OBJECTIVES: Some changes are found in the labyrinth anatomy during postnatal development. Although the spatial orientation of semicircular canals was thought to be stable after birth, we investigated the age-related orientational changes of human semicircular canals during development. METHODS: We retrospectively studied the computed tomography (CT) images of both ears of 76 subjects ranged from 1 to 70 years old. They were divided into 4 groups: group A (1-6 years), group B (7-12 years), group C (13-18 years), and group D (>18 years). The anatomical landmarks of the inner ear structures were determined from CT images. Their coordinates were imported into MATLAB software for calculating the semicircular canals orientation, angles between semicircular canal planes and the jugular bulb (JB) position. Differences between age groups were analyzed using multivariate statistics. Relationships between variables were analyzed using Pearson analysis. RESULTS: The angle between the anterior semicircular canal plane and the coronal plane, and the angle between the horizontal semicircular canal plane and the coronal plane were smaller in group D than those in group A (P<0.05). The JB position, especially the anteroposterior position of right JB, correlated to the semicircular canals orientation (P<0.05). However, no statistically significant differences in the angles between ipsilateral canal planes among different age groups were found. CONCLUSION: The semicircular canals had tendencies to tilt anteriorly simultaneously as a whole with age. The JB position correlated to the spatial arrangement of semicircular canals, especially the right JB. Our calculation method helps detect developmental and pathological changes in vestibular anatomy.
Ear ; Ear, Inner ; Humans* ; Methods ; Parturition ; Retrospective Studies ; Semicircular Canals* ; Tomography, X-Ray Computed

Objective:To analyze the clinical characteristics of fulminant type 1 diabetes (FT1DM) in China.Methods:Clinical data of 279 cases related to FT1DM in Chinese Database from January 2005 to December 2018 were collected, and other 20 patients from our hospital were included in the present study.Results:(1) There has been a progressive increasing in the number of reported cases every year in China, and the number in the southern region were significantly more than that in the northern region. (2) The median age of the onset of FT1DM patients in China was 32.5 years old, without significant gender difference. Moreover, 36.5% (54/148) of the female patients caught the disease during their prenatal period, most of them were onset in the second or third trimesters of pregnancy and 2 weeks after delivery (37/40), and the prognosis of the fetus was extremely poor. (3) Compared with new-onset type 1 diabetes, FT1DM patients were younger, and with higher blood glucose [(39.7±15.3) vs (21.2 ± 9.9) mmol/L], higher serum creatinine [(188.4±115.9) vs (51.8 ±23.1) μmol/L], and higher amylase levels [245.5 (26.0-5 137.0) vs 54.7 (14.0-404.9) U/L]. FT1DM patients were with more severe acidosis, and lower HbA 1C level [(6.6 ±0.8)% vs (12.9 ± 2.5)%, P<0.01]. (4) FT1DM patients may combine with multiple organ dysfunction or severe metabolic disorders, electrolyte disorders, as well as liver and kidney dysfunctions, and elevation of amylase and muscle enzymes. Conclusion:FT1DM are with some clinical characteristics different from classic new-onset type 1 diabetes, including adult-onset, frequent in the southern China. Pregnancy may be a predisposing factor for female patients. Significant metabolic disorders and multiple organ involvements are common in the patients with FT1DM.

Objective:To research the association between exposure to solid fuels for heating and its duration and the risk of respiratory diseases morbidity.Methods:Data from the China Kadoorie Biobank project sited in Pengzhou City, Sichuan Province. Cox proportional hazard regression model was used to analyze the association between exposure to solid fuels for heating and its duration and the risk of total respiratory diseases and the association between exposure to solid fuels for heating and the risk of chronic obstructive pulmonary disease (COPD) and pneumonia among respiratory diseases.Results:A total of 46 082 participants aged 30-79 years were enrolled, with 11 634 (25.25%) heating during the winter, of whom 8 885 (19.28%) used clean fuels and 2 749 (5.97%) used solid fuels, of whom 34 448 (74.75%) did not heat. After controlling for multiple confounding factors, Cox proportional hazard regression model was used, which revealed that compared with clean fuels, unheating could reduce the risk of total respiratory disease ( HR=0.81,95% CI:0.77-0.86), COPD ( HR=0.86,95% CI:0.78-0.95) and pneumonia ( HR=0.80,95% CI:0.74-0.86), respectively. Exposure to solid fuels increased the risk of total respiratory disease ( HR=1.10, 95% CI:1.01-1.20) and were not associated with COPD and pneumonia. Compared with no solid fuel exposure, the risk of total respiratory disease (1-19 years: HR=1.23, 95% CI:1.10-1.37; 20-39 years: HR=1.25, 95% CI:1.16-1.35; ≥40 years: HR=1.26, 95% CI:1.15-1.39) and COPD (1-19 years: HR=1.21, 95% CI:1.03-1.42; 20-39 years: HR=1.30, 95% CI:1.16-1.46; ≥40 years: HR=1.35, 95% CI:1.18-1.54) increased with the length of exposure of solid fuels (trend test P<0.001). Solid fuels exposure for 1-19 years and 20-39 years increased the risk of COPD by 23% ( HR=1.23,95% CI:1.02-1.49) and 16% ( HR=1.16, 95% CI:1.00-1.35). Conclusion:Heating solid fuels exposure increases the risk of total respiratory disease, COPD, and pneumonia.

