BACKGROUND:Head and neck squamous cell carcinoma (HNSCC) is a highly heterogeneous cancer characterized by difficulties in early diagnosis and outcome prediction. Aberrant glycosylated structures produced by the aberrant expression of glycosyltransferases are prevalent in HNSCC. In this study, we aim to construct glycosyltransferase-related gene signatures with diagnostic and prognostic value to better stratify patients with HNSCC and improve their diagnosis and prognosis. METHODS:Bioinformatic tools were used to process data of patients with HNSCC from The Cancer Genome Atlas (TCGA) database. The prognostic model was formatted using univariate and multivariate Cox regression methods, while the diagnostic signature was constructed using support vector machine (SVM) and LASSO analysis. The results were verified using the Gene Expression Omnibus (GEO) cohort. The tumor microenvironment and benefits of immune checkpoint inhibitor (ICI) therapy in subgroups defined by glycosyltransferase-related genes were analyzed. Molecular biology experiments, including western blotting, cell counting kit (CCK)-8, colony formation, wound healing, and Transwell assays, were conducted to confirm the oncogenic function of beta-1,4-galactosyltransferase 3 (B4GALT3) in HNSCC. RESULTS:We established a five-gene prognostic signature and a 15-gene diagnostic model. Based on the median risk score, patients with low risk had longer overall survival than those in the high-risk group, which was consistent with the results of the GEO cohort. The concrete results suggested that high-risk samples were related to a high tumor protein (TP)53 mutation rate, high infiltration of resting memory cluster of differentiation (CD)4 T cells, resting natural killer (NK) cells, and M0 macrophages, and benefited from ICI therapy. In contrast, the low-risk subgroup was associated with a low TP53 mutation rate; and high infiltration of naive B cells, plasma cells, CD8 T cells, and resting mast cells; and benefited less from ICI therapy. In addition, the diagnostic model had an area under curve (AUC) value of 0.997 and 0.978 in the training dataset and validation cohort, respectively, indicating the high diagnostic potential of the model. Ultimately, the depletion of B4GALT3 significantly hindered the proliferation, migration, and invasion of HNSCC cells. CONCLUSIONS:We established two new biomarkers that could provide clinicians with diagnostic, prognostic, and treatment guidance for patients with HNSCC.

目的 探讨双极电凝联合显微镜在儿童先天性耳前瘘管感染期手术中的应用,分析总结其安全性和可行性.方法 总结分析亳州市人医院2018年1月至2020年12月收住院并行手术治疗的感染期先天性耳前瘘管患儿50例,年龄1～11岁,平均年龄6.5岁,均为单侧感染期手术,术前明确耳前瘘管合并感染,经抗炎治疗并根据情况切开引流换药3～5次后及时行手术治疗,手术采用全身麻醉,术中使用双极电凝配合显微镜完全切除瘘管组织,同时清理感染灶,术前切开引流口根据情况在术中尽可能采取缝合措施.结果 术后46例愈合良好,按时拆线,4例术后切口延迟愈合,经积极换药后痊愈.常规随访半年,无复发病例.结论 先天性耳前瘘管患儿感染期手术可以有效减少感染期反复换药对患儿带来的痛苦,同时双极电凝联合显微镜感染期手术可以达到更好地控制出血、彻底分离并切除瘘管组织,术后随访无复发病例,值得临床推广.

临床资料 患儿,男,12个月,因"鼻塞流涕伴夜间呛咳4 d"在外院诊断为"急性鼻炎",予以雾化吸入及口服药物治疗,效果不佳.患儿流脓涕逐渐增多,易哭闹,反复揉鼻,进食差,夜间反复呛咳.为求进一步诊治于2022-06-25就诊于亳州市人民医院,门诊行鼻内镜检查见患儿鼻黏膜水肿、右侧鼻腔深处大量脓性分泌物附着(图1A).

鼻窦黏液囊肿临床也很常见,多发生在筛窦、额窦,但是发生在上颌窦者少见,破坏上颌窦骨壁侵犯窦外组织者更少见,早期可无任何临床表现,若有窦壁破坏发生,则进展迅速,出现局部破坏症状,如:面颊部膨胀,局部隆起,鼻塞、硬腭塌陷等改变.上颌窦黏液囊肿的CT特点通常表现为:窦腔膨胀性扩大,含气腔消失,窦壁骨质受压变薄,有轻度硬化,局部窦壁骨质吸收缺损,但缺损边缘光滑,一般为类圆形均匀软组织密度影,边界清楚,增强CT或MRI表现为囊肿壁的轻度强化,其内部组织不强化,上颌窦黏液囊肿病理学分析,囊壁被覆纤毛柱状上皮,内含杯状细胞,上皮下为疏松纤维组织及涎腺组织,散在有淋巴细胞及浆细胞浸润,少许嗜酸性白细胞浸润,与上颌窦黏膜结构相同,在该病的处理上,应根据囊肿的大小和侵犯情况选择合适的手术方式,近期本科收治1例特殊的上颌窦巨大黏液性囊肿,现报道如下.