The NF-kappaB pathway regulates the expression of over 150 target genes, e.g., cytokines, chemokines, leukocyte adhesion molecules and inducible effector enzymes. Consequently, it plays a crucial role in innate and adaptive immune responses, inflammatory response, stress responses, apoptosis and so on. IkappaB kinase (IKK) is the key of this pathway, and it owns a special structure which consists of catalytic subunit and regulatory subunit. Naturally, the activation of IKK needs the interaction of the two subunits and phosphorylation by its upstream kinases. Actually, there are two methods of activation of the NF-kappaB pathway, and both of the methods need the IKK complex. Given to the crucial role of IKK, researchers have isolated and synthesized amounts of IKK inhibitors, and these provide a great convenience to develop novel anti-inflammatory and anti-tumor drugs.

Objective: To explore the clinical effects of repair of wounds in the fingers after electrical burn with wrist perforator free flaps. Methods: Twelve patients (13 fingers) with electrical burn were hospitalized in our burn ward from January 2016 to January 2017. After radical debridement, the size of wounds ranged from 5.0 cm×2.0 cm to 10.0 cm×7.0 cm. Wounds with size below or equal to 6.0 cm ×2.5 cm were repaired with free flaps based on the superficial palmar branch of radial artery, with flap area ranging from 2.5 cm×2.2 cm to 6.0 cm×4.5 cm. The superficial palmar branch of radial artery, subcutaneous vein, and palmar cutaneous branch of the median nerve underwent end-to-end anastomosis with digital proper artery, dorsal superficial vein, and digital proper nerve in the finger, respectively. The donor sites were sutured directly. Wounds with size larger than 6.0 cm×2.5 cm were repaired with free flaps based on the dorsal carpal branch of ulnar artery, with flap area ranging from 4.5 cm×3.0 cm to 12.0 cm×8.5 cm. The dorsal carpal branch of ulnar artery, subcutaneous vein, and medial antebrachial cutaneous nerve underwent end-to-end anastomosis with digital proper artery, dorsal superficial vein, and digital proper nerve in the finger, respectively. The donor sites were sutured directly or covered by full-thickness skin graft from abdomen. Results: Five free flaps based on the superficial palmar branch of radial artery and 8 free flaps based on the dorsal carpal branch of ulnar artery were used in the patients. In one week after surgery, 12 flaps survived completely, while one free flap based on the dorsal carpal branch of ulnar artery suffered from slight infection, after depressing change, it survived in the end. After the follow-up of half a year, the flaps were full in shape and the distance of two-point discrimination of ranged from 4.0 to 7.0 mm. The fingers showed good functional recovery and no deformity. The grade of function of the fingers was excellent in 10 cases and good in 3 cases. There were small incision scars in donor sites. Conclusions The wrist perforator free flap is safe and reliable for repairing electrical burn wound of finger. The wounded finger shows good appearance and function after operation.

Objective: To investigate the clinical outcome of expanded frontotemporal flap pedicled with bilateral superficial temporal vessels, in repairing facial and cervical scar contracture deformity. Methods: From January 2012 to December 2017, 12 male patients with severe facial and cervical scar hyperplasia and contracture deformity, ranging from preauricular region, cheek, chin to neck, were treated in the Burn Department of the First People′s Hospital in Zhengzhou. The patients were aged at 15-58 years, with the mean age of 29.3 years. The frontotemporal scalp flaps were simultaneously expanded to prefabricate a flap pedicled with bilateral superficial temporal arteries and veins. The operations were carried out in 3 stages. Stage Ⅰ: A 400-600 ml cylindrical expander was placed in the frontal region, underneath of galea aponeurosis and frontal muscle, meanwhile, a 50-100 ml cylindrical expander was placed in the temporal region on each side, between the deep temporal fascia and temporal muscle. Stage Ⅱ: The expanded flap pedicled with bilateral superficial temporal vessels were received, to repair the secondary wound after scar resection and contracture release. The neck curve was reshaped. The donor area was directly sutured. Stage Ⅲ: The flap pedicle was repaired, and residual scar was removed. Laser hair removal was performed on the skin flaps about 3 weeks after operation. Results: Seven patients underwent simultaneously cervical and thoracic tissue expansion. The expansion time was 5-6 months (average 5.2 months). The expanded flap was 40 cm×9 cm to 45 cm×15 cm in size. All flaps survived. The venous reflux disorder after the second stage operation occurred in 1 patient. The affected area was purple and swollen. It was recovered after acupuncture and compression bandage for 1 week. Laser hair removal was performed in 8 flaps. Flap thinning was performed in 5 flaps. All 12 patients were followed up for 4 to 24 months. The flaps have good appearance, without bloating. The transferred flaps have similar color and texture with adjacent the facial skin. The cervical mobility was significantly improved. The hairline of the head was normal, and the suture scar was slight and concealed. Conclusions The expanded frontal and temporal flaps provide considerable amount of tissue with thin skin and reliable blood supply. It is an alternative method to repair facial and cervical scar contracture.

