Τετάρτη 15 Σεπτεμβρίου 2021

Covid 19 Pandemic-Training of Healthcare Workers in Obtaining a Nasopharyngeal Swab: Our Experience

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Abstract

To describe the training of healthcare workers (HCW) in nasopharyngeal swabbing during the COVID 19 pandemic. Study design: Retrospective study. Setting: Tertiary care teaching hospital. Subjects and methods: One hundred and seventy eight health care workers were trained from May 2020 to January 2021. Three modules were designed to train the health care workers in the technique of obtaining a nasopharyngeal swab specimen.Training consisted of an instructional video on how to perform nasopharyngeal swabs and live demonstration followed by hands-on supervised training. The trainees included 30 doctors, 101 nurses, 31 respiratory therapists, 3 physiotherapists, 9 interns and 4 lab technicians. There were 39 male and 139 female trainees. After attending all 3 modules of training, they were confident and efficient in taking a non-traumatic nasopharyngeal swab. Good knowledge and adequate training is key to a good nasopharyngeal sampling for SARS CoV-2 testing.

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The development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug 7;56(8):812-818. doi: 10.3760/cma.j.cn115330-20200925-00771.

ABSTRACT

Objective: To investigate the development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children and the relationship between the two abilities. Methods: This retrospective study analyzed 31 preschool children with an average age of (2.3±1.2) years. All cases were assessed at pre-implant, 6 months and 12 months post-implant using the Infant-toddler Meaningful Auditory Integration Scale (IT-MAIS), the Meaningful Auditory Integration Scale (MAIS) and the Mandarin Early Speech Perception test (MESP) to evaluate their listening and speech perception abilities, and using the Speech,Spatial,and Other Qualities of Hearing Scale for Parents (SSQ-P) questionnaires to evaluate their speech perception and spatial hearing a bilities. SPSS 23.0 was used for the statistical analysis. Results: All children performed better at 6 months and 12 months post-implant with IT-MAIS/MAIS, MESP than pre-implant, and the scoring rate continued to improve, with a significant difference (P<0.01). For the SSQ-P (Speech) and SSQ-P (Spatial) scores, the mean scores of pre-implant were (0.9±0.2) points and (0.8±0.3) points, those of 6 months post-implant were (4.6±0.2) and (2.6±0.3), and 12 months post-implant were (6.2±0.2) and (6.3±0.3), the scores of the two groups were significantly different at pre-implant, 6 months and 12 months post-implant (P<0.01). The growth rate of SSQ-P (Spatial) from pre-implant to 12 months post-implant was 675.3%, and the growth rate from 6 months post-implant to 12 months post-implant was 140.6%, the growth rate showed an significant increase compared with IT-MAIS/MAIS, MESP and SSQ-P (Speech).SSQ-P (Speech) and SSQ-P (Spatial) scores were moderate correlat ion at 12 months post-implant(r=0.465, P=0.008). Conclusions: Within one year after cochlear implantation, listening, speech perception and spatial hearing abilities of preschool prelingual deaf children could show a comprehensive, continuous and significant progress as the implantation time increasing. The growth rate of spatial hearing is greater than that of speech perception at 12 months post-implant, and the spatial hearing could still show rapid development characteristics after 6 months post-implant.

PMID:34521164 | DOI:10.3760/cma.j.cn115330-20200925-00771

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Parathyroid hormone assay with eluent of aspirated tissues in parathyroidectomy

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug 7;56(8):844-847. doi: 10.3760/cma.j.cn115330-20201109-00858.

