasias Hipofaríngeas , Terapia Neoadjuvante , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Terapia Neoadjuvante/métodos , Neoplasias Hipofaríngeas/terapia , Neoplasias Hipofaríngeas/tratamento farmacológico , Neoplasias Hipofaríngeas/mortalidade , Neoplasias Hipofaríngeas/patologia , Idoso , Estudos Retrospectivos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Adulto , Cisplatino/uso terapêutico , Cisplatino/administração & dosagem , Paclitaxel/uso terapêutico , Paclitaxel/administração & dosagem , Paclitaxel/efeitos adversos , Inibidores de Checkpoint Imunológico/uso terapêutico , Inibidores de Checkpoint Imunológico/efeitos adversos , Imunoterapia/métodos , Laringe/patologia , Laringe/efeitos dos fármacos , Tratamentos com Preservação do Órgão/métodosRESUMO
KEY MESSAGE: Thirteen QTLs associated with rice grain shape were localized by genome-wide association study. LOC_Os01g74020, the putative candidate gene in the co-localized QTL-qGSE1.2 interval, was identified and validated. Grain shape (GS) is a key trait that affects yield and quality of rice. Identifying and analyzing GS-related genes and elucidating the physiological, biochemical and molecular mechanisms are important for rice breeding. In this study, genome-wide association studies (GWAS) were conducted based on 1, 795, 076 single-nucleotide polymorphisms (SNPs) and three GS-related traits, grain length (GL), grain width (GW) and thousand-grain weight (TGW), in a natural population which comprised 374 rice varieties. A total of 13 quantitative trait locus (QTLs) related to GL, GW and TGW were identified, respectively, of which two QTLs (qGSE1.2 and qGSE5.3) were associated with both GL and TGW. A known key GS regulatory gene, GW5, was present in the interval of qGSE5.3. Based on the qRT-PCR results, LOC_Os01g74020 (OsGSE1.2) was identified as a GS candidate gene. Functional analysis of OsGSE1.2 showed that glume cell width and GW were significantly reduced, and that glume cell length, GL, TGW and single-plant yield were significantly increased in OsGSE1.2 knockout lines than those of wild type. OsGSE1.2 affects rice grain length by suppressing the elongation of glume cell and is a novel GS regulatory gene. These findings laid the foundation for molecular breeding to improve rice GS and increase rice yield and profitability.
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Mapeamento Cromossômico , Grão Comestível , Genes de Plantas , Oryza , Fenótipo , Polimorfismo de Nucleotídeo Único , Locos de Características Quantitativas , Oryza/genética , Oryza/crescimento & desenvolvimento , Grão Comestível/genética , Grão Comestível/crescimento & desenvolvimento , Estudo de Associação Genômica Ampla , Melhoramento Vegetal , Estudos de Associação Genética , Sementes/genética , Sementes/crescimento & desenvolvimentoRESUMO
Several studies reveal that allergic rhinitis (AR) is a significant risk factor of systemic lupus erythematosus (SLE). However, studies investigating the common pathogenesis linking AR and SLE are lacking. Our study aims to search for the shared biomarkers and mechanisms that may provide new therapeutic targets for preventing AR from developing SLE. GSE50223 for AR and GSE103760 for SLE were downloaded from the Gene Expression Omnibus (GEO) database to screen differentially expressed genes (DEGs). The Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed to explore the functions of shared DEGs. Hub genes were screened by cytoHubba (a plugin of Cytoscape) and validated in another two datasets. Gene set enrichment analysis (GSEA) and single-sample Gene set enrichment analysis (ssGSEA) algorithm were applied to understand the functions of hub gene. ENTPD1 was validated as a hub gene between AR and SLE. GSEA results revealed that ENTPD1 was associated with KRAS_SIGNALING_UP pathway in AR and related to HYPOXIA, TGF_BETA_SIGNALING and TNFA_SIGNALING_VIA_NFKB pathways in SLE. The expression of ENTPD1 was positively correlated with activated CD8 T cell in both diseases. Thus, ENTPD1 may be a novel therapeutic target for preventing AR from developing SLE.