Objective: To explore application effects of CT angiography (CTA) and three-dimensional reconstruction technique in repairing scar around the mouth and chin with expanded forehead axial flap. Methods: From June 2013 to October 2017, 9 patients with hyperplastic scar around the mouth and chin after deep burns on face were admitted to our unit. The sizes of scars of patients ranged from 8 cm×7 cm to 13 cm×8 cm. One cylindrical skin soft-tissue dilator with nominal volume of 400 to 500 mL was implanted in forehead area of each patient. Five to six months after the dilator was implanted, scar around the mouth and chin was resected, and the dilator was removed. The secondary wound after scar resection was repaired by expanded forehead axial flap with bilateral superficial temporal vessel pedicles. Three of the nine patients received microstomia diorthosis at the same time. Before the operation, CTA and three-dimensional reconstruction were applied to obtain three-dimensional images of superficial temporal arteries and the branches in the donor site, which could identify the travel, adjacent location, and vascular anastomosis of the above-mentioned vessels to guide flap design. The sizes of flaps of patients ranged from 25 cm×9 cm to 30 cm×8 cm. Two to three weeks after the operation, flap pedicles were cut off, restored, and trimmed. The donor site was sutured directly. Ten to twelve days after the flap repair operation, the flap site received depilation treatment with semiconductor freezing point laser once a month for 4 to 6 times. Results: Flaps of all patients survived well, with no blood circulation disorder. The flaps of three patients were slightly bulky, while they were with natural appearance after flap thinning operation in 3 months post flap repair operation. During follow-up of 6 months to 2 years after the operation, color, texture, and thickness of the flaps were close to normal skin around scars. The appearance of perioral and mental region, and opening function of mouth improved significantly, with no recurrence of scar. Frontotemporal incision was hidden, hair on head grew normally, and reconstructed hairline was natural. Conclusions Scar around the mouth and chin repaired with expanded forehead axial flap were with good appearance and function in operation area and good shape in donor site. CTA and three-dimensional reconstruction technique can provide clear three-dimensional images of superficial temporal arteries and the branches in expanded forehead axial flaps, which can provide reliable basis for preoperative designing of flap, reduce operative risk, and improve survival rate of flap, thus having clinical application value.

Objective: To investigate the effect of Meek skin grafting on patients with extensive deep burn at different age groups. Methods: Eighty-four patients with extensive deep burns conforming to the study criteria were hospitalized in our unit from April 2011 to April 2015. Patients were divided into children group (C, with age less than 12 years old), young and middle-aged group (YM, with age more than 18 years and less than 50 years old), and old age group (O, with age more than 55 years old) according to age, with 28 patients in each group. All patients received Meek skin grafting treatment. The use of autologous skin area, operation time, wound healing time, and hospitalization time were recorded. The survival rate of skin graft on post operation day 7, complete wound healing rate in post treatment week 2, and the mortality were calculated. Data were processed with one-way analysis of variance, t test, and χ² test. Results: The use of autologous skin area of patients in group C was (5.1±1.0)% total body surface area (TBSA), significantly less than (8.3±1.0)%TBSA and (8.3±1.4)%TBSA in groups YM and O, respectively (with t values 32.900 and 52.624, respectively, P values below 0.05). The operation time, wound healing time, and hospitalization time of patients in group C were (1.368±0.562) h, (9.6±0.6) and (32±11) d, significantly shorter than those in group YM [(3.235±0.011) h, (16.9±2.6) and (48±12) d, respectively] and group O [(3.692±0.481) h, (17.3±2.6) and (46±13) d, respectively, with t values from 4.350 to 21.160, P values below 0.05]. The survival rate of skin graft of patients on post operation day 7 in group C was (92±15)%, significantly higher than (81±10)% and (72±12)% in groups YM and O, respectively (with t values 5.509 and 3.229, respectively, P values below 0.05). The above indexes in groups YM and O were similar (with t values from 0.576 to 22.958, P values above 0.05). Complete wound healing rate in post treatment week 2 and the mortality of patients in group C were similar to those in groups YM and O (with χ² values 0.365 and 0.122, respectively, P values above 0.05). Conclusions Meek skin grafting can be used in the treatment of patients with extensive deep burns at different age groups, compared with the young and middle-aged and old patients, the effect in children was better.

