-
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jun 2024To establish a staging system for guiding clinical treatment and prognostic risk assessment by retrospectively analyzing the cases with radionecrosis of the nasopharynx...
To establish a staging system for guiding clinical treatment and prognostic risk assessment by retrospectively analyzing the cases with radionecrosis of the nasopharynx and skull base (RNSB) after radiotherapy for nasopharyngeal carcinoma. A total of 86 cases of RNSB from January 2019 to December 2022 visited Department of Otorhinolaryngology Head and Neck, the People's Hospital of Guangxi Zhuang Autonomous Region. Seventeen patients gave up the treatment, and 69 patients who underwent treatment were included for analysis. By analyzing the results of electronic nasopharyngolaryngoscopy combined with magnetic resonance (MR), CT, and other imaging examinations, a staging system for RNSB was proposed. The relationship between the staging system and the surgical effectiveness and clinical prognosis was further analyzed. According to the severity and extent of destruction of soft tissue, bone, and the adjacent neurovascular structures, the RNSB was categorized into closed type (=5) and open type (=64), of which the open type was subdivided into five types: type Ⅰ(=4), type Ⅱ(=6), type Ⅲ(=39, of which 21 cases were type Ⅲa and 18 cases were type Ⅲb), type Ⅳ(=12), and type Ⅴ(=8). The clinical stage of RNSB were classified based on nasopharyngolaryngoscopy and imaging examinations, receiving the second course of radiotherapy or not, the involvement of the infection site, the extent of bone destruction, the degree of internal carotid artery involvement, and the degree of brain tissue necrosis: stageⅠ(1-2 scores), 11 cases at stageⅡ(3-4 scores), 24 cases at stage Ⅲ(5-6 scores), and 30 cases at stage Ⅳ( ≥ 7 scores or more). Twenty-two patients chose conservative treatment (2 patients at stage Ⅰ, 3 patients at stage Ⅱ, 7 patients at stage Ⅲ, and 10 patients at stage Ⅳ). Forty-seven patients chose nasal endoscopic surgical treatment (2 patients at stage Ⅰ, 8 patients at stage Ⅱ, 17 patients at stage Ⅲ, and 20 patients at stage Ⅳ), of which 16 cases had received free mucosal flap and/or stented septum mucosal flap repair. Patients at stages Ⅰ, Ⅱ, and Ⅲ achieved satisfactory efficacy after surgical treatment. In addition, higher clinical stage was found to correlate with the worse prognosis and higher incidence of perioperative complications, which included failure of healing because of surgical site infection, cerebrospinal fluid nasal leakage, progressive osteonecrosis, nasopharyngeal hemorrhage, and death. The staging system proposed in our study can be used for early detection of RNSB during regular follow-up, and is also valuable for clinical treatment guidance and prognosis assessment.
Topics: Humans; Male; Female; Skull Base; Nasopharyngeal Neoplasms; Retrospective Studies; Middle Aged; Necrosis; Radiation Injuries; Nasopharynx; Adult; Aged; Magnetic Resonance Imaging; Prognosis; Tomography, X-Ray Computed
PubMed: 38858113
DOI: 10.13201/j.issn.2096-7993.2024.06.007 -
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke... Apr 2024
Topics: Humans; Mediastinitis; Pyriform Sinus; Empyema, Pleural; Necrosis; Fistula; Drainage
PubMed: 38622024
DOI: 10.3760/cma.j.cn115330-20230811-00041 -
Medicine Mar 2024Acute pharyngitis (AP) refers to the acute inflammation of the pharynx, characterized by swelling and pain in the throat. Shuangyang houbitong granules (SHG), a...
BACKGROUND
Acute pharyngitis (AP) refers to the acute inflammation of the pharynx, characterized by swelling and pain in the throat. Shuangyang houbitong granules (SHG), a traditional Chinese medicine compound, have been found to be effective in providing relief from symptoms associated with AP.
METHODS
The chemical components of SHG were screened using Traditional Chinese Medicine Systems Pharmacology database, HERB database, and China National Knowledge Infrastructure. The targets of the granules were predicted using SwissTargetPrediction database. A network was constructed based on the targets of AP obtained from Genecards database, and protein-protein interaction analysis was performed on the intersection targets using STRING database. Key targets were screened for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis, and the binding activity of components and targets was predicted using AutoDockTools-1.5.7.
RESULTS
A total of 65 components of SHG that met the screening criteria were retrieved, resulting in 867 corresponding targets. Additionally, 1086 AP target genes were retrieved, and 272 gene targets were obtained from the intersection as potential targets for SHG in the treatment of AP. Molecular docking results showed that the core components genkwanin, acacetin, apigenin, quercetin can stably bind to the core targets glyceraldehyde 3-phosphate dehydrogenase, interleukin 6, tumor necrosis factor, serine/threonine protein kinase, tumor protein 53, and epidermal growth factor receptor.
