Objective:To evaluate surgical strategies and clinical outcomes in supra-labyrinthine cholesteatoma management, providing evidence-based guidance for therapeutic decision-making. Methods:Seven patients with supra-labyrinthine cholesteatoma in our hospital from 2021 to 2023 were enrolled in this study. The clinical manifestations, imaging findings, and surgical outcomes of patients were retrospectively analyzed. A systematic literature review focused on surgical anatomy correlations and imaging-based approach selection. Results:All seven cases of supra-labyrinthine cholesteatoma were unilateral. Preoperative otoendoscopy, CT, and intraoperative findings confirmed that they were classified as supral-abyrinthine cholesteatoma according to Sanna's classification. Two cases were operated entirely with otoendoscopy, three cases used a postauricular approach with microscopic assistance, and two cases involved a combined approach with endoscopy and microscopy. Hearing reconstruction with ossicular prosthesis was performed in five cases, while two cases did not undergo hearing reconstruction due to preoperative anacusis confirmed by both subjective and objective hearing tests. In all seven cases, various segments of the facial nerve were exposed during surgery, but postoperative facial nerve function remained intact, hearing was preserved, no cerebrospinal fluid leakage occurred, and no recurrences have been observed to date（as of June 2024）. Conclusion:With the advancement of imaging techniques and microsurgical technology, early diagnosis and surgical methods for supral-abyrinthine cholesteatoma have significantly improved. Compared to traditional approaches, the newer methods reduce unnecessary complications and offer advantages such as minimal surgical trauma, superior hearing preservation rates, and shorter recovery times with better postoperative neural function. This study reviews recent literature on petroclival cholesteatomas, combined with our own cases, to analyze the classification of supral-abyrinthine cholesteatoma and surgical approach selection. The findings aim to optimize treatment strategies and guide appropriate surgical methods, ultimately improving patient prognosis and quality of life.
Humans ; Cholesteatoma/surgery* ; Ear, Inner/surgery* ; Retrospective Studies ; Treatment Outcome

Gastric cancer (GC) is characterized by high morbidity and mortality rates. Chinese agarwood comprises the resin-containing wood of Aquilaria sinensis (Lour.) Gilg., traditionally utilized for treating asthma, cardiac ischemia, and tumors. However, comprehensive research regarding its anti-GC effects and underlying mechanisms remains limited. In this study, Chinese agarwood petroleum ether extract (CAPEE) demonstrated potent cytotoxicity against human GC cells, with half maximal inhibitory concentration (IC₅₀) values for AGS, HGC27, and MGC803 cells of 2.89, 2.46, and 2.37 μg·mL^-1, respectively, at 48 h. CAPEE significantly induced apoptosis in these GC cells, with B-cell lymphoma-2 (BCL-2) associated X protein (BAX)/BCL-2 antagonist killer 1 (BAK) likely mediating CAPEE-induced apoptosis. Furthermore, CAPEE induced G₀/G₁ phase cell cycle arrest in human GC cells via activation of the deoxyribonucleic acid (DNA) damage-p21-cyclin D1/cyclin-dependent kinase 4 (CDK4) signaling axis, and increased Fe²⁺, lipid peroxides and reactive oxygen species (ROS) levels, thereby inducing ferroptosis. Ribonucleic acid (RNA) sequencing, real-time quantitative polymerase chain reaction (RT-qPCR), and Western blotting analyses revealed CAPEE-mediated upregulation of heme oxygenase-1 (HO-1) in human GC cells. RNA interference studies demonstrated that HO-1 knockdown reduced CAPEE sensitivity and inhibited CAPEE-induced ferroptosis in human GC cells. Additionally, CAPEE administration exhibited robust in vivo anti-GC activity without significant toxicity in nude mice while inhibiting tumor cell growth and promoting apoptosis in tumor tissues. These findings indicate that CAPEE suppresses human GC cell growth through upregulation of the DNA damage-p21-cyclin D1/CDK4 signaling axis and HO-1-mediated ferroptosis, suggesting its potential as a candidate drug for GC treatment.
Animals ; Humans ; Mice ; Antineoplastic Agents, Phytogenic ; Apoptosis/drug effects* ; Cell Line, Tumor ; Cyclin D1/genetics* ; Cyclin-Dependent Kinase 4/genetics* ; DNA Damage/drug effects* ; Drugs, Chinese Herbal/pharmacology* ; Ferroptosis/drug effects* ; G1 Phase Cell Cycle Checkpoints/drug effects* ; Heme Oxygenase-1/genetics* ; Mice, Inbred BALB C ; Mice, Nude ; Plant Extracts/pharmacology* ; Stomach Neoplasms/physiopathology* ; Thymelaeaceae/chemistry* ; Up-Regulation/drug effects*

