Beneficial effect of integrated nutritional interventions in patients with hematological diseases undergoing hematopoietic stem cell transplant.

INTRODUCTION: The nutritional status of patients undergoing hematopoietic stem cell transplantation (HSCT) is critically important. This study was aimed to assess the impact of comprehensive nutritional interventions on the well-being of individuals with hematological diseases who underwent HSCT. METHODS: A total of 175 patients with hematological diseases who underwent HSCT were included, with 94 in the control group and 81 in the research group. Patients in the control group received standard nursing care, while those in the research group underwent integrated nutritional interventions. Nutritional status was evaluated using the mini nutritional assessment (MNA) and subjective global assessment (SGA), along with body measurements and serum levels of albumin, prealbumin, and hemoglobin. RESULTS: There were no significant differences in the proportion of malnourished patients evaluated by MNA or SGA between the control and research groups at admission. However, at discharge and 3 months post-discharge, fewer patients in the research group were malnourished compared to the control group, as assessed by both MNA and SGA. At admission, there were no significant differences in albumin, prealbumin, hemoglobin levels, weight, calf circumference (CC), triceps skinfold thickness (TSF), or subscapular skinfold thickness (SSF) between groups. However, at discharge and 3 months post-discharge, the levels of these indicators significantly decreased compared to those upon admission. Levels of albumin, prealbumin, and hemoglobin, as well as weight, CC, TSF, and SSF, were significantly higher in the research group than in the control group at both discharge and 3 months post-discharge. CONCLUSION: HSCT led to a decline in nutritional status among patients with hematological diseases, but integrated nutritional interventions effectively improved their nutritional status.

Evaluation of Clinical Graded Treatment of Acute Nonsuppurative Otitis Media in Children with Acute Upper Respiratory Tract Infection.

Objective: To treat children with acute nonsuppurative otitis media induced by acute upper respiratory tract infection of varying severity and evaluate its therapeutic effects. Materials and Methods: Patients from the emergency department with acute nonsuppurative otitis media were followed up between September 2015 and December 2018. A total of 420 patients were classified into grades I to III according to tympanic membrane intactness and systemic reactions and treated according to grading. Results: Grade I patients showed no significant difference in the recovery of acute symptoms whether antibiotics are used or not. Grade II patients, after 3 months of follow-up, showed no tympanic membrane perforation, and 9 cases of binaural B-type children did not improve but were cured by operation. In grade III patients, after treatment for 4 hours in the experimental group 3, the earache subsided, 1 case had tympanic membrane perforation, and the patients recovered after 2 weeks (64/92) and after 3 months (28/92) of drug treatment. After treatment for 4 h in the control group 3, the earache eased, and 3 patients developed tympanic membrane perforation and were treated for 3 months. 4 binaural B-type children did not improve but recovered after surgical treatment. Conclusion: Grade I patients could be closely followed up by clinical observation. For anti-inflammatory patients with grade II disease, treatment has therapeutic significance. For patients with grade III, some patients still have TMP, but the use of cephalosporin third-generation drugs plus an appropriate amount of hormone therapy is effective in reducing symptoms and tympanic local reactions.

The spatio-temporal expression analysis of parathyroid hormone like hormone gene provides a new insight for bone growth of the antler tip tissue in sika deer.

OBJECTIVE: Parathyroid hormone like hormone (PTHLH), as an essential factor for bone growth, is involved in a variety of physiological processes. The aim of this study was to explore the role of PTHLH gene in the growth of antlers. METHODS: The coding sequence (CDS) of PTHLH gene cDNA was obtained by cloning in sika deer (Cervus nippon), and the bioinformatics was analyzed. The quantitative real-time polymerase chain reaction (qRT-PCR) was used to analyze the differences expression of PTHLH mRNA in different tissues of the antler tip at different growth periods (early period, EP; middle period, MP; late period, LP). RESULTS: The CDS of PTHLH gene was 534 bp in length and encoded 177 amino acids. Predictive analysis results revealed that the PTHLH protein was a hydrophilic protein without transmembrane structure, with its secondary structure consisting mainly of random coil. The PTHLH protein of sika deer had the identity of 98.31%, 96.82%, 96.05%, and 94.92% with Cervus canadensis, Bos mutus, Oryx dammah and Budorcas taxicolor, which were highly conserved among the artiodactyls. The qRT-PCR results showed that PTHLH mRNA had a unique spatio-temporal expression pattern in antlers. In the dermis, precartilage, and cartilage tissues, the expression of PTHLH mRNA was extremely significantly higher in MP than in EP, LP (p<0.01). In the mesenchyme tissue, the expression of PTHLH mRNA in MP was significantly higher than that of EP (p<0.05), but extremely significantly lower than that of LP (p<0.01). The expression of PTHLH mRNA in antler tip tissues at all growth periods had approximately the same trend, that is, from distal to basal, it was first downregulated from the dermis to the mesenchyme and then continuously up-regulated to the cartilage tissue. CONCLUSION: PTHLH gene may promote the rapid growth of antler mainly through its extensive regulatory effect on the antler tip tissue.