ABSTRACT

Objective: To explore the values of intraoperative fine-needle aspiration (IFNA) and parathyroid hormone (PTH) detection in the eluate of aspirated tissue during parathyroidectomy. Methods: Fifty-four patients with secondary hyperparathyroidism (SHPT) including 24 males and 30 females, aged 20-83 years, admitted to Zhongnan Hospital of Wuhan University from January 2019 to October 2019, were included. All patients received subtotal parathyroidectomy with autologous transplantation, during surgery, IFNA and PTH detection in the eluate of aspirated tissue were performed, and also routine postoperative pathological examination was performed. The results of PTH detection in the eluate of aspirated tissue and postoperative pathological examinations were compared and analyzed by SPSS and R software for e valuating of the sensitivity, specificity, positive predictive value, negative predictive value, misdiagnosis rate, missed diagnosis and accuracy. Results: Surgery was completed successfully in all patients. After surgery, the symptoms were improved in the patients except two who were asymptomatic. None had any serious postoperative complications such as hypocalcaemia or hoarseness. A total of 231 aspirated tissue samples were tested, of which 216 were identified as parathyroid and 15 non-parathyroid based on intraoperative PTH detection in tissue eluate; while 217 were confirmed as parathyroid tissues and 14 non-parathyroid tissues with postoperative pathological examinations. The specificity and sensitivity of intraoperative IFNA and PTH detection in tissue eluate for identifying parathyroid tissues were 99.5% and 100.0%, respectively. Conclusion: The IFNA and PTH detection in tissue eluate is a rapid, simple, and accurate procedure, which helps the surgeon to identi fy parathyroid tissue and to ensure the endocrine activity of preserved or autografted parathyroid tissue during parathyroidectomy.

PMID:34521169 | DOI:10.3760/cma.j.cn115330-20201109-00858

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Detection of oropharyngeal sensory function in normal population

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug 7;56(8):830-836. doi: 10.3760/cma.j.cn115330-20200831-00713.

ABSTRACT

Objective: To study the oropharyngeal sensory function by Current Perception Threshold(CPT) detection, to explore the detection method of oropharyngeal sensory function in normal population, and to analyze the possible influencing factors. Methods: Fifty-eight normal subjects were included prospectively in this study. Age, gender, body mass index (BMI) were collected. The age of the subjects ranged from 20 to 76 (43.27±13.52) years old. There were 34 females with 17 in childbearing period and 17 in menopause; and 24 males were included.In all the cases, 6 cases were in low BMI, 39 cases were in normal BMI, 10 cases were overweight and 3 cases were suffering from obesity. The CPT system of Neurometer was used to stimulate bilateral palatoglossal arch and tongue base.The current used was 2000 Hz, 25 0 Hz and 5 Hz respectively.The function of type Aβ, Aδ and C sensory nerve fibers were tested and the CPT values were recorded.The values were inversely proportional to pharyngeal sensation function.To evaluate the oropharyngeal sensory function of the subjects, the CPT values of each frequency at each testing point were compared. SPSS 25.0 software was used for statistical analysis. Results: The CPT value of palatoglossal arch was significantly lower than that of tongue base (t=-2.58,-2.65,-2.54,-2.47,-2.37,-2.77,P<0.05), 2 000 Hz>250 Hz>5 Hz, and there was no significant difference between left and right sides(t=-0.03,-0.51,-0.49,0.06,-0.16,0.13,P>0.05). The CPT value of male was slightly higher than that of female (t=0.92,1.55,0.27,0.78,1.44,1.26,0.35,0.77,1.27,0.24,0.78,0.96,P>0.05). The CPT values of women in childbearing period were significantly less than those in menopausal women (t=-3.90,-3.64,-2.14,-4 .20,-4.28,-4.28,-3.52,-4.46,-3.41,-3.63,-4.66,-2.86,P<0.05). The CPT value increased with age, and the values of all frequency of 20 to 30 years old group was significantly lower than those of subjects over 40 years old at each point (The t values of bilateral palatoglossal arch at 2 000 Hz were -5.57,-6.22,-10.18,-11.00;the t values of bilateral palatoglossal arch at 250 Hz were -6.39,-8.79,-6.39,-15.61;the t values of bilateral palatoglossal arch at 5 Hz were -7.09, -5.57, -9.26, -15.23;the t values of tongue base at 2 000 Hz were -3.11,-3.88,-7.60,-8.55;the t values of tongue base at 250 Hz were -6.31,-10.59,-8.52,-10.60;the t values of tongue baseat 5 Hz were -6.69,-5.09,-8.70,-7.07,P<0.05).The values at all frequencies and testing points of 30-40 years old group were significantly lower than those of all subjects over 60 years old (The t values of bilateral palatoglossal arch at 2 000 Hz were -10.91,-12.42;the t values of bilateral palatoglossal arch at 250 Hz were -6.25,-10.87;the t values of bilateral palatoglossal arch at 5 Hz were -5.53,-11.01;the t values of tongue base at 2 000 Hz were -8.62,-10.12;the t values of tongue base at 250 Hz were -6.89,-7.82;the t values of tongue base at 5 Hz were -6.13,-6.48,P<0.05). Conclusions: CPT can be used to evaluate oropharyngeal sensory function. The sensitivity of tongue base is lower than that of palatoglossal arch, there is no significant difference in oropharyngeal sensory function between male and female,between left and right sides. There are many factors influencing oropharyngeal sensory function. Age, hormone level changes may affect the sensitivity of oropharyngeal sensory function.

