Abstract Objective Serum uric acid is proven to be associated with chronic hearing loss, but its effect on Sudden Sensorineural Hearing Loss (SSNHL) is unclear. This study aims to evaluate the prognostic values of serum uric acid levels in SSNHL patients. Methods The clinical records of SSNHL patients were retrospectively reviewed. Patients were divided into different groups based on hearing recovery and audiogram type, and uric acid levels were compared. Based on uric acid levels, patients were categorized into normouricemia and hyperuricemia groups, and clinical features and hearing recovery were evaluated. Univariate and multivariate analyses were performed to identify prognostic factors. Results In total, 520 SSNHL patients were included in this study, including 226 females and 294 males. In female patients, 186 patients were included in the normouricemia group, and 40 patients were enrolled in the hyperuricemia group. Significant differences were observed in uric acid levels, Total Cholesterol (TC), rate of complete recovery, and slight recovery between the two groups. In male patients, 237 subjects were categorized into the normouricemia group, and 57 patients were included in the hyperuricemia group. The rate of complete recovery and slight recovery was lower in the hyperuricemia group compared to the normouricemia group. All patients were further divided into good recovery and poor recovery groups based on hearing outcomes. The uric acid levels, initial hearing threshold, rate of hyperuricemia, and TC were lower in the good recovery group than the poor recovery group both in female and male patients. Binary logistic regression results showed that uric acid levels, initial hearing threshold, and hyperuricemia were associated with hearing recovery. Conclusion Hyperuricemia might be an independent risk factor for hearing recovery in SSNHL patients. Serum uric acid and initial hearing threshold possibly affected the hearing outcome in males and females with SSNHL. Level of evidence Level 4. loss (SSNHL unclear reviewed type evaluated factors total 52 22 29 18 4 TC, , (TC) 23 5 outcomes 2 1 (TC

Abstract Objective The video otoscope has already proven to be useful for the diagnosis of several pathologies, so the objective of this study was to evaluate the diagnostic accuracy of the video otoscope in cases of tympanic membrane perforation. Methods This is a diagnostic accuracy study performed at the hearing health division of a tertiary-level referral hospital. Patients older than 8 years of age who had any symptom that could be related to perforation (otalgia, otorrhea, tinnitus, and/or hypoacusis) were invited to participate in the study. Participants were evaluated by three different diagnostic methods (otomicroscope, conventional otoscope, and video otoscope) performed by three different evaluators in a blind fashion. The microscope was considered the reference standard. Results 176 patients were evaluated, totaling 352 tympanic membranes. Twenty-seven tympanic membrane perforations were diagnosed by the microscope, a prevalence of 7.7%. The video otoscope showed a sensitivity of 85.2% (95% CI 81.5%‒88.9%), specificity of 98.1% (95% CI 96.7%‒99.5%) and accuracy of 97.1% (95% CI 95.4 %-98.8 %). The conventional otoscope showed a sensitivity of 96.3% (95% CI 94.3-98.3), specificity of 98.8% (95% CI 97.7-99.9) and accuracy of 98.6% (95% CI 97.4-99.8). The Kappa value between the microscope and the video otoscope was 0.8 and between the microscope and the conventional otoscope was 0.9. Regarding the participants' perception, 53.4% (p < 0.001) considered the