OBJECTIVE: Assess and compare the clinical efficacy and safety of cochlear implantation in deaf patients with inner ear malformation and in the ones with normal inner ear structure, so that to clarify whether it is effective to restore hearing for the deaf patients with inner ear malformation. METHOD: The literature with relevant key words were retrieved in the databases including PubMed, YZ365. com, WANFANG data, CMJD, CHKD and CNKI with language limited to Chinese and English. Extracted data included author, year of publication, diagnosis, treatment, et al. The clinical efficacy of cochlear implantation was assessed by the complications, electrode impedance, behavior T-level, hearing abilities and speech discrimination. Meta-analysis was performed using random or fixed effects model according to the heterogeneity of data. RESULT: There were 11 randomized control studies involving 655 patients included in this study. There was no statistically significant difference among the deaf patients in mixed inner ear-malformation group, Mondini group and large vestibular aqueduct syndrome group in the aspects of postoperative complications, electrode impedance, behavior T-level, hearing abilities and speech discrimination. CONCLUSION Cochlear implantation could be the way of treatment and rehabilitation for deaf patients with inner ear malformation. Further controlled studies with longer follow-up periods and more multiracial cases included may help to evaluate the efficacy of cochlear implantation for deaf patients with inner ear malformation more reliably.
Cochlear Implantation ; Ear, Inner ; abnormalities ; Electric Impedance ; Electrodes ; Hearing ; Hearing Loss ; therapy ; Humans ; Postoperative Complications ; Randomized Controlled Trials as Topic ; Speech Perception

OBJECTIVE: This study conduct a qualitative synthesis and quantitative meta-analysis of VFAFI, aimed to study whether it is a useful treatment for UVCP. METHOD: Electronic databases PubMed, YZ365. COM, WANFANG DATA, CMJD, CHKD,CNKI were searched using relevant keywords. Reported treatment outcomes were clustered into three categories,i. e. subjective, perceptual,acoustic,aerodynamic,and stroboscopic. Meta-analyses were performed on studies with numerical results using random effects model. RESULT: Five articles were identified with a total of 404 patients. All the studies reported significant improvements or decrease after VFAFI in each category of outcome measurements. Meta-analysis demonstrated a significant increase or decrease in all categories. Adverse effects include slight inflammatory reponse can resolve spontaneously within 1 month. The recurrence rate after VFAFI was high due to the self absorption. NNE and Jitter of post-operation is lower than pre-operation,there is no significantly change between the control group and experimental group; F0, Shimmer and MPT of post-operation is higher than pre-operation, there is no significantly change between the control group and experimental group. CONCLUSION The invasiveness and morbidity of VFAFI are low and the side effects are self-limited. Meta-analyses demonstrated significant improvements or decreased from both objective and subjective measurements. Further controlled studies with longer follow-up periods and more person were included may evaluate the effectiveness of VFAFI more reliably.
Adipose Tissue ; transplantation ; Humans ; Injections ; Treatment Outcome ; Vocal Cord Paralysis ; therapy ; Voice Quality

