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OBJECTIVE: The objective of this study was to compare the outcomes of endoscopic cartilage underlay myringoplasty(CNM) with or without balloon Eustachian tuboplasty (BET) for the treatment of chronic perforation with Eustachian tube dysfunction (ETD). MATERIALS AND METHODS: A total of 50 ears diagnosed with chronic perforation and ETD were randomly divided into receiving alone CNM and CNM + BET. During the 12 months follow-up, the Eustachian tube score (ETS), Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), ET inflammation scale, hearing results and graft success rate of the patients were recorded and analyzed. RESULTS: The improvement in the ETDQ-7 score was 6.23 ± 2.51 in the CNM + BET group, which was significantly higher than that in the CNM group (4.22 ± 3.85, P < 0.01) at postoperative 3 months, however, no significant between-group difference was found at post-12 months.The graft success rate was 88.0 % in the CNM group and 92.0 % in the CNM + BET group at postoperative 3 months (P > 0.05). Also, no significant difference was found among two groups (84.0 % vs 88.0 %, P > 0.05).The ABG improvement was 13.16 ± 3.19 dB in the CNM + BET group and 9.74 ± 2.56 dB in the CNM group, with a statistically significant between-group difference (P < 0.01)at postoperative 3 months. However, no significant between-group difference was found at postoperative 12 months. During followup process, neither complications nor patulous symptoms were noted. No patients developted atelectasis or otitis media with effusion. However, myringitis was seen in 8 % patients in the CNM group and 12 % patients in the CNM + BET group. CONCLUSIONS: Although BET combined with endoscopic cartilage myringoplasty had better short-term improvement of hearing and ETDQ-7 scores compared with endoscopic cartilage myringoplasty for the treatment of chronic large perforation with ETD, the long-term outcomes was not satisfactory. Also, BET did not improve the 3-and 12 months graft success rate.
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Background: This study aims to investigate the correlation between serum levels of interleukin-2 (IL-2) and interferong (IFN-g) and the clinical prognosis of patients with nasopharyngeal carcinoma (NPC). Additionally, the study aims to analyse the risk factors associated with this correlation. Methods: The clinical data of 195 NPC patients admitted to our hospital from October 2020 to October 2022 were selected for a retrospective study. Based on the Glasgow score, patients were divided into two groups: the good prognosis group (group g), consisting of patients who scored 0 points, and the poor prognosis group (group p), consisting of patients who scored 1-2 points. The levels of serum IL-2 and IFN-g were compared between the two groups, and the clinical values of serum IL-2 and IFN-g in the prognosis of patients were analysed. The clinical parameters of the patients were collected, and the risk factors affecting the prognosis of NPC were analysed by univariate and multivariate logistic regression.
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OBJECTIVE: The objective of this study was to evaluate the graft outcomes of endoscopic perichondrium-cartilage myringoplasty with preserving of anterior margins for repairing anterior perforation with 3 year followup. STUDY DESIGN: Prospective case series. SETTING: Tertiary university hospital. MATERIALS AND METHODS: We performed a prospective study in 47 patients with anterior perforation who underwent perichondrium-cartilage myringoplasty with preserving of anterior margins and tuck grafts. The operation time, graft success rate, hearing outcome, and complications were evaluated at 6 months and 3 years after surgery. RESULTS: A total of 47 ears with anterior marginal perforation were included in the study. The perforation size was subtotal in 2 (4.3%) eras, large in 11 (23.4%) ears, medium in 27 (57.4%) ears, and small in 7 (14.9%). The mean operation time was 41.2 ± 5.4 minutes. All patients completed 6 months of follow-up. Residual perforation was observed in 2 patients with medium perforations, the graft success rate was 95.7% (45/47). The mean preoperative and postoperative AC PTAs were 38.1 ± 7.3 dB and 25.4 ± 4.6 dB (P < .05), while the mean preoperative and postoperative BC PTAs were 9.0 ± 4.6 dB and 9.6 ± 1.9 dB (P = .672). The functional success was 91.5% (43/47). None of the patients reported sensorineural hearing loss, altered taste, facial nerve palsy, vertigo, or tinnitus during the follow-up period. In addition, 34 (72.3%) patients completed 3 years followup and performed temporal bone CT examination, the mean followup time was 39.1 ± 2.7 months, CT revealed the well pneumatization of mastoids and middle ear. CONCLUSIONS: Endoscopic perichondrium-cartilage myringoplasty with preserving of anterior margins and tuck grafts is a safe, suitable, and reliable method for repair of anterior perforation with few risk of anterior blunting and lateralization.
