Immunopathogenesis of Type 1 and Type 2 Leprosy Reaction: An Update Review.

Leprosy reactions are acute exacerbations of the signs and symptoms of leprosy occurring during the natural course of the disease and during or after treatment. Left untreated or improperly managed, reactions can lead to severe nerve function impairment and subsequently to disabilities. In the present context of leprosy eradication efforts, leprosy reactions continue to pose a significant and enduring challenge. Type 1 leprosy reaction and type 2 leprosy reaction are substantial contributors to nerve impairment and the subsequent development of enduring impairments. The study of immunopathogenesis of leprosy reactions has emerged as a significant area of research due to its potential to identify critical targets for the early detection and management of these episodes. This study aims to reveal the pathogenesis of type 1 and 2 leprosy reactions so that they can form the basis for their treatment. The study used scientific journals from reputable platforms such as PubMed, Scopus, and Google Scholar to evaluate the pathogenesis of leprosy reaction type 1 and 2 in leprosy patients. This review indicates that the progression of leprosy nerve damage and sensitivity to reactions may be predicted using genetic and serum markers in the human host. A more profound comprehension of the molecular processes underlying leprosy reactions may offer a logical plan for early detection and leprosy reaction complication prevention.

Managing the Skin Microbiome as a New Bacteriotherapy for Inflammatory Atopic Dermatitis.

The microbiome, comprising various bacteria, assumes a significant role in the immune system's maturation and maintaining bodily homeostasis. Alterations in the microbial composition can contribute to the initiation and progression of inflammation. Recent studies reveal that changes in microbial composition and function, known as dysbiosis in the skin and gut, have been associated with altered immunological responses and skin barrier disruption. These changes are implicated in the development of several skin diseases, such as atopic dermatitis (AD). This review examines research demonstrating the potential of microbiome repair as a therapeutic approach to reduce the effect of inflammatory processes in the skin during atopic dermatitis. This way, corticosteroids in atopic dermatitis therapy can be reduced or even replaced with treatments focusing on controlling the skin microbiome. This study used scientific literature from recognized platforms, including PubMed, Scopus, Google Scholar, and ScienceDirect, covering publications from 2013 to 2023. The primary aim of this study was to assess the efficacy of skin microbiome management in treating atopic dermatitis. This study concludes that physicians must comprehensively understand the microbiome's involvement in atopic dermatitis, including its pathophysiological implications and its relevance to therapeutic interventions.

Biomodulator of Diode Laser Irradiation on Odontoblast-Like Cells by Expression of Vascular Endothelial Growth Factor-A and Transforming Growth Factor-ß1.

OBJECTIVE: This study aimed to prove that the effect of diode laser 650-nm irradiation to the expression of vascular endothelial growth factor (VEGF)-A and transforming growth factor (TGF)-ß1 plays important roles in dental pulp-regulating cell proliferation, differentiation, and revascularization. MATERIALS AND METHODS: The research was performed by randomized posttest only control group design using Rattus norvegicus. A total of 48 samples were provided and divided into eight groups of 6 samples each with a random-sample allocation. Each group were prepared, and perforation of maxillary first molar were done. In control groups (groups 1-4), glass ionomer cement (GIC) was used to restore the teeth, while in laser groups (groups 5-8), the teeth were irradiated with diode laser 650 nm for 40 seconds before application of GIC. Half of the groups (groups 1, 2, 5, and 6) were necropsied in 7 days, and the rest (groups 3, 4, 7, and 8) were necropsied in 14 days. Immunohistochemistry (IHC) evaluation were implemented to check the expression of both VEGF-A and TGF-ß1. STATISTICAL ANALYSIS: Both data of VEGF-A and TGF-ß1 expression were analyzed using a one-way ANOVA (α = 0.05) with SPSS statistical software. RESULTS: The study showed that the diode laser 650-nm irradiation increased expression of VEGF-A and TGF-ß1, and there was a significant difference between diode laser and control group on VEGF-A expression (p = 0.001) and TGF- ß1 (p = 0.000) on days 7 and 14. CONCLUSION: Diode laser 650 nm with 40-second irradiation time shows increment from day 7 to day 14 reflecting increase in pulp healing by modulating VEGF-A and TGF-ß1 expression since days 7 to 14.

Effectiveness of Sclerotherapy to Cure Lower Limb Chronic Venous Insufficiency Grades 1-6: A Systematic Review and Meta-Analysis.

