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In this paper, through the Fourier infrared spectrum analysis of the Inner Mongolia Hulunbeier Yannan coal mine lignite sample, phenyl and active groups, methoxy (-OCH3) and methylene (-CH2-), were taken as the research objects, and a simple small molecule model of hydroxyl (-OH) at the ortho, meta, and para positions of active groups was constructed. The structural optimization and simulation calculation of simple small molecules were carried out by Gaussview 6.0.16 and Gaussian 16 software at room temperature and pressure. The DFT-B3LYP method and 6-311G(d,p) basis set were used to study the effect of the -OH position on the oxidation reaction characteristics from various aspects of electrostatic potential, frontier orbital, activation energy, enthalpy change, and Gibbs free energy change. The results show that the coexistence of the active groups -OCH3 and -CH2- with -OH makes the small molecule model add an active site, that is, the oxygen atom in -OH, which makes the active groups generate hydrogen radicals (Hâ¢). Comparing different positions of -OH, the analysis shows that -OH at the ortho position has a vital impact on the oxidation reaction, and the oxidation reaction releases the largest amount of heat and has the fastest occurrence rate, making it easier to overcome energy barriers and making the reaction easier to proceed. The purpose of this study is to reveal the interaction and complex reaction path of lignite through an in-depth study of its properties, structural composition, and reaction behavior and to accurately grasp its chemical composition, thermal properties, and microstructure, so as to lay a foundation for further efficient conversion and comprehensive utilization.
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BACKGROUND: Tranexamic acid (TXA) has been utilized in spinal surgery to effectively reduce intraoperative blood loss (IBL) and allogeneic blood transfusion rates. However, the traditional TXA regimen might last the entire duration of hyperfibrinolysis caused by surgical trauma, resulting in its limited ability to reduce postoperative blood loss (PBL). Therefore, the aim of this study was to investigate the effectiveness of perioperative sequential administration of multiple doses of TXA in reducing PBL in patients who underwent posterior lumbar interbody fusion (PLIF). METHODS: From October 2022 to June 2023, 231 patients who were diagnosed with lumbar degenerative disease and scheduled to undergo PLIF were prospectively enrolled in the present study. The patients were randomly divided into three groups. Moreover, all patients received an intravenous injection of TXA at a dose of 15 mg/kg 15 min before the surgical skin incision. Patients in Group A received a placebo of normal saline after surgery, while patients in Group B received three additional intravenous injections of TXA at a dose of 15 mg/kg every 24 h. Patients in Group C received three additional intravenous injections of TXA at a dose of 15 mg/kg every 5 h. The primary outcome measure was PBL. In addition, this study assessed total blood loss (TBL), IBL, routine blood parameters, liver and kidney function, coagulation parameters, fibrinolysis indexes, inflammatory indicators, drainage tube removal time (DRT), length of hospital stay (LOS), blood transfusion rate, and incidence of complications for all subjects. RESULTS: The PBL, TBL, DRT, and LOS of Group B and Group C were significantly lower than those of Group A ( P <0.05). The level of D-dimer (D-D) in Group C was significantly lower than that in Group A on the first day after the operation ( P =0.002), and that in Group B was significantly lower than that in Group A on the third day after the operation ( P =0.003). The interleukin-6 levels between the three groups from 1 to 5 days after the operation were in the order of Group A > Group B > Group C. No serious complications were observed in any patient. The results of multiple stepwise linear regression analysis revealed that PBL was positively correlated with incision length, IBL, smoking history, history of hypertension, preoperative fibrinogen degradation product level, and blood transfusion. It was negatively correlated with preoperative levels of fibrinogen, red blood cells, blood urea nitrogen, and age. Compared to female patients, male patients had an increased risk of PBL. Finally, the incidence of PBL was predicted. CONCLUSIONS: Sequential application of multiple doses of TXA during the perioperative period could safely and effectively reduce PBL and TBL, shorten DRT and LOS, reduce postoperative D-D generation, and reduce the postoperative inflammatory response. In addition, this study provided a novel prediction model for PBL in patients undergoing PLIF.
