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20 May 2025 Volume 39 Issue 3
  
Shanghai Sixth Peoples Hospital Otorhinolaryngology & Head and Neck Surgery Department dedicated to “120th Anniversary of the Sixth Hospital” Commemorative Theme
CAMK4-mediated oxidative stress injury in auditory central neurons induced by bilirubin
KE Bingbing, CHEN Ming, WANG Hongyang, LI Chunyan, YIN Shankai
2025, 39(3):  1-10.  doi:10.6040/j.issn.1673-3770.0.2024.509
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Objective The present study aims to investigate the role of calcium/calmodulin-dependent protein kinase 4(CAMK4)in bilirubin-mediated auditory central neurotoxicity. Methods The binding ability between CAMK4 and bilirubin was assessed using molecular docking and micro-scale thermophoresis(MST). The expression of CAMK4 in the cochlear nucleus was detected by immunofluorescence staining on paraffin sections. Primary cochlear nucleus neurons were cultured in vitro and treated with bilirubin(25 μmol/L)or bilirubin combined with the CAMK4 inhibitor KN-93(1 μmol/L). The neuronal ROS levels, mitochondrial membrane potential changes, Annexin V/PI staining, and live/dead cell staining were then evaluated. Results The molecular docking analysis revealed that the binding energy between bilirubin and CAMK4 was -9.71 kcal/mol, and the MST analysis gave a dissociation constant of(1.294 4±1.080 3)μmol/L, suggesting a strong binding affinity between the two. In the cochlear nucleus, CAMK4 was predominantly expressed in neurons. In vitro experiments demonstrated that the CAMK4 inhibitor KN-93 significantly suppressed bilirubin-induced ROS accumulation, mitochondrial membrane potential decline, late-stage apoptosis, and reduced cell survival in cochlear nucleus neurons. Conclusion CAMK4 has been demonstrated to play a crucial role in bilirubin-mediated oxidative stress injury in auditory central neurons.
The antagonistic effects of NAD+ on cisplatin-induced oxidative stress injury in hair cells and the regulation of related gene expression
CHEN Ming, KE Bingbing, CUI Yaqi, WU Cuiping, CHEN Zhengnong, LI Chunyan, YIN Shankai
2025, 39(3):  11-18.  doi:10.6040/j.issn.1673-3770.0.2025.054
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Objective The present study aims to investigate the effect and underlying mechanism of nicotinamide adenine dinucleotide(NAD+). The present study aims to explore the mitigating effect of NAD+ on cisplatin-induced ototoxicity, with a view to elucidating the underlying mechanism. Methods In vitro, HEI-OC1 cells and cochlear basement membrane cultures from 3-day-old C57BL/6J mice were utilized to evaluate the protective effects of NAD+ against cisplatin-induced toxicity. In vivo, the administration of cisplatin and NAD+ was conducted via tympanic injections in adult C57BL/6J mice, followed by auditory brainstem response testing. Transcriptome sequencing was performed to analyze differential gene expression between the cisplatin and cisplatin+ NAD+ groups in HEI-OC1 cells, and the quantitative polymerase chain reaction was applied to validate the key genes. Results The present study investigates the impact of NAD+ on the viability of HEI-OC1 cells exposed to cisplatin, with a particular focus on the phenomenon of apoptosis. The results demonstrate a significant enhancement in cell viability in the presence of NAD+, accompanied by a substantial reduction in apoptosis. In the cochlear basilar membrane model, NAD+ significantly increased hair cell survival and decreased reactive oxygen species(ROS)production. Furthermore, NAD+ effectively mitigated cisplatin-induced hearing loss in vivo. Transcriptome analysis revealed 204 genes to be significantly overexpressed and 214 genes to be significantly underexpressed in the cisplatin + NAD+ group, with differential genes notably enriched in the Platinum drug resistance and Glutathione metabolism pathways. Key genes associated with oxidative stress, drug metabolism, and cyto-protection, such as Gstm6 and Gsta2 were significantly upregulated. Conclusion NAD+ has been demonstrated to possess a protective effect against cisplatin-induced ototoxicity, potentially by modulating the glutathione metabolism pathway in order to counteract oxidative stress. Consequently, these findings imply that NAD+ has therapeutic potential in preventing cisplatin-induced hearing loss.
Comparison of different modes of I-scan and WL in the application of electronic nasopharyngoscope
NI Lingda, TANG Xulan, MENG Lili, ZHOU Huiqun, SU Kaiming
2025, 39(3):  19-25.  doi:10.6040/j.issn.1673-3770.0.2023.515
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Objective To investigate the applicability of different modes of Pentax I-scan(intelligent scan)and WL(white light)in the imaging of nasopharyngeal and laryngological diseases. Methods The image data of 96 patients with nasopharyngeal and laryngological diseases were retrospectively analysed and the images taken under the 6 modes of I-scan and WL were compared. Results There are significant differences in the images of nasopharyngeal and laryngological diseases taken in different modes. In the imaging of nasopharyngeal and laryngological diseases, the images of Mode p,b,e,g and c are superior to WL in the detail display and the prominent aspect of blood vessels. Mode g and Mode c are more obvious. The effect of Mode v is worse than that of WL. Conclusion In the picture data acquisition of nasopharyngeal diseases, I-scan modes effectively complement the short board of WL, and the complementary use of them improves the efficiency of clinical diagnosis, which is worthy of clinical application.
