Cell Senescence-Related Genes as Biomarkers for Prognosis and Immunotherapeutic Response in Colon Cancer.

Colon adenocarcinoma (COAD) stands out as the most prevalent malignancy diagnosed within the gastrointestinal tract, bearing substantial incidence and mortality rates. The processes of ageing and senescence intricately intertwine with tumorigenesis and immune regulation, concurrently exerting influence on the remodelling of the tumor microenvironment (TME). This phenomenon, in turn, significantly impacts the efficacy of immunotherapeutic interventions. Despite this awareness, the comprehensive understanding of the intricate interplay between cellular senescence and TME in the context of COAD remains elusive. Further inquiry is imperative to comprehensively gauge the relevance of cellular senescence-related genes (CSGs) in the realms of immune infiltration and the prognostication of COAD. Differentially expressed cell senescence-related genes (DE-CSGs) within COAD tumors and normal specimens were discerned through analysis of the TCGA-COAD dataset. Leveraging univariate, LASSO, and multivariate Cox regression analyses, we formulated a prognostic risk signature. Subsequent validation utilised two independent GEO datasets. Furthermore, a nomogram was devised to gauge the prognostic significance of this signature. Additionally, the immune landscape of the Cell Senescence-related Signature (CSS) was characterised using CIBERSORT and TIMER algorithms. The expression levels of CSGs were quantified through RT-PCR in COAD specimens. Drawing upon mRNA expression profiles of 191 DE-CSGs, we successfully established a 9-gene CSS, demonstrating its autonomy as a prognostic determinant for COAD patients. Those assigned high-risk scores exhibited an immunosuppressive phenotype, marked by elevated proportions of resting CD4+memory T cells and macrophages M0, correlating with diminished overall survival. Subsequent analyses uncovered that the amalgamation of CSS with the expression profiles of immune checkpoint key genes effectively predicted patient prognosis. Furthermore, patients with low-risk scores demonstrated a potential association with more favourable therapeutic outcomes in the context of immunotherapy. This study has culminated in the development of a prognostic risk signature grounded in cell senescence-related genes for COAD. We posit that the CSS plays a regulatory role in immune infiltration, emerging as a robust biomarker for prognosis and a predictive indicator for immunotherapeutic responsiveness within the COAD landscape.

Recent advances in biological therapy of diabetic retinopathy / 眼科新进展

Diabetic retinopathy(DR)is one of the most common fundus vascular diseases and a leading cause of blindness in adults of working age.The occurrence and development of DR involves a variety of pathophysiologic mecha-nisms,including metabolic dysregulation,oxidative stress,inflammation,and neurovascular unit hypofunction.Conven-tional clinical treatments,such as anti-vascular endothelial growth factor drugs and retinal laser photocoagulation,have long treatment cycles and variable outcomes in some patients and sometimes require vitrectomy in the later stages of the disease.With the in-depth research on the molecular level of the pathogenesis of DR,a number of biological therapeutic modalities,such as targeted therapy,gene therapy,immunotherapy and cell therapy,have received more and more atten-tion from researchers.This review summarizes the biologic therapeutic modalities currently available for DR and outlines the benefits and limitations of these approaches with a view to informing researchers.

Ventral hernia repair in rat using nanofibrous polylactic acid/polypropylene meshes.

AIM: In the present study, we combined a nanofibrous polylactic acid (PLA) scaffold fabricated by electrospinning with a polypropylene (PP) material to generate a new type of mesh for hernia repair. MATERIALS & METHODS: The PLA/PP mesh was tested with tensile testing, in vitro cytocompatibility and degradation. A total of 90 rats were randomly allocated to PLA/PP, PP and polyester (PE) mesh groups for the in vivo study to evaluate the properties of PLA/PP mesh. RESULTS: PLA/PP mesh had superior mechanical properties. It also resulted in less inflammation adhesion formation (p < 0.05), which was related to the TGF-ß1/Smad pathway. The distribution of collagen I and III in PLA/PP mesh was also superior to those in the other two groups (p < 0.05). CONCLUSION: The PLA/PP mesh would be suitable for ventral hernia repair in the future.

