OBJECTIVES: This study aimed to evaluate the effect of disc morphology and disc-condyle angle on the treatment of anterior repositioning splint (ARS) for anterior disc displacement with reduction (ADDwR). METHODS: On the basis of the inclusion and exclusion criteria, a total of 11 patients diagnosed with ADDwR were included. The effects of changes in disc length, thickness, and morphology classifications on the clinical symptoms, disc morphology parameters, and disc-condyle angles after ARS treatment were evaluated using magnetic resonance imaging and the Helkimo index. RESULTS: After ARS treatment, the Ai and Di of all patients with ADDwR decreased, the disc length increased, and the thickness decreased. The Ai of patients with slight ADDwR and those with type 1 joint discs was reduced to 0, with the most significant decrease observed in Di. The disc length of mild ADDwR (increased to 8.65 mm±1.79 mm) and type 5 disc (increased to 10.71 mm±2.62 mm) significantly increased the most. The disc thickness of slight ADDwR decreased to 3.08 mm±0.51 mm significantly. CONCLUSIONS The therapeutic effect of ARS is correlated with the displacement degree and morphological features of the disc, providing evidence for clinical treatment decisions.
Humans ; Magnetic Resonance Imaging ; Conservative Treatment ; Temporomandibular Joint Disc/diagnostic imaging* ; Male ; Adult ; Female ; Intervertebral Disc Displacement/pathology* ; Middle Aged

Objective:To analyze the disease burden of Noise-Induced Hearing Loss (NIHL) in China from 1990 to 2019, forecast the disease burden of NIHL from 2020 to 2030, and provide data support for the prevention and control of NIHL.Methods:In July 2022, the disease burden data of NIHL in different age groups and genders in China during 1990-2019 were selected from the GBD database. The Jointpoint regression model was established to analyze the trend of the disease burden of NIHL in China. An age-period-cohort model was constructed to analyze the changing trend of NIHL in terms of age, period, and cohort, and a Bayesian age-period-cohort model was developed to predict the disease burden of NIHL in China from 2020 to 2030.Results:From 1990 to 2019, the disability adjusted life year (DALY) of China's NIHL increased from 1361600 to 2327700 years. The coarse rate of DALY increased from 115.03/100000 to 163.65/100000 (AAPC=1.23, P<0.001), and the normalization rate of DALY decreased from 127.67/100000 to 119.83/100000 (AAPC=-0.21, P<0.001). It is predicted that from 2020 to 2030, the DALYs of China's NIHL will increase from 2412900 in 2020 to 2655000 in 2030, and the DALY normalization rate will decrease from 241.29/100000 in 2020 to 125.71/100000 in 2030. Conclusion:The burden of noise-induced hearing loss (NIHL) in China is significant and should not be overlooked. To reduce this burden, we need to focus on strengthening source management, process control, personal protection, and comprehensive prevention and treatment through various methods.

Objective:To analyze the disease burden of Noise-Induced Hearing Loss (NIHL) in China from 1990 to 2019, forecast the disease burden of NIHL from 2020 to 2030, and provide data support for the prevention and control of NIHL.Methods:In July 2022, the disease burden data of NIHL in different age groups and genders in China during 1990-2019 were selected from the GBD database. The Jointpoint regression model was established to analyze the trend of the disease burden of NIHL in China. An age-period-cohort model was constructed to analyze the changing trend of NIHL in terms of age, period, and cohort, and a Bayesian age-period-cohort model was developed to predict the disease burden of NIHL in China from 2020 to 2030.Results:From 1990 to 2019, the disability adjusted life year (DALY) of China's NIHL increased from 1361600 to 2327700 years. The coarse rate of DALY increased from 115.03/100000 to 163.65/100000 (AAPC=1.23, P<0.001), and the normalization rate of DALY decreased from 127.67/100000 to 119.83/100000 (AAPC=-0.21, P<0.001). It is predicted that from 2020 to 2030, the DALYs of China's NIHL will increase from 2412900 in 2020 to 2655000 in 2030, and the DALY normalization rate will decrease from 241.29/100000 in 2020 to 125.71/100000 in 2030. Conclusion:The burden of noise-induced hearing loss (NIHL) in China is significant and should not be overlooked. To reduce this burden, we need to focus on strengthening source management, process control, personal protection, and comprehensive prevention and treatment through various methods.

