[An analysis of clinical efficacy of microvascular decompression for 21 inpatients suffering from primary hemifacial spasm].

Objective:To assess the effectiveness of microvascular decompression（MVD） in treating inpatients suffering from primary hemifacial spasm（HFS）. Methods:A total of 21 inpatients with HFS underwent MVD. The clinical effect was follow up evaluated according to the clinical symptoms until post operative 6 months. Results:The effective rate of MVD for 1 day, 14 days, 1 month, 3 months and 6 months post-operation was 95.2%, 100%, 100%, 100% and 100%, respectively.one patient had transient tinnitus and the symptom disappeared within 6 days postoperatively.one patient developed postoperative incomplete facial paralysis（HB grade IV facial nerve function, grade Ⅱ） and recovered 6 days after surgery; There was no cerebrospinal fluid leakage, intracranial infection, death or disability occurred during follow-up. Conclusion:Microvascular decompression is a safe and effective method for the treatment of primary hemifacial spasm, which is worthy of clinical promotion.

Dosimetry and plan parameters study of three-dimensional-printed template-based intra-cavitary/interstitial interpolation technology using computed tomography-guided high-dose-rate brachytherapy in locally advanced cervical cancer.

Purpose: To explore differences in dosimetry and planning parameters between intra-cavitary/interstitial interpolation (IC + ISBT) three-dimensional (3D)-printed template-based (3D-printed) and simple intra-cavity (ICBT) radiation techniques using a fixed Rotterdam three-tube applicator (TT) for computed tomography-guided high-dose-rate brachytherapy in locally advanced cervical cancer. Material and methods: This retrospective study included 100 patients (n = 50 each in 3D-printed and Rotterdam three-tube applicator treatment groups) with FIGO stages IIB-IVB cervical cancer from May 2019 to May 2022. Using high-risk clinical target volume, 377 of 400 plans categorized at intervals of 10 cm3 into 20-30, 30-40, 40-50, 50-60, 60-70, and 70-80 cm3; 23 plans with < 20 and > 80 cm3 volume were excluded. Dosimetry parameters (D90 and D98 of high-risk clinical target volume, and D2cc of organs at risk, including bladder, rectum, sigmoid, and bowel) and planning parameters (homogeneity index [HI], conformation number [CN], and organ at risk sparing factor) were compared between the two groups separately for six high-risk clinical target volume plan categories. Results: For the 3D-printing group, target coverage, organs at risk protection, and plan conformity and uniformity were better than those for the Rotterdam three-tube group. Particularly, in high-risk clinical target volume plans between 50-60 cm3, the mean D90 and D98 of high-risk clinical target volume were approximately 0.35 and 0.3 Gy higher, while the average D2cc of the bladder, rectum, sigmoid, and bowel were approximately 1.3, 0.9, 0.9, and 0.8 Gy significantly lower than those of the Rotterdam three-tube group, respectively (p < 0.05). The above-mentioned planning parameters differed significantly between the groups (p < 0.05). Conclusions: For the 3D-printing group, IC/ISBT reduced the dose for organs at risk while ensuring target coverage and conformation. This was especially noticeable for plans with high-risk clinical target volume of 50-60 cm3.

Integrative bioinformatics analysis to identify novel biomarkers associated with non-obstructive azoospermia.

