Objective To investigate the expression and significance of activating transcription factor 4 (ATF4) in the hepatocyte steatosis models induced by oleic acid,and to explore the relationship between the expression of ATF4 and nonalcoholic fatty liver disease (NAFLD). Methods L02 cells were treated by 20 mg/ml oleic acid for 0,24,48 and 72 h respectively to induce the hepatocytes steatosis,and then the cells were collected and the total RNA and protein were extracted. Reverse transcriptional polymerase chain reaction (RT-PCR) and Western blot analysis were used to detect the expressions of ATF4 gene at different time points. Results With the development of deterioration of steatosis,the expression levels of ATF4 mRNA were 1.01?0.12,1.87?0.24,2.01?0.13,and 1.79?0.19 respectively correspondingly from 0 h to 72 h. The peak of ATF4 mRNA expression was reached at the 48th hour,and then showed the tendency of down-regulation. At the same time points,the protein expression of ATF4 were 0.31?0.16,0.57?0.14,0.91?0.20,and 0.89?0.17 separately,and the protein expression was maintained at a high level up to the 72nd hour. There were significantly differences compared with the control group(P

Objective To develop a noninvasive diagnostic model comprising of transabdominal ultrasonography and serum markers for assessing esophageal varices in liver cirrhosis.Methods Totally 230 liver cirrhosis patients were randomly allocated to either an estimation group(161 cases)or a validation group(69 cases).Gastroscope was performed and whether esophageal varices existed or not was assessed in every patient.Seventeen common ultrasonographic and serum markers were analyzed initially in the estimation group to derive a predictive model.The model created was then assessed with ROC analysis.It was also applied to the validation group to test its accuracy.Results Among seventeen variables associated with esophageal varices selected by univariate analysis,splenic thickness,diameter of portal vein,prothrombin time were indentified by multivariate Logistic regression analysis as independent risk factors of varices.A varices index constructed from the above three markers was established.In ROC analysis,the AUC was 0.853(0.764,0.942)for predicting existence of varices using the optimal cutoff score 6.3.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 81.2%,85.7%,92.35%,68.21%,82.77% respectively.For the validation group,the AUC and diagnostic accuracy were 0.889(0.814,0.965)and 82.86% respectively.Conclusion A noninvasive model consisting of splenic thickness,diameter of portal vein and prothrombin time is helpful in predicting existence of esophageal varices in cirrhosis.

Objective The goal of the present study was to determine the effects of different location perfora-tions on the middle ear transfer functions by measuring the velocity and pattern of the tympanic membrane vibration in guinea pigs with intact and perforated TM .Methods A laser Doppler vibrometer was used to measure the sound transmission properties on the movement of the tympanic membrane on 6 fresh temporal bones of guinea pigs in the frequency range of 0 .5~8 kHz at 90 dB SPL .The velocity was measured at three points on the manubrium before and after a different location perforation was made with a 20-gauge needle(1 .1 mm diameter) .The locations of the perforations were in anterior -inferior quadrants of left ears and in posterior -inferior quadrants of right ears .And the velocity was measured from 6 poins with the intact tympanic membrane .Results The highest velocities were re-corded at the site of inferior umbo throughout the frequency range .The manubrium vibration velocity losses were noted in the perforated ears below 1 .5 kHz ,the velocity losses were smaller above 1 .5 kHz ,and the maximum ve-locity loss was about 7 dB at 500 Hz with the posterior -inferior quadrant perforation .Although there was a trend for anterior-inferior perforations to show a slighter loss than posterior -inferior perforations in velocity below 1 .5 kHz ,no statistical differences in velocity loss were found between different perforations .The average ratio of short process velocity to umbo velocity at all frequencies was approximately 0 .5 ,and the ratios were found no systematic differences before and after perforation at almost all frequencies from different perforations .Conclusion The manu-brium vibration velocity losses from TM perforation are frequency -dependent and the largest losses occur at the lowest sound frequencies .Different sites of small perforation have not any important effects on middle ear sound transmission .