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Biomarcadores , Lúpus Eritematoso Sistêmico , Rinite Alérgica , Humanos , Lúpus Eritematoso Sistêmico/genética , Rinite Alérgica/genética , Ontologia Genética , Perfilação da Expressão Gênica , Bases de Dados Genéticas , Transdução de Sinais , Redes Reguladoras de Genes , Biologia Computacional/métodosRESUMO
Fibrosis is a complex pathological process that can lead to the permanent loss of biological function, with P2ry2 playing a crucial role in this process. Long non-coding RNAs (lncRNAs) have been reported to play an critically important role in the fibrotic process. However, it remains unclear whether lncRNAs can regulate fibrosis through P2ry2. In this study, we detected the expression of the long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (lnc-MALAT1). We investigated the expression patterns of lnc-MALAT1 and P2ry2 in denervated skeletal muscle, a classical model of fibrosis. Additionally, we utilized a TGF-ß-mediated fibrosis model in NIH/3T3 cells to examine the effects of lnc-MALAT1 and P2ry2 on fibroblast activation and the underlying regulatory mechanisms in vitro. Our results demonstrated that the expression levels of lnc-MALAT1 and P2ry2 were consistently elevated in denervated skeletal muscle, correlating with the degree of fibrosis. In vitro experiments confirmed the regulatory effect of lnc-MALAT1 on P2ry2. Furthermore, we identified miR-335-3p as a potential key molecule in the regulatory relationship of lnc-MALAT1/P2ry2. Dual luciferase reporter assays and AGO2-RIP verified the molecular sponging effect of lnc-MALAT1 on miR-335-3p. Additionally, we validated the regulation of the lnc-MALAT1/miR-335-3p/P2ry2 axis through experimental approaches. In conclusion, our study identified a crucial role of lnc-MALAT1/miR-335-3p/P2ry2 axis in fibroblast activation, providing a promising treatment option against the fibrosis.
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Fibroblastos , Fibrose , MicroRNAs , RNA Longo não Codificante , Animais , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo , MicroRNAs/genética , MicroRNAs/metabolismo , Camundongos , Fibroblastos/metabolismo , Células NIH 3T3 , Músculo Esquelético/metabolismo , Músculo Esquelético/patologia , Masculino , Camundongos Endogâmicos C57BL , Fator de Crescimento Transformador beta/metabolismo , Regulação da Expressão Gênica , RNA Endógeno CompetitivoRESUMO
Long-term denervation-induced atrophy and fibrosis of skeletal muscle due to denervation leads to poor recovery of muscle function. Studies have shown that the transforming growth factor-ß1 (TGF-ß1)-Smad signaling pathway plays a central role in muscle atrophy and fibrosis. Recent studies demonstrate the role of microRNAs (miRs) in various pathological conditions, including muscle regeneration. miR-21 has been shown to play a dynamic role in inflammatory responses and in accelerating injury responses to fibrosis. We used both RNA sequencing and quantitative RT-PCR strategies to examine the alternations of miRNAs during denervation-induced gastrocnemius muscle atrophy and fibrosis. Our data showed that MiR-21 was upregulated in denervated gastrocnemius muscle tissue, and TGF-ß1treatment increased miR-21 expression. Inhibition of miR-21 reduced gastrocnemius muscle fibrosis and significantly downregulated the expression of p-SMAD2/3 and the fibrosis-associated markers TGF-ß1, connective tissue growth factor, alpha smooth muscle actin. Masson's trichrome staining revealed that atrophy and fibrosis in gastrocnemius muscle tissue were reduced in the miR-21 inhibition group compared to the control group. We confirmed that SMAD7 is a direct target of miR-21 using a dual luciferase assay. Furthermore, Immunofluorescence and Western blot analyses revealed that miR-21 inhibition reduced SMAD2/3 phosphorylation and nuclear translocation. While SMAD7-siRNA abolished the effect. Consequently, the discovery that miR-21 regulates the atrophy and fibrosis of the gastrocnemius muscle offers a possible therapeutic approach for their management.
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INTRODUCTION: Cerebrotendinous xanthomatosis (CTX) is an autosomal recessive lipid metabolism disorder. It is caused by a defect in the sterol-27-hydroxylase gene, leading to the deposition of cholesteryl and bile alcohol in large amounts, causing a variety of clinical manifestations; however, tremor as the main manifestation of CTX has not been reported. PATIENTS CONCERNS AND CLINICAL FINDINGS: Herein, we report a 27-year-old woman, who developed head and body tremors at the age of 12 years. Many hospitals misdiagnosed her condition as idiopathic tremor and Parkinson disease, with a poor curative effect. PRIMARY DIAGNOSIS AND INTERVENTION: We diagnosed her with CTX and treated with chenodeoxycholic acid and clonazepam. CONCLUSION: The patient's condition considerably improved. This case could help avoid misdiagnosis and mistreatment in clinical practice.