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Antifibrinolíticos , Hemorragia Posoperatoria , Fusión Vertebral , Ácido Tranexámico , Humanos , Ácido Tranexámico/administración & dosificación , Masculino , Femenino , Antifibrinolíticos/administración & dosificación , Persona de Mediana Edad , Estudios Prospectivos , Hemorragia Posoperatoria/prevención & control , Fusión Vertebral/efectos adversos , Anciano , Vértebras Lumbares/cirugía , Adulto , Método Doble CiegoRESUMEN
Background: Tranexamic acid (TXA) has previously been shown to be effective in reducing intraoperative blood loss (IBL) and transfusion requirements in spine surgery. A conventional TXA regimen is a simple preoperative or intraoperative administration. However, the hyperfibrinolysis caused by surgical trauma lasts at least 24 h, and a single dose of TXA cannot cover the whole process of hyperfibrinolysis. Moreover, its ability to control postoperative blood loss (PBL) may be insufficient. Therefore, this study aimed to explore the effects and safety of sequential perioperative intravenous TXA for reducing bleeding after posterior lumbar interbody fusion (PLIF). Methods: Patients requiring PLIF were randomly divided into two groups. All patients were intravenously injected with 1 g of TXA 15 min before skin resection. Every day after the surgery, 200 ml saline was intravenously injected for 1-3 days in Group A, while Group B received 1 g of TXA instead of saline. The total blood loss (TBL), IBL, PBL, HCT, Hb, blood transfusion volume, inflammation-related indicators, and complications were recorded. Results: TBL, PBL, and hidden blood loss (HBL) in Group B were significantly lower than those in Group A (P < 0.05). The maximum decreases in HCT and Hb in Group B were also significantly lower than those in Group A (P < 0.05), and the drainage removal time (DRT) was sooner in Group B than in Group A (P = 0.003). On the 3rd and 5th days after surgery, the level of CRP in Group B was significantly lower than that in Group A (P < 0.05). Similarly, IL-6 levels were significantly lower in Group B for the first 5 days postoperatively (P < 0.001). Sex, operation time, level of decompression, length of incision, and change in HCT were significant predictors of both TBL and HBL. TBL was also significantly associated with BMI and preoperative fibrinogen, while postoperative TXA was a significant predictor of HBL only. Conclusion: Intravenous injection of 1 g of TXA 15 min before skin resection combined with continuous intravenous injection of 1 g of TXA 1 to 3 days after PLIF can reduce postoperative bleeding and shorten the time to drainage tube removal. In addition, it can also inhibit the postoperative inflammatory response. Clinical trial registration: ChiCTR2200056210.
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BACKGROUND: Postoperative nasal treatment is an important factor affecting the outcomes of endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS). This study aimed to determine the effect of recombinant human acidic fibroblast growth factor (rh-aFGF) on nasal mucosal healing after ESS. METHODS: This study is a prospective, single-blind, and randomized controlled clinical study. Fifty-eight CRS patients with nasal polyps (CRSwNP) with bilateral ESS were enrolled and randomly given 1 mL of budesonide nasal spray and 2 mL of rh-aFGF solution (rh-aFGF group) or 1 mL of budesonide nasal spray and 2 mL of rh-aFGF solvent (budesonide group)-infiltrated Nasopore nasal packing after ESS. Preoperative and postoperative scores for Sino-Nasal Outcome Test (SNOT-22), Visual Analogue Scale (VAS), and Lund-Kennedy were collected and analyzed. RESULTS: Forty-two patients completed the 12-week follow-up. Postoperative SNOT-22 scores and VAS scores showed no significant differences between the two groups. In terms of the Lund-Kennedy scores, there was a statistically significant difference between the two groups at the 2-, 4-, 8-, and 12-week postoperative visits, but not at the 1-week visit. Twelve weeks after surgery, the nasal mucosa had completely epithelialized in 18 patients in the rh-aFGF group and in 12 patients in the budesonide group (χ2 = 4.200, P = 0.040). CONCLUSION: The combined application of rh-aFGF and budesonide significantly improved postoperative endoscopic appearance in the nasal mucosal healing process.
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Pólipos Nasales , Senos Paranasales , Rinitis , Sinusitis , Humanos , Senos Paranasales/cirugía , Factor 1 de Crecimiento de Fibroblastos/farmacología , Factor 1 de Crecimiento de Fibroblastos/uso terapéutico , Rociadores Nasales , Estudios Prospectivos , Método Simple Ciego , Rinitis/tratamiento farmacológico , Rinitis/cirugía , Sinusitis/tratamiento farmacológico , Sinusitis/cirugía , Mucosa Nasal , Pólipos Nasales/tratamiento farmacológico , Pólipos Nasales/cirugía , Budesonida , Endoscopía , Enfermedad Crónica , Resultado del TratamientoRESUMEN
Ubiquitin-like with plant homeodomain and ring finger domains 1 (UHRF1) promotes the maintenance of established patterns of DNA methylation in mammalian cells. Extensive methylation of connexin26 (COX26) during hearing impairment has been demonstrated. The present study aims to determine whether UHRF1 can induce the methylation of COX26 in cochlea damaged by intermittent hypoxia (IH). After the establishment of the cochlear injury model through IH treatment or isolation of the cochlea containing Corti's organ, pathological changes were observed via HE staining. Expressions of COX26 and UHRF1 were detected by quantitative reverse-transcription polymerase chain reaction and Western blot. The effect of COX26 methylation levels was analyzed by methylation-specific PCR (MSP). Phalloidin/immunofluorescence staining was used to observe structural changes. The binding relationship between UHRF1 and COX26 was verified by chromatin immunoprecipitation. IH caused cochlear damage, accompanied by increased methylation of COX26 and expression of UHRF1 in the cochlea of neonatal rats. CoCl2 treatment caused the loss of cochlear hair cells, downregulation and hypermethylation of COX26, abnormal upregulation of UHRF1, and disordered expressions of apoptosis-related proteins. UHRF1 in cochlear hair cells binds to COX26, and its knockdown upregulated COX26 level. Overexpressed COX26 partially alleviated the CoCl2-caused cell damage. UHRF1 induces COX26 methylation and aggravates the cochlear damage caused by IH.