Aim: This study aimed to identify autophagy-related genes (ARGs) associated with non-obstructive azoospermia and explore the underlying molecular mechanisms. Methods: Two datasets associated with azoospermia were downloaded from the Gene Expression Omnibus database, and ARGs were obtained from the Human Autophagy-dedicated Database. Autophagy-related differentially expressed genes were identified in the azoospermia and control groups. These genes were subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Genomes, protein-protein interaction (PPI) network, and functional similarity analyses. After identifying the hub genes, immune infiltration and hub gene-RNA-binding protein (RBP)-transcription factor (TF)-miRNA-drug interactions were analyzed. Results: A total 46 differentially expressed ARGs were identified between the azoospermia and control groups. These genes were enriched in autophagy-associated functions and pathways. Eight hub genes were selected from the PPI network. Functional similarity analysis revealed that HSPA5 may play a key role in azoospermia. Immune cell infiltration analysis revealed that activated dendritic cells were significantly decreased in the azoospermia group compared to those in the control groups. Hub genes, especially ATG3, KIAA0652, MAPK1, and EGFR were strongly correlated with immune cell infiltration. Finally, a hub gene-miRNA-TF-RBP-drug network was constructed. Conclusion: The eight hub genes, including EGFR, HSPA5, ATG3, KIAA0652, and MAPK1, may serve as biomarkers for the diagnosis and treatment of azoospermia. The study findings suggest potential targets and mechanisms for the occurrence and development of this disease.

Characteristics of preplan-based three-dimensional individual template-guided brachytherapy compared to freehand implantation.

Image-guided adaptive intracavitary/interstitial brachytherapy (IC/IS IGABT) has exhibited superior dosimetry advantage and local control for locally advanced cervical cancer (LACC). Our group designed a type of cylindrical three-dimensional (3D) printed vaginal template combining an intracavitary applicator with straight and oblique interstitial needles according to the preplan on computed tomography images. This work aimed to research the consistency of the preplan with the treatment plan at every fraction to verify the practical guiding significance of the preplan. We also investigated the difference between 3D-printed template-guided implantation compared with freehand implantation for LACC. Twenty-six patients were treated with 3D-printed individual templates (3D template group), and 20 patients were treated by using freehand insertion (freehand group). Patients in the 3D template group would take a preplan one week before treatment to design and print the individual template, while the freehand group did not. All patients accepted volumetric rotational intensity-modulated radiotherapy at a dose of 49.4 Gy in 26 fractions and subsequent brachytherapy at a dose of 26 Gy in four fractions. All analyses were performed by utilizing SPSS 26. The insertion depth was decreased in fractions 1 and 4 compared with the preplan. None of the dose volume histogram parameters of fractions 1-3, nor the D2cc of bladder and bowel at fraction 4 were barely changed compared with the preplan. The D90 and D98 of the high-risk clinical target volume in the 3D template group were statistically higher than those in the freehand group (p < 0.01). The D2cc of the rectum, bladder, bowel, and sigmoid in the 3D template group were all lower than those in the freehand group (p < 0.01). The preplan in this research is consistent with treatment plans, which is important to ensure the feasibility of applying a 3D-printed template in brachytherapy. The 3D-printed individual guidance template was an effective method in brachytherapy for locally advanced cervical cancer.

miRNA-195-5p/PSAT1 feedback loop in human triple-negative breast cancer cells.

BACKGROUND: Substantial evidence suggests that non-coding RNAs, such as microRNAs (miRNAs), play a vital role in human cancer. Phosphoserine aminotransferase 1 (PSAT1) is a serine biosynthesis-related member of the aminotransferase family and is closely associated with worse prognosis in triple-negative breast cancer (TNBC). OBJECTIVE: The present study elucidated the molecular mechanisms underlying PSAT1 regulation by miRNAs in TNBC. METHODS: After collecting breast cancer and para-cancerous tissues, expression and functional testing of microRNA-195-5p (miR-195-5p) and PSAT1 were implemented both in vivo and in vitro. RESULTS: Abnormally low miR-195-5p expression was confirmed in TNBC tissues and cells. The specific targeting effect of miR-195-5p on PSAT1 was screened. Our observations revealed that biological tumor behavior was inhibited after miR-195-5p upregulation and this inhibition could be reversed by PSAT1 overexpression both in vivo and in vitro. CONCLUSION: Our study revealed the regulatory axis of miR-195-5p/PSAT1 in TNBC, suggesting a promising targeted therapy for clinical application.