Subject(s)
Myringoplasty , Tympanic Membrane Perforation , Humans , Myringoplasty/methods , Prospective Studies , Tympanic Membrane Perforation/surgery , Treatment Outcome , Cartilage , Retrospective StudiesABSTRACT
The purpose of this experiment was to explore the effects and mechanism of circ_KATNAL1 on inflammatory injury and apoptosis of human middle ear epithelial cells (HMEECs) induced by lipopolysaccharide (LPS). For this aim, the cell inflammatory injury model was established by HMEECs cells induced by LPS. It was divided into a blank control, model, circ_KATNAL1 and circ_KATNAL1 + LPS groups. The cell viability was detected by the MTT method. The apoptosis rate of each group was detected by flow cytometry. The cell migration ability of each group was detected by cell scratch assay. The mRNA expression levels of miR-153-3p and TLR4 in the cells of each group were detected by RT -PCR method. The protein expressions of BCL-2 and TLR4 in the cells of each group were detected by WB method. The levels of IL-6 and TNF-α were detected by ELISA method. Results showed that compared with the control group, the cell viability in the model group was decreased, the cell apoptosis rate was increased, the cell migration ability was weakened, the mRNA expression level of miR-153-3p and protein expression level of BCL-2 in the cells were decreased, and the mRNA and protein expression levels of TLR4 were increased and the levels of IL-6 and TNF-α in the cell supernatant were increased. Compared with the model group, the cell viability in the circ_KATNAL1 group was increased, the cell apoptosis rate was decreased, and the cell migration ability was increased, the mRNA expression level of miR-153-3p and BCL-2 protein expression level in the cells were increased, the mRNA and protein expression levels of TLR4 were decreased, and the contents of IL-6 and TNF-α in the cell supernatant were decreased. Compared with the model group, the cell viability in the circ_KATNAL1 + LPS group was decreased, cell apoptosis rate was increased, cell migration ability was weakened, the mRNA expression level of miR-153-3p and protein expression level of BCL-2 in cells were decreased, mRNA and protein expression levels of TLR4 were increased, and the content of IL-6 and TNF-α in the cell supernatant were increased. The differences were all statistically significant (P ﹤0.05). It showed that LPS could promote cell injury by increasing inflammatory cell pyroptosis, and the abnormal expression of circ_KATNAL1 played an important role in cell inflammation induced by LPS. Up-regulation of circ_KATNAL1 could promote inflammatory pyroptosis in HMEECs induced by LPS. miR-153-5p and TLR4 were downstream targets of circ_KATNAL1. The inhibition of miR- 153-5p or up-regulation of TLR4 could reverse the protective effects of silencing circ_KATNAL1. In conclusion, circ_KATNAL1 can promote an inflammatory role in human middle ear epithelial cells through the miR- 31-5p / TLR4 axis, which may become an important target for the diagnosis and treatment of otitis media.
Subject(s)
Lipopolysaccharides , MicroRNAs , Humans , Apoptosis/genetics , Ear, Middle , Epithelial Cells , Inflammation/genetics , Interleukin-6/genetics , Lipopolysaccharides/pharmacology , MicroRNAs/genetics , Toll-Like Receptor 4/genetics , Tumor Necrosis Factor-alpha/geneticsABSTRACT
OBJECTIVE: The objective of this study was to compare the healing outcome of fibroblast growth factor 2 (FGF2), ofloxacin ear drops (OFLX) and spontaneous healing for repairing large traumatic tympanic membrane (TM) perforations. MATERIAL AND METHODS: A total of 75 traumatic large perforations with >1/4 of TM were randomly divided into FGF2 (n = 25), OFLX (n = 25), and spontaneous healing (n = 25) groups. The closure rates, closure times, and hearing gains were compared at 3 months. RESULTS: At 2 weeks after treatment, the closure rate was 95.8 % in the FGF2 group, 96.0 % in the ofloxacin ear drops group, and 14.3 % in the spontaneous healing group (P < 0.01), respectively. At 3 months after treatment, the closure rate was 100 % in the FGF2 group, 100 % in the OFLX group, and 85.7 % in the spontaneous healing group, no among-group differences were significant (P > 0.05). The mean closure time was 9.69 ± 2.46 days in the FGF2 group, 9.45 ± 2.32 days in the OFLX group, and 30.94 ± 8.95 days in the spontaneous healing group (P < 0.01). The mean ABG was 10.37 ± 2.51 dB for the FGF2 group, 11.01 ± 1.31 dB for the OFLX group, and 10.86 ± 1.94 dB for the spontaneous healing group, no significant difference was found among three groups (P > 0.05). CONCLUSIONS: This study suggested that both FGF2 and OFLX significantly shortened the mean closure time and improved the closure rate compared with spontaneous healing for repairing large traumatic perforations, while the healing outcome wasn't significantly different among FGF2 and OFLX groups.
