A comparison of radiofrequency Coblation and cold steel excision in the treatment of idiopathic vocal process granulomas

OBJECTIVE

To compare the effectiveness of radiofrequency Coblation assisted excision and cold steel excision in the treatment of idiopathic vocal process granulomas.

METHODS

A retrospective study was performed of patients with idiopathic vocal process granulomas who underwent radiofrequency Coblation excision or cold steel excision between January 2013 and January 2020. The recurrence rate was compared among the two groups at six months post-operatively.

RESULTS

Of the 47 patients with vocal process granulomas, 28 were in the cold steel excision (control) group and 19 were in the Coblation-assisted group. The recurrence rate in the control group was significantly higher than that in the Coblation-assisted group (60.7 per cent vs 5.3 per cent; p < 0.001). In addition, the voice recovery of the Coblation-assisted group was significantly better than that of the control group; vocal quality recovered one month after surgery in the Coblation-assisted group.

CONCLUSION

Radiofrequency Coblation should be considered the optimal method when approaching idiopathic vocal process granulomas surgically.

A new diagnostic index for sarcopenia and its association with short-term postoperative complications in patients undergoing surgery for colorectal cancer

AIM

Sarcopenia is a robust prognostic indicator of outcomes after surgery for colorectal cancer (CRC). However, there are no serum markers routinely available for estimating skeletal muscle mass (SMM). The present study aimed to describe a new sarcopenia index (SI), serum creatinine (Scr) × cystatin C-based glomerular filtration rate, and investigate its association with short-term complications after curative resection of CRC.

METHOD

Consecutive patients who underwent curative resection of CRC from December 2011 to January 2017 were retrospectively identified. Skeletal muscle cross-sectional area was analysed on L3 computed tomographic images. Receiver operating characteristic curve analysis showed that the cutoff points of SI for sarcopenia were below 56.1 in men and below 43.7 in women. Patients were classified into low and high SI groups in accordance with these cutoff values. The association between SI and body composition and the impact of preoperative SI on postoperative outcomes were analysed.

RESULTS

Among 417 patients, SI showed a stronger correlation with skeletal muscle area (SMA) (r = 0.537, P < 0.001) than with the Scr/cystatin C ratio (r = 0.469, P < 0.001) and Scr (r = 0.447, P < 0.001). The low SI group had a lower SMA, lower preoperative haemoglobin, a higher prevalence of sarcopenia and experienced more postoperative complications compared with the high SI group (all P < 0.001). Multivariate logistic regression analysis showed that the independent risk factors for overall complications were low preoperative haemoglobin, low SI, sarcopenia and American Society of Anesthesiologists grade ≥ 3.

CONCLUSION

This new SI is a simple and useful surrogate marker for estimating SMM, and is associated with outcomes after CRC surgery.

Knockdown of 14-kDa phosphohistidine phosphatase expression suppresses lung cancer cell growth in vivo possibly through inhibition of NF-κB signaling pathway

In previous study, we reported that 14-kDa phosphohistidine phosphatase (PHP14) was associated with lung cancer cell migration and invasion. We also found that the expression of PHP14 was markedly increased in a part of human lung cancer tissues. In this study, we investigated the impact of PHP14 knockdown on lung cancer cell tumorigenesis in vitro and in vivo, as well as the regulatory pathway. Depletion of endogenous PHP14 expression in lung cancer cells reduced colony formation activity of lung cancer cells in vitro and inhibited the xenograft tumor growth in vivo. Further experiments revealed that the NF-κB signal pathway inhibitor PDTC inhibited the upregulated expression of MMP9 induced by PHP14 overexpression in lung cancer cells. Furthermore, knockdown of PHP14 in lung cancer cells correlated with decreased expression of a subset of NF-κB-regulated genes, such as BCL-2, COX-2, MCP-1, MMP9 and VEGF-C, which play an important role in tumor progression. Together these data suggest that knockdown of PHP14 in lung cancer cells inhibits lung cancer tumor growth in vivo, possibly via regulating the NF-κB pathway.

A new hope: the immunotherapy in small cell lung cancer

Small cell lung cancer (SCLC) is of a high-grade malignancy with a high metastatic potential and poor clinical prognosis. Unfortunately, SCLC initially exhibits a good response to chemotherapy and radiation therapy, but inevitably, relapses decrease patients' chance of survival. Despite tremendous advances on the development of new chemotherapeutic agents, the prognosis of this disease remains poor. Immunotherapy plays a role in eliciting an anticancer response by modulating the patient's immune response of the tumor. Several studies have demonstrated that abnormal autoimmune regulation has a close relationship with SCLC. Thus, several immunotherapy trials are focused on SCLC treatment, including such approaches as immune checkpoints blockers, tumor vaccine, antigenic targets and adoptive cellular immunotherapy to benefit patients with SCLC. To date, the results from immunotherapy in SCLC have not been promising. For example, tumor vaccines have not been demonstrated to have a significant survival benefit. However, there have been many promising advances with immune checkpoints blockers. This review will provide a general overview of immunotherapy in SCLC. The landmark clinical trials in previous successful immunotherapy studies are summarized here. Finally, the challenges of immunotherapy in SCLC are discussed to facilitate the prediction of possible and valuable strategies for future therapy.

[Characteristics of Dix-Hallpike test induced nystagmus]

Objective:To retrospectively analyze the characteristics of 100 cases with Dix-Hallpike test induced nystagmus, especially the vertical downward component.Method:One hundred cases with positive Dix-Hallpike test between December 2017 and January 2018 were included in this study. Dix-Hallpike test and roll test were performed in all patients, and the max slow phase velocity (SPV), latency and duration of positional nystagmus were analyzed with SPSS 22.0 software.Result:According to the difference in the direction and duration of the nystagmus in the head-hanging position on Dix-Hallpike test, 100 patients were classified into 9 types. When only the vertical components were considered, 56 cases presented with bilateral or unilateral vertical upward component, among which 52 cases had unilateral torsional with vertical upward component, 4 cases had bilateral torsional with vertical upward component; 7 cases presented with vertically upward in one side and the vertically downward in the other side; 47 cases presented with bilateral or unilateral vertical downward component. In addition, 8 cases showed the reverse phase nystagmus. Of the 100 patients with positive Dix-hallpike, 20 cases were positive in roll test and 5 cases showing horizontal nystagmus and 15 cases showing torsional and vertical nystagmus.Conclusion:Vertical component in the positional nystagmus was common, and care should be taken to interpret the nystagmus into the underlying disorder.