OBJECTIVE: To analysis the characteristics of sudden sensorineural hearing loss (SSHL) patients with tinnitus, and explore the relationship of characteristics of tinnitus and audiology. METHOD: Patients diagnosed as SSHL with tinnitus were studied in the research. All patients' clinical features were analyzed, such as tinnitus frequency, pure tone audiometry, tinnitus, hearing loss degree, results of residual inhibition test. RESULT: Thirty cases were identified as mild degree hearing loss, 13 cases as moderate degree, 28 cases as severe degree and 34 cases as profound degree. And hearing impaired frequency of 13 cases was ascertained at low-frequency, 39 cases at middle-high-frequency, and 53 cases at full-range-frequency. The incidence of patients with low-frequency was about 41. 9% (44/105), and it was about 21. 9% (23/105) in those with middle-frequency. And it was 36. 2% (38/105) in cases of high-frequency tinnitus. The chi-square test show statistically significant differences between patients with the low-frequency, middle-frequency and high-frequency of the hearing loss (P<0. 05). In tinnitus residual inhibition test, positive rate of convergence type masking curve was about 72.0%, tinnitus separated type masking curve 20.0%, overlapping type was 57.9%, and the spacing type was 43.5%. There was a statistically significant difference among cases with different type masking curve (P<0. 05)with the spacing residual inhibition test positive rate. CONCLUSION There are individual differences of clinical characteristics among SSHL patients with tinnitus. Tinnitus frequency is consistent with the frequency of hearing loss. Patients had the more serious the degree of hearing loss, who had more serious tinnitus grading. Cases with the converged type curve will be fit for tinnitus masking. Therefore, combining the tinnitus detection with the audiological tests, we could obtain the clinical characteristics of SSHL patients with tinnitus.
Audiometry, Pure-Tone ; Deafness ; Hearing Loss ; Hearing Loss, Sensorineural ; complications ; pathology ; Humans ; Tinnitus ; complications ; pathology

OBJECTIVE: The aim of this retrospective study was to analyze the recovery rate of sudden sensorineural hearing loss in children, and explore the prognostic factors in order to guide the clinical diagnosis and treatment. METHOD: A retrospective review was conducted for the prognosis of children with sudden sensorineural hearing loss during the past 5 years (from November 2010 to May 2015) in Chinese PLA General Hospital. This paper have a complete clinical data of 101 patients (113 ears)with sudden hearing loss, ranging from 0 to 18 years old Patients were divided into four groups according to hearing recovery and eight putative prognostic factors were analyzed. RESULT: Among 101 patients (113 ears), the ratio of male and female was 60:53. Treatment was initiated from 1 to 183 days after disease onset, with an average of (18.5 ± 22.1) d. Bilateral and unilateral hearing loss were 24 ears and 89 ears, respectively. The proportion of mild hearing loss, moderate hearing loss, severe hearing loss and profound hearing loss were 7.1%, 6.2%, 23.9% and 62.8%, respectively. Vertigo and tinnitus occurred in 54.9% and 77.9% of the patients, respectively. After the treatment, the complete recovery rate was 9.7% and the overall recovery rate was 36.3%. The degree of hearing loss, earlier treatment onset, sex and bilateral involvement were significantly associated with hearing recovery (P < 0.05). CONCLUSION Sudden sensorineural hearing loss in children was generally identified as severe and profound hearing loss, but after positive and timely treatment, it can be improved or even cured. The mild hearing loss, earlier treatment onset, unilateral hearing loss and female were positive prognostic factors. The concurrence of tinnitus or vertigo, the results of ABR and DPOAE had no significant influence on prognosis.
Adolescent ; Child ; Child, Preschool ; Female ; Hearing Loss, Sensorineural ; diagnosis ; Hearing Loss, Sudden ; diagnosis ; Hearing Loss, Unilateral ; diagnosis ; Hearing Tests ; Humans ; Infant ; Infant, Newborn ; Male ; Prognosis ; Retrospective Studies ; Tinnitus ; complications ; Vertigo ; complications