Subject(s)
Ofloxacin , Tympanic Membrane Perforation , Humans , Ofloxacin/therapeutic use , Fibroblast Growth Factor 2 , Tympanic Membrane , Wound Healing , Treatment Outcome , Tympanic Membrane Perforation/drug therapy , Tympanic Membrane Perforation/etiologyABSTRACT
To explore the correlation between pure tone audiometry at all frequencies and distortion product otoacoustic emission (DPOAE) of hidden hearing loss (HHL). The workers exposed to noise from a factory in Zhangjiakou (noise exposure group, n = 73) and normal young and middle-aged people recruited by society (control group, n = 77) from August 2021 to April 2022 were study subjects, and all of them underwent audiometry in clinic. Compared with the control group, the noise exposure group had significantly higher threshold by extended high-frequency audiometry at all frequencies and higher signal-to-noise ratio threshold (SNR50) (all P < 0.001), and higher amplitude ratio of SP to AP of the waveform induced by short sound at 96, 90, 80 and 70 dB nHL and lower SNR at 6 kHz and above (all P < 0.05). The pure tone audiometry was correlated with DPOAE test results at the frequencies of 6, 8, 9 and 10 kHz (P < 0.001). The results of speech audiometry in noise were related to the average SNR of DPOAE test at each frequency (P = 0.026,r = -0.265). The ratio of SP to AP in electrocochleogram recorded at the intensity of 96 dB nHL was correlated with the average SNR at 6 kHz and above in DPOAE test (P = 0.018,r = -0.461), and with the average auditory threshold at each frequency in extended high-frequency audiometry (P = 0.032, r = 0.421). DPOAE has certain value in detecting HHL.
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OBJECTIVE: The objective of this study was to compare the efficacy of ofloxacin ear drops, vaseline gauze (VG) and dry gelfoam alone on the large traumatic perforations of tympanic membrane (TM). MATERIAL AND METHODS: A randomized prospective analysis was performed for the treatment of traumatic perforation larger than 25 % of the entire TM. The closure rate, closure time, and hearing gain between ofloxacin ear drops, VG and gelfoam alone groups were compared at 3 months. RESULTS: Final analysis was performed on 70 patients. The closure rates of perforation in the ofloxacin ear drops, VG, and dry gelfoam patch groups were 100.0 %, 92.0 %, and 87.5 %, respectively (P = 0.41).The mean closure times were 8.67 ± 3.1, 10.65 ± 4.2, and 14.33 ± 7.5 days for the ofloxacin ear drops, VG, and gelfoam patch alone groups, respectively. The closure times among the 3 groups were significantly different (P = 0.003). In addition, there was a significant difference between the ofloxacin ear drops and gelfoam patch alone groups with regard to closure time (P = 0.003), while there was no significant difference between the ofloxacin ear drops and VG groups (P = 0.080) or VG and gelfoam patch groups (P = 0.056).The mean hearing gain was 11.4 ± 2.3 dB for the ofloxacin ear drops group, 11.7 ± 4.1 dB for the VG group, and 12.2 ± 1.6 dB for the gelfoam patch group (P = 0.69). CONCLUSIONS: The repairing of traumatic perforations didn't require an exogenous biological scaffold. Ofloxacin ear drops and VG were a deal material for repairing traumatic perforation in otology clinic, which not only was readily available and inexpensive but also showed faster closure compared with dry gelfoam alone.