Objective:To investigate the effects of mild SARS-CoV-2 infection on hematological parameters of adult blood donors and the suitability of apheresis platelet donation,the changes of the hematological parameters in blood donors with mild infection of the SARS-CoV-2 Omicron variant strain were evaluated.Methods:Seventy-two blood donors with mild COVID-19 symptoms who donated consecutive apheresis platelets for 3 times from December 2022 to January 2023,42 cases among which were included in the infection-positive group,and 30 cases in the suspected infection group.Forty-two donors un-vaccinated against SARS-CoV-2,un-infected,and donated three consecutive apheresis platelets from October to November 2022 were included in the control group.The changes of blood routine testing in the positive group and the suspected infection group were retrospectively compared before(Time1)and after(Time2 and Time3)the onset of symptoms,three consecutive times(Time1,Time2,Time3)in the control group by repeated measures analysis of variance.The Bayesian discriminant method was used to establish a discriminant equation to determine whether the recent infection of SARS-CoV-2 occurred or not.Results:Simple effect of the number times of tests in the positive and suspected infection groups was significant(Finfection-positive group=6.98,P＜0.001,partial η2=0.79,Fsuspected infection group=4.31,P＜0.001,partial η2=0.70).The positive group and the suspected infection group had lower RBC,HCT,and HGB,and higher PLT and PCT at Time2 compared to Time1 and Time3(P＜0.05).The positive group and the suspected infection group showes RDW-CV and RDW-SD at Time3 higher than Time1 and Time2(P＜0.001).The simple effect of the number times of tests in the control group was not significant(F=0.96,P=0.55,partial η2=0.34).The difference of the whole blood count parameters in the control group for three times was not statistically significant(P＞0.05).We established a discriminant equation to determine whether the recent infection of SARS-CoV-2 occurred or not.The equation had an eigenvalue of 0.22,a canonical correlation of 0.43(x2=27.81,P＜0.001),and an analysis accuracy of 72.9％.Conclusion:The hematological indicators of RBC,HCT,HGB,PLT,PCT,RDW-CV and RDW-SD in blood donors who had infected with mild COVID-19 showed dynamic changes.The discriminant equation for whether they are infected recently with COVID-19 has a high accuracy rate.

Objective To summarize the epidemiological and clinical features of infectious diseases of the central nervous system(CNS)by a single-center analysis.Methods A retrospective analysis was conducted on the data of 1247 cases of CNS infectious diseases diagnosed and treated in the First Medical Center of PLA General Hospital from 2001 to 2020.Results The data for this group of CNS infectious diseases by disease type in descending order of number of cases were viruses 743(59.6％),Mycobacterium tuberculosis 249(20.0％),other bacteria 150(12.0％),fungi 68(5.5％),parasites 18(1.4％),Treponema pallidum 18(1.4％)and rickettsia 1(0.1％).The number of cases increased by 177 cases(33.1％)in the latter 10 years compared to the previous 10 years(P<0.05).No significant difference in seasonal distribution pattern of data between disease types(P>0.05).Male to female ratio is 1.87︰1,mostly under 60 years of age.Viruses are more likely to infect students,most often at university/college level and above,farmers are overrepresented among bacteria and Mycobacterium tuberculosis,and more infections of Treponema pallidum in workers.CNS infectious diseases are characterized by fever,headache and signs of meningeal irritation,with the adductor nerve being the more commonly involved cranial nerve.Matagenomic next-generation sequencing improves clinical diagnostic capabilities.The median hospital days for CNS infectious diseases are 18.00(11.00,27.00)and median hospital costs are ￥29,500(￥16,000,￥59,200).The mortality rate from CNS infectious diseases is 1.6％.Conclusions The incidence of CNS infectious diseases is increasing last ten years,with complex clinical presentation,severe symptoms and poor prognosis.Early and accurate diagnosis and standardized clinical treatment can significantly reduce the morbidity and mortality rate and ease the burden of disease.

