[The value of acoustic parameters in the voice therapy for patients with unilateral vocal cord paralysis]

Objective: To investigate the value of acoustic parameters in the voice therapy for patients with unilateral vocal cord paralysis (UVCP). Methods: From May 2015 to April 2018, 51 patients with UVCP and 59 healthy controls in Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, were involved in this research retrospectively. The UVCP patients were diagnosed with stroboscopic laryngoscopy. The minimum glottal area (MGA) was calculated by KIPS software when the people were pronouncing/i:/. The fundamental frequency (F0), Jitter, Shimmer and NHR were detected by CSL4500 multiple acoustic voice analyzer. Results: MGA of UVCP patients was much higher than that of healthy control (male: 433.68±64.52 vs. 294.41±51.82, t=9.23, P=0.000; female: 498.80±73.42 vs. 302.03±76.54, t=13.21, P=0.000), which meaned vocal cord insufficiency.After voice therapy, MGA reduced significantly (male: 288.48±55.09, female: 258.22±57.17, t=24.41 and 31.22, P=0.000 vs. pre-therapy). MGA of untreated patients decreased in varying degrees. Compared with the voice therapy group, the MGA decreased in a significantly lower extent (24.25±22.91 vs. 188.31±54.37, t=8.97, P=0.000). The F0, Jitter, Shimmer and NHR raised significantly in UVCP patients group (P=0.000 vs. healthy control group), and they were reduced by voice therapy (all P<0.05). Each of the four acoustic parameters was relative with MGA, r=0.551, 0.867, 0.853 and 0.875 in turn, P=0.001, 0.000, 0.000, and 0.000. Conclusion: MGA and acoustic parameters can reflect the acoustic features of UVCP patients, which are useful tools in the UVCP assessment and voice therapy.

[Application of narrow band imaging in laryngeal tumor]

Objective:To explore the application of narrow band imaging(NBI) technology in laryngeal tumor.Method:From Appril 2014 to Otober 2016, three hundred and twenty-two patients with suspected laryngeal cancer or precancerous lesions were enrolled in the First Central Hospital of Tianjin. Each patient was examined by electronic nasopharyngolaryngoscope under white light and NBI model. The sensitivity, specificity and accuracy of laryngeal tumor diagnosis under white light mode and NBI mode was compared based on pathological results. Result:The sensitivity, specificity and accuracy of white light mode in laryngeal tumor diagnosis were 77.17%,62.07% and 74.36%, respectively whereas the NBI model were 92.91%,77.59% and 90.06%, respectively.The sensitivity and accuracy of NBI model in laryngeal tumor diagnosis were significantly higer than white light model(P<0.05),but not the specificity. Conclusion:The electronic nasopharyngolaryngoscope of NBI technology not only found early lesions of laryngeal cancer, but also can improve the sensitivity and accuracy of laryngeal tumor diagnosis.

TCF7L2 gene polymorphisms and susceptibility to breast cancer: a meta-analysis

Numerous studies have evaluated the association between TCF7L2 gene polymorphisms (rs12255372 and rs7903146) and breast cancer risk. However, the results have been inconsistent. Therefore, in the current study, we performed a meta-analysis. A systematically literature search of the PubMed and EMBASE databases was conducted in November 2013, and the reference lists of articles were retrieved. A summary odds ratio (OR) with its 95% confidence interval (CI) were calculated to evaluate the strength of association. Publication bias was investigated using Begg's funnel plot. Meta-analysis was performed using STATA package version 12.0. A total of 4 case-control studies met our inclusion criteria, including 4600 cases and 5289 controls. Overall, TCF7L2 gene polymorphisms were significantly associated with an increased risk of breast cancer in genetic comparison models (rs12255372 for GG vs GT: OR = 0.90, 95%CI = 0.83-0.98; rs7903146 for CC vs TT: OR = 0.75, 95%CI = 0.63-0.90, CC vs CT: OR = 0.88, 95%CI = 0.81-0.97, dominant model: OR = 1.16, 95%CI = 1.06-1.27, recessive model: OR = 0.79, 95%CI = 0.67-0.94). This meta-analysis demonstrated that TCF7L2 gene polymorphisms (rs12255372 and rs7903146) are associated with an increased susceptibility to breast cancer. However, further studies including large sample sizes are needed to validate this association.