Chronic venous insufficiency is a medical condition that impacts the venous system in the lower limbs. The primary characteristic of this condition is the continual elevation of pressure within the leg veins due to walking, which leads to a range of associated issues, such as discomfort, swelling, alterations in the skin, and the development of ulcers. Sclerotherapy has emerged as a potentially effective treatment for chronic venous insufficiency, involving the injection of a sclerosing agent into the affected veins. This study aimed to evaluate the effectiveness of sclerotherapy in treating chronic venous insufficiency grades 1-6 in the lower limb through a systematic review and meta-analysis. The method for conducting this research is by searching articles with relevant keywords carried out through electronic databases, such as Cochrane Library, Pubmed, and Google Scholar. The researchers conducted a comprehensive search and included randomized controlled trials and clinical trials that assessed outcomes, such as patient satisfaction, clinical resolution, quality of life (QoL), and closure rates. Statistical methods were used to analyze the data. The results of the meta-analysis from 9.670 total samples showed that sclerotherapy is the most effective therapy for reducing clinical severity in lower limb venous insufficiency patients (pooled MD = -0.85, 95% CI (-1.41, -0.29), p < 0.00001, I2 = 99%). Sclerotherapy is the most effective therapy for increasing QoL if we use Venous Insufficiency Epidemiology and Economic Study-Quality of Life (VEINES-QOL) as a tool for measuring the QoL (VEINES-QOL scale types; pooled MD = 10.34, 95% CI (8.78, 11.90), p < 0.00001, I2 = 0%). Additionally, sclerotherapy is a more effective therapy for increasing QoL compared to placebo (pooled MD = -1.64, 95% CI (-2.60, -0.67), p = 0.002, I2 = 90%), deferred ablation (pooled MD = -0.22, 95% CI (-0.40, -0.03), p = 0.02), and ligation therapy (pooled MD = -1.29, 95% CI (-1.62, -0.97), p = 0.00001). It is also the most effective therapy for increasing the closure rate for 12-month duration outcome measures (pooled RR = 0.72, 95% CI (0.55, 0.94), p = 0.001, I2 = 91%). However, high heterogeneity was observed in the meta-analysis results, indicating the need for further research to address this variability. This study contributes to the existing body of knowledge on the treatment options for chronic venous insufficiency and highlights the potential of sclerotherapy as an effective treatment modality.

[Digital orthopedics technology leads the new development direction of arthroplasty].

Digital orthopedics technology is a new interdisciplinary subject, known as the third technological wave in the field of orthopedics. The development direction of arthroplasty is focused on hoping to improve the long-term prognosis of patients by imitating more natural kinematics and optimizing implant positioning strategies. At present, various digital orthopedic technologies such as virtual reality technology, navigation assistance systems, and patient-specific instrumentation (PSI) and robot-assisted surgery in joint surgery are in full swing. In this article, relevant domestic and foreign literature were extensively reviewed and the author's own experiences were summarize, and the advantages, disadvantages, clinical efficacy and future prospects of the above-mentioned various technologies were evaluated too.

Development of application-based education model and prenatal yoga in reducing the occurrence of cesarean section (CS) delivery: Study protocol.

BACKGROUND: In the last 20 years, the public health community has expressed concerns over the unprecedented increase of cesarean section (CS) delivery. Rising global concerns over this escalation that has gone out of control should not be overseen. The purpose of this study is to develop an application-based education model and prenatal yoga to reduce the occurrence of cesarean section (CS) delivery. MATERIAL AND METHOD: This studywasan exploratory mixed methodsresearchthat consisted of twostages: stage 1, which wasa qualitative study on model formulation through in-depth interviews and forum group discussions (FGDs); and stage 2, which aimed to test whether the formulated model was effective in reducing the occurrence of cesarean section delivery. CONCLUSION: The result of this study wasused todevelop an application-based education model, which wascombined with prenatal yoga, to reduce the occurrence of cesarean section delivery.

[A case of subacute combined degeneration of spinal cord caused by inhaling laughing gas].

Laughing gas (Nitrogen monoxide) is currently abused due to its low price and easy availability. This article discussed the clinical manifestations of a patient with subacute combined degeneration of the spinal cord caused by inhalation of laughing gas. The patient developed numbness of extremities, unstable walking, and decreased serum vitamin B(12) level. MRI of the cervical spine showed abnormal signals in the lateral and posterior cords of the cervical spinal cord (C2-6) , neuroelectrophysiological examination showed peripheral nerve damage in the extremities. After treatment with vitamin B(12) supplementation, the patient's condition gradually improved. Clinicians diagnose subacute combined degeneration of the spinal cord, especially when the patient has no gastrointestinal disease, diet, malnutrition, etc., they need to carefully inquire about the history of nitrous oxide inhalation to avoid missed diagnosis.

