The construction and validation of prognostic prediction model for sudden sensorineural hearing loss in middle-aged and elderly people.

OBJECTIVE: Idiopathic sudden sensorineural hearing loss (ISSNHL), as an otologic emergency, is commonly encountered and its prevalence has been climbing every year recently. To our knowledge, the prognosis of middle-aged and elderly patients is worse than that of young patients. Previous researches mainly focused on the adult population, which was considered as prognostic models who performed hearing recovery in ISSNHL. However, few studies regarding the middle-aged and elderly population who are regarded as prognostic models have been reported. Therefore, we aim to construct and validate a nomogram-based prognostic prediction model, which can provide a reference for the prognostic assessment in the middle-aged and elderly patients with ISSNHL. METHOD: A total of 371 middle-aged and elderly ISSNHL patients who were admitted to the Department of Otolaryngology-Head and Neck Surgery, Yanbian Hospital, Yanbian University, from April 2018 to April 2023 were enrolled in the study. All subjects were randomly divided into two groups including training group (n = 263) and validation group (n = 108). Lasso regression and multi-factor logistic regression were jointly utilized to screen out prognosis-related independent risk factors and establish a nomogram-based risk prediction model. The accuracy and clinical application value of the model were evaluated by combining the Bootstrapping method and k-fold cross-validation, plotting the receiver operating characteristic  (ROC)  curve, calculating the area under the ROC curve (AUC), plotting the decision curve analysis (DCA), and the calibrating curve. RESULT: We used the method of lasso regression combined with multivariate logistic regression and finally screened out eight predictors (including age, number of affected ears, degree of hearing loss, type of hearing curve, duration of disease, presence of vertigo, diabetes, and lacunar cerebral infarction) that were included into the nomogram. The C-index were 0.823 [95% CI (0.725, 0.921)] and 0.851 [95% CI (0.701, 1.000)], and the AUC values were 0.812 and 0.823 for the training and validation groups, respectively. The calibration curve for the validation group was approximately conformed to that for the modeling group, indicating favorable model calibration. The DCA results revealed the modeling group (3%-86%) and the validation group (2%-92%) showed significant net clinical benefit under the majority of thresholds. CONCLUSION: This study developed and validated a nomogram-based prognostic prediction model which based on the eight independent risk factors mentioned above. The predictors are conveniently accessible and may assist clinicians in formulating individualized treatment strategies.

[Research advances in the correlation between chronic subjective tinnitus and anxiety state].

Tinnitus and anxiety disorder are common clinical symptoms. Comorbidity between tinnitus and anxiety state is increasing year by year. The relationship between tinnitus and anxiety state has always been a hot topic, and this paper reviews the literature on the relationship between chronic subjective tinnitus and anxiety state in recent years.

Characteristics of vestibular migraine, probable vestibular migraine, and recurrent vertigo of childhood in caloric and video head impulse tests.

Objective: Vertigo is very common in children, but the specific diagnosis and characteristics are not clear. The main objective of this study was to analyze the characteristics of caloric test (CT) and video head impulse test (vHIT) in vestibular migraine of childhood (VMC), probable vestibular migraine of childhood (PVMC), and recurrent vertigo of childhood (RVC), which can provide a reference value for their clinical diagnosis. Methods: We selected VMC, PVMC and RVC patients under 18 years of age from the outpatient Department of Otolaryngology-Head and Neck Surgery between May 2021 and August 2022. All patients underwent vestibular function examinations, including eye movement recording CT and vHIT. CT results depended on whether both canal paresis and directional preponderance were under normal limits, and vHIT results depended on the gain values of vestibulo-ocular reflex. The results of both tests were analyzed according to the disease type. Results: Among the 81 pediatric vertigo patients aged 5-17 years, 44 were females and 37 were males. According to the type of vertigo, 29 patients (25.80%) were diagnosed with VMC, 11 (13.58%) with PVMC, and 41 (50.62%) with RVC. The abnormal rates of the CT in VMC, PVMC, and RVC patients were 24.14%, 36.36%, and 17.07%, respectively. There was no significant difference in the abnormal rates among the three groups (P > 0.05). None of the patients showed abnormal vHIT results (all abnormal rates 0.00%). The abnormal CT rates were significantly higher than those of abnormal vHIT rates (P < 0.05). Conclusions: VMC, PVMC, and RVC are more likely to be diagnosed by symptoms, as neither CT nor vHIT are specific to any conditions. Due to different clinical presentations of vertigo in pediatric patients, it is critical to further clarify the diagnosis with medical history and clinical characteristics.

