Effect of Electroacupuncture Added to ERAS on Perioperative Parameters and Postoperative Quality of Life in Breast Cancer: A Single-Center, Randomized Controlled Trial.

PURPOSE: Acupuncture is a potentially beneficial addition to the enhanced recovery after surgery (ERAS) strategy for improving the quality of surgical care for breast cancer. This study evaluated the advantages of acupuncture in postoperative recovery after breast cancer surgery. DESIGN: A prospective, blinded, randomized, case-control study. METHODS: In this single-center, parallel-group, randomized controlled trial, 144 breast cancer patients undergoing surgery were allocated to the following groups: (group A) conventional group (no acupuncture treatment); (group B) preoperative acupuncture (acupuncture treatment given 1 day before surgery); (group C) intraoperative acupuncture (acupuncture treatment given on the day of surgery); and (group D) a combination of preoperative and intraoperative acupuncture (n = 36/group). The primary outcome was the intraoperative consumption of anesthetics. The secondary outcomes included heart rate and blood pressure changes, intraoperative blood glucose level, pH, and bispectral index, recovery and extubation time, postoperative functional assessment of cancer therapy-breast score, and adverse reactions. FINDINGS: Intraoperative consumption of sufentanil and blood glucose level was significantly decreased in group C, and no interactive effect was found between the preoperative and intraoperative acupuncture groups. Preoperative heart rate in groups B and C showed significant changes. The 1-week postoperative functional assessment of cancer therapy-breast score was most markedly improved in group C compared with other groups. No adverse reaction occurred with acupuncture. CONCLUSIONS: Intraoperative acupuncture alone is adequate for optimizing the intraoperative state, and preoperative acupuncture seems unnecessary. Acupuncture is safe, with potential benefits for enhanced recovery after surgery in breast cancer surgery. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1800019979.

Tailoring Mechanical and Optical Properties of Sputtered SiNx/BN Coatings.

The swift evolution of contemporary electronics products, such as flexible screens and wearable electronic devices, highlights the significance of flexible protective coatings, which combine superior mechanical and optical properties. Even though the recently developed polymer protective coatings can satisfy requirements for flexibility and transparency, their intrinsic nature often results in a hardness below 1 GPa, rendering them susceptible to scratches. On the other hand, traditional inorganic coatings, known for their high hardness and transparency, fall short of meeting flexibility requirements. In the present study, a SiNx/BN periodical nanolayered coatings (PNCs) structure has been tailored to achieve high mechanical durability, transparency, and flexibility. In SiNx/BN PNCs, the optical and mechanical properties of the single-layer SiNx film are crucial to the overall performance of the PNCs. Therefore, pulse direct current (DC) magnetron sputtering was optimized first to enhance the ionization efficiency of Si and N, thereby promoting their reaction and diminishing the presence of elemental silicon in SiNx. The effects of the pulse frequency and duty cycle on SiNx were evaluated. Additionally, the influence of the thickness ratio and modulation periods on the overall performance of the SiNx/BN PNCs was investigated. As a result, a SiNx/BN coating with sapphire-grade hardness, almost no optical absorption in the visible-near-infrared (vis-NIR) range, high wear resistance, and exceptional flexibility was demonstrated.

Mid-Infrared Photons Alleviate Tinnitus by Activating the KCNQ2 Channel in the Auditory Cortex.

Tinnitus is a phantom auditory sensation often accompanied by hearing loss, cognitive impairments, and psychological disturbances in various populations. Dysfunction of KCNQ2 and KCNQ3 channels-voltage-dependent potassium ion channels-in the cochlear nucleus can cause tinnitus. Despite the recognized significance of KCNQ2 and KCNQ3 channels in the auditory cortex, their precise relationship and implications in the pathogenesis of tinnitus remain areas of scientific inquiry. This study aimed to elucidate the pathological roles of KCNQ2 and KCNQ3 channels within the auditory cortex in tinnitus development and examine the therapeutic potential of mid-infrared photons for tinnitus treatment. We utilized a noise-induced tinnitus model combined with immunofluorescence, electrophysiological recording, and molecular dynamic simulation to investigate the morphological and physiological alterations after inducing tinnitus. Moreover, in vivo irradiation was administered to verify the treatment effects of infrared photons. Tinnitus was verified by deficits of the gap ratio with similar prepulse inhibition ratio and auditory brainstem response threshold. We observed an important enhancement in neuronal excitability in the auditory cortex using patch-clamp recordings, which correlated with KCNQ2 and KCNQ3 channel dysfunction. After irradiation with infrared photons, excitatory neuron firing was inhibited owing to increased KCNQ2 current resulting from structural alterations in the filter region. Meanwhile, deficits of the acoustic startle response in tinnitus animals were alleviated by infrared photons. Furthermore, infrared photons reversed the abnormal hyperexcitability of excitatory neurons in the tinnitus group. This study provided a novel method for modulating neuron excitability in the auditory cortex using KCNQ2 channels through a nonthermal effect. Infrared photons effectively mitigated tinnitus-related behaviors by suppressing abnormal neural excitability, potentially laying the groundwork for innovative therapeutic approaches for tinnitus treatment.