A retrospective 'real-world' cohort study of azole therapeutic drug monitoring and evolution of antifungal resistance in cystic fibrosis.

BACKGROUND: Individuals with cystic fibrosis (CF) have an increased susceptibility to fungal infection/allergy, with triazoles often used as first-line therapy. Therapeutic drug monitoring (TDM) is essential due to significant pharmacokinetic variability and the recent emergence of triazole resistance worldwide. OBJECTIVES: In this retrospective study we analysed the 'real-world' TDM of azole therapy in a large CF cohort, risk factors for subtherapeutic dosing, and the emergence of azole resistance. METHODS: All adults with CF on azole therapy in a large single UK centre were included. Clinical demographics, TDM and microbiology were analysed over a 2 year study period (2015-17) with multivariate logistic regression used to identify risk factors for subtherapeutic dosing. RESULTS: 91 adults were treated with azole medication during the study period. A high prevalence of chronic subtherapeutic azole dosing was seen with voriconazole (60.8%) and itraconazole capsule (59.6%) use, representing significant risk factors for subtherapeutic levels. Rapid emergence of azole resistance was additionally seen over the follow-up period with a 21.4% probability of CF patients developing a resistant fungal isolate after 2 years. No significant relationship was found however between subtherapeutic azole dosing and azole resistance emergence. CONCLUSIONS: Our study demonstrates a high prevalence of subtherapeutic azole levels in CF adults with increased risk using itraconazole capsules and voriconazole therapy. We show rapid emergence of azole resistance highlighting the need for effective antifungal stewardship. Further large longitudinal studies are needed to understand the effects of antifungal resistance on outcome in CF and the implications of subtherapeutic dosing on resistance evolution.

Erratum to: A retrospective 'real-world' cohort study of azole therapeutic drug monitoring and evolution of antifungal resistance in cystic fibrosis.

[This corrects the article DOI: 10.1093/jacamr/dlab026.].

DUXAP8 promotes the proliferation and migration of ovarian cancer cells via down-regulating microRNA-29a-3p expression.

OBJECTIVE: To study the role of long-chain non-coding RNA (lncRNA) DUXAP8 in ovarian cancer (OCa) and the underlying potential mechanism. PATIENTS AND METHODS: The expression pattern of DUXAP8 in ovarian cancer was analyzed using the GEPIA database. Quantitative real-time polymerase chain reaction (qRT-PCR) was applied to determine the expression of DUXAP8 in OCa tissues; at the same time, OCa cell lines were cultured to complete functional experiments, including cell counting kit-8 (CCK-8), plate cloning experiments and transwell experiments to evaluate the effects of DUXAP8 on the proliferative and migration ability of OCa cell lines. Bioinformatics analysis and Dual-Luciferase reporter genes were used to determine the binding and expression of DUXAP8 to its downstream key gene microRNA-29a-3p in OCa cells. In addition, co-transfection technology and cell function recovery experiments were used to verify the important role of the DUXAP8/microRNA-29a-3p regulatory network in OCa. RESULTS: DUXAP8 was abnormally highly up-regulated in OCa tissues and cell lines, besides, its expression was related to poor prognosis of patients. CCK-8 and plate cloning experiments showed that knockdown of DUXAP8 in OCa cells can significantly inhibit the proliferation of OCa cells. Transwell results suggested that knockdown of DUXAP8 can significantly inhibit OCa cell migration. In addition, it was found that DUXAP8 can bind and negatively regulate the expression of microRNA-29a-3p in OCa. Functional experiments in OCa cells also revealed that microRNA-29a-3p was a key downstream gene that mediated the regulation of DUXAP8 on OCa function. CONCLUSIONS: DUXAP8 has abnormally high expression in OCa and can lead to malignant progression of the tumor.

Severe Dumping Symptoms Are Uncommon Following Transthoracic Esophagectomy But Significantly Decrease Health-Related Quality of Life in Long-Term, Disease-Free Survivors.