Value of dissection of lymph nodes posterior to the right recurrent laryngeal nerve in patients with cN0 papillary thyroid carcinoma.

Background: Tumor metastasis to lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) is a main cause of disease recurrence in patients with papillary thyroid carcinoma (PTC), which may increase the risk of recurrence and secondary surgery, and the disruption of normal anatomical relationships during secondary surgery increases the risk of laryngeal nerve injury and hypoparathyroidism. However, controversy remains as to whether the dissection of LN-prRLN is required in cN0 PTC patients. The purpose of this study is to explore the factors associated with LN-prRLN metastasis in patients with cN0 PTC and the need for LN-prRLN node dissection in patients with cN0 PTC who undergo right central compartment dissection. Methods: The clinical data of 290 patients with cN0 PTC who received radical thyroid cancer surgery from December 2019 to March 2022 at our center were retrospectively analyzed. All the patients underwent thyroid lobectomy and right central lymph node dissection (CLND), along with other treatments. SPSS 26.0 statistical software was used for the analysis. The measurement data were compared using the rank-sum test, and the count data were compared using the chi-square test. Results: LN-prRLN metastasis was detected in 65 (22.4%) of the 290 cN0 PTC patients. The metastasis sites included level VIa (51.72%), the left central compartment (22.76%), and the prelaryngeal compartment (8.97%). The univariate analysis revealed that tumor multifocality, a tumor diameter >1 cm, capsular invasion, LN metastasis in the left central compartment, and level VIa positivity were influencing factors of LN-prRLN metastasis in PTC patients. The logistic regression analysis showed that a tumor diameter >1 cm (OR =2.897, 95% CI: 1.630-5.147, P<0.001), LN metastasis in the left central compartment (OR =3.724, 95% CI: 2.039-6.801, P<0.001), and level VIa (OR =3.405, 95% CI: 1.846-6.281, P<0.001) positivity were independent risk factors of LN-prRLN metastasis in PTC patients. Conclusions: The high-risk factors of LN-prRLN metastasis in cN0 PTC patients include a large tumor (a diameter >1 cm), lymph node metastasis in the left central compartment, and lymph node metastasis in level VIa. For patients with cN0 PTC undergoing right CLND, with high-risk factors of LN-prRLN metastasis, LN-prRLN dissection is recommended. Keywords: Papillary thyroid carcinoma (PTC); lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN); central compartment lymph node dissection; risk factor.

Massive prolapsed cervical lumps in cervical cancer treated with three-dimensional implant brachytherapy: a case report.

Background: Cervical cancer is one of the most common gynecological malignancies in developing countries. But the cervical cancer patients with tumor prolapse are very rare. The treatment principle of cervical cancer has been written into the guide, while the management of cervical lumps prolapse associated with cervical cancer is not standardized. Every doctor has different opinions on treatment strategies. Herein, we describe the three-dimensional brachytherapy treatment for massive prolapsed cervical lumps. Case Description: A 48-year-old woman diagnosed with cervical cancer developed a huge cervical mass prolapsed after defecation on the second day of chemotherapy. The mass surface was continuously bleeding and unable to return to the vagina. Therefore, uterine artery embolization interventional hemostasis was performed and then three-dimensional brachytherapy treatment was applied. The mass was necrotic and shedding and then retracted into the vagina on the 7th day after implantation treatment. Finally, the patient successfully received radical radiotherapy [pelvic and abdominal cavity external beam radiotherapy-PCTV 50.4 Gy/28 F, pelvic metastatic lymph nodes PGTVn 61.0 Gy/28 F, plus vaginal three-dimensional brachytherapy-HRCTV (D90) 27.25 Gy/4 F]. Conclusions: If cervical cancer combined with tumor prolapse is inoperable, three-dimensional implants brachytherapy seems to be an adequate therapeutic option.