Transcriptional profile changes caused by noise-induced tinnitus in the cochlear nucleus and inferior colliculus of the rat.

INTRODUCTION: Tinnitus is a prevalent and disabling condition characterized by the perception of sound in the absence of external acoustic stimuli. The hyperactivity of the auditory pathway is a crucial factor in the development of tinnitus. This study aims to examine genetic expression variations in the dorsal cochlear nucleus (DCN) and inferior colliculus (IC) following the onset of tinnitus using transcriptomic analysis. The goal is to investigate the relationship between hyperactivity in the DCN and IC. METHODS: To confirm the presence of tinnitus behavior, we utilized the gap pre-pulse inhibition of the acoustic startle (GPIAS) response paradigm. In addition, we conducted auditory brainstem response (ABR) tests to determine the baseline hearing thresholds, and repeated the test one week after subjecting the rats to noise exposure (8-16 kHz, 126 dBHL, 2 h). Samples of tissue were collected from the DCN and IC in both the tinnitus and non-tinnitus groups of rats. We employed RNA sequencing and quantitative PCR techniques to analyze the changes in gene expression between these two groups. This allowed us to identify any specific genes or gene pathways that may be associated with the development or maintenance of tinnitus in the DCN and IC. RESULTS: Our results demonstrated tinnitus-like behavior in rats exposed to noise, as evidenced by GPIAS measurements. We identified 61 upregulated genes and 189 downregulated genes in the DCN, along with 396 upregulated genes and 195 downregulated genes in the IC. Enrichment analysis of the DCN revealed the involvement of ion transmembrane transport regulation, synaptic transmission, and negative regulation of neuron apoptotic processes in the development of tinnitus. In the IC, the enrichment analysis indicated that glutamatergic synapses and neuroactive ligand-receptor interaction pathways may significantly contribute to the process of tinnitus development. Additionally, protein-protein interaction (PPI) networks were constructed, and 9 hub genes were selected based on their betweenness centrality rank in the DCN and IC, respectively. CONCLUSIONS: Our findings reveal enrichment of differential expressed genes (DEGs) associated with pathways linked to alterations in neuronal excitability within the DCN and IC when comparing the tinnitus group to the non-tinnitus group. This indicates an increased trend in neuronal excitability within both the DCN and IC in the tinnitus model rats. Additionally, the enriched signaling pathways within the DCN related to changes in synaptic plasticity suggest that the excitability changes may propagate to IC. NEW AND NOTEWORTHY: Our findings reveal gene expression alterations in neuronal excitability within the DCN and IC when comparing the tinnitus group to the non-tinnitus group at the transcriptome level. Additionally, the enriched signaling pathways related to changes in synaptic plasticity in the differentially expressed genes within the DCN suggest that the excitability changes may propagate to IC.

Global research trends in acupuncture treatment for post-stroke depression: A bibliometric analysis.