The interaction between Mycobacterium tuberculosis and host, as well as the regulation of some signaling pathways in the host, were involved in pathogen latency in macrophages. microRNAs (miRNAs) regulate the gene expression and biological functions, indicating that miRNAs played a regulatory role in bacterial infections. However, whether the host's miRNAs were also involved in the process of Mycobacterium tuberculosis infection had not been thoroughly studied. This study infected macrophages with pathogenic Mycobacterium tuberculosis strain H37Rv and low virulence strain H37Ra to explore the functional miRNAs. By identifying the expression profile of miRNAs in host cells after infection, the expression of 17 miRNAs significantly changed (P < 0.05) in the human macrophage THP-1 infected with highly pathogenic H37Rv strain (Rv), H37Rv inactivated strain (Rv-), and non-pathogenic H37Ra (Ra) strains respectively, indicating that host miRNAs may be involved in the interaction of Mycobacterium tuberculosis and host. Meanwhile, 10 types of miRNAs showed significant differences in cells infected with pathogenic and non-pathogenic Mycobacterium tuberculosis, suggesting that host miRNAs may play an important role in the pathogenicity and intracellular survival of Mycobacterium tuberculosis. Further study had found that miR-449a, miR-502-5p, and miR-708 were downregulated in cells infected with Mycobacterium marinum. Overexpression of these three miRNAs displayed the significant inhibitory effect on the growth of Mycobacterium marinum, indicating that miRNAs played a pivotal role in the interaction between the host and Mycobacterium marinum. This study provided the new insights into the pathogenesis of Mycobacterium tuberculosis and the treatment of tuberculosis.

The demographic characteristics, drug use, clinical symptoms and other data of the patients treated with Huoxiang Zhengqi Oral Liquid were collected. The latent class analysis(LCA) was performed to reveal the distribution of primary symptoms, and then the doubly robust estimation was employed to analyze the efficacy of different doses of Huoxiang Zhengqi Oral Liquid in different populations. A total of 11 273 patients were enrolled in this study, including 4 347 males and 6 926 females. A total of 15 primary symptoms were included, with the top 3 being dizziness(53.9%), head heaviness(39.6%), and nausea(39.4%). According to the LCA, the population was divided into 3 groups of spleen deficiency and dampness exuberance(5 604 cases, 49.71%), upward harassing of wind-phlegm(4 955 cases, 43.96%), and spleen Qi deficiency(714 cases, 6.33%). Double robust estimation showed that the time to recovery of the patients with spleen Qi deficiency had no significant difference regarding the daily dose. Compared with the daily dose of 20 mL, the daily doses of 40, and 60 mL shortened the time to recovery by 16.67(95%CI[5.23, 28.12]) and 15.94 h(95%C1[7.45, 24.43]) in the patients with upward harassingof wind-phlegm, the daily doses of 30, 40, and 60 mL shortened the time to recovery by 4.42(95%CI[1.06, 7.77]), 13.07(95%CI[1.61, 24.54]), 13.92 h(95%CI[5.14, 22.70]) in the patients with spleen deficiency and dampness exuberance, respectively. The patients with cold due to wind-cold and dampness stagnation had more primary syndromes, and the disease locations were mainly in the head, stomach, and spleen. In clinical practice, the daily dose of Huoxiang Zhengqi Oral Liquid can be increased according to the symptoms of patients, which can shorten the time to recovery.
Humans ; Male ; Female ; Drugs, Chinese Herbal/therapeutic use* ; Middle Aged ; Adult ; Young Adult ; Aged ; Adolescent ; Administration, Oral ; Wind ; Child ; Spleen/drug effects* ; Cold Temperature ; Aged, 80 and over

