Systemic inflammation response index predicts the postoperative recurrence of chronic rhinosinusitis with nasal polyps: a retrospective study in the Chinese population.

PURPOSE: Endoscopic sinus surgery (ESS) is now frequently used to treat chronic sinusitis with nasal polyps (CRSwNP), but postoperative recurrence plagues many patients. We aimed to assess the value of the systemic inflammation response index (SIRI) and the systemic immune-inflammatory index (SII) for the prediction of postoperative recurrence in patients with CRSwNP. METHODS: A total of 143 patients with CRSwNP and 76 age- and sex-matched healthy subjects were enrolled. Patients were divided into the recurrence group and the non-recurrence group according to the recurrence of CRSwNP. Univariate and multivariate analyses showed independent risk factors for the recurrence. A receiver operating characteristic curve analysis was conducted to assess the predictive accuracy of the variables and determine the optimal cut-off values. Finally, a survival analysis was conducted. RESULTS: Univariate analysis revealed that age, sex, CRP, EOS, SIRI, SII, NLR, ELR, and Lund-Mackay CT scores were significant predictors of the recurrence of CRSwNP. Multivariate analysis confirmed that SIRI (OR = 1.310, p < 0.001) and Lund-Mackay CT scores (OR = 1.396, p < 0.001) were independent predictors. SIRI (AUC = 0.761, 95% CI: 0.685-0.836) had a certain value in predicting the recurrence of CRSwNP. CONCLUSION: SIRI is a potential predictive marker of the postoperative recurrence of CRSwNP.

Knowledge, attitudes and practices of patients with chronic pharyngitis toward laryngopharyngeal reflux in Suzhou, China.

BACKGROUND: This study aimed to investigate the knowledge, attitudes and practices (KAP) of patients with chronic pharyngitis in Suzhou, China toward laryngopharyngeal reflux (LPR). METHODS: This cross-sectional study was conducted in patients with chronic pharyngitis in Suzhou, China at the otolaryngology outpatient clinic of the First Affiliated Hospital of Soochow University between November, 2022, and May, 2023. Data was collected through a self-designed online questionnaire encompassing the sociodemographic characteristics and three dimensions of KAP. The questionnaire was administered using SoJump, and data were exported from this platform. Subsequently, statistical analysis, including Structural Equation Modeling, was performed using SPSS 22 software to evaluate the KAP scores. RESULTS: A total of 487 valid questionnaires were collected, with 275 (56.35%) female patients. The mean score of KAP were 4.76 ± 2.93 (possible range: 0-11), 33.10 ± 4.46 (possible range: 8-40), 31.29 ± 6.04 (possible range: 8-40), respectively. Pearson's correlation analysis showed significant positive correlations between knowledge and attitude dimensions (r = 0.413, P < 0.001), knowledge and practice dimensions (r = 0.355, P < 0.001), and attitude and practice dimensions (r = 0.481, P < 0.001). Structural equation modeling revealed that education exhibited positive effect on knowledge (ß = 0.476, P < 0.001) and attitude (ß = 0.600, P < 0.001), and having family history of chronic pharyngitis showed positive effect on knowledge (ß = 0.580, P = 0.047), experienced with reflux symptoms showed positive effect on knowledge (ß = 0.838, P = 0.001) and attitude (ß = 0.631, P = 0.085). Moreover, knowledge showed positive effect on attitude (ß = 0.555, P < 0.001) and practice (ß = 0.351, P < 0.001). Attitude, in turn, showed positive effect on practice (ß = 0.511, P < 0.001). CONCLUSION: Patients with chronic pharyngitis had inadequate knowledge, positive attitudes and suboptimal practices toward LPR. Education, family history of chronic pharyngitis, experienced with reflux symptoms might have effect on their KAP.

Enhanced effect of recombinant adenoviruses co-expression of ING4 and OSM on anti-tumour activity of laryngeal cancer.