Animals ; Entomology ; history ; History, 20th Century ; Insecta

Objective: To analyze the current situation and related factors of physical exercise behavior among high school students, so as to provide theoretical basis for improving their health level. Methods: In May 2022, a stratified cluster random sampling method was used to select 17 high schools in the jurisdiction of Taizhou City. A total of 3 402 high school students were selected by class to conduct a survey on the prevalence and related factors of physical exercise behavior by Chinese Sports Activity Level Scale. And binary Logistic regression analysis was conducted to analyze the influencing factors. Results: Among the surveyed high school students, the rate of poor physical exercise behavior reached 53.4%. The rates of poor physical exercise behavior varied within the group in terms of gender, urban and rural areas, whether they were only children, maternal education, parental emotions, parental exercise habits, parenting styles, family income and academic performance were statistically significant (χ2=12.38, 11.73, 742.71, 28.86, 24.38, 39.98, 71.92, 33.34, 176.97, P<0.01). High school students of grade 3, female students, parents with low education, parents who occasionally and never exercise, intergenerational discipline, low family income, and average academic performance were the tendency factors for poor physical exercise behavior(OR=1.39, 1.18, 1.62, 1.30, 1.36, 2.21, 1.53, 1.46, 1.52, P<0.05). Conclusions The rate of poor physical exercise behavior among high school students in Taizhou City is relatively high and is affected by various factors such as age, gender, academic performance, and family background. It should actively reduce the impact of unfavorable factors, promote high school students to participate in physical exercise, and improve the health level of high school students.

OBJECTIVETo achieve early diagnosis for inheritable hearing loss and determine carrier rate of deafness causing gene mutations in order to provide information for premarital, prenatal and postnatal genetic counseling.

METHODSA total of 17 000 dried heel blood spots of normal newborns in Chengdu were collected with informed consent obtained from their parents. Genomic DNA was extracted from dried blood spots using Qiagen DNA extraction kits. Microarrays with 9 common mutation loci of 4 deafness-associated genes in Chinese population were used. Nine hot mutations including GJB2 (35delG, 176del16, 235delC and 299delAT), GJB3 (538C> T), SLC26A4 (IVS 7-2A> G, 2168A> G), and mitochondrial DNA 12S rRNA (1555A> G, 1494C> T) were detected by PCR amplification and microarray hybridization. Mutations detected by microarray were verified by Sanger DNA sequencing.

RESULTSOf the 17 000 new-borns, 542 neonates had mutations of the 4 genes. Heterozygous mutations of GJB2, at 235delC, 299delAT, and 176del16 were identified in 254, 55, and 15 newborns, respectively. Two newborns had homozygous mutation of GJB2, 235delC. Heterozygous mutations at 538C> T of GJB3, 2168A> G and IVS 7-2A> G of SLC26A4 were found in 23, 17 and 128 newborns, respectively. For mutation analysis of mitochondrial DNA 12S rRNA, 1494C> T and 1555A> G were homogeneous mutations in 4 and 42 neonates, respectively. In addition, 6 complexity mutations were detected, which demonstrated that one newborn had heterozygous mutations at GJB2 235delC and SLC26A4, IVS7-2A> G, one had heterozygous mutation GJB2 235delC and 12S rRNA homogeneous mutation, 1555 A> G, one heterozygous mutations at GJB2, 299delAT, and GJB3, 538C> T, one at GJB2, 299delAT and 12S rRNA, 1555 A> G, two at GJB2, 299delAT, and SLC26A4, IVS7-2A> G. All mutations as above were confirmed by DNA sequencing.

CONCLUSIONThe total mutation carrier rate of the 4 deafness genes is 3.19% in healthy newborns at Chengdu. Mutations of GJB2 and SLAC26A4 are major ones (86.5% of total). The mutation rate of mitochondrial DNA 12S rRNA is 2.71‰, which may have deafness induced by aminoglycoside antibiotics. Newborn screening for mutation of genes related to hereditary deafness plays an important role in the early detection and proper management for neonatal deafness as well as genetic counseling for premarital, prenatal and postnatal diagnosis.

Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; Connexin 26 ; Connexins ; genetics ; DNA Mutational Analysis ; DNA, Mitochondrial ; chemistry ; genetics ; Deafness ; diagnosis ; ethnology ; genetics ; Dried Blood Spot Testing ; Genetic Predisposition to Disease ; ethnology ; genetics ; Genetic Testing ; methods ; Humans ; Infant, Newborn ; Membrane Transport Proteins ; genetics ; Microarray Analysis ; methods ; Mutation ; Neonatal Screening ; methods ; RNA, Ribosomal ; genetics