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BACKGROUND The GJB2 gene is reported to be the main hereditary factor responsible for non-syndromic hearing impairment in infants. Several kinds of hearing loss have been linked to elevated inflammatory markers. This study aimed to evaluate serum levels of IL-2, IL-4, IL-6, IL-10, IL-17, alpha-TNF, and γ-IFN and the severity of hearing loss. MATERIAL AND METHODS Ninety newborns were divided into 3 groups: severe hearing impairment (31 infants), moderate hearing impairment (30 infants), and normal hearing (29 infants). Hearing screening was performed using otoacoustic emissions test. Mutations of the GJB2 gene were detected with Sanger sequencing. The patients had DNFB1 mutation. Seven blood inflammatory markers were tested using Cytometric Bead Array. We performed the t test to examine differences in expression of 7 inflammatory markers between sexes in the groups. The correlation between indicators within groups was studied using the Pearson correlation test. Correlation of different indicators among groups was studied using the Spearman correlation test. RESULTS When compared among the 3 groups (severe, moderate hearing impairment, and normal hearing group), we found that IL-10 had a positive correlation with the severity of GJB2-associated hearing loss, which was statistically significant (P<0.05). CONCLUSIONS This research aimed to assess the relationship of 7 serum inflammatory markers with GJB2-associated hearing loss in infants. Inflammatory marker IL-10 had a positive correlation with the severity of GJB2-associated infant hearing loss, and it might have the potential to become a future therapeutic target.
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Sordera , Pérdida Auditiva Sensorineural , Pérdida Auditiva , Humanos , Lactante , Recién Nacido , Conexinas/genética , Conexina 26/genética , Interleucina-10/genética , Pérdida Auditiva/genética , Mutación/genética , Biomarcadores , Pérdida Auditiva Sensorineural/genéticaRESUMEN
Bone defects resulting from trauma, bone tumors, infections and skeletal abnormalities are a common osteoporotic condition with respect to clinical treatment. Of the known bone morphogenetic proteins (BMPs), BMP9 has the strongest osteogenic differentiation potential, which could be beneficial in the construction of tissue-engineered bone. Silent mating type information regulator 2 homolog-1 (SIRT1) is a highly conserved nicotinamide adenine dinucleotide-dependent deacetylase that deacetylates and modulates histone or non-histone substrates. However, the role of SIRT1 in BMP9-induced osteogenic differentiation of stem cells has not been studied. Furthermore, it is unclear whether SIRT1 interacts with the BMP/Smad and BMP/MAPK pathways in stem cells. We found that SIRT1 expression decreased gradually in a time-dependent manner during BMP9-induced osteogenic differentiation of MSCs. Interactions between SIRT1 and Smad7 promoted degradation of Smad7 and increased Smad1/5/8 phosphorylation. SRT2104, an activator of SIRT, enhanced the expression of osteogenic- and angiogenic-related proteins in BMP9-induced MSCs. In addition, we found that activation of the BMP/MAPK pathway led to osteogenic and angiogenic differentiation of MSCs. Our study demonstrated that SIRT1 expression decreased during BMP9-induced differentiation. The SIRT1 activator SRT2104 promoted BMP9-induced osteogenic and angiogenic differentiation of MSCs through the BMP/Smad and BMP/MAPK signaling pathways.