The inhibitor of growth family member 4 (ING4) is one of the ING family genes, serves as a repressor of angiogenesis or tumour growth and suppresses loss of contact inhibition. Oncostatin M (OSM) is a multifunctional cytokine that belongs to the interleukin (IL)-6 subfamily with several biological activities. However, the role of recombinant adenoviruses co-expressing ING4 and OSM (Ad-ING4-OSM) in anti-tumour activity of laryngeal cancer has not yet been identified. Recombinant Ad-ING4-OSM was used to evaluate their combined effect on enhanced anti-tumour activity in Hep-2 cells of laryngeal cancer in vivo. Moreover, in vitro function assays of co-expression of Ad-ING4-OSM were performed to explore impact of co-expression of Ad-ING4-OSM on biological phenotype of laryngeal cancer cell line, that is Hep-2 cells. In vitro, Ad-ING4-OSM significantly inhibited the growth, enhanced apoptosis, altered cell cycle with G1 and G2/M phase arrest, and upregulated the expression of P21, P27, P53 and downregulated survivin in laryngeal cancer Hep-2 cells. Furthermore, in vivo functional experiments of co-expressing of Ad-ING4-OSM demonstrated that solid tumours in the nude mouse model were significantly suppressed, and the co-expressing Ad-ING4-OSM showed a significant upregulation expression of P21, P53, Bax and Caspase-3 and a downregulation of Cox-2, Bcl-2 and CD34. This study for the first time demonstrated the clinical value and the role of co-expressing Ad-ING4-OSM in biological function of laryngeal cancer. This work suggested that co-expressing Ad-ING4-OSM might serve as a potential therapeutic target for laryngeal cancer patients.

Expression and functional implications of YME1L in nasopharyngeal carcinoma.

Mitochondria play a crucial role in the progression of nasopharyngeal carcinoma (NPC). YME1L, a member of the AAA ATPase family, is a key regulator of mitochondrial function and has been implicated in various cellular processes and diseases. This study investigates the expression and functional significance of YME1L in NPC. YME1L exhibits significant upregulation in NPC tissues from patients and across various primary human NPC cells, while its expression remains relatively low in adjacent normal tissues and primary nasal epithelial cells. Employing genetic silencing through the shRNA strategy or knockout (KO) via the CRISPR-sgRNA method, we demonstrated that YME1L depletion disrupted mitochondrial function, leading to mitochondrial depolarization, reactive oxygen species (ROS) generation, lipid peroxidation, and ATP reduction within primary NPC cells. Additionally, YME1L silencing or KO substantially impeded cell viability, proliferation, cell cycle progression, and migratory capabilities, concomitant with an augmentation of Caspase-apoptosis activation in primary NPC cells. Conversely, ectopic YME1L expression conferred pro-tumorigenic attributes, enhancing ATP production and bolstering NPC cell proliferation and migration. Moreover, our findings illuminate the pivotal role of YME1L in Akt-mTOR activation within NPC cells, with Akt-S6K phosphorylation exhibiting a significant decline upon YME1L depletion but enhancement upon YME1L overexpression. In YME1L-silenced primary NPC cells, the introduction of a constitutively-active Akt1 mutant (caAkt1, at S473D) restored Akt-S6K phosphorylation, effectively ameliorating the inhibitory effects imposed by YME1L shRNA. In vivo studies revealed that intratumoral administration of YME1L-shRNA-expressing adeno-associated virus (AAV) curtailed subcutaneous NPC xenograft growth in nude mice. Furthermore, YME1L downregulation, concurrent with mitochondrial dysfunction and ATP reduction, oxidative injury, Akt-mTOR inactivation, and apoptosis induction were evident within YME1L-silenced NPC xenograft tissues. Collectively, these findings shed light on the notable pro-tumorigenic role by overexpressed YME1L in NPC, with a plausible mechanism involving the promotion of Akt-mTOR activation.

CircHIPK2 promotes proliferation of nasopharyngeal carcinoma by down-regulating HIPK2.

Background: Circular RNAs (circRNAs) are a new family of endogenous non-coding RNAs generated by a covalently closed loop, and a mounting body of data suggests they control gene expression. While the circRNA-homeodomain-interacting protein kinase-2 (circHIPK2) is generated from the homeodomain-interacting protein kinase 2 (HIPK2) gene, the function of circHIPK2 in nasopharyngeal cancer (NPC) along with the responsible mechanisms are still unclear. Methods: RNA-sequencing data was utilized to determine the differentially expressed circRNAs, and circHIPK2 was established as a novel prospective circRNA. The expressions of circRNAs along with messenger RNAs (mRNAs) in NPC tissues and cells was assessed via quantitative real-time polymerase chain reaction (qRT-PCR), and the transfection of NPC cells with plasmids in vitro and in vivo was adopted to explore the effects of circHIPK2 in NPC. Western blotting was adopted to assess the expressions of HIPK2 and ß-catenin, while Cell Counting Kit (CCK)-8 assay coupled with colony-forming assay were utilized to assess the biological functions. The expression of nuclear and cytoplasmic HIPK2 was detected via nucleocytoplasmic separation assay. Results: Herein, we established that circHIPK2 was upregulated in NPC tissues. Over-expression of circHIPK2 promoted cell proliferation in vitro and in vivo, and further studies revealed it inhibited the protein level of HIPK2 in a post-transcriptional pattern, decreasing ß-catenin expression and suppressing the proliferation of NPC. Conclusions: Our findings demonstrated elevated circHIPK2 facilitated the cell proliferation of NPC cells via the circHIPK2/HIPK2 axis, suggesting circHIPK2 might be an oncogene to promote the process of NPC and could be a novel treatment target for its management.

