Predictors for Difficult Laryngeal Exposure in Suspension Laryngoscopy: A Systematic Review and Meta-Analysis.

Objectives/Hypothesis: Many researchers have investigated parameters that could independently predict difficult laryngeal exposure (DLE) in suspension laryngoscopy; however, inconsistent results and conclusions have been reported in previous studies. We conducted a meta-analysis of the existing literature to determine the parameters that are significant for a standardized preoperative DLE prediction system. Methods: The literature was retrieved systematically from PubMed, Embase, Web of Science, China national knowledge infrastructure (CNKI), and Wangfang until October 2022. In eligible studies, data were extracted and analyzed using the R language, and effective measures were odds ratios with 95% confidence intervals (CIs) for dichotomous variables and mean differences (MD) with 95% CIs for continuous variables. Results: The search yielded 1574 studies, of which eighteen involving 2263 patients were included. Pooled analysis demonstrated that patients with DLE during microsurgery are often men (OR =1.73, 95% CI = [1.16, 2.57]); older age (MD = 5.47 years, 95% CI = [2.44, 8.51]); high body mass index (BMI; MD = 1.19Kg/m2, 95% CI = [0.33, 2.05]); bullnecked (MD =2.50cm, 95% CI = [1.56, 3.44]); limited mouth opening (MD = -0.52cm, 95% CI = [-0.88, -0.15]); limited neck flexibility (MD = -10.05cm, 95% CI = [-14.10,-6.00]); specific anatomical characteristics; and modified Mallampati's index or test (OR = 3.37, 95% CI = [2.07, 5.48]). Conclusion: Our study made a comprehensive and systematic analysis of The DLE relevant factors. Gender, age, body mass index(BMI), neck circumference (NC), modified Mallampati's index(MMI), inter-incisor gap(IIG), hyoid-mental distance (HMD), thyroid-mental distance (TMD), sterno-mental distance (SMD), and flexion-extension angle were eventually identified as highly correlated factors for DLE.

Allergic Diseases and Chronic Adenotonsillar Diseases: A Mendelian Randomization Study.

OBJECTIVE: The existing epidemiological evidence regarding the intricate relationship between allergic diseases and chronic adenotonsillar diseases (CATD) remains inconclusive. Herein, the objective of our study is to explore the causal association using Mendelian randomization (MR). METHODS: Employing data from large genome-wide association studies, a comprehensive two-sample bidirectional MR study was conducted. The studied traits encompassed allergic rhinitis (cases n = 9707, controls n = 331173), allergic asthma (cases n = 8525, controls n = 193857), allergic conjunctivitis (cases n = 18321, controls n = 324178), atopic dermatitis (cases n = 11964, controls n = 306909), and CATD (cases n = 38983, controls n = 258553). All the patients were of European descent and participants in cohort studies. The primary analysis was executed using inverse-variance-weighted MR. Furthermore, six additional MR methods (MR-Egger, weighted median, simple mode, weighted mode, MR pleiotropy residual sum and outlier, MR robust adjusted profile score) were employed to ensure the reliability and detect potential horizontal pleiotropy within the results. The estimates obtained from the MR analysis were factored into the overall effect calculation. RESULTS: Genetically anticipated outcomes demonstrated a significant association between CATD risk and allergic rhinitis (OR = 1.141, p = 6.30E-06), allergic asthma (OR = 1.115, p = 8.31E-05), allergic conjunctivitis (OR = 1.197, p = 8.69E-07), and a suggestive association with atopic dermatitis (OR = 1.053, p = 0.040). However, no substantial correlation was observed in the reverse direction. CONCLUSIONS: Findings of our study provide evidence supporting a causal role of allergic diseases in the development of CATD, whereas the converse relationship does not appear to hold true. LEVEL OF EVIDENCE: 3 Laryngoscope, 2024.

Total thyroidectomy versus unilateral lobectomy for unilateral multifocal papillary thyroid carcinoma: systematic review and meta­analysis.