Homoharringtonine-induced apoptosis of MDS cell line MUTZ-1 cells is mediated by the endoplasmic reticulum stress pathway.

Homoharringtonine has been shown to lead to apoptosis of leukemic cells in several studies. Here we showed that the endoplasmic reticulum (ER) may be the initial site of apoptotic signal induced by homoharringtonine in MUTZ-1 cells. After incubation with homoharringtonine, the percentage of apoptotic MUTZ-1 cells increased in a time-dependent manner, Ca(2+) translocated from ER pool to cytosol, the mitochondrial membrane potential decreased, and Bid protein translocated from ER to mitochondria. The activation of ER stress-associated proapoptotic factor CHOP and ER chaperones BiP and XBP1 genes followed by cleavage of caspase-3 but not caspase-4 protein were also observed.

Research progress of vitamin D and obstetric maternal and infant outcomes / 中国综合临床

Vitamin D is a fat soluble steroid derivative, which is very important to maintain human normal physiological function. It plays an important role in embryogenesis, bone development and calcium homeostasis. Vitamin D deficiency is widespread in the world, and the prevalence of vitamin D deficiency during pregnancy is also significantly increased, accompanied by adverse maternal and neonatal outcomes, such as gestational diabetes mellitus, preeclampsia, premature delivery, and low birth weight. At present, there is no consensus on whether vitamin D supplementation is helpful to improve the prognosis of mothers and infants, and whether vitamin D is the etiology or marker of adverse pregnancy outcome. This paper reviews the latest research progress on the relationship between vitamin D level during pregnancy and maternal and infant outcomes.

Pregnancy management of hepatolenticular degeneration in pregnancy / 中国综合临床

Hepatolenticular degeneration (HLD) is Wilson's disease, which is an autosomal recessive inherited disease caused by gene abnormality and copper transport disorder in liver cells. The pregnancy of HLD patients is safe. During pregnancy, the treatment of eliminating copper should be continued, the dosage of drugs should be reduced according to the condition, and regular monitoring should be done. HLD patients with satisfactory copper control had better pregnancy outcomes than untreated HLD patients. The treatment during pregnancy should be individualized, and perinatal care should be coordinated by obstetrics, hepatology, liver transplantation, genetic counseling, pharmacy, anesthesiology, pediatrics and other disciplines.

Performance verification of nucleic acid testing project based on ISO 15189 / 中国输血杂志

【Objective】 To explore the performance verification of NAT and its procedures for HBV DNA, HCV RNA and HIV RNA-1 using PCR-fluorescence via Cobas s201 automatic NAT system and supporting MPX V2.0 reagents that applied in the laboratories of blood stations, in order to satisfy ISO 15189 accreditation requirements and ensure the accuracy of NAT results. 【Methods】 Samples used in external quality assessment(EQA) of year 2020 were taken to verify the concordance, Performance evaluation panel and sensitivity verification panel of Roche second-generation NAT system were used to verify the sensitivity/ specificity and the lower limit of detection, respectively.And HBV DNA, HCV RNA and HIV RNA-1 quality control products were used to verify the anti-interference ability. 【Results】 The concordance rate of 40 EQA, samples was 100%. The sensitivity and specificity of Cobas s201 automatic NAT system and supporting MPX V2.0 reagents in detecting HBV DNA, HCV RNA and HIV RNA-1 were all 100%. The lower detection limit for HBV DNA, HCV RNA and HIV RNA-1 all met the requirements of reagent instructions. The yielding of HBV DNA, HCV RNA and HIV RNA-1 were affected little with hemolysis at 500 mg/dL but interfered seriously as lipemia reached 3 300 mg/dL. 【Conclusion】 The concordance rate, sensitivity, specificity and lower detection limit of the Cobas s201 fully-automatic NAT system and MPX V2.0 reagents by PCR-fluorescence method all met the requirements of reagent instructions. The verification of anti-interference ability demonstrated the requirements of ISO 15189 and the needs of blood station laboratories could be satisfied, and the detection methods and procedures can ensure the accuracy of NAT results.