CONCLUSION
The research results preliminarily predict and verify the mechanism of action of SHG in the treatment of AP, providing insights for further in-depth research.
Topics: Humans; Molecular Docking Simulation; Network Pharmacology; Pharyngitis; Pharynx; Neck; Drugs, Chinese Herbal; Medicine, Chinese Traditional
PubMed: 38552049
DOI: 10.1097/MD.0000000000037674 -
Journal of the American Animal Hospital... Mar 2024A 3 yr old female spayed Labrador retriever was referred for the treatment of a chronic oropharyngeal stick injury. After computed tomography scan evaluation, the...
A 3 yr old female spayed Labrador retriever was referred for the treatment of a chronic oropharyngeal stick injury. After computed tomography scan evaluation, the cervical area was explored surgically and a right-sided cervical abscess that contained a wooden stick was identified adjacent to the vagosympathetic trunk and carotid artery. The ipsilateral mandibular salivary gland was resected concurrently given its abnormal appearance, and histology confirmed inflammation and necrosis of the gland, which was suspected to be due to direct trauma from the foreign body. The clinical signs initially improved but then recurred, and a follow-up computed tomography scan was suggestive of sialadenosis or sialadenitis in the right parotid, zygomatic, and molar salivary glands. A presumptive diagnosis of sialadenosis was made and a course of phenobarbital was initiated. The clinical signs resolved completely within a few days, and there was no recurrence several months after termination of the phenobarbital treatment. This is the first case report of presumptive sialadenosis in a dog as a suspected complication of an oropharyngeal stick injury. Informed consent was obtained from the owner of the dog and the patient was managed according to contemporary standards of care.
Topics: Dogs; Female; Animals; Dog Diseases; Sialadenitis; Oropharynx; Phenobarbital; Parotid Gland
PubMed: 38394695
DOI: 10.5326/JAAHA-MS-7389 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2023The aim: This study aims to investigate and analyze the microbiome of the nasopharyngeal zone in acute respiratory infections (ARI) and their relationship with...
OBJECTIVE
The aim: This study aims to investigate and analyze the microbiome of the nasopharyngeal zone in acute respiratory infections (ARI) and their relationship with inflammatory markers.
PATIENTS AND METHODS
Materials and methods: Examination of 112 children (10-14 years old) with acute respiratory infections (ARI) of the upper respiratory tract was carried out. The control group consisted of 25 healthy children identical in age and examination parameters.
RESULTS
Results: When analyzing the microflora of the nasopharynx of patients, 29,0% of strains were gram-positive bacteria and 71,0% were gram-negative bacteria (Escherichia coli representing 37,0%). Biochemical examination of the biomaterial revealed the presence of sucrase (n=69), maltase (n=87), lactorepoxidase (n-89) and alcohols - sorbitol (hexahydric alcohol, n=102), mannitol (hexahydric alcohol, n=84), xylitol (pentahydric alcohol, n=86). Regarding the markers of inflammatory response, the following dynamics was noted: increase in the level of IgM (3,91 ± 1,79 g/l, p<0,01) by 2,2 times, elevation of Ig G level by 10 times (145, 91 ± 53,04 g/l, p< 0,01), slightly higher than the reference values IgE level. In addition, increased IL-1, IL-4, IL-6, γ-IFN, TNF-α, Neopterin levels were detected. The level of Thyroid stimulating hormone (TSH) was significantly different compared to the control group (0,62 ± 0,57 vs. 1,98 ± 0,30 mIU/ ml, p< 0,01), but within the reference values.
CONCLUSION
Conclusions: Predominance of Gram-negative bacteria in the nasopharyngeal microflora of patients along with elevated inflammatory markers and lactop-eroxydase enzyme predominance was detected in the study.
Topics: Child; Humans; Adolescent; Nasopharynx; Respiratory Tract Infections; Tumor Necrosis Factor-alpha; Microbiota
PubMed: 38112358
DOI: 10.36740/WLek202311112 -
Zhejiang Da Xue Xue Bao. Yi Xue Ban =... Dec 2023To explore the mechanism of in treatment of Alzheimer's Disease (AD).
OBJECTIVES
To explore the mechanism of in treatment of Alzheimer's Disease (AD).