video otoscope as the best method for understanding the tympanic membrane condition presented by them. Conclusions The video otoscope showed relevant sensitivity and specificity for clinical practice in the diagnosis of tympanic membrane perforation. Moreover, this is an equipment that can facilitate the patient's understanding of the otologic pathology presented by him/her. In this regard, this method may be important for better patient compliance, requiring further studies to evaluate this hypothesis. Level of evidence Is this diagnostic or monitoring test accurate? (Diagnosis)—Level 2 (Individual cross-sectional studies with consistently applied reference standard and blinding). pathologies tertiarylevel tertiary level hospital otalgia, otalgia (otalgia otorrhea tinnitus andor hypoacusis otomicroscope, otomicroscope (otomicroscope fashion 17 35 membranes Twentyseven Twenty seven 77 7 7.7% 852 85 85.2 95% 95 (95 81.5%‒88.9%, 815889 81.5%‒88.9% , 81 5 88 9 81.5%‒88.9%) 981 98 1 98.1 96.7%‒99.5% 967995 96 99 971 97 97.1 954 4 95. %98.8 988 % 98.8 %-98. %. . %) 963 3 96.3 94.398.3, 943983 94.3 98.3 94 94.3-98.3) 97.799.9 977999 97.7 99.9 97.7-99.9 986 6 98.6 97.499.8. 974998 97.4 99.8 97.4-99.8) 08 0 0. 09 0.9 participants perception 534 53 53.4 p 0.001 0001 001 them Moreover s himher him her him/her regard compliance hypothesis accurate DiagnosisLevel Diagnosis Individual crosssectional cross sectional blinding. blinding blinding) 7.7 85. (9 81588 81.5%‒88.9 98. 96.7%‒99.5 96799 97. %98. %-98 96. 398 94.398.3 94398 943 94. 983 94.3-98.3 799 97.799. 97799 977 999 99. 97.7-99. 499 97.499.8 97499 974 998 97.4-99.8 53. 0.00 000 00 7. ( 8158 81.5%‒88. 96.7%‒99. 9679 %98 %-9 39 94.398. 9439 94.3-98. 79 97.799 9779 97.7-99 49 97.499. 9749 97.4-99. 0.0 815 81.5%‒88 96.7%‒99 967 %9 %- 94.398 94.3-98 97.79 97.7-9 97.499 97.4-99 81.5%‒8 96.7%‒9 94.39 94.3-9 97.7- 97.49 97.4-9 81.5%‒ 96.7%‒ 94.3- 97.4- 81.5% 96.7% 81.5 96.7 81.

Abstract Objective This study investigated the effects of WN on LE in subjects with chronic tinnitus and normal hearing thresholds. The study was a prospective, non-randomized, before-and-after, intra-participant intervention. Methods Twenty-five subjects performed the following tests: conventional and high-frequency audiometry, acuphenometry, screening questionnaires for depression and anxiety symptoms, Tinnitus Handicap Inventory (THI), Montreal Cognitive Assessment, and high WM test from the Working Memory Assessment Battery, Federal University of Minas Gerais (WMAB) as the LE measure in two conditions: No Added Noise (NAN) and with Added Noise (AN). Results Seventeen participants (68%) performed better on AN condition. Data analysis revealed a 45% improvement in the WMAB total span count on AN setting, with a significant p value (p = 0.001). Conclusion The subgroup of participants without traces of anxiety symptoms, up to mild traces of depressive symptoms, having unilateral tinnitus, and a THI level up to grade 2, had improved WM performance in the presence of WN, which suggests a release of cognitive resources and less auditory effort under these combined conditions. Evidence level 4. thresholds prospective nonrandomized, nonrandomized non randomized, randomized non-randomized beforeandafter, beforeandafter before after, after before-and-after intraparticipant intra participant intervention Twentyfive Twenty five tests highfrequency frequency audiometry acuphenometry symptoms THI, , (THI) Battery (WMAB conditions NAN (NAN AN. . (AN) 68% 68 (68% condition 45 setting 0.001. 0001 0.001 0 001 0.001) 2 4 (THI (AN 6 (68 000 0.00 00 (6 0.0 ( 0.