OBJECTIVE: Post-stroke depression (PSD) is a prevalent and severe sequela of stroke. It is an emotional disorder that significantly impacts functional recovery, prognosis, secondary stroke risk, and mortality among stroke survivors. The incidence rate of PSD is 18 %∼33 %, with symptoms such as low mood, decreased interest, sleep disorders, decreased appetite, impaired attention, and in severe cases, hallucinations and even suicidal tendencies. While diverse therapeutic modalities are employed globally to address PSD, each approach carries its inherent advantages and limitations. Notably, acupuncture stands out as a promising and effective intervention for ameliorating PSD symptoms and enhancing stroke prognosis. This study aims to conduct a bibliometric analysis to scrutinize the current landscape, identify hotspots, and explore frontiers in acupuncture research for PSD. METHODS: A systematic search for acupuncture and PSD-related research was conducted from January 2014 to October 2023 on the Web of Science Core Collection (WoSCC). The data were downloaded and processed using Bibliometrix and VOSviewer to generate knowledge visualization maps. RESULTS: A total of 11,540 articles related to acupuncture and PSD were retrieved. China emerged as the leading contributor with the highest volume of articles on acupuncture and PSD. Author Liu CZ attained the highest H-index, focusing primarily on investigating the compatibility effects and mechanisms of acupoints. Common hotspot keywords included pain, stimulation, mechanisms, complementary, and alternative medicine. The main research frontiers were mechanisms, neuroinflammation, gut microbiota, and therapeutic methods. CONCLUSION: This study offered multifaceted insights into acupuncture for PSD, unveiling pivotal areas, research hotspots, and emerging trends. The findings aimed to guide researchers in exploring novel research directions and selecting appropriate journals for advancing the understanding and treatment of PSD through acupuncture interventions.

Acupuncture ameliorates depression-like behavior of poststroke depression model rats through the regulation of gut microbiota and NLRP3 inflammasome in the colon.

This study was conducted to examine the effects of acupuncture on gut microbiota and expression of NLRP3 inflammasome in the colon in poststroke depression (PSD) model rats. Sprague-Dawley male rats were randomized into four groups: sham surgery group, poststroke depression group, acupuncture group, and probiotics group. Acupuncture therapy at Baihui (GV20), Shenting (GV24), bilateral Zusanli (ST36) acupoints in the acupuncture group and probiotic gavage therapy in the probiotics group were performed once per day for 2 weeks. Behaviors of depression were assessed by using weight measurements, sucrose preference test, open field test, and forced swimming test. Histopathological alterations in the colon were determined by hematoxylin-eosin staining, the expression of NLRP3/ASC/caspase-1 pathway-related proteins was analyzed by western blotting. Serum levels of IL-1ß and IL-18 were derived from ELISA. The 16S rRNA gene sequencing was performed to examine and analyze the differences of gut microbiota of rats among all groups. Acupuncture was effective to increase weight and ameliorate depressive-like behaviors in PSD rats. Acupuncture increased the diversity of gut microbiota, upregulated the abundance of Bifidobacteriaceae and Lactobacillaceae, and decreased the relative abundance of Peptostreptococcaceae, Rikenellaceae, Eggerthellaceae, and Streptococcaceae at family level. Acupuncture effectively improved the pathological changes in the colon. Meanwhile, acupuncture reduced NLRP3, ASC, caspase-1 protein expressions in the colon, and serum levels of IL-18 and IL-1ß. Acupuncture may reduce depressive-like behaviors of PSD by regulating the gut microbiota and suppressing hyperactivation of NLRP3 inflammasome in the colon. Microbiota-gut-brain axis may be an effective target pathway for acupuncture treatment of PSD.

[Baroreflex failure syndrome after the resection of complex paragangliomas of head and neck: a case report].

Protection of cranial nerves is one of the major challenges in the resection of paragangliomas of head and neck, especially in complex paragangliomas. We report a case of bilateral jugular tumor with unilateral carotid body tumor. Baroreflex failure syndrome（BFS） occurred after staged resection of bilateral lesions. There is still a lack of effective treatment for this complication. More prudent and reasonable treatment strategy is important to reduce the incidence of BFS.

Glutathione­degrading enzymes in the complex landscape of tumors (Review).

Glutathione (GSH)­degrading enzymes are essential for starting the first stages of GSH degradation. These enzymes include extracellular γ­glutamyl transpeptidase (GGT) and intracellular GSH­specific γ­glutamylcyclotransferase 1 (ChaC1) and 2. These enzymes are essential for cellular activities, such as immune response, differentiation, proliferation, homeostasis regulation and programmed cell death. Tumor tissue frequently exhibits abnormal expression of GSH­degrading enzymes, which has a key impact on the development and spread of malignancies. The present review summarizes gene and protein structure, catalytic activity and regulation of GSH­degrading enzymes, their vital roles in tumor development (including regulation of oxidative and endoplasmic reticulum stress, control of programmed cell death, promotion of inflammation and tumorigenesis and modulation of drug resistance in tumor cells) and potential role as diagnostic biomarkers and therapeutic targets.

