Push-Through Myringoplasty Versus External Auditory Canal Flap Tympanoplasty for Chronic Marginal Perforations.

OBJECTIVE: We compared the operation times, graft success rates, and hearing gains between push-through (PT) myringoplasty and external auditory canal (EAC) flap tympanoplasty in patients with chronic marginal perforations. MATERIALS AND METHODS: A total of 77 patients with chronic marginal perforations were randomly allocated to endoscopic perichondrium-cartilage myringoplasty with raising of the EAC flaps (n = 39) and PT technique (n = 38) groups. The graft outcomes, mean operation times, and postoperative complications were compared 6 months after operation. RESULTS: The graft success rate was 97.4% (38/39) in the EAC group and 81.6% (31/38) in the PT group; the difference was significant (P = .056). The mean operation time was 40.7 ± 10.4 min in the EAC group and 42.4 ± 8.3 min in the PT group (P = .741). In the EAC group, the mean pre- and postoperative air-bone gap (ABG)s were 29.3 (range: 28.4 ± 8.6) and 12.1 (range: 11.8 ± 2.4) dB (P < .01), respectively; the respective values were 29.5 (range: 29.1 ± 5.4) and 12.6 (range: 12.0 ± 1.3) dB (P < .01) in the PT group. No significant group difference was observed in the pre- (P = .794) or postoperative (P = .689) ABG values or mean ABG gain (16.7 ± 5.3 vs 17.1 ± 7.7 dB; P = .526). In addition, graft medialization occurred in 7.9% patients in the PT group. However, graft lateralization, significant blunting, deteriorative sensorineural hearing loss, vertigo, or tinnitus were not encountered in either group. No taste change was reported and no inclusion cholesteatoma was seen in the EAC group. CONCLUSION: Endoscopic perichondrium-cartilage myringoplasty with raising of an EAC flap is useful and minimally invasive to repair chronic marginal perforations; the technique is simple, has a high graft success rate in comparison to the PT technique.

Can XunTian Tai Chi intervention improve the level of emotional regulation of crew members in the Controlled Ecological Life Support System?

To explore the appropriate exercise methods and means for astronauts in confined and small isolation conditions, a set of XunTian Tai Chi suitable for the spaceflight workforce was created, with the aim of discovering the practical effects of XunTian Tai Chi and providing a scientific basis for the subsequent development of new astronaut health maintenance techniques with Chinese characteristics. Using the Controlled Ecological Life Support System (CELSS) as a research platform, we observed the changes in a crew member's emotion regulation-related indexes during 180 days of working and living in a confined isolation chamber through periodic interventions of the XunTian Tai Chi and conducted statistical analyses. During the 180-day cabin mission, expression suppression, cognitive reappraisal, attention index, and relaxation index were all lower than those before entering the cabin, suggesting that the crew member's emotion regulation ability decreased during the in-cabin mission. A single Tai Chi exercise could cause favorable changes in the indicators, positively affecting the crew member's emotional regulation. The attention and relaxation indices of the occupants were improved significantly by both single and periodic Tai Chi exercises. After the Tai Chi exercise cycle, the results of each index showed a certain degree of effect. The 180-day ground-based simulation of Tai Chi in the confinement of a space capsule positively affects the occupant's emotional regulation.

Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis.

Objective: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. Methods: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. Results: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.91)] and diastolic blood pressure (DBP) [MD = -4.68, 95% CI (-7.23, -2.12)], as well as increasing the content of nitric oxide (NO) [MD = 0.99, 95% CI (0.69, 1.28)]. The blood lipid metabolism ability may also be improved after more than 12 weeks of Tai Chi exercise, total cholesterol (TC) [SMD = -0.68, 95% CI (-0.89, -0.46), triglyceride (TG) [SMD = -0.84, 95% CI (-1.25, -0.43)], low-density lipoprotein cholesterol (LDL-C) [SMD = -1.58, 95% CI (-2.29, -0.86)]. However, the improvement of high-density lipoprotein cholesterol (HDL-C) [SMD = 0.54, 95% CI (0.28, 0.79)] was better with a less than 12 weeks exercise cycle. A subgroup analysis for exercise frequency and time showed that the exercise frequency should preferably be more than or equal to 5 times per week for patients with hypertension, and for patients with hypertension plus hyperlipidemia, the exercise frequency less than 5 times per week with exercise time less than 60 min each day may be more beneficial. Conclusion: The meta-analysis indicated that a more than 12 weeks Tai Chi exercise cycle with less than 60 min each time and more than 5 times per week may be more beneficial in blood pressure reduction, NO level increasing and blood lipid metabolism improving in the comparison with the other exercise cycles. For patients with hypertension plus hyperlipidemia, exercise frequency of less than 5 times per week may be better. Systematic Review Registration: [http://www.crd.york.ac.uk/prospero], identifier [CRD42022352035].