Metabotropic glutamate subtype 7 and 8 receptors oppositely modulate cardiac nociception in the rat nucleus tractus solitarius

Recent study from our laboratory has indicated that microinjection of glutamate into the nucleus tractus solitarius (NTS) facilitates the cardiac-somatic reflex induced by pericardial capsaicin. Further, N-methyl-d-aspartate (NMDA) receptors and metabotropic glutamate receptors (mGluRs) mediate this function. However, the roles of the individual receptor subtypes or subunits in modulating cardiac nociception are unknown. Among the three groups of mGluRs, group III mGluRs are the primary mGluR subtype expressed in visceral afferent neurons in the NTS. The present study examined the roles of group III mGluRs and their subtype 7 and 8 receptors (mGluR7 and mGluR8) in modulating the cardiac-somatic reflex induced by pericardial capsaicin, which was monitored by recording electromyogram (EMG) activity from the spinotrapezius muscle in anesthetized rats. Intra-NTS microinjection of a group III mGluR agonist, l-(+)-2-Amino-4-phosphonobutyric acid (l-AP4, at 1, 10, and 20 nmol) or a selective mGluR7 agonist, N,N'-diphenylmethyl-1,2-ethanediamine dihydrochloride (AMN082, at 1, 2, and 4 nmol) both decreased the EMG response in a dose-dependent manner. This decrease was inhibited by the group III mGluR antagonist (RS)-α-Methylserine-O-phosphate (MSOP, at 20 nmol). In contrast, intra-NTS microinjection of a selective mGluR8 agonist, (S)-3, 4-dicarboxyphenylglycine (DCPG, at 6 and 8 nmol), significantly increased the EMG response above control levels. This effect was eliminated by intra-NTS MSOP and by vagal deafferentation. These data suggest that group III mGluRs and mGluR7 in the NTS display an inhibitory effect, while mGluR8 displays a facilitatory effect in modulating cardiac nociception, and this facilitatory effect is dependent on vagal afferents.

Chemical lesioning and glutamate administration reveal a major role for the nucleus tractus solitarius in the cardiac-somatic reflex in rats

Many patients suffer from secondary muscle hyperalgesia after experiencing angina pectoris. In this study, we examined the role of the nucleus tractus solitarius (NTS) and glutamate receptors in modulating cardiac-evoked muscle hyperalgesia induced by pericardial capsaicin, which was monitored by recording electromyogram (EMG) activity from the spinotrapezius muscle in the anesthetized rat. Unilateral chemical lesioning of the commissural NTS with the neurotoxin ibotenic acid significantly depressed the cardiac-somatic reflex; the EMG responses decreased to 56.4 ± 6.9% of that of the controls (5 of 5). Microinjection of the excitatory amino acid glutamate, at 10, 20, and 50 nmol, into the commissural NTS increased the EMG response, in a dose-dependent manner, to 116.9 ± 4.9%, 143.9 ± 10.2%, and 214.2 ± 15.8% (n=8), respectively, of that of the controls. In contrast, microinjection of the N-methyl-D-aspartate (NMDA) receptor antagonist (+)-5-methyl-10, 11-dihydro-5H-dibenzo [a, d]-cyclohepten-5,10-imine maleate (MK-801) at 4 and 6 nmol, decreased the EMG response to 45.2 ± 10.6% and 36.8 ± 14.3%, respectively, of that of the controls (n=8 for each dose). Similarly, the metabotropic glutamate receptor (mGluR) antagonist (RS)-a-methyl-4-carboxyphenylglycine (MCPG), at 2.5 and 5 nmol, decreased the EMG response to 65.2 ± 16.3% and 57.0 ± 4.2%, respectively, of that of the controls. When a combination of MK-801 and MCPG was administrated, the EMG response further decreased to 22.5 ± 13.2% (n=6) of that of the controls. However, administration of a non-NMDA receptor antagonist 6, 7-dinitroquinoxaline-2, 3-dione (DNQX), at 2 and 5 nmol, had no effect on the EMG response. These results suggest that the NTS is involved in the facilitation of the cardiac-somatic reflex, and that the NMDA receptor and mGluRs play an important role in mediating this effect.

Imaging of nasopharyngeal carcinoma with Tc-99m MIBI

PURPOSE

Differentiation of recurrent nasopharyngeal carcinoma (NPC) from radiation fibrosis using conventional diagnostic methods can be difficult. The authors prospectively studied patients with NPC to determine the efficacy of Tc-99m MIBI scintigraphy in detecting the primary, residual, and recurrent tumors.

MATERIALS AND METHODS

The authors performed Tc-99m MIBI SPECT studies of the head and neck and whole-body scans on 21 healthy adult volunteers and 43 patients with NPC before (n = 26) or after (n = 17) radiotherapy. The images were qualitatively assessed by comparing the nasopharyngeal uptake to scalp radioactivity. MIBI uptake index was calculated as a ratio of mean counts per pixel in the normal nasopharynx or tumor to mean counts per pixel in the scalp.

RESULTS

There was significantly higher uptake of Tc-99m MIBI by NPC than normal nasopharynx and radiation fibrosis (P < .05). The authors determined the optimum cutoff MIBI uptake index value of 1.3 with a sensitivity of 97%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 96%, and an accuracy of 98% for diagnosing NPC.

CONCLUSION

This study suggests that Tc-99m MIBI SPECT is useful for detecting primary NPC and for differentiating residual or recurrent tumor from radiation fibrosis. The authors propose the cutoff MIBI uptake index value of 1.3 for diagnosing NPC.