Effect of infarct location and volume on cognitive dysfunction in elderly patients with acute insular cerebral infarction.

BACKGROUND: The aging of the population has become increasingly obvious in recent years, and the incidence of cerebral infarction has shown an increasing trend annually, with high death and disability rates. AIM: To analyze the effects of infarct location and volume on cognitive dysfunction in elderly patients with acute insular cerebral infarction. METHODS: Between January 2020 and December 2023, we treated 98 cases of elderly acute insula, patients with cerebral infarction in the cerebral infarction acute phase (3-4 weeks) and for the course of 6 months in Montreal Cognitive Assessment Scale (MoCA) for screening of cognition. Notably, 58 and 40 patients were placed in the cognitive impairment group and without-cognitive impairment group, respectively. In patients with cerebral infarction, magnetic resonance imaging was used to screen and clearly analyze the MoCA scores of two groups of patients with different infarctions, the relationship between the parts of the infarction volume, and analysis of acute insula cognitive disorder in elderly patients with cerebral infarction and the relationship between the two. RESULTS: The number of patients with cognitive impairment in the basal ganglia and thalamus was significantly higher than that without cognitive impairment (P < 0.05). The total infarct volume in the cognitive impairment group was higher than that in the non-cognitive impairment group, and the difference was statistically significant (P < 0.05). The infarct volumes at different sites in the cognitive impairment group was higher than in the non-cognitive impairment group (P < 0.05). In the cognitive impairment group, the infarct volumes in the basal ganglia, thalamus, and mixed lesions were negatively correlated with the total MoCA score, with correlation coefficients of -0.67, -0.73, and -0.77, respectively. CONCLUSION: In elderly patients with acute insular infarction, infarction in the basal ganglia, thalamus, and mixed lesions were more likely to lead to cognitive dysfunction than in other areas, and patients with large infarct volumes were more likely to develop cognitive dysfunction. The infarct volume in the basal ganglia, thalamus, and mixed lesions was significantly negatively correlated with the MoCA score.

PEGylated-liposomal astaxanthin ameliorates Aß neurotoxicity and Alzheimer-related phenotypes by scavenging formaldehyde.

Alzheimer's disease (AD), which is a prevailing type of dementia, presents a significant global health concern. The current therapies do not meet clinical expectations. Amyloid-beta (Aß) has been found to induce endogenous formaldehyde (FA) accumulation by inactivating FA dehydrogenase (FDH); in turn, excessive FA triggers Aß aggregation that eventually leads to AD onset. Hence, scavenging FA by astaxanthin (ATX, a strong exogenous antioxidant) may be pursued as a promising disease-modifying approach. Here, we report that liposomal nanoparticles coupled with PEG (PEG-ATX@NPs) could enhance water-solubility of ATX and alleviate cognitive impairments by scavenging FA and reducing Aß deposition. To enable drug delivery to the brain, liposomes were used to encapsulate ATX and then coupled with PEG, which produced liposomal nanoparticles (PEGATX@NPs) with a diameter of <100 nm. The PEG-ATX@NPs reduced Aß neurotoxicity by both degrading FA and reducing FA-induced Aß assembly in vitro. Intraperitoneal administration of PEG-ATX@NPs in APPswe/PS1dE9 mice (APP/PS1, a familial model of AD), not only decreased the levels of brain FA and malondialdehyde (MDA, a typical product of oxidative stress), but also attenuated both intracellular Aß oligomerization and extracellular Aß-related senile plaque (SP) formation. These pathological changes were accompanied by rescued ability of spatial learning and memory. Collectively, PEG-ATX@NPs improved the water-solubility, bioavailability, and effectiveness of ATX. Thus, it has the potential to be developed as a safe and effective strategy for treating AD.

Clinical Application of Stromal Vascular Fraction Gel in Unilateral Vocal Fold Paralysis.

PURPOSE: To investigate the therapeutic effect of the stromal vascular fraction gel (SVF gel) in unilateral vocal fold paralysis. METHODS: A retrospective study was performed on 22 patients who underwent SVF gel autotransplantation for unilateral vocal fold paralysis between June 2017 and December 2018. Fat was removed from the medial thigh under anesthesia and the SVF gel was prepared using standard techniques and injected using a suspension microlaryngoscopy. The SVF gel was transplanted into the vocal fold muscle and the paraglottic space, and subjective and perceptual assessments, aerodynamic and acoustic assessments, and a videostroboscopic assessment were evaluated pre- and postoperatively at 1day, 12 months and 18 months. RESULTS: The GRBAS evaluation results showed that the voice quality of the patients at 12 and 18 months after the operation was significantly improved, and voice analysis showed that in males maximum speech time (MPT) increased and the normalized noise energy decreased 1 day after surgery. The voice quality parameters at 12 months and 18 months after surgery improved significantly compared to preoperatively (P < 0.05), except for the fundamental frequency (F0), at 12 months, which was similar to the values before surgery. In females, the MPT and amplitude (shimmer) at 1 day after the surgery were significantly different from before the surgery, and the MPT, fundamental frequency (jitter), shimmer, and normalized noise energy at 12 months and 18 months after the surgery were significantly improved compared to before the surgery while the F0 was not significant. CONCLUSION: SVF gel autotransplantation can effectively improve the voice quality in unilateral vocal fold paralysis, and the long-term effect is stable.