Abstract Objective Translate and cross-culturally adapt into Brazilian Portuguese the Glasgow Children’s Benefit Inventory instrument used for the quality-of-life assessment after pediatric ENT interventions. Method This is a methodological study of translation and cross-cultural adaptation of the GCBI instrument following seven stages: 1) Translation of two versions by two independent translators, 2) Elaboration of a consensual synthetized version, 3) Assessment of the synthetized version by experts, 4) Assessment by the target audience, 5) Back-translation, 6) Pilot study and 7) Use of the instrument. The final version of the instrument was answered by a sample of 28 people responsible for children aged from 2 to 7 years, submitted to tonsillectomy between January 2019 and December 2021, in a public hospital in Porto Alegre. The collection considered patients with a minimum of 6-months and a maximum of 3-years of postoperative follow-up. Result The instrument final version was compared to the original version showing semantic equivalence, absence of consistent translation difficulties and appropriate cross-cultural adaptation, and well understood by the target audience. The application of the questionnaire in the sample showed a Cronbach alpha coefficient of 0.944 corresponding to a high degree of reliability of the instrument. Conclusion The translation and cross-cultural adaptation showed semantic appropriateness and its use when assessing ENT postoperative results in a pediatric population showed high reliability of the instrument. Level of evidence 4. crossculturally cross culturally Childrens Children s qualityoflife quality life interventions crosscultural cultural stages 1 translators 3 experts 4 audience 5 Backtranslation, Backtranslation Back translation, Back-translation 6 years 201 2021 Alegre 6months months 3years followup. followup follow up. up follow-up equivalence 0944 0 944 0.94 20 202 094 94 0.9 09 9 0.

Abstract Objectives To evaluate the efficacy and tolerance after the electrochemotherapy treatment for local therapy of cutaneous and subcutaneous metastases of head-and-neck tumors and malignant melanoma refractory to standard therapies, mainly in neck metastasis of squamous cell carcinoma. And, to evaluate the relation of this response according to the skin reaction (healing with ulcer or dry crust). Methods prospective pase II, observational clinical study of 56 patients with metastases of head-and-neck squamous cell carcinoma (n = 13), papillary thyroid carcinoma (n = 4), adenoid cystic carcinoma of parotid gland (n = 1) or malignant melanoma (n = 37, 5 in head). Patients were treated by electrochemotherapy (application of electrical pulses into the tumor) after the administration of a single intravenous dose of bleomycin. Kaplan-Meier curves were performed. The statistical significance was evaluated using log-rank test; p-value of less than 0.05 was considered as significant. Results Overall clinical response was observed in 47 patients (84%). Local side effects were mild in all the patients. Ten patients (76.9%) with neck metastasis of squamous cell carcinoma had some degree of response, but only in one was complete. Patients even with only partial response had a higher overall survival than patients without response (p = 0.02). Most of the patients with squamous cell carcinoma had diminution of pain and anxiety. Response rate and overall survival was higher in MM patients (86.5%) than in squamous cell cancer patients (76.9%) (p = 0.043). The healing process (dry crust/ulcer) was not associated with the overall survival (p = 0.86). Conclusions Electrochemotherapy is associated a higher overall survival and diminution of pain and anxiety. Therefore, it is an option as palliative treatment for patients with neck metastasis of squamous cell carcinoma refractory to other therapies or even as a concomitant treatment with newer immunotherapies. The type of healing of the surgical wound could not be associated with a higher rate of response or survival. Level of evidence III. headandneck head And crust. crust . crust) II n 13, 13 , 13) 4, 4 4) 1 37 head. head) application tumor bleomycin KaplanMeier Kaplan Meier performed logrank log rank test pvalue p value 005 0 05 0.0 significant 84%. 84 84% (84%) 76.9% 769 76 9 (76.9% complete 0.02. 002 0.02 02 0.02) anxiety 86.5% 865 86 (86.5% 0.043. 0043 0.043 043 0.043) crust/ulcer crustulcer 0.86. 086 0.86 0.86) Therefore immunotherapies III 3 00 0. 8 (84% 76.9 7 (76.9 86.5 (86.5 004 0.04 04 08 0.8 (84 76. (76. 86. (86. (8 (76 (86 ( (7

