OBJECTIVE: To explore the best time of intratympanic dexamethasone injection to treat sudden sensorineural hearing loss (SSNHL) as salvage therapy so that to improve the curative efficacy on sudden deafness at the utmost. METHOD: A total of 192 patients with SSNHL were included in this study, among whom 63 cases received the systemic steroid therapy throughout the study, while the other ones were treated with systemic steroid as initial treatment and were given intratympanic steroid administration as salvage treatment starting at different time point. The salvage treatment started on the 3rd day after the beginning of the initial treatment for 29 cases, on the 7th day for 38 cases, on the 14th day for 43 cases, and 1 month later for 19 cases. All the patients were followed up for 2 months. RESULT: The recovery rates and total effective rates showed no statistically significant difference between the patients received only systemic steroid therapy and the ones received intratympanic steroid administration on the 3rd, 7th day and 1 month later after the initial treatment. The recovery rate and total effective rate exhibited statistically significant difference between the patients received intratympanic steroid administration since the 14th day after the initial treatment and the ones received only systemic steroid therapy, with the numerical value of P 0. 037 and 0. 034, respectively. CONCLUSION (1) As an initial management plan, the curative effects. between the intratympanic steroid administration and the systemic steroid therapy were not significantly different. (2) As a salvage treatment, intratympanic steroid was a better choice for patients who have not completely recover from ISSNHL after failure of initial management with systemic steroid only. (3) The best time point of salvage treatment with intratympanic steroid was about 2 weeks after initial management with systemic steroid.
Hearing Loss, Sensorineural ; drug therapy ; Hearing Loss, Sudden ; drug therapy ; Humans ; Injection, Intratympanic ; Salvage Therapy ; Steroids ; therapeutic use ; Treatment Outcome ; Tympanic Membrane

OBJECTIVETo investigate the feasibility of continuation of aspirin before tooth extraction in the elderly.

METHODSThe patients enrolled in this study were the elderly requiring a single non-impacted tooth extraction. 300 elderly outpatients used lidocaine local infiltration anesthesia, 200 patients without using aspirin before tooth extraction served as control group I, 100 patients with prolong use of aspirin before tooth extraction as observation group I. 300 elderly outpatients used compound articaine local infiltration anesthesia, 200 patients without using aspirin before tooth extraction served as control group II, 100 patients with prolong use of aspirin before tooth extraction as observation group II.Bleedings at 5, 10, 30 min, 24 h after tooth extraction were observed and the relationship between postoperative bleeding and intake of aspirin was analyzed.

RESULTSThere was no significant difference at 5, 10, 30 min, 24 h in postoperative bleeding after extraction between control group I and observation group. The incidence of bleeding of observation group II after tooth extraction at 5 min was higher than that of control group II and there was no significant difference at 10, 30 min, 24 h between the two groups.

CONCLUSIONSContinuation of aspirin have no influence on postoperative bleeding. Therefore we suggest that there was no indication to discontinue aspirin for the elderly before a single non-impacted tooth extraction.

Aged ; Aged, 80 and over ; Anesthesia, Local ; Aspirin ; adverse effects ; Female ; Humans ; Lidocaine ; Male ; Middle Aged ; Oral Hemorrhage ; etiology ; Platelet Aggregation Inhibitors ; adverse effects ; Postoperative Hemorrhage ; etiology ; Tooth Extraction ; adverse effects