[Otitis media with antineutrophil cytoplasmic antibody-associated vasculitis].

Objective:To analyze clinical features, diagnosis and treatment of otitis media with antineutrophil cytoplasmic antibody（ANCA） -associated vasculitis（OMAAV）. Methods:This study reported three OMAAV patients and discussed the diagnosis and treatment of OMAAV combined with the recent literature. Results:Two males and one female were included. The age of these three patients ranged from 56 to 72 years. Their characteristics were as follows: ①tympanic membrane with granulation and bloody secretions in two patients; ②progressive bone-conducted hearing loss within a short period of time; ③facial palsy in two patients; ④the laboratory test of ANCA is positive; ⑤conventional treatment of otitis media is ineffective, while glucocorticoid combined with immunosuppressive therapy is effective. Conclusion:OMAAV is a rare disease and prone to misdiagnosis. Early diagnosis and treatment with corticosteroids and immunosuppressants are critical. Invasive tests and surgery during the active phase of OMAAV may aggravate symptoms and should be avoided.

[To address on the refined and individualized comprehensive evaluation of inner ear function].

Auditory and vestibular function detection technology is the premise and key to the diagnosis and management for inner ear diseases. Concurrent damage to the auditory and vestibular system occurs in many inner ear diseases. The general points and issues on hearing and vestibular function tests, as well as the clinical significance of refined and individualized comprehensive evaluation of inner ear function are described in this paper.

[Gain characteristics of three pairs of semicircular canals in video head impulse paradigm test and suppression head impulse paradigm test in healthy young Chinese population].

Objective:To summarize gain characteristics of three pairs of semicircular canals in head impulse paradigm （HIMP） and suppression head impulse paradigm （SHIMP） in healthy young Chinese population. Methods:HIMP and SHIMP tests were performed on 40 healthy young volunteers enrolled as study group, by using EyeseeCam examiantion system （Interacoustics，Denmark）. The elicitation rates and gain values of the two saccades were recorded, and the gain values were compared and analyzed. Results:The results of 40 healthy young people were as follows: in HIMP, the instantaneous gain at 60 ms of the horizontal semicircular canals were 1.11±0.07 on the left side and 1.08±0.07 on the right side; the regression gain of the horizontal semicircular canals were 1.09±0.06 on the left side and 1.10±0.06 on the right side; the regression gain of the vertical semicircular canals were 1.08±0.12 on the right anterior, 1.07±0.11 on the left posterior, 1.41±0.16 on the right posterior and 1.42±0.16 on the left anterior. So in HIMP, no significant difference could be found between left and right side in both horizontal and vertical semicircular canal conjugate plane regarding regression gain （P>0.05）, except that 60 ms instantaneous gain on the left horizontal semicircular canals was slightly higher than that on the right side （P<0.05）.The instantaneous gain values of the horizontal semicircular canal at 60 ms in SHIMP were 1.08±0.08 on the left side and 1.06±0.07 on the right side; the regression gain in horizontal semicircular canals were 1.06±0.07 on the left side and 1.07±0.06 on the right side, respectively; the regression gains of vertical semicircular canal were 1.06±0.13, 1.08±0.16, 1.49±0.16, 1.39±0.15, on the right anterior, left posterior, right posterior, and left anterior side. So in SHIMP, no significant difference could be found in 60 ms instantaneous gain in horizontal conjugate plane, regression gain in horizontal conjugate plane and regression gain in right anterior left posterior conjugate plane （P>0.05）, while the regression gain of the left anterior right posterior conjugate plane in the right was found slightly higher than that of the left （P<0.05）.Both 60 ms instantaneous gain and regression gain in horizontal conjugate plane in HIMP were slightly higher than that of SHIMP （P<0.05）, while no significant difference could be found in vertical conjugate planes （P>0.05）. In both HIMP and SHIMP tests, gains of the left anterior right posterior conjugate plane was slightly higher than that of both horizontal plane and the right anterior left posterior conjugate plane （P<0.05）, while no significant difference could be found in gains between horizontal and the right anterior left posterior conjugate plane （P>0.05）. Conclusion:Gain values of HIMP and SHIMP were slightly different among different semicircular canals conjugate planes.It is suggested that each examination center should establish normal values for their own and make correction regularly.

