[Application of internal carotid artery stent in glomus jugular paraganglioma surgery].

Objective:To summarize the application of internal carotid artery stent in glomus jugular paraganglioma surgery, and to provide an effective strategy for reducing the risk of internal carotid artery injury. Methods:This article reviewed the surgical cases of internal carotid artery stent implanting from 2018.06 to 2022.12, and discussed the stent placement method, treatment protocols, and perioperative management strategies. Results:A total of 5 patients underwent a comprehensive evaluation of the degree of internal carotid artery invasion using imaging techniques such as MRI, carotid CT angiography （CTA）, and digital silhouette angiography （DSA）. All patients were found to have varying degrees of internal carotid artery involvement. Stenting of the internal carotid artery was performed in all patients before surgery, and the stenting process went smoothly without any internal carotid artery injury. Three months after stenting, tumor resection or subtotal resection surgery was performed to avoid internal carotid artery injury during the surgery, and the surgical process was successfully completed. Postoperative follow-up from 4 months to 2 years showed that the internal carotid artery was patent after stent placement, with great endothelialization process and no stent-related complications. Conclusion:In patients with glomus jugular paraganglioma, when preoperative imaging shows internal carotid artery involvement, preoperative stenting is a safe and effective therapeutic strategy to reinforce the arterial wall structure, protect and maintain the integrity of the artery, and reduce the risk of vascular injury during the surgery. This article summarizes the experience of internal carotid artery stent in glomus jugular paraganglioma surgery, which provides an important reference for clinical practice.

Electroencephalography microstate alterations reflect potential double-edged cognitive adaptation in Ménière's disease.

PURPOSE: To explore the microstate characteristics and underlying brain network activity of Ménière's disease (MD) patients based on high-density electroencephalography (EEG), elucidate the association between microstate dynamics and clinical manifestation, and explore the potential of EEG microstate features as future neurobiomarkers for MD. METHODS: Thirty-two patients diagnosed with MD and 29 healthy controls (HC) matched for demographic characteristics were included in the study. Dysfunction and subjective symptom severity were assessed by neuropsychological questionnaires, pure tone audiometry, and vestibular function tests. Resting-state EEG recordings were obtained using a 256-channel EEG system, and the electric field topographies were clustered into four dominant microstate classes (A, B, C, and D). The dynamic parameters of each microstate were analyzed and utilized as input for a support vector machine (SVM) classifier to identify significant microstate signatures associated with MD. The clinical significance was further explored through Spearman correlation analysis. RESULTS: MD patients exhibited an increased presence of microstate class C and a decreased frequency of transitions between microstate class A and B, as well as between class A and D. The transitions from microstate class A to C were also elevated. Further analysis revealed a positive correlation between equilibrium scores and the transitions from microstate class A to C under somatosensory challenging conditions. Conversely, transitions between class A and B were negatively correlated with vertigo symptoms. No significant correlations were detected between these characteristics and auditory test results or emotional scores. Utilizing the microstate features identified via sequential backward selection, the linear SVM classifier achieved a sensitivity of 86.21% and a specificity of 90.61% in distinguishing MD patients from HC. CONCLUSIONS: We identified several EEG microstate characteristics in MD patients that facilitate postural control yet exacerbate subjective symptoms, and effectively discriminate MD from HC. The microstate features may offer a new approach for optimizing cognitive compensation strategies and exploring potential neurobiological markers in MD.

Cone-beam CT evaluation of post-extraction alveolar bone changes at the maxillary incisor sites in an East Asian population: A cross-sectional study.

Objective: Understanding the characteristics of alveolar bone resorption in an East Asian population after maxillary incisor extraction and providing a reference for implant treatment plans. Study design: Cone-beam computerized tomography (CBCT) data of 125 East Asian patients with unilateral extraction of maxillary incisors for 3 months were collected. The alveolar bone width and height in the extraction sites were measured and compared with the corresponding contralateral sites. Results: The differences in alveolar bone width between the extraction site and contralateral site were as follows: 4.11 mm, 2.68 mm, and 2.09 mm (3 mm, 5 mm, 7 mm apical from CEJ of the contralateral tooth). Data are expressed as the median. The horizontal resorption ratio of alveolar bone was 49.94 %, 31.5 %, and 24.46 %. The difference in alveolar bone height was 0.78 mm. The vertical resorption ratio was 7.78 %. The resorption did not differ significantly between sexes and was not significantly affected by tooth positions. Conclusions: In the studied East Asian population, significant horizontal and vertical alveolar bone resorption occurs after natural healing of maxillary incisor extraction for 3 months. The closer to the alveolar ridge crest, the more significant the horizontal resorption, resulting in an "inverted triangle" shape residual alveolar bone.