The optimal surgical procedure(s) for unilateral multifocal papillary thyroid carcinomas is currently controversial. As such, the present study aimed to compare the efficacies of total thyroidectomy and lobectomy in patients with unilateral multifocal papillary thyroid carcinoma. A literature search of the PubMed/Medline, Embase, Web of Science, Cochrane Library, Wan Fang, and Zhi Wang databases for relevant studies, published from inception to October 31, 2022, was performed. Two researchers independently extracted data from the included studies. Lymph node metastasis, vocal fold paralysis, parathyroid injury, postoperative recurrence, and disease-free survival were evaluated. The meta-analysis included 7 studies comprising 1540 patients, of whom 496 and 1044 underwent lobectomy and total thyroidectomy, respectively. Compared with lobectomy, total thyroidectomy resulted in more vocal cord paralysis (odds ratio [OR] 0.35 [95% confidence interval (CI) 0.13 to 0.96]; P = 0.04) and parathyroid injury (OR 0.11 [95% CI 0.03-0.39]; P = 0.001) but with better disease-free survival (OR 0.21 [95% CI 0.09-0.49]; P = 0.000), although vocal cord paralysis and parathyroid injury, in large part, resolved within 1 year after surgery. In addition, there was no difference in postoperative lymph nodes metastasis (OR 0.74 [95% CI 0.13-4.21]; P = 0.737) and postoperative recurrence (OR 2.37 [95% CI 0.42-13.38]; P = 0.33). Excluding studies that deviated from the general trend, total thyroidectomy was beneficial in reducing recurrence. Compared with lobectomy, total thyroidectomy was beneficial in reducing recurrence and disease-free survival and may be considered a more optimal approach for unilateral multifocal papillary thyroid carcinoma.

Adenosine Triphosphate-Activated Cascade Reactor for On-Demand Antibacterial Treatment Through Controlled Hydroxyl Radical Generation.

Nanozymes have shown promise for antibacterial applications, but their effectiveness is often hindered by low catalytic performances in physiological conditions and uncontrolled production of hydroxyl radicals (·OH). To address these limitations, a comprehensive approach is presented through the development of an adenosine triphosphate (ATP)-activated cascade reactor (GGPcs). The GGPcs reactor synergistically combines the distinct properties of zeolitic imidazolate framework-8 (ZIF-8) and chitosan-integrated hydrogel microsphere. The ZIF-8 allows for the encapsulation of G-quadruplex/hemin DNAzyme to achieve ATP-responsive ·OH generation at neutral pH, while the hydrogel microsphere creates a confinement environment that facilitates glucose oxidation and provides a sufficient supply of H2 O2 . Importantly, the integrated chitosan in the hydrogel microsphere shields ZIF-8 from undesired disruption caused by gluconic acid, ensuring the responsive specificity of ZIF-8 toward ATP. By activating GGPcs with ATP secreted by bacteria, its effectiveness as an antibacterial agent is demonstrated for the on-demand treatment of bacterial infection with minimal side effects. This comprehensive approach has the potential to facilitate the design of advanced nanozyme systems and broaden their biological applications.

Transoral robotic surgery vs. non-robotic surgeries for oropharyngeal squamous cell carcinoma: systematic review and meta-analysis.

To compare the effectiveness of transoral robotic surgery (TORS) and non-robotic surgeries (NRES) in patients with oropharyngeal squamous cell carcinoma (OPSCC), medical databases were searched including PubMed, Web of Science, Medline, Embase, and Cochrane Library up to January 2023. The methodology follows PRISMA guidelines, including the PRISMA flow diagram. Data from the included studies were extracted independently by two researchers. Seven studies involving five hundred seventy-seven patients were included. Of these, 275 underwent TORS and 302 underwent NRES. The disease-free survival rate was significantly higher in the TORS group than in the NRES group (OR = 3.43, 95% CI 1.92-6.15, P < 0.0001). However, there were no significant differences in positive surgical margins, hospital stays, operation time, blood loss, postoperative bleeding rate, perioperative tracheostomy, perioperative feeding tube, and overall survival rate. These findings can initially guide the preoperative counseling of TORS in patients with OPSCC, and preliminarily confirm that the adoption of TORS deserves careful consideration.