Investigating the impact of serum bilirubin levels on the prognosis of patients with acute epiglottitis
SHEN Bojun, LIU Suru, LI Chunyan, SU Kaiming
2025, 39(3):  26-31.  doi:10.6040/j.issn.1673-3770.0.2024.120
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Objective To investigate the serum bilirubin levels in patients with acute epiglottitis and their impact on the prognosis of the disease. Methods This single-center retrospective case-control study included 105 patients diagnosed with acute epiglottitis and 52 patients with vocal cord nodules as the control group. General clinical data, hospitalization duration, bilirubin levels, and inflammatory markers were collected. Differences in bilirubin levels between the two groups were compared. Correlation analysis and multiple linear regression models were used to assess the associations between age, bilirubin levels, inflammatory markers, and the duration of hospital stay in patients with acute epiglottitis, and to further analyze the correlation between bilirubin and inflammatory markers. Results Upon admission, patients with acute epiglottitis had significantly higher bilirubin levels compared to the control group(P<0.001). Bilirubin levels decreased before discharge compared to at admission(P<0.001). Correlation analysis showed that the duration of hospital stay was negatively correlated with bilirubin levels at admission(P=0.030), and positively correlated with age, C-reactive protein, and white blood cell count(P<0.05). Multiple linear regression models indicated that bilirubin levels at admission were an independent factor influencing the duration of hospital stay(P=0.003). No linear correlation was found between admission bilirubin levels and systemic inflammatory markers such as white blood cell count, C-reactive protein, absolute neutrophil count, and absolute lymphocyte count(P>0.05). Conclusion Serum bilirubin levels are elevated in patients with acute epiglottitis, and bilirubin may serve as a potential risk assessment indicator for these patients.
The effect of ABCLOVE voice training method on voice function in patients undergoing surgery for benign proliferative lesions of the vocal cords
ZOU Song, XU Baoyuan, ZHANG Jinxing, CHEN Qiaoting, LI Jianxiang
2025, 39(3):  32-37.  doi:10.6040/j.issn.1673-3770.0.2024.622
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Objective To explore the effect of ABCLOVE voicetraining method used in surgical patients with benign proliferative lesions of the vocal folds on the recovery of voice function. Methods 96 patients with benign hyperplastic lesions of the vocal folds were selected for elective braced laryngoscopic surgery, and were divided into an observation group(48 cases)and a control group(48 cases)according to the treatment plan. The observation group was treated with ABCLOVE voice training method for postoperative vocal training, and the control group was treated with postoperative conventional treatment. The clinical efficacy, voice handicap index(VHl), voice hoarseness assessment(GRBAS)and voice acoustic analysis were compared between the two groups. Results After treatment, the clinical efficacy of the observation group was higher than that of the control group(P<0.05); 1 and 3 months after surgery, the VHl and GRBAS scores of the 2 groups decreased, and the decrease in the observation group was more obvious(P<0.05); 1 and 3 months after surgery, the jitter and the shimmer of the 2 groups decreased, and the decrease in the observation group was more obvious(P<0.05); 1 and 3 months after surgery, the HNR of the 2 groups increased. HNR were elevated in both groups, and the elevation was more obvious in the observation group(P<0.05). Conclusion ABCLOVE voice training method can effectively restore the voice function of surgical patients with benign proliferative lesions of the vocal folds, improve their articulation problems and correct bad voice habits, thus improving their quality of life.
Kynurenine mediates liver injury induced by obstructive sleep apnea: a cross-sectional study
WEI Zhicheng, PENG Yu, LI Lilin, SHEN Hangdong, LI Xinyi, XU Huajun, GUAN Jian
2025, 39(3):  38-44.  doi:10.6040/j.issn.1673-3770.0.2024.037
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Objective Kynurenine is an important product of the tryptophan metabolic pathway, which mediates a variety of pathophysiological activities. This study aims to investigate the relationship between serum kynurenine and the severity of obstructive sleep apnea(OSA)and liver function damage. Methods From January to June 2019, 142 subjects with suspected OSA were selected from 200 subjects who visited the Sleep Center of the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine due to snoring. Anthropometric data, biochemical indicators, and sleep monitoring data were collected, and serum kynurenine, indoleamine-2,3-dioxygenase 1(IDO1), Alanine Aminotransferase(ALT), and Aspartate Aminotransferase(AST)levels were detected. The correlation and mediating factors between sleep parameters, kynurenine, ALT, and AST, were analyzed and evaluated. Results After adjusting for gender, age, and body mass index(BMI), linear regression analysis revealed that apnea-hypopnea index(AHI), lowest oxygen saturation(LSpO2), oxygen desaturation index(ODI), and kynurenine were independent related factors for ALT. AHI, mean oxygen saturation(MSpO2), LspO2, ODI, the cumulative sleep time at SpO2<90%(CT90), and kynurenine were independent risk factors for AST. Mediation analysis showed that kynurenine could explain 50.0%, 43.0%, 54.4%, and 52.4% of the effects of AHI, MSpO2, LSpO2, and ODI on serum AST in OSA patients, respectively. Conclusion Kynurenine plays an important mediating role in OSA-induced liver function damage and may be a potential therapeutic target.