PMID:34521167 | DOI:10.3760/cma.j.cn115330-20200831-00713

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Body mass index and type 2 diabetes and breast cancer survival: a Mendelian randomization study

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Am J Cancer Res. 2021 Aug 15;11(8):3921-3934. eCollection 2021.

ABSTRACT

The causal relationship between body mass index (BMI) and type 2 diabetes (T2D) and breast cancer prognosis is still ambiguous. The aim of this study was to investigate the prognostic effect of BMI and T2D on breast cancer disease-free survival (DFS) among Asian individuals. In this two-sample Mendelian randomization (MR) study, the instrumental variables (IVs) were identified using a genome-wide association study (GWAS) among 24,000 participants in the Taiwan Biobank. Importantly, the validity of these IVs was confirmed with a previous large-scale GWAS (Biobank Japan Project, BBJ). In this study, we found that a genetic predisposition toward higher BMI (as indicated by BMI IVs, F = 86.88) was associated with poor breast cancer DFS (hazard ratio [HR] = 6.11; P < 0.001). Furthermore, higher level of genetically predicted T2D (as indicated by T2D IVs) was associa ted with an increased risk of recurrence of and mortality from breast cancer (HR = 1.43; P < 0.001). Sensitivity analyses, including the weighted-median approach, MR-Egger regression, Radial regression and Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) supported the consistency of our findings. Finally, the causal relationship between BMI and poor breast cancer prognosis was confirmed in a prospective cohort study. Our MR analyses demonstrated the causal relationship between the genetic prediction of elevated BMI and a greater risk of T2D with poor breast cancer prognosis. BMI and T2D have important clinical implications and may be used as prognostic indicators of breast cancer.

PMID:34522458 | PMC :PMC8414374

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Genetically predicted high circulating insulin-like growth factor-1 and insulin-like growth factor binding protein-3 increase the risks of soft tissue sarcoma

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Am J Cancer Res. 2021 Aug 15;11(8):3980-3989. eCollection 2021.

ABSTRACT

Insulin growth factor-1 (IGF-1) plays important roles in carcinogenesis. Previous studies have linked circulating IGF-1 and its main binding protein, insulin-like growth factor-binding protein-3 (IGFBP-3), to cancer risks. However, no study has been conducted in soft tissue sarcoma (STS). In this study, we investigated the relationship of genetically predicted circulating IGF-1 and IGFBP-3 with STS risks. Recent large genome-wide association studies (GWAS) have identified 413 single nucleotide polymorphisms (SNPs) associated with IGF-1 and 4 SNPs associated with IGFBP-3. We genotyped these SNPs in 821 patients and 851 healthy controls. We constructed weighted genetic risk scores (GRS) to predict circulating IGF-1 and IGFBP-3. We determined the associations of individual SNPs and GRS with the risks of STS using multivariate logistic regression analysis. We found hi gh genetically predicted circulating IGF-1 and IGFBP-3 were both associated with increased STS risks. Dichotomized at the median values of IGF-1 and IGFBP-3 in controls, individuals with high level of IGF-1 exhibited a 27% increased risk of STS (odds ratio [OR]=1.27, 95% confidence interval [CI]=1.04-1.54, P=0.017), whereas the OR for high IGFBP-3 was 1.45 (95% CI=1.20-1.77, P<0.001). Interestingly, the significant association between IGFBP-3 and STS risk was only evident in women (OR=1.88, 95% CI=1.42-2.49, P<0.001), but not in men (OR=1.00, 95% CI=0.75-1.33, P=0.992). In stratified analyses by major STS subtypes, the strongest associations were observed in angiosarcoma for IGF-1, leiomyosarcoma for IGFBP-3, and gastrointestinal stromal tumors for IGFBP-3 in women. In conclusion, high circulating IGF-1 and IGFBP-3 levels were both associated with increased STS risks.