Modifiable factors for benign salivary gland neoplasms: A Mendelian randomization study.

BACKGROUND: Observational studies have found associations between smoking, alcohol, radiation, body mass index (BMI), periodontitis, and the hazard of benign salivary gland neoplasms (BSGNs). Nevertheless, the etiology of BSGNs remains unclear. This study aims to assess the causal association between these modifiable factors and the BSGNs. METHODS: Genetic instruments associated with exposures at the genome-wide significance level were selected from corresponding genome-wide association studies. The summary statistics for BSGNs were obtained from the FinnGen consortium (2445 cases and 340,054 controls). The inverse variance-weighted method was used as the primary analysis, and several sensitivity analyses were performed to test the reliability. RESULTS: Genetically predicted higher lifetime smoking index (odds ratio [OR] = 2.10, p = 0.012) and BMI (OR = 1.58, p = 2.29 × 10-5 ) were associated with elevated risk of BSGNs, whereas other exposures do not. Sensitivity analyses showed consistency. The causal effect of the lifetime smoking index became more significant after adjusting for BMI (OR = 2.89, p = 0.005) and alcohol consumption (OR = 2.49, p = 0.002). A slight negative association emerged for alcohol consumption with adjustment for cigarettes per day (OR = 0.53, p = 0.034) but disappeared when adjusting for cigarettes per day and BMI. CONCLUSION: This study supports the independent causal role of lifetime smoking index and BMI in BSGNs risk.

The Prognostic Model Established by the Differential Expression Genes Based on CD8+ T Cells to Evaluate the Prognosis and the Response to Immunotherapy in Osteosarcoma.

Osteosarcoma (OS) is a malignant tumor with an extremely poor prognosis, especially in progressive patients. Immunotherapy based on immune checkpoint inhibitors (ICIs) is considered to be a promising treatment option for OS. Due to tumor heterogeneity, only a minority of patients benefit from immunotherapy. Therefore, it is urgent to explore a model that can accurately assess the response of OS to immunotherapy. In this study, we obtained the single-cell RNA sequencing datasets of OS patients from public databases and defined 34 cell clusters by dimensional reduction and clustering analysis. PTPRC was applied to identify immune cell clusters and nonimmune cell clusters. Next, we performed clustering analysis on the immune cell clusters and obtained 25 immune cell subclusters. Immune cells were labeled with CD8A and CD8B to obtain CD8+ T cell clusters. Meanwhile, we extracted the differentially expressed genes (DEGs) of CD8+ T cell clusters and other immune cell clusters. Furthermore, we constructed a prognostic model (CD8-DEG model) based on the obtained DEGs of CD8+ T cells, and verified the excellent predictive ability of this model for the prognosis of OS. Moreover, we further investigated the value of the CD8-DEG model. The results indicated that the risk score of the CD8-DEG model was an independent risk factor for OS patients. Finally, we revealed that the risk score of the CD8-DEG model correlates with the immune profile of OS and can be used to evaluate the response of OS to immunotherapy. In conclusion, our study revealed the critical role of CD8 cells in OS. The risk score model based on CD8-DEGs can provide guidance for prognosis and immunotherapy of OS.

Boron-Assisted Selective Citrulline Modification under Mild Conditions.

Protein citrullination is one type of protein post-translational modification. Previous methods entail the use of a strongly acidic condition (pH <1), which impedes its exploration under physiological and pathological conditions. Here, we developed a biocompatible method based on o-boron-assisted citrulline modification. We demonstrated that this method enables selective and mainly irreversible modification of citrulline residues under neutral conditions. We expect that it will provide a valuable tool for the study of protein citrullination.

Adenosine triphosphate-activated prodrug system for on-demand bacterial inactivation and wound disinfection.