Circ-0036602 Acts As a Sponge of MiR-34a-5p and MiR-431-5p to Promote Cervical Cancer Proliferation and Invasion.

Background: Cervical cancer (CC) is one of the most common female malignancies worldwide. An increasing body of evidence suggests that circular RNAs (circRNAs) participate in the pathogenesis of various cancers, including CC. However, the expression profile and underlying molecular mechanisms remain largely unknown. Methods: In this study, high throughput sequencing was applied to identify circRNA in HPV-16 positive CC tissues. Quantitative real-time PCR (qRT-PCR) was performed to validate the expression in CC tissues and cell lines. RNase R treatment, gel-electrophoresis, and RNA fluorescent in situ hybridization (FISH) were used to characterize the circRNAs. Subsequently, the Cell Counting Kit-8 assay (CCK8), transwell and wound healing assays were performed to assess circRNA function. Meanwhile, dual-luciferase reporter and western blot were used to clarify the associated molecular mechanisms. Results: Circ0036602 was upregulated in HPV-16 positive CC and correlated with a poor prognosis. Moreover, circ0036602 expression significantly correlated with the clinicopathologic characteristics. Knockdown of circ0036602 inhibited CC cell proliferation, migration, and invasion. Further studies showed that circ0036602 could bind to miR-34-5p and miR-431-5p to regulate the expression of the target gene HMGB1. Conclusions: Taken together, our findings suggest that circ0036602 is a tumor-promoting circRNA that promotes CC cells by sponging miR-34-5p and miR-431-5p to regulate HMGB1. Circ0036602 has huge prospects as a potential therapeutic target for CC patients.

Changes of Vestibular Symptoms in Menière's Disease After Triple Semicircular Canal Occlusion: A Long-Term Follow-Up Study.

BACKGROUND: The clinical efficacy of triple semicircular canal occlusion (TSCO) and vestibular nerve resection (VNS) for patients with Ménière's disease has been unclear. OBJECTIVE: To explore changes in vestibular symptoms after TSCO and its advantages compared to the classical operation of VNS in patients with Menière's disease. METHODS: In total, 36 patients with Menière's disease performed TSCO or VNS at Shanghai Jiao Tong University Affiliated Sixth People's Hospital, China from May 2005 to July 2021, and all of them were enrolled in our study. Twelve of them underwent TSCO, 23 underwent VNS, and 1 had both treatments. We compared the demographic parameters, clinical symptoms, and selected test results between the two surgical methods. Ten patients each who underwent TSCO and VNS completed the follow-up. We collected and compared data pertaining to changes in vestibular symptoms. RESULTS: No significant difference in demographic parameters, clinical symptoms, or auditory or vestibular test results was detected between the two groups preoperatively. The TSCO group with vertigo as the main complaint experienced less residual paroxysmal dizziness after surgery than the VNS group (P = 0.020). Also, 57% of the patients in the VNS group had unsteadiness after surgery, while no such problems were reported in the TSCO group (P = 0.025). CONCLUSIONS: Our study shows that TSCO controls vertigo in most Menière's disease patients, and also has the advantage of lower rates of postoperative paroxysmal dizziness and unsteadiness than VNS. Thus, TSCO may be an effective surgery for refractory Menière's disease.

LncRNA SNHG5 promotes the glycolysis and proliferation of breast cancer cell through regulating BACH1 via targeting miR-299.