Assuntos
Ácido Quenodesoxicólico , Tremor , Xantomatose Cerebrotendinosa , Humanos , Xantomatose Cerebrotendinosa/diagnóstico , Xantomatose Cerebrotendinosa/complicações , Xantomatose Cerebrotendinosa/tratamento farmacológico , Xantomatose Cerebrotendinosa/genética , Feminino , Adulto , Tremor/etiologia , Tremor/diagnóstico , Ácido Quenodesoxicólico/uso terapêutico , Clonazepam/uso terapêutico , Diagnóstico DiferencialRESUMO
PURPOSE: Treating an infiltration of the recurrent laryngeal nerve (RLN) by thyroid carcinoma remains a subject of ongoing debate. Therefore, this study aims to provide a novel strategy for intraoperative phenosurgical management of RLN infiltrated by thyroid carcinoma. METHODS: Forty-two patients with thyroid carcinoma infiltrating the RLN were recruited for this study and divided into three groups. Group A comprised six individuals with medullary thyroid cancer who underwent RLN resection and arytenoid adduction. Group B consisted of 29 differentiated thyroid cancer (DTC)patients who underwent RLN resection and ansa cervicalis (ACN)-to-RLN anastomosis. Group C included seven patients whose RLN was preserved. RESULTS: The videostroboscopic analysis and voice assessment collectively indicated substantial improvements in voice quality for patients in Groups A and B one year post-surgery. Additionally, the shaving technique maintained a normal or near-normal voice in Group C one year post-surgery. CONCLUSION: The new intraoperative phonosurgical strategy is as follows: Resection of the affected RLN and arytenoid adduction is required in cases of medullary or anaplastic carcinoma, regardless of preoperative RLN function. Suppose RLN is found infiltrated by well-differentiated thyroid cancer (WDTC) during surgery, and the RLN is preoperatively paralyzed, we recommend performing resection the involved RLN and ACN-to-RLN anastomosis immediately during surgery. If vocal folds exhibit normal mobility preoperatively, the MACIS scoring system is used to assess patient risk stratification. When the MACIS score > 6.99, resection of the involved RLN and immediate ACN-to-RLN anastomosis were performed. RLN preservation was limited to patients with MACIS scores ≤ 6.99.
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Nervo Laríngeo Recorrente , Neoplasias da Glândula Tireoide , Tireoidectomia , Humanos , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Nervo Laríngeo Recorrente/cirurgia , Tireoidectomia/métodos , Paralisia das Pregas Vocais/etiologia , Paralisia das Pregas Vocais/cirurgia , Idoso , Qualidade da Voz , Invasividade Neoplásica/patologia , Resultado do TratamentoRESUMO
Nitrogen (N) is one of the essential nutrients for the growth and development of crops. The adequate application of N not only increases the yield of crops but also improves the quality of agricultural products, but the excessive application of N can cause many adverse effects on ecology and the environment. In this study, genome-wide association analysis (GWAS) was performed under low- and high-N conditions based on 788,396 SNPs and phenotypic traits relevant to N uptake and utilization (N content and N accumulation). A total of 75 QTLs were obtained using GWAS, which contained 811 genes. Of 811 genes, 281 genes showed different haplotypes, and 40 genes had significant phenotypic differences among different haplotypes. Of these 40 genes, 5 differentially expressed genes (Os01g0159250, Os02g0618200, Os02g0618400, Os02g0630300, and Os06g0619000) were finally identified as the more valuable candidate genes based on the transcriptome data sequenced from Longjing31 (low-N-tolerant variety) and Songjing 10 (low-N-sensitive variety) under low- and high-N treatments. These new findings enrich the genetic resources for N uptake and utilization in rice, as well as lay a theoretical foundation for improving the efficiency of N uptake and utilization in rice.
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Oryza , Plântula , Plântula/genética , Mapeamento Cromossômico , Oryza/genética , Estudo de Associação Genômica Ampla , Nitrogênio , Produtos Agrícolas/genéticaRESUMO
Tongue squamous cell carcinoma (TSCC) is the main pathologic subtype of oral cancer, and the current therapeutic effect is far from satisfactory. The signal peptide-CUB-EGF domain-containing protein 3 (SCUBE3) has been shown to be a tumor-promoting factor in several malignancies. However, little is known about the role of SCUBE3 in TSCC. In this study, we identified that SCUBE3 was highly expressed in TSCC. Clinically, high expression of SCUBE3 was positively associated with tumor stage and T stage of TSCC. Functionally, SCUBE3 silence remarkably restrained cell proliferation, migration, and invasion, induced apoptosis as well as cell cycle arrest in G2-phase, and weakened the tumorigenicity of TSCC cells in vivo. Mechanistically, SCUBE3 promoted the direct binding of CCAAT enhancer binding protein alpha (CEBPA) to C-C motif chemokine ligand 2 (CCL2) promoter in TSCC cells. Interestingly, CCL2 overexpression partially reversed the inhibitory effect of SCUBE3 deficiency on TSCC cell viability and migration. Moreover, STAT3 signaling contributed to CCL2-mediated phenotypes in TSCC cells. IMPLICATIONS: Our data revealed a tumor-promoting role for SCUBE3 in TSCC via the CEBPA/CCL2/STAT3 axis, which provided new insight into novel potential therapeutic target for TSCC.