[The effect of different rotation modes on testing resulting of the subjective visual vertical].

Objective:To investigate the effect of different rotations modes of control rod on testing results of the subjective visual vertical （SVV）. Methods:Twenty-four normal young volunteers were selected for this study, and the control rod of SVV was rotated in clockwise, counterclockwise and any direction at the head tilt-positions of 0°, 45° left and 45° right. The differences of SVV deflection angle values at different rotation modes were analyzed. Results:①The deviation angle values of SVV obtained by rotating the control rod in clockwise, counterclockwise and any direction at the head tilt-positions of 0° were 1.56°±0.21°, 3.05°±0.24°, and 2.16°±0.22°, respectively，and the difference was statistically significant （P<0.05）,the deviation angle value of SVV in clockwise direction was smaller; ②At head tilt-positions of 45° left, the SVV deviation angle values obtained by rotating the control rod in three rotation modes were 2.59°±0.53°, 4.03°±0.51°, and 3.49°±0.54°, respectively, and the difference was statistically significant（P<0.05）,the deviation angle value in the clockwise direction was also smaller; ③At the head tilt-positions of 45° right, the SVV deviation angle values in three modes were 4.68°±0.58°, 7.23°±0.72°, and 5.93°±0.96°, respectively, and the difference was statistically significant （P<0.05）,the deviation value of SVV was also smaller when rotated in the clockwise direction; ④Comparison of SVV deviation angle values in three rotation modes at the head tilt-positions of 45° left and 45° right showed that there was no statistical difference in clockwise and in any direction （P>0.05）, while the difference was statistically significant when rotated in the counterclockwise direction （P<0.05）. Conclusion:Different rotation modes of the control rod during SVV testing will affect the test results. Rotating the control rod in clockwise direction to make the SVV values more accurate is recommended.

[Characteristics of wideband tympanometry in patients with Ménière's disease based on neutral network].

Objective:To construct a prediction model for Ménière's disease based on neural network and evaluate its prediction ability. Methods:Sixty-four patients with Ménière's disease underwent gadolinium enhanced magnetic resonance imaging of inner ear which showed endolymphatic hydrops. Meanwhile, 40 healthy adults were enrolled as controls. The database of wideband tympanometry of patients and control subjects was analyzed, and the neural network model was established by MATLAB 2021a software. The prediction ability of the model was evaluated by accuracy, positive predictive value, negative predictive value, the Youden index, sensitivity, specificity, receiver operating characteristic curve and area under curve （AUC）. Results:A feedforward network model was built with a single hidden layer to predict Ménière's disease with wideband tympanometry. There were 104 features in the input layer, 13 neuron nodes in the hidden layer and 1 output neuron in the output layer. The accuracy of the model was 83.2%, the positive predictive value was 80.7%, the negative predictive value was 84.3%, the sensitivity was 76.5%, the specificity was 83.7%, the Youden index was 0.602, and the AUC was 0.855. Conclusion:Based on neural network, the prediction model of Ménière's disease with high accuracy was constructed according to the results of wideband tympanometry, which provided reference for the diagnose of Ménière's disease.

[Myotonia-rectified bone-conducted vibration vestibular evoked myogenic potential in normal adults].

Objective:To study the characteristics of bone-conducted vibration vestibular evoked myogenic potential（BCV-VEMP） in normal adult with and without myotonia rectification, and to provide accurate reference for clinical vestibular function evaluation. Methods:Thirty normal adults（60 ears） aged 20-32 years old were selected to receive BCV-VEMP in a sitting position. BCV-VEMP were induced by B-81 bone-conducted vibrator at 129.5 FL, the P1 latency, N1 latency, P1-N1interval, amplitude, and amplitude asymmetry ratios were recorded in two test conditions. Results:Clear and repeatable waveforms of BCV-cVEMP and BCV-oVEMP were obtained in all normal adults. The P1 and N1 latencies of BCV-cVEMP were（16.00±2.02） ms and（25.04±2.57） ms, respectively, P1-N1 interval was（9.04±1.78） ms. The N1 and P1 latencies of BCV-oVEMP were（10.39±0.81） ms and（15.85±1.00） ms, respectively, iand interval was（5.46±0.86） ms. The amplitudes of BCV-cVEMP and BCV-oVEMP in two test conditions were statistically significant（P<0.05）. The amplitude asymmetry ratios of BCV-cVEMP and BCV-oVEMP after rectification were （17.03±9.14）% and （20.43±11.65）%, respectively. Conclusion:BCV-VEMP is a feasible and reliable tool for vestibular function assessment. The establishment of a normal values such as amplitude and amplitude asymmetry ratio after rectification can provide a more reliable and accurate reference.