Hyaluronic acid-conjugated methotrexate and 5-fluorouracil for targeted drug delivery.

The delivery of chemotherapeutical drugs via nanomaterials has become a focus of pharmaceutical research over several decades due to improved drug delivery to cancer cells, decreased side effects on normal tissues, and increased therapeutic efficacy. Herein, a novel hyaluronic acid-conjugated methotrexate and 5-fluorouracil nanodrug system has been developed to address the critical limitations associated with the high toxicity and side effects of methotrexate and 5-fluorouracil. Furthermore, this nanodrug system enhances the targeting capacity of drug molecules and facilitates the potential integration of multimodal drug therapies. Concomitantly, the synergistic effects of MTX with 5-fluorouracil have been shown to improve the therapeutic index of MTX while attenuating the associated toxicities of MTX. The structure and micromorphology of the novel nanodrug can be confirmed by 1HNMR, FT-IR, UV-Vis, DLS, TEM, and AFM. Due to the ability of HA to bind to CD44 receptors activated on the surface of cancer cells and its enhanced permeability and retention (EPR) effect, the novel nanodrug we designed and synthesized can effectively target cancer cells. Cell counting Kit-8 (CCK8), flow cytometry, and live-dead staining assays in vitro showed that this nanodrug system had high targeting and antitumor activity against CD44 receptors. By using drugs to act on patient-derived colorectal, liver, and breast cancer organoids, the anticancer effect of the nanodrug was identified and verified. These results showed that the nanodrug system developed in this study may have great potential as a targeted therapy for cancer.

The Association Between Tinnitus Sensation-Level Loudness and Sleep Quality in Patients With Subjective Consecutive Tinnitus: A Mediation Analysis.

PURPOSE: So far, there have been no in-depth analyses of the connection between tinnitus sensation-level loudness and sleep quality. Accordingly, the present study was formulated as a mediation analysis focused on exploring this relationship. METHOD: Overall, 1,255 adults with consecutive subjective tinnitus who had sought outpatient treatment were enrolled in the present study. RESULTS: Direct effects of tinnitus sensation-level loudness on sleep quality were not statistically significant (95% confidence intervals [CI] include zero), as measured by the point estimate, -0.016. However, the 95% CI for indirect effects did not include zero when assessing the Self-Rating Anxiety Scale (SAS) scores, the Self-Rating Depression Scale (SDS) scores, the visual analogue scale (VAS) scores, and self-reported tinnitus annoyance. CONCLUSIONS: These results suggest that tinnitus sensation-level loudness does not directly have an effect on sleep quality. However, it indirectly impacts sleep quality, mediated by SAS scores, SDS scores, the impact of tinnitus on life measured using the VAS, and self-reported tinnitus annoyance. As such, alleviating anxiety and depression in patients with tinnitus may result in reductions in their insomnia even if there is no reduction in tinnitus loudness. Importantly, otolaryngologists and other clinicians treating tinnitus should refer patients with tinnitus suffering from insomnia with comorbid depression or anxiety for appropriate psychological and/or psychiatric treatment.

Connexin 43 Prevents Radiation-Induced Intestinal Damage via the Ca2+-Dependent PI3K/Akt Signaling Pathway.

Radiation-induced intestinal damage (RIID) is a common side effect of radiotherapy in patients with abdominopelvic malignancies. Gap junctions are special structures consisting of connexins (Cxs). This study aimed to investigate the expression and role of connexins in RIID and underlying mechanism. In this study, a calcein-AM fluorescence probe was used to detect changes in gap junctional intercellular communication in intestinal epithelial IEC-6 cells. Our results show that gap junctional intercellular communication of IEC-6 cells was reduced at 6, 12, 24, and 48 h after irradiation, with the most pronounced effect at 24 h. Western blotting and immunofluorescence results showed that the expression of Cx43, but not other connexins, was reduced in irradiated intestinal epithelial cells. Silencing of Cx43 reduced gap junctional intercellular communication between irradiated intestinal epithelial cells with increased ROS and intracellular Ca2+ levels. Furthermore, knockdown of Cx43 reduced the number of clonal clusters, decreased cell proliferation with increased cytotoxicity and apoptosis. Western blotting results showed that silencing of Cx43 resulted in changed γ-H2AX and PI3K/AKT pathway proteins in irradiated intestinal epithelial cells. Administration of the PI3K/AKT pathway inhibitor LY294002 inhibited the radioprotective effects in Cx43-overexpressing intestinal epithelial cells. Our study demonstrated that Cx43 expression is decreased by ionizing radiation, which facilitates the radioprotection of intestinal epithelial cells.