Objective:To conduct a scope review on the application of ICU diaries in critically ill patients, laying the foundation for further exploration and construction of ICU diary patterns and frameworks that were in line with the national conditions and tailored to different regions and cultural backgrounds.Methods:The Joanna Briggs Institute Reviewer′s Manual was used as the methodological framework, and a computer search was conducted in nine domestic and international databases, including China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, Cochrane Library, PubMed, and Embase, etc. The search period was from the inception of the databases until March 13, 2023. The included literature was screened, summarized, and analyzed.Results:A total of 19 articles were included. ICU diaries were commonly recorded using a combination of text and visuals, with the involvement of both healthcare professionals and family members. Most patients received ICU diaries approximately one month after their transfer from the ICU. Out of the 15 studies, ICU diaries were found to be effective, while 4 studies indicated no significant improvement in patients′ psychological issues. However, ICU diaries were still considered acceptable by patients and their families.Conclusions:The application of ICU diaries has shown positive significance in critically ill patients, but further research and exploration are needed to investigate its impact on issues such as post-traumatic stress disorder, anxiety, depression, and quality of life. In the future, a combination of multiple forms and high-quality research designs with large samples, long periods, and structured approaches should be employed to explore its application effects and long-term outcomes on psychological problems.

A 55-year-old male patient was admitted to the hospital due to "recurrent chest pain for 8 months, with worsening symptoms for 2 weeks". After admission, comprehensive relevant examinations led to the consideration of a giant chronic left ventricular pseudoaneurysm caused by myocardial infarction with non-obstructive coronary arteries. Surgical treatment was performed at our hospital. We discuss the diagnosis and treatment of this patient.

Objective:To investigate the agreement of ultrasound derived fat fraction (UDFF) with magnetic resonance imaging proton density fat fraction (MRI PDFF) on evaluating hepatic steatosis, and the performance of UDFF on diagnosing metabolic dysfunction associated steatotic liver disease (MASLD).Methods:One hundred and twenty-five volunteers and one hundred and seven inpatients who underwent abdominal ultrasound examination in Zhongda Hospital Southeast University from November 2023 to February 2024 were prospectively enrolled.UDFF and MRI PDFF were applied to evaluate hepatic steatosis. Spearman correlation test and Bland-Altman plot were applied to analyze the agreement of UDFF and MRI PDFF. Receiver operating characteristic curve (ROC) was applied to calculate the performance of UDFF on diagnosing MASLD.Results:In our participants, compared to individuals without hepatic steatosis, patients with MASLD had higher body mass index (BMI), waist-to-hip ratio, prevalence of diabetes mellitus, levels of alanine transaminase (ALT), aspertate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT), triglyceride, and UDFF (all P<0.05). The percentage of hepatic steatosis measured by UDFF and MRI PDFF was strongly correlated[ρ=0.873(95% CI=0.837-0.901), P<0.001]. UDFF performed excellent for diagnosing MASLD with an area under the curve (AUC) of 0.983(95% CI=0.956-0.995, P<0.001), and was better than semi-quantitative assessment based on two-dimensional ultrasound as well as ultrasound attenuation parameter. The optimal cut off value of UDFF to diagnose MASLD was ≥6%. Conclusions:The percentage of hepatic steatosis measured by UDFF and MRI PDFF agrees with each other, and UDFF obtains an excellent performance on diagnosing MASLD, so that UDFF should be considered a reliable imaging technique for quantitively evaluating hepatic steatosis and diagnosing MASLD.