Objective To study the preventive effects of Nitroglycerin (NTG) on post-ERCP pancreatitis (PEP) and hyperamylasemia.Methods A total of 150 patients were enrolled and randomly divided into 2 groups to receive buccal NTG 0.5mg (NTG group) or buccal Vitamin C 0.1 g (control group).Incidence of PEP and hyperamylasemia and adverse reactions were observed.Results Three patients were excluded according to the exclusion criteria. The overall incidcnces of PEP and hyperamylascmia were 16.3％ (24/147) and 28.6％ (42/147),respectively.The incidence of hyperamylasemia in NTG group (15/74,20.3％) was significantly lower than that of control group (27/73,37.0％) (x2=5.032,P=0.025).Incidence of PEP in NTG group (12.2％) was lower than that of control group (20.5％) without significance (x2=1.892,P=0.169).No severe adverse effects was observed.Conclusion NTG can effectively prevent post-ERCP hyperamylaemia,but its effect on PEP is limited.

OBJECTIVE: To study the relative factors of the changes of preoperative and postoperative bone conduction thresholds in chronic suppurative otitis media. METHOD: The preoperative and postoperative bone conduction thresholds were prospectively investigated in 45 patients with unilateral chronic suppurative otitis media after tympanoplasty. Preoperatively (within 3 days before operation), 10 dB or more depression of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was considered to be significant. Similarly in the postoperative period (3 months after operation), 10 dB or more improvement or impairment of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was regarded as significant. RESULT: Thirty-five of 45 cases (77.8%) were found to have depressed bone conduction threshold before operation, 6 of 35 cases (17.1%) had improved bone conduction thresholds and 5 of 45 cases (11.1%) had depressed bone conduction thresholds after tympanoplasty. CONCLUSION In cases with chronic suppurative otitis media, successful results could be achieved after tympanoplasty disregarding air conduction threshold, the air-bone gap and deteriorated bone conduction threshold. Impairment of bone conduction thresholds could be induced by chronic suppurative otitis media itself and could also be induced by touching the ossicle chain crudely and by the noise of drilling during the operation.
Adolescent ; Adult ; Auditory Threshold ; Bone Conduction ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Otitis Media, Suppurative ; physiopathology ; surgery ; Postoperative Period ; Tympanoplasty ; Young Adult

OBJECTIVE: To evaluate the effect of over-under myringoplasty technique on repairing tympanic membrane perforation regarding with the rate of perforation closure, the frequency of postoperative complications occurrence and the level of hearing improvement. METHOD: In this retrospective study, a total of 74 patients (77 ears) underwent myringoplasty and had been followed up for over 6 months, which was performed by means of the underlay technique in 44 patients (45 ears) and over-under technique in 30 patients (32 ears) from Jan 2002 to Jan 2007. In the underlay group, the grafted membrane was placed medial to the remaining drum and the manubrium of the malleus. In the over-under group, the grafted membrane was placed under the remaining drum and over the malleus. Comparatively evaluate the effect of the underlay technique and that of the over-underlay technique on repairing tympanic membrane perforation. RESULT: The rate of perforation closure and hearing improvement in the underlay group of 45 ears was 89.0% and 57.5% respectively, while that in the over-under group of 32 ears were 87.5% and 71.9% respectively. The air-bone gap decreased by 4.9 dB in the underlay group, while it decreased by 9.7 dB in over-under group. After more than 6 months of following-up, the frequency of postoperative atelectasis of the underlay group and the over-under group was 17.8% and 6.25% respectively. Meanwhile, the frequency of postoperative reperforation of these two groups was 5.9% and 6.25% respectively. Blunting of the anterior angle of the tympanic membrane occurred in 3 ears in the over-under group. Lateralization of the graft was not observed in either group. CONCLUSION Over-under technique could reduce the occurrence of the adhesions between the grafted membrane and promontorium tympani by placing the grafted membrane between the remaining drum and the malleus. Furthermore, the level of hearing improvement in over-under group was higher than that in underlay group. Over-under myringoplasty is a more effective technique as comparison to underlay myringoplasty for repairing middle to large tympanic membrane perforations.
Adolescent ; Adult ; Hearing ; Humans ; Middle Aged ; Myringoplasty ; methods ; Retrospective Studies ; Treatment Outcome ; Tympanic Membrane ; surgery ; Young Adult