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Células Madre Mesenquimatosas , Osteogénesis , Proteínas Morfogenéticas Óseas/metabolismo , Diferenciación Celular , Factor 2 de Diferenciación de Crecimiento/metabolismo , Factor 2 de Diferenciación de Crecimiento/farmacología , Compuestos Heterocíclicos con 2 Anillos , Células Madre Mesenquimatosas/metabolismo , NAD/metabolismo , Sirtuina 1/metabolismoRESUMEN
Inflammatory stress of nucleus pulposus cells (NPCs) plays an important role in the pathogenesis of intervertebral disc degeneration (IVDD). Pyroptosis and NLRP3 inflammasome activation have been reported aggravating IVDD. SIRT1 is essential for mammalian cell survival and longevity by participating in various cellular processes. However, few studies analyzed the potential mechanism of SIRT1 in NLRP3- activated pyroptosis in NPCs. In this study, we confirmed that IL-1ß could induce pyroptosis and NLRP3 inflammation activation, meanwhile, resulted in mitochondrial oxidative stress injury and dysfunction in NPCs. When the mitochondrial ROS was inhibited by Mito-Tempo, the pyroptosis and NLRP3 inflammation activation was also inhibited. SIRT1 overexpression could ameliorate IL-1ß induced mitochondrial dysfunction and ROS accumulation, inhibit NLRP3 inflammasome activation by promoting PINK1/Parkin mediated mitophagy, however, these protective phenomena reversed by autophagy inhibitor 3-MA pretreatment. In vivo, SIRT1 agonist (SRT1720) treatment decreased the expression of NLRP3, p20, and IL-1ß, increased the expression of PINK1 and LC3, delayed IVDD process in the rat model. Taken together, our results indicate that SIRT1 alleviates IL-1ß induced NLRP3 inflammasome activation via mitophagy in NPCs, SIRT1 may be a potential therapeutic target to alleviate NLRP3- activated pyroptosis in the inflammatory stress related IVDD.
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Degeneración del Disco Intervertebral , Núcleo Pulposo , Animales , Inflamasomas/metabolismo , Inflamación/metabolismo , Interleucina-1beta/metabolismo , Degeneración del Disco Intervertebral/metabolismo , Mamíferos , Mitofagia , Proteína con Dominio Pirina 3 de la Familia NLR/genética , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Proteínas Quinasas/metabolismo , Piroptosis , Ratas , Especies Reactivas de Oxígeno/metabolismo , Sirtuina 1/genética , Sirtuina 1/metabolismoRESUMEN
BACKGROUND: While patients with benign paroxysmal positional vertigo (BPPV) commonly develop residual dizziness (RD) after successful repositioning, the factors predictive of RD remain controversial. OBJECTIVE: To identify factors predictive of RD onset in patients with BPPV following successful repositioning. METHODS: This multi-center prospective cohort study enrolled 243 patients with idiopathic BPPV. Vestibular functional and psychological wellbeing assessments administered before repositioning provided the data used to identify factors predictive of RD with a log-binomial model. The endpoint was RD at 1 week after successful repositioning. RESULTS: Of the enrolled patients, 118 reported RD. After adjusting for cofounders, mild [risk ratio (RR), 2.06; 95% confidence interval (CI), 1.39-3.04] or severe (RR, 3.08; 95% CI, 2.17-4.38) anxiety and abnormal vestibular ratio of sensory organization test (RR, 2.68; 95% CI, 1.82-3.95) were identified as risk predictors. Presence of ocular vestibular evoked myogenic potentials responses, either unilateral (RR, 0.55; 95% CI, 0.44-0.69) or bilateral (RR, 0.49; 95% CI, 0.36-0.68), were protective factors. CONCLUSIONS: Anxiety and abnormal balance are significant predictors of RD, while the presence of ocular vestibular evoked myogenic potentials responses predicts against it. These findings may help to improve BPPV outcomes by informing prognoses and guiding treatment strategies. TRIAL REGISTRATION: ChiCTR1800018004 (date of registration: 26 August 2018).
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Vértigo Posicional Paroxístico Benigno , Potenciales Vestibulares Miogénicos Evocados , Vértigo Posicional Paroxístico Benigno/diagnóstico , Mareo , Humanos , Posicionamiento del Paciente , Estudios ProspectivosRESUMEN
The surgical implant is an interdisciplinary therapeutic modality that offers unique advantages in the daily practice of otorhinolaryngology. Some well-known examples include cochlear implants, bone-anchored hearing aids, sinus stents, and tracheostomy tubes. Neuroprotective, osteogenic, anti-inflammatory, and antimicrobial effects are among their established or pursued functions. Implant-based drug delivery affords an efficient and potent approach to enhancing these therapeutic functions. Recent innovations have infiltrated all four elements of a drug-eluting implant. The purpose of this pre-clinical, biotechnology-oriented review is to discuss these developments in terms of the implant biomaterial, loaded medication, delivery pattern, and system fabrication. Cell-mediated neurotrophin release, fabrication of a hydroxyapatite-supported system, biodegradable polymer-based implants, and multiclass and multidrug delivery are some representative advancements. The ultimate goal here is to bridge the gap between biotechnology advances and clinical needs. The review is concluded with a perspective regarding the future opportunities and challenges in this popular and rapidly developing subject of research. STATEMENT OF SIGNIFICANCE: Surgical implants and local drug delivery are representative modern modalities of surgical treatment and medical treatment, respectively. Their synergy offers unique therapeutic advantages, such as minimal systemic side effects, proximity-related high efficiency, and potential absorbability. The applications of implant-based drug delivery have infiltrated otorhinolaryngology and head & neck surgery, which is well known for its related tissue diversity and surgical complexity. Examples discussed here include cochlear implants, bone-anchored hearing aids, sinus stents, and airway tubes. This timely review focuses primarily on the four fundamental components of an implant-based drug delivery system, namely implant biomaterial, loaded medication, delivery pattern, and system fabrication. A particular emphasis is placed upon the in vitro cellular and in vivo animal studies that demonstrate pre-clinical potentials.