Abstract Objectives To identify and understand the evidence regarding hearing changes related to acquired Dengue, Chikungunya, and Zika virus infection in adult individuals. Methods A scoping review was performed according to the recommendations of The Joanna Briggs Institute and guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews in the Embase, PubMed/Medline, ScienceDirect, Scopus, and Web of Science databases without restriction on language and year of publication. Case studies, observational studies, and clinical trials reporting hearing loss in adult subjects (>18-60 years of age) of both sexes with DENV, CHIKV, or ZIKV diagnosed by positive molecular/serological examination by RT-PCR or IgM/IgG by ELISA method were included. Results Thirteen studies met the inclusion criteria and were selected for review. The occurrence of auditory symptoms caused by arboviroses and the presence of permanent or transient sensorineural hearing loss was variable in adults. Conclusions Dengue, Chikungunya, and Zika infections in adults are associated with a variety of auditory symptoms. The frequency of permanent or transient sensorineural hearing loss is low but not negligible. Dengue Chikungunya individuals MetaAnalyses Meta Analyses Embase PubMedMedline PubMed Medline PubMed/Medline ScienceDirect Scopus publication >1860 1860 >18 60 18 (>18-6 age DENV CHIKV molecularserological molecular serological RTPCR RT PCR IgMIgG IgM IgG included negligible >186 186 >1 6 1 (>18- > (>18 (>1 (> (

Abstract Objective Cutaneous Squamous Cell Carcinoma (cSCC), a tumor with a significantly increasing incidence, is mostly diagnosed in the head region, where tumors have a worse prognosis and a higher risk of metastases. The presence of metastases reduces specific five-year survival from 99% to 50%. As the risk of occult metastases does not exceed 10%, elective dissection of the tributary parotid and neck lymph nodes is not recommended. Methods We retrospectively analyzed a group of 12 patients with cSCC of the head after elective dissections of regional (parotid and cervical) nodes by means of superficial parotidectomy and selective neck dissection. Results We diagnosed occult metastases neither in the cervical nor parotid nodes in any patient. None were diagnosed as a regional recurrence during the follow-up period. Conclucion Our negative opinion on elective parotidectomy and neck dissection in cSCC of the head is in agreement with the majority of published studies. These elective procedures are not indicated even for tumors showing the presence of known (clinical and histological) risk factors for lymphogenic spread, as their positive predictive value is too low. Elective parotidectomy is individually considered as safe deep surgical margin. If elective parotidectomy is planned it should include only the superficial lobe. Completion parotidectomy and elective neck dissection are done in rare cases of histologically confirmed parotid metastasis in the parotid specimen. Preoperatively diagnosed parotid metastases without neck involvement are sent for total parotidectomy and elective selective neck dissection. Cases of clinically evident neck metastasis with no parotid involvement, are referred for comprehensive neck dissection and elective superficial parotidectomy. The treatment of concurrent parotid and cervical metastases includes total conservative parotidectomy and comprehensive neck dissection. Level of evidence How common is the problem? Step 4 (Case-series) Is this diagnostic or monitoring test accurate? (Diagnosis) Step 4 (poor or non-independent reference standard) What will happen if we do not add a therapy? (Prognosis) Step 4 (Case-series) Does this intervention help? (Treatment Benefits) Step 4 (Case-series) What are the COMMON harms? (Treatment Harms) Step 4 (Case-series) What are the RARE harms? (Treatment Harms) Step 4 (Case-series) Is this (early detection) test worthwhile? (Screening) Step 4 (Case-series) cSCC, , (cSCC) incidence region fiveyear five year 99 50 50% 10 10% recommended 1 patient followup follow up period studies clinical histological spread low margin lobe specimen problem Caseseries Case series (Case-series accurate Diagnosis (Diagnosis poor nonindependent non independent standard therapy Prognosis (Prognosis help Treatment Benefits harms Harms early detection worthwhile Screening (Screening (cSCC 9 5