A Comparison of Local Endolymphatic Sac Decompression, Endolymphatic Mastoid Shunt, and Wide Endolymphatic Sac Decompression in the Treatment of Intractable Meniere's Disease: A Short-Term Follow-Up Investigation.

BACKGROUND: Meniere's disease (MD) is an inner ear disorder, characterized by recurrent attacks of vertigo, low-frequency sensorineural hearing loss, tinnitus, and aural fullness. Endolymphatic sac surgery is an effective treatment to control vertigo attacks but without causing a hearing loss for intractable MD. However, the methods and effects of endolymphatic sac surgery have been controversial for many years, and the relationship between the vertigo control rates of different endolymphatic sac surgery methods is not well-documented. OBJECTIVES: This study compared the vertigo control rate, hearing outcome, and quality of life (QOL) among different endolymphatic sac surgery, such as local endolymphatic sac decompression (LESD), endolymphatic sac mastoid shunt (ESMS), and wide endolymphatic sac decompression (WESD). MATERIALS AND METHODS: We retrospectively analyzed the patients who underwent endolymphatic sac surgery from January 2008 to June 2019. The control rate of vertigo and QOL scores were compared after 2 years of follow-up. The QOL was scored with validation of the MD patient-oriented symptom-severity index (MDPOSI). The pure tone thresholds of all patients at pre- and postoperation were also compared. RESULTS: In total, 83 MD patients with complete follow-up data were included in the study, i.e., 20 patients with LESD, 28 patients with ESMS, and 35 patients with WESD. Results showed a better vertigo control with WESD than the other groups (70% with LESD, 71.4% with ESMS, and 88.6% with WESD). The QOL was improved after surgery in all groups in which the difference was statistically significant (QOL, preoperative vs. postoperative, 38.2 vs. 10.1 with LESD, 37.8 vs. 9.6 with ESMS, and 37.6 vs. 8.3 with WESD), respectively. After endolymphatic sac surgery, the hearing was well-preserved in the three groups [pure tone averages (PTAs), dB, preoperative vs. postoperative, 41.0 ± 19.3 vs. 40.8 ± 17.9 with LESD, 39.7 ± 16.4 vs. 40.8 ± 18.2 with ESMS, and 38.5 ± 18.7 vs. 36.6 ± 19.5 with WESD]. CONCLUSION: Wide endolymphatic sac decompression has a higher vertigo control rate, better improvement of QOL, and relatively higher hearing stability or improvement rate after surgery in patients with MD compared with LESD and ESMS.

Dammarane-type saponins from Gynostemma pentaphyllum and their cytotoxicities.

Heat-processed Gynostemma pentaphyllum has shown strong activity against human lung carcinoma A549 cells. In this study, two dammarane-type saponins together with two known compounds were isolated from the ethanol extract of the heat-processed leaves of G. pentaphyllum. They were identified as 2α,3ß,12ß-trihydroxydammar-20(22),24-diene-3-O-ß-D-glucopyranoside (1, namely damulin E), 2α,3ß,12ß-trihydroxydammar-20,24-diene-3-O-ß-D-glucopyranoside (2, namely damulin F), damulin A (3) and damulin B (4), respectively, using NMR and mass spectra. Damulin E and damulin F showed moderate activity against A549, H1299, T24, SH-SY5Y and K562 cell lines in vitro using CCK-8 assay.

Early Postnatal NT-3 Gene Delivery Enhances Hearing Acquisition in the Developmental Period.