At present ICU transition management in China is still in the exploration stage, and the existing research results are difficult to be promoted in the clinic, and the management plan lacks unified and feasible standards. This paper introduces the concept and model of ICU transition management, and provides an overview of the current situation of ICU transition management for patients transferred out of ICU, adverse outcomes for patients transferred out of ICU, and the content of ICU transition management for patients transferred out of ICU, aiming to provide a reference for the formation of a unified and standardized ICU transition management scheme.

Objective:To compare the diagnostic efficiency of colloidal gold dipstick method (PTH dipstick method) with that of doctors’ experience method based on nano-carbon method for rapid identification of parathyroid gland in thyroidectomy of thyroid cancer.Methods:From March to July 2020, 90 patients underwent thyroid surgery in the Friendship Hospital, Capital Medical University participated in the experimental study, and 155 samples underwent empirical judgment, parathyroid dipstick and pathological examination. All operations were performed by senior specialists. SPSS statistics 17.0 software was used for statistical analysis.Results:Seventy-four cases of parathyroid gland confirmed by both pathology and empirical judgment, and 81 cases of non-parathyroid gland confirmed by pathology; 130 cases of parathyroid glands confirmed by both PTH dipstick method and pathology, and 22 cases of non-parathyroid glands confirmed by pathology. The accuracy rate of PTH dipstick method was 85.53% which was much higher than that of empirical judgment method (47.74%). The data were statistically significant ( χ2=49.14, P<0.05). The sensitivity of PTH method was 95.89%, the specificity of PTH method was 75.94%, and the Youden index was 0.7183. The sensitivity of empirical judgment method was 81.3%, the specificity of empirical judgment method was 47.74%, and the Youden index was 0.2904. Conclusions:The diagnostic efficiency of the PTH method is higher than that of empirical judgment method to identify parathyroid gland in thyroid surgery. The two methods can be used together to increase the protection of parathyroid gland during operation.

Objective:To investigate the relationship between dosimetric parameters and tumor volume change after 125I implantation for thyroid cancer and obtain better dosimetric parameters that predict the curative effect more accurately. Methods:A total of 22 consecutive patients with thyroid cancer (23 targets) who received 125I interstitial brachytherapy in Department of Oncology, Hebei General Hospital were retrospectively analyzed. All the patients received post-operative dose verification, and the D 90 (Minimum dose received by 90% target volume) was calculated. After a regular follow-up, the tumor volume reduction ratio after t months (R t) , actual absorbed dose (D 1m) , efficacy corrected absorbed dose (D 1e) , and sensitivity corrected absorbed dose (D 1s) of the first month were calculated according to the actual follow-up CT images. The statistical test was carried out by SPSS21.0. The Spearman linear analysis was applied to analyze the relationship between D 90, D 1m, D 1e, D 1s and R t, and the curve fitting was also completed. Results:The post-operative D 90, D 1m, D 1e, D 1s and R t were (129.73±14.22) Gy, (36.95±7.35) Gy, (43.45±11.32) Gy, (41.78±13.39) Gy, and (32.00±19.00) %, respectively. And the correlation coefficient were 0.692, 0.551, 0.728, and 0.858, respectively, which showed significant positive relevance between dosimetric parameters and tumor volume change ( P<0.01) , the curve fitting presented cubic function. Conclusion:The post-operative D 90, D 1m, D 1e, and D 1s can be predictors for curative effect, and D 1s is the best predictor.

