Distribution characteristics of intestinal flora in patients with OSAHS and the relationship between different intestinal flora and sleep disorders, hypoxemia and obesity.

OBJECTIVE: To investigate the distribution characteristics of intestinal flora in patients with obstructive sleep apnoea hypopnea syndrome (OSAHS) of different severities and the relationship between different intestinal flora and sleep structure disorder, hypoxemia and obesity. METHODS: A total of 25 healthy volunteers and 80 patients with OSAHS were enrolled in this study. The control group was healthy, and the experimental group comprised patients with OSAHS. The apnoea-hypopnea index (AHI), minimum saturation of peripheral oxygen (SpO2min), mean saturation of peripheral oxygen, body mass index, maximum apnoea time and other indicators were collected in clinical practice. The patients with OSAHS were divided into 20 mild and 42 moderate OSAHS cases, as well as 18 patients with severe OSAHS according to the AHI classification. Bioinformatics-related statistics were analysed using the QIIME2 software, and clinical data were analysed with the SPSS 22.0 software. RESULTS: The changes in microbial alpha diversity in the intestinal flora of patients with OSAHS showed that richness, diversity and evenness decreased, but the beta diversity did not change significantly. The Thermus Anoxybacillus, Anaerofustis, Blautia, Sediminibacterium, Ralstonia, Pelomonas, Ochrobactrum, Thermus Sediminibacterium, Ralstonia, Coccidia, Cyanobacteria, Anoxic bacilli and Anaerobes were negatively correlated with AHI (r = -0.38, -0.36, -0.35, -0.33, -0.31, -0.29, -0.22, -0.18) and positively correlated with SpO2min (r =0.38, 0.2, 0.25, 0.22, 0.24, 0.11, 0.23, 0.15). CONCLUSION: Some bacteria showed a significant correlation with clinical sleep monitoring data, which provides a possibility for the assessment of disease risk, but the mechanisms of their actions in the intestinal tract are not clear at present. Further research and observations are needed.

Comparison of the efficacy of vocal training and vocal microsurgery in patients with early vocal fold polyp / Comparação entre a eficácia do treinamento vocal e da fonocirurgia em pacientes com pólipo de prega vocal incipiente

Abstract Introduction: Vocal fold polyp is a benign proliferative disease in the superficial lamina propria of the vocal fold, and vocal microsurgery can improve the voice quality of patients with vocal fold polyp. In preliminary studies, we found that vocal training could improve the vocal quality of patients with early vocal fold polyp. Objective: This study aimed to compare the efficacies of vocal training and vocal microsurgery in patients with early vocal fold polyp. Methods: A total of 38 patients with early vocal fold polyp underwent 3 months of vocal training (VT group); another 31 patients with early vocal fold polyp underwent vocal microsurgery (VM group). All subjects were assessed using laryngostroboscopy, voice handicap index, and dysphonia severity index, and the efficacies of vocal training and vocal microsurgery were compared. Results: The cure rates of vocal training and vocal microsurgery were 31.6% (12/38) and 100% (31/31), respectively. The intragroup paired-sample t-test showed that the post treatment vocal handicap index, maximum phonation time, highest frequency (F0-high), lowest intensity (I-low), and dysphonia severity index in both the VT and VM groups were better than those before treatment, except for the jitter value. The intergroup independent-sample t-test revealed that the emotional values of vocal handicap index (t = − 2.22, p = 0.03), maximum phonation time (t = 2.54, p = 0.013), jitter (t = − 2.11, p = 0.03), and dysphonia severity index (t = 3.24, p = 0.002) in the VT group were better than those in the VM group. Conclusions: Both, vocal training and vocal microsurgery could improve the voice quality of patients with early vocal fold polyp, and these methods present different advantages.