Subject(s)
Tympanic Membrane Perforation , Tympanic Membrane , Humans , Tympanic Membrane Perforation/therapy , Tympanic Membrane Perforation/drug therapy , Wound Healing , Treatment Outcome , Randomized Controlled Trials as Topic , Ofloxacin/therapeutic useABSTRACT
Background: To investigate the pathophysiology of age-related hearing loss (ARHL) and the mechanism of resveratrol (RSV) in prevention and treatment of ARHL. Methods: C57BL/6 mice of different ages were used in this study. Auditory brainstem response (ABR) was performed to assess hearing and identify abnormalities. Surface preparation and hair cell-specific marker Myo VIIa were employed to evaluated cochlear hair cell losses. Scanning electron microscopy (SEM) was to observe the microstructure of the organ of Corti (OC). The expression of related proteins in the RIPK1/RIPK3/MLKL pathway in cochlear tissue was detected by immunofluorescence. Results: In old mice (15 months), the ABR threshold increased significantly compared with the young mice. After 50 mg/kg RSV intervention, the hearing threshold of the old mice was significantly reduced at 8 kHz and 12 kHz as well as click. 100 mg/kg RSV led to a statistically significant reduction in hearing threshold only at clicks, whereas 300 mg/kg RSV showed no difference at all frequencies tested. In terms of cochlear hair cell loss, the damage of OHC and IHC was severe in old mice, but the damage was evidently reduced in RSV 50 mg/kg group. Notably, in the RSV 300 mg/kg group, the loss and disorientation of both the OHCs and IHCs were aggravated. Under SEM, a large number of OHCs were lost in the old group, but increased significantly in the RSV 50 mg/kg group, and even the OHCs were more seriously damaged in the RSV 300 mg/kg group. Furthermore, immunofluorescence showed that 50 mg/kg RSV significantly reduced the expression of RIPK3, RIPK1, and MLKL in the cochlea during aging, especially in necroptosis-sensitive regions OCs and SGN. Conclusion: Low-dose RSV inhibited RIPK3-mediated necroptosis in aging cochlea and delayed the onset of ARHL, which was a promising therapeutic strategy for ARHL.
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(1) Background: To enhance the walking-assistance efficiencies of exoskeletons, this paper proposed the biomechanical-based cooperativity model based on a passive exoskeleton prototype to fill the technical gap in exoskeleton design regarding the torque transmission law between humans and exoskeletons. (2) Methods: The cooperativity model was used to solve the key system parameters based on the minimum average dispersion degree, in which the average dispersion degree algorithm based on the joint angle was designed and applied. (3) Results: The influence of the cooperativity model on the exoskeleton was indicated by comparing the walking-assistance efficiencies of the exoskeletons with the same structure but with different elastic parameters of the energy storage components, in which the exoskeleton based on the cooperativity design exhibited the highest walking-assistance performance. The walking-assistance efficiency of the exoskeleton with the optimal parameter combinations was also tested by comparing the respiratory metabolisms with and without the exoskeleton, in which the exoskeleton provided the average walking-assistance efficiency of 14.45% for more than 80% of the subjects. (4) Conclusions: The effects of the cooperativity model on exoskeletons were proven, but the accuracy and efficiency of the model still have room for improvement, especially the accuracy of the offset principle.
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OBJECTIVE: The objective of this was to evaluate anatomical and hearing results of modified inlay butterfly perichondrium-cartilage myringoplasty for repairing central perforation in an office setting. MATERIAL AND METHODS: We performed a prospective study in 81 patients with chronic central perforations who underwent modified inlay butterfly perichondrium-cartilage myringoplasty in an office setting. The graft success rate, hearing outcome, and complications were evaluated at postoperative 3, 6 and 24 months. RESULTS: 81 patients with 81chronic perforations were included in this study. The graft success rate was 100.0% (81/81) at postoperative 3 months. At postoperative 24 months, 16 patients lost follow-up, the graft success rate was 98.5% (64/65). The mean preoperative ABG was 23.0 ± 2.6 dB, while the mean postoperative ABG postoperatively 12 months was 11.4 ± 3.1 dB; the difference between these values was significant (P < .05). No graft-related complications (e.g., graft lateralization, graft medialization, graft keratin pearl, middle ear cholesteatoma) were encountered during the follow-up period. In addition, excess perichondrium lateral to the superficial layer of TM remnant became necrotic and crust at postoperative 2-3 months. However, graft keratin pearl and intra-tympanic cholesteatoma/epithelial inclusion cyst weren't found in any patients at postoperative 24 months. Granular myringitis with minimal moistness but without infection has been noted in 6 patients. CONCLUSIONS: Modified inlay butterfly perichondrium-cartilage myringoplasty is a viable and less invasive option for closure of central perforations in an office setting because this technique does not require tympanomeatal flap elevation and general anesthesia.