[Clinical characteristics and prognosis of two anastomosis techniques in the treatment of facial nerve defects].

Objective:To investigate the characteristics and prognosis of two anastomosis techniques in repairing facial nerve defects. Methods:A retrospective analysis was conducted on 30 patients who underwent facial nerve anastomosis（direct or rerouting） for facial nerve defects in our department from January 2012 to December 2021. Among them, 21 were male and 9 were female, with an average age of（37.53±11.33） years, all with unilateral onset. Preoperative House-Brackmann（H-B） facial nerve function grades were Ⅳ in 2 cases, Ⅴ in 9 cases, and Ⅵin 19 cases. The duration of facial paralysis before surgery was within 6 months in 21 cases, 6-12 months in 6 cases, and over 1 year in 3 cases. The causes of facial paralysis included 14 cases of cholesteatoma, 6 cases of facial neurioma, 6 cases of trauma, and 4 cases of middle ear surgery injury. Surgical approaches included 9 cases of the middle cranial fossa approach, 8 cases of labyrinthine-otic approach, 7 cases of mastoid-epitympanum approach, and 6 cases of retroauricular lateral neck approach. Results:All patients were followed up for more than 2 years. The direct anastomosis was performed in 10 cases: 6 cases with defects located in the extratemporal segment and 4 cases in the tympanic segment. Rerouting anastomosis was performed in 20 cases: 11 cases with defects located in the labyrinthine-geniculate ganglion, 4 cases from the internal auditory canal to the geniculate ganglion, 3 cases in the internal auditory canal, and 2 cases in the horizontal-pyramid segment. Postoperative H-B facial nerve grades were Ⅱ in 2 cases, Ⅲ in 20 cases, and Ⅳ in 8 cases, with 73.3%（22/30） of patients achieving H-B grade Ⅲ or better. Conclusion:Both direct and rerouting anastomosis techniques can effectively repair facial nerve defects, with no significant difference in efficacy between the two techniques. Most patients can achieve H-B grade Ⅲ or better facial nerve function recovery. Preoperative facial nerve function and duration of facial paralysis are the main prognostic factors affecting the outcome of facial nerve anastomosis.

Treatment of Peripheral Facial Paralysis After COVID-19 Infection With Traditional Chinese Medicine Therapies: A Case Report.

Peripheral facial paralysis, characterized by facial expression and motor dysfunction of facial muscle groups, stems from lower motor neuron lesions of the facial nerve and can arise from various medical conditions such as viral infections, trauma, tumors, and autoimmune disorders, among others. It affects individuals across all age groups, from pediatric to geriatric populations. While many cases have no discernible cause, some are associated with infectious or non-infectious factors. Typically, most patients experience gradual recovery within one to three months following appropriate treatment in the acute phase, which may include inflammation control, antiviral therapy, reduction of neuroedema, and nerve nourishment. Although relatively rare, there have been few reports of peripheral facial paralysis following COVID-19 infection. Here, we present a case possibly linked to COVID-19: a 23-year-old male who reported numbness, facial asymmetry, and ear pain on the right side of his face persisting for five days after contracting COVID-19. Upon physical examination, peripheral facial paralysis of House-Brackmann grade IV was observed, prompting the initiation of traditional Chinese medicine (TCM) treatment. On the 10th day of treatment, acupoint catgut embedding was introduced as an adjunct therapy. Following four weeks of combined treatment, the patient's peripheral facial paralysis improved to grade I, and treatment was subsequently discontinued. TCM therapies, including acupuncture, electroacupuncture, plum blossom needle, moxibustion, acupoint catgut embedding, Chinese herbal medicine, etc., are safe and promising complementary treatments for the acute management of peripheral facial paralysis. However, additional large-scale, randomized controlled studies are needed to determine whether these interventions have a significant additive or synergistic effect on achieving full recovery in patients with peripheral facial paralysis.