Urinary Equol and Equol-Predicting Microbial Species Are Favorably Associated With Cardiometabolic Risk Markers in Chinese Adults.

BACKGROUND: The association between soy isoflavones intake and cardiometabolic health remains inconclusive. We investigated the associations of urinary biomarkers of isoflavones including daidzein, glycitein, genistein, equol (a gut microbial metabolite of daidzein), and equol-predicting microbial species with cardiometabolic risk markers. METHODS AND RESULTS: In a 1-year study of 305 Chinese community-dwelling adults aged ≥18 years, urinary isoflavones, fecal microbiota, blood pressure, blood glucose and lipids, and anthropometric data were measured twice, 1 year apart. Brachial-ankle pulse wave velocity was also measured after 1 year. A linear mixed-effects model was used to analyze repeated measurements. Logistic regression was used to calculate the adjusted odds ratio (aOR) and 95% CI for the associations for arterial stiffness. Each 1 µg/g creatinine increase in urinary equol concentrations was associated with 1.47%, 0.96%, and 3.32% decrease in triglycerides, plasma atherogenic index, and metabolic syndrome score, respectively (all P<0.05), and 0.61% increase in high-density lipoprotein cholesterol (P=0.025). Urinary equol was also associated with lower risk of arterial stiffness (aOR, 0.28 [95% CI, 0.09-0.90]; Ptrend=0.036). We identified 21 bacterial genera whose relative abundance was positively associated with urinary equol (false discovery rate-corrected P<0.05) and constructed a microbial species score to reflect the overall equol-predicting capacity. This score (per 1-point increase) was inversely associated with triglycerides (percentage difference=-1.48%), plasma atherogenic index (percentage difference=-0.85%), and the risk of arterial stiffness (aOR, 0.27 [95% CI, 0.08-0.88]; all P<0.05). CONCLUSIONS: Our findings suggest that urinary equol and equol-predicting microbial species may improve cardiometabolic risk parameters in Chinese adults.

Urinary enterolignans and enterolignan-predicting microbial species are favourably associated with liver fat and other obesity markers.

Aims: Plant-derived lignans may protect against obesity, while their bioactivity needs gut microbial conversion to enterolignans. We used repeated measures to identify enterolignan-predicting microbial species and investigate whether enterolignans and enterolignan-predicting microbial species are associated with obesity. Methods: Urinary enterolignans, fecal microbiota, body weight, height, and circumferences of the waist (WC) and hips (HC) were repeatedly measured at the baseline and after 1 year in 305 community-dwelling adults in Huoshan, China. Body composition and liver fat [indicated by the controlled attenuation parameter (CAP)] were measured after 1 year. Multivariate-adjusted linear models and linear mixed-effects models were used to analyze single and repeated measurements, respectively. Results: Enterolactone and enterodiol levels were both inversely associated with the waist-to-hip ratio, body fat mass (BFM), visceral fat level (VFL), and liver fat accumulation (all P < 0.05). Enterolactone levels were also associated with lower WC (ß = -0.0035 and P = 0.013) and HC (ß = -0.0028 and P = 0.044). We identified multiple bacterial genera whose relative abundance was positively associated with the levels of enterolactone (26 genera) and enterodiol (22 genera, all P false discovery rate < 0.05), and constructed the enterolactone-predicting microbial score and enterodiol-predicting microbial score to reflect the overall enterolignan-producing potential of the host gut microbiota. Both these scores were associated with lower body weight and CAP (all P < 0.05). The enterolactone-predicting microbial score was also inversely associated with the BFM (ß = -0.1128 and P = 0.027) and VFL (ß = -0.1265 and P = 0.044). Conclusion: Our findings support that modulating the host gut microbiome could be a potential strategy to prevent obesity by enhancing the production of enterolignans.

[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.

Evaluate the effects of low-intensity pulsed ultrasound on dental implant osseointegration under type II diabetes.