BACKGROUND: Breast cancer (BC) is one of the most common malignant tumors in women. Accumulating studies have been reported that long non-coding RNA (lncRNA) SNHG5 is highly expressed in BC. However, the specific molecular mechanism of SNHG5 in BC is unclear. METHODS: Gene and protein expressions in BC cell were detected by qRT-PCR and western blotting. The proliferation and cell cycle were measured using colony formation assay and flow cytometry analysis, separately. The glucose consumption and lactate production were determined by using the glucose assay kit and lactate assay kit. A dual-luciferase reporter assay was performed to measure the interaction between miR-299 and SNHG5 or BACH1. RESULTS: SNHG5 and BACH1 expressions were increased in BC cell while miR-299 level was decreased. SNHG5 increased BACH1 expression by directly targeting miR-299. SNHG5 silencing or miR-299 overexpression suppressed the proliferation of BC cell, arrested the cell cycle in the G1 cell phase, and decreased the glucose consumption and lactate production of BC cell. However, inhibition of miR-299 or overexpression of BACH1 could reverse the inhibitory effects of sh-SNHG5 on cell proliferation and glycolysis in BC. CONCLUSION: SNHG5 promoted the BC cell growth and glycolysis through up-regulating BACH1 expression via targeting miR-299. These findings may improve the diagnostic and therapeutic approaches to BC.

A clinical observation of stage I implant breast reconstruction for mass-like granulomatous lobular mastitis.

BACKGROUND: Granulomatous lobular mastitis (GLM) is a chronic benign inflammatory breast disease, and mainly mass-like granulomatous lobular mastitis (MGLM) clinically. There are few reports on applications of stage I implant breast reconstruction in GLM. This observational study was conducted to evaluate the safety and efficacy of stage I implant breast reconstruction in the treatment of MGLM. METHODS: Patients suffering from MGLM who visited at hospital from April 2019 to June 2020 were selected and graded according to the magnetic resonance imaging (MRI) examination. Patients with MGLM were grouped into the prosthesis implantation group and the traditional treatment group according to their preferences. Clinical parameters of the two groups were analyzed before and after surgery, such as postoperative infection, recurrence, and satisfaction with appearance and aesthetics were observed. To evaluate the safety and efficacy of the implant breast reconstruction in MGLM. RESULTS: There were 59 cases of MGLM, 31 cases of grade 3-4 GLM, 11 cases of bilateral metachronous GLM. There were 18 patients in the prosthesis implantation group, including 9 patients with bilateral metachronous GLM, 2 patients with synchronous GLM, and 41 patients in the traditional treatment group. All the patients were followed up with a median of 17.5 months. One patient in the observation group had an infection on the reconstructed side 3 weeks after surgery, and the implant was retained after 2 weeks of conservative treatment such as antibiotics. Two patients in the prosthesis implantation group were not satisfied with size of the reconstructed breast was smaller than the opposite side. In the traditional treatment group, there were 3 cases of postoperative infection or delayed wound healing, and 26 cases of postoperative breast asymmetry. CONCLUSIONS: For patients with MGLM, it is safe to select stage I prosthesis implantation after conservative treatment, with exact effect and high patient satisfaction.

The protective role of Ephrin-B2/EphB4 signaling in osteogenic differentiation under inflammatory environment.

Inflammation and alveolar bone destruction constitute the main pathological process of periodontitis. However, the molecular mechanisms of bone destruction under the inflammation environment remain unclear. This study aims to explore the role of Ephrin-B2/EphB4 signaling in osteogenic differentiation under the inflammation environment. Mouse pre-osteoblasts MC3T3-E1 were pretreated with lipopolysaccharide of Porphyromonas gingivalis (Pg-LPS). The Ephrin-B2/EphB4 signaling was activated, and the osteogenic differentiation of cells was examined. The results showed that activation of Ephrin-B2/EphB4 signaling promoted the expression levels of osteogenic differentiation-related genes, and also relieved the inhibitory effect of Pg-LPS on osteogenesis. Noticeably, the effect of Ephrin-B2/EphB4 signaling might be related to the mitogen-activated protein kinase (MAPK) pathway. While applying Ephrin-B2-Fc and EphB4-Fc to periodontitis mice, we observed the reduction of alveolar crest destruction. The current study revealed the possible role of Ephrin-B2/EphB4 signaling in reducing bone destruction in periodontitis and suggested its potential values for further research.