The prodrug approach has emerged as a promising solution to combat bacterial resistance and enhance treatment efficacy against bacterial infections. Here, we report an adenosine triphosphate (ATP)-activated prodrug system for on-demand treatment of bacterial infection. The prodrug system benefits from the synergistic action of zeolitic imidazolate framework-8 and polyacrylamide hydrogel microsphere, which simultaneously transports indole-3-acetic acid and horseradish peroxidase in a single carrier while preventing the premature activation of indole-3-acetic acid. The ATP-responsive characteristic of zeolitic imidazolate framework-8 allows the prodrug system to be activated by the ATP secreted by bacteria to generate reactive oxygen species (ROS), displaying exceptional broad-spectrum antimicrobial ability. Upon disruption of the bacterial membrane by ROS, the leaked intracellular ATP from dead bacteria can accelerate the activation of the prodrug system to further enhance antibacterial efficiency. In vivo experiments in a mouse model demonstrates the applicability of the prodrug system for wound disinfection with minimal side effects.

Erratum to "Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway".

[This corrects the article DOI: 10.1515/med-2022-0453.].

Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway.

The activation of signaling pathways induced by Toll-like receptor (TLR) has been demonstrated to play essential roles in multiple liver diseases. Toll-interacting protein (Tollip) acts as an endogenous negative modulator of TLR signaling and is implicated in various cardio-metabolic diseases. However, the effect of Tollip in hepatocellular carcinoma (HCC) remains elusive. In the current study, enhanced Tollip expression was observed in HCC cells and tissues examined by RT-PCR, western blot, and immunohistochemistry staining. Moreover, the co-immunofluorescence staining demonstrated that increased Tollip expression was primarily located in hepatocytes. Functionally, Tollip overexpression significantly increased proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of HCC cells, which ultimately accelerated tumorigenesis. Mechanistically, Tollip overexpression dramatically promoted the activation of PI3K/AKT signaling pathway in HCC cells which was attenuated by Tollip silencing. Importantly, the inhibition of PI3K/AKT axis can abolish the promoted effects of Tollip on proliferation and EMT of HCC cells. Our current study demonstrated that Tollip played an important role in the regulation of HCC development by engaging PI3K/AKT signaling pathway. These evidences suggested that the blockade of Tollip-PI3K/AKT axis was an ideal therapeutic treatment for management of HCC.

Effects of Cardiopulmonary Rehabilitation Promotion Mode Intervention Combined with Oxygen Therapy on Cardiopulmonary Function and Blood Gas Analysis Indexes of COPD Patients with Cor Pulmonale.

Chronic obstructive pulmonary disease is a common respiratory disease. This paper observes the effects of cardiopulmonary rehabilitation promotion mode intervention combined with oxygen therapy on cardiopulmonary function and blood gas analysis indexes in patients with chronic obstructive pulmonary disease (COPD) complicated with cor pulmonale. A total of 136 COPD patients with cor pulmonale admitted to our hospital from July 2018 to October 2020 were selected as the research objects and divided into two groups by a simple random method. 136 patients are given oxygen therapy while the traditional group and cardiopulmonary rehabilitation group are given traditional mode and cardiopulmonary rehabilitation promotion mode intervention. Cardiopulmonary rehabilitation promotion mode intervention combined with oxygen therapy can improve the cardiopulmonary function of COPD patients with cor pulmonale, regulate the expression of related serum factors, improve self-care ability, and reduce the number of hospitalizations.

Comparison of the effectiveness and safety of unilateral and bilateral percutaneous vertebroplasty for osteoporotic vertebral compression fractures: A protocol for systematic review and meta-analysis.