Objective:To investigate the effect of different cleaning methods on the cleaning effect of Da Vinci robotic electrosurgical instruments and the feasibility of adenosine triphosphate(ATP) fluorescence detection technology for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.Methods:A total of 180 electrosurgical instruments were divided into control group and test group by random digits table method from June 2018 to June 2019 after robotic surgery. For the control group, 90 cases were manually cleaned to complete the device cleaning process, and for the test group, 90 cases were mechanically cleaned to complete the device cleaning process. Through visual observation, magnifying glass examination and ATP fluorescence detection technology, the cleaning effect of the two methods and the correlation between the evaluation results obtained by ATP fluorescence detection technique and traditional inspection method were compared.Results:The qualified rate of visual observation, magnifying lens examination and ATP fluorescence detection in the control group were 95.56%(85/90), 86.67% (78/90) and 84.44% (76/90), respectively, and that in the test group were 100.00% (90/90), 97.78% (88/90) and 98.89% (89/90), respectively. The test group was higher than the control group. The difference between the two groups was statistically significant ( χ2 values were 4.310, 7.745, 12.291, P<0.05 or 0.01). In the control group, there was a positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.374, P < 0.01), and a significant positive correlation between the qualified rate of magnifying lens examination ( r value was 0.538, P < 0.01). In the test group, There was also a significant positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.754, P < 0.01), and between the qualified rate of magnifying lens examination( r value was 0.556, P < 0.01). Conclusions:Mechanical cleaning is used to clean Da Vinci robotic electrosurgical instruments, which is superior to traditional manual cleaning. ATP fluorescence detection technology is feasible for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.

Objective To explore the clinical characteristics of patients with thyrotropin-secreting pituitary adenomas ( TSHomas) in China. Methods All the articles related to TSHomas were retrieved from the Chinese journal databases up to July 2017. All reported cases were assessed. Results TSHomas have been diagnosed in all ages (range:12-81 years old, average 41.9 ± 13.8 years old) with no gender difference (male : female=84: 69). The rate of misdiagnosis fell from 84.6％(11/13) to 50.6％(39/77) in the last 10 years. In 92 cases (60.1％), the level of TSH was elevated [median 1.57×ULN (upper limits of normal)]. The most common elevated hormones associated with TSHomas were growth hormone ( GH) and prolactin ( PRL;11.1％and 9.7％, respectively) . 37 cases underwent octreotide suppression test, of which the inhibitory rates ranged from 26. 2％ to 94. 9％ ( median 71.79％). The detection rate of micro-adenoma was 7.7％(1/13)before year 2000, 11.4％(4/35)from 2000 to 2006, and 26.7％(28/105) after 2006. Although TSHomas usually invade surrounding tissues, they hardly cause pituitary apoplexy. Surgery orγ-knife was performed in 132 cases ( 86. 3％) . Immunohistochemistry of tumors showed that 87 (52.9％) of 46 were pure TSH adenomas and 32 (36.8％) cases were mixed ones, while GH and PRL were most common (75.0％and 56.3％respectively) in the mixed adenomas. Negative immunohistochemistry for TSH was found in 9 cases (10.3％). In the follow-up, the restoring rates of thyroid hormone and TSH level were 77.0％(87/113) and 80.0％( 36/45) respectively. Conclusion TSHoma is diagnosed at an earlier age in China than that reported in Europe and America, while at similar age compared with Japan. Macro-adenomas were more common in spite of the increasing detection rate of micro-adenomas. Macro-adenomas are often invasive but less likely to induce pituitary apoplexy. Immunostaining for TSH could be negative. The most common positive immunostaining in mixed adenoma is GH and/or PRL. However, a positive immunostaining for one pituitary hormone does not necessarily correlates with its hypersecretion of that hormone.