Objective:To form the consensus of nursing experts in accelerated rehabilitation surgery in perioperative period of chronic rhinosinusitis in order to promote the standardized development of accelerated rehabilitation surgery nursing in perioperative period of chronic rhinosinusitis in China.Methods:By consulting the literature evidence and combining with the clinical practice experience, the consensus draft was formed by more than 5 nurses in charge of nursing. According to the Grading of Recommendations Assessment, Development and Evaluation System, (GRADE), the evidence quality and recommendation grade of each item were evaluated.Results:The consensus covered 4 aspects of pre-hospital care guidance, including preoperative care, postoperative care, and discharge care for chronic rhinosinusitis, with a total of 12 items, including health education, individualized treatment guidance, network platform use, adaptive training, diet management, activity guidance, pain management, and discharge follow-up.Conclusions:The content of this consensus covers all aspects of accelerated rehabilitation surgery nursing during perioperative period of chronic rhinosinusitis, which is scientific, rigorous and authoritative, and can provide reference and guidance for accelerated rehabilitation surgery nursing in the perioperative period of chronic rhinosinusitis.

OBJECTIVETo investigate the effects of Xinfeng Capsule (XFC) on pulmonary function and related mechanism in adjuvant-induced arthritis (AA) rats.

METHODSThe rats were randomly divided into five groups: normal control (NC), model control (MC) groups, methotrexate (MTX), tripterygium glycosides tablet (TPT) and Xinfeng capsule (XFC) treatment groups. The adjuvant-induced arthritis model was established by intracutaneous injection of 0.1 mL Freund ' s complete adjuvant in the right paw of rats; the drugs were given 19 d after model establishment. The toe swelling degree (E), arthritis index (AI), pulmonary function, peripheral blood Treg levels, pathological changes of lung tissue and expression of Foxp3, TGF-β1, Smad3, Smad7 proteins in lung tissue were measured 30 d after drug administration.

RESULTSCompared to NC group, the levels of E, AI, alveolitis score, TGF-β1 and Smad3 were significantly increased (P <0.05 or P <0.01); maximum expiratory flow 25% of vital capacity (FEF25),50% maximal expiratory vital capacity flow (FEF50), maximum expiratory flow at 75% of vital capacity (FEF75), maximum mid-expiratory flow (MMF), force peak expiratory flow (PEF), CD4+ CD25+ Treg, Foxp3 and Smad7 were significantly decreased in MC group (P <0.05 or P < 0.01). Compared to MC group,the expression of E, AI, TGF-β1 and Smad3 were reduced, while FEF50, FEF75, MMF, PEF, Treg, Foxp3 and Smad7 were elevated in XFC group (P <0.05 or P <0.01). Compared to XFC group, the level of body mass,FEF25,FEF50, FEF75, MMF and Treg were lower in MTX and TPT groups (P <0.05 or P <0.01).

CONCLUSIONThere are inflamed joints and reduced pulmonary function in rats of adjuvant-induced arthritis. XFC can inhibit paw edema degrees, reduce arthritis response, and improve pulmonary function, which is associated with up-regulating expression of Treg and Foxp3, down-regulating the expression of TGF-β1 and adjusting TGF-β1/Smads signal pathway.