BACKGROUND: High-quality documentation of dumping symptoms after esophagectomy is currently limited. The aim of the study was to describe the incidence of symptoms associated with dumping syndrome and their relationship with health-related quality of life after esophagectomy. METHODS: The study cohort was identified from prospective IRB-approved databases from two high-volume esophagectomy centers. Patients that were alive and without evidence of recurrence in April 2018 completed the validated Dumping Symptom Rating Scale and health-related quality of life questionnaires. Compound dumping symptom score was created by combining the individual scores for severity and frequency for each symptom. RESULTS: In total, 171 patients who underwent esophagectomy 1995-2017 responded to the questionnaires, corresponding to a response rate of 77.0%. Median age was 66 years and median time from operation to survey was 5.5 years. Absent or mild problems in all nine dumping symptoms were reported by 94 (59.5%) patients; 19 (12.0%) patients reported moderate or severe problems in at least three symptoms, the most common being postprandial "need to lie down," "diarrhea," and "stomach cramps." Increasing compound dumping symptom score was associated with significantly decreased function scores in all aspects of health-related quality of life except physical functioning (P < 0.005). CONCLUSIONS: Esophagectomy has the potential to change long-term eating patterns; however, the majority of patients in the study did not have severe postoperative dumping symptoms. On the other hand, moderate-to-severe dumping symptoms, which were reported by 12% of patients in this study, were strongly associated with decreased health-related quality of life.

Effect of oviposition by Bactrocera dorsalis on the antioxidant activity of orange juice / Efeito da oviposição de Bactrocera dorsalis na atividade antioxidante do suco de laranja

Abstract Among fruits and fruit products, oranges and orange juice are the most widely consumed worldwide. However, the effects of pest infestation of oranges on the quality of orange juice are not yet known. To evaluate the effect of the oriental fruit fly Bactrocera dorsalis on the antioxidant activity of orange juice, we measured changes in the vitamin C (Vc) concentration, total phenol content, and antioxidant activity of orange juice after the introduction of fruit fly eggs. Ten days after the eggs were introduced (larvae removed), the concentration of Vc in orange juice was 18.65 µg/mL, which was 9.16 µg/mL lower than that measured in healthy orange juice. In addition, the total phenol content decreased by 46.519 mg Gallic Acid Equivalents (GAE)/g to 9.748 mg GAE/g. Furthermore, the free-radical scavenging activity decreased from 22.297% to 5.393%. Correlation analysis indicated significant correlations between Vc concentration, total phenol content, and antioxidant activity of orange juice after B. dorsalis infestation. The decrease in Vc concentration, total phenol content and free-radical scavenging activity indicated that B. dorsalis changed the quality of orange juice by affecting the antioxidant activity of the juice after the oranges were infested.

Resumo Entre frutas e produtos de frutas, as laranjas e suco de laranja são os mais consumidos em todo o mundo. No entanto, os efeitos da infestação de laranjas sobre a qualidade do suco de laranja ainda não são conhecidos. Para avaliar o efeito da mosca-das-frutas oriental, Bactrocera dorsalis, sobre a atividade antioxidante do suco de laranja, foram medidas as mudanças na concentração de vitamina C (Vc), no teor de fenol total e na atividade antioxidante do suco de laranja após a introdução de ovos da mosca-das-frutas oriental. Dez dias após a introdução dos ovos (larvas removidas), a concentração de Vc no suco de laranja foi de 18,65 µg/mL, que foi 9,16 µg/mL menor do que a medida em suco de laranja saudável. Além disso, o teor total de fenol diminuiu de 46,519 mg em equivalente de ácido gípico (GAE)/g para 9,748 mg de GAE/g. Ademais, a atividade de eliminação de radicais livres diminuiu de 22,297% para 5,393%. A análise de correlação indicou correlações significativas dentre a concentração de Vc, o conteúdo total de fenol e a atividade antioxidante do suco de laranja após a infestação por B. dorsalis. A diminuição na concentração de Vc, o conteúdo total de fenol e a atividade sequestradora de radicais livres indicaram que B. dorsalis alterou a qualidade do suco de laranja, afetando a atividade antioxidante do suco após a infestação das laranjas.

Effect of oviposition by Bactrocera dorsalis on the antioxidant activity of orange juice.

Among fruits and fruit products, oranges and orange juice are the most widely consumed worldwide. However, the effects of pest infestation of oranges on the quality of orange juice are not yet known. To evaluate the effect of the oriental fruit fly Bactrocera dorsalis on the antioxidant activity of orange juice, we measured changes in the vitamin C (Vc) concentration, total phenol content, and antioxidant activity of orange juice after the introduction of fruit fly eggs. Ten days after the eggs were introduced (larvae removed), the concentration of Vc in orange juice was 18.65 µg/mL, which was 9.16 µg/mL lower than that measured in healthy orange juice. In addition, the total phenol content decreased by 46.519 mg Gallic Acid Equivalents (GAE)/g to 9.748 mg GAE/g. Furthermore, the free-radical scavenging activity decreased from 22.297% to 5.393%. Correlation analysis indicated significant correlations between Vc concentration, total phenol content, and antioxidant activity of orange juice after B. dorsalis infestation. The decrease in Vc concentration, total phenol content and free-radical scavenging activity indicated that B. dorsalis changed the quality of orange juice by affecting the antioxidant activity of the juice after the oranges were infested.

