Objective To study clinical characteristics and treatment effects on old patients with sudden sen-sorinerural hearing loss .Methods To compare clinical characteristics and effects of 357 cases of unilateral SSHL from Sep ,2013 to Mar ,2015 in the First Affiliated Hospital of Zhengzhou University .The patients were divided into 2 groups :the old group(66 cases)≥60 years ,and the control group(291 cases)<60 years .All cases were trea-ted with drugs to supply nutrition to the nerves and drugs to improve circulation and intratympanic injection of dexa-methasone .Results The genders ,ear sides ,concomitant symptoms and onset time ,degrees of hearing in 2 groups showed no significant difference (P>0 .05) ,but there were less patients with the type in low frequencies (1 .51% ) and more with the type in high frequencies (22 .73% ) and the type in total deafness (50 .0% ) than those of in the control group(14 .43% ,15 .44% ,39 .52% ) .The old group had more patients with systemic diseases (60 .61% ) and the hearing impairment of the other ear (57 .58% ,P<0 .05) .Total effective rate was 70 .03% ,which the old group and the control group were 60 .61% and 72 .16% ,respectively .The difference had no statistical significance (P>0 .05) .The old group's complete recovery rate was 10 .61% ,which was significantly lower than that in the control (P<0 .05) .Conclusion The old group has more patients with systemic diseases and the hearing impairment of the other ear .Their hearing impairment more easily occurs in the type in high frequencies and the type in total deafness . But the complete recovery rate is low ,the doctors and patients should have a reasonable expectation .

Objective To investigate the recurrent etiologic causes in otitis media with effusion(OME).Meth-ods The patients with OME had been conducted clinical evaluation and ventilation tube insertion.Among 255 cases observed,85 cases were recurrence within one year,while 170 cases were recovered.Factors including age,gender, course of disease,smoking environment,recurrent respiratory tract infection,chronic nasal sinusitis,nasal struc-tural abnormalities,adenoid hypertrophy/nasopharyneal lymphadenosis,and mastoid gasification condition,histo-ry of tube insertion,duration of ventilation tube were evaluated by univariate analysis and multivariate logistic re-gression analysis and compared among preschool children,school age children and adults.Results In univariate a-nalysis,it was strongly associated with age,higher prevalence of recurrent respiratory tract infection(χ2= 22.546,P= 0.000),chronic nasal sinusitis(χ2= 5.211,P= 0.023),adenoid hypertrophy/nasopharyneal lymphadenosis(χ2= 10.338,P= 0.002),mastoid pneumatization adverse(χ2= 15.196,P= 0.000)and duration of ventilation tubeand (χ2= 11.347,P= 0.001).In multivariate logistic regression model,five of these factors were found to be predictors of recurrent OME,which were younger age,recurrent respiratory tract infection (P= 0.001,OR= 2.992),adenoid hypertrophy/nasopharyneal lymphadenosis (P= 0.021,OR= 2.198),mastoid pneumatization adverse (P= 0.000, OR= 3.433)and duration of ventilation tube(3~6 m)(P= 0.010,OR= 2.237).When comparing the difference a-mong preschool children,school age children and adults,recurrent respiratory tract infections in preschool and school age children had the statistic significance(P<0.05),and adenoid hypertrophy in preschool had the statistic significance(P<0.05).Conclusion Younger age,recurrent respiratory tract infection,chronic nasal sinusitis,ade-noid hypertrophy/nasopharyneal lymphadenosis,mastoid pneumatization adverse and less time of ventilation tube are the risk factors causing recurrence of OME.When comparing the recurrent preschool children,school age chil-dren and adults cases,more recurrent respiratory tract infection in preschool and school age children have statistic significance,and adenoid hypertrophy in preschool has the statistic significance.