Enhanced activity of ZnS (111) by N/Cu co-doping: Accelerated degradation of organic pollutants under visible light.

High-efficiency photocatalysts are of great significance for the application of photocatalytic technology in water treatment. In this study, N/Cu co-doped ZnS nanosphere photocatalyst (N/Cu-ZnS) is synthesized by a hydrothermal method for the first time. After doping, the texture of nanosphere becomes loose, the nanometer diameter is reduced, making the specific surface area of catalyst increased from 34.73 to 101.59 m2/g. The characterization results show that more ZnS (111) crystal planes are exposed by N/Cu co-doping; the calculations of density functional theory show that N/Cu co-doping can increase the catalytic activity of the ZnS (111) crystal plane, enhance the adsorption capacity of (111) crystal plane to O2, and promote the generation of •O2-. The energy levels of the introduced impurities can be hybridized with the energy levels of S and Zn at the top of valence band and the bottom of conduction band, which makes the band gap narrower, thus enhancing the absorption of visible light. Compared with pure ZnS, the degradation rates of 2,4-dichlorophenol (2,4-DCP) and tetracycline (TC) by N/Cu-ZnS under visible light (>420 nm) are increased by 83.7 and 51 times, respectively. In this research, a promising photocatalyst for photocatalytic degradation of organic pollutants in wastewater is provided.

[Effects of different types of exercise on contractile properties and expressions of MuRF1, PGC-1α /FNDC5 in soleus muscle of unloaded rats].

Objective: To investigate the effects of aerobic versus resistance exercise on soleus muscle contractile properties and the expressions of MuRF1, PGC-1α and FNDC5 in amyotrophic rats after unloading, and the possible molecular biological mechanisms. Methods: Male Wistar rats were randomly divided into recovery group (CT), aerobic exercise group (A), resistance exercise group (R) and control group (C), with 6 rats in each group. The control group did not receive any treatment. The other three groups underwent tail suspension for 2 weeks, and then the recovery group recovered quietly. The aerobic group and the resistance group underwent a 2-week exercise intervention. Exercise plan: the aerobic group rats were treated with treadmill speed corresponding to 65% maximum oxygen uptake (VO2max), 60 min/d, 5 d/w; the rats in the resistance group were allowed to climb the ladder with 65% of the maximum voluntary weight-bearing (MVCC) for 3 times, with a total of 5 sets. Each time had a rest of 1 min, with an interval of 2 min among sets, and 5 d/w. Fasting for 24 hours after the last exercise, the soleus muscle samples were collected to observe the histological changes, test the contractility, and detect MuRF1 and PGC-1α and FNDC5 expressions. Results: compared with the control group, the body weight, soleus muscle wet weight, average cross-sectional area of muscle fibers and muscle contractility of the recovery group were decreased significantly(P<0.01), and the expression of MuRF1 was increased significantly(P<0.01). Compared with the recovery group, the body weight, wet weight of soleus muscle, the average cross-sectional area of muscle fiber and muscle contractility of rats in aerobic group and resistance group were increased (P<0.01), the expression of PGC-1α/FNDC5 was increased (P<0.01) and the expression of MuRF1 was decreased significantly (P<0.01). Compared with the aerobic group, the expression of PGC-1α in soleus muscle of rats in the resistance group was increased (P<0.05), while the expression of MuRF1 was decreased (P<0.05). Conclusion: Aerobic and resistance exercise can significantly improve muscle contractility, upregulate the expression of PGC-1α/FNDC5, and inhibit the expression of MuRF1, indicating that the molecular mechanisms of aerobic and resistance exercise to improve unloaded muscular atrophy may be related to PGC-1α and MuRF1.

Effectiveness of the Rehabilitation Training Combined with Maitland Mobilization for the Treatment of Chronic Ankle Instability: A Randomized Controlled Trial.