Abstract Objective To measure the average time for the diagnosis and for the therapeutic prescription of Continuous Positive Airway Pressure (CPAP) at a hospital in Botucatu Medical School - State University São Paulo, UNESP. Method A retrospective observational study was carried out by collecting data from the electronic medical records of patients over 18-years of age, who had a diagnostic polysomnography testing scheduled between January and December 2017. Result Of the 347 patients eligible for the study, 94 (27.1%) missed follow-up and 103 (29.7%) had a referral for CPAP use. Until February 2021, only 37 (35.9%) of these patients had already acquired and were using the device, the remaining 66 (64.1%) were waiting or gave up the therapy. The mean value of the waiting time interval between the referral of the diagnostic test and its performance was equivalent to 197 days (6.5 months). The mean time between diagnostic polysomnography and CPAP prescription was 440-days (14.5-months), with a total mean time of 624 days (21-months). Conclusion As in other services, the diagnostic-therapeutic flow proved to be highly inefficient, with a long waiting period, difficult access to treatment and a high dropout rate. These findings highlight the need to establish new patient-centered strategies with measures that speed up the flow and facilitate access to CPAP, in order to reduce the morbidity and mortality associated with this condition. Level of evidence Level 3 - Non-randomized controlled cohort/follow-up study Recommendation B. (CPAP Paulo UNESP 18years years 18 age 2017 34 9 27.1% 271 27 1 (27.1% followup follow 10 29.7% 297 29 7 (29.7% use 2021 35.9% 359 35 (35.9% device 6 64.1% 641 64 (64.1% therapy 19 6.5 65 5 (6. months. months . months) 440days 440 14.5months, 145months 14.5 , 14 (14.5-months) 62 21months. 21months 21 (21-months) services diagnostictherapeutic inefficient period rate patientcentered patient centered condition Nonrandomized Non randomized cohort/followup cohortfollowup cohort/follow cohort B 201 27.1 2 (27.1 29.7 (29.7 202 35.9 (35.9 64.1 (64.1 6. (6 44 5months 14.5months 145 14. (14.5-months (21-months cohortfollow 20 27. (27. 29. (29. 35. (35. 64. (64. ( 4 (27 (29 (35 (64 (2 (3

Abstract Objectives To assess the hearing thresholds in acute otitis media, otitis media with effusion and chronic otitis media (non-suppurative, non-cholesteatomatous suppurative and cholesteatomatous) and to compare the hearing outcomes with non-diseased ears (in bilateral cases) or contralateral healthy ears (in unilateral cases), since hearing loss is the most frequent sequel of otitis media and there is no previous study comparing the audiometric thresholds among the different forms of otitis media. Methods Cross sectional, controlled study. We performed conventional audiometry (500-8000 Hz) and tympanometry in patients with otitis media and healthy individuals (control group). Hearing loss was considered when the hearing thresholds were > 25 dBHL. Results Of the 112 patients diagnosed with otitis media (151 ears), 48 were men (42.86%) and 64 were women (57.14%). The average age was 42.72 years. Of those, 25 (22.32%) were diagnosed as AOM, 15 (13.39%) were diagnosed with OME and the remaining 72 (63.28%) were diagnosed with COM (non-suppurative COM, n = 31; suppurative COM, n = 18; cholesteatomatous COM, n = 23). As compared with controls, all forms of otitis media had significantly higher bone-conduction thresholds (500-4000 Hz). Conductive hearing loss was the most frequent type of hearing loss (58.94%). However, the number of patients with mixed hearing loss was also relevant (39.07%). We noted that the presence of sensorioneural component occurred more frequently in 1) Higher frequencies; and 2) In groups of otitis media that were more active or severe in the inflammatory/infective standpoint (AOM, suppurative COM and cholesteatomatous COM). Conclusion All types of otitis media, even those with infrequent episodes of inflammation and otorrhea, had worse bone conduction thresholds as compared with nondiseased ears (p < 0.01). We observed worse hearing outcomes in ears with recurrent episodes of otorrhea and in ears with AOM, especially in high frequencies. nonsuppurative, nonsuppurative non suppurative, noncholesteatomatous diseased cases cases, , sectional 5008000 500 8000 (500-800 Hz control group. group . group) 2 dBHL 11 151 (15 ears, ears) 4 42.86% 4286 42 86 (42.86% 6 57.14%. 