Transcriptional-profile changes in the medial geniculate body after noise-induced tinnitus.

Tinnitus is a disturbing condition defined as the occurrence of acoustic hallucinations with no actual sound. Although the mechanisms underlying tinnitus have been explored extensively, the pathophysiology of the disease is not completely understood. Moreover, genes and potential treatment targets related to auditory hallucinations remain unknown. In this study, we examined transcriptional-profile changes in the medial geniculate body after noise-induced tinnitus in rats by performing RNA sequencing and validated differentially expressed genes via quantitative polymerase chain reaction analysis. The rat model of tinnitus was established by analyzing startle behavior based on gap-pre-pulse inhibition of acoustic startles. We identified 87 differently expressed genes, of which 40 were upregulated and 47 were downregulated. Pathway-enrichment analysis revealed that the differentially enriched genes in the tinnitus group were associated with pathway terms, such as coronavirus disease COVID-19, neuroactive ligand-receptor interaction. Protein-protein-interaction networks were established, and two hub genes (Rpl7a and AC136661.1) were identified among the selected genes. Further studies focusing on targeting and modulating these genes are required for developing potential treatments for noise-induced tinnitus in patients.

Targeted demethylation and activation of NLRC5 augment cancer immunogenicity through MHC class I.

Impaired expression of MHC (major histocompatibility complex) class I in cancers constitutes a major mechanism of immune evasion. It has been well documented that the low level of MHC class I is associated with poor prognosis and resistance to checkpoint blockade therapies. However, there is lmited approaches to specifically induce MHC class I to date. Here, we show an approach for robust and specific induction of MHC class I by targeting an MHC class I transactivator (CITA)/NLRC5, using a CRISPR/Cas9-based gene-specific system, designated TRED-I (Targeted reactivation and demethylation for MHC-I). The TRED-I system specifically recruits a demethylating enzyme and transcriptional activators on the NLRC5 promoter, driving increased MHC class I antigen presentation and accelerated CD8+ T cell activation. Introduction of the TRED-I system in an animal cancer model exhibited tumor-suppressive effects accompanied with increased infiltration and activation of CD8+ T cells. Moreover, this approach boosted the efficacy of checkpoint blockade therapy using anti-PD1 (programmed cell death protein) antibody. Therefore, targeting NLRC5 by this strategy provides an attractive therapeutic approach for cancer.

Exploration of the effects of Yang's pricking-cupping therapy on eczema-induced pruritus based on rs-fMRI. / 基于rs-fMRI探讨杨氏絮刺火罐对湿疹瘙痒的影响.

OBJECTIVES: To explore the clinical effect of Yang's pricking-cupping therapy and its central mechanism in treatment of eczema-induced pruritus using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: Fifty patients with eczema-induced pruritus were enrolled in the observation group, and 50 healthy subjects were enrolled in the control group. No any intervention was delivered in the control group. Yang's pricking-cupping therapy was operated at Dazhui (GV 14) and bilateral Quchi (LI 11), Xuehai (SP 10) and Sanyinjiao (SP 6), once a week, lasting 6 weeks in the observation group. The scores of the 12-item pruritus severity scale (12-PSS), the eczema area and severity index (EASI), the dermatology life quality index (DLQI), the Pittsburgh sleep quality index (PSQI), and the self-rating anxiety scale (SAS) were compared before and after treatment in the observation group. The rs-fMRI scanning was conducted and the regional homogeneity (ReHo) analysis performed in all of the participants before and after treatment in the observation group, as well as at the time of subject enrollment in the control group. The correlation was analyzed between ReHo values in the different areas of the brain and the scores of the above scales. RESULTS: Compared with those before treatment, the scores of 12-PSS, EASI, DLQI, PSQI, and SAS were reduced after treatment in the observation group (P<0.01, P<0.05). ReHo values were increased in the right caudate nucleus, the right middle temporal gyrus, the right orbitofrontal gyrus, the right thalamus and the left angular gyrus before treatment in the observation group when compared with those in the control group (P<0.001); and ReHo values in the above areas of the brain were decreased after treatment when compared with those before treatment in the observation group (P<0.001). In comparison with the control group, ReHo values were reduced in the left middle temporal gyrus, the left superior parietal lobule and the left supplementary motor area in the observation group before treatment (P<0.001); while when compared with those before treatment, ReHo values in the above areas of the brain were elevated after treatment in the observation group (P<0.001). Before treatment, ReHo value in the left supplementary motor area was positively correlated with 12-PSS score (r=0.432, P=0.004), and the value in the right orbitofrontal gyrus was negatively correlated with PSQI score (r=-0.318, P=0.04) in the observation group. After treatment, ReHo value in the left superior parietal lobule was positively correlated with 12-PSS score (r=0.384, P=0.012) in the observation group. CONCLUSIONS: The abnormal cerebral functional activities are exhibited in multiple areas of the brain involved in stimulus response, emotional regulation, behavior control and attention in the patients with eczema-induced pruritus. Yang's pricking-cupping therapy can effectively relieve the pruritus symptoms and skin lesions of the patients, which may be related to reversing the abnormal cerebral functional activities induced by pruritus.