Analysis of the prevalence of anemia and its influencing factors in the urban communities-dwelling elderly population in Beijing / 中华老年医学杂志

Objective:To analyze the prevalence of anemia and its influencing factors in the elderly population dwelling in urban communities in Beijing.Methods:A random cluster sampling method was adopted to select the elderly people of communities in Beijing, and cross-sectional research was conducted through questionnaire surveys, field tests and blood sample collection.The criteria for diagnosing anemia were from WHO standards, and the health evaluation indicators in the questionnaire survey included demographic data and eating habits, socio-economic information, information on enjoying health services, health and physical fitness and other information.Blood samples were drawn for routine blood tests and biochemical tests.Results:A total of 1 947 elderly people aged 65 years and above were investigated, including 789 males(40.5%)and 1 158 females(59.5%). Among the 1 947 survey subjects, 288 elderly people had anemia, with the prevalence of anemia of 14.79%(288/1 947). The prevalence of anemia was 16.35%(129/789)in males and 13.73%(159/1 158)in females.There was no statistically significant difference in the prevalence of anemia between male and female( χ2=2.760, P=0.097). Logistic regression analysis was used to analyze the factors affecting anemia.The results showed that the higher age( OR=1.055, P=0.000), the higher frequency of meat-eating( OR=1.353, P=0.046), the lower frequency of fruit-eating( OR=0.759, P=0.048), the worse health status of cohabitants( OR=0.757, P=0.037), the lower BMI( OR=0.905, P=0.001)and the lower exercise frequency( OR=0.769, P=0.012)were correlated to the higher anemia risk in the elderly population dwelling in urban communities in Beijing. Conclusions:The prevalence of anemia is relatively high in the elderly in Beijing communities.According to our findings, older people should reduce the frequency of eating meat, while ensuring nutritional intake, increase the intake of fruits and take appropriate exercises to reduce the prevalence of anemia.

Study on the relationship between acute stress disorder and symptom group in stroke patients with motor impairment / 中国综合临床

Objective:To explore the influence of symptom group of stroke patients with exercise disorder on acute stress disorder.Methods:Patients with stroke and motor impairment hospitalized in the Department of Neurology and surgery of North China University of technology from October 2018 to August 2019 were selected as the research objects.The general information of patients, brain injury subscale (BIS) and Stanford acute stress reaction questionnaire (SARSQ) were investigated by questionnaire.Results:A total of 324 patients with stroke and motor disorders were investigated.The demographic characteristics of education, age, degree of motor function, number of combined dysfunction and Activity Of Daily Living Scale(ADL) grade had effects on acute stress disorder, and the differences were statistically significant( P<0.05). The score of acute stress disorder in stroke patients with motor disorders was (99.60±13.69 ) points.From the highest to the lowest symptom group, the scores were obsessive symptom (11.35±2.71), depression (7.44±1.86), hostility (7.23±2.26), somatization (3.69±1.42) and psychosis (2.81±1.09). The results of correlation analysis showed that somatization, depression, obsessiveness, hostility and psychosis were positively correlated with the total score of acute stress disorder and the scores of each dimension ( r=0.164, 0.355, 0.329, 0.298, 0.279, all P<0.05), the symptoms were also positively correlated with all the dimensions of acute stress disorder(all P<0.05). Multiple linear regression analysis showed that age(Regression coefficient=7.682, 95% CI: 4.930-10.435, P<0.001), the number of combined dysfunction(Regression coefficient=3.937, 95% CI: 0.268-7.605, P=0.036), depression(Regression coefficient=1.662, 95% CI: 0.727-2.597, P=0.001) had influence on ASD of stroke patients. Conclusion:The level of acute stress disorder in stroke patients with motor impairment is on the high side, and the characteristics of symptom group are obvious, which has a positive correlation with acute stress disorder.Medical staff should pay attention to the characteristics of symptom group and acute stress reaction level of stroke patients with motor impairment, so as to provide targeted intervention strategies to avoid disease recurrence and improve the quality of life.

