[Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population]

Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.

MicroRNA-203a-3p affects the biological characteristics of nasopharyngeal carcinoma by targeting vascular endothelial growth factor-C

Nasopharyngeal carcinoma (NPC) has a high incidence in Southeast Asia and China. This study aims to investigate the effect of miR-203a-3p and vascular endothelial growth factor-C (VEGF-C) on nasopharyngeal carcinoma. In this study, we investigate the transfection of miR-203a-3p mimics and the ability of miR-203a-3p to inhibit in nasopharyngeal carcinoma cell line 5-8F and C666-1, the expression levels of protein AKT, p-AKT in VEGF-C and the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signal pathway by plate clone formation experiment, flow cytometer PI staining method, transwell cell experiment, vasculogenic mimicry experiment, and Western blot. The results showed that miR-203a-3p in the nasopharyngeal carcinoma cell line significantly decreased, while VEGF-C in nasopharyngeal carcinoma tissues and cell lines significantly increased. Furthermore, miR-203a-3p inhibited the proliferation of nasopharyngeal carcinoma cells and blocked the cell cycle of nasopharyngeal carcinoma in the G⁰/G¹ phase, reduced the vasculogenic phenomena and epithelial-mesenchymal transition of nasopharyngeal carcinoma cells, and effectively inhibited the growth of nasopharyngeal carcinoma in vivo. The low expression of VEGF-C can inhibit the proliferation, vasculogenic mimicry, and epithelial-mesenchymal transition of nasopharyngeal carcinoma cells. We found that miR-203a-3p was expressed to a low degree in nasopharyngeal carcinoma. Furthermore, miR-203a-3p regulated the PI3K/AKT signal pathway by downregulating the expression of VEGF-C, thereby inhibiting the proliferation, migration, invasion, vasculogenic mimicry, epithelial-mesenchymal transition, and other malignant biological characteristics of nasopharyngeal carcinoma cells.

[Analysis on endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach under the microscope for skull base tumor with intra and extra-cranial involvement]

Objective: To evaluate the application of combination use of endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach microscopically in skull base tumor with intra and extra-cranial involvement. Methods: A total of 7 patients (4 males and 3 females, aging from 27 to 65 years old, with a medium age of 48) undergone complicated skull base surgeries via endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach microscopically from May 2016 to January 2018 were reviewed respectively. The patients included 2 cases of recurrent invasive pituitary adenoma, 3 cases of basal skull meningiomas, 1 case of clivus chondrosarcoma, and 1 case of recurrent nasopharyngeal carcinoma. The lesion extensively infiltrated nasal cavity, extending to the paranasal sinus, bilateral cavernous sinus, sellar region, suprasellar, superior clivus, temporal lobe, pterygopalatine fossa, infratemporal fossa and important intracranial vessels. All the 7 patients were treated under general anesthesia by endoscopic endonasal approach combined with frontotemporal orbitozygomatic approach under the microscope. Total excision rate, intraoperative and postoperative complications and postoperative curative effect were observed. All of them were followed up for 6 to 12 months. The Glasgow Outcome Scale (GOS) was used to evaluate the prognosis. Result: Total tumor removal was performed in 5 cases, subtotal removel in 2 cases. There was no complication during the operation. Postoperative severe complications occurred in 2 cases, including 1 case of cerebrospinal fluid rhinorrhea and intracranial infection, which was cured by lumbar cistern drainage and intrathecal injection; 1 case occurred oculomotor nerve paralysis, which recovered during follow-up. Postoperative complications occurred in 1 case of trochlear nerve dysfunction, 2 cases of facial numbness, and 1 case of tinnitus. During follow-up, all patients recovered to varying degrees. There was no bleeding and death after the operation. No tumor recurred during the follow-up period. All patients were recovered well with GOS grade Ⅳ-Ⅴ. Conclusions: Endoscopic transnasal approach combined with microscopic frontotemporal orbitozygomatic approach can remove tumors in one stage, reduce surgical complications and improve surgical effect. It has good application prospects and is suitable for excising complex intracranial and extracranial communicating tumors of widely involving sellar, clivus and petrous apex area.