The study aims to determine whether routine rehabilitation training combined with the Maitland mobilization is more effective than routine rehabilitation training alone in patients with chronic ankle instability, intending to provide a novel rehabilitation strategy for chronic ankle instability. A total of 48 subjects were divided into three groups: EG (Maitland mobilization and routine rehabilitation), CG (routine rehabilitation), and SG (sham mobilization and routine rehabilitation). The intervention was performed three times each week for 4 weeks, for a total of 12 sessions. Before and after the intervention, the muscle strength, star excursion balance test (SEBT), weight-bearing dorsiflexion range of motion (WB-DFROM), ankle range of movement, Cumberland ankle instability tool (CAIT), self-comfort visual analog scale (SCS-VAS), and self-induced stability scale (SISS-VAS) were assessed. The results showed that the improvement of SEBT, WB-DFROM, and active ankle range of movement without the pain in EG was more obvious than CG and SG, but the improvement of the self-report of ankle severity and muscle strength was not. Compared with routine rehabilitation training alone, routine rehabilitation training combined with Maitland mobilization for patients with chronic ankle instability may provide more benefit in terms of balance and ankle range of movement than routine rehabilitation alone, but the improvement in muscle strength was not evident enough.

The effect of vibration training on delayed muscle soreness: A meta-analysis.

BACKGROUND: Delayed onset muscle soreness (DOMS) is caused by unaccustomed exercise, especially eccentric exercise, and is highly likely to cause skeletal muscle injury. It mainly manifests as ultrastructural changes in skeletal muscle, as well as decreased muscle strength, muscle soreness, swelling, and elevated levels of creatine kinase (CK). Vibration training (VT) has been attracting increasing attention as a new type of rehabilitation therapy. It can effectively minimize the occurrence and relieve the symptoms of DOMS, reduce muscle stiffness and soreness, and reduce serum concentrations of CK and lactate dehydrogenase (LDH). This article systematically assessed the impact of VT on the mitigation of DOMS through a meta-analysis to provide updated evidence-based information. METHODS: Electronic databases such as China Knowledge Network, VIP Electronics, PubMed, EBSCO, and Web of Science were searched to identify randomized controlled trials of VT on DOMS. Searches were performed from database creation to November 2021. The quality of the literature was assessed using the Cochrane Manual for the Systematic Review of Interventions, and meta-analyses were performed using RevMan 5.4 software. RESULTS: VT intervention in DOMS was shown to effectively reduce subjective pain, improve pain tolerance, and accelerate the reduction of serum CK and LDH concentrations. Subgroup analysis of different test time periods showed that subjective pain decreased more significantly after 48 hours than after the other 2 time periods, and pain tolerance increased more significantly after 72 hours than the other 2 time periods; serum CK was significantly increased after 24 and 48 hours of intervention, but showed no significant change compared with the control group after 72 hours. Serum LDH decreased significantly after 24 hours of intervention, but there was no significant difference compared with the control group after 48 hours or 72 hours. CONCLUSION: VT effectively reduced the subjective pain sensation after DOMS, increased the pain threshold, reduced serum LDH and CK concentrations, and accelerated muscle damage repair compared with control interventions. However, the effect of improving the range of motion of the joints is not clear and should be studied further. REGISTRATION: number: INPLASY2021120115.

Predicting individual muscle fatigue tolerance by resting-state EEG brain network.

Objective.Exercise-induced muscle fatigue is a complex physiological phenomenon involving the central and peripheral nervous systems, and fatigue tolerance varies across individuals. Various studies have emphasized the close relationships between muscle fatigue and the brain. However, the relationships between the resting-state electroencephalogram (rsEEG) brain network and individual muscle fatigue tolerance remain unexplored.Approach.Eighteen elite water polo athletes took part in our experiment. Five-minute before- and after-fatigue-exercise rsEEG and fatiguing task (i.e. elbow flexion and extension) electromyography (EMG) data were recorded. Based on the graph theory, we constructed the before- and after-task rsEEG coherence network and compared the network differences between them. Then, the correlation between the before-fatigue rsEEG network properties and the EMG fatigue indexes when a subject cannot keep on exercising anymore was profiled. Finally, a prediction model based on the before-fatigue rsEEG network properties was established to predict fatigue tolerance.Main results. Results of this study revealed the significant differences between the before- and after-exercise rsEEG brain network and found significant high correlations between before-exercise rsEEG network properties in the beta band and individual muscle fatigue tolerance. Finally, an efficient support vector regression (SVR) model based on the before-exercise rsEEG network properties in the beta band was constructed and achieved the accurate prediction of individual fatigue tolerance. Similar results were also revealed on another 30 subject swimmer data set further demonstrating the reliability of predicting fatigue tolerance based on the rsEEG network.Significance.Our study investigates the relationship between the rsEEG brain network and individual muscle fatigue tolerance and provides a potential objective physiological biomarker for tolerance prediction and the regulation of muscle fatigue.