Objective:The study retrospectively analyzed the etiology, clinical manifestations, emergency treatment and etiological treatment of a large sample of cases with hypercalcemic crisis.Methods:The clincial data of patients with hypercalcaemia cirisis who were administered in First Medical Center of Chinese PLA General Hospital from January 2009 to July 2022 were analyzed, inculding the general data, clinical manifestations, etiology, photographic examination, emergency treatment, etiological treatment, serological examination before and after treatment, pathological immunohistochemical findings and prognosis.Results:A total of 143 hypercalcaemia crisis patients(84 males and 59 females) with a mean age of 53.51±16.60 were enrolled. The most common disease was hyperparathyroidism(62/143), followed by solid malignancy(57/143) and multiple myeloma(12/143). Patients presented with digestive system symptoms at 76.91%, followed by neurological symptoms at 63.60%, urinary system symptoms at 58.76%, musculoskeletal symptoms at 55.23%, and cardiovascular system symptoms at 32.91%. After emergency calcium-lowering treatment, the remission rate of hypercalcemic crisis in 143 patients was 100%(143/143), and after etiological treatment, the remission rate of hypercalcemia was 85.31%(122/143).Conclusion:Early identification, emergency treatment and etiology treatment of hypercalcaemia crisis are essential. Effective treament with comprehensive calcium reduction can quickly relieve clinical symptoms and create opportunities for treatment for the cause. Targeted etiological interventions can lead to the correction or long-term remission of hypercalcemia.

Objective To investigate the mechanism of morin-induced autophagy in non-small cell lung cancer A549 cells based on mTOR/STAT3 signaling axis.Methods A549 cells were divided into blank group and 30,60,90,120 and 150 μg·mL-1 of morin groups.After 24,48 and 72 hours of culture,the cell proliferation activity was detected by CCK-8 method,and the cell inhibition rate was calculated.A549 cells were divided into blank group and 30,90,150 μg·mL-1 morin groups.After 14 days of culture,the cell proliferation was detected by colony formation assay.After 24 hours of culture,the cell proliferation ability was detected by BeyoClickTM EdU-488.Apoptosis was detected by flow cytometry;acridine orange staining was used to detect cell autophagy;the formation of autophagosomes was observed by transmission electron microscopy.Western Blot was used to detect the expression levels of apoptosis,autophagy and mTOR/STAT3 signaling axis-related proteins in cells.A549 cells were divided into blank group,blank group + chloroquine(10 μg·mL-1)group,morin(30,150 μg·mL-1)group,morin(30,150 μg·mL-1)+ chloroquine(10 μg·mL-1)group.After 48 hours of intervention,the cell activity was detected by CCK-8 method,and the cell survival rate was calculated.Results Compared with the blank group,the inhibition rate of A549 cells in 60,90,120,150 μ g·mL-1 of morin group was significantly increased after 24 hours of intervention(P＜0.05,P＜0.001).The inhibition rates of A549 cells in 30,60,90,120 and 150 μg·mL-1 of morin groups were significantly increased after 48 and 72 hours of intervention(P＜0.001).The number of A549 cell colonies and the number of green fluorescent proliferation positive cells in the 30,90,150 μg·mL-1 of morin groups were significantly decreased(P＜0.01,P＜0.001),the apoptosis rate was significantly increased(P＜0.01,P＜0.001),and the protein expression level of cleaved-PARP was significantly increased(P＜0.001).The protein expression levels of p-P38/P38 MAPK in A549 cells of 90 and 150 μg·mL-1 of morin groups were significantly increased(P＜0.01,P＜0.001).Different degrees of orange fluorescence appeared in A549 cells of 30,90 and 150 μg·mL-1 of morin groups,and the orange fluorescence of 90 and 150 μg·mL-1 of morin groups was significant.Autophagosomes and autolysosomes appeared in the cytoplasm of A549 cells in 150 μg·mL-1 of morin group,respectively.The protein expression of LC3-Ⅱ in A549 cells of 150 μg·mL-1 of morin group was significantly up-regulated(P＜0.05).The protein expression of Atg16L1-Ⅱ in A549 cells of 90,150 μg·mL-1 of morin group was significantly up-regulated(P＜0.001),and the protein expressions of p-mTOR/mTOR and p-STAT3/STAT3 were significantly down-regulated(P＜0.001).Compared with the morin(150 μg·mL-1)group,the survival rate of A549 cells in the morin(150 μg·mL-1)+chloroquine(10 μg·mL-1)group was significantly increased(P＜0.05).Conclusion Morin can promote the apoptosis of A549 cells and induce autophagy in A549 cells,and the mechanism may be related to mTOR/STAT3 axis.