Burden status quo and influencing factors of main caregivers in stroke patients with home enteral nutrition / 重庆医学

Objective To investigate the burden status quo of caregivers in stroke patients with home enteral nutrition and to analyze the factors influencing the caregivers burden.Methods A total of 202 direct caregivers in stroke patients with enteral nutrition treatment during hospitalization period in this hospital and continued home enteral nutrition after discharge from hospital were collected as the study subjects.The Caregiver Burden Inventory,Self—Rating Anxiety Scale,Self—Rating Depression Scale,patients and caregivers general condition questionnaire were adopted to conduct the survey.The burden level status of caregivers and its related influencing factors were statistically analyzed.Results The results showed that the burden total score in 202 caregivers receiving the investigation was (50.17± 9.75) points.The univariate analysis results showed that that the age of caregivers,family income per capita level,whether caregivers having negative emotions (anxiety or depression),care time,NIHSS scores of patients and feeding mode burden score had statistical differences (P＜0.05).The multivariate analysis results showed that the care time of caregivers,feeding mode,accompanying anxietyor depression in caregivers,NIHSS scores of patients were the main influencing factors of caregivers burden(P＜0.05).Conclusion The caregivers have a great burden in caring the patients,which should arouse attention.

Evaluation of wearable health monitoring equipment for community-based management of hypertension / 中华健康管理学杂志

Objective@#To evalate the effectiveness and suitability of a wearable health monitoring device for community-based management of hypertension.@*Methods@#In December 2015, 400 patients with hypertension were enrolled from Beijing, Chaoyang. Subjects were divided into an experimental group (220 cases) and control group (180 cases), and baseline data were collected. The control group received follow-up with general planning while the experimental group received wearable health devices. Follow-up was performed three times using a questionnaire (April, August, and December 2016), and medical staff provided feedback and guidance. The experimental group was also classified according to risk factors and intervention measures were individually designed, and included monitor and medication compliance, self-management ability, and social support. Communication between patients and medical staff was recorded to form a case system. Evaluation indexes included accuracy and reliability, blood pressure management efficacy, behavior intervention efficacy, satisfaction, and disease burden. A t-test, non-parametric test, and chi-square test were used to compare the experimental and control groups before and after intervention.@*Results@#At 1-year follow-up, after correcting for differences in baseline information between the two groups, statistically significant differences in numerical indexes were observed for number of visits within 1 month [1(1) vs. 1(1), Z=5.42], payment within 1 month [85(141) yuan vs. 40(70) yuan, Z=-2.66], visiting time [20(20) min vs. 20(15) min, Z=-2.82], exercise times [4.79(2.24) times/week vs. 4.09(2.00) times/week, Z=9.27], medication compliance score [7.33(5.77) vs. 8.70(5.24), Z=6.86], satisfaction [9.27(0.08) vs. 8.88(0.10), Z=11.77], diastolic pressure [(78.93±0.56) mmHg vs. (81.32±0.61)mmHg, F=8.70] (1 mmHg=0.133 kPa), and body mass index [(25.55±0.27) kg/m2 vs. (27.74±0.43) kg/m2, F=-2.24]. In addition, classification indexes adjusted for normalized blood pressure and habitus were different between experimental and control groups (χ2=3.89, 8.38, P≤0.05). The equipment worked well, with performance rates of over 90% (90.9%, 97.3%, and 92.7%).@*Conclusion@#The wearable health monitoring equipment showed good stability and reliability, and was able to effectively support health management in patients with hypertension in the community. At the same time, the equipment can improve healthy lifestyle compliance and awareness or self-management of blood pressure. In this manner, the burden of disease is reduced and the quality of life is improved.

Pirh2 mediates the sensitivity of myeloma cells to bortezomib via canonical NF-κB signaling pathway