5714 57.14% 57 14 (57.14%) 4272 42.7 years 22.32% 2232 22 32 (22.32% AOM 1 13.39% 1339 13 39 (13.39% 7 63.28% 6328 63 28 (63.28% 31 18 23. 23 23) controls boneconduction 5004000 4000 (500-400 Hz. 58.94%. 5894 58.94% 58 94 (58.94%) However 39.07%. 3907 39.07% 07 (39.07%) frequencies inflammatoryinfective inflammatory infective (AOM COM. COM) p 0.01. 001 0.01 0 01 0.01) 500800 50 800 (500-80 (1 42.86 428 8 (42.86 571 57.14 5 (57.14% 427 42. 22.32 223 3 (22.32 13.39 133 (13.39 63.28 632 (63.28 500400 400 (500-40 589 58.94 9 (58.94% 390 39.07 (39.07% 00 0.0 50080 80 (500-8 ( 42.8 (42.8 57.1 (57.14 22.3 (22.3 13.3 (13.3 63.2 (63.2 50040 40 (500-4 58.9 (58.94 39.0 (39.07 0. 5008 (500- (42. 57. (57.1 22. (22. 13. (13. 63. (63. 5004 58. (58.9 39. (39.0 (500 (42 (57. (22 (13 (63 (58. (39. (50 (4 (57 (2 (6 (58 (39 (5 (3

Abstract Objectives Our study aimed to verify the evidence of auditory training employed in the audiological treatment of tinnitus in adults and older adults. Methods Scoping review based on a search for articles in journals available in MEDLINE (PubMed), Embase (Elsevier), LILACS (BVS), and Cochrane Library. Titles and abstracts of the retrieved articles were assessed by peers, following the eligibility criteria; they were afterward read in full text, and the references were hand searched in the results found. Studies’ level of evidence was classified into very high (Level A+), high (Level A), moderate (Level B), limited (Level C), low (Level D), or very low (Level D−) based on the Critically Appraised Topics. Results 2160 records were identified in the searching stage and 15 studies were eligible for data extraction. Study design, sample characterization, auditory training tasks, sound stimuli, outcome measures, and results were extracted. Frequency discrimination training was the most frequent strategy, followed by auditory attentional skills training and multisensory training. Almost all studies with daily auditory training sessions reported significant benefits demonstrated in at least one outcome measure. Studies that used auditory discrimination training and attentional auditory skill stimulation to treat tinnitus obtained quality evidence levels ranging from limited to high (C‒A) and studies that applied multisensory training or attentional training combined with counseling and passive listening in tinnitus patients reached a high-quality evidence level (A). Conclusion Recent studies had higher levels of evidence and considered attentional factors and multisensory pathways in auditory training strategies. PubMed, PubMed , (PubMed) Elsevier, Elsevier (Elsevier) BVS, BVS (BVS) Library peers criteria text found Level A+, A A+ A+) A, A) B, B B) C, C C) D, D D) D− Topics 216 1 extraction design characterization tasks stimuli measures extracted strategy measure C‒A CA (C‒A highquality A. . (A) strategies (PubMed (Elsevier (BVS 21 (A 2

Abstract Objective Nasopharyngeal Carcinoma (NPC) is a malignancy of epithelium of epithelium of the nasopharynx, with the highest incidence of otolaryngeal malignancies. A growing number of studies confirm that Circular RNA (circRNA) plays an important role in tumor development, including Hsa_circ_0013561. This study aims to elucidate the process and mechanism of NPC regulation hsa_circ_0013561. Methods In this study, circRNA expression nodes and subcellular localization in NPC tissues were analyzed by fluorescence in situ hybridization. The expression of hsa_circ_0013561 in NPC cells was further clarified by RT-qPCR. At the same time, the lentivirus vector interfered by hsa_circ_0013561 was constructed and transfected. The cell proliferation was detected by CCK-8 method, EdU