Significance of ovarian transposition in the preservation of ovarian function for young cervical cancer patients undergoing postoperative volumetric modulated radiotherapy.

BACKGROUND: This paper aimed to evaluate the effectiveness of ovarian transposition (OT) and the dose constraint for preserving ovarian function in young cervical cancer patients who underwent postoperative volumetric modulated arc therapy (VMAT). METHODS: A retrospective analysis was conducted of young cervical cancer patients who accepted postoperative VMAT in the Affiliated Cancer Hospital of Nanjing Medical University from September 2015 to September 2018. VMAT plans for OT and non-OT patients were compared, and the patients' ovarian function was followed up. The transposed position of the ovaries and the radiation dose constraint were further explored using a receiver operator characteristic (ROC) curve. RESULTS: A total of 51 young patients (age ≤40 years) were included in the study, 32 of whom underwent OT and 19 of whom did not. For these OT and non-OT patients, the homogeneity index (HI), conformity index (CI), organs at risk (OARs), average number of monitor units (MUs), and mean treatment time were similar and showed no statistically significant difference (P≥0.05). Through follow-up studies, the number of patients with preserved ovarian function was found to be 22 (out of 32) and 0 (out of 19) in the OT and non-OT patients, respectively. The minimal distance for preserving ovarian function was determined as 2.1 cm between the center of a transposed ovary and the planning target volume (PTV) margin. The optimal limited radiation doses were estimated as maximum dose (Dmax) 9.8 Gy and mean dose (Dmean) 4.6 Gy, respectively. CONCLUSIONS: OT shows no negative effects on dose distribution, target region conformity, protection of OARs, or treatment efficacy and is therefore a reliable method in the preservation of ovarian function for young cervical cancer patients undergoing postoperative radiotherapy using the VMAT technique. Specifically, when the distance between the center of a transposed ovary and the PTV margin is more than 2.1 cm, and the radiation dose is limited to a Dmax of less than 9.8 Gy and a Dmean of less than 4.6 Gy, the function of transposed ovaries may be preserved.

The expression and meaning of CD68, CD163, CD57, and IgG4 in granulomatous lobular mastitis.

BACKGROUND: The exact etiology and pathogenesis of granulomatous lobular mastitis (GLM) are yet to be illuminated. This study aimed to investigate CD68, CD163-positive M2 macrophages, CD57-positive natural killer (NK) cells, and IgG4 in GLM lesion tissue to explore their correlation with the occurrence and clinical features of GLM. METHODS: Surgical pathologic specimens of GLM were collected from patients admitted to Hunan Provincial People's Hospital between October, 2014 and October 2015. Based on the postoperative pathological diagnosis, the tissues were divided into 3 groups: the experimental group (GLM, n=36), control group 1 (plasma cell mastitis, PCM, n=17), and control group 2 (breast cystic hyperplasia, n=10). Immunohistochemical staining was carried out using Elivision super testing to detect CD68, CD163, CD57, and IgG4 expression in the pathological tissue samples. The relationship between clinical parameters, including age, reproductive condition, nipple retraction, and tumor size, and the expressions of CD68, CD163, CD57, and IgG4 was analyzed. RESULTS: There was no obvious difference in the levels of CD68, CD163, and CD57 expression between the GLM group and the PCM group, although both groups had higher expression levels of expression than the breast cystic hyperplasia group (P<0.05). In the GLM group, the expression level of CD57 at 2 weeks-3 months was significantly higher than at ≤2 weeks (P<0.05). The expression level of CD57 in PCM patients >2 years after lactation was significantly higher than in patients ≤2 years after lactation (P<0.05). The level of IgG4 expression in GLM patients with nipple retraction was significantly higher than in those without nipple retraction (P<0.05). CONCLUSIONS: Inflammatory cells are closely linked to the occurrence of GLM and PCM. In our study, both the GLM and PCM groups had low expression of IgG4, but the expression level of IgG4 in GLM patients with inverted nipples was significantly higher than that in patients without inverted nipples. This suggests that there may be two different clinical subtypes of GLM. Furthermore, our research also found that NK cells can provide a basis for GLM clinical staging.