Animals ; Arthritis, Experimental ; drug therapy ; metabolism ; physiopathology ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Forkhead Transcription Factors ; metabolism ; Lung ; drug effects ; pathology ; physiopathology ; Male ; Rats ; Rats, Wistar ; Smad3 Protein ; metabolism ; Smad7 Protein ; metabolism ; T-Lymphocytes, Regulatory ; metabolism ; Transforming Growth Factor beta1 ; metabolism

OBJECTIVE: To study the efficacies of intratympanic prednisolone and dexamethasone injection for the subjective tinnitus. METHOD: A prospective study was designed to compare the efficacies of intratympanic prednisolone injection, intratympanic dexamethasone injection and carbamazepine by oral administration for subjective tinnitus. Seventy-three cases (78 ears) with subjective tinnitus for more than one month and treated by conservative therapy (such as vasodilator agent, Vitamin B, etc. by oral intake. ) were involved. The patients were randomized into 3 groups. Thirty-four cases (35 ears) were included in prednisolone group, 18 cases (18 ears) in dexamethasone group with intratympanic injection of prednisolone or dexamethasone, and 21 cases (25 ears) in carbamazepine group as a control group with oral administration of carbamazepine. All of the cases in intratympanic perfusion group were injected twice in the first week, then once a week consecutively. The patients were acupunctured 4-5 times in the whole course of treatment. All of the cases accepted Betahistine Mesylate, Mecobalamin and Vitamin B1 by oral intake at the same time. Pure tone audiogram and tinnitus matching were tested before the treatment immediately after the course of treatment, and were tested again after half a year's following up. RESULT: All of the cases accepted the whole treatment and were followed up for half a year successfully. The effective rate of the prednisolone group, dexamethasone group and the carbamazepine group was 48.6%, 33.3%, 44.0%, respectively; the control rate half a year after the treatment was 45.7%, 27.8%, 36.0%, respectively. There was no statistically significant difference in the effective rate and control rate between intratympanic perfusion group and carbamazepine group. There is a statistically significant difference both in the effective rate and the control rate between the prednisolone group and the dexamethasone group. Prednisolone may be better than dexamethasone in intratympanic perfusion for subjective tinnitus. CONCLUSION Intratympanic steroid injection has a positive effect on subjective tinnitus and may be considered to be an alternative treatment to subjective tinnitus.
Adolescent ; Adult ; Aged ; Carbamazepine ; administration & dosage ; therapeutic use ; Dexamethasone ; administration & dosage ; therapeutic use ; Drug Administration Routes ; Female ; Humans ; Male ; Middle Aged ; Prednisolone ; administration & dosage ; therapeutic use ; Prospective Studies ; Tinnitus ; drug therapy ; Treatment Outcome ; Young Adult

OBJECTIVE: To study the bone conductive hearing loss in adults of otitis media with effusion (OME). METHOD: Fifty adults of OME treated in our hospital, from Mar. 2009 to Feb. 2010, were enrolled for analyzing bone conduction hearing loss (BCHL) before auripuncture and after auripuncture, the difference between which were compared in 51 ears. BCT of pre auripuncture 24 subjects, BCT of post-auripuncture 22 subjects, and BCT recovered from OME 9 subjects compared with the contralateral ear respectively. High and extend high frequency (8, 10, 12, 16 kHz) air conduction threshold (ACT) after recover from OME was compared to the normal contralateral ear in 4 adults. RESULT: BCT improved significantly after auripuncture at the frequencies (0.5-4.0 kHz), and the improvements in 4.0 kHz are more than that in 0.5 kHz significantly (P<0.05). In the unilateral OME subjects, BCT, of post auripuncture and recovered from OME, nearly recovered to the same level as the contralateral ear in most cases. While high and extend-high frequency (8, 10, 12, 16 kHz) ACT elevated in 3 of 4 patients recovered from OME. CONCLUSION Both effusion in middle ear and injury in inner ear could result in the elevation of BCT. Elevation of BCT at regular frequencies (0.5-4.0 kHz) is frequently associated with the effusion in middle ear, while these frequencies were insensitive in the early inner ear injury. The high and extend high frequency ACT elevation may be sensitive for the early sensorineural hearing loss. As the disease prolonged, sensorineural hearing loss of the lower frequencies (0.5-4.0 kHz) could be detected of OME patient.
Adult ; Aged ; Aged, 80 and over ; Bone Conduction ; Female ; Hearing Loss, Conductive ; etiology ; physiopathology ; Humans ; Male ; Middle Aged ; Otitis Media with Effusion ; complications ; physiopathology