Objective To study the effects of thymus transplantation(TT)combined with CD4--DLI on T cell reconstitution after allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods BALB/c mice were randomly divided into three groups:hematopoietic stem cell transplantation (HSCT group),hematopoietic stem cell transplantation combined with thymus transplantation(TT group)and hematopoietic stem cell transplanta-tion combined with thymus transplantation plus CD4+ T cell-depleted lymphocyte infusion(CD4--DLI group). On day-1,the mice were treated with the lethal dose of radiotherapy. On day 0,C57BL/6 mice were used as donor for hematopoietic stem cell transplantation. The mice were sacrificed on 5 days,2 weeks,4 weeks and 3 months after transplantation,respectively. The peripheral blood and spleen cells of mice were collected for determinations of T cell surface antigen,T cell receptor,naive T cells and intracellular cytokines. HE staining was used to assess the development of donor thymus. Results TT and CD4--DLI did not impair each other′s effects on T cell reconstitu-tion. TT combined with CD4--DLI increased the number of T cell reconstruction. CD4--DLI promoted the effect of TT on enlargement naive CD4+and CD8+T cell pool. Combination of TT and CD4--DLI enhanced the cytokine pro-duction of T cells. Conclusion TT combined with CD4--DLI had no side effects on TCR repertoire and thymus. Conclusion TT combined with CD4--DLI can enhance the reconstitution of T cell number and function via thymus dependent and thymus independent mechanism.

Patients with advanced hepatocellular carcinoma (HCC) often have poor prognosis, and early diagnosis and effective treatment measures can significantly improve the survival rate of patients. At present, alpha-fetoprotein (AFP) is the most widely used serum marker for the diagnosis of HCC in the world; however, no increase in AFP was found in some HCC patients. This article analyzes the application potential of AFP, hepatitis B core-related antigen, liquid biopsy technology, microRNA, long non-coding RNA, and exosomes in the early diagnosis of HCC and reviews related research advances, so as to provide a basis for exploring new methods for the early diagnosis of HCC.

Objective To explore the changes of Beclin-1,P62/SQSTM1,microtubule-associated protein 1 light chain 3 (LC3)and unc-51 like autophagy activating kinase 1 (ULK-1)in the brains of the rats in the deve-lopmental stage with epilepsy. Methods Seventy-two male Sprague Dawley (SD)rats aged 21 days were randomly divided into the control group and the epilepsy group. The rats in 2 groups were randomly subdivided into 4 groups according to the time intervals (3 h,6 h,12 h and 48 h),respectively,with 9 rats in each group. The rats in the epilep-sy group were injected with kainic acid (12 mg/kg)to induce epilepsy,and the rats in the control group were injected with equal volume of saline. The rats in 2 groups were anaesthetized and sacrificed. Then,the brain tissues of the rats were quickly removed according to the time intervals. The brain damages were determined by adopting Nissl staining method. The apoptotic cells were detected by Terminal - deoxynucleoitidyl transferase mediated nick end labeling (TUNEL)assays. The expressions of Beclin-1,P62/SQSTM1,LC3 and ULK-1 mRNA levels in cortex were mea-sured by using real-time quantitative polymerase chain reaction (qPCR)analysis. Results Nissl staining indicated that many neurons were damaged performing vague outline,irregularly aligned,pyknotic nuclei and shrunken somata in the epilepsy 48 h group. In addition,there was a huge loss of neurons in cortex in the epilepsy 48 h group [(82 ± 8)num-bers],compared with the control group [(122 ± 8)numbers],and the difference was statistically significant (F＝3. 768, P＝0. 01). The apoptotic cells tremendously increased in the epilepsy 48 h group [(13 ± 7)numbers],compared with the control group [(2 ± 1)numbers]by TUNEL analysis,and the diffe-rence was statistically significant (t＝ -3. 821, P＝0. 003). qPCR showed the mRNA levels of Beclin-1,P62/SQSTM1,LC3 and ULK-1 were upregulated in the epi-lepsy 12 h group (1. 70 ± 0. 75,1. 75 ± 0. 77,1. 52 ± 0. 43,7. 48 ± 6. 12)and the epilepsy 48 h group (1. 63 ± 0. 43, 1. 48 ± 0. 74,1. 74 ± 0. 55,7. 69 ± 5. 65),compared with the control group (1. 00,1. 00,1. 00,1. 00),and the differences were statistically significant (F＝2. 820,3. 452,5. 811,5. 002,all P＜0. 05). Conclusion The autophagy activates be-fore apoptosis occurs,and autophagy-related genes probably are involved in epilepsy-induced brain damage.