PMID:34522462 | PMC:PMC8414386

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Downregulation of NEAT1 sensitizes gemcitabine-resistant pancreatic cancer cells to gemcitabine through modulation of the miR-506-3p/ZEB2/EMT axis

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Am J Cancer Res. 2021 Aug 15;11(8):3841-3856. eCollection 2021.

ABSTRACT

Chemoresistance is a major cause of treatment failure in pancreatic cancer (PC). It has been demonstrated that epithelial-to-mesenchymal transition (EMT) is closely related to drug resistance in PC; however, the underlying mechanisms are not yet fully understood. Recently found evidence has suggested that nuclear-enriched abundant transcript 1 (NEAT1) is involved in the development of chemoresistance. However, the role and mechanism of NEAT1 in PC gemcitabine resistance remain unknown. In the present study, we first established two independent gemcitabine-resistant (GR) PC cell lines, PANC-1/GR and SW1990/GR. We found that GR cells displayed markedly enhanced migration and invasion abilities, decreased expression of E-cadherin, and upregulation of N-cadherin, Vimentin, Snail, ZEB1, and ZEB2. Our findings suggested that downregulation of NEAT1 enhanced the sensitiv ity of GR cells to gemcitabine by reversing the EMT process. Mechanistically, NEAT1 mediates ZEB2 mRNA expression through sponging miR-506-3p. Downregulation of NEAT1 can reverse the EMT process of GR PC cells by reducing the expression of ZEB2, thus enhancing the sensitivity of GR PC cells to gemcitabine. These findings were further confirmed in a nude mouse xenograft model. Taken together, downregulation of NEAT1 sensitized the GR PC cells to gemcitabine through modulation of the miR-506-3p/ZEB2/EMT axis. These results provide the novel evidence for understanding the function and molecular mechanism of NEAT1, and a new direction for improving the chemotherapeutic effects in PC.

PMID:34522453 | PMC:PMC8414385

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bFGF-mediated phosphorylation of δ-catenin increases its protein stability and the ability to induce the nuclear redistribution of β-catenin

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Am J Cancer Res. 2021 Aug 15;11(8):3877-3892. eCollection 2021.

ABSTRACT

Recently, we have shown that δ-catenin strengthened the epidermal growth factor receptor (EGFR)/Erk1/2 signaling pathway through the association between EGFR and δ-catenin. Now, we further analyzed the correlation between basic fibroblast growth factor (bFGF)/fibroblast growth factor receptor 1 (FGFR1) and δ-catenin in prostate cancer and investigated the molecular mechanism underlying the role of bFGF/FGFR1 modulation in CWR22Rv-1 (Rv-1) cells. Here, we demonstrated that bFGF phosphorylated the tyrosine residues of δ-catenin in Rv-1 cells and further proved that the bFGF mediated FGFR1/δ-catenin tyrosine phosphorylation was time dependent. Furthermore, we demonstrated that bFGF stabilized the expression of δ-catenin through weakening its association with GSK3β and enhancing its stability to induce β-catenin into the nuclear by strengthening the processing of E-cadherin. In a word, these results indicated that bFGF/FGFR1 signaling pathway could enhance the tumor progression of prostate cancer via δ-catenin.

PMID:34522455 | PMC:PMC8414378

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Phonosurgery Training in Human Larynx Preserved with Thiel’s Embalming Method

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Background: To describe the suitability of larynges preserved with Thiel's embalming method for phonosurgery training. Methods: A training model for phonosurgery techniques simulating vocal pathology and glottal insufficiency is developed to compare and evaluate the perception of embalmed vocal cords through a voluntary and anonymous survey rated on a scale of 1–5. A total of 10 residents and young otolaryngologists participated in the surgical training in phon osurgery. Results: Ten larynges preserved in formalin and 10 Thiel's embalmed larynges were used for the investigation. Phonosurgery procedures were performed following microflap and injection laryngoplasty techniques. The larynges preserved with Thiel's method demonstrated vocal cords that maintain their pliability and good tissue quality allowing a sensation of realism compared to the living body and providing suitable conditions for realistic laryngeal training. Participants held a positive experience, believed them to be useful and that these models of embalmed larynges were similar to the clinical setting and improved skills and confidence in performing phonosurgery. Conclusions: The human larynges embalmed with Thiel's method maintain the pliability of the vocal cords, thus representing a unique model to practice and reproduce training for endolaryngeal procedures without the risks of contamination, anatomical variation, or rigidity of other m odels.
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