Subject(s)
Cholesteatoma, Middle Ear , Tympanic Membrane Perforation , Cartilage/transplantation , Cholesteatoma, Middle Ear/surgery , Endoscopy/methods , Hearing , Humans , Keratins , Myringoplasty/methods , Outpatients , Postoperative Complications/epidemiology , Postoperative Complications/surgery , Prospective Studies , Treatment Outcome , Tympanic Membrane Perforation/etiology , Tympanic Membrane Perforation/surgeryABSTRACT
OBJECTIVE: The objective of this study was evaluate the short-and long-term graft outcome and complications of endoscopic modified perichondrium-cartilage sandwich graft for repairing chronic subtotal and total perforations. STUDY DESIGN: Prospective case series. MATERIALS AND METHODS: 135 patients with chronic subtotal and total perforations who underwent endoscopic modified perichondrium-cartilage sandwich graft technique. The graft success rate, hearing outcome, and complications were evaluated at postoperative 6 and 24 months. RESULTS: 124 patients were finally included in this study. The graft success rate was 96.3% in subtotal perforation and 97.7% in total perforation (P = 0.874), with an overall success rate of 96.8% at postoperative 6 months. The graft success rate was 95.8% (68/71) in subtotal perforation and 94.9% (37/39) in total perforation (P = 0.795), with an overall success rate of 95.5% (105/110) at postoperative 24 months. The mean ABG improved from 28.0 ± 5.3 dB preoperatively to 14.9 ± 4.8 dB postoperatively 12 months (P < 0.05) for subtotal perforations; from 33.4 ± 7.4 dB preoperatively to 16.1 ± 2.4 dB postoperatively 12 months (P < 0.05) for total perforations. No graft-related complications (e.g., graft lateralization, significant blunting, graft medialization) were encountered during the follow-up period. Of the 110 patients, temporal bone CT revealed well pneumatization of the middle ear and mastoid region. However, graft keratin pearl was noticed in 1.8% (2/110) patients. CONCLUSIONS: Endoscopic modified perichondrium-cartilage sandwich graft for repairing subtotal and total perforations had excellent short and long-term graft success rate with less time-consuming and minimal complications.
Subject(s)
Ear Cartilage/transplantation , Endoscopy/methods , Myringoplasty/methods , Tympanic Membrane Perforation/surgery , Adult , Aged , Audiometry, Pure-Tone , Chronic Disease , Female , Graft Survival , Hearing , Humans , Male , Middle Aged , Otitis Media/complications , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Period , Prospective Studies , Treatment Outcome , Tympanic Membrane Perforation/etiologyABSTRACT
Globally, depression is one of the most serious debilitating psychiatric mental disorders. In this study, we validated the expression levels of fibrinogen alpha (FGA), fibrinogen beta (FGB), fibrinogen gamma (FGG), Complement factor B (CFB) and serpin family D member 1(SERPIND1) in the acute phase response signaling pathway in plasma samples using enzyme-linked immunosorbent assay (ELISA).Then illuminate the roles of FGA, FGB, FGG, CFB, SERPIND1 in depression using microarray data. Gene expression dataset GSE98793 was downloaded from the Gene Expression Omnibus database. There were 128 whole blood samples included 64 patients with major depressed patients and 64 healthy controls. Differentially expressed genes (DEGs) were identified, and then protein-protein interaction (PPI) network was constructed to screen crucial genes associated with FGA, FGB, FGG, CFB and SERPIND1. Moreover, gene ontology (GO) biological processes analyses was performed. The ELISA data showed that the expression levels of FGA, FGB, FGG, CFB and SERPIND1 were up-regulated in depressed patients. The enriched GO terms were predominantly associated with the biological processes including more genes were inflammation related. The PPI network was found these five genes interacted with 11 genes. FGA, FGB, FGG, CFB and SERPIND1 may be important in the pathogenesis of depression.