Predictive value of postoperative GH and IGF-1 levels for long-term remission in non-invasive growth hormone-secreting pituitary adenoma
GU Yuelong, TANG Ru, MAO Song, ZHANG Weitian
2025, 39(3):  45-50.  doi:10.6040/j.issn.1673-3770.0.2024.510
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Objective To investigate the clinical efficacy of endoscopic transsphenoidal surgery in the treatment of non-invasive growth hormone(GH)-secreting pituitary adenoma, and to analyze the predictive value of postoperative GH and insulin-like growth factor-1(IGF-1)levels for long-term hormonal biochemical remission. Methods The clinical data of 38 patients with non-invasive GH-secreting pituitary adenoma who underwent endoscopic transsphenoidal surgery at our institution from October 2012 to August 2024 were retrospectively collected and factors influencing long-term remission were analyzed. Receiver operating characteristic(ROC)curves were used to evaluate the predictive performance of GH and IGF-1 levels on the postoperative day 1, as well as the postoperative IGF-1/preoperative IGF-1 ratio. Results Among the 38 patients included in the study,26 achieved long-term biochemical remission, with a remission rate of 68.4%. Compared to the non-remission group, the remission group had significantly lower GH levels(P<0.001), IGF-1 levels(P=0.026)on the postoperative day 1, and a lower postoperative IGF-1/preoperative IGF-1 ratio(P=0.003). ROC analysis revealed that the area under the curve(AUC)for postoperative GH, IGF-1, and the IGF-1 ratio were 0.904, 0.789, and 0.839, respectively. A postoperative GH level of <1.66 ng/mL was found to predict long-term remission with a sensitivity of 91.7% and a specificity of 84.6%, while a postoperative IGF-1/preoperative IGF-1 ratio of <75.8% was found to predict remission with a sensitivity of 75.0% and a specificity of 85.7%. Conclusion The endoscopic transsphenoidal surgery is an effective treatment for non-invasive GH-secreting pituitary adenoma. Patients exhibiting lower postoperative GH and IGF-1 levels, as well as a lower postoperative IGF-1/ preoperative IGF-1 ratio, are more likely to achieve long-term biochemical remission. Of these, postoperative GH levels demonstrated the highest predictive value.
Single-cell RNA sequencing reveals cellular communication between spiral ganglion neurons and inner and outer hair cells in postnatal mice
DONG Wenqi, YU Dongzhen
2025, 39(3):  51-60.  doi:10.6040/j.issn.1673-3770.0.2023.294
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Objective To investigate the cell populations of cochlea during hearing formation and maturation phases and the ligand receptors that regulating the expression of signaling pathways between spiral ganglion neuron and inner and outer hair cells. Methods We investigated the potential cell-cell interactions between inner and outer hair cells and adjacent cells by collecting single-cell sequencing data from mouse cochlea and using CellChat software. Results Seurat analysis showed 15 significant groups of cell types in the mouse cochlea, including Fibroblast, Hensen's cell, Tympanic Border Cell, Coch+/Spp1+ Fibroblast, Inner/Outer Sulcus Cell, Inner Phalangeal Cell/Inner Border Cell, Outer Hair Cell, Reissner's Membrane, Macrophage, Spindle Cell/Root Cell, Spiral Ganglion Neuron, Intermediate Cell, Schwann Cell/Satellite Glial Cell, Inner Hair Cell and Red Blood Cell. Through the CellChat analysis, we observed that the communication relationship between inner and outer hair cells and spiral ganglion neurons in the P14 mouse cochlea was mainly mediated by the Bdnf/Ntrk2 signaling pathway, and Gdf6/(Bmpr1a+Bmpr2), Bmp6/(Bmpr1a+Bmpr2), Ntf3/Ntrk3, Ntf3/Ntrk2, Spp1/Cd44, Spp1/(Itgav+Itgb1), Pdgfa/Pdgfra, Gas6/Tyro3 signaling pathways during P28 period. Conclusion This study initially identified specific ligand receptors between spiral ganglion neuron and inner and outer hair cells during the cochlear hearing formation and cochlea maturation phases based on single-cell transcriptome data.