Establishment of Nomogram for Prediction of Hearing Preservation after Retrosigmoid Approach in Patients with Vestibular Schwannoma.

OBJECTIVE: To derive and validate a prognostic nomogram for the prediction of hearing preservation (HP) after retrosigmoid approach (RSA) in patients with vestibular schwannoma (VS) and further assist in clinical decision-making. STUDY DESIGN: Retrospective study. SETTING: Tertiary referral center. PATIENTS: A total of 111 patients diagnosed with VS with serviceable hearing from January 2013 to March 2023. INTERVENTIONS: All patients underwent surgery via RSA, and hearing outcomes were reviewed 2 weeks postoperatively. MAIN OUTCOME MEASURES: Preoperative and postoperative hearing were analyzed and stratified according to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). RESULTS: In multivariate analysis of the primary group, preoperative hearing, tumor size, and tumor origin were significantly related to postoperative HP ( p = 0.029, p = 0.043, and p = 0.018, respectively). Factors derived from the multivariate analysis were all assembled into the nomogram. The receiver operating characteristic (ROC) curves showed good predictive accuracy of the nomogram model in both primary and validation groups with area under the ROC curve (AUC) values of 0.802 and 0.797, respectively. CONCLUSION: Independent predictors of postoperative HP in patients with VS were selected to create the nomogram. The nomogram was able to stratify patients into different risk groups and assist in clinical decision making.

The significance of extended high-frequency audiometry in tinnitus patients with normal hearing as evaluated via conventional pure tone audiometry.

OBJECTIVE: This study was designed to determine whether extended high-frequency audiometry was capable of better differentiating between participants with normal hearing who did or did not have subjective tinnitus. METHODS: A total of 96 study participants were enrolled: 36 patients with unilateral tinnitus, 28 patients with bilateral tinnitus and 32 volunteers as controls. All 96 participants exhibited normal audiometry findings and hearing thresholds. Extended high-frequency audiometry was used to evaluate these patients. RESULTS: There were differences between the extended high-frequency hearing thresholds of affected and unaffected ears in those with unilateral tinnitus, and in the 20-29-year-old bilateral tinnitus group, at 11.2, 12.5 and 14 kHz. Unilateral tinnitus subgroups had higher extended high-frequency hearing thresholds than those in control subjects, at all extended high frequencies. CONCLUSION: Extended high-frequency audiometry can offer additional information regarding the hearing status of patients with tinnitus who exhibit normal pure tone thresholds when analysed via conventional hearing thresholds.

Characterization and anti-tumor activities of polysaccharide isolated from Brassica rapa L. via activation of macrophages through TLR2-and TLR4-Dependent pathways.

We have previously shown the immunostimulatory effects by Nozawana (Brassica rapa L.). In this report, we determined the characteristics of Nozawana polysaccharide (NPS) and evaluated the immunomodulatory effects and anti-tumor activity of NPS mediated by macrophage activation. The molecular weight of NPS was determined by gel filtration chromatography with an average molecular weight of approximately 100.6 kDa. HPLC analysis showed that NPS contained glucose, galacturonic acid, galactose, and arabinose. NPS increased cytokine and nitric oxide (NO) production by macrophages in a Toll-like receptor (TLR)2 and TLR4-dependent manner. Furthermore, NPS induced apoptosis significantly against 4T1 murine breast cancer cells cultured in conditioned medium from NPS-treated macrophages through tumor necrosis factor-α. In tumor-bearing mouse model, tumor growth was significantly reduced in NPS-treated mice compared with control mice. These results support the potential use of NPS as an immunotherapeutic material found in health food products.

