[Development and validation of a persistent postural-perceptual dizziness screening questionnaire]

Objective: To develop a simple screening questionnaire for persistent postural-perceptual dizziness (PPPD) and evaluate its screening ability. Methods: A convenience sample of 296 individuals who met the inclusion criteria between November 2021 and January 2023 were prospectively selected for three rounds of screening at the Vertigo Specialty Clinic of the Department of Otorhinolaryngology-Head and Neck Surgery in the First Hospital of Shanxi Medical University. In conjunction with expert opinion and statistical analysis, the first and second rounds of screening were used to modify and finalize the questionnaire entries, and the third round of screening was used to evaluate the questionnaire's screening ability. Independent sample t-test was used for inter group comparison, reliability and validity indicators were employed to screen and evaluate questionnaire entries, and the receiver operating characteristic (ROC) curve was plotted to determine the optimal cut-off value and corresponding sensitivity and specificity. Results: The final PPPD screening questionnaire entries included 21 items. In evaluating the reliability of this questionnaire, the Cronbach's alpha coefficient was 0.831, the half folding coefficient was 0.742, the content validity was 0.86, and the Kaiser-Meyer-Olkin (KMO) value in the structural validity was 0.811. Additionally, there were six factors with characteristic root>1 and a cumulative contribution rate of 62.62%. The area under the ROC curve of the screening questionnaire was 0.935 (95%CI: 0.877-0.992), and the optimal cut-off value was 8.5, with a sensitivity of 85.0%, a specificity of 85.5%, and a Kappa value of 0.653. Conclusion: The PPPD simple screening questionnaire designed in this study has a high sensitivity and specificity, making it a useful tool for identifying PPPD patients.

[Prognostic value of the age-adjusted Charlson comorbidity index in patients over 60 years old with laryngeal squamous cell carcinoma]

Objective: To evaluate the value of the age-adjusted Charlson comorbidity Index (ACCI) in predicting the prognosis and guiding the clinical treatment of laryngeal squamous cell carcinoma (LSCC) in patients over 60 years old. Methods: Retrospective analysis of 249 cases of LSCC in Shanxi Provincial Cancer Hospital and First Hospital of Shanxi Medical University from 2008 to 2015 was performed. There were 234 males and 15 females, aged from 60 to 88 years. The clinical characteristics, treatment information and follow-up data were collected. ACCI was used to score the comorbidities of the patients. Receiver operating characteristic (ROC) curve was drawn and the patients were divided into high ACCI group and low ACCI group according to the cut-off value of ACCI. Prognostic factors were analyzed. Kaplan-Meier method was used for survival analysis, rank sum test was used for comparison between groups, χ² test was used for enumeration data. Results: Overall survival (OS) was 54.6%, progression-free survival (PFS) was 59.4%, and cancer-specific survival (CSS) was 58.6%. Both the median survival time and PFS time were 60 months. The best cutoff point of the ACCI group was 5. Cox multivariate analysis showed that ACCI was an independent risk factor for OS, PFS and CSS (OR=1.553, 1.499 and 1.534,respectively, all P<0.05). In the high ACCI group, OS (χ²=4.120 and 4.115,P<0.05) and CSS (χ²=4.510 and 5.009,P<0.05) of patients treated with surgery plus radiotherapy and patients with radiotherapy alone were better than those of patients with surgery alone (P<0.05). But in the low ACCI group, there was no significant difference in prognosis among the three treatment regimens (P>0.05). Conclusion: High ACCI offors important prognostic information for LSCC in patients over 60 years old, and can guide clinical treatment options.

[Meta-analysis of comparison for efficacies between surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced hypopharyngeal cancer]

Objective: Meta-analysis was used to compare the long-term efficacy and laryngeal function preservation rate of patients with advanced hypopharyngeal cancer treated with surgery plus radio(chemo)therapy (SRT) or non-surgery chemoradiotherapy (CRT). Methods: We searched publicly published articles on case-control studies of surgical and non-surgical comprehensive treatment of advanced hypopharyngeal cancer in PubMed, the Cochrane Library, Wanfang Database, Chinese Journal Full-text Database, and Chinese Science and Technology Periodical Database. The search language was limited to Chinese and English, and the period was from 1990 to 2018. These literatures were rigorously screened by inclusion and exclusion criteria. The data needed for this study were extracted and the Meta analysis was performed using RevMan 5.3 software. Results: A total of 13 literatures were included, and the overall quality of the literature was relatively high, and no significant publication bias was suggested. A total of 1 994 subjects, including 720 in the SRT group and 1 274 in the CRT group. The average 3-year overall survival rates were 42.9% in SRT group and 44.8% in CRT group,with no significant difference (OR=1.14, 95%CI: 0.62-2.06, P=0.68). The average 5-year overall survival rate (OR=1.42, 95%CI: 1.10-1.84, P<0.01), 5-year local recurrence-free survival rate (OR=1.68, 95%CI: 1.11-2.55, P=0.01) and 5-year local control rate (OR=2.17, 95%CI: 1.52-3.12, P<0.01) of SRT group were 46.4%, 47.4% and 71.2%, respectively, which were higher than those of non-surgical group (37.9%, 32.0%, and 52.2% respectively). The average laryngeal function preservation rate was 19.8%,being significantly lower than 80.6% of the non-surgical group(OR=0.03, 95%CI: 0.01-0.07, P<0.01). Conclusions: SRT has better long-term efficacy, while CRT has better preservation of laryngeal function.