Hemodynamics in Patients With Pheochromocytoma or Paraganglioma Undergoing Non-neuroendocrine Operations.

INTRODUCTION: Surgical resection of pheochromocytoma and paraganglioma (PPGL) may be associated with excessive hemodynamic variability. Whether hemodynamic variability occurs in patients with undiagnosed PPGL undergoing unrelated, non-neuroendocrine, operations is unknown. METHODS: We identified patients who underwent non-neuroendocrine surgical procedures up to 5 y before pathologic diagnosis of PPGL. For each PPGL, two non-PPGL patients were matched based on sex, age, type, and year of operation. Electronic medical records were reviewed for intraoperative blood pressures, heart rates, and hemodynamic variability was assessed with range (maximum-minimum), standard deviation, coefficient of variation, and average real variability. RESULTS: Thirty-seven PPGL patients underwent operations preceding the diagnosis of PPGL: 25 pheochromocytomas, 11 paragangliomas, and one metastatic pheochromocytoma. Median interquartile range tumor size at diagnosis was 35 mm (23 to 60). The time from index operation to PPGL diagnosis was ≤12 mo in 21 (56.8%) patients. In 23 (62.2%) patients, the subsequently diagnosed PPGL was functional. Fifteen (40.5%) PPGL and 20 (27.0%) control patients were preoperatively treated for hypertension (P = 0.149). Maximum intraoperative systolic BP was >180 mmHg for 4 (10.8%) PPGL patients and 3 (4.1%) controls (P = 0.219). Two PPGL patients had intraoperative systolic BP >230 mmHg. No significant differences were found with all other measures of intraoperative hemodynamic variability. Similarly, in secondary analysis there was no significant difference in intraoperative hemodynamic variability between biochemically active PPGL and their respective controls. CONCLUSIONS: Patients with undiagnosed PPGL undergoing a wide variety of non-neuroendocrine operations had intraoperative hemodynamic variability comparable to non-PPGL patients undergoing the same type of procedures.

Photocatalytic degradation of organic pollutants in water by N-doping ZnS with Zn vacancy: enhancement mechanism of visible light response and electron flow promotion.

In order to improve the visible light response, N-doping ZnS (N-ZnS) nanospheres with Zn vacancy and porous surface were prepared by a simple one-pot hydrothermal method. Characterizations and density functional theory simulations showed excellent visible light response of N-ZnS. N-doping introduced impurity energy levels, which led to orbital hybridization and changed the original dipole moment. The presence of ortho Zn vacancy (O-Znv) can effectively reduce e--h+ recombination and photocorrosion. Furthermore, O-Znv caused lattice distortion (twisted the -S-Zn-N-(O-Znv)-S-Zn-S- chemical bond chain), resulting in "vacancy effect" to accelerate e- flow. Under visible light, the photocatalytic degradation efficiency of tetracycline (TC) and 2,4-dichlorophenol (2,4-DCP) was 90.31% and 60.84%, respectively. TOC degradation efficiency was 31.4% and 25.6%, respectively. Combined with Fukui index and LC-MS methods, it was found that TC and 2,4-DCP were degraded under the constant attack of active substances such as ·OH. This work can provide a reference for the application of catalytic materials in the field of visible light photocatalysis.

Effect of Kinesio taping on Pregnancy-related low back pain: A protocol for systematic review and meta-analysis.