MNX1 Promotes Malignant Progression of Cervical Cancer via Repressing the Transcription of p21cip1.

Motor neuron and pancreas homeobox 1 (MNX1) is a development-related genes and has been found to be highly expressed in several cancers. However, its biological function in cervical cancer remains largely unexplored. QRT-PCR, western blot, and IHC showed that MNX1 was abnormally overexpressed in cervical cancer tissues and cell lines. The high expression level of MNX1 correlated with poorer clinicopathologic characteristics in cervical cancer patients. Evaluated by RTCA (Real Time Cellular Analysis) proliferation assay, colony formation assay, EdU assay, transwell assay, and matrigel assay, we found that knockdown of MNX1 inhibited proliferation, migration and invasion of cervical cancer in vitro, while overexpression of MNX1 promoted malignant phenotype of cervical cancer. And subcutaneous xenograft model confirmed the malignant phenotype of MNX1 in vivo. Furthermore, flow cytometry, chromatin immunoprecipitation, and luciferase reporter assay indicated that MNX1 accelerated cell cycle transition by transcriptionally downregulating cyclin-dependent kinases p21cip1. In summary, our study revealed that MNX1 exerted an oncogenic role in cervical cancer via repressing the transcription of p21cip1 and thus accelerating cell cycle progression. Our results suggested that MNX1 was a potential diagnostic marker and therapeutic target for cervical cancer patients.

Prevalence of High Jugular Bulb across Different Stages of Adulthood in A Chinese Population.

Pulsatile tinnitus, ear fullness, vertigo, hearing disorders, and vestibular dysfunction have been found to be related to high jugular bulb. Anatomical variation in this region also affects surgical planning and approaches. Therefore, knowledge on the detailed anatomy of the high jugular bulb is critical for middle ear and lateral skull base surgery. Prevalence of high jugular bulb is uncertain as data are usually derived from temporal bone specimens and patient reports from hospitals. Therefore, a community-based epidemiological study is necessary to understand the significance of high jugular bulb anatomy. Here, we report a cross-sectional study to characterize the prevalence of high jugular bulb and jugular bulb size using a 3.0 T magnetic resonance imaging. Furthermore, we studied the relationship between the prevalence of high jugular bulb and age-related changes. We enrolled 4539 permanent residents (9078 ears) from two communities in the Shanghai region who underwent magnetic resonance imaging between 2007 and 2011. We divided participants into four subgroups according to age: 35-44 (early middle age), 45-54 (middle age), 55-64 (late middle age), and 65-75 (late adulthood) years. We found that the overall prevalence of high jugular bulb was 14.5% in a Chinese population. There was a higher prevalence of high jugular bulb on the right side and especially in women (both p < 0.001). The occurrence of high jugular bulb was higher in the early middle age group and gradually decreased with age, but was still present in the late adulthood group (p = 0.039). These findings provide useful information on the prevalence of high jugular bulb in a Chinese population and the distribution in age groups, suggesting that high jugular bulb should be considered, even in those without ear disorders. This work serves as a foundation for further research on the relationship between jugular bulb changes and disease symptoms.

[A case of eosinophil otitis media with smear-negative middle ear effusion and literature review].

We report a case of eosinophil otitis media with smear-negative middle ear effusion. This case is a special type of otitis media characterized by highly viscous middle ear effusion associated with bronchial asthma and nasal polyposis. However, unlike the classical cases that tested positive for eosinophils, smear examination of middle ear effusion in this case showed unusual presence of neutrophils. The diagnosis was validated by pathological biopsy of granulation tissue in the tympanic cavity, showing predominantly eosinophils in the mucosa of the middle ear. Surgery, focal applications of corticosteroid and antibiotics to control inflammation and bacterial infection were effective to ameliorate the middle ear condition in this case.