[Analysis of correlation between magnetic resonance imaging features and prognosis of invasive pituitary adenoma]

Objective: To explore the application of conventional nuclear magnetic resonance imaging, diffusion-weighted imaging and dynamic contrast-enhanced imaging in invasive pituitary adenoma, and to study the correlation between its imaging features and prognosis. Methods: The imaging manifestations (including T1WI, T2WI, ADC and dynamic contrast-enhanced MR), clinical features and pathological data of 47 cases of invasive pituitary adenomas (IPA) in Tianjin Huanhu Hospital from June 2017 to June 2018 were retrospectively analyzed, and compared with 16 cases of non-invasive pituitary adenoma (NIPA). The differences in tumor/white matter signal intensity ratio on T1WI and T2WI images, MR signs, ADC values and time signal-curve type, peak enhancement time and average enhancement rate between the two groups were observed. Postoperative MR enhanced scan and related hormone results were reviewed to evaluate the prognosis of all patients. Logistic stepwise regression analysis was used to analyze the relationship between IPA imaging characteristics and prognosis. Results: The location, shape, size, Knosp classification and ADC value of tumors were significantly different between IPA and NIPA groups (χ(2) values were 41.344, 21.818, 28.596 respectively, t values were 5.869, 11.720 respectively, all P<0.05). The majority of T1WI, T2WI and enhanced heterogeneous signals occurred in IPA group (P<0.05). IPA showed two-stage enhancement characteristics of rapid enhancement and fast subsidence phase. There were significant differences in peak enhancement time between intrasellar tumors and invasive cavernous sinus tumors. There were no significant differences in signal intensity of T1 and diffusion limitation and two-stage enhancement characteristics between the two groups (all P>0.05). There was a significant correlation between the ratio of tumor body/white matter signal on T2WI, ADC value and the constitution of invasive pituitary tumors (all P<0.05). In IPA, 9 cases(19%) were totally resected, 25 cases(53%) subtotally resected and 13 cases(28%) partially resected. Postoperative symptoms were improved in 29 cases(62%), alleviated in 6 cases(13%), unhealed in 3 cases(6%), assisted drug therapy in 7 cases and radiotherapy in 15 cases. All cases were followed up for 7 to 16 months, with a median time of 12.5 months. Eight cases recurred, with a recurrence rate of 17%. There were significant differences in the total/subtotal resection rate, the improvement rate of symptoms and the need for adjuvant treatment among IPA with different texture (all P<0.05).Knosp grade, tumor size and the ratio of tumor body to white matter on T2WI were associated with IPA recurrence (all P<0.05). Conclusion: It is helpful to diagnose IPA by analyzing the distribution, shape, size, ADC value and signal difference of tumors in sella turcica region through MR and DWI signs. Combined with dynamic contrast enhancement features, the invasion of IPA and its surrounding tissues can be early judged, and the texture of the tumors can be assessed by imaging signs, so as to better evaluate the therapeutic effect and prognosis of IPA.

[Magnetic resonance imaging characteristics and differential diagnosis of common sellar cystic lesions]

Objective: To investigate magnetic resonance imaging (MRI) characteristic and differential diagnostic keypoints of common sellar regional cystic lesions with the purpose of improving differential diagnostic accuracy. Methods: In total, 174 cases of the pathologically diagnosed cystic lesions in sellar region between March 2016 and June 2019 were included in the current retrospective analysis. These cases included Rathke's cleft cyst (n=68), craniopharyngioma (n=48), pituitary adenoma (n=56) and arachnoid cyst (n=2) in the sellar region. The position, texture and morphology of leisions, signal of cystic and solid part, invasion of surrounding tissues and maximum diameter of cysts on the MRI images were evaluated and compared between different groups. SPSS 25.0 software was used for statistical analysis. Results: There were several specific changes on several MRI sequences in Rathke's cleft cysts, craniopharyngioma and pituitary adenoma groups. For Rathke's cleft cysts, round shape, rare polycystic structure, lack of solid part and maximum diameter of cysts which was significantly less than that of craniopharyngioma and pituitary adenoma groups ((17.37±6.12) mm vs (30.29±13.51) mm vs (28.18±11.13) mm, t value was 6.680, 5.838, respectively, all P<0.05), were favorable diagnostic criteria. While, the intracystic nodules were mostly found in craniopharyngioma. There was no high signal intensity in cystic wall on T1WI and T2WI of pituitary adenoma. MRI signal of arachnoid cyst in sellar region was basically the same as CSF signal, with low signal intensity on T1WI and DWI, high signal intensity on T2WI, without enhanced signal. Conclusions: Common sellar regional cystic lesions showed characteristic manifestations on different MRI sequences. Valuable information in the morphology, MRI signal intensity, maximum diameter measurements may improve accuracy of differential diagnosis for sellar regional cystic lesions.

