PD-L1 plays a pivotal role as an immunoregulatory checkpoint within the immune system, exerting a critical influence on the internal functioning and survival mechanisms of cancer cells. Our study aimed to elucidate the clinical significance of PD-L1 expression in circulating tumor cells (CTCs) derived from individuals afflicted with Hypopharyngeal and Laryngeal Cancers (HLC), as well as its potential implications for clinical practice. CTC were identified using an immunomagnetic positive sorting methodology. Simultaneous detection was conducted on the CTC levels among PD-L1-positive patients, aiming to ascertain the dynamic relationship between real-time CTC fluctuations and the clinicopathological indices of the patients. The constructed immunolipid magnetic nano-beads demonstrated pronounced efficacy in capturing CTCs, and the lipid nanoparticles exhibited noteworthy capture efficiency coupled with minimal cytotoxic effects. This investigation encompassed a cohort exceeding 30 individuals, wherein PD-L1 expression analysis was executed to delineate CTC variations within PD-L1-positive patients, thereby yielding auxiliary insights for clinical diagnosis. Subsequent assessment of PD-L1 expression consistency between CTCs and tissue specimens revealed a substantial agreement surpassing 70%. Furthermore, inhibition of PD-L1 yielded a significant elevation in the cytokine TNF-α levels, accompanied by a concomitant reduction in IL-10 levels. The CTC sorting system devised in this investigation boasts attributes of remarkable specificity and sensitivity. By virtue of PD-L1 expression analysis, it holds the potential to offer instructive implications for tailoring individualized treatments in clinical scenarios.

OBJECTIVES:To investigate the effect of transoral CO2 laser-modified posterior cordotomy combined with plasma ablation subtotal arytenoidectomy for bilateral vocal fold paralysis (BVFP).DESIGN:A retrospective study with medical records from 2017 to 2021 in our hospital.SETTING:A single-centre study.PARTICIPANTS:This retrospective study included 22 patients with BVFP. They underwent transoral CO2 laser-modified posterior cordotomy combined with plasma ablation subtotal arytenoidectomy in our hospital from 2017 to 2021.MAIN OUTCOME MEASURES:Preoperative and postoperative swallowing and phonation functions were evaluated in all patients.RESULTS:All 22 patients with a tracheostomy were successfully decannulated within 6 months after surgery without subsequent revision operations, and the width of the posterior glottis was more than 3.9 mm in all patients when they inspired. The statistical analysis showed that there was no difference in vocal function and swallowing function in all patients compared to preoperative (p > .05).CONCLUSION:Transoral CO2 laser-modified posterior cordotomy combined with plasma ablation subtotal arytenoidectomy enlarges the posterior glottis in patients with BVFP, which maintains airway patency without significant worsening in voice and swallowing function.

Background To investigate the prognostic value of pre-treatment Controlling Nutritional Status (CONUT) score in laryngeal cancer. Methods Preoperative CONUT score was retrospectively calculated in 154 laryngeal cancer patients who underwent curative resection in our hospital from 2013 to 2016. The associations of CONUT with clinicopathological factors and survival were evaluated. The efficacy of CONUT score to predict prognosis was evaluated. Results The CONUT score was associated with body mass index (p = 0.033), neutrophil (p = 0.011), tumor size (p = 0.017), pTNM stage (p = 0.001), adjuvant radiotherapy (p < 0.001), negative pathologic factors (p < 0.001), and larynx preservation (p < 0.001). Patients with a higher CONUT score had worse overall survival (hazard ratio: 1.94, 95% confidence interval [CI]: 1.13-3.72, p = 0.039) and disease-free survival (hazard ratio: 2.16, 95% CI: 1.19-3.90, p = 0.011). The area under the curve of CONUT score (0.728) was higher than Preoperative Nutritional Index (0.72), platelet-to-lymphocyte ratio (0.675), and neutrophil-to-lymphocyte ratio (0.687). Conclusion The CONUT score can be useful for predicting survival in laryngeal cancer patients after curative resection.

OBJECTIVE: To evaluate the impact of ovarian endometrioma on the serum anti-Mullerian hormone (AMH) level and natural postoperative conception outcomes in patients with endometriosis lesions.STUDY DESIGN: A retrospective analysis was conducted of 164 women (<= 35 years) with infertility: 92 patients with ovarian endometrioma (case group) and 72 patients with tubal infertility (control group). All patients underwent laparoscopic treatment. After the surgical procedure the patients were followed up over a period of 12-24 months to assess the frequency of natural pregnancy. Their basal serum AMH levels were compared.RESULTS: The serum AMH level of patients with endometriosis was not significantly lower than that of the control group. However, the serum AMH level was significantly lower in patients with large ovarian endometrioma (>= 5 cm) than in those with small ovarian endometrioma (< 5 cm). The endometriosis fertility index (EFI) score was significantly correlated with pregnancy outcome (p=0.002). Patients with endometriosis reported a cumulative natural pregnancy rate of 53.48% during the 1-2 postoperative years.CONCLUSION: Ovarian endometriomas (>= 5 cm) independently affect the serum AMH level. The EFI score significantly correlates with postoperative pregnancy outcome, which indicates that surgical intervention can efficiently improve the fertility outcomes for patients with endometriosis.

OBJECTIVE:To discuss the application of anatomization of the recurrent laryngeal nerve under the microscope in thyroid surgery.METHOD:292 patients with different types of thyroid diseases who underwent surgical intervention were discussed by regression analysis. For all patients, the movement of both vocal cords was normal before the surgery by laryngoscope. And routine anatomization of the recurrent laryngeal nerve under the microscope was conducted during thyroid surgery.RESULT:The total number of recurrent laryngeal nerve exposure in this study was 402. Only three of them got temporary injury. None had permanent damage.CONCLUSION:The recurrent laryngeal nerve can be visualized more clearly by dissection under the microscope, which can best avoid the recurrent laryngeal nerve injury. Particularly it is beneficial for the patients who have prior thyroid surgery history or have thyroid gland cancer.