OBJECTIVES/HYPOTHESIS: The purpose of this study was to investigate the effect of early postnatal neurotrophin-3 (NT3) support on hearing acquisition. STUDY DESIGN: A prospective experimental animal study. METHODS: Adenoviral (Ad) vectors expressing green fluorescence protein (GFP) alone or in combination with NT3 were injected into the scala tympani through the round window of 5-postnatal-day-old (P5) rats. Changes in NT3 mRNA level, hearing thresholds, and morphological studies were done after the viral vector injection. RESULTS: NT3 mRNA was significantly increased in the Ad-GFP-NT3 group compared to the normal-developmental group and Ad-GFP alone group. GFP was widely expressed in the cochlea such as in the hair cells, supporting cell area, and spiral ganglion neurons. Auditory brainstem response thresholds were significantly lower in the Ad-GFP-NT3 group compared to the normal-developmental group and Ad-GFP alone group at P15. CONCLUSIONS: These results show that early postnatal NT3 overexpression may accelerate the acquisition of hearing in rats. LEVEL OF EVIDENCE: NA Laryngoscope, 126:E379-E385, 2016.

Serum cholinesterase: a potential assistant biomarker for hand, foot, and mouth disease caused by enterovirus 71 infection.

BACKGROUND: Hand, foot, and mouth disease (HFMD) caused by enterovirus 71 (EV71) is a potentially life-threatening infectious disease that commonly occurs in children. Diagnosis of HFMD caused by EV71 largely depends on clinical manifestations and rare serological biomarkers used to identify children suffering from HFMD. Serum cholinesterase (SChE) activity has frequently been reported as a potential biomarker for solid central nervous system tumors, chronic heart failure, and liver cirrhosis. However, its potential value in the diagnosis of neurotropic virus infections, such as HFMD caused by EV71, remains to be determined. FINDINGS: In our study, 220 children hospitalized with HFMD caused by EV71, 34 inpatients infected with coxsackievirus A16 (CVA16), and 43 undefined enterovirus-infected HFMD inpatients were recruited at the Anhui Provincial Children's Hospital between January 2011 and December 2012. SChE activity was measured. The non-parametric Mann-Whitney U test showed that SChE activity in children diagnosed with HFMD caused by EV71 was significantly higher than in healthy controls (p < 0.001), as well as in children with upper respiratory tract infections (p = 0.011), bronchopneumonia (p < 0.001), septicemia (p < 0.001), amygdalitis (p < 0.001), and appendicitis (p < 0.001). In addition, higher SChE activity was observed in male inpatients with HFMD caused by EV71 (47.7 % positivity) compared to female inpatients (26.1 % positivity) (chi-square test, p = 0.002). In our study, no significant differences in SChE levels were observed among different ages (up to 120 months) (r = -0.112, p > 0.05). An important finding was that SChE activity declined in the recovery phase of HFMD caused by EV71 compared to the acute phase (p < 0.001). CONCLUSIONS: Elevated SChE activity was observed in patients with severe HFMD caused by EV71. Therefore, SChE might be a potential assistant biomarker for the diagnosis of HFMD caused by EV71 in children.

MR spectroscopy for assessing the effects of oxytocin on marrow adipogenesis induced by glucocorticoid in rabbits.

BACKGROUND: Previous studies suggest that oxytocin (OT) negatively modulates adipogenesis while promoting osteogenesis in vitro. Because of its effects on marrow stromal cells, OT might have potential utility in therapy for glucocorticoid-induced osteoporosis (GIO). PURPOSE: To explore the effects of OT on marrow adipogenesis in a rabbit model of GIO. MATERIAL AND METHODS: Thirty-six-month-old female New Zealand rabbits were randomly assigned to the control, GIO, and GIO + OT groups. Magnetic resonance (MR) spectroscopy and multi-detector computed tomography (MDCT) were performed to detect marrow fat content (MFC) and bone mineral density (BMD) at baseline, and 1, 2, and 3 months. After 3 months of treatment, marrow adipocytes were quantitatively evaluated by histopathology. RESULTS: In the GIO group, MFC substantially increased from 34.1% to 43.2% at month 1, and it was maintained until month 3 (by 59.2%, all P <0.01). MFC values in the GIO group were significantly different from the control and OT-treated groups over time. Early OT treatment reversed marrow adiposity to levels of the controls. BMD values were significantly lower in the GIO group at months 2 and 3 compared to the controls; however, partial recovery of vertebral BMD (87.1% of baseline) and femoral BMD (89.3% of baseline) in the OT-treated group were observed. The mean diameter and density of adipocyte and percentage of adipocyte area increased by 30.0%, 70.1%, and 88.9%, respectively (all P <0.05) in the GIO group, but remained unchanged in the OT-treated group. CONCLUSION: Early OT treatment was sufficient to eliminate glucocorticoid-induced marrow adiposity.