OBJECTIVE: To systematically evaluate the efficacy and safety of anterior decompression and posterior decompression in the treatment of thoracolumbar fractures with spinal cord injury, so as to provide a good scientific basis for more effective treatment of thoracolumbar fractures with spinal cord injury. METHODS: A clinical data about comparative study of anterior decompression and posterior decompression in the treatment of thoracolumbar fractures with spinal cord injury was searched and collected. The databases of Pubmed, Embase, Cochrane Library, CNKI, CBM, Wanfang Medical Network were searched by computer. Artificially collected journals included Spine, European Spine Journal, The Journal of Bone and Joint Surgery. Two spine surgeons independently screened the literature according to established inclusion and exclusion criteria and assessed the quality of the included studies. Meta-analysis was performed on the data using Review Manager 5.3 software, the indicators included operative time, intraoperative blood loss, postoperative tactile score, postoperative motor score, postoperative vertebral height, hospitalization time, neurological function recovery, efficiency of treatment, postoperative complications. RESULTS: Fifteen randomized controlled trials (RCTs) were enrolled in a total of 1 360 patients, including 680 anterior decompression and 680 posterior decompression. The results of Meta-analysis showed that the anterior decompression group had longer operation time [MD=80.09, 95% CI(36.83, 123.34), P=0.000 3], more intraoperative blood loss [MD=225.21, 95%CI(171.07, 279.35), <0.000 01], longer hospitalization time [MD=2.31, 95% CI(0.32, 4.31), P=0.02]. And the postoperative tactile score [MD=13.39, 95% CI(9.86, 16.92), <0.000 01], postoperative motor score [MD=13.15, 95% CI(7.02, 19.29), <0.000 1], vertebral height [MD=1.36, 95% CI(0.79, 1.92), <0.000 01] in anterior decompression were higher than that in posterior decompression. There was no statistically significant differences in the efficacy of treatment [OR=1.14, 95% CI(0.56, 2.31), P=0.72], neurological recovery [OR=0.87, 95% CI(0.57, 1.33), P=0.52] between two groups. CONCLUSIONS Compared with posterior decompression, the anterior decompression has the advantages of longer operating time, more intraoperative blood loss, longer hospitalization time, higher postoperative tactile score, higher postoperative motor score, and higher injury vertebral height, But there was no significant difference in the treatment efficiency and nerve function recovery between two groups.
Decompression, Surgical ; Humans ; Lumbar Vertebrae ; Spinal Cord Injuries ; Spinal Fractures ; Thoracic Vertebrae ; Treatment Outcome

Objective To investigate the effect of matrine on the cardiac function and left ventricular remodeling in rats with isoproterenol (ISO) -induced cardiac hypertrophy.Methods Seventy-two adult male SD rats were randomly divided into six groups as follows:normal group,model group,control group (matrine 200 mg · kg-1 · d-1),large-,medium-and small-dose experimental groups(matrine 200,100,50 rng · kg-1 · d-1),and there were 12 rats in each group.The 5 mg · kg-1 · d-1 isoproterenol (ISO) was subcutaneously injected to establish the model of chronic pathological left ventricular hypertrophy in model group and experimental groups.The 0.9％ NaCl was administrated to rats in normal group and control group.The aforementioned medications were offered once daily to 12 rats of each group for 7 successive days.On day 8,cardiac function was evaluated by the biological function experiment system.The hematoxylin-eosin staining was used to observe pathological morphology changes of the left ventricular tissues.Insulin-like growth factor-1 (IGF-1) and transforming growth factor-β1(TGF-β1)levels in serum were determined by ELISA.Expression levels of IGF-1and TGF-β1 genes in myocardial tissues were detected by real time fluorescence quantitative PCR method.Results After drug-concerned treatment,serum IGF-1 levels in normal group,model group,control group,large-,medium-and small-dose experimental groups were separately (2.04 ± 0.52),(3.66 ± 0.97),(2.08±0.95),(1.98 ± 0.98),(1.93 ±0.78) and (1.59 ± 0.48)ng · mL-1;moreover,serum TGF-β1 levels in those groups were (94.11 ±10.63),(139.98 ± 37.64),(90.36 ± 30.02),(84.55 ± 45.70),(74.74 ± 42.18) and (72.84 ± 21.43) pg · mL-1.In contrast with model group,the serum IGF-1 or TGF-β1 levels were lowered in other groups (P ＜ 0.05).Similarly,expression levels of cardiac IGF-1 genes in normal group,model group,control group,large-,medium-and small-dose experimental groups were sequentially 3.34 ± 3.27,10.91 ± 7.44,3.09 ± 1.86,0.62 ± 0.44,0.64 ± 0.26,1.00 ± 0.35;furthermore,expression levels of cardiac TGF-β1 genes were successively 0.70 ± 0.67,10.97 ± 9.86,0.63 ± 0.32,1.25 ± 0.98,1.76 ± 2.40,0.86 ± 0.46;and hence the TGF-β1 gene levels in model group were much higher than those of other groups (P ＜ 0.01).Conclusion Matrine significantly improved the cardiac function in rats with ISO-induced left ventricular hypertrophy and simultaneously regulated the cardiac hypertrophy-causing cytokines.