miR-141-3p promotes proliferation and metastasis of nasopharyngeal carcinoma by targeting NME1.

PURPOSE: This study aimed to investigate the expression and biological function of miR-141-3p in nasopharyngeal carcinoma (NPC) via targeting neoplasm metastasis 1 (NME1). MATERIALS AND METHODS: The expression of miR-141-3p and NME1 in 5-8F, C666-1, CNE-1, CNE-2, 6-10B and NP69 nasopharyngeal epithelial cells were detected using real-time Polymerase Chain Reaction (real-time PCR) and western blot, respectively. Cell proliferation was detected using Cell Counting Kit-8 (CCK-8), and the metastasis was detected using Transwell. The binding of miR-141-3p to NME1 was detected by dual luciferase reporter gene detection system. The effects of miR-141-3p on tumor growth were also determined in vivo. RESULTS: The results showed that the expression of miR-141-3p significantly increased in various tumor cell lines and the expression of NME1 was higher in NP69 cells and lower in 5-8F cells, which had significant negative correlation. Furthermore, the expression of NME1 was significantly reduced after transfection of miR-141-3p and miR-141-3p promoted cell proliferation and metastasis. The double luciferase reporter gene detection system confirmed that NME1 was the target gene of miR-141-3p. Knockout of NME1 promoted the proliferation and metastasis of NP69 or 6-10B cells and the activation of p-Akt, which were abrogated by miR-141-3p. In vivo, the tumor volumes and weights in the miR-141-3p group significantly increased followed by down-regulation of NME1 and activation of p-Akt. CONCLUSIONS: We confirmed that miR-141-3p promotes the proliferation and metastasis of NPC by targeting NME1.

[Endoscopic reconstruction skull base using pedicled nasoseptal flap and its anatomy measurement].

OBJECTIVE: The harvesting procedures on cadaver heads and a radioanatomic study of measuring dimensions of skull base by endoscopic endonasal approach were performed. The measurements could do help to design the nasoseptal mucoperiosteum and improve the rate of repair success. METHOD: The surgical procedures were demonstrated on cadaver heads specimens. Then 20 adult CT scans of sinus and skull base were calculated by workstations. The dimensions of three different skull base (the defect of anterior skull base/cribriform plate approach, sellar region/planum sphenoidale region and clivus region) of maximum areas, length and width, were measured. And with these data the nasoseptal flap were designed for providing enough area to cover the defect. The distance from the projection of sphenopalatine foramen to related area of skull base were plused for obtaining desired the length of nasoseptal flap. RESULT: The mean length from the projection of sphenopalatine to the anterior skull base, planum/sella area and clivus were 49.56 mm, 57.47 and 67.19 mm, respectively. The means of areas of anterior dural defect, transsellar defect and panclivectomy were 16.13 cm2, 14.03 cm2 and 13.12 cm2, respectively. The average length of the nasoseptal flap ranged between 64.71-65.93 mm, the width ranged between 28.57-30.95 mm with an average area of 22.95 cm2. CONCLUSION: One side of nasal septal flap can provide enough area to reconstruct the anterior skull base and planum/sella area. In some cases, the flap can not completely cover the area of clivus region because of the limitation of its length.

[Reconstruction of external nose defect with local flaps].