Clinical success of the proteasome inhibitor established bortezomib as one of the most effective drugs in treatment of multiple myeloma (MM). While survival benefit of bortezomib generated new treatment strategies, the primary and secondary resistance of MM cells to bortezomib remains a clinical concern. This study aimed to highlight the role of p53-induced RING-H2 (Pirh2) in the acquisition of bortezomib resistance in MM and to clarify the function and mechanism of action of Pirh2 in MM cell growth and resistance, thereby providing the basis for new therapeutic targets for MM. The proteasome inhibitor bortezomib has been established as one of the most effective drugs for treating MM. We demonstrated that bortezomib resistance in MM cells resulted from a reduction in Pirh2 protein levels. Pirh2 overexpression overcame bortezomib resistance and restored the sensitivity of myeloma cells to bortezomib, while a reduction in Pirh2 levels was correlated with bortezomib resistance. The levels of nuclear factor-kappaB (NF-κB) p65, pp65, pIKBa, and IKKa were higher in bortezomib-resistant cells than those in parental cells. Pirh2 overexpression reduced the levels of pIKBa and IKKa, while the knockdown of Pirh2 via short hairpin RNAs increased the expression of NF-κB p65, pIKBa, and IKKa. Therefore, Pirh2 suppressed the canonical NF-κB signaling pathway by inhibiting the phosphorylation and subsequent degradation of IKBa to overcome acquired bortezomib resistance in MM cells.

Predictive model for early neurological deterioration in minor ischemic stroke without reperfusion therapy / 中风与神经疾病杂志

@#Objective　To explore independent risk factors for early neurological deterioration in first-ever minor ischemic stroke without reperfusion therapy,and to achieve individualized prediction by constructing a nomogram model.Methods　We enrolled first-ever minor ischemic stroke patients of non-reperfusion therapy from January 1,2017 to December 31,2019 in the Zhaoqing First People’s Hospital.The clinical and imaging data of the Neurological deterioration group(END group) and the non-END group were analyzed.The independent related factors were screened and the nomogram model was constructed.Results　A total of 384 cases were enrolled,including 66 cases (17.19%) in the END group and 318 cases (82.81%) in the non-END group.Logistic regression analysis showed that diabetes mellitus,TOAST typing,albumin levels,and cerebral atherosclerosis score (CAS) were independent influencing factors (P<0.05).The nomogram model is constructed and the ROC curve is generated,and the area under the curve is 0.859［95%CI(0.758,0.864)］.Model consistency can be hinted at by the calibration curve and the Hoster-Lemeshow test.Finally,the clinical decision curve indicates that the model has clinical application value.Conclusion　This study explores the nomogram model for END in first-ever minor ischemic stroke without reperfusion therapy,which has some clinical application value,is composed of four major factors:diabetes mellitus,TOAST typing,albumin level and CAS.

Preliminary construction of the tissue-engineered oral and maxillofacial vessel / 中国组织工程研究

BACKGROUND:Insufficient blood supply after major bone defects leads to osteocyte necrosis;therefore, the tissue-engineered bone cannot meet the clinical requirements. OBJECTIVE:To construct an artificial vessel using in vitro cultured rabbit bone marrow stromal stem cel s and human umbilical vein endothelial cel s combined with the rabbit aortic decel ularized vascular matrix. METHODS:Rabbit bone marrow stromal stem cel s were cultured by adherent method, human umbilical vein endothelial cel s were cultured in vitro and isolated, and rabbit aortic decel ularized vascular stent was prepared. The stent-cel composite was constructed, and its biocompatibility was observed under scanning electron microscope. There were three groups:blank control, control (bone marrow stromal stem cel-stent) and experimental (stent-cel composites) groups (n=10 per group), fol owed by implantation around the smal vessels. Three months later, the vascular samples were col ected for gross observation and hematoxylin-eosin staining. RESULTS AND CONCLUSION:Fibroblast-like cel clones were formed by adherent method, and were positive for CD44+and STRO-1+after climbing;calcified nodule formed in the ossification. Flow cytometry showed CD34+accounting for 43.83%, and visible VIII factor in the endothelial cel s. In the experimental group, endothelial cel s formed a single cel layer onto the scaffold under scanning electron microscope;the artificial vessel grew wel and tubular structure presented and eight angiod structures were found. Thin film-like vessels formed in the blank control group and there were only endothelial-like tissues in the control group. These results suggest that angiod structures can form after the stent-cel composite implantation, causing no immune reaction, but the artificial vessel is visible in absence of muscular layer.