assay and plate cloning assay. The cell cycle and apoptosis were detected by flow cytometry, and the cell migration ability was detected by wound healing assay and Transwell assay. Western blotting examined the expression of apoptosis, Epithelial-Mesenchymal Transition (EMT)-associated proteins, and Janus Kinase/Signal Transductor and Activator of Transcription (JAK/STAT) signaling pathway-related proteins. Results The results showed that the expression of hsa_circ_0013561 in NPC samples was significantly upregulated and hsa_circ_0013561 localized in the cytoplasm. After down-regulating hsa_circ_0013561 expression, it significantly inhibited the proliferation and metastasis ability of NPC, inhibited EMT progression, and promoted apoptosis. Further studies showed that interference hsa_circ_0013561 significantly inhibited JAK2/STAT3 signaling pathway activation and induced the expression of apoptosis-related proteins. Conclusion In summary, we found that hsa_circ_0013561 is a pro-tumor circRNA in NPC, which can reduce the activation of JAK2/STAT3 pathway by knocking down hsa_circ_0013561, thereby slowing down the malignant progression of NPC. Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence Level 4. (NPC nasopharynx malignancies (circRNA development Hsacirc0013561 Hsacirc Hsa circ 0013561 Hsa_circ_0013561 hsacirc0013561 hsacirc hsa hybridization hsa_circ_001356 RTqPCR. RTqPCR RT qPCR. qPCR RT-qPCR time transfected CCK8 CCK 8 CCK- method cytometry EpithelialMesenchymal Epithelial Mesenchymal EMTassociated associated proteins KinaseSignal Kinase Signal JAK/STAT JAKSTAT JAK STAT (JAK/STAT pathwayrelated related cytoplasm downregulating regulating JAK2STAT3 JAK2 STAT3 JAK2/STAT apoptosisrelated summary protumor pro EvidenceBased Based 201 4 Hsacirc001356 001356 Hsa_circ_001356 hsacirc001356 hsa_circ_00135 JAK2STAT 20 Hsacirc00135 00135 Hsa_circ_00135 hsacirc00135 hsa_circ_0013 2 Hsacirc0013 0013 Hsa_circ_0013 hsacirc0013 hsa_circ_001 Hsacirc001 001 Hsa_circ_001 hsacirc001 hsa_circ_00 Hsacirc00 00 Hsa_circ_00 hsacirc00 hsa_circ_0 Hsacirc0 0 Hsa_circ_0 hsacirc0 hsa_circ_ Hsa_circ_ hsa_circ Hsa_circ

Abstract Objectives Nasopharyngeal carcinoma (NPC) is an aggressive epithelial cancer. The expression of miR-186 is decreased in a variety of malignancies and can promote the invasion and metastasis of cancer cells. This study aimed to explore the role and possible mechanism of miR-186 in the metastasis and epithelial-mesenchymal transformation (EMT) of NPC. Methods The expression of miR-186 in NPC tissues and cells was detected by RT-PCR. Then, miR-186 mimic was used to transfect NPC cell lines C666-1 and CNE-2, and cell activity, invasion and migration were detected by CCK8, transwell and scratch assay, respectively. The expression of EMT-related proteins was analyzed by western blotting analysis. The binding relationship between miR-186 and target gene Zinc Finger E-Box Binding Homeobox 1 (ZEB1) was confirmed by double luciferase assay. Results The expression of miR-186 in NPC was significantly decreased, and transfection of miR-186 mimic could significantly inhibit the cell activity, invasion, and migration, and regulate the protein expressions of E-cadherin, N-cadherin and vimentin in C666-1 and CNE-2 cells. Further experiments confirmed that miR-186 could directly target ZEB1 and negatively regulate its expression. In addition, ZEB1 has been confirmed to be highly expressed in NPC, and inhibition of ZEB1 could inhibit the activity, invasion, metastasis and EMT of NPC cells. And co-transfection of miR-186 mimic and si-ZEB1 could further inhibit the proliferation and metastasis of NPC. Conclusion miR-186 may inhibit the proliferation, metastasis and EMT of NPC by targeting ZEB1, and the miR-186/ZEB1 axis plays an important role in NPC. (NPC miR186 miR 186 miR-18 epithelialmesenchymal mesenchymal (EMT RTPCR. RTPCR RT PCR. PCR RT-PCR Then C6661 C C666 C666- CNE2, CNE2 CNE 2, 2 activity CCK8 CCK assay respectively EMTrelated related analysis EBox E Box ZEB (ZEB1 Ecadherin, Ecadherin cadherin, cadherin E-cadherin Ncadherin N CNE- addition cotransfection co siZEB1 siZEB si si-ZEB miR186/ZEB1 miR186ZEB1 miRZEB 186/ZEB1 miR-186/ZEB miR18 18 miR-1 C66 (ZEB miR186/ZEB miR186ZEB 186ZEB1 186/ZEB miR1 miR- C6 186ZEB