Selecting Potential Neuronal Drug Leads from Conotoxins of Various Venomous Marine Cone Snails in Bali, Indonesia.

Many conotoxins, natural peptides of marine cone snails, have been identified to target neurons. Here, we provide data on pharmacological families of the conotoxins of 11 species of cone snails collected in Bali. The identified definitive pharmacological families possibly targeting neuronal tissues were α (alpha), ι (iota), κ (kappa), and ρ (rho). These classes shall target nicotinic acetylcholine receptors, voltage-gated Na channels, voltage-gated K channels, and α1-adrenoceptors, respectively. The VI/VII-O3 conotoxins might be prospected as an inhibitor of N-methyl-d-aspartate. Con-ikot-ikot could be applied as an α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor blocker medicine. The definitive pharmacology classes of conotoxins as well as those yet to be elucidated need to be further established and verified.

The aberrant activation of Wnt pathway caused by ß-catenin mutation and its prognostic significance in NK/T-cell lymphoma.

The aberrant activation of the Wnt/ß-catenin signal has an important role in the progression of cancers. Herein, we investigated ß-catenin mutation and the activation of the Wnt pathway in association with the clinical-pathological characteristics, chemo-resistance and prognosis of NK/T-cell lymphoma (NKTCL). Real-time quantitative PCR, immunocytochemistry and immunohistochemistry SP methods detected the levels of ß-catenin, c-myc and cyclin D1 in human NKTCL cell lines (SNK-6 and YTS) and NKTCL tissues. Mutation analysis was detected in exon 3 of ß-catenin gene; and we analyzed cell viability after histone deacetylase inhibitor (HDACi) treatment. As a result, 19 (38%) of NK/T-cell lymphoma displayed nuclear ß-catenin and 16 (32%) contained mutations in exon 3; while no mutations were detected in lymphomas negative for ß-catenin nuclear staining (p<0.05). Most mutations affecting ß-catenin were adjacent to regulatory phosphorylation sites. ß-catenin, c-myc and cyclin D1 were significantly elevated in SNK-6 and YTS cell lines compared to normal NK/T cells (p<0.05). Furthermore, the high expression of ß-catenin, c-myc and cyclin D1 significantly correlated with the III/IV Ann Arbor stage. Additionally, the expression of ß-catenin in the SNK-6 cell line decreased significantly after treatment with HDACi, and Kaplan-Meier survival analysis revealed that the elevated expression of ß-catenin correlated with poor prognosis in NKTCL patients (23.66±2.77 months vs 31.65±1.78 months, p=0.023). In conclusion: mutations in exon 3 of ß-catenin and the activated Wnt pathway are common in NK/T-cell lymphoma that has nuclear ß-catenin, and it is closely correlated with the Ann Arbor stage and prognosis in NKTCL patients.

Identification and Distribution of Pathogens in a Major Tertiary Hospital of Indonesia.

The nosocomial persistence of multiple drug resistance organisms constitutes a global threat. Healthcare-setting acquired infections are subject to substantial selection pressure and are frequently associated with drug resistance. As part of the microbiological surveillance of the Sanglah tertiary referral hospital in the island province of Bali, the distribution of bacterial pathogen and their relative susceptibilities were recorded over a 30 months period. This is the first such detailed study benchmarking the type and sensitivity of bacterial pathogens in a major tertiary referral hospital within Indonesia and it is hoped that it will lead to similar reports in the near future, while informing local and national antimicrobial stewardship policies.

[Analysis on epidemiological characteristics and related factors of dyslipidemia among adult residents of Xinjiang Uygur Autonomous Region during 2013-2014].