Trends and projections of the burden of age-related hearing loss in China from 1990 to 2021
DONG Lingkang, YU Dongzhen
2025, 39(3):  61-69.  doi:10.6040/j.issn.1673-3770.0.2024.511
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Objective To analyze the long-term trends and future projections of the burden of age-related hearing loss(ARHL)in China between 1990 and 2021, with comparisons to global data. Methods Using publicly available data from the Global Burden of Disease Study 2021, we estimated the burden of ARHL in China based on prevalence and disability-adjusted life-years(DALYs)and their age-standardized rates. Estimated annual percentage change(EAPC)was used to assess trends from 1990 to 2021, while autoregressive integrated moving average models were used to predict prevalence and DALYs for China and globally from 2022 to 2050. Results Between 1990 and 2021, the number of ARHL cases in China increased by 124.7%(from 198 million to 445 million), surpassing the global increase of 108.6% with 1.546 billion cases worldwide during the some period. The age-standardized DALYs rate(ASDR)increased from 557.47 to 630.67 per 100,000 person-years(EAPC=0.35), exceeding the global trend(EAPC=0.16). Significant gender differences were observed, with males exhibiting higher ASDR(667.54 vs. 592.27 per 100,000)and faster growth(EAPC: 0.35 vs. 0.17). Age-specific analysis revealed the highest number of cases in the 55-59 age group(65.80 million), with prevalence exceeding 70% in individuals aged ≥70 years. In particularly, the <20 age group showed the fastest growth in prevalence(EAPC=0.81). Projections indicate that China will have 662 million ARHL cases by 2050, with a 71.3% increase in DALYs, significantly higher than the global increase of 11.3%. Conclusion China is experiencing a rapidly growing ARHL burden with unique characteristics that require targeted interventions focusing on hearing care for older adults and noise protection for younger populations.
Bipolar coagulation forceps applied in the treatment of 6 cases of shamblin type III carotid body tumors
ZENG Qiying, ZHU Huaming, GUAN Jian, WU Hongmin, YE Haibo, YI Hongliang
2025, 39(3):  70-76.  doi:10.6040/j.issn.1673-3770.0.2024.272
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Objective The study aims to evaluate the utility of bipolar electrocoagulation forceps in the surgical management of Shamblin III carotid body tumours(CBT). Methods A retrospective analysis of the clinical data of 12 patients with Shamblin III type tumours treated at our hospital was performed. All patients underwent preoperative evaluation including neck ultrasound, Computed Tomography Angiography(CTA), Magnetic Resonance Imaging(MRI), and Digital Subtraction Angiography(DSA). The study was divided into a control group and an observation group. The control group underwent traditional surgical resection, while the observation group used bipolar electrocoagulation forceps as an adjunct to surgery. All operations were performed by the same team of surgeons. Differences between the two groups in intraoperative indicators and postoperative complication rates were compared. Results The intraoperative blood loss in the bipolar coagulation forceps group was significantly lower than that in the traditional surgery group(298 mL vs. 633 mL), and the surgical time was also notably shorter in the bipolar coagulation group(201 minutes vs. 326 minutes). The incidence of postoperative complications in the surgical group(16.7%)was significantly lower than that in the control group(100.0%), with a statistically significant difference(P<0.05). Conclusion With comprehensive preoperative evaluation and a rational surgical plan, the use of bipolar electrocoagulation forceps to assist in the resection of Shamblin Ⅲ-type carotid body tumours can reduce blood loss, shorten operation time, and decrease postoperative complications, thereby significantly improving surgical safety.
Adenotonsillectomy in a child with congenital fibrinogen deficiency and literature review
WANG Yao, CHEN Jingyi, YANG Yingchao, SU Kaiming
2025, 39(3):  77-80.  doi:10.6040/j.issn.1673-3770.0.2024.514
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Objective To investigate the perioperative management strategies for adenotonsillectomy in pediatric patients with Congenital Hypofibrinogenemia(CFD). Methods We reviewed and analyzed the perioperative management of a pediatric patient with CFD who underwent adenotonsillectomy using plasma ablation at our hospital, in conjunction with a review of the relevant literature. Results With perioperative fibrinogen replacement therapy, the patient's fibrinogen level was successfully raised from 0.23 g/L to 0.92 g/L, allowing for the safe performance of adenotonsillectomy. The patient recovered well postoperatively without any bleeding complications. A literature search revealed no previous reports of adenotonsillectomy in patients with CFD. However, the target fibrinogen level for supplementation in CFD patients undergoing other surgical procedures is typically 0.5-1.0 g/L or appropriately higher. Conclusion Adenotonsillectomy can be safely performed in pediatric patients with CFD through effective perioperative fibrinogen replacement therapy.
Modifications and applications of lateral expansion abduction suspension suture technique in the treatment of obstructive sleep apnea
MA Xin, DONG Lingkang, WU Hongmin, YI Hongliang, ZOU Jianyin
2025, 39(3):  81-88.  doi:10.6040/j.issn.1673-3770.0.2024.507
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Obstructive sleep apnea is a sleep-related breathing disorder characterized primarily by symptoms such as snoring, apnea, and daytime sleepiness. Currently, for patients who do not tolerate continuous positive airway pressure ventilation and have oropharyngeal obstruction, the clinic usually adopts suspensory palatopharyngoplasty. Nevertheless, recent studies have identified the lateral pharyngeal wall as the crucial point of obstruction to airflow. Consequently, many scholars have used this as a basis for improving or redesigning the surgical approach in order to expand the cross-sectional area of the pharyngeal cavity, reduce the severity of obstructive sleep apnea, and minimize patients' discomfort and complications. This article focuses on the current abduction suspension suture technique for the lateral pharyngeal wall, aiming to explore how to maximize the expansion of the lateral pharyngeal wall with minimal damage, improve the symptoms of patients with obstructive sleep apnea, and reduce postoperative complications, thus providing a useful reference for the relevant clinical treatment work.