Objective To systematically review the efficacy and safety of bevacizumab biosimilars versus original drugs in treatment of metastatic colorectal cancer.Methods PubMed,Embase,Cochrane Library,CNKI,WanFang Data,VIP and SinoMed databases were electronically searched to collect the randomized controlled trials(RCTs)of bevacizumab biosimilar in patients with metastatic colorectal cancer from inception to June 18,2023.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies,and a meta-analysis was conducted using Stata 17.0 software.Results A total of 4 RCTs involving 1 052 patients were included.The results of meta-analysis showed that no significant difference was found in overall response rate(RD=﹣0.01,95%CI ﹣0.06 to 0.05,P=0.86),progression free survival(HR=1.00,95%CI 0.91 to 1.09,P=0.94),the total incidence of adverse drug reactions(RR=1.05,95%CI 0.85 to 1.31,P=0.91)and the incidence of severe adverse events(RR=0.886,95%CI 0.377 to 2.081,P=0.60)between bevacizumab biosimilars group and original drugs group.Conclusion The current evidence shows that bevacizumab biosimilar is equivalent to original drugs in treatment of metastatic colorectal cancer.Due to limited quality and quantity of the included studies,more high quality studies are required to verify the above conclusions.

The ICR(Institute of Cancer Research)mouse infection model was constructed to study the pathogenicity of Sal-monella Telelkebir serotype,and the pathogenic identification of mouse isolates was carried out.Observe the bacterial excretion cycle,evaluate the pathogenicity of Salmonella serotype to mice,and calculate the LD50 by the changes in clinical characteris-tics,histopathology and tissue bacterial load of infected mice;by flight mass spectrometry,biochemical identification,serotype identification,molecular typing and other experiments,compared with human isolates;virulence gene analysis was carried out by PCR experiment and whole genome sequencing.The LD50 of Salmonella Telelkebir is 2.67 × 108 CFU/mL;curling and fluffing may occur 0.5 h after infection;autopsy of dead mice showed that the small intestine was severely congested,with more bubbles and fluid accumulation,cecal necrosis,liver apical degeneration and necrosis,necrotic foci on the surface of the kidney and spleen atrophy;the bacterial load of spleen,kidney,lung,liver and jejunum in mice reached its peak at 3 days after infection,while that of heart at 6 days;the bacterial excretion time of the high-dose group exceeded 100 days;The level of CD3 in tissues increased with increasing dose,with inflammatory cell infiltration,myocardial capillary dilation and hyperemia,large area of vacuoles,degeneration and necrosis of hepatocytes,obvious enlargement of splenic sinus,blurred zoning,thickening of glomerular basement membrane,partial exfoliation of ciliated epithelium,atrophy and exfoliation of jejunal villi;PCR and whole genome sequencing revealed Salmonella-related virulence genes such as cdtB,plt A and pltB.This study was the first to successfully establish the ICR mouse model of Salmonella Telelkebir,demonstrating that this serotype of Salmonella has some pathogenicity.