In this study, ivabradine hydrochloride (IVB) was prepared as elementary osmotic pump tablets whose administration frequency was reduced to once daily. The dissolution method was developed, and effects on drug release profiles were evaluated by single factor analysis involving suspending agents, osmotic active agents and aging process. Orthogonal test was carried out at 3 levels on 3 factors including the amount of polyoxyethylene (PEO) in the core, polyethylene glycol (PEG) percentage and weight increase of controlled-release film coatings. The final formulation consisted of IVB (16.25 mg), PEO N80 (60 mg), hypromellose E5 (10 mg), lactose (111.75 mg), magnesium stearate (2 mg); and the film coatings consisted of PEG (15%), cellulose acetate (85%), with a weight increase of 7.5%. In vitro drug release behaviors were investigated. Prepared tablets exhibited similar release profiles in different pH dissolution media, with no risk of dose dumping in 40% ethanol solutions. The osmotic pressure differences inside and outside the membrane drove drug release. IVB osmotic pump tablets could reduce the frequency of administration and improve patients'' compliance, thus with better application values.

Objective:To analyze risk factors of dry eye in patients with type 2 diabetic retinopathy, construct a dry eye risk nomogram model and conduct external verification.Methods:The study was a cross-sectional study. A total of 366 patients with type 2 diabetic retinopathy treated in the Ophthalmology Clinic of the First Affiliated Hospital of Naval Medical University from March 2020 to November 2021 were conveniently selected as the research objects. They were divided into the modeling group and the validation group by random number table method, with 183 cases in each group. The prevalence of dry eye in patients with type 2 diabetic retinopathy was counted. The risk factors of dry eye were screened by univariate analysis and binomial Logistic regression analysis, and the nomogram model of dry eye risk was constructed based on the data of the patients in the modeling group. Calibration curve and receiver operating characteristic (ROC) curve analysis were performed on the data of patients in the validation group to evaluate the calibration and discrimination of the nomogram model.Results:The prevalence of dry eye in patients with type 2 diabetic retinopathy was 57.38% (210/366) . More than 60 years old, more than 4 hours of daily screen viewing time, duration of diabetes longer than or equal to 5 years, glycated hemoglobin greater than equal to 7.0% and diabetic retinopathy grade of severe non-proliferative type and proliferative type were risk factors for dry eye in patients with type 2 diabetic retinopathy ( P<0.05) , and sleep time greater than or equal to 7 hours per night was a protective factor ( P<0.01) . The χ 2 value of Hosmer-Lemeshow test of the nomogram model of dry eye risk constructed by six factors was 14.280 ( P=0.075) , showing that the actual observation curve was consistent with the predicted curve. The area under the ROC curve was 0.815 (95% CI: 0.750-0.880) . Conclusions:Patients with type 2 diabetic retinopathy have a high prevalence of dry eye. More than 60 years old, more than 4 hours of daily screen viewing time, duration of diabetes longer than or equal to 5 years, glycated hemoglobin greater than equal to 7.0% and diabetic retinopathy grade of severe non-proliferative type and proliferative type are risk factors for dry eye in patients with type 2 diabetic retinopathy, and sleep time greater than or equal to 7 hours per night is a protective factor. The nomogram model constructed in this study has good calibration and discrimination, which can help medical staff identify the risk of dry eye as early as possible.

Objective: To investigate the clinical significance of tumor associated macrophages (TAM) in multiple myeloma (MM) and the relationship with angiogenesis and immunosuppression. Methods: Seventy cases of MM patients diagnosed from August 2015 to June 2017 were enrolled in the study as experimental group, 20 cases of benign hematological diseases (13 with iron deficiency anemia and 7 with megaloblastic anemia) patients as control group. Immunohistochemical method was used to detect the expression of CD163, CD34 and VEGF in bone marrow samples, and flow cytometry was used to detect the proportion of regulatory T cell (Treg cells), ELISA was used to detect the level of IL-10, and the clinical features were analyzed. Results: ①Among the 70 patients, there were 31 males and 39 females with a median age of 65 (50~78) years old. TAM infiltration density, microvascular density (MVD), VEGF expression level, Treg ratio and IL-10 level in bone marrow samples of 70 MM patients were significantly higher than those of benign hematological diseases (P<0.05). ②In the MM group, the above indexes of the patients with disease stabilized (15 cases) were lower than those of the newly diagnosed group (35 cases) and the relapse refractory group (20 cases) (P<0.05), those of relapse refractory group were higher than those of newly diagnosed group (P>0.05). ③Of the 35 newly diagnosed MM patients, 27 completed 4 courses of treatment. In the effective group (15 cases), the TAM infiltration density after treatment was significantly lower than that before treatment, the difference was statistically significant[(20.20±7.66) vs (28.87±11.97), t=2.362, P=0.025]; while in the ineffective group of 12 cases, the difference of the TAM infiltration density before and after treatment was not statistically significant[(42.00±13.76) vs (48.25±13.59), t=1.119, P=0.275]. ④TAM infiltration density in the effective group after bortezomib treatment (21 cases) were lower than those in the non-bortezomib treatment group (18 cases)[(16.52 ±4.26) vs (19.27 ±5.82), t=1.662, P=0.170]. ⑤The TAM infiltration density in MM patients was positively correlated with MVD, VEGF expression level, Treg cell ratio and IL-10 level (P<0.001). Conclusion The infiltration of TAM in the microenvironment of MM, which may promoting angiogenesis and inhibiting immune response, is related to the occurrence, development, therapeutic effect and drug resistance of MM.