Dalbergioidin Ameliorates Doxorubicin-Induced Renal Fibrosis by Suppressing the TGF-ß Signal Pathway.

We investigated the effect of Dalbergioidin (DAL), a well-known natural product extracted from Uraria crinita, on doxorubicin- (DXR-) induced renal fibrosis in mice. The mice were pretreated for 7 days with DAL followed by a single injection of DXR (10 mg/kg) via the tail vein. Renal function was analyzed 5 weeks after DXR treatment. DXR caused nephrotoxicity. The symptoms of nephrotic syndrome were greatly improved after DAL treatment. The indices of renal fibrosis, the phosphorylation of Smad3, and the expression of alpha-smooth muscle actin (α-SMA), fibronectin, collagen III (Col III), E-cadherin, TGF-ß, and Smad7 in response to DXR were all similarly modified by DAL. The present findings suggest that DAL improved the markers for kidney damage investigated in this model of DXR-induced experimental nephrotoxicity.

Accompanying mild hypothermia significantly improved the prognosis of septic mice than artificial mild hypothermia.

BACKGROUND: Some patients with sepsis are found with accompanying mild hypothermia (ACMH); however, the effects of ACMH on the patients with sepsis are poorly understood. OBJECTIVE: To compare the impacts of ACMH and artificial mild hypothermia (ATMH) on mortality, systemic inflammatory reactions, and organ functions in mice with sepsis. METHODS: Septic mouse models were induced and divided into ACMH, un-hypothermia, keep normothermia, and ATMH groups, according to the anal temperature and the thermic intervention strategy. The mortality rate, serum levels of tumor necrosis factor α (TNF-α), interferon γ (IFN-γ), and interleukin (IL)-4 and liver and renal functions of the mice in each group were recorded. Liver, lung, and renal tissues of the mice were stained and examined under optic microscope. RESULTS: The mortality rate in the ACMH group was the lowest among all the sepsis groups. Increased serum levels of TNF-α, IFN-γ, and IL-4 and impairments of the liver and renal functions were found in the septic mice. The serum levels of TNF-α, IFN-γ, and IL-4 were significantly lower and the liver and renal functions of ACMH group were not impaired significantly as compared with other sepsis groups. Pathological examinations of the lung, liver, and renal tissues showed that the ACMH group were with the lowest pathological score among all the sepsis groups. CONCLUSION: Accompanying mild hypothermia and ATMH could both reduce mortalities in mice with sepsis, and ACMH could reduce mortality even lower, and more alleviate systemic inflammatory responses and the damages in lung, kidney, and other organs were lighter.

Urinary N-acetyl-beta-D-glucosaminidase as an early marker for acute kidney injury in full-term newborns with neonatal hyperbilirubinemia.

PURPOSE: To investigate renal function estimated by markers in full-term newborns with hyperbilirubinemia. METHODS: A total of 332 full-term newborns with hyperbilirubinemia and 60 healthy full-term newborns were enrolled. Total serum bilirubin, serum creatinine (Cr), serum blood urea nitrogen (BUN), serum cystatin C (Cys-C), urinary beta-2-microglobulin (ß 2MG) index, and urinary N-acetyl-beta-D-glucosaminidase (NAG) index were measured before and after treatment. All newborns were divided into three groups according to total serum bilirubin levels: group 1 (221-256), group 2 (256-342), and group 3 (>342). RESULTS: The control group and group 1 did not differ significantly in regard to serum Cr, serum BUN, serum Cys-C, urinary ß 2MG index, and urinary NAG index. Urinary NAG index in group 2 was significantly higher than that in control group (P < 0.001). Between control group and group 3, serum Cys-C, urinary ß 2MG index, and urinary NAG index differed significantly. The significant positive correlation between total serum bilirubin and urinary NAG index was found in newborns when total serum bilirubin level was more than 272 µmol/L. CONCLUSIONS: High unconjugated bilirubin could result in acute kidney injury in full-term newborns. Urinary NAG might be the suitable marker for predicting acute kidney injury in full-term newborns with hyperbilirubinemia.

Buyang Huanwu Decoction fraction protects against cerebral ischemia/reperfusion injury by attenuating the inflammatory response and cellular apoptosis.