OBJECTIVE: To assess the clinical effeetiveness of prelingually deaf children after cochlear implantation at different ages so as to provide reasonable expectations for the patients and guidance for the clinical treatment. METHOD: Electronic databases PubMed, YZ365. COM, WANFANG DATA, CMJD, CHKD, CNKI were searched using relevant keywords. Extracted data included author, year of publication, diagnosis, et al. Reported treatment outcomes were clustered into speech discrimination and hearing abilities. Meta-analyses were performed on studies with numerical results using random or fixed effects model. RESULT: There were eight randomized control studies including 442 patients. Comparing speech perception of prelingually deaf children after cochlear implantation younger than three years old (experimental group) and 3-6 years old (control group), three and six months after operation showed that experimental group performed significantly worse than control group; 12 months after operation showed that experimental group performed significantly better than control group. Comparing hearing abilities, three and six months after operation showed that experimental group performed significantly worse than control group; 12 months after operation showed showed that experimental group performed significantly better than control group. Comparing speech perception of younger or older than 4. 5 years old children showed that after 1.5-2 years of operation children implanted younger than 4.5 years of age performed significantly better than children implanted older than 4.5 years old. Comparing speech perception of 7-12 years old children showed that after 3, 6, 12 months of operation patients of 7-12 years old performed significantly better than those children older than 12 years old. Comparing speech perception of implantation younger or older than 18 years old (7-14 yeas old was group A, > 14-18 yeas old was group B, older than 18 yeas old was group C) showed that after one and four years of operation A > B > C, and there were significant differences among them. Comparing warble tone threshold average (WTA) showed that after one year of operation A < B < C, and there were significant differences among them. However, after four years of operation, there was no significant difference among them. CONCLUSION Prelinguistically deafened patients younger than three years old with cochlear implantation, insisting on scienctific rehabilitation training for a long period of time can receive the optimal recovery effect. The older patients are suggested as early as possible receiving cochlear implantation. The longer they are implanted, the better results they will receive. Moreover, the younger age they are implanted, the faster postoperative language progress they will receive. Further controlled studies with longer follow-up periods and more person included may make the effectiveness of cochlear implantaion more reliable.
Adolescent ; Child ; Cochlea ; Cochlear Implantation ; Deafness ; Hearing Tests ; Humans ; Language ; Language Development ; Speech Perception ; Treatment Outcome

The pathogenesis and progression of nonalcoholic fatty liver disease (NAFLD) are closely associated with the activation of the innate immune system. This article reviews how various types of immune cells, Toll-like receptors, and their downstream signaling pathways are involved in insulin resistance and mediate oxidative stress, inflammation, and fibrosis in the liver. Reduction or elimination of dendritic cells delays inflammatory responses and fibrosis in the liver. A decrease in natural killer T cells induces lipid accumulation at the stage of simple steatosis, but alleviates fibrosis at the inflammation stage. The mTOR signaling pathways for insulin and amino acids suppresses autophagy through short-term or long-term regulation, which leads to endoplasmic reticulum stress and altered insulin resistance, thereby modulating the development and progression of NAFLD. The research on the mechanisms by which traditional Chinese medicine offers therapeutic benefits for NAFLD increasingly focuses on the potential role of immunity.

Stroke has become one of the main causes of death in China, and ischemic stroke is the most common type. At the same time, the prevalence of chronic kidney disease (CKD) is also increasing, and there are many similar risk factors with ischemic stroke. More and more studies have shown that CKD increases the incidence, severity and risk of poor outcome of ischemic stroke, but the specific mechanism of its interaction is not completely clear. For ischemic stroke patients with CKD, the most effective treatment and prevention measures are lack of sufficient evidence. This article reviews the relationship between CKD and ischemic stroke, as well as the treatment and prevention.

To investigate the effects of clinical P-glycoprotein inhibitors on oral bioavailability and brain penetration of gefitinib, 16 inhibitors and gefitinib were co-administered orally to ICR mice. The suspension of gefitinib and CMC-Na were co-administered to the control group. The suspension of gefitinib and clinical P-glycoprotein inhibitors were co-administered to the control group. Blood samples and brain homogenate samples were extracted by protein precipitation with acetonitrile and determinated by LC-MS/MS. It was found that ritonavir can significantly increase the oral bioavailability of gefitinib, and the area under the plasma concentration-time curves(AUC)of gefitinib was increased by 2 times; while brain exposure was increased, there was no increment in brain penetration. Some other drugs can also increase the plasma AUC of gefitinib, but can not enhance the brain penetration; After we corrected brain concentration with fraction of unbound drug in brain, it was found that the brain concentration of gefitinib in both control group and ritonavir group did not achieve the in vitro IC50 of inhibiting non-small cell lung cancer(NSCLC)cell growth. Our results suggest that clinical doses of the 16 clinical P-glycoprotein inhibitors can not specifically increase brain tissue exposure, more specific and safer P-gp inhibitors are required. After we corrected brain concentrations with fraction of unbound drug in brain, our preclinical studies found that insufficient brain exposure may be one of the reasons for the unsatisfactory efficacy of gefitinib in the treatment of brain metastases.