[How to initially screen common central "malignant vertigo" at the bedside?]

Most of the common dizziness/vertigo diseases in otology clinic are peripheral vertigo diseases, and while about 20% -30% of all vertigo diseases are caused by central nervous system diseases. Pseudo vestibular neuritis, acute ischemic stroke with audiovestibular loss, and central paroxysmal positional vertigo are the three types of central "malignant vertigo" diseases which are most easily misdiagnosed by otologists. This article described the clinical characteristics and bedside physical performance of these three diseases, and summarized the differential diagnosis points for clinical reference.

[The expressions and correlations of IL-10, CD14 and CD68 in laryngal squamous cell carcinoma]

Objective:The aim of this study is to investigate the distribution of IL-10, CD14 and CD68 in the tumor microenvironment of LSCC with the clinicopathologic factors. Method:We detected the expressions of IL-10, CD14 and CD68 in 46 primary LSCC tumor tissues by immunohistochemistry staining and explore the relationship between them and clinicopathologic factors. Result:We found that the expressions of IL-10, CD14 and CD68 were significantly correlated with clinical stage and T stage (P<0.01). IL-10 and CD14 were correlated with lymph node metastasis (P<0.01), and CD68 was correlated with pathological differentiation (P<0.05). There is a positive correlation trend between the expression of IL-10 and CD14 (P<0.01). Conclusion:We confirm that the high level expressions of IL-10, monocytes and TAMs contribute to the tumor development of LSCC and there is a positive correlation between the expression of IL-10 and monocytes.

[The clinical characteristics and treatment strategies of differentiated thyroid carcinoma in adolescents and children]

Objective:To investigate the effects of hsa-miR-193b on the proliferation and apoptosis of Hep-2 cells.Method:The experiment was divided into Blank, NC, and miR-193b inhibitor. We used the qRT-PCR to identify the expression of miR-193b in Hep-2 cells. Cell proliferation was monitored using the MTT assay kit. Cell cycle and apoptosis were analyzed by flow cytometry. Cell invasion was monitored using the Transwell assay staining. The target of miR-193b was forecasted by bioinformatics.The expression level of SMAD3 protein was detected by Western blot. Result:After miR-193b inhibitor transfection, qRT-PCR showed that the expression of miR-193b was downregulated significantly (compared with Blank and NC,P<0.01)，and there was no significant difference between Blank and NC(P>0.05). Compared with NC, miR-193b inhibitor induced a significant inhibition of cells growth at 24 h, 48 h and 72 h(P<0.05,P<0.01 and P<0.01), and flow cytometry revealed that miR-193b inhibitor significantly promoted cell apoptosis(P<0.01) and cell cycle was blocked in G1/S stage(P<0.01), meanwhile miR-193b inhibitor also inhibited the invasive property of Hep-2 cells(P<0.01). Predicting outcomes indicated that SMAD3 was a target of miR-193b. Furthermore, the over-expression of miR-193b down-regulated the expression of SMAD3(compared with NC，P<0.05). Conclusion:miR-193b inhibitor can inhibit the proliferation, migration and invasion abilities, and promote the apoptosis of Hep-2 cells. It indicates that miR-193b acts as an "oncogene" for laryngal squamous cell carcinoma and may serve as a novel antitumor target of therapy.

[Substituting esophagus with colon in the treatment of hypopharyngeal and esophageal disease]

OBJECTIVE

To study the feasibility and effect of substituting esophagus with colon in the treatment of advanced stage hypopharyngeal carcinoma, cervical esophagus cancer and serious esophageal stenosis on the basis of laryngeal function preservation.

METHODS

From 1989 to 1996. 25 patients in our department were retrospectively reviewed among them, nine were hypopharyngeal carcinoma, T3 (No1, N1 4, N2 2), T4 N1 M0 2 (UICC 1997), thirteen were cervical esophagus cancer, T1N0M0 2, T2 (N0 4, N1 7), there were serious esophageal stenosis, length was 3-5 cm. The patients with carcinoma were given postoperation radiotherapy.

RESULT

The total survival rates in 3, 5 years are 54.5%, 42.9% respectively. The 3-year survival rates are 44.4% in the cases with advanced stage hypopharyngeal carcinoma, and 61.5% with cervical esophagus cancer, respectively.

CONCLUSION

Substituting esophagus with colon is in conformity with physical demand, can reduce complication and improve life quality.

[Reconstruction of larynx with epiglottis and strip muscular flap after extended partial laryngectomy with T3 category]

Fourty patients with T3 glottic cancer were treated by extended partial laryngectomy with reservation of epiglottis and posterior part of thyroid cartilage. The operative defect was covered by bilateral strip muscular flap to reconstruct the sphincter function of the glottis. The 3-year survival rate was 82.5% (32/40) and 5-year survival rate 72.9%(27/37). The function of the reconstructed laryngx was satisfactory. The authors believe that the strip muscular flap is a good material for the reconstruction of the new laryngx because of its good blood supply and wide-range repairing capability.