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Implantes Absorbibles , Otolaringología , Animales , Materiales Biocompatibles/farmacología , Sistemas de Liberación de Medicamentos , Durapatita , PolímerosRESUMEN
Hereditary non-syndromic hearing loss is the most common inherited sensory defect in humans. More than 40 genes have been identified as causative genes for autosomal dominant non-syndromic hearing loss (ADNSHL), but there are many other candidate genes that remain to be discovered. We aimed to identify the causative gene mutation for post-lingual progressive ADNSHL in a Chinese family. Whole-exome sequencing, bioinformatic analysis, and Sanger sequencing were used to verify the co-segregation of a novel pathogenic variant (NM_ 001244580, c.511C>T, p.Arg171Cys) in the TRansformation/tRanscription domain-Associated Protein gene associated with hearing loss in a three-generation Chinese family with ADNSHL). Additionally, three more novel variants of transformation/transcription domain associated protein (TRRAP) were detected in 66 sporadic cases of hearing loss. Morpholino oligonucleotides knockdown and clustered regularly interspaced short palindromic repeats/Cas9 knockout zebrafish were constructed to validate the genetic findings. Knockdown or knockout of TRRAP resulted in significant defects in the inner ear of zebrafish, indicating that TRRAP plays an important role in inner ear development. In conclusion, TRRAP (NM_ 001244580, c.511C>T, p.Arg171Cys) co-segregated with hearing loss in a Chinese family with ADNSHL, and TRRAP deficiency caused hearing disability in zebrafish, suggesting TRRAP is a gene associated with ADNSHL.
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Proteínas Adaptadoras Transductoras de Señales/genética , Genes Dominantes , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Pérdida Auditiva/diagnóstico , Pérdida Auditiva/genética , Mutación , Proteínas Nucleares/genética , Proteínas Adaptadoras Transductoras de Señales/metabolismo , Animales , Animales Modificados Genéticamente , Modelos Animales de Enfermedad , Femenino , Marcación de Gen , Estudios de Asociación Genética/métodos , Genotipo , Humanos , Masculino , Proteínas Nucleares/metabolismo , Linaje , Fenotipo , Análisis de Secuencia de ADN , Tomografía Computarizada por Rayos X , Secuenciación del Exoma , Pez CebraRESUMEN
Hereditary hearing impairment is a clinically and genetically heterogeneous disease. Whole-exome sequencing was performed on seven affected and six unaffected members in a large Chinese family with autosomal-dominant nonsyndromic hearing loss. The pathogenic variant of the gene encoding human topoisomerase IIß TOP2B (c.G4837C:p.D1613H) was cosegregated with hearing loss in this pedigree and another two variants of TOP2B were detected in 66 sporadic patients with hearing loss. top2b knockdown led to significant defects in zebrafish inner ears and caused downregulation of akt which resulted in inactivation of PI3K-Akt signalling. As a result, supporting cell and hair cell numbers were reduced through inhibition of the PI3K-Akt pathway. Therefore, we hypothesized that mutations in TOP2B can cause autosomal-dominant nonsyndromic hearing impairment through inhibition of the PI3K-Akt signalling pathway. DATABASE: The whole-exome sequence data in the study are available at the Sequence Read Archive database (NCBI) under the accession numbers SRR9050868, SRR9050867, SRR90508676, SRR90508675, SRR90508674, SRR90508673, SRR90508672, SRR90508671, SRR90508679, SRR90508670, SRR9050859. SRR9050858 and SRR9050857, respectively.