Objective:To explore the relationship between insomnia and osteoporosis.Methods:Mendelian randomization (MR) analysis were used in this study. The single nucleotide polymorphisms (SNPs) related to insomnia from genome-wide association analysis research data were selected as the instrumental variables by using inverse variance weighted (IVW), MR-Egger regression, weighted median method, maximum likelihood, penalized weighted median estimator, and Mendelian randomization robust adjusted profile score (MR-RAPS) to determine the causal relationship between insomnia and osteoporosis. Odds ratio ( OR) and 95% confidence interval ( CI) values were used to evaluate the association between insomnia and osteoporosis. Cochran′s Q-test was used to detect heterogeneity of SNPs, MR-Egger regression was used to test for level pleiotropy, and the leave-one-out method was used to test sensitivity, MR pleiotropy residual sum and outlier (MR-PRESSO) method and radial MR were used to detect erroneous outliers. Results:The screening criteria were set based on the three major assumptions of MR; finally, 31 SNPs were included in the MR analysis. The results of MR causal effect analysis using the IVW method showed that insomnia increased the risk of osteoporosis by about 0.7% ( OR=1.007, 95% CI 1.001-1.014, P=0.044); heterogeneity testing showed heterogeneity between SNPs ( Q=57.91, P<0.001); and the MR- Egger intercept test did not indicate horizontal pleiotropy in this study (intercept value=3.807×10 -5, P=0.888). Leave-one-out method showed that no single SNP had a significant impact on the overall results. No abnormal SNP was detected according to the MR-PRESSO results ( P=0.059), and radial MR did not detect any outliers. Conclusion:Mendelian randomization analysis showed that insomnia can increase the risk of osteoporosis.

Objective To examine the prospective associations between airflow obstruction (AFO) and risks of major chronic diseases morbidity in Chinese adults.Methods Samples of this study were from the China Kadoorie Biobank.A total of 486 996 participants aged 30 to 79 years (mean 51.5 years) at the baseline study,were included after excluding those who self-reported of having heart disease,stroke and cancer at baseline.AFO was defined under the Global Initiative on Obstructive Lung Disease (GOLD) criteria and forced expiratory volume per one second in percentage of the expected one (FEV1％P).Cox regression models were used to investigate the associations of AFO with incidence rates of ischemic heart disease,cerebrovascular disease and lung cancer after adjusted for potential confounders.Results Over a period of 7 years through the follow-up program,the incident cases of ischemic heart disease,cerebrovascular disease and lung cancer appeared as 24 644,36 336 and 3 218,respectively.Compared with people without AFO,the HR (95％CI) of GOLD-1 to GOLD-4 were 0.89 (0.78-1.01),1.05 (0.98-1.12),1.29 (1.18-1.40) and 1.65 (1.42-1.91) respectively for ischemic heart disease.The HR (95％ CI) of GOLD-1 to GOLD-4 were 0.96 (0.70-1.26),1.12 (0.96-1.31),1.38 (1.14-1.65) and 1.48 (1.05-2.02) respectively for lung cancer.No statistically significant differences in the associations between GOLD level and cerebrovascular disease morbidity were found.However,each 10％ decrease in FEV1％P was associated with 7.2％ (95％CI:6.4％-8.0％),3.6％ (95％CI:3.0％-4.3％) and 10.5％ (95％CI:8.4％-12.6％) increased the risks of ischemic heart disease,cerebrovascular disease and lung cancer respectively.The results were persistant when stratified by smoking status.Conclusion Higher degree of AFO seemed to be associated with the risks of ischemic heart disease,cerebrovascular disease and lung cancer morbidity among the Chinese adults.

Objective To investigate the distribution of sleep duration,daytime naps habits,and insomnia-related symptoms among participants from the China Kadoorie Biobank (CKB) study,and to examine the associations between the sleep-associated factors.Methods A self-designed computer-based questionnaire was adopted to collect social-demographic information and lifestyle-related factors of the participants.A total of 452 829 Chinese adults aged 30-79 years,without self-reported histories of coronary heart disease,stroke,chronic obstructive pulmonary diseases or cancer,were included in this study.General linear regression and multinomial logistic regression models were used to estimate the distributions on duration of sleep,daytime naps habits,and insomnia-related symptoms in different populations,after adjusted for gender,age,and residential regions.Gender-specific logistic regression model was adopted to examine the associations between the above mentioned sleep-related factors.Results The average sleep duration of the participants was 7.41 hours per day,with 20.3％ of them having daytime naps all year round,but 40.1％ only had daytime naps in summer,and 39.6％ had no habits of daytime naps.11.0％,10.0％,and 2.1％ of the participants reported having had symptoms as difficulty in falling asleep,waking up too early or with daytime dysfunction,respectively.There were significant differences on the distributions in sleep-related factors between participants with different gender,age,residential areas,education levels,household income,and marital status (P＜0.05).Results from the logistic regression showed that longer sleep duration was associated with lower risks of insomnia-related symptoms trend (P＜0.001).Factor as without habits of daytime naps seemed to be associated with higher risks of insomnia-related symptoms (P＜0.05).Participants with longer sleep duration were more likely to have the habit of taking daytime naps (P＜0.05).Conclusions The distributions of sleep duration,habits on daytime naps and insomnia-related symptoms varied according to the differences on social-demographic factors.There were associations existed between the sleeping-related factors,which would influence the promotion on optimal sleep duration and better quality of sleep.