Research progress on the mechanism of comorbidity between obstructive sleep apnea and depression
LI Lilin, LI Xinyi, GUAN Jian
2025, 39(3):  89-96.  doi:10.6040/j.issn.1673-3770.0.2024.513
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Obstructive sleep apnea(OSA)is a common sleep-related breathing disorder. Depression, also known as depressive disorder, is a prevalent mental disorder. OSA and depression interact with each other. Patients with OSA have a higher prevalence of depression, as poor sleep structure, daytime fatigue and complaints from others about snoring negatively affect the mood of OSA patients; patients with depression frequently experience sleep disturbances, which may increase the risk of OSA through abnormal neurotransmitter levels and altering muscle tone. Moreover, co-occurrence of these disorders often manifests as more severe symptomatology and complex therapeutic challenges. Shared pathophysiological mechanisms include neuroinflammation, oxidative stress, gut microbiota dysbiosis, impaired synaptic plasticity, lower 5-HT levels, and complement activation. These mechanisms interact in the occurrence and development of OSA and depression, and jointly promote the progression of the disease. In this paper, we summarize the epidemiology, pathogenesis, and treatment of OSA and depression comorbidity, aiming to deepen the understanding of the two co-comorbidities and to provide scientific support for precise treatment of patients.
Etiology and treatment advances in glottic insufficiency
ZHOU Zhihang, LIU Suru, ZHOU Jing, CHEN Dan, YANG Jiajing, LIU Rui, ZHOU Li
2025, 39(3):  97-103.  doi:10.6040/j.issn.1673-3770.0.2024.519
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Glottic insufficiency refers to the incomplete closure of the bilateral vocal cords in the absence of space-occupying lesions, resulting in air "leakage." The primary manifestations include persistent hoarseness, weak phonation, and a breathy voice. Some patients may also exhibit symptoms such as choking, dysphagia, and even aspiration. The etiologies of glottic insufficiency encompass structural voice disorders, such as vocal fold sulcus and vocal fold scarring, as well as regulatory voice disorders, such as vocal fold paralysis and phonatory fatigue. Clinically, assessment tools often include the voice-related quality of life scale, laryngoscopy, acoustic analysis of the voice, electroglottography, and aerodynamic measurements. For patients suspected of having vocal fold paralysis, laryngeal electromyography is employed. The treatment of glottic insufficiency aims to reduce the glottic gap during phonation, thereby improving the patient's voice quality. This paper reviews the common causes and treatment methods for glottic insufficiency, summarizes the latest advancements in diagnosis and treatment, and provides a reference for clinicians.
Original Article
Research on screening the key genes of age-related hearing loss by GEO database
ZHANG Lixia, LI Lin
2025, 39(3):  104-114.  doi:10.6040/j.issn.1673-3770.0.2024.011
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Objective Screen for the key genes of age-related hearing loss(ARHL)using bioinformatics methods, and provide a new theoretical basis for the clinical diagnosis and treatment of ARHL. Methods Two data sets related to ARHL were obtained from the GEO database and differentially expressed genes(DEGs)were analyzed using the GEO2R tool. DEGs were analyzed using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genome(KEGG)enrichment analysis using the DAVID tool, and a protein-protein interaction(PPI)network was constructed based on STRING database and Cytoscape software. The key genes were screened by the CytoHubba plug-in in Cytoscape software. Key genes were verified in the DEAF model mice. Results 100 DEGs(Differentially Expressed Genes)were selected from the GSE127204 and GSE196870datasets, and the enrichment analysis of GO and KEGG found that they were mainly enriched in cytokine-cytokine receptor interaction and other pathways. Key genes were selected by Cytoscape software, including IRF7, PTPRC, CXCL10, IFI44, IFI204, USP18 and CD4. On this basis, RT-qRCR was used to detect the expression of 7 key genes in mouse cochlear tissue, which further verifying that the above 7 genes were highly expressed in age-related deafness. Conclusion In this study, bioinformatics screening combined with RT-qRCR detection of mouse cochlear tissue and other experimental results confirmed that the expression of 7 key genes was significantly increased in age-related hearing loss.This study provides a new idea and theoretical basis for the early diagnosis and clinical treatment of age-related hearing loss.