Objective:To investigate the feasibility, safety and effectiveness of Da Vinci robotic surgical system in the reoperation of recurrent or residual thyroid cancer.Methods:Retrospective analysis was performed on the clinical data of 9 patients with Da Vinci robot-assisted reoperation for thyroid cancer in the 960th Hospital of the People′s Liberation Army of China from September 2018 to January 2022, the operation time, number of lymph nodes dissected, intraoperative blood loss, length of hospital stay, total postoperative drainage volume, incidence of complications, satisfaction with postoperative aesthetic effect, visual analyogue scale (VAS) score at the 24 h after surgery and number of recurrence during follow-up were counted.Results:The surgery time of 9 cases was (186.67±44.44) min, the number of lymph nodes cleared were (15.77±13.59), intraoperative blood loss was (21.11±16.91) mL, hospital stay were (10.67±3.32) days, total postoperative drainage was (286.94±90.85) mL. There was no complications, and all patients were satisfied with the postoperative cosmetic effect whose VAS score was (8.22±1.09), and VAS score was 0 to 3 (2.44±0.73) points, no recurrence during the follow-up period from 6 to 46 months.Conclusion:With adequate preoperative evaluation and an experienced surgeon team, the use of robots in recurrent or residual thyroid cancer resurgery is feasible, safe and effective.

BACKGROUND: Men who have sex with men (MSM) have become a high risk population of HIV infection due to their risky sexual behaviors. The latent pattern of psychosocial characteristics plays an important effect in HIV-related risky behaviors among HIV-negative MSM. METHOD: Participants were recruited from Wuhan, Nanchang, and Changsha city from September 2017 to January 2018. Social support was assessed by the multidimensional scale of social support, Connor-Davidson Resilience scale-10 items for reliance, the assessment of Stigma towards Homosexuality for sexual minority stigma, the Likert subscale of nondisclosure for identity concealment, the ACE questionnaire-Kaiser-CDC for adverse childhood experience, the Centers for Epidemiological Studies Depression Scale for depression. Latent profile analysis (LPA) and multivariate regression were used to analyze the data. RESULTS: Three psychosocial characteristic patterns were revealed by the LPA. "Social support and resilience group" (SR group), "Identity concealment group" (IC group) and "Adverse childhood experience" (ACE group) were identified, respectively. In comparison with "SR group", "IC group" have a higher likelihood of one-night male partners (AOR = 2.74, 95%CI = [1.54, 4.90]), both fixed and one-night male partners (AOR = 2.01, 95%CI = [1.34, 3.01]) and HIV-unsure male partner (AOR = 2.12, 95%CI = [1.44, 3.13]). Similarly, "ACE group" were more likely having inconsistent condom use (AOR = 2.58, 95%CI = [1.41, 4.73]), and having sex with HIV-positive male partner (AOR = 4.90, 95%CI = [1.95, 12.30]) with comparison of "SR group". In addition, we further revealed that "ACE group" had a higher ratio (90.0%) of inconsistent condom use among MSM whose male partners were HIV-positive. CONCLUSIONS Six important psychosocial factors were divided into three latent pattern classes. Compared with "SR group", "IC group" and "ACE group" were more likely to engage in HIV-related risky sexual behaviors. Further research may pay more attention to "IC group" and "ACE group" for targeted intervention.
Humans ; Male ; HIV Infections/epidemiology* ; Homosexuality, Male/psychology* ; Risk Factors ; Sexual and Gender Minorities/psychology* ; Sexual Behavior/psychology*