BACKGROUND: Pregnancy-related low back pain (PLBP) affects the daily living activities of pregnant women, even leading to fetal agitation and threatened abortion. Kinesio taping (KT) can improve the circulation of blood and provide elastic supports, which is a reliable method to treat low back pain. At present, although many studies have been published on the effects of KT on PLBP, the results are inconsistent, and some studies even report that KT does not affect PLBP. there is still a lack of high-level clinical evidence for the treatment of PLBP with KT. Therefore, this study proposes a protocol for a systematic review and meta-analysis of published Randomized Controlled Trials (RCTs) to evaluate the efficacy and safety of KT for PLBP. METHODS: This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. We will search the following database sources of the RCTs: PubMed, the Cochrane Library, EMBASE, Web of Science, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science, and the Wanfang Database. From the establishment of the database to April 2021. The retrieval word adopts the combination of theme words and free words. Take "Kinesiotape, Tape Athletic, Orthotic Tape, Athletic Tape, Pregnancy, Pregnancies, Gestation, low back pain" as a term for retrieval. Two independent investigators will conduct an electronic literature search, study selection, data extraction, and quality assessment to summarize and evaluate the efficacy of KT in the treatment of PLBP. Retrospective trials are not included, and the risk of bias will be assessed using the Cochrane bias risk tool. All data analysis will be conducted using Revman5.3 software. RESULTS: Quality outcomes in systematic review studies depend on inclusion and search criteria to obtain high-quality data, as well as how the data are processed and interpreted. Among the results, this study will objectively and comprehensively evaluate the efficacy and safety of the randomized controlled trial of KT in the treatment of PLBP, and make a detailed analysis of the effect of KT in the treatment of PLBP. The results will be analyzed by the Visual Analogue Scale of Pain and the Roland Morris Dysfunction Questionnaire. If applicable, a subgroup analysis will also be performed, which will be grouped according to the duration of pregnancy, grade of pain, etc. Finally, the results are submitted to a peer-reviewed journal for publication. CONCLUSION: Based on the results, this study will analyze and summarize the effect of KT on improving PLBP. It includes whether KT can improve the pain and lumbar function of PLBP, or it has adverse effects and reactions on pregnant women, then analysis and interpretation of other related issues. It is expected that the results of this study will provide a reference to the method and time of taping for clinical staff, as well as high-quality evidence to resolve the effect of KT on low back pain and provide corresponding guidance for pregnant women with low back pain. It aims to improve the status of low back pain in pregnant women and improve their physical health. PROTOCOL REGISTRATION NUMBER: PROSPERO CRD42021250373; https://clinicaltrials.gov/.

[Effects of heavy-load exercise on skeletal muscle cells apoptosis and mechanisms of mitochondrial apoptosis in rats].

OBJECTIVE: To analyze the molecular mechanisms of skeletal muscle cells apoptosis induced by heavy-load exercise with Omi as the entry point. METHODS: One hundred and twenty-six adult SD rats were randomly divided into five groups: control group(C), eccentric exercise group (E), simple blocking group (U), DMSO group (D) and exercise block group (EU). In addition to the C group, the other four groups were randomly divided into 0 h after experiment, 12 h after experiment, 24 h after experiment, 48 h after experiment and 72 h after experiment with 6 rats in each group. E and EU group were submitted to a heavy-load exercise on a treadmill down a 16° decline, 16 m/min for 90 minutes. U, D and EU group were one-time intervened with drugs. U and EU groups were intraperitoneally injected with 1.5 µmol/kg ucf-101, D group were intraperitoneally injected with 1.5 µmoL/kg 0.5% DMSO. The rats were sacrificed in batches at different time points after experiment, then the soleus were saved to detect the Caspase-3,-8,-9,-12 activities and protein expressions of Omi and XIAP. RESULTS: Compared with group C, the mitochondrial distribution and morphology appeared the typical ultrastructure pathological changes, the opening degree of MPTP was increased significantly (P＜0.01) or (P＜0.05), protein expressions of Omi and XIAP were increased significantly (P＜0.01 or P＜0.05), the activities of Caspase-9 and Caspase-3 were increased significantly (P＜0.01 or P＜0.05) in group E. Compared with group C, there was no significant difference in XIAP protein and caspase-9, - 3 activities in group U and Group D. The change trend of XIAP protein and Caspase-9, - 3 activities was the same as those between EU group and E group, but the change range of XIAP protein in EU group was significantly higher than that in E group (P＜0.01), and the change ranges of caspase-9, - 3 activities in EU group were significantly lower than those in E group (P＜0.01). CONCLUSION: A single heavy-load exercise can induce changes in the mitochondria morphology and structure in rats, open the high permeability of MPTP, and improve the expression of Omi protein, then through its downstream XIAP-Caspase pathway, start the mitochondrial apoptosis pathway mediated by caspase-9, and finally lead to myocyte apoptosis. The inhibition of Omi can reduce the cell apoptosis level of motor induced skeletal muscle cells.

Excising or preserving perforation margins in endoscopic transtympanic cartilage myringoplasty does not affect surgical success.