OBJECTIVE: The role of different local flaps in small external nasal skin defect reconstruction was discussed. METHOD: Forty-two cases of the small size nasal defects (diameter < 2 cm) were repaired with local external nose flap (includes the dorsal nasal flap, nasolabial flap and bilobed flap). The clinical and follow-up data were analyzed of patients with small external nasal skin defects, who accepted different local flaps reconstruction. Dorsal nasal flap, nasolabial flaps (includes island flap, slid flap and axial flap) and bilobed flap were tailored to reconstruct different external nasal defect. Twenty-seven patients were male and fifteen patients were female, the patients' age ranged from 28 to 74 years, the median age was 61 years. Thirty-eight cases resulted from resection of skin malignant tumor and four cases were benign lesions. The diameter of defects was 1-2 cm. The defects were reconstructed by single-stage dorsal nasal flap in 7 cases. There were 30 cases of caudolateral nasal defects were reconstructed by nasolabial flap, single-stage island nasolabial flap in 7 cases, axial flap in 18 cases and slid flap in 5 cases. Superior lateral defects were reconstructed by single-stage bilobed flap in 5 cases. RESULT: All defects were repaired successfully. All tissue flaps survived and had not necrosis. There was no tumor recurrence during 3 months to 2 years follow-up. CONCLUSION: The dorsal nasal flap, nasolabial flap and bilobed flap can be used safely and effectively to repair the small external nasal defect and have satisfactory curative effect.

[The role of MR and endoscopy in postoperative management of skull base reconstruction by vascular pedicle septal flap].

OBJECTIVE: To explore the significance of MR and endoscopy in the postoperative management of skull base reconstruction with a vascular pedicle nasoseptal mucoperiosteal flap. METHOD: The immediate, and delayed postoperative MR imaging scans and endoscopic data of 8 patients who underwent endonasal endoscopic reconstruction of skull base dural defects with a vascular pedicle nasoseptal mucoperiosteal flap were retrospectively studied. Among the 8 patients, 7 cases have integrated immediate, delayed postoperative MR and synchronous endoscopic data which were harvest at the first week and at a 3- to 7-month interval respectively. One case was followed up by CT and endoscopy. The intracranial parenchymal changes, local situation of skull base defect site, the septal flap, healing of flap donor site and the transition of naso sinus mucosa were fully evaluated to explore the healing process and to improve the success rate of the reconstruction. RESULT: We can obtain the key postoperative information of intracranial and the skull base reconstruction site with MR and endoscopy. The MR can exclude the intracranial complications such as postoperative intracranial hematoma, cerebral edema, or pneumocephalus, and clearly show the location and extent of skull base defects, the position of the flap, the overlapping manner between the dural defect margin and the flap and the postoperative cerebrospinal fistula. In immediate and postoperative follow-up with MR, the septal flap had homogeneous enhanced image with a roughly "C" figure under the skull base, indicating stable blood supplement. The synchronous endoscopic examination also proved the survival of the septal flaps in 7 cases , the cerebrospinal fluid leakage in 1 case. One case flap necrosis. The septal flaps presented edema and congested in the immediate postoperative endoscopy, and returned to normal in the delayed examination. The non-vascular materials such as gelatin sponge and fat tissue had the different characteristics signal. Nasal mucosal edema and sinus ventilation continually recovered during the follow up and the exposed septal cartilage on the donor site resurfaced by mucosa in 2 months. CONCLUSION: MR and endoscopy could provide the critical postoperative information about the vascular pedicle septal flap reconstruction. MR combined with endoscopy not only could rule out the complications, but also could gain the information such as the position, blood supply and healing of the flap, at the same time detected the cerebrospinal fluid leakage to provide accurate information for the secondary stage reconstruction. The information got from MR and endoscopy were important for the surgeon and the radiologist to recognize the flap and to evaluate for variations that may suggest potential flap failure.

[Reconstruction of large external nose defect with forehead flap].

OBJECTIVE: To discuss the role of forehead flap in large external nasal defect reconstruction. METHOD: We retrospectively reviewed the clinical and follow-up data of 11 patients with large or full-thickness external nasal defects, which were reconstructed with single-or two-stage interpolated or island forehead flaps from January 2007 to June 2011. All patients were male,defects of 9 cases were resulted from resection of skin malignant tumor and traumatic defect in 2 cases. The average diameter of defects was 3.3 cm (2.5-5.0 cm). Four cases had alar full thickness defect. The supratrochlear and angular artery of the elders (>70 yrs) and patients with suspicious peripheral blood vessel lesions were scanned before the surgery by Doppler ultrasonic. The defects were reconstructed by two-stage interpolated flap in 7 cases; five cases were reconstructed by single-stage island flap technique. A nasolabial flap based on piriform aperture was turned into the nasal cavity to reconstruct the lining. RESULT: All defects were repaired successfully. All tissue flap survived and the scar was not conspicuous. One patient had nostril stenosis with mild nasal congestion complain at the 6th postoperative month. CONCLUSION: The forehead flap, interpolated or island, can be used safely and effectively to repair the large external nasal defect in experienced hands.