BACKGROUND: The objective of this study was to compare the efficacy of lateral and bilateral percutaneous vertebroplasty (PVP) in treating osteoporotic vertebral compression fractures (OVCFs). METHODS: A comprehensive literature search was performed using PubMed, Cochrane Library, EMBASE, CMB, CNKI, Wanfang, and VIP databases between January 2014 and December 2020. The clinical efficacy of the 2 approaches was evaluated by comparing perioperative outcomes (operation time, X-ray exposure time, volume of injected cement), clinical outcomes (degree of vertebral height restoration, improvement of Cobb angle, visual analogue scale score, and Oswestry Disability Index scores), and operation-related complications (rate of cement leakage, adjacent vertebral fracture rate, and nerve root stimulation). Data were analyzed using RevMan 5.3.3 and Stata 15.1. RESULTS: A total of 237 related articles were retrieved, and 17 randomized controlled trials were included. Meta-analysis results showed that compared to bilateral PVP, unilateral PVP led to decreased operation times (mean difference [MD] = -15.24, 95% confidence interval [CI]: [-17.77, -12.70], P < .05), decreased X-ray exposure time (MD-8.94, 95% CI[-12.08,-5.80]; P < .01), decreased volumes of injected cement (MD-1.57, 95% CI[-2.00,-1.14]; P < .05), and lower incidence of cement leakage (risk ratio [RR] = 0.6,95% CL[0.48,0.77], P < .01). Patients that underwent unilateral PVP experienced more effective pain relief at the last follow-up (MD-0.09, 95% CI [-0.15,-0.03];P=.006 < .05) and had a low degree of vertebral height restoration (MD-0.38, 95% CL [-0.71, -0.06]; P=.02 < .05). However, no differences in adjacent vertebral fractures (RR 1.19, 95% CI [0.78,1.82]; P = .41 > .01), nerve root stimulation (RR 1.98, 95% CI [0.22, 17.90]; P = .54 > .01), improvement of Cobb angle (MD = -0.18, 95% CI [-0.49, 0.13], P = .26 > .01), and improvement of ODI score (MD = 0.22, 95% CI[-0.37, 0.80], P > .05) were found between the 2 approaches. CONCLUSIONS: Although both unilateral and bilateral PVP can improve the quality of life of this patient population by managing pain effectively, unilateral PVP offers more benefits, including shorter operation time and less fluoroscopy, and should be recommended in clinical practice for OVCFs.

miR-3187-3p enhances migration and invasion by targeting PER2 in head and neck squamous cell carcinomas.

Invasion and metastasis are major contributors to treatment failure in patients with head and neck squamous cell carcinomas (HNSCCs) and microRNAs (miRNAs) are reported to play important roles in tumor progression. Our study therefore try to find the crucial miRNAs and reveal their molecular and functional mechanisms involved in migration and invasion of HNSCCs. Through The Cancer Genome Atlas (TCGA) data analysis, we screened out miR-3187-3p and its biological function and specific mechanism were further analyzed. The wound-healing and transwell invasion assay demonstrated that miR-3187-3p promoted the capacity of migration and invasion of HNSCCs in vitro. Luciferase reporter assays showed that PER2 was a direct target of miR-3187-3p, which could reverse the effect of miR-3187-3p in HNSCCs. Furthermore, we found that miR-3187-3p / PER2 axis activated the Wnt / ß-catenin signaling pathway in HNSCCs. Altogether, our study indicated that miR-3187-3p enhanced migration and invasion by targeting PER2 in HNSCCs.

Comprehensive analysis of ubiquitin-proteasome system genes related to prognosis and immunosuppression in head and neck squamous cell carcinoma.

The ubiquitin-proteasome system (UPS) with a capacity of degrading multiple intracellular proteins is an essential regulator in tumor immunosurveillance. Tumor cells that escape from recognition and destruction of immune system have been consistently characterized an important hallmark in the setting of tumor progression. Little know about the exact functions of UPS-related genes (UPSGs) and their relationships with antitumor immunity in head and neck squamous cell carcinoma (HNSCC) patients. In this study, for the first time, we comprehensively identified 114 differentially expressed UPSGs (DEUPSGs) and constructed a prognostic risk model based on the eight DEUPSGs (BRCA1, OSTM1, PCGF2, PSMD2, SOCS1, UCHL1, UHRF1, and USP54) in the TCGA-HNSCC database. This risk model was validated using multiple data sets (all P < 0.05). The high-risk score was found to be an independently prognostic factor in HNSCC patients and was significantly correlated with T cells suppression. Accordingly, our risk model can act as a prognostic signature and provide a novel concept for improving the precise immunotherapy for patients with HNSCC.