Personalized use of batroxobin in the treatment of sudden sensorineural hearing loss with full frequency decline
LIN Yushan, LU Biaoqing
2025, 39(3):  115-121.  doi:10.6040/j.issn.1673-3770.0.2024.097
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Objective To study the therapeutic effect of different doses of batroxobin in the treatment of sudden deafness with full frequency hearing loss. Methods Individuals who consented to receive Batroxobin treatment for sudden full frequency descending deafness were categorized into three groups based on their level of plasma fibrinogen prior to treatment(also known as Fib). Group A(23 cases)consisted of 1 g/L≤Fib<2 g/L; Group B(41 cases)consisted of 2 g/L≤Fib≤4 g/L, and Group C(22 cases)consisted of Fib>4 g/L; or patients not receiving Batroxobin medication, were assigned to group D(34 cases). Groups A, B and C received 5 Bu, 10 Bu and 15 Bu of batroxobin, respectively, for the first time based on traditional medication treatment, and Fib was rechecked 1-2 days later. Drug use was temporarily stopped if Fib was less than 1 g/L; if Fib(rechecked)was between 1 and 2 g/L, 5 Bu of batroxobin was administered; if 2 g/L was between 1 and 4 g/L, 10 Bu of batroxobin was administered; while if Fib(rechecked)was greater than 4 g/L, 15 Bu of batroxobin was administered. The entire course of treatment involved three doses of batroxobin, ranging in dosage from 15 Bu to 45 Bu. Patients in each group's total effective rate was compared with patient rates throughout the entire course of treatment. Results The average hearing threshold of patients in groups A to D improved after treatment, and the average hearing threshold before and after treatment within the group was statistically significant(P<0.05); The total effective rates of groups A to D were 56.52%, 46.34%, 63.64%, and 20.59%, respectively, with statistical significance(P<0.05). There was a statistically significant difference in total effective rates between groups A and D, B and D, C and D(P<0.05), while there was no statistically significant difference in total effective rates between groups A, B and C(P>0.05); There was no statistically significant difference in efficacy classification between the four groups of patients(P>0.05). Conclusion All four treatment methods are effective, with Group A, Group B, and Group C having better efficacy than Group D. It is believed that in the treatment of sudden deafness with full frequency decline, the addition of batroxobin has better efficacy. However, the difference in initial and maintenance doses of Batroxobin does not affect final efficacy.
Prediction model of cardiovascular disease risk in people with dual sensory impairment: analysis based on CHARLS
LYU Yong, FENG Yun
2025, 39(3):  122-128.  doi:10.6040/j.issn.1673-3770.0.2024.638
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Objective To establish a prediction model of cardiovascular disease(CVD)in people with dual sensory impairment based on the data of CHARLS database. Methods A cohort from China Longitudinal Study on Health and Retirement(CHARLS)in 2011 was included. The baseline population was people over 45 years of age with dual sensory impairment and no CVD, and the follow-up CVD in 2013, 2015, 2018 and 2020 was used as the outcome variable. LASSO regression and Logistic regression were used to screen the best predictors in the model, and a prediction model was constructed. Then, the research population was randomly divided into training set and verification set at the ratio of 75% to 25%. The prediction performance is evaluated by ROC curve, calibration curve and decision curve analysis. Results A total of 5866 participants with double sensory impairment were included, and the incidence of CVD was 16%(938/5866). Lasso regression and multivariate logistic regression selected age, sex, sleep duration, dyslipidemia, nephropathy, waist circumference, BMI and diabetes as predictors to build a prediction model, and the formula was: 0.027 40×age-0.052 52×gender-0.073 61×sleep duration+0.153 26×BMI-0.372 05×dyslipidemia -0.057 37×diabetes -0.252 30×nephropathy-0.014 67×waist circumference. The AUC value of the model was 0.729 in the training set and 0.692 in the verification set. Conclusion In this study, a prediction model was established to evaluate the risk of CVD in people with double sensory impairment.
The value of a novel nasal secretion eosinophil cationic protein-myeloperoxidase test paper assay in allergic rhinitis
ZHANG Zhuping, PENG Zican, XIAO Zhenlong, LI Cheng, YU Di, WANG Xinglong, CHEN Wei, Guo Bei
2025, 39(3):  129-134.  doi:10.6040/j.issn.1673-3770.0.2023.449
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Objective To investigate the value of a novel nasal secretion eosinophil cationic protein-myeloperoxidase(ECP-MPO)test paper in allergic rhinitis(AR). Methods We included 123 patients with AR admitted to the department of otolaryngology head and neck surgery, the central hospital of Wuhan from January 2022 to December 2022 as the AR group and 36 healthy patients as the control group. AR patients were treated with budesonide nasal spray for 14 days. The degree of ECP coloration in the AR group before and after treatment and in the control group was determined using nasal secretion ECP-MPO test paper, and the concentration of ECP in nasal secretion was also detected. Nasal secretion smears were made to count the percentage of eosinophils(EOS%), and subjective symptom scores were collected. The differences and correlations between the indexes were analyzed, and the working efficacy of ECP test paper scores in the auxiliary diagnosis of AR was analyzed by using the receiver operating characteristic curve(ROC). Results The pre-treatment ECP test strip scoring was higher in AR group than the post-treatment and the control group. The chromogenic grade correlated positively with ECP concentration of nasal secretion, EOS% of nasal secretion, rhinoconjunctivitis total nasal symptom score(TNSS)and visual analogue scale(VAS). ROC curve analysis showed that the area under ROC curve was 0.935, the sensitivity was 89.4% and specificity was 91.7% for the detection of AR with 1 as cut-off value. Conclusion The ECP-MPO test paper can effectively detect ECP concentration in nasal secretions, and its chromogenic grade can reflect the severity of symptoms in AR patients, which has a good auxiliary diagnostic value for AR.