[Expression of mTOR and 4E-BP1 in extranodal Nasal-type NK/T-cell Lymphoma and implication for prognosis]

Objective: To study the expression of mTOR and 4E-BP1 in extranodal Nasal-type NK/T-cell Lymphoma(ENKTCL) and the correlation with the clinicopathological factors and prognosis of ENKTCL.Method: Immunohistochemistry was used to detect the expresstion of mTOR and 4E-BP1 in the tissues of ENKTCL and nasal pharyngeal lymphoid hyperplasia. The relationship between the expression of mTOR and 4E-BP1 and clinicopathological features was analyzed using the Chi-square test, which including sorting clinical stage, general condition score and international prognostic index(IPI). Result: The expression rates of mTOR and 4E-BP1 in ENKTCL were 63.9% and 58.3% respectively, and significantly higher than those（15.0% and 10.0%）in patients with nasal pharyngeal lymphoid hyperplasia(χ ²=12.355, P=0.0001; χ ²=12.410, P=0.0001). The positive expression rate of mTOR was linked to clinical staging, and the positive protein expressions in Stage Ⅲ and Ⅳwere higher than those in stageⅠand Ⅱ(χ ²=17.902, P=0.0001). mTOR expression was related to 4E-BP1(r=0.655,P=0.001). The positive expression rates of 4E-BP1were linked to IPI of lymphoma(χ ²=4.051, P=0.044). Conclusion: High-expressions of mTOR and 4E-BP1 in patients with ENKTCL are related to the biological progression and recurrence of ENKTCL and are malignant indicators to identify ENKTCL from nasal pharyngeal lymphoid hyperplasia. mTOR and 4E-BP1 may play important roles to assess ENKTCL prognosis..

[Clinical analysis of endoscopic endonasal approach for removal of sellar tumors]

Objective:To investigate the safety and efficacy of endoscopic endonasal approach for removal of sellar tumors. Method: The clinical data of 18 patients with sellar tumors undergoing endoscopic endonasal surgery were analyzed retrospectively. This series consisted of ten pituitary adenomas, five craniopharyngiomas, three meningiomas. The headache, visual improvement, endocrine, extent of resection and surgical complications were evaluated. Result:Total removal was achieved in 14 patients (77.8%), almost total removal was achieved in one patient of pituitary adenoma with two craniopharyngiomas (16.7%), and one patient with the subtotal removal of craniopharyngioma (5.6%) received gamma knife therapy. Overall, 18 patients with headache got improved obviously; 15 patients presented with visual and view impairment, All of them, vision and view were improved or even recovered to normal following surgery; There were 2 new cases of postoperative diabetes insipidu; 5(27.8%) patients had hyposmia after operation; 1 patient (5.6%) with adenoma suffered cerebrospinal fluid rhinorrhea, the second operation was successful. The follow-up lasted 12-84 months, no tumor recurrence was identified by MRI examination, and no patient died. Conclusion:The endoscopic endonasal approach is feasible and safe for the treatment of tumors in the sellar region. With advantages of clear vision, better exposure, without brain retraction, and preservation of vascular and neurological function. Skilled endoscopic technique and reliable skull base reconstruction are important to ensure success of surgery.

[Olfactory functional magnetic resonance imaging in patients with mild cognitive impairment]