Virtual Reality Technology Combined with Comprehensive Pulmonary Rehabilitation on Patients with Stable Chronic Obstructive Pulmonary Disease.

With the popularization of medical knowledge and the development of medical technology, people pay more and more attention to COPD. This paper mainly studies the effect of virtual reality technology combined with comprehensive lung rehabilitation on patients with stable chronic obstructive pulmonary disease. 60 patients with stable chronic obstructive pulmonary disease were selected to collect their general information, such as name, gender, and age. They were divided into the experimental group and control group, 30 patients in each group. The experimental group was treated with virtual reality technology combined with lung rehabilitation, while the control group was treated with conventional rehabilitation. Patients in both groups needed medication and participated in a 30-minute disease description activity once a week. In addition, patients in the control group should walk for 20 minutes every day to monitor muscle fatigue. Breathing exercises are also carried out regularly. Patients are instructed to use their lips and abdomen for 5 minutes each time. The respiratory rate was 7 beats per minute. In addition to the routine training of the control group, the experimental group will also train the simulated bicycle for 20 minutes, which will be automatically saved on the computer after the training. After the experiment, the muscle function and motor ability of the two groups were evaluated, and the results were statistically analyzed. The total self-efficacy scores of patients before and after telemedicine technical support increased significantly (2.15 ± 0.21 before telemedicine technical support, 2.39 ± 0.20 after telemedicine technical support), and the difference was statistically significant (P < 0.05). The results show that the application of virtual reality technology can improve the rehabilitation belief of patients and strengthen the training effect.

Comprehensive Analysis of Myeloid Signature Genes in Head and Neck Squamous Cell Carcinoma to Predict the Prognosis and Immune Infiltration.

Myeloid cells are a major heterogeneous cell population in the tumor immune microenvironment (TIME). Imbalance of myeloid response remains a major obstacle to a favorable prognosis and successful immune therapy. Therefore, we aimed to construct a risk model to evaluate the myeloid contexture, which may facilitate the prediction of prognosis and immune infiltration in patients with head and neck squamous cell carcinoma (HNSCC). In our study, six myeloid signature genes (including CCL13, CCR7, CD276, IL1B, LYVE1 and VEGFC) analyzed from 52 differentially expressed myeloid signature genes were finally pooled to establish a prognostic risk model, termed as myeloid gene score (MGS) in a training cohort and validated in a test cohort and an independent external cohort. Furthermore, based on the MGS subgroups, we were able to effectively identify patients with a poor prognosis, aggressive clinical parameters, immune cell infiltration status and immunotherapy response. Thus, MGS may serve as an effective prognostic signature and predictive indicator for immunotherapy response in patients with HNSCC.

Willingness to receive SARS-CoV-2 vaccine among healthcare workers in public institutions of Zhejiang Province, China.