METHODS
The active ingredients and targets of for treatment of AD were screened with network pharmacology methods, the protein-protein interaction (PPI) network was constructed and the core targets were analyzed. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways enriching analysis was performed. The peripheral blood lymphocytes were extracted and lymphoblastoid cell lines (LCL) were constructed and an cell model of LCL-SKNMC was established. MTT and CCK-8 methods were used to quantify SKNMC/LCL cells, 2 ´, 7 ´-dichlorodihydrofluorescein diacetate (DCFH-DA) probe was used to detect reactive oxygen species (ROS), and immunofluorescence staining was used to detect the generation of Aβ in a co-cultured model. Western blotting was used to detect protein expression in the co-culture model. The lifespan of N2 nematodes was observed under oxidative stress, normal state, and heat stress; ROS generated by N2 nematodes was detected by DCFH-DA probes. The paralysis time of CL4176 N2 nematodes was evaluated by paralysis assay, and Aβ deposition in the pharynx was detected by Thioflavin S staining.
RESULTS
Through network pharmacology, 15 potential active ingredients and 103 drug-disease targets were identified. PPI analysis showed that the might play anti-AD roles through albumin, Akt1, tumor necrosis factor, epidermal growth factor receptor (EGFR), vascular endothelial growth factor A (VEGFA), mammalian target of rapamycin (mTOR), amyloid precursor protein (APP) and other related targets. KEGG analysis showed that the pharmacological effects of might involve the biological processes of Alzheimer's disease, endocrine resistance, insulin resistance; and neuroactive ligand-receptor interaction, phosphatidylinositol 3-kinase (PI3K)-Akt signaling pathway, calcium signaling pathway, AGE-RAGE signaling pathway in diabetes complications, neurotrophic factor signaling pathway and others. The cell experiments showed that was able to reduce the production of ROS and Aβ (both <0.01), inhibit the expression of β-secretase 1 (BACE1), APP and Aβ proteins (all <0.05), up-regulate the expression of p-PI3K/PI3K, p-AKT/AKT, p-GSK3β/GSK3β in SKNMC cells (all <0.05). The studies further confirmed that prolonged the lifespan of under stress and normal conditions, reduced the accumulation of ROS and the toxicity of Aβ deposition.
CONCLUSIONS
may reduce the production of Aβ in AD and inhibit its induced oxidative stress, which may be achieved by regulating the PI3K/Akt/GSK-3β pathway.
Topics: Animals; Alzheimer Disease; Amyloid Precursor Protein Secretases; Drugs, Chinese Herbal; Glycogen Synthase Kinase 3 beta; Proto-Oncogene Proteins c-akt; Vascular Endothelial Growth Factor A; Caenorhabditis elegans; Network Pharmacology; Phosphatidylinositol 3-Kinases; Reactive Oxygen Species; Aspartic Acid Endopeptidases; Amyloid beta-Protein Precursor; Paralysis; Mammals; Fluoresceins
PubMed: 38105702
DOI: 10.3724/zdxbyxb-2023-0362 -
Cureus Sep 2023Toxic epidermal necrolysis (TEN) is a life-threatening, blistering dermatitis. It is characterized by fever and the development of mucocutaneous lesions, which lead to...
Toxic epidermal necrolysis (TEN) is a life-threatening, blistering dermatitis. It is characterized by fever and the development of mucocutaneous lesions, which lead to necrosis and sloughing of the epidermis. It is commonly triggered by medications and infections. We present the case of a 75-year-old male who presented to the hospital with a fever and widespread exfoliating skin rash involving 41% of his body surface area (BSA). He has a past medical history of gout, hypertension, asthma, and depression. He was recently started on allopurinol by his general practitioner (GP) for hyperuricemia. The condition also involved oral, eye, and pharynx mucosae. He was diagnosed with toxic epidermal necrolysis and was managed with intravenous (IV) hydrocortisone, steroid and antibiotic eye drops, and steroid and antibiotic topical creams. Due to the weak available evidence supporting the use of ciclosporin and intravenous immunoglobulins, this patient was managed with steroid use only. His rash initially worsened, but ultimately, he made a full recovery without any sequelae. The patient was reviewed in the dermatology clinic four weeks post-discharge, and he did not have any residual disease.
PubMed: 37809172
DOI: 10.7759/cureus.44812 -
International Journal of Surgery Case... Oct 2023The laryngopharynx wound is considered to be one of the most severe wounds of neck both in war and in peace, as it may cause life threatening changes in the whole body...
INTRODUCTION AND IMPORTANCE
The laryngopharynx wound is considered to be one of the most severe wounds of neck both in war and in peace, as it may cause life threatening changes in the whole body (asphyxia, bleeding, shock). Important aspects of surgical treatment are to ensure full breathing, acceptable ways of feeding, and the use of reliable wound closure techniques aimed to prevent digestive tract failure and to maintain the framework and aerostasis of the laryngotracheal region.