Subject(s)
Acute-Phase Reaction/blood , Acute-Phase Reaction/diagnosis , Complement Factor B/metabolism , Depression/blood , Depression/diagnosis , Heparin Cofactor II/metabolism , Acute-Phase Reaction/psychology , Adult , Biomarkers/blood , Depression/psychology , Female , Fibrinogen/metabolism , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: To explore the relationship between family environment and depressive symptoms and to evaluate the influence of hard and soft family environmental factors on depression levels in a large sample of university students in China. METHODS: A multi-stage stratified sampling procedure was used to select 6,000 participants. The response rate was 88.8%, with 5,329 students completing the Beck Depression Inventory (BDI) and the Family Environment Scale Chinese Version (FES-CV), which was adapted for the Chinese population. Differences between the groups were tested for significance by the Student's t-test; ANOVA was used to test continuous variables. The relationship between soft family environmental factors and BDI were tested by Pearson correlation analysis. Hierarchical linear regression analysis was conducted to model the effects of hard environmental factors and soft environmental factors on depression in university students. RESULTS: A total of 11.8% of students scored above the threshold of moderate depression (BDIâ§14). Hard family environmental factors such as parent relationship, family economic status, level of parental literacy and non-intact family structure were associated with depressive symptoms. The soft family environmental factors--conflict and control--were positively associated with depression, while cohesion was negatively related to depressive symptom after controlling for other important associates of depression. Hierarchical regression analysis indicated that the soft family environment correlates more strongly with depression than the hard family environment. CONCLUSIONS: Soft family environmental factors--especially cohesion, conflict and control--appeared to play an important role in the occurrence of depressive symptoms. These findings underline the significance of the family environment as a source of risk factors for depression among university students in China and suggest that family-based interventions and improvement are very important to reduce depression among university students.
Subject(s)
Depression/psychology , Environment , Students/psychology , Adult , China , Female , Humans , Male , Personality Inventory , Psychiatric Status Rating Scales , Risk Factors , Socioeconomic Factors , Surveys and Questionnaires , Universities , Young AdultABSTRACT
BACKGROUND: Burnout is recognized as an occupational hazard, and nursing has a high risk of burnout. This study aims to explore the relationship between psychological capital (PsyCap) and burnout among Chinese nurses and the mediating role of coping style in this relationship. METHODS: A total of 1,496 nurses (effective response rate: 80.11%) from two large general hospitals in Daqing City of China were selected as participants. Data were collected via the Chinese Maslach Burnout Inventory (CMBI), the psychological capital questionnaire (PCQ-24), the Chinese Trait Coping Style Questionnaire (TCSQ) and demographic and caregiver-patient relationship. Hierarchical linear regression analyses were performed to explore the mediating role of positive coping and negative coping, and we used the Bootstrap method to confirm the mediating effect. RESULTS: Self-efficacy, hope, resilience and optimism of nurses were all negatively related with emotional exhaustion, depersonalization and reduced personal accomplishment among Chinese nurses. Positive coping partially mediated the relationship between hope/optimism and emotional exhaustion and between self-efficacy/optimism and reduced personal accomplishment. Negative coping fully mediated the relationship between self-efficacy and emotional exhaustion, and in the regression model self-efficacy was positively correlated with emotional exhaustion. And negative coping also partially mediated the relationship between hope/optimism and emotional exhaustion and between optimism and depersonalization. CONCLUSION: PsyCap had effects on burnout and coping style was a mediator in this relationship among Chinese nurses. Nurses who had a strong sense of self-efficacy adopted more negative coping style, which in turn would lead to higher levels of emotional exhaustion. These findings shed light on the influence of negative coping on burnout, and positive coping was a positive resource for fighting against nurses' burnout. Hence, in order to avoid negative coping style, improve skill of coping and enhance PsyCap of nurses, active interventions should be developed in the future.