OBJECTIVE: To compare the outcome of endoscopic transtympanic cartilage myringoplasty with and without removal of perforation edges for repairing chronic perforations with mucosal chronic otitis media (COM). STUDY DESIGN: Quasi-randomised clinical trial. SETTING: Tertiary referral centre. MATERIALS AND METHODS: Patients with chronic perforations and mucosal COM undergoing endoscopic transtympanic cartilage myringoplasty were allocated to a control group for whom the perforation edges were preserved (n = 40) and an intervention group for whom the edges were removed (n = 39). Mean operation time, graft success rate, mean scores of graft neovascularisation and epithelialisation, and hearing were compared between the groups at 4 weeks and/or 6 months postoperatively. RESULTS: Graft success rate was 95% (38/40) in the control group and 97% (38/39) in the intervention group at 6 months postoperatively; the difference was not significant. Mean graft neovascularisation scores 4 weeks postoperatively were 2.52 ± 0.59 in the control group and 2.58 ± 0.55 in the intervention group; the difference was not significant. Mean graft epithelisation scores 4 weeks postoperatively were 1.48 ± 0.57 in the control group and 1.68 ± 0.51 in the intervention group; the difference was not significant and remained nonsignificant 6 months postoperatively (2.5 ± 0.55 vs. 2.76 ± 0.36). Audiological outcomes at 6 months did not differ between the groups. CONCLUSION: Endoscopic, transtympanic cartilage underlay myringoplasty with preservation of the perforation margins did not affect graft neovascularisation, epithelialisation or success. Longer-term outcomes and risk of cholesteatoma require further study.

Comparison of long-term outcome of two endoscopic transtympanic myringoplasty without tympanomeatal flap elevating for repairing large chronic perforations.

OBJECTIVE: We compare the long-term efficacy of the cartilage-perichondrium modified over-underlay technique and transtympanic underlay alone technique using endoscopic myringoplasty without tympanomeatal flap elevating for repairing large chronic perforations. MATERIAL AND METHODS: Nine chronic large perforations with mucosal chronic otitis media were recruited and randomly allocated to endoscopic cartilage-perichondrium modified over-underlay myringoplasty (MOUM, n = 55) and endoscopic cartilage-perichondrium transtympanic underlay alone myringoplasty (TUAM, n = 54). The graft success rate, hearing gain, mean operation time and postoperative complications were compared between the groups at 6 and 24 months. RESULTS: In total, 99 patients were finally analysed. The graft success rates 6 months after surgery between MOUM and TUAM groups were not significantly different (100.0% vs 96.0%, p = 0.484). However, the MOUM group had a significantly higher success rate 24 months after surgery than the TUAM group (93.9% vs 76.0%, p = 0.028). In addition, postoperative ABG < 10 dB was 73.5% patients in the MOUM group and 76.0% in the TUAM group, the difference wasn't significant (p = 0.953). CT examination revealed well-pneumatised middle ears 24 months after surgery in both groups, and no middle ear cholesteatoma was observed. CONCLUSION: Endoscopic modified cartilage-perichondrium over-underlay myringoplasty without tympanomeatal flap elevating is reliable and effective for repairing large perforations. It improves the long-term graft success rate compared to the endoscopic cartilage-perichondrium transtympanic underlay alone technique. The risk for iatrogenic cholesteatoma is minimal.

Comparison of Electrocoagulation Tuboplasty and Continued Medical Therapy for Treating Persistent Eustachian Tube Dysfunction With Hypertrophic Mucosa Disease.

OBJECTIVES: The objective of this trial was to compare outcomes of electrocoagulation tuboplasty and continued medical therapy for treating persistent Eustachian tube dysfunction (ETD) with hypertrophic mucosa disease in the Eustachian tube (ET) orifice. STUDY DESIGN: Prospective, case-control trial. MATERIAL AND METHODS: Patients with persistent ETD were recruited and allocated to electrocoagulation tuboplasty and continued medical therapy groups. The ETD questionnaire-7 (ETDQ-7) score and objective parameters were compared between the groups at 6 and 12 months. RESULTS: The proportion of patients with a decrease in ETDQ-7 scores was greater in the electrocoagulation group than in the medical therapy group at the 6-month follow-up (53.49% and 34.38%, respectively; p = .158), but the difference was not statistically significant. However, at the 12-month follow-up, there was a significantly higher proportion of patients with a decrease in ETDQ-7 scores in the electrocoagulation group (88.37% and 40.63%, respectively; p = .001). Additionally, a significant difference was observed between the groups in terms of the proportion of patients who improved 12 months after the treatment (tympanometry: 72.09% and 9.38%, respectively; p = .001; air-bone gap: 79.07% and 25.00%, respectively; p = .001; tympanic membrane status: 62.79% and 0.00%, respectively). In addition, the proportion of patients with improvements in the ET inflammation score was significantly different between the groups at 6-month (67.44% and 34.38%, respectively; p = .009) and 12-month (93.02% and 34.38%; p = .001) follow-ups. No device- or procedure-related serious adverse events were reported in any patients. CONCLUSIONS: Electrocoagulation Eustachian tuboplasty appears to be a safe and feasible procedure for adult persistent ETD with hypertrophic mucosa disease in the ET orifice, and is superior to continued medical management alone. The improvements in ETDQ-7 and objective parameters persisted for 12 months.