Objective:To explore the detection of potentially pathogenic bacteria (PPB) in the nasopharynx of children with respiratory syncytial virus (RSV) bronchiolitis and the influence of PPB types on disease severity.Methods:In this retrospective cohort study, clinical data of patients hospitalized for RSV bronchiolitis at Department of Respiratory Medicine, Children′s Hospital of Soochow University between January 1, 2017 and December 31, 2019 were retrospectively analyzed.The virus, Mycoplasma pneumoniae and bacteria in nasopharyngeal secretion of children were detected.They were classified into <3 months group, 3-<6 months group, 6 months-<1 year group and 1-2 years group based on the age.In addition, they were further classified into RSV infection group, RSV+ G + group, RSV+ G - group and RSV+ G + + G - group based on detected PPB in the nasopharynx.Comparison of RSV + PPB frequency between groups was performed by Chi- squared test, clinical characteristics were compared by using Mann- Whitney U test. Results:A total of 280 patients with RSV bronchiolitis were included in the study, involving 113 cases (40.4%) with PPB in the nasopharynx.The most-common detection bacterium was Streptococcus pneumoniae.The detection rate of Streptococcus pneumoniae increased with age ( χ2=12.609, P=0.005), while that of Staphylococcus aureus decreased with age ( χ2=8.387, P=0.034). Compared with RSV group, patients in RSV+ G - group had a longer length of stay, higher rate of fever and shortness of breath, higher oxygen supplement and higher C-reactive protein (CRP) (all P<0.05). Compared with RSV group, patients in RSV+ G + group were older, and they had higher rate of fever, higher percentage of neutrophil, lower percentage of lymphocyte and higher CRP (all P<0.05). Conclusions:PPB in nasopharynx can be detected in about 40% of children hospitalized with RSV bronchiolitis, and nasopharynx complicated with PPB infection may affect the severity of RSV bronchiolitis.

Objective:To investigate the diagnostic value of circular RNA circ_100367 in thyroid cancer (THCA) and its relationship with immune-related factors.Methods:According to the data chip provided by the National Center for Biotechnology Information (NCBI) website, the differentially expressed circRNAs in THCA were analyzed, then circ_100367 was included in this study. The serum of 175 THCA patients and healthy people were collected, and the expression levels of circ_100367 and its linear transcript DCAF8 mRNA in serum samples were detected by qRT-PCR, and the correlation between circ_100367 and DCAF8 was calculated. The correlation between the expression of circ_100367 and the clinicopathological characteristicsof the patients, immune infiltration level and immunosuppressive factor PD-1 was analyzed.Results:Compared with serum of healthy people (1.00±0.37) , expression level of circ_100367 in serum of THCA patients was significantly increased (1.37±0.41) ( t=8.80, P<0.001) , and there was no significant difference in DCAF8 mRNA expression ( t=1.67, P=0.095) , but circ_100367 was positively correlated with DCAF8 mRNA expression ( r=0.17, P=0.028) . Analysis of expression and clinicopathological characteristics of circ_100367 showed that compared with patients in M0 group (1.26±0.40) , circ_100367 was overexpressed in M1 and Mx patients (1.43±0.40) ( t=2.63, P=0.009) ; compared with N0 patients (1.24±0.36) , circ_100367 was overexpressed in serum of N1 and Nx patients (1.45±0.42) ( t=3.48, P=0.001) ; compared with serum of patients with negative lymph node detection (1.28±0.36) , circ_100367 was overexpressed in serum of positive patients (1.42±0.43) ( t=2.14, P=0.034) ; compared with T1+T2 stage patients (1.30±0.37) , circ_100367 expression was overexpressed in serum ofT3+T4 patients (1.40±0.43) ( t=2.22, P=0.028) . Analysis of the expression and immune infiltration levels of circ_100367 found that highly expressed circ_100367 was associated with CD8+ T cells ( r=0.25, P=0.024) , macrophages ( r=0.22, P=0.038) , CD4+ T cells ( r=0.25, P=0.020) and B cell ( r=0.23, P=0.033) levels. The expression of circ_100367 was also positively correlated with the immunosuppressive factor PD-1 ( r=0.19, P=0.011) . Conclusion:circ_100367 can be used as a marker for the diagnosis of THCA and its expression is strongly correlated with immune-related factors.