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ADN-Topoisomerasas de Tipo II/genética , Secuenciación del Exoma/métodos , Pérdida Auditiva Sensorineural/genética , Mutación Puntual , Proteínas de Unión a Poli-ADP-Ribosa/genética , Transducción de Señal , Animales , Femenino , Técnicas de Silenciamiento del Gen , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Células Ciliadas Auditivas/metabolismo , Humanos , Masculino , Linaje , Fosfatidilinositol 3-Quinasas/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , Pez CebraRESUMEN
Nasopharyngeal carcinoma (NPC) is one of the most common malignant head and neck cancers in southern China. Although the local and regional control of NPC has been considerably improved, patients with advanced disease still suffer from poor prognosis. Statins inhibit the mevalonate pathway and play antiproliferative and proapoptotic roles in a number of cancer cells. However, the effects and molecular mechanism of statins in NPC treatment remain unclear. In this study, the cell viability of NPC cell line, C666-1, after simvastatin exposure was determined using the alamarBlue Cell Viability Assay. Cell apoptosis in C666-1 treated with simvastatin was assessed by flow cytometry and TUNEL assay. The expression levels of cell cycle regulatory proteins were determined using western blotting. Simvastatin markedly decreased cell viability in a concentration-dependent manner, increased caspase 3 activity and induced apoptosis in C666-1 cells. Simvastatin induced Bim expression by regulating phosphorylation of transcriptional factor c-Jun. Simvastatin treatment induced cell cycle arrest in the G1 phase in C666-1 cells by inhibiting the expression of cyclin D1 and cyclin-dependent kinase 4, and enhancing p27 expression. Simvastatin treatment inhibited protein kinase B and extracellular signal regulated kinase 1/2 activation. In conclusion, the results of the present study reveal the possible molecular mechanism of simvastatin-induced anti-tumor effects in C666-1 and suggest that simvastatin is a potential chemotherapy agent in NPC treatment.
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PURPOSE: Nasal packing is frequently used after septoplasty and some complications caused by nasal packing are unavoidable. A nasal septal retainer has recently been developed. We evaluated the safety and clinical efficacy of the retainer in septoplasty, and the subjective symptoms of patients with the retainer were compared with Merocel nasal packing. METHODS: A prospective, randomized, controlled study was performed in patients who had undergone septoplasty. In total, 39 patients were randomized to receive Merocel (n = 17) or the retainer (n = 22) after septoplasty. The deviation of nasal septum and nasal mucosa was evaluated by endoscopy. The clinical efficacy and subjective symptoms were compared using the visual analog scale. RESULTS: During the packing/retaining period, the mean scores of headache, nasal obstruction, epiphora, and facial pressure in the retainer group were significantly lower than in the Merocel group (P < 0.05); the mean scores of nasal pain, nasal itching, rhinorrhea, dysphagia, and sleep disturbance in the retainer group were lower than in the Merocel group, but the difference did not reach statistical significance. On the removal of Merocel/retainer, nasal pain was significantly lower in patients with the retainer (P < 0.05). In the retainer group, the incidence of grade 1 bleeding was 45.5%, and grade 0 bleeding was 54.5%. In the Merocel group, the incidence of grade 2 bleeding was 23.5%, grade 1 was 47.1%, and grade 0 was 29.4%. CONCLUSIONS: The nasal septal retainer is suitable for use after septoplasty with more beneficial effects than nasal packing.
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Formaldehído/uso terapéutico , Obstrucción Nasal , Tabique Nasal/cirugía , Procedimientos Quírurgicos Nasales , Alcohol Polivinílico/uso terapéutico , Hemorragia Posoperatoria , Adulto , Endoscopía/métodos , Femenino , Hemostáticos/uso terapéutico , Humanos , Masculino , Cavidad Nasal/diagnóstico por imagen , Obstrucción Nasal/diagnóstico , Obstrucción Nasal/etiología , Obstrucción Nasal/prevención & control , Procedimientos Quírurgicos Nasales/efectos adversos , Procedimientos Quírurgicos Nasales/métodos , Apósitos Oclusivos/efectos adversos , Hemorragia Posoperatoria/diagnóstico , Hemorragia Posoperatoria/prevención & control , Resultado del TratamientoRESUMEN
BACKGROUND: Posterior lumbar spinal fusion has been widely used in degenerative lumbar stenosis, but adjacent segment degeneration (ASD) was common. Researchers have found many risk factors for ASD after one or two levels of surgery, but few clinical studies focused on multi-level surgery. The purpose of this study was to clarify risk factors for upper ASD after multi-level posterior lumbar spinal fusion. METHODS: A retrospective study was performed on the clinical data of 71 patients with degenerative lumbar stenosis who underwent multi-level (at least 3 levels) posterior lumbar spinal fusion from January 2013 to December 2016. Two groups were divided according to lamina and posterior ligamentous complex (PLC) maintenance of proximal fixed vertebrae in surgery. In the 22 patients of group A, the proximal fixed vertebral lamina and PLC were not resected, and in the 49 patients of group B, the proximal fixed