Does whole-body vibration training have a positive effect on balance and walking function in patients with stroke? A meta-analysis.

Objective: After a stroke, patients usually suffer from dysfunction, such as decreased balance ability, and abnormal walking function. Whole-body vibration training can promote muscle contraction, stimulate the proprioceptive system, enhance the muscle strength of low limbs and improve motor control ability. The study aims to evaluate the effectiveness of whole-body vibration training on the balance and walking function of patients with stroke. Methods: PubMed, CNKI, VIP, CBM, EBSCO, Embase and Web of Science were searched. According to the inclusion and exclusion criteria, randomized controlled trials on the effectiveness of whole-body vibration training on the balance and walking function of patients with stroke were collected. The search time ranged from the date of database construction to November 2022. The included trials were evaluated by the Cochrane risk-of-bias tool. The meta-analysis was performed using two software packages, consisting of RevMan 5.4 and Stata 12.2. If the results included in the literature were continuous variables, use the mean difference (MD) and 95% confidence interval (CI) for statistics. Results: (1) A total of 22 randomized controlled trials (RCTs) with a total of 1089 patients were included. (2) The results of meta-analysis showed that: compared with the controls, step length (MD = 6.12, 95%CI [5.63, 6.62], p < 0.001), step speed (MD = 0.14, 95%CI [0.09, 0.20], p < 0.001), cadence (MD = 9.03, 95%CI [2.23, 15.83], p = 0.009), stride length (MD = 6.74, 95%CI [-3.47, 10.01], p < 0.001), Berg Balance Scale (BBS) (MD = 4.08, 95%CI [2.39, 5.76], p < 0.001), Timed Up-and-Go test (TUGT) (MD = -2.88, 95%CI [-4.94, 0.81], p = 0.006), 10-meter Walk Test (10MWT) (MD = -2.69, 95%CI [-3.35, -2.03], p < 0.001), functional ambulation category scale (FAC) (MD = 0.78, 95%CI [0.65, 0.91], p < 0.001), Fugl-Meyer motor assessment of lower extremity (FMA-LE) (MD = 4.10, 95%CI [2.01, 6.20], p = 0.0001). (3) The results of subgroup analysis showed that, compared with other vibration frequencies, at 20-30 Hz frequency, WBV training had an obvious improvement effect only in TUGT. (4) The safety analysis showed that WBV training may be safe. Conclusion: Whole-body vibration training has a positive effect on the balance and walking function of patients with stroke. Thus, whole-body vibration training is a safe treatment method to improve the motor dysfunction of patients with stroke. Systematic review registration: [http://www.crd.york.ac.uk/PROSPERO], identifier [CRD4202348263].

Cox-2 Antagonizes the Protective Effect of Sevoflurane on Hypoxia/Reoxygenation-Induced Cardiomyocyte Apoptosis through Inhibiting the Akt Pathway.

OBJECTIVE: To uncover the protective role of sevoflurane on hypoxia/reoxygenation-induced cardiomyocyte apoptosis through the protein kinase B (Akt) pathway. METHODS: An in vitro hypoxia/reoxygenation (H/R) model was established in cardiomyocyte cell line H9c2. Sevoflurane (SEV) was administrated in H9c2 cells during the reoxygenation period. Viability, layered double hydroxide (LDH) release, and apoptosis in H9c2 cells were determined to assess H/R-induced cell damage. Relative levels of apoptosis-associated genes were examined. Moreover, phosphorylation of Akt was determined. RESULTS: H/R injury declined viability and enhanced LDH release and apoptotic rate in H9c2 cells. Cyclooxygenase-2 (Cox-2) was upregulated following H/R injury, which was partially reversed by SEV treatment. In addition, SEV treatment reversed changes in viability and LDH release owing to H/R injury in H9c2 cells, which were further aggravated by overexpression of Cox-2. The Akt pathway was inhibited in H9c2 cells overexpressing Cox-2. CONCLUSIONS: Sevoflurane protects cardiomyocyte damage following H/R via the Akt pathway, and its protective effect was abolished by overexpression of Cox-2.

Endoscopic inlay cartilage and perichondrium myringoplasty for repairing large perforations in teenagers.