Objective: To analyze the activation of brain regions associated with olfactory in patients with mild cognitive impairment (MCI) by olfactory functional magnetic resonance imaging (fMRI). Methods: Twenty six patients with MCI were compared with twenty six controls in the dementia center of Tianjin HuanHu hospital in terms of olfactory function T&T testing, the differences between the activation of the whole brain and region of interest associated with olfactory (bilateral primary olfactory cortex(POC), bilateral hippocampus, bilateral orbital frontal gyrus) by olfactory stimulator using event correlation design for olfactory fMRI scanning. To analyze the correlation between the number of activator in POC and the threshold of olfactory discriminate as well as the severity of cognitive impairment.SPSS 19.0 software was used for the statistical analysis. Results: T&T olfactory testing revealed that MCI patients had higher scores than controls (3.57±1.29 (x±s) vs 1.02±0.35, t=4.372, P<0.05). The activation range of whole brain in MCI patients was less than controls (pleasant odor (po) 147.36±21.45 vs 323.11±39.76, unpleasant odor (upo) 201.86±24.93 vs 447.73±57.22, t(po)=4.241, t(upo)=5.365, both P<0.05). The activation range of whole brain in inhaling unpleasant odor was more than pleasant odor in controls (447.73±57.22 vs 323.11±39.76, t=3.936, P<0.05). The number of activator in ROI(awo) in MCI patients was less than controls (pleasant odor (po) 51.0[8.0, 109.0](M[P(25), P(75)]) vs 135.0[21.0, 321.5], unpleasant odor (upo) 65.0[6.0, 158.0]vs 205.0[36.5, 491.0], Z(po)=-2.199, Z(upo)=-2.216, both P<0.05). The number of activator in POC in MCI patients was less than controls (pleasant odor (po) 19.0[4.0, 35.5]vs 46.0[9.0, 118.5], unpleasant odor (upo) 26.0[2.0, 51.0]vs 79.0[17.5, 189.0], Z(po)=-1.898, Z(upo)=-2.167, both P<0.05). The number of activator in POC was negatively correlated with olfactory discriminate threshold in MCI patients (r(po)=-0.415, r(upo)=-0.409, both P<0.05). The number of activator in POC was positively correlated with MoCA in MCI patients (r(po)=0.289, r(upo)=0.296, both P<0.05). Conclusion: Olfactory fMRI can objectively assess the olfactory function in MCI, it is a imaging indicator with neuropsychological tests for detection in MCI, the number of activator in POC can reflect the severity of MCI.

[Immune checkpoint inhibitor therapy in advanced head and neck cancer]

Immune checkpoint inhibitor therapy, which targets regulatory pathways in T cells to enhance antitumor immune responses, improves the life quality of cancer patients and has joined the ranks of surgery, radiation, and chemotherapy to become a major choice for cancer therapy. Over the past few years, multiple exciting results have been obtained on checkpoint inhibitor therapy in advanced head and neck cancer. However, questions such as patient selection and biomarkers for assessing the therapy are largely unsolved. Herein, we briefly review recent findings in checkpoint inhibitor therapy for advanced head and neck cancer. We will also discuss possible mechanism, safety, combination therapy, and side effects for the therapy. Checkpoint inhibitor therapy has led to important clinical advances and will provide a new weapon against cancer.

Speciation of gold(III)-L-histidine complex: a multi-instrumental approach

The formation and structure of gold (III)-L-histidine complex was investigated with the use of carbon (13C) and proton (1H) nuclear magnetic resonance (NMR), infrared (IR) spectroscopy, capillary electrophoresis (CE), capillary electrophoresis-inductively coupled plasma-mass spectroscopy (CE-ICP-MS), X-ray fluorescence spectroscopy (XRF), matrix-assisted laser desorption/ionization (MALDI), and laser desorption mass spectroscopy (LDMS). It was found that two L-histidine molecules and one gold ion slowly form a complex in acidic solution. Each L-histidine molecule provided two nitrogen ligands; one was the alpha-amino group and the other from the imidazole ring. The Au(III)-bis-L-histidine complex precipitates after deprotonation of the free carboxylic group, resulting in an increase in the solution acidity. Determination of the exact sequence of events and the identity of the complex was a comprehensive instrumental analysis problem involving the above techniques.

Powering the analytical glow discharge

The glow discharge may be powered by direct current (dc), radio frequency (rf) and pulsed discharge sources. Each has specific advantages and special features that should be considered by analysts using the various forms of glow discharge spectroscopy. This paper reviews some of the factors that contribute to the selection of a power source for the glow discharge.

Microsecond-pulse glow discharge atomic emission

A microsecond pulsed glow discharge was produced with high pulse magnitude and small duty cycle. Time resolved emission and absorption spectroscopy was applied to study the processes of atomization, excitation and ionization in the glow discharge. Experimental results show that, without overheating the sample, the emission peak intensity is several orders greater than that obtained in the conventional dc mode. This implies that a much more intense plasma is generated during pulsed "on" region.