Potential application value of pigment epithelium-derived factor in sensorineural hearing loss.

The inner ear is a complex and precise auditory perception system responsible for receiving and converting sound signals into neural signals, enabling us to perceive and understand sound. However, the occurrence and development of inner ear diseases and auditory disorders, such as sensorineural hearing loss, remain a global problem. In recent years, there has been increasing research on the treatment of inner ear diseases and auditory regeneration. Among these treatments, pigment epithelium-derived factor (PEDF), as a multifunctional secretory protein, exhibits diverse biological activities and functions through various mechanisms, and has shown potential applications in the inner ear. This minireview comprehensively evaluates the performance of PEDF in sensorineural hearing loss in inner ear and its potential targets and therapeutic prospects.

[Humidified high flow nasal cannula and visual laryngoscope].

Objective:To study the application value of humidified high flow nasal cannula （HHFNC） combined with visual laryngoscopy in the arytenoid cartilage dislocation. Methods:Twenty-nine patients with arytenoid cartilage dislocation were randomly double-blind into HHFNC group and general nasal catheter oxygen suction group, and the intraoperative and postoperative evaluation indicators, anesthesia-related indicators and postoperative vocal cord were compared. Results:There were statistically significant differences in intraoperative blood oxygen saturation, microstream end-tidal carbon dioxide partial pressure EtCO2, respiratory rate and respiratory intervention times between the two groups （P<0.05）, and statistically significant differences in postoperative heart rate, oxygen saturation and respiratory rate （P<0.05）. After reduction, the voice disturbance index, the degree of voice abnormality, rough voice, breath sound, powerless pronunciation and catatonic pronunciation changed significantly after operation. Conclusion:HHFNC combined with visual laryngoscopy in the arytenoid cartilage dislocation has high anesthetic safety, good cooperation of patients, and good surgical effect.

Pitavastatin protects against neomycin-induced ototoxicity through inhibition of endoplasmic reticulum stress.

Irreversible injury to inner ear hair cells induced by aminoglycoside antibiotics contributes to the formation of sensorineural hearing loss. Pitavastatin (PTV), a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, has been reported to exert neuroprotective effects. However, its role in aminoglycoside-induced hearing loss remains unknown. The objectives of this study were to investigate the beneficial effects, as well as the mechanism of action of PTV against neomycin-induced ototoxicity. We found that PTV remarkably reduced hair cell loss in mouse cochlear explants and promoted auditory HEI-OC1 cells survival after neomycin stimulation. We also observed that the auditory brainstem response threshold that was increased by neomycin was significantly reduced by pretreatment with PTV in mice. Furthermore, neomycin-induced endoplasmic reticulum stress in hair cells was attenuated by PTV treatment through inhibition of PERK/eIF2α/ATF4 signaling. Additionally, we found that PTV suppressed the RhoA/ROCK/JNK signal pathway, which was activated by neomycin stimulation in HEI-OC1 cells. Collectively, our results showed that PTV might serve as a promising therapeutic agent against aminoglycoside-induced ototoxicity.

[Autologous fat granule filling combined with microsuture technique for sulcus vocalis].

Objective:To explore and observe voice effect of the resection of the vocal fold sulcus, suture of the vocal fold mucosa, and fat granule packing under the support laryngoscope. Methods:A total of 25 patients with vocal fold sulcus underwent vocal fold sulcus resection under a support laryngoscope. After the vocal fold sulcus was removed, the mucosa on both sides of the vocal fold sulcus was sutured into a pouch. Next the fat granules removed from the abdomen were stuffed into the pouch until the vocal folds were full, and the mucosa was repaired, and then the pouched mucosa was sutured. After the operation, the patients were silent for 2 weeks and followed up at 3, 6, and 12 months postoperatively to observe the state of the vocal fold mucosa and the voice effect of the vocal fold under the stroboscopic laryngoscopy. The main outcome measures were the mucosal movement, fundamental frequency （F0）, fundamental frequency perturbation （Jitter）, amplitude perturbation （Shimmer）, normalized noise energy （NNE）, harmony/noise （H/N） and maximum phonation time （MPT）. Results: Among the 25 patients, 23 patients had good vocal fold closure and smooth mucosa. Under the stroboscopic laryngoscope, the mucosal movement was good and smooth, and the F0, Jitter, Shimmer, NNE, H/N, MPT were significantly improved, and the voice quality was significantly improved. The other 2 patients had fat particles spillover in the vocal fold. The voice function recovered well after the second treatment. Conclusion:Resection of vocal fold sulcus, suture of vocal fold mucosa, and fat granule packing under support laryngoscope are very effective for the treatment of vocal fold sulcus. Indispensably, the operation is done properly, and the patient silence the voice according to the doctor's advice, thus the voice quality will be satisfactory after the operation. .