Acupuncture and Traditional Chinese Medicine in the Treatment of Peripheral Facial Palsy Caused by Wisdom Tooth Extraction: A Case Report.

BACKGROUND: Peripheral facial palsy is characterized by acute peripheral facial nerve paralysis. While most cases have no identifiable cause, some are linked to infectious or noninfectious factors. The potential connection between herpes simplex virus-1 and peripheral facial palsy has been studied since the 1970s, with a small number of cases reported following tooth extraction. Patients who have treatment delayed for over a year and still exhibit no signs of recovery have a bleak prognosis. In this case, factors contributing to facial paralysis in this patient are facial nerve injury as a result of wisdom teeth extraction, improper nursing, and delayed treatment. CASE PRESENTATION: A 23-year-old female presented with numbness and stiffness on the right side of the outer skin around the lips. These symptoms persisted for about 4 years after the extraction of the right lower wisdom tooth. Physical examination revealed House-Brackmann grade II peripheral facial paralysis. Acupuncture and traditional Chinese medicine treatments were initiated with an aim to facilitate nerve repair and neurofacilitation in the affected area. Following a 4-week course of treatment, the patient experienced a decrease in numbness and stiffness in the area, and treatment was discontinued. CONCLUSION: The combination of acupuncture and traditional Chinese medicine is a safe and promising supplementary therapy for peripheral facial palsy caused by wisdom tooth extraction. Nevertheless, it is imperative to conduct larger scale and randomized controlled studies to determine whether these complementary interventions have a significant additive or synergistic effect toward achieving complete recovery in the patients.Die periphere Fazialisparese ist durch eine akute periphere Gesichtsnervenlähmung gekennzeichnet. Meist ist keine erkennbare Ursache feststellbar, doch besteht bei einigen Fällen ein Zusammenhang mit infektiösen oder nicht-infektiösen Faktoren. Ein möglicher Zusammenhang zwischen dem Herpes-simplex-Virus-1 (HSV-1) und der peripheren Fazialisparese wird seit den 1970er Jahren untersucht, und es wurde über eine kleine Zahl von Fällen nach einer Zahnextraktion berichtet. Patienten, bei denen die Behandlung erst nach einjähriger Verzögerung oder noch später beginnt und die keine Anzeichen für eine Besserung zeigen, haben eine ungünstige Prognose. In diesem Fall sind die Faktoren, die zur Gesichtslähmung des Patienten beitragen, eine Verletzung des Nervus facialis infolge der Weisheitszahnextraktion, unsachgemäße Pflege und ein verzögerter Behandlungsbeginn.Eine 23-jährige Frau stellte sich mit Taubheitsgefühl und Steifigkeit auf der rechten Seite im Bereich der äußeren Haut um die Lippen herum vor. Die Symptome bestanden seit der Extraktion des rechten unteren Weisheitszahns etwa 4 Jahre zuvor. Die körperliche Untersuchung ergab eine periphere Fazialisparese Grad II nach House-Brackmann. Es wurde eine Behandlung mit Akupunktur und traditioneller chinesischer Medizin begonnen, um die Nervenreparatur und die Neurofazilitation im betroffenen Bereich zu fördern. Nach vierwöchiger Behandlung kam es bei der Patientin zu einer Abnahme des Taubheitsgefühls und der Steifigkeit im betroffenen Bereich und die Behandlung wurde beendet.Die Kombination von Akupunktur und traditioneller chinesischer Medizin ist eine sichere und erfolgversprechende ergänzende Therapie für die periphere Fazialisparese nach Weisheitszahnextraktion. Allerdings müssen unbedingt größere und randomisierte kontrollierte Studien durchgeführt werden, um festzustellen, ob diese komplementärmedizinischen Methoden in Hinblick auf das Ziel einer vollständiger Genesung der Patienten einen signifikanten additiven oder synergistischen Effekt haben.