CASE PRESENTATION
A case of unilateral multiple wounds of the laryngopharynx was described in the article. The features of diagnostics, surgical treatment and conservative therapy in the postoperative period with this injury were presented. The wounded man was urgently operated. During surgery the pharynx was mobilized. The metal fragment was removed. The wound of the pharynx was sutured with a two-row suture. The next stage of the surgical treatment was myoplasty. In the case of the patient, the purpose of myoplasty was additional sealing of the pharyngeal suture and myoplasty of the thyroid cartilage injury zone for the purpose of aerostasis. Because of the size of the wounds and their anatomical localization, we used the mobilized lower edge of the Musculus sternocleidomastoideus for myoplasty and proposed the method of ladder myoplasty developed by us.
CLINICAL DISCUSSION
In myoplasty method the following criteria must be followed: the muscle flap must be of sufficient length and width, so as not to cause excessive tension in the myoplasty area; the flap must be thick enough to avoid necrosis that may cause subsequent infectious complications; when taking the flap, the most sparing operative access should be used to avoid functional and anatomical disorders; the volume of the taken muscle flap must not lead to functional and anatomical disorders.
CONCLUSION
The proposed method of ladder myoplasty using Musculus sternocleidomastoideus is unique, and proves its high efficiency in unilateral multiple laryngopharyngeal injuries, and can be recommended for wide clinical implementation in such clinical situations.
PubMed: 37797522
DOI: 10.1016/j.ijscr.2023.108875 -
Cleveland Clinic Journal of Medicine Aug 2023
Topics: Humans; Infectious Mononucleosis; Splenic Infarction; Palatine Tonsil
PubMed: 37527871
DOI: 10.3949/ccjm.90a.22079 -
Journal of Ethnopharmacology Jan 2024Hosta plantaginea (Lam.) Aschers flower is a famous Mongolian folk medicine in China and has a therapeutic effect on acute pharyngitis (AP). However, the effect and...
BACKGROUND
Hosta plantaginea (Lam.) Aschers flower is a famous Mongolian folk medicine in China and has a therapeutic effect on acute pharyngitis (AP). However, the effect and potential mechanism of H. plantaginea flower on AP have not been fully elucidated.
AIM OF THE STUDY
The present work aimed to evaluate the effects and mechanisms of the crude extract of H. plantaginea flowers (HP) and its four fractions of petroleum ether fraction (HPA), ethyl acetate fraction (HPB), n-butanol fraction (HPC), and water residue (HPD) against AP in rats.
MATERIALS AND METHODS
A 15% ammonia-induced AP rat model in rats was established. Therapeutic effects of HP and HPA∼D in model rats were evaluated based on body weight, histopathological analysis, and inflammatory parameters, including tumor necrosis factor α (TNF-α), prostaglandin E2 (PGE2), interleukin 1β (IL-1β), and IL-6. The protein expression of nuclear factor kappa-B p65 (NF-κB p65), inhibitor of NF-κB alpha (IκBα), c-Jun N-terminal kinases (JNK), mitogen-activated protein kinase (MAPK) p38, extracellular signal-regulated kinase (Erk), just another kinase 1 (JAK1), signal transducer and activator of transcription 3 (STAT3), phosphoinositide 3-kinase (PI3K), and protein kinase B (Akt) were detected by a Western blotting assay.
RESULTS
HP, HPB, and HPC treatments markedly alleviated AP in rats by increasing body weight and improving pathological damages in pharyngeal tissues. In addition, HP, HPB, and HPC treatments significantly inhibited inflammation, including decreasing the levels of TNF-α, PGE2, IL-1β, and IL-6, and suppressing phosphorylated protein expression of p65, IκBα, JNK, p38, Erk, JAK1, STAT3, PI3K, and Akt in pharyngeal tissues of rats.
CONCLUSION
Collectively, HP, HPB, and HPC can attenuate pharynx injury in rats by suppressing inflammation via inhibition of NF-κB, MAPKs, JAK-STAT, and PI3K-Akt pathways, which supports the traditional use of H. plantaginea flowers.
Topics: Rats; Animals; Proto-Oncogene Proteins c-akt; NF-kappa B; Signal Transduction; NF-KappaB Inhibitor alpha; Phosphatidylinositol 3-Kinases; Hosta; Interleukin-6; Inflammation; Extracellular Signal-Regulated MAP Kinases; Tumor Necrosis Factor-alpha; Pharyngitis; Flowers
PubMed: 37499845
DOI: 10.1016/j.jep.2023.116966