Correlation between the occurrence of localized amyloidosis of the larynx and abnormalities of glutathione in men
LI Pengze, YU Shuang, WANG Jiafeng
2025, 39(3):  135-140.  doi:10.6040/j.issn.1673-3770.0.2025.052
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Objective To perform a retrospective descriptive analysis of the clinical features of localized amyloidosis(LA)of the larynx and to search for biochemical indicators that may be associated with pathogenesis. Methods Clinical symptoms and blood biochemical measurement data from case records of patients with pathologically diagnosed laryngeal LA were descriptively analyzed, and risk factors associated with laryngeal LA in men and women were analyzed by binary logistic regression using case-control study methodology. Results 1.General description of the 46 patients with laryngeal LA: 31 males and 15 females, male-to-female ratio of 2.07∶1.00, age at first diagnosis of 46 years old, and main symptom of hoarseness. The site of laryngeal LA lesions, unilateral vocal folds in 18 cases, bilateral vocal folds in 16 cases, and non-vocal area in 12 cases. The duration of hoarseness symptoms before diagnosis was long, with a mean of(86.57±32.52)months. 37 cases of laryngeal LA underwent laryngoscopic CO2 laser resection, and the remaining 6 were treated with conventional laryngoscopic surgery, and only 1 case recurred 10 years after surgery. The median follow-up period was 10.61 years, and only one case died of cerebral hemorrhage 1.5 years after surgery, and all other patients survived, with a survival rate of 97.8%. 2.Comparative analysis of male and female patients with laryngeal LA: males had higher levels of alanine aminotransferase(ALT), aspartate aminotransaminase(AST), and gamma-glutamyl transpeptidase(GGT)than women, and the difference was statistically significant. In the regression analysis with reciprocal adjusting factors, an association was found between elevated ALT levels and the risk of laryngeal LA in men(OR=1.461,95%CI=1.021-2.090, P=0.038). Conclusion Laryngeal LA, whose main symptom is hoarseness and which lasts for a long time before diagnosis, is more frequent in men than in women, and surgical resection is highly effective,with a survival rate of more than 95% after 10 years of follow-up. The gender comparison suggests that elevated ALT may be associated with the risk of laryngeal LA in men, but multicenter prospective studies with larger samples are needed to confirm this.
Therapeutic effects of human umbilical cord mesenchymal stem cells induced by TNF-α on limbal stem cell deficiency in mice
YU Haonan, ZHONG Yingying, WANG Xinmeng, ZHANG Min, JIANG Qingmin, LI Nan, LI Yan
2025, 39(3):  141-147.  doi:10.6040/j.issn.1673-3770.0.2023.433
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Objective To investigate the repairing effect of local application of tumor necrosis factor alpha(TNF-α)-induced human umbilical cord mesenchymal stem cell conditioned medium(hUCMSC-CM)on limbal stem cell deficiency(LSCD)in mice. Methods Primary human umbilical cord mesenchymal stem cells were isolated and cultured in vitro by the adherent tissue block culture method, the fourth generation hUCMSCs were induced with TNF-α, and the TNF-α-induced human umbilical cord mesenchymal stem cell conditioned medium(hUCMSC-CMT)was collected. Forty-eight healthy 6-week-old C57 male mice were randomly divided into the control group(group N)and LSCD experimental group, and the LSCD experimental group model was established by limbal alkali burn and divided into negative PBS injection control group(group A), hUCMSC-CM injection treatment group(group B), and the injection treatment group hUCMSC-CMT(group C)according to the different components of subconjunctival injection after modeling, and the subconjunctival injection was once a day for 7 consecutive days. On the 3rd and 7th days after LSCD modeling, the degree of corneal epithelial defect was observed and scored by slit-lamp microscopy, and corneal neovascularization was observed and scored by slit-lamp microscopy on the 7th and 21st days after LSCD modeling. Immunohistochemical staining was used to detect the expression of α-smooth muscle actin(α-SMA)and ocular surface mucin 5AC(Muc-5AC). Results The mice in group A showed large areas of corneal epithelial defect on day 3 after modeling; obvious congested limbal blood vessels were observed on day 7 after modeling. The corneal epithelial defect developed in more than 2/3 of the cornea. On the 21st day after modeling, more neovascularization in the corneal limbus was observed, and some could reach 2/3 of the corneal diameter. According to the statistical results, both group B and group C had significant improvements in reducing corneal neovascularization and repairing corneal epithelial defect, and the curative effect was stronger in group C than in group B. Immunohistochemical staining showed that there was no expression of α-SMA in the corneal stroma and no expression of Muc-5AC in the corneal epithelial layer of the normal group. At 7 and 21 days after modeling, the cornea of each experimental group showed positive expression of α-SMA. The expression of α-SMA was significantly lower in groups B and C than in group A. The average optical density values of Muc-5AC in three experimental groups on the 7th day after modeling were not significantly different. Conclusion Subconjunctival injection of hUCMSC-CMT or hUCMSC-CM could enhance the function of limbal stem cells, promote corneal epithelial repair, and protect ocular surface tissues. In addition, hUCMSC-CMT had stronger repairing and therapeutic effects on limbal stem cell deficiency in mice than hUCMSC-CM.