Objective: To study the epidemiological characteristics and related factors of dyslipidemia among adult residents in Xinjiang Uygur Autonomous Region (Xinjiang) in 2013-2014. Methods: A total of 4 120 adult residents consisting of Han and Uygur group aged over 18 years old were selected by using a stratified cluster random sampling method in 8 counties of Xinjiang from 2013 to 2014. The related factors of dyslipidemia were collected by questionnaire and physical measurement. The total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were detected by enzyme method. Factors associated with dyslipidemia were analyzed by chi-squared test and a multivariate unconditioned logistic regression model adjusted for gender, urban or rural area, age-group, body mass index (BMI), central obesity, smoking, drinking, education attainment, diabetes mellitus and hypertension. Results: The prevalence of dyslipidemia was 45.00% (1 854 cases). The prevalence of dyslipidemia was higher in Uygur group (47.80% (977/2 044)) than that in Han group (42.24% (877/2 076)) (χ(2)=12.84, P<0.001). The analysis showed that dyslipidemia was related with gender (OR=0.41, 95%CI: 0.33-0.51), urban area (OR=0.54, 95%CI: 0.39-0.76), BMI (overweight group (OR=1.52, 95%CI: 1.18-1.96); obesity group (OR=2.20, 95%CI: 1.64-2.96)), central obesity (OR=1.66, 95%CI: 1.29-2.14) and diabetes mellitus (OR=1.49, 95%CI: 1.06-2.11) in Uygur group. The analysis also showed that dyslipidemia was related with BMI (overweight group (OR=1.72, 95%CI: 1.32-2.25), obesity group (OR=2.60, 95%CI: 1.85-3.64)), central obesity (OR=1.45, 95%CI: 1.13-1.87), smoking (OR=1.46, 95%CI: 1.09-1.95), diabetes mellitus (OR=1.77, 95%CI: 1.38-2.25) and hypertension (OR=1.62, 95%CI: 1.31-2.00) in Han group. Conclusions: The prevalence of dyslipidemia in Xinjiang was higher than the national average prevalence. The prevalence of dyslipidemia in Uygur group was significantly higher than that in Han group. The gender, living area, BMI, central obesity and diabetes mellitus were risk factors of dyslipidemia in Uygur group, and BMI, central obesity, smoking, diabetes mellitus and hypertension were risk factors of dyslipidemia in Han group in Xinjiang.

Electroacupuncture treatments for gut motility disorders.

Functional gastrointestinal (GI) diseases are common and there are patients who are refractory to medical therapies as not all treatments work in all patients. Consequently, a large number of patients with functional GI diseases use complementary and alternative medicine, such as acupuncture or electroacupuncture (EA). In this issue, Zheng et al. reported interesting results of a multi-center placebo-controlled clinical study on the use of EA for treating refractory functional dyspepsia; another study reported a multi-center clinical trial on EA for chronic functional constipation; Liang et al. studied mechanisms of EA involving enteric nervous system and neurotransmitters in treating constipation in rats. While controversial reports are available in the literature, EA with appropriate methodologies as shown in these recent studies is believed to be effective in treating certain functional GI diseases. In this mini-review, a number of clinical studies, including those included in this issue on the use of EA for treating gastro-esophageal reflux, functional dyspepsia, irritable bowel syndrome, and constipation are reviewed. Some critically important issues, such as the choice of stimulation parameters for EA, the administration frequency of the therapy, and the appropriate choice of placebo for clinical research are also discussed. Mechanisms of action involved in the therapeutic effects of EA for gut dysmotility and future research directions are also presented.

[Analysis of related factors of coins foreign bodies crossing the esophagus in 204 cases of children].

Objective:To evaluate the effect of systemic and intratympanic dexamethasone combination therapy on sudden deafness.Method:A total of 98 patients randomly divided into three groups: an intravenous corticosteroid (systemic corticosteroid monotherapy group); an intratympanic corticosteroid (IT monotherapy group); and a combination therapy group (IT plus systemic combination group). All patients were treated additionally with ginkgo-damole and mecobalamine and proton pomp inhibitor. An audiometry was performed before and after the therapies in all patients. Result:Of the total of 98 patients, 39 were receiving systemic corticosteroids, 28 received intratympanic(IT) corticosteroids, and 31 were receiving a combination of the two. A total of 65 patients (66.3%) responded positively to corticosteroid therapy. No significant differences were observed between the three groups (systemic group, IT and combination therapy group) in their overall response to treatment (P=0.61). Patients who suffered from concomitant tinnitus and dizziness responded less positively to the treatment (P=0.00）. Positive family history of SSNHL seems to be negative prognostic factors in the response to treatment (P=0.02).The response to treatment was not related to the initial severity of hearing loss (P=0.68) and pattern (P=0.28). Conclusion:This study did not find any difference in the rate of hearing improvement between systemic, intratympanic, and combined corticosteroid therapy for sudden hearing loss.