Removal of biofilm is essential for long-term ventilation tube retention.

BACKGROUND: Although long-term retention of a ventilation tube is required in many ear diseases, spontaneous removal of conventional ventilation tube is observed in patients within 3 to 12 mo. To address this issue, we aimed to determine a new method for long-term retention of the ventilation tube. AIM: To explore the value of removing the biofilm for long-term retention of tympanostomy ventilation tubes. METHODS: A case-control study design was used to evaluate the safety and effectiveness of long-term tube retention by directly removing the biofilm (via surgical exfoliation) in patients who underwent myringotomy with ventilation tube placement. The patients were randomly divided into two groups: Control group and treatment group. Patients in the treatment group underwent regular biofilm exfoliation surgery in the clinic, whereas those in the control group did not have their biofilm removed. Only conventional ventilation tubes were placed in this study. Outcome measures were tube position and patency. Tube retention time and any complications were documented. RESULTS: Eight patients with biofilm removal and eight patients without biofilm removal as a control group were enrolled in the study. The tympanostomy tube retention time was significantly longer in the treatment group (43.5 ± 26.4 mo) than in the control group (9.5 ± 6.9 mo) (P = 0.003). More tympanostomy tubes were found to be patent and in correct position in the treatment group during the follow-up intervals than in the control group (P = 0.01). CONCLUSION: Despite the use of short-term ventilation tubes, direct biofilm removal can be a well-tolerated and effective treatment for long-term tube retention of tympanostomy ventilation tubes in patients who underwent myringotomy.

Fluxapyroxad induces developmental delay in zebrafish (Danio rerio).

Succinate dehydrogenase inhibitor (SDHI) fungicides are extensively used in agriculture. Some SDHI fungicides show developmental toxicity, immune toxicity and hepatotoxicity to fish. Fluxapyroxad (FLU) is a broad spectrum pyrazole-carboxamide SDHI fungicide and its potential impacts on fish embryonic development are unknown. We exposed zebrafish embryos to 1, 2 and 4 µM FLU. Developmental malformations, including yolk sac absorption disorder, decreased pigmentation and hatch delay were induced after FLU exposure. FLU caused significantly increased transcription levels in the ectoderm marker foxb1a but no significant changes in endoderm and mesoderm development markers (foxa2, ntl and eve1). Transcription levels of genes in the early stage embryos (gh, crx, neuroD and nkx2.4b) decreased significantly after FLU treatments. The content of glutathione (GSH) increased after FLU exposure. This study shows that FLU is toxic to zebrafish through its developmental effects and oxidative stress. FLU may pose risks to other non-target aquatic organisms.

Efficacy and Timing of Neonatal Ear Correction Molding.

BACKGROUND AND AIM: Given the incidence of congenital auricular anomalies varies racially, this study aimed to investigate the efficacy and timing of ear correction molding in infants with auricular anomalies. MATERIALS AND METHODS: A total of 141 auricular anomalies of 100 infants less than 4 months of age were treated using the Earlimn molding system. Treatment outcomes were graded (three categories) in terms of auricular morphology. The efficacies and outcomes of modeling were evaluated in infants according to age and anomaly type. RESULTS: The mean age at which correction was initiated was 35.13 days of life, and the average treatment duration was 17.81 days. Of all anomalies, 86% were corrected. Both deformations and certain malformations were satisfactorily corrected. The outcomes of children with conchal crura and mixed anomalies were relatively poor. Although no differences in treatment efficiency were evident among the three age groups, infants < 3 weeks old required shorter treatment courses than those > 6 weeks old. The only complications were mild skin ulcers. CONCLUSIONS: Ear correction molding is remarkably effective for infants with auricular deformations/malformations. Molding efficacy depends on the type of anomaly. Initiation of molding at less than 6 weeks of age is essential to minimize treatment duration. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.