Tonsil Burkitt lymphoma involving pulmonary and maxilla in children: a case report and literature review
HUANG Aiping, WANG Juan, WANG Li, GENG Jiangqiao, WANG Yafang, WEN Xin
2025, 39(3):  148-152.  doi:10.6040/j.issn.1673-3770.0.2024.208
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Objective To investigate the pathogenesis, diagnostic strategy and prognosis of pediatric tonsil Burkitt lymphoma(BL). Methods The clinical data of a child with tonsil BL involving the maxilla and pulmonary were retrospectively analyzed, and relevant literature was reviewed. Results Pediatric tonsil BL is rare, and there are no clinical reports involving the maxillary bones and pulmonary. The diagnosis of tonsil BL relies on pathological examination. The main treatment approach involves high-dose, short-course, and multi-drug combined chemotherapy. Conclusion Pediatric tonsil BL is highly aggressive, and the disease progresses rapidly and has diversified clinical manifestations. Early diagnosis and timely chemotherapy are crucial for effective treatment of the disease.
Review
Progress of m6A recognition protein IGF2BPs in head and neck cancer
YANG Ming, LIU Xuexia, ZHANG Hua
2025, 39(3):  153-161.  doi:10.6040/j.issn.1673-3770.0.2024.240
Abstract ( 39 )   PDF (1698KB) ( 7 )   Save
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RNA epigenetic modifications play a crucial role in tumor development, with N6-methyladenosine being the primary epigenetic modification found in all eukaryotic messenger RNAs. Recently discovered, the m6A reader family known as IGF2BPs targets GG(m6A)C sequences and enhances mRNA stability, thereby promoting tumor cell proliferation, invasion and migration, and contributing to tumorigenesis and development. This paper aims to review the involvement of IGF2BPs in head and neck tumors along with their underlying mechanisms, providing new insights for clinical molecular targeting therapy on IGF2BPs.
Study on the relationship between the effects of hyperlipidemia on retinal damage and choroid thickness
MAO Yiheng, FENG Jie, HE Runtian
2025, 39(3):  162-167.  doi:10.6040/j.issn.1673-3770.0.2023.442
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The patients with hypercholesterolemia and high and low-density lipoproteinemia comprise a high proportion of patients with fundus diseases. This has thus become an important risk factor in the occurrence and development of fundus diseases. The present study explored the effects of hypercholesterolemia and high- and low-density lipoproteins on choroidal thickness and the retinal photosensitive cell layer. These effects include promotion of the aggregation of inflammatory factors and vascular endothelial growth factor, as well as changes of choroidal thickness in fundus diseases such as macular degeneration, macular edema, and choroidal detachment. The law of change of choroidal thickness was summarized to provide a reference for early warning of the occurrence and development of these diseases.
Mechanistic study and prevention of visual field defects after vitrectomy
LI Zhifu, GAO Yu
2025, 39(3):  168-176.  doi:10.6040/j.issn.1673-3770.0.2023.518
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Currently, standard three-port ciliary flattening pars plana vitrectomy(PPV)is the most commonly used surgical procedure for the treatment of posterior segment diseases. In recent years, with the development of medical technology, PPV has entered the era of minimally invasive sutureless surgery, and its indications have expanded with fewer complications. However, visual field defects(VFD)after PPV have been frequently reported and have a serious impact on patients' lives, but the mechanism of VFD is still unknown, and there is a lack of systematic classification and summarization of the causes of VFD. In this article, we summarize the major causes of VFD after PPV and preventive measures to help reduce such complications in clinical treatment.
Changes of ocular surface parameters of digital eye strain and its prevention and mitigation measures
CHEN Liqun, HALIMUBIEKE Shamali, WANG jing, WANG Fujiang, Yi Xianglong
2025, 39(3):  177-182.  doi:10.6040/j.issn.1673-3770.0.2024.063
Abstract ( 46 )   PDF (1028KB) ( 13 )   Save
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Digital eye strain is a variety of eye discomfort caused by the application of digital devices, including blurred vision, conjunctival congestion, visual adjustment disorders, etc., as well as some extraocular symptoms, such as headache, neck and back muscle pain and so on. At present, this phenomenon is widespread, and it has caused many adverse effects on people's life and work. Therefore, it is imperative to correctly understand and deal with such problems. This paper summarizes a number of related studies in recent years, discusses the relationship between the use of intelligent devices and digital eye strain, and puts forward a number of measures to preventdigital eye strain, in order to better provide scientific guidance for the eye health of intelligent device users.

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