Buyang Huanwu Decoction fraction extracted from Buyang Huanwu Decoction contains saponins of Astragalus, total paeony glycoside and safflower flavones. The aim of this study was to demonstrate the neuroprotective effect and mechanism of Buyang Huanwu Decoction fraction on ischemic injury both in vivo and in vitro. In vivo experiments showed that 50-200 mg/kg Buyang Huanwu Decoction fraction reduced infarct volume and pathological injury in ischemia/reperfusion rats, markedly inhibited expression of nuclear factor-κB and tumor necrosis factor-α and promoted nestin protein expression in brain tissue. Buyang Huanwu Decoction fraction (200 mg/kg) exhibited significant effects, which were similar to those of 100 mg/kg Ginkgo biloba extract. In vitro experimental results demonstrated that 10-100 mg/L Buyang Huanwu Decoction fraction significantly improved cell viability, decreased the release of lactate dehydrogenase and malondialdehyde levels, and inhibited the rate of apoptosis in HT22 cells following oxygen-glucose deprivation. Buyang Huanwu Decoction fraction (100 mg/L) exhibited significant effects, which were similar to those of 100 mg/L Ginkgo biloba extract. These findings suggest that Buyang Huanwu Decoction fraction may represent a novel, protective strategy against cerebral ischemia/reperfusion injury in rats and oxygen-glucose deprivation-induced damage in HT22 cells in vitro by attenuating the inflammatory response and cellular apoptosis.

Developmental changes in the responsiveness of rat spiral ganglion neurons to neurotrophic factors in dissociated culture: differential responses for survival, neuritogenesis and neuronal morphology.

The way that the development of the inner ear innervation is regulated by various neurotrophic factors and/or their combinations at different postnatal developmental stages remains largely unclear. Moreover, survival and neuritogenesis in deafferented adult neurons is important for cochlear implant function. To address these issues, developmental changes in the responsiveness of postnatal rat spiral ganglion neurons (SGNs) to neurotrophin-3 (NT-3), brain-derived neurotrophic factor (BDNF) and leukemia inhibitory factor (LIF) were examined by using a dissociated cell culture system. SGNs at postnatal day (P) 0, P5 and P20 (young adult) were cultured with the addition of NT-3, BDNF, or LIF or of a combination of NT-3 and BDNF (N + B) or of NT-3, BDNF and LIF (ALL factors). SGNs were analyzed for three parameters: survival, longest neurite length (LNL) and neuronal morphology. At P0, SGNs required exposure to N + B or ALL factors for enhanced survival and the ALL factors combination showed a synergistic effect much greater than the sum of the individual factors. At P5, SGNs responded to a wider range of treatment conditions for enhanced survival and combinations showed only an additive improvement over individual factors. The survival percentage of untreated SGNs was highest at P20 but combinations of neurotrophic factors were no more effective than individual factors. LNL of each SGN was enhanced by LIF alone or ALL factors at P0 and P5 but was suppressed by NT-3, BDNF and N + B at P5 in a dose-dependent manner. The LNL at P20 was enhanced by ALL factors and suppressed by N + B. Treatment with ALL factors increased the proportion of SGNs that had two or more primary neurites in all age groups. These findings suggest that NT-3, BDNF, LIF and their combinations predominantly support different ontogenetic events at different developmental stages in the innervation of the inner ear.

Vestibular evoked myogenic potentials of children with inner ear malformations before and after cochlear implantation.

CONCLUSIONS: Our results show that among the patients with inner ear malformations, there were two patients with sensory cells of sacculus and inferior vestibular neurons and at least five patients with inferior vestibular neurons only, but no patients without sensory cells and vestibular neurons, as determined on the basis of vestibular evoked myogenic potentials (VEMPs). OBJECTIVE: The aim of this study was to investigate whether sensory cells of sacculus or inferior vestibular neurons or both are present in cochlear implant patients with inner ear malformations, particularly common cavity (CC) deformity, using VEMPs. PATIENTS AND METHODS: Seven children with inner ear malformation who underwent cochlear implantation (CI) participated in this study. The patients had CC deformity (n=2), incomplete partition type I (n=2), incomplete partition type II (n=1), or a narrow internal auditory canal (IAC) (n=2). It was possible to record VEMPs before and after CI in three patients and not before but after CI in four patients. After surgery, VEMPs were recorded with the cochlear implant device switched both off and on. RESULTS: Before the CI, two patients showed VEMPs and one patient showed no VEMPs, whereas in four patients no VEMPs could be recorded. All the patients showed VEMPs with the cochlear implant on.