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Proteínas Estimuladoras de Ligação a CCAAT , Quimiocina CCL2 , Regiões Promotoras Genéticas , Neoplasias da Língua , Humanos , Neoplasias da Língua/genética , Neoplasias da Língua/patologia , Neoplasias da Língua/metabolismo , Quimiocina CCL2/metabolismo , Quimiocina CCL2/genética , Animais , Camundongos , Proteínas Estimuladoras de Ligação a CCAAT/metabolismo , Proteínas Estimuladoras de Ligação a CCAAT/genética , Masculino , Linhagem Celular Tumoral , Feminino , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/metabolismo , Proliferação de Células , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Movimento Celular , Regulação Neoplásica da Expressão Gênica , Pessoa de Meia-Idade , Camundongos Nus , Proteínas de Ligação ao Cálcio/metabolismo , Proteínas de Ligação ao Cálcio/genética , ApoptoseRESUMO
Low-temperature chilling is a major abiotic stress leading to reduced rice yield and is a significant environmental threat to food security. Low-temperature chilling studies have focused on physiological changes or coding genes. However, the competitive endogenous RNA mechanism in rice at low temperatures has not been reported. Therefore, in this study, antioxidant physiological indices were combined with whole-transcriptome data through weighted correlation network analysis, which found that the gene modules had the highest correlation with the key antioxidant enzymes superoxide dismutase and peroxidase. The hub genes of the superoxide dismutase-related module included the UDP-glucosyltransferase family protein, sesquiterpene synthase and indole-3-glycerophosphatase gene. The hub genes of the peroxidase-related module included the WRKY transcription factor, abscisic acid signal transduction pathway-related gene plasma membrane hydrogen-ATPase and receptor-like kinase. Therefore, we selected the modular hub genes and significantly enriched the metabolic pathway genes to construct the key competitive endogenous RNA networks, resulting in three competitive endogenous RNA networks of seven long non-coding RNAs regulating three co-expressed messenger RNAs via four microRNAs. Finally, the negative regulatory function of the WRKY transcription factor OsWRKY61 was determined via subcellular localization and validation of the physiological indices in the mutant.
Assuntos
MicroRNAs , Oryza , RNA Longo não Codificante , Oryza/metabolismo , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo , Antioxidantes , Perfilação da Expressão Gênica , MicroRNAs/genética , MicroRNAs/metabolismo , Redes Reguladoras de Genes , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Peroxidases/genética , Superóxido Dismutase/genéticaRESUMO
OBJECTIVES: The present study was performed to determine whether the inhalation of carboxymethyl (CM)-chitosan can alleviate tracheal fibrosis in a rabbit model. METHODS: We designed a rabbit model of tracheal stenosis involving electrocoagulation with a spherical electrode. Twenty New Zealand white rabbits were randomly divided into experimental and control groups (10 animals each). Tracheal damage was successfully established by electrocoagulation in all animals. The experimental group was given CM-chitosan (inhalation for 28 days), while the control group inhaled saline. The effects of CM-chitosan inhalation on tracheal fibrosis were analyzed. Laryngoscopy was performed to evaluate and grade tracheal granulation, while tracheal fibrosis was evaluated by histological examination. The effects of CM-chitosan inhalation on the tracheal mucosa were examined by scanning electron microscopy (SEM), and hydroxyproline content in tracheal scar tissue was determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: Laryngoscopy showed that the tracheal cross-sectional area was smaller in the experimental than control group. The amounts of loose connective tissue and damaged cartilage, as well as the severity of collagen and fibrosis, decreased following inhalation of CM-chitosan. According to the ELISA, the experimental group had low levels of hydroxyproline in the tracheal scar tissue. CONCLUSION: The findings presented here showed that inhalation of CM-chitosan mitigated posttraumatic tracheal fibrosis in a rabbit model, thus suggesting a potential new treatment for tracheal stenosis.