Objective:To explore the function of tumor derived IgG (tIgG) and whether the tIgG can inhibit T cells activity.Methods:The tIgG was purified from ovarian cancer tissue.The cord blood monocyte cells (CBMC) and cord blood lymphocyte (CBL) were isolate from human umbilical cord blood.The CBMC and CBL were stimulated with phytohaemagg lutinin (PHA) in order to let the CBMC and CBL in the state of proliferation.Carboxyfluorescein succinimidyl amino ester (CFSE) was cultured with CBMC and CBL.CFSE had no cell toxicity,which could penetrate through the cell membrane and combine the intracellular protein.The fluorescence intensity decreased with the proliferation of cells step by step,so the proliferation of these cells could be detected in flow ctytometry.The tlgG which was puri fied from ovarian cancer tissue was divided into three groups,1 mg/L group,10 mg/L group,and 100 mg/L group,and the intravenous immunoglobulin (IVIG) was also divided into three groups too.The CBMC and CBL were treated by tIgG with 1 mg/L,10 mg/L,and 100 mg/L in order to observe the proliferation of T cells.The cells were treated with IVIG as a positive control group,and the cells were treated with phosphate buffer saline (PBS) as a negative control.The proliferation of CD4 + or CD8 + T cells were detected in CBMC and CBL.The proliferation of the T cells in CBMC and CBL after 64 h and 86 h were detected.Results:In the system of CBMC,the tIgG could suppress the proliferation of CD4 + or CD8 + T cells.The results could also be found in the system of CBL.The CD4 + or CD8 + T cells in the group which were treated with PBS were more active than those in the group which were treated with tIgG and IVIG.The suppression in the group which were treated with tIgG,was stronger than that in the group treated with IVIG.In addition,the suppression of T cells in the group which were stimulated with tIgG as 100 mg/L was more effective than that in the group which were stimulated with tIgG as 10 mg/L.This could prove that tIgG had the function of immunomodulation.Conclusion:The tIgG can be involved in immune escape of cancer.

OBJECTIVE: To explore the effect of electroacupuncture on heroin seeking behavior and FosB expression in relevant brain regions. METHODS: Rat model of heroin relapse behaviors was developed with progressive fixed ratio program,and model rats were randomly divided into 3 groups: a restraint group, a needle retention group, and a electroacupuncture group. The heroin seeking behavior was elicited by a small dose of heroin. FosB expression in relevnt brain region was assessed with immunohistochemical technique. RESULTS: Tests on reinstatement of drug seeking behavior induced by heroin priming showed that compared with the restraint group, active pokes in the electroacupuncture group decreased significantly(P<0.05). Compared with the restraint group, the expression of FosB positive nuclei in Acd, Pcg and CeA of rats brain both in the electroacupuncture group and the needle retention group (P<0.05) decreased significantly. In LC, the expression of FosB positive nuclei in the needle retention group decreased significantly compared with the restraint group (P<0.05). CONCLUSION Continuous acupuncture and needle retention attentuate the reinstatement of heroin-seeking behaviors induced by heroin priming, and the inhibitory effect may be mediated partially by the expression of FosB in relevant regions which are involved in the process of heroin addiction.
Amygdala ; metabolism ; Animals ; Behavior, Animal ; Brain ; metabolism ; Electroacupuncture ; methods ; Heroin Dependence ; metabolism ; psychology ; therapy ; Male ; Nucleus Accumbens ; metabolism ; Proto-Oncogene Proteins c-fos ; biosynthesis ; Random Allocation ; Rats ; Rats, Sprague-Dawley

AIMTo observe mRNA expression of muscarinic acetylcholine receptors in spinal cord and brainstem in morphine dependent or withdrawal rats.

METHODSThe mRNA expression level of m1, m2, m3, m4 and m5 were determined by RT-PCR, the beta-actin mRNA expression was used as internal control.

RESULTSThe mRNA level of m1, m2, m3, m4 and m5 in spinal cord and m1 and m2 in brainstem were increased significantly during morphine dependence, and the levels of m1, m2, m3 and m4 in spinal cord and m1 in brainstem were decreased 1 h after the injection of naloxone (4 mg.kg-1, i.p.) in morphine dependent rats. Either scopolamine (0.5 mg.kg-1) or pirenzepine (10 mg.kg-1) was shown to significantly decrease the morphine withdrawal symptoms in rats. The levels of m1, m2, m3 and m5 in spinal cord were increased by pretreatment with pirenzepine and the levels of m2, m3 and m4 in spinal cord were increased by pretreatment with scopolamine.

CONCLUSIONThe adaptive expression of muscarinic receptors at spinal and supraspinal levels play important role in mediating morphine dependence and withdrawal in rats.

Animals ; Brain Stem ; drug effects ; metabolism ; Gene Expression ; drug effects ; Male ; Morphine ; toxicity ; Morphine Dependence ; metabolism ; RNA, Messenger ; biosynthesis ; drug effects ; Rats ; Rats, Sprague-Dawley ; Receptors, Muscarinic ; biosynthesis ; classification ; genetics ; Spinal Cord ; drug effects ; metabolism ; Substance Withdrawal Syndrome ; metabolism