vertebral lamina and PLC were resected completely. Age, sex, body mass index (BMI), number of fixed vertebrae and fused levels, spinopelvic parameters, coronal Cobb angle, and modified Pfirrmann grading system were measured for each patient. A Cox proportional hazards model was used to analyze risk factors for upper ASD. RESULTS: No symptomatic ASD was found during the follow-up period. Patients who underwent proximal fixed vertebral lamina and PLC resection had a significantly higher percentage of radiographic ASD (P = 0.042). The Cox proportional hazards model showed that age, sex, BMI, preoperative lumbar lordosis, sacral slope, pelvic tilt, coronal Cobb angle, number of fixed vertebrae, and interbody fusion levels had no significant differences for radiographic ASD. But a preoperative modified Pfirrmann grade higher than 3, a high degree of preoperative pelvic incidence, and more decompressed levels had statistical significance (P = 0.024, 0.041, and 0.008, respectively). CONCLUSIONS: A preoperative modified Pfirrmann grade higher than 3, a high degree of preoperative pelvic incidence, and more decompressed levels might be risk factors for upper radiographic ASD after multi-level posterior lumbar spinal fusion surgery.
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Degeneración del Disco Intervertebral/diagnóstico por imagen , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/cirugía , Complicaciones Posoperatorias/diagnóstico por imagen , Fusión Vertebral/tendencias , Anciano , Femenino , Humanos , Degeneración del Disco Intervertebral/epidemiología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Fusión Vertebral/efectos adversos , Estenosis Espinal/diagnóstico por imagen , Estenosis Espinal/cirugíaRESUMEN
BACKGROUND: Combination therapy is the first-line option for total-deafness sudden sensorineural hearing loss (SSNHL). Age may act as a crucial prognostic factor. OBJECTIVE: The aim of this study was to compare efficacy of combination therapy between adolescent and adult patients with total-deafness SSNHL. MATERIALS AND METHODS: Twenty-five adolescent patients (adolescent group) and 106 adult patients (adult group) with total-deafness SSNHL were recruited. All the recruited patients underwent initial treatment with batroxobin, methylprednisolone, and gastrodin. After 10-day treatment, hearing outcomes were determined by pure-tone average measured by audiometry. Moreover, the total effective rates in the hearing recovery and improvement of tinnitus were calculated. RESULTS: There existed no significant difference between two groups in the total effective rate of the hearing recovery (p = .110). However, a significant difference was found in the total effective rate of improvement of tinnitus between two groups (p = .016). Both adolescent and adult patients could receive the optimal hearing gains at 500 Hz (20.2 ± 13.3 and 23.1 ± 13.9dB, respectively), followed by those at 1000 Hz (18.8 ± 12.5 and 22.7 ± 14.8dB, respectively). Yet, adult patients could get better hearing gains only at 500 Hz than adolescent patients (p = .02). CONCLUSION: Compared with adult patients, adolescent patients with total-deafness SSNHL undergoing combination therapy may be less likely to have hearing recovery and the improvement of tinnitus.
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Antiinflamatorios/administración & dosificación , Batroxobina/administración & dosificación , Alcoholes Bencílicos/administración & dosificación , Fibrinolíticos/administración & dosificación , Glucósidos/administración & dosificación , Pérdida Auditiva Súbita/tratamiento farmacológico , Metilprednisolona/administración & dosificación , Adolescente , Factores de Edad , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Branchio-oto-renal (BOR) syndrome is one of the most common autosomal dominant hearing loss syndromes and features clinical and genetic heterogeneity. When there is no renal deformity, this disease can also be called branchio-otic (BO) syndrome. Though many genes have been reported, there are still many BO syndrome-related genes to be identified. To identify a hitherto unknown candidate gene causing BO syndrome in a three-generation Chinese family, clinical, genetic, and functional analyses were employed. METHODS: Whole-exome sequencing (WES) was conducted in three affected family members and two unaffected family members. PCR-Sanger sequencing was performed in all of the family members for segregation analysis and verification of the candidate variants. PCR-Sanger sequencing was also employed in 150 healthy people to examine the variants. In silico analysis was used to predict possible changes in the protein structure that may affect the phenotype. RESULTS: We identified a heterozygous missense variant in ANLN: NM_018685.4: c.G1105A; NP_061155.2: p.G369R that segregated in the pedigree with an autosomal dominant pattern. No variant was found in the 150 controls and normal family members at this site. The variant c.G1105A was located in a highly conserved F-actin binding site. The amino acid residue at position 369 in the ANLN protein was highly conserved across different species. CONCLUSION: In this study, we identified, for the first time, a heterozygous missense variant in ANLN (NM_018685.4: c.G1105A; NP_061155.2: p.G369R) that is likely to be a candidate causative gene of BO syndrome in a specific Chinese family.
