Serotonin Transporter Gene (SLC6A4) Polymorphism May Be Associated with Chinese Globus Pharyngeus and Its Antidepressant Effects.

BACKGROUND: Although globus pharyngeus is not rare in clinical practice, little is known about its associated gene polymorphism. We investigated the association between the SLC6A4 polymorphism and globus pharyngeus and its response to treatment with antidepressants. METHODS: A total of 84 patients were diagnosed with globus pharyngeus according to Rome III, and 160 healthy controls were genotyped for the SLC6A4 polymorphism using polymerase chain reaction amplification and agarose gel electrophoresis. All patients with globus were studied using high-resolution manometry pre-therapy. Globus patients were randomized into paroxetine or amitriptyline groups for a 6-week treatment and asked to complete the following pre- and post-therapy questionnaires: the Glasgow Edinburgh Throat Scale (GETS), the Pittsburgh Sleep Quality Index, and the Hamilton Rating Scale Anxiety/Depression. Treatment response was defined as a >50% reduction in the GETS scores. RESULTS: A significant difference was observed in the globus S/S genotype with anxiety compared to that without anxiety (χ2 = 14.579, p = 0.006). The L/S genotype showed a significant difference between high upper esophageal sphincter pressure (>104 mm Hg) and non-high upper esophageal sphincter pressure patients (χ2 = 14.433, p = 0.006). A significant association between the S/S genotype and the response to antidepressant treatment was also observed, while patients with sleep disorders or depression showed no association. CONCLUSION: A significant association was observed between the S/S genotype of the SLC6A4 polymorphism and globus pharyngeus, suggesting that SLC6A4 is a potential candidate gene involved in the pathogenesis of globus pharyngeus.

Clinical-psychological characteristics of refractory globus patients in China.

BACKGROUND: Refractory globus is not rare in clinical practice, but little research about it. AIMS: To investigate the clinical-psychological characteristics of patients with refractory globus. METHODS: Six hundred and nineteen globus patients were divided into the refractory globus group (n=149) and the non-refractory globus group (n=470). All subjects completed the following questionnaires: demographic characteristics, medical information, Hamilton Rating Scale of Anxiety/Depression, Pittsburgh Sleep Quality Index, Glasgow Edinburgh Throat Scale, and 36-item Short Form Health Survey. RESULTS: No significantly differences were found in demographic characteristics between the two groups, but the refractory globus group had longer disease duration and more serious symptoms. Sought healthcare more frequently but still had poorer quality of life than did the non-refractory globus group. Compared with the non-refractory globus group, the refractory globus group also had higher percentages of anxiety, depression, and sleep disorders. Positive correlations were observed between the severity of globus symptoms and HAMA, HAMD, and PSQI scores. CONCLUSIONS: Refractory globus is not rare in clinical practice and should receive more attention from patients and doctors because of its severe symptoms, long disease duration, poor quality of life, and accompanied by psychological disorders and sleep disorders.

[Audiological assessment value of click-evoked auditory brainstem response combined with single stimulation of the auditory steady-state evoked response on normal young people].

OBJECTIVE: Analysis of normal young people multiple stimuli ASSR (m-ASSR), single stimuli ASSR (s-ASSR), C-ABR, PTA threshold, exploratory investigation of relevance of hearing test combination thresholds (C-ABR combines with 0.5, 1.0 kHz s-ASSR) predict behavioral thresholds, using a within-subjects design. METHOD: Forty-three normal hearing adults (86 ears) were treated with pure tone audiometry (PTA), m-ASSR, 0.5, 1.0 kHz s-ASSR, C-ABR. Data were analyzed by SPSS 18.0 for bivariate correlation analysis. RESULT: There was significant correlation between thresholds of hearing test combination and PTA,and the correlation coefficient (r) were 0.803, 0.650, 0.649, 0.734 at 0.5, 1.0, 2.0 and 4.0 kHz; while the correlation coefficient (r) between thresholds of m-ASSR and PTA were 0.48, 0.64, 0.57, 0.64. CONCLUSION: There is significant correlation between thresholds of hearing test combination and PTA, hearing test combination can be more accurate, more reliable assessment of adults with normal hearing threshold level.

[Clinical analysis of the laryngeal injury].

OBJECTIVE: To explore the management of the laryngeal injury. METHOD: The forty five patients of laryngeal injury had been rescued. Twenty eight patients were treated with the tracheotomy and twenty four patients of them were treated with the laryngoplasty. RESULT: All the patients were survived. Tracheostomy tube of twenty eight patients was taken away without the cicatricial structure of larynx. CONCLUSION: With the reasonable management after the laryngeal injury, the injury could be cured in time without complications.

[Evaluation of tympanoplasty with reconstruction of the external canal after mastoidectomy for cholesteatoma].

OBJECTIVE: To investigate the method to repair the deletion of external canal and opened mastoid space after mastoidectomy. METHOD: One stage tympanoplasty with reconstruction of the external canal with temporal cortex was completed in 58 cases (58 ears) with cholesteatoma. RESULT: During the follow-up ranging from one to three years, there was only one relapse. The configuration of external canal was almost normal and pneumatic mastoid space was maintained. Hearing was improved over 30dB in five ears, 20 to 29 dB in 11 ears, 10 to 19 dB in 30 ears, less 10 dB in eight ears and hearing wasn't improved in four ears. CONCLUSION: One stage tympanoplasty with reconstruction of the external canal after mastoidectomy for cholesteatoma is a practical way to improve hearing and decrease recurrence.

[Effects of acute hypoxia on expression of heat shock protein 70 in cochlea of guinea pigs].

OBJECTIVE: To investigate the changes of the expression of heat shock protein 70 (HSP70) in the cochlea of guinea pigs under acute hypoxia. METHOD: Different degrees of acute hypoxia were imposed on guinea pigs and slices of the cochlea were examined by immunohistochemistry to detect HSP70. RESULT: In normal situation, HSP70 is expressed in guinea pig's cochlea, especially in spiral ganglion and Corti's organ, under acute hypoxia, this expression was strengthened, and the degree of this strengthening showed no correlation with degree of hypoxia. CONCLUSION: These results suggest that acute hypoxia can strengthen the expression of HSP70 in guinea pig's cochlea, and the degree of hypoxia has no effects on the degree of this strengthening. The expression of HSP70 in the cochlea may be a kind of protection to the structure and the function of the inner ear.

Influence of evoked HSP70 expression on hearing function of the cochlea in guinea pigs.

OBJECTIVE: To investigate the effect of evoked heat shock protein 70 (HSP70) expression on the hearing function of the cochlea in guinea pigs. METHODS: Guinea pigs were divided into pre-exposure group (pre-treated with white noise exposure at 100 dB SPL for 45 min) and none pre-exposure group. Auditory brainstem response (ABR) thresholds were recorded at 12, 60 and 108 h after the animals in both groups were exposed to loud white noise (125 dB SPL, 90 min). RESULTS: HSP70 expression was evoked by pre-treatment with white noise (100 dB SPL, 45 min). There was no significant difference of ABR thresholds between the 2 groups (P>0.05) at 12 h after exposure to loud noise, while ABR thresholds became lower in pre-exposure group than in none pre-exposure group (P<0.01) at both 60 and 108 h. In the pre-exposure group, ABR thresholds at 108 h were significantly lower than that measured at 60 h (P<0.05), but which was not the case in none pre-exposure group. CONCLUSION: HSP70 expression induced by pre-exposure to noise protects the hearing function of the cochlea in guinea pigs.