Objective To explore the value of vesical imaging reporting and data system(VI-RADS)combined with absolute tumor-wall contact length(ABTCL)and actual tumor-wall contact length(ACTCL)in diagnosing muscle invasive bladder cancer(MIBC).Methods The MRI data of 113 patients with pathologically confirmed bladder cancer(BCa)were analyzed retrospectively.All patients underwent conventional MRI,diffusion weighted imaging(DWI)and dynamic contrast enhanced(DCE)MRI before sur-gery.Two radiologists independently evaluated MRI images based on VI-RADS score,and measured quantitative parameters,inclu-ding ABTCL and ACTCL.The Chi-square test was used to compare the difference of VI-RADS scores between MIBC and non-mus-cle invasive bladder cancer(NMIBC).Quantitative parameters between MIBC and NMIBC were compared by Mann-Whitney U test.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of VI-RADS,quantitative parameters and VI-RADS combined with quantitative parameters in the diagnosis of MIBC.Results VI-RADS,ABTCL and ACTCL had significant differences between MIBC and NMIBC(P＜0.05).The area under the curve(AUC)for VI-RADS,ABTCL and ACTCL in diagno-sing MIBC were 0.89,0.76 and 0.77,respectively.There was no significant difference between the AUC for ABTCL and ACTCL(P＞0.05).The AUC for VI-RADS combined with ABTCL or ACTCL in diagnosing MIBC was 0.93,higher than that of only VI-RADS(P＜0.05).Conclusion The combination of VI-RADS with either ABTCL or ACTCL can effectively improve the diagnostic performance of MIBC.ABTCL obtainedby linear measurement is easier to implement in clinical practice than ACTCL obtained by curved measurement.

Objective:To investigate the clinicopathological characteristics of acidophil stem cell pituitary neuroendocrine tumors (PitNET)/adenoma.Methods:Five cases of acidophil stem cell PitNET/adenoma were diagnosed between May 2022 and July 2023 at the Second Hospital of Hebei Medical University, Shijiazhuang, China. The clinicopathological features of the tumor were analyzed by using histology, immunohistochemistry, and electron microscopy. The relevant literature was reviewed.Results:There were 1 male and 4 females, aged from 23 to 69 years. Patient 3 was 55 years old at the time of diagnosis and first surgery, and relapsed 5 years later. The patients′ median age was 32 years. Patients 1 and 5 showed elevated blood prolactin, with various degrees of hormonal symptoms except Patient 3, who showed only tumor compression symptoms. Imaging studies showed that all cases involved the sellar floor. The tumors of Patients 1, 2 and 5 were closely related to the cavernous sinus segment of the internal carotid artery. The tumors exhibited a diffuse growth pattern with chromophobic to slightly acidophilic cytoplasm. A few of tumor cells showed chromophobic cytoplasm. The nucleoli were conspicuous. Intranuclear inclusion bodies and variably-sized clear vacuoles were observed occasionally. Under electron microscope, marked mitochondrial abnormalities were observed, including increased mitochondria number, expanded hypertrophy, and absence of mitochondrial ridge fracture. Some mitochondrial matrices were dense, while some were vacuolated.Conclusions:Acidophil stem cell PitNET/adenoma is a rare type of pituitary adenomas/PitNETs. It often has a more clinically aggressive manner with immature cells, diffuse expression of PIT1, prolactin, and varying degrees of growth hormone expression. Because of the obvious diversity of their clinical hormone status and hormone immune expression, the diagnosis of this type tumor is still a challenge.