Resumo Introdução: O pólipo de prega vocal é uma doença proliferativa benigna da camada superficial da lâmina própria da prega vocal e a microfonocirurgia pode melhorar a qualidade vocal desses pacientes. Em estudos preliminares, observamos que o treinamento vocal era capaz de melhorar a qualidade vocal de pacientes com pólipo incipiente de prega vocal. Objetivo: Este estudo teve como objetivo comparar a eficiência entre treinamento vocal e microfonocirurgia em pacientes com pólipo incipiente de prega vocal. Método: Um total de 38 pacientes com pólipo incipiente de prega vocal foram submetidos a três meses de treinamento vocal (grupo TV); outros 31 pacientes foram submetidos à microfonocirurgia (grupo MC). Todos os indivíduos foram avaliados por meio de laringoestroboscopia, índice de desvantagem vocal e índice de severidade da disfonia e a eficácia entre treinamento vocal e microfonocirurgia foi comparada. Resultados: As taxas de cura do treinamento vocal e da microfonocirurgia foram de 31,6% (12/38) e 100% (31/31), respectivamente. O teste t para amostras pareadas intragrupo mostrou que o índice de desvantagem vocal pós-tratamento, tempo máximo de fonação, frequência máxima, intensidade mínima e índice de severidade da disfonia nos grupos TV e MC foram melhores do que aqueles antes do tratamento, exceto pelo valor do jitter. O teste t para amostras independentes intergrupos revelou que o valor emocional do índice de desvantagem vocal (t = -2,22, p = 0,03), tempo máximo de fonação (t = 2,54, p = 0,013), jitter (t = -2,11, p = 0,03) e índice de severidade da disfonia (t = 3,24, p = 0,002) no grupo TV foram melhores do que os do grupo MC. Conclusões: Tanto o treinamento vocal quanto a microfonocirurgia podem melhorar a qualidade da voz de pacientes com pólipo incipiente de prega vocal e esses métodos apresentam diferentes vantagens.

Comparison of the efficacy of vocal training and vocal microsurgery in patients with early vocal fold polyp.

INTRODUCTION: Vocal fold polyp is a benign proliferative disease in the superficial lamina propria of the vocal fold, and vocal microsurgery can improve the voice quality of patients with vocal fold polyp. In preliminary studies, we found that vocal training could improve the vocal quality of patients with early vocal fold polyp. OBJECTIVE: This study aimed to compare the efficacies of vocal training and vocal microsurgery in patients with early vocal fold polyp. METHODS: A total of 38 patients with early vocal fold polyp underwent 3 months of vocal training (VT group); another 31 patients with early vocal fold polyp underwent vocal microsurgery (VM group). All subjects were assessed using laryngostroboscopy, voice handicap index, and dysphonia severity index, and the efficacies of vocal training and vocal microsurgery were compared. RESULTS: The cure rates of vocal training and vocal microsurgery were 31.6% (12/38) and 100% (31/31), respectively. The intragroup paired-sample t-test showed that the post treatment vocal handicap index, maximum phonation time, highest frequency (F0-high), lowest intensity (I-low), and dysphonia severity index in both the VT and VM groups were better than those before treatment, except for the jitter value. The intergroup independent-sample t-test revealed that the emotional values of vocal handicap index (t=-2.22, p=0.03), maximum phonation time (t=2.54, p=0.013), jitter (t=-2.11, p=0.03), and dysphonia severity index (t=3.24, p=0.002) in the VT group were better than those in the VM group. CONCLUSIONS: Both, vocal training and vocal microsurgery could improve the voice quality of patients with early vocal fold polyp, and these methods present different advantages.

An Analysis of the Effects of Voice Therapy on Patients With Early Vocal Fold Polyps.

OBJECTIVE: This study aimed to analyze the voice characteristics of patients with early vocal fold polyps and to investigate the effects of voice therapy on patients. METHODS: Voice therapy was conducted on 88 patients with early vocal fold polyps in an experimental group. Laryngostroboscopy, the voice handicap index (VHI), and the dysphonia severity index (DSI) were applied to evaluate the patients' voice quality before and after treatment. Thirty-one healthy volunteers also underwent evaluation of voice quality as a control group. The intergroup and intragroup differences in the results of laryngostroboscopy, VHI, and DSI were compared statistically. RESULTS: In the experimental group, 22 patients withdrew from the treatment for various reasons. After voice therapy, the cure rate was 30.3% (20/66). All the VHI values in the experimental group before treatment were statistically worse than the values in the control group. The P and T values of the VHI in the experimental group were still worse after treatment than the values in the control group, although the VHI did improve after treatment in the experimental group. The maximum phonation time (MPT), jitter, I-low, and DSI were statistically different between the control group and the experimental group both before and after treatment. Furthermore, the MPT, jitter, F0-high, I-low, and DSI improved after treatment in the experimental group. CONCLUSIONS: Patients with early vocal fold polyps have some degree of subjective and objective dysphonia. Voice therapy can improve the voice quality in these patients.