Assuntos
Quitosana , Estenose Traqueal , Animais , Coelhos , Estenose Traqueal/tratamento farmacológico , Estenose Traqueal/etiologia , Cicatriz/etiologia , Hidroxiprolina , FibroseRESUMO
Salinity stress is one of the major abiotic stresses affecting crop growth and production. Rice is an important food crop in the world, but also a salt-sensitive crop, and the rice seedling stage is the most sensitive to salt stress, which directly affects the final yield formation. In this study, two RIL populations derived from the crosses of CD (salt-sensitive)/WD (salt-tolerant) and KY131 (salt-sensitive)/XBJZ (salt-tolerant) were used as experimental materials, and the score of salinity toxicity (SST), the relative shoot length (RSL), the relative shoot fresh weight (RSFW), and the relative shoot dry weight (RSDW) were used for evaluating the degree of tolerance under salt stress in different lines. The genetic linkage map containing 978 and 527 bin markers were constructed in two RIL populations. A total of 14 QTLs were detected on chromosomes 1, 2, 3, 4, 7, 9, 10, 11, and 12. Among them, qSST12-1, qSST12-2, and qRSL12 were co-localized in a 140-kb overlap interval on chromosome 12, which containing 16 candidate genes. Furthermore, transcriptome sequencing and qRT-PCR were analyzed in CD and WD under normal and 120 mM NaCl stress. LOC_Os12g29330, LOC_Os12g29350, LOC_Os12g29390, and LOC_Os12g29400 were significantly induced by salt stress in both CD and WD. Sequence analysis showed that LOC_Os12g29400 in the salt-sensitive parents CD and KY131 was consistent with the reference sequence (Nipponbare), whereas the salt-tolerant parents WD and XBJZ differed significantly from the reference sequence both in the promoter and exon regions. The salt-tolerant phenotype was identified by using two T3 homozygous mutant plants of LOC_Os12g29400; the results showed that the score of salinity toxicity (SST) of the mutant plants (CR-3 and CR-5) was significantly lower than that of the wild type, and the seedling survival rate (SSR) was significantly higher than that of the wild type, which indicated that LOC_Os12g29400 could negatively regulate the salinity tolerance of rice at the seedling stage. The results lay a foundation for the analysis of the molecular mechanism of rice salinity tolerance and the cultivation of new rice varieties.
Assuntos
Oryza , Tolerância ao Sal , Tolerância ao Sal/genética , Oryza/genética , Plântula/genética , Transcriptoma , Salinidade , Análise de SequênciaRESUMO
The role of 5-methylcytosine (m5C) in tumor initiation and progression has been increasingly recognized. However, the precise association between the regulation of m5C and the progression, metastasis, and prognosis of head and neck squamous cell carcinoma (HNSCC) has not yet been fully explored. Data from 545 HNSCC patients obtained from The Cancer Genome Atlas (TCGA) database were analyzed. Unsupervised cluster analysis was conducted using the expression levels of m5C regulatory genes. Additionally, gene set variation analysis (GSVA), single-sample gene set enrichment analysis (ssGSEA), and Cox regression analysis were utilized. Quantitative reverse transcription polymerase chain reaction (RT-qPCR), colony formation assay, transwell experiments and western blots were performed in the HNSCC cell line UM-SCC-17B to assess the expression and functional role of one of the novel signatures, CNFN. Significant expression differences were found in m5C regulatory genes between tumor and normal tissues in HNSCC. Two distinct m5C modification patterns, characterized by substantial prognostic differences, were identified. Cluster-2, which exhibited a strong association with epithelial-mesenchymal transition (EMT), was found to be associated with a poorer prognosis. Based on the m5C clusters and EMT status, differentially expressed genes (DEGs) were identified. Using DEGs, an 8-gene signature (CAMK2N1, WNT7A, F2RL1, AREG, DEFB1, CNFN, TGFBI, and CAV1) was established to develop a prognostic model. The performance of this signature was validated in both the training and external validation datasets, demonstrating its promising efficacy. Furthermore, additional investigations using RT-qPCR on clinical specimens and experimental assays in cell lines provided compelling evidence suggesting that CNFN, one of the genes in the signature, could play a role in HNSCC progression and metastasis through the EMT pathway. This study highlighted the role of m5C in HNSCC progression and metastasis. The relationship between m5C and EMT has been elucidated for the first time. A robust prognostic model was developed for accurately predicting HNSCC patients' survival outcomes. Potential molecular mechanisms underlying these associations have been illuminated through this research.