Objective: The objective of this study is to assess the impact of low-intensity pulsed ultrasound (LIPUS) therapy on the peri-implant osteogenesis in a Type II diabetes mellitus (T2DM) rat model. Methods: A total of twenty male Sprague-Dawley (SD) rats were randomly allocated into four groups: Control group, T2DM group, Control-LIPUS group, and T2DM-LIPUS group. Implants were placed at the rats' bilateral maxillary first molar sites. The LIPUS treatment was carried out on the rats in Control-LIPUS group and T2DM-LIPUS group, immediately after the placement of the implants, over three consecutive weeks. Three weeks after implantation, the rats' maxillae were extracted for micro-CT, removal torque value (RTV), and histologic analysis. Results: Micro-CT analysis showed that T2DM rats experienced more bone loss around implant cervical margins compared with the non-T2DM rats, while the LIPUS treated T2DM rats showed similar bone heights to the non-T2DM rats. Bone-implant contact ratio (BIC) were lower in T2DM rats but significantly improved in the LIPUS treated T2DM rats. Bone formation parameters including bone volume fraction (BV/TV), trabecular thickness (Tb.Th), bone mineral density (BMD) and RTV were all positively influenced by LIPUS treatment. Histological staining further confirmed LIPUS's positive effects on peri-implant new bone formation in T2DM rats. Conclusion: As an effective and safe treatment in promoting osteogenesis, LIPUS has a great potential for T2DM patients to attain improved peri-implant osteogenesis. To confirm its clinical efficacy and to explore the underlying mechanism, further prospective cohort studies or randomized controlled trials are needed in the future.

Surface-coated AlF3 nanolayers enable polysulfide confinement within biomass-derived nitrogen-doped hierarchical porous carbon microspheres for improved lithium-sulfur batteries.

The electrically insulating and volumetric deformation of sulfur and the shuttle effect of the intermediate lithium polysulfide (LiPSs) have severely hindered the development of lithium-sulfur batteries (LSBs). Herein, a synergistic strategy of hierarchical porous nitrogen-doped carbon microspheres (PNCM) derived from low-cost biomass with surface-coated AlF3 nanolayer as a multifunctional sulfur host (denoted as PNCM@S@AlF3) was developed. The PNCM not only possesses an abundant pore structure, large surface area, and high electrical conductivity but also features an intrinsic N-doped and fluorinated framework, which effectively enhances the physical adsorption and chemical anchoring to LiPSs. In addition, the AlF3 nanolayer protects the open surface of the porous carbon to isolate sulfur species from the electrolyte to reduce irreversible losses while accelerating the redox kinetics of LiPSs through strong polar adsorption and bonding. Hence, the PNCM@S@AlF3 cathode exhibits an initial capacity as high as 1176.2 mAh/g at 0.2C, and the cycling stability and rate capability are superior to that of PNCM@S without AlF3 coating. Impressively, the PNCM@S@AlF3 cathode delivers stable long-term cycling performance at a high rate of 2C, with 95.6% capacity retention after 500 cycles. This work presents a facile, sustainable, and efficient synergistic strategy for developing advanced LSBs.

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.

Finite element analysis of maxillary first molar with mesial-occlusal-distal-palatal defect restored with different post-and-core strategies.

Purpose: To explore which restoration strategy generates the most favorable stress distribution in an endodontically-treated maxillary first molar with mesial-occlusal-distal-palatal defect. Methods: Models with one post in palatal canal (PP), each post in palatal and distobuccal canals (PDP), each post in palatal and mesiobuccal canals (PMP), and each post in all canals (PDMP) were established for an endodontically-treated maxillary first molar with mesial-occlusal-distal-palatal defect either with fiber-reinforced composite (FRC) post or gold alloy cast (GAC) post. A 400-N vertical force and a 225-N lateral force were respectively applied. The Mohr-Coulomb stress ratio (σMC ratio) in the residual tooth structure (RTS), the resin cement, and the crowns, the tensile stress (σt) and compressive stress (σc) in the FRC posts, the von-Mises stress ratio (σvM ratio) in the GAC post-and-cores, and the σt and shear stress (σs) at the adhesive interfaces were calculated using finite element analysis. Results: FRC posts generated lower σMC ratio than GAC posts in the RTS (0.3274-0.3643 vs. 0.3399-0.4118). Among the FRC post groups, the PDMP group got the lowest σs at the dentin-post interface (14.92 MPa) and the abutment-crown interface (8.242 MPa) under vertical loading, as well as the lowest σMC ratio in the RTS (0.3381) and the lowest σs at the dentin-post interface (38.00 MPa) under lateral loading. Conclusions: From the point of stress distribution, placing FRC posts in the palatal, distobuccal, and mesiobuccal canals is the optimal strategy in restoring a severely damaged maxillary first molar, provided that lateral occlusal force is reduced.