[Observation of bacterial biofilms in patients with chronic rhinosinusitis].

OBJECTIVE: To explore the presence of bacterial biofilms (BF) in patients with CRS and the effect of BF on clinical symptoms and postoperative outcomes. METHODS: Seventy-two patients with chronic sinusitis were enrolled in this study. The control group included 15 patients with deviation of the nasal septum and 10 patients had a fracture of the nasal bone. Mucosa of the uncinate process or ethmoid near the ostium of the maxillary sinus was obtained during endoscopic sinus surgery. The specimens were subjected to scanning electron microscopy. Patients were followed for 1 year and observed by the Lund-Kennedy endoscopy, and the Haikou standard classification (ESS-1997). Statistical analysis was performed by t-test or chi-square test. RESULTS: Three patients were lost to follow-up. The scanning electron microscopy analysis showed bacterial biofilms in 49 of the 69 patients with chronic sinusitis. A marked destruction of the epithelium and cilia was observed in samples positive for bacterial biofilms. No bacterial biofilms were detected in the control group, and scanning electron microscopy showed normal epithelium and cilia in those specimens. There was no significant difference in gender, classification or duration of disease between the BF(-) and BF(+) groups. At six months and one year postoperative, the Lund-Kennedy endoscopy scores for CRS patients with BF (4.78 +/- 1.67; 4.55 +/- 1.61) were significantly higher than those without BF (3.65 +/- 1.39; 3.65 +/- 1.18) (t = -2.654, P < 0.01; t = -2.264, P < 0.05). Based on the Haikou standard classification, there was a significantly difference between patients with BF and those without BF (chi2 = 18.014, 22.063, P < 0.001, respectively). CONCLUSIONS: Different life stages of bacterial biofilms were demonstrated to be present in CRS. Gender, classification or duration of disease did not affect the presence of bacterial biofilms in patients with CRS. There is a correlation between bacterial biofilms and an unfavorable outcome in patients with CRS after ESS.

Factors affecting bacterial biofilm expression in chronic rhinosinusitis and the influences on prognosis.

PURPOSE: The purpose of the study was to investigate the expression of bacterial biofilm (BF) for chronic rhinosinusitis (CRS) and to find out factors affecting BF expression and the influences on its prognosis. MATERIALS AND METHODS: All specimens were analyzed by a scanning electron microscope and bacterial cultivation from a panel of 93 patients with CRS, 20 with nasal septum deviation, and 17 with nasal bone fractures as the control group. Referring to the grade classification criteria from the sinusitis-specific questionnaire Sino-Nasal Outcome Test-20, patients were assessed preoperatively based on common clinical manifestations. Patients were followed up for condition improvement as assessed by visual analogue scale and nasal endoscopic examination. RESULTS: In the experimental group, among all the patients, 3 were lost (lost 3.2%). Bacterial biofilm was positive in 64 (71.1%) of 90 patients. Mucosal cilia were observed in varying degrees of injury. Bacterial culture was positive in 60 (66.7%) patients. In the control group, no BF was found and no bacterium was cultured. Bacterial biofilm expression was correlated with the bacterial culture. The BF(+) patients' visual analogue scale scores 6 months and 1 year postoperation were lower than the BF(-) patients' scores (P < .05). The BF(+) patients' Lund-Kennedy scores at 6 months and 1 year postoperation were higher than the BF(-) patients' scores (P < .05). CONCLUSIONS: Bacterial biofilm is involved in the pathogenesis of CRS and is associated with the bacterial culture. Bacterial biofilm has a certain impact on patients' prognosis.