Asunto(s)
Síndrome Branquio Oto Renal/genética , Proteínas de Microfilamentos/genética , Mutación Missense , Adulto , Síndrome Branquio Oto Renal/patología , Niño , Femenino , Heterocigoto , Humanos , Masculino , Persona de Mediana Edad , LinajeRESUMEN
Previous studies confirmed that KDM5B expression is dysregulated in most human tumors. However, KDM5B expression in human laryngeal squamous cell carcinoma (HLSCC) has not been reported. In this paper, the relationship between KDM5B expression and clinical features of HLSCC is clarified, and its prognostic value in HLSCC patients is evaluated. In our study, KDM5B expression was examined by immunohistochemical analysis in 63 HLSCC clinical tissue samples and 20 adjacent normal tissue samples. Subsequently, the relationship between KDM5B expression and clinicopathologic factors in 63 HLSCC patients was clarified, and its prognostic value was evaluated according to Cox model analysis. Our results showed that KDM5B was over-expressed in HLSCC cells and over-expression of KDM5B was related to the histologic type, clinical stages, lymph node metastasis, and recurrence of tumor. Furthermore, over-expression of KDM5B had poor five-year overall survival in HLSCC patients. The result of a multivariate analysis indicated that over-expression of KDM5B was an independent risk factor for poor prognosis. These results indicated that over-expression of KDM5B was closely correlated with tumorigenesis, metastasis, and poor overall survival in HLSCC patients. Furthermore, KDM5B might serve as a specific and novel prognostic biomarker in HLSCC patients.
RESUMEN
Allergic rhinitis (AR) is a common chronic inflammatory condition. It has been previously indicated that oxidative stress may contribute to allergic inflammation, including AR. Although molecular hydrogen (H2), an antioxidative agent, has been effective in treatment of numerous oxidative stress-associated diseases, the effect of inhalation of a high concentration of H2 on AR remains unknown. In the current study, female BALB/c mice were sensitized with ovalbumin (OVA) followed by intranasal OVA challenge to establish an animal model of AR. Mice were subjected to exposure to H2 and the inert gas helium at different frequencies and durations. The frequencies of sneezing/scratching and the body weights of mice were recorded. Histological analysis and multiplex cytokine assays were performed to evaluate the effects of H2 on AR. Challenge with OVA induced significant nasal mucosa inflammation. H2 inhalation reduced the infiltration of inflammatory cells into mucosa and lowered the levels of interleukin (IL)-5, IL-13 and monocyte chemoattractant protein-1 in serum. H2 inhalation slightly increased the level of interferon-γ, however the difference was not statistically significant. Treatment with H2 limited the weight increase in healthy mice and reversed the weight loss in mice with AR. Furthermore, H2 inhalation induced a therapeutic effect on AR in a dose-dependent manner. The current results demonstrate that H2 may demonstrate a therapeutic value for allergic diseases.
RESUMEN
OBJECTIVE: This study aimed to compare the efficacy of intratympanic dexamethasone (ITD) therapy and hyperbaric oxygen(HBO) therapy for the salvage treatment of patients with high-frequency sudden sensorineural hearing loss (SSNHL) after the failure of conventional therapy. MATERIALS AND METHODS: 104 refractory high-frequency SSNHL patients were enrolled in our study. Among them, 31 received ITD alone (ITD group), 32 received HBO alone (HBO group) and 41 received no salvage therapies (control group). Hearing outcomes were determined by pure-tone average measured by audiometry. The total effective rates in the hearing recovery and improvement of tinnitus were calculated before and after salvage treatment. RESULTS: There was no significant difference of the total effective rates in the hearing recovery between ITD and HBO group (pâ¯=â¯0.368). However, ITD therapy showed much better improvements of tinnitus than HBO therapy (pâ¯=â¯0.039). After ITD and HBO therapy, there were no significant differences in hearing gains at 2 and 4â¯KHz between ITD and HBO group (pâ¯=â¯0.468 and 0.934, respectively). Nevertheless, ITD therapy showed significant improvements of hearing gains at 8â¯KHz (pâ¯=â¯0.049) compared to that of HBO therapy. CONCLUSION: ITD therapy may have better improvements of tinnitus and hearing gains at 8 KHz than HBO therapy in patients with refractory high-frequency SSNHL.