Association between hemoglobin level and health status in elderly people living in communities in Beijing / 中华老年医学杂志

Objective To investigate the correlation between hemoglobin level and health status of the elderly living in communities in Beijing.Methods A random cluster sampling method was used to select residents living in communities of Beijing city,and a cross-sectional study was carried out by questionnaires,scene testing and blood sample collection.WHO-formulated criteria were applied for diagnosing anemia.The health indicators in questionnaires included visual impairment,physical disability,decreased health,self-care,fatigue,anorexia,independent walking distance,exercise frequency,intelligence status and computing power.Results Complete information was obtained in a total of 1 948 elderly people,including 790 cases of male and 1 158 cases of female,with an average age of(73.9±6.1)years and a median age of 74 years(65-100).The mean level of hemoglobin in the 1 948 people was(135.65 ± 14.48) g/L,with (142.56 ± 15.56) g/L in male and (130.95 ± 11.53) g/L in female.Hemoglobin level was significantly lower in female than in men (t =54.739,P＜ 0.01).Hemoglobin level was decreased with aging,and negatively associated with appetite,physical strength,walk assistance,visual acuity and physical ability(r=-0.055,-0.067,-0.071,-0.114,-0.095;P =0.022,0.005,0.004,0.000,0.000),while positively associated with health status,activities in daily life,athletic ability,exercise frequency and intelligence (r =0.073,0.126,0.122,0.066,0.124;P =0.002,0.000,0.000,0.006,0.000).Conclusions The hemoglobin level of the elderly decreases with aging and is associated with health status and quality of life in the elderly,which should be taken care seriously.

Expression and significance of pepsin in lingual tonsil hypertrophy / 中华耳鼻咽喉头颈外科杂志

Objective@#To discuss the relationship between lingual tonsil hypertrophy and laryngopharyngeal reflux.@*Methods@#Ninety-two patients who received throat surgery in Nanfang Hospital between October 2015 and October 2016 were enrolled. Twenty-six healthy volunteers were recruited as normal controls. All participants were assessed with the reflux finding score(RFS) and the size of lingual tonsils were evaluated using a clinical grading system proposed by Friedman under electronic laryngoscope. The score of reflux symptom index(RSI), personal history and medical history were gathered. Biopsy specimens of lingual tonsils were taken from all participants for the immunohistochemical stain of pepsin.SPSS 19.0 software was used for statistical analysis.@*Results@#There were 46.2% (12/26) pepsin-positive and 53.8% (14/26) pepsin-negative volunteers in normal controls. There were 87.0% (80/92) pepsin-positive and 13.0% (12/92) pepsin-negative patients in study group. The severity of lingual tonsil hypertrophy and expression intensity of pepsin in patients were significantly higher in volunteers (Z=-3.636, Z=-5.273, P<0.01). The severity of lingual tonsil hypertrophy was positively associated with the pepsin level in patients (r=0.556, P<0.01). The patients with pepsin-positive expression showed significant correlation between lingual tonsil hypertrophy and the positive rate of RSI and RFS (r=0.258, r=0.225, P<0.05). Analysis of correlated factors indicated that lingual tonsil hypertrophy was associated with smoking (χ2=8.502, P<0.05).@*Conclusions@#The expression of pepsin can be detected in lingual tonsil tissues. The lingual tonsil hypertrophy is closely related to laryngopharyngeal reflux.

Tendinopathy and the extracellular matrix：to deeply study the key proteins and enzymes in the bone-tendon junction / 中国组织工程研究

BACKGROUND:In recent years, research on tendinopathy is becoming a hot topic in the sports medicine and rehabilitation, and the extracelular matrix plays a considerable role in the occurrence, development and healing of tendinopathy. OBJECTIVE: To explore the relationship between tendinopathy and the extracelular matrix. METHODS: CNKI, VIP, CBM, Wanfang, PubMed and Embase were retrieved for articles related to colagen, protein, glycoprotein and matrix remodeling published since 2000. RESULTS AND CONCLUSION:After tendinopathy, there are obvious changes in colagen, proteoglycans, glycoprotein and related enzymes; and these changes also affect the reconstruction and repair of tendinopathy. Currently, most of researches focus on the tendon rather than the bone-tendon junction. This means that there are no in-depth studies on the correlation between many important proteins and tendinopathy, and the effects of exercise intervention.