OBJECTIVE: This study compared the long-term graft success rates and hearing outcomes of overlay-underlay and underly cartilage myringoplasty for repairing large perforations in Teenagers. STUDY DESIGN: prospective, randomized study. SETTING: Tertiary referral center. METHODS: Pediatric patients older than 12 years with chronic perforations were randomly divided into two groups:intervention group (n = 39) and control group (n = 41). The graft success rate, hearing improvement, and complications were compared between the two groups. RESULTS: A total of 80 patients were included in this study. The graft success rate was 100% in the intervention group and 95.1% in the control group at postoperative 3 months, the difference wasn't significant (P = 0.496). Also, the graft success rate was not significantly different between the two groups at 12 months postoperatively (100.0% vs 87.8%, p = 0.073). However, the difference of graft success rate was significant between the two groups at 24 months postoperatively (97.4% vs 75.6%, p = 0.012). CT examination revealed well-pneumatized middle ears 24 months after surgery in both group. However, epithelial pearls near the umbo were seen at 31 months postoperatively in one patient in the observation group. CONCLUSIONS: Compared to the endoscopic cartilage with perichondrium composite graft underlay technique, endoscopic perichondrial graft overlay and cartilage underlay had a better long-term graft success rate and lower rate of long-term re-perforation in teenagers. However, the graft technique had no effect on hearing outcome.

Postoperative ethmoid sinus mucoceles: Late complication of endoscopic ethmoidectomy and MWA management in outpatient.

OBJECTIVE: The aim of this study was to investigate the feasibility of intranasal endoscopic microwave ablation (MWA) on the management of postoperative ethmoid sinus mucoceles. METHODS AND MATERIALS: The patients with postoperative ethmoid sinus mucoceles were ablated through intranasal endoscopic MWA. Postoperative pain intensity was measured via visual analogue scale (VAS), post-operative complications were recorded. RESULTS: Of the 26 patients with unilateral postoperative ethmoid sinus mucoceles, the mucoceles were diagnosed 3 to 11 years with average time of time of 6.9 ± 2.7 years after endoscopic ethmoidectomy. The ipsilateral middle turbinate was present and intact in 24 patients and partially resected during the original surgery in the remaining 2. There were adhesions in the middle meatus in one case. All 26 patients were successfully treated with the intranasal endoscopic ablation technique in outpatient. The ablation time was 6 to 11 min, with an average duration of 6.84 ± 1.27 min. The mean VAS pain score was 2.41 ± 1.22. There were no perioperative complications reported in this series. No evidence of recurrence was observed in any patients during follow-up periods. CONCLUSIONS: The present study demonstrates the safety and efficacy of intranasal endoscopic MWA in the office. The procedure is well tolerated by patients with low complication rates. Thus, it is alternative to conventional endonasal endoscopic marsupialization for treatment of postsurgical ethmoid sinus mucoceles.

Microwave ablation eustachian tuboplasty: a preliminary investigation with long-term follow-up.

OBJECTIVES: This study was performed to evaluate the efficacy of microwave ablation (MWA) eustachian tuboplasty for the treatment of patients with retracted tympanic membrane (TM) due to eustachian tube dysfunction (ETD). METHODS: This was a prospective study of 20 patients with ETD (middle ear atelectasis) who underwent MWA eustachian tuboplasty. Outcomes included the ability to perform a Valsalva maneuver, audiometry results, tympanometry results, ETD Questionnaire (ETDQ-7) score, and TM status. RESULTS: Eighteen patients (18 ears) were included in this study. There were statistically and clinically significant improvements in the mean ETDQ-7 score at 6 months postoperatively (change in mean score of 16.7 ± 3.6, P < 0.001) and at 30 months postoperatively (change in mean score of 18.9 ± 2.9, P < 0.001). Type A tympanogram was obtained in 27.8% of patients (5/18) at 6 months postoperatively, and in 77.7% at 30 months postoperatively. A Valsalva maneuver was possible in 72.2% of patients at 6 months postoperatively and in 88.9% of patients at 30 months postoperatively. In addition, the ears of 13 patients (72.2%) showed both normal tympanograms and TM at 30 months postoperatively. Interestingly, 38.5% of patients (5/13) exhibited complete sclerosis of the pars tensa. None of the patients experienced severe MWA-related complications during follow-up. CONCLUSIONS: MWA eustachian tuboplasty is a feasible alternative to conventional tuboplasty, and can improve subjective and objective outcomes in patients with ETD for up to 30 months following treatment. In addition, this study showed that the extent of sclerotic plaque increased over time, whereas the extents of atrophy and tensa retraction decreased following tuboplasty in most patients.