This study aims to investigate healthcare workers' (HCWs) willingness to receive SARS-CoV-2 vaccine in Zhejiang and to discover the related influential factors. The survey was conducted in six regions of Zhejiang Province, China, and 13 hospitals and 12 Centers for Disease Control and Prevention (CDC) were incorporated into the survey research. Participants were healthcare workers and a total of 3726 questionnaires were collected online, of which 3634 (97.53%) were analyzed. The relationships between the factors and the willingness to get vaccinated against COVID-19 were computed as odds ratios (ORs) by means of multi-factor non-conditional logistic regression analysis. Of the 3634 participants, 2874 (79.09%) HCWs expressed their willingness to get vaccinated if the SARS-CoV-2 vaccine becomes available. Respondents who were younger than 50 years (OR = 1.502, 95% CI: 1.047-2.154), those who believed that they were somewhat likely (OR = 1.658, 95% CI: 1.297-2.120) or likely (OR = 1.893, 95% CI: 1.334-2.684) to get infected by SARS-COV-2 and those with a positive attitude toward the SARS-CoV-2 vaccine were more willing to get vaccinated. Furthermore, compared to doctors, nurses were more reluctant to get vaccinated. In addition, it was found that higher the education level, lower the willingness to get vaccinated. This study revealed that HCWs in Zhejiang Province had a high willingness to get vaccinated. Awareness about the vaccine's effectiveness and safety and the disease severity should be promoted among HCWs over 50 years of age and nurses to increase the willingness to get vaccinated.

Endoscopy-Assisted Transoral Approach to Resect Parapharyngeal Space Tumors: A Systematic Review and Meta-Analysis.

OBJECTIVES: By comparing the endoscopy-assisted transoral approach (EATA) with external approaches (EAs) for the resection of parapharyngeal space tumors (PPSTs), we determined whether the EATA has advantages in terms of operation time, intraoperative bleeding volume, postoperative hospitalization, drainage volume, and complications. At the same time, we summarized the surgical indications for the EATA. METHODS: Systematic literature retrieval was performed in the PubMed, Web of Science, Embase, CNKI, Wanfang, and CQVIP databases up to February 2020. We calculated the mean difference (MD) with a 95% confidence interval (CI) for continuous outcomes and pooled odds ratio (OR) with 95% CI for dichotomous outcomes. The measured outcomes were operative time, bleeding volume, postoperative hospitalization, drainage volume, and complications. RESULTS: Seven studies involving 318 patients were eligible. Of these patients, 145 patients underwent EATA and 173 patients underwent EA surgery. All the former tumors were benign and located medial or anteromedial to the carotid sheath except for the unrecorded tumors. Compared with EAs, the EATA significantly shortened the operation time (MD = -5.56 min, 95% CI: -9.58 to -1.55), shrank the bleeding volume (MD = -89.02 ml, 95% CI: -126.16 to -51.88), shortened the postoperative hospitalization (MD = -2.44 days, 95% CI: -3.37 to -1.51), reduced the drainage volume (MD = -32.97 ml, 95% CI: -36.24 to -29.70), and lowered the incidence of complications (OR = 0.30, 95% CI: 0.16 to 0.59). CONCLUSION: As for PPSTs, with an appropriate and precise patient selection, the EATA is a safe, effective, minimally invasive, and aesthetic surgical modality. Laryngoscope, 131:2246-2253, 2021.

NANOG regulates the proliferation of PCSCs via the TGF-ß1/SMAD pathway.

PURPOSE: In prostate cancer, castration resistance is a factor that frequently leads to death in individuals with this disease. Recent studies have suggested that prostate cancer stem cells (PCSCs) are pivotal regulators in the establishment of castration resistance. The nanog homeobox (NANOG) and the transforming growth factor (TGF)-ß1/drosophila mothers against decapentaplegic protein (SMAD) signaling pathways are involved in several cancer stem cells but are not involved in PCSCs. The purpose of this study is to investigate the effect of NANOG on the proliferation of PCSCs regulated by the TGF-ß1/SMAD signaling pathway. METHODS: In this study, we used flow cytometry to isolate CD44+/CD133+/NANOG+ PCSCs from DU145 prostate cancer cells. Then we used short hairpin RNA to silence NANOG and observed the biological behavior and the TGF-ß1/SMAD signal of PCSCs. RESULTS: NANOG decreased PCSC proliferation, increased apoptosis, and blocked cell cycling at G0/G1. Furthermore, reduction in the TGF-ß1, p15, and p-SMAD2 expression was observed. CONCLUSION: These findings suggest that NANOG positively regulates the growth of PCSCs through the TGF-ß1/SMAD signaling pathway.