Clinical analysis of patients with pleural effusion of unknown causes examined by flexi-rigid thoracoscopy (25 cases) / 中国内镜杂志

Objective To investigate the value of flexi-rigid thoracoscopy in pleural effusion of unknown causes and the correlation with CEA, TK1 and ADA. Methods The clinical data and results of CEA, TK1 and ADA of 25 patients were retrospective analyzed in our department from 2015 January to November 2015. These patients accepted the examination of flexi-rigid thoracoscopy with pleural effusion of unknown causes. Results In the 25 patients with pleural effusion of unknown causes, definite diagnosis was made in 22 cases (88.00 %), of which 9 cases were malignant pleural effusion (36.00 %), 11 cases were tuberculous pleural effusion (44.00 %), 2 cases were inflammatory pleural effusion (8.00 %), 3 cases were undetermined (12.00 %). The positive rate of TK1 and CEA in malignant group was significantly higher than that in the tuberculosis group and inflammatory group, the positive rate of ADA in the tuberculosis group was significantly higher than that in the malignant group and inflammatory group. Conclusion Flexi-rigid medical thoracoscopy examination is an effective and safe method for diagnosis of unexplained pleural effusion with high exact diagnosis rate, less trauma and less complication. Combination with CEA, TK1 and ADA are helpful to improve diagnostic rate of pleural effusion of unknown causes.

The clinical efficacy of composite acoustic therapy in patients of sudden deafness with tinnitus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To determine whether the composite acoustic therapy is effective to treat tinnitus in patients with sudden deafness and to explore the mechanisms.@*METHOD@#Ninety-six cases (96 ears) were divided into experimental group and control group, and all the patients underwent drug treatment. The patients in experimental group were given personalized composite acoustic therapy in the first 30 days, music therapy in next 31-90 days, however, the patients in control group were not given sound therapy. Additionally, pure tone audiogram, tinnitus pitch and loudness as well as questionnaires (including THI, VAS, and SAS) were conducted for each patient before treatment, at day 30 and day 90 posttreatment.@*RESULT@#Eighty-nine patients (n = 47 for experimental group and n = 42 for control group) completed the trial. The results of day 30 posttreatment showed there were no significant differences in VAS and hearing recovery rate between these two groups, but THI and SAS showed significant differences. The results of day 90 posttreatment showed significant differences in VAS (P < 0.05), THI (P < 0.01) and SAS (P < 0.01), and no significant difference of hearing recovery rate was detected. The most significant changes of VAS appeared in the first 30 days of treatment. The hearing and tinnitus recovery in experimental group were better for the first 30 days of treatment than for the next 31-90 days, and similar results were obtaind in control group. (P < 0.01).@*CONCLUSION@#Composite acoustic treatment combined with drug therapy can improve the tinnitus and anxiety symptoms of patients with sudden deafness, and the effect on hearing recovery still need to be confirmed in further studies.

Clinical characteristics of tinnitus complaint: an analysis of 453 patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the clinical characteristics of tinnitus complaint.@*METHOD@#The information of 628 patients with subjective tinnitus was collected using questionnaires from October, 2013 to June, 2014. Among them, 453 cases were included in this study, whose quality of life and sleep were significantly affected. Then we elucidated the features of tinnitus, tinnitus incentives and systemic diseases and analyzed their relationship.@*RESULT@#The proportion of the patients complaint was highest in gruop ≤ 30 y. The patients with tinnitus complaint were more likely to have persistent tinnitus with higher loudness VAS scores than their counterparts. 65.4% of the total patients had at least one treatment (52.2% of patients can tolerate, and only 13. 2% can not tolerate). More patients had cranial Ming on the left than on the right ear. The proportion of patients with polyphony in bilateral tinnitus was higher than those with unilateral tinnitus (P < 0.05). Moreover, 59% patients had tinnitus inducing factors, and 44% patients had systemic comorbidities (The three most frequently involved systems were otolaryngologic, cardiovascular and digestive system). There was no significantly statistical difference of the tinnitus severity between patients with other systematic diseases and those without.@*CONCLUSION@#Patients with tinnitus complaint were younger in age (≤ 30 y) and more likely to have persistent tinnitus with higher loudness VAS scores Predisposing factors are closely associated with mental or physical trauma. The accompanied diseases can be classified by organ system.