Objective: To explore the clinical characteristics and prognostic factors of female patients with Stanford type B aortic dissection. Methods: This is a single-centre retrospective study. Consecutive patients diagnosed with Stanford type B aortic dissection in General Hospital of Northern Theater Command from June 2002 to August 2021 were enrolled, and grouped based on sex. According to the general clinical conditions and complications of aortic dissection tear, patients were treated with thoracic endovascular aortic repair, surgery, or optimal medication. The clinical characteristics and aortic imaging data of the patients at different stages were collected, adverse events including all-cause deaths, stroke, and occurrence of aortic-related adverse events were obtained during hospitalization and within 30 days and at 1 and 5 years after discharge. According to the time of death, death was classified as in-hospital death, out-of-hospital death, and in-hospital death was divided into preoperative death, intraoperative death and postoperative death. According to the cause of death, death was classified as aortic death, cardiac death and other causes of death. Aortic-related adverse events within 30 days after discharge included new paraplegia, post-luminal repair syndrome, and aortic death; long-term (≥1 year after discharge) aortic-related adverse events included aortic death, recurrent aortic dissection, endoleak and distal ulcer events. The clinical characteristics, short-term and long-term prognosis was compared between the groups. Logistic regression analysis was used to explore the association between different clinical factors and all-cause mortality within 30 days in female and male groups separately. Results: A total of 1 094 patients with Stanford type B aortic dissection were enrolled, mean age was (53.9±12.1) years, and 861 (78.7%) were male and 233 (21.3%) were female. (1) Clinical characteristics: compared with male patients, female patients were featured with older average age, higher proportion of aged≥60 years old, back pain, anemia, optimal medication treatment, and higher cholesterol level; while lower proportion of smoking and drinking history, body mass index, calcium antagonists use, creatine kinase level, and white blood cell count (all P<0.05). However, there was no significant difference in dissection tear and clinical stage, history of coronary heart disease, diabetes, hypertension, and cerebrovascular disease between female and male patients (all P>0.05). (2) Follow-up result: compared with male patients, female patients had a higher rate of 30-day death [6.9% (16/233) vs. 3.8% (33/861), P=0.047], in-hospital death (5.6% (13/233) vs. 2.7% (23/861), P=0.027), preoperative death (3.9% (9/233) vs. 1.5% (12/861), P=0.023) and aorta death (6.0% (14/233) vs. 3.1% (27/861), P=0.041). The 1-year and 5-year follow-up results demonstrated that there were no significant differences in death, cerebrovascular disease, and aorta-related adverse events between the two groups (all P>0.05). (3) Prognostic factors: the results of the univariate logistic regression analysis showed that body mass index>24 kg/m² (HR=1.087, 95%CI 1.029-1.149, P=0.013), history of anemia (HR=2.987, 95%CI 1.054-8.468, P=0.032), hypertension (HR=1.094, 95%CI 1.047-1.143, P=0.040) and troponin-T>0.05 μg/L (HR=5.818, 95%CI 1.611-21.018, P=0.003)were associated with an increased risk of all-cause mortality within 30 days in female patients. Conclusions: Female patients with Stanford type B aortic dissection have specific clinical characteristics, such as older age at presentation, higher rates of anemia and combined back pain, and higher total cholesterol levels. The risk of death within 1 month is higher in female patients than in male patients, which may be associated with body mass index, hypertension, anemia and troponin-T, but the long-term prognosis for both female and male patients is comparable.
Humans ; Male ; Female ; Adult ; Middle Aged ; Aged ; Prognosis ; Hospital Mortality ; Retrospective Studies ; Troponin T ; Aortic Aneurysm, Thoracic/surgery* ; Blood Vessel Prosthesis Implantation/adverse effects* ; Treatment Outcome ; Endovascular Procedures/adverse effects* ; Aortic Dissection ; Hypertension/complications* ; Cholesterol ; Risk Factors

Objective: To investigate the influence of blood pressure control after discharge on prognosis of patients with acute aortic syndrome (AAS) complicated with hypertension who underwent thoracic endovascular aortic repair (TEVAR). Methods: This is a retrospective case analysis. Patients diagnosed with AAS complicated with hypertension and undergoing TEVAR in Northern Theater Command General Hospital from June 2002 to December 2021 were consecutively enrolled. Average systolic blood pressure (SBP) and the occurrence of endpoint events were recorded at one month, one year and every 2 years after TEVAR. According to the patients' average SBP, patients with average SBP<140 mmHg (1 mmHg=0.133 kPa) or<150 mmHg were divided into the target blood pressure achievement group, and the others were divided into target blood pressure non-achievement group. Endpoint events included all-cause death, aortic death, stroke, renal insufficiency, aortic related adverse events and a composite of these events (overall clinical adverse events), and re-accepting TEVAR. The incidence of endpoint events was compared between the two groups at each follow-up period. Results: A total of 987 patients were included, aged (55.7±11.7) years, including 779 male (78.9%). When the cutoff value was 140 mmHg, the rate of average target SBP achievement was 71.2% (703/987) at one month, 66.7% (618/927) during 1st to 12th month and 65.1% (542/832) from the first year to the third year after TEVAR. The proportion of patients taking≥2 antihypertensive agents was higher in the group of target blood pressure non-achievement group than the target blood pressure achievement group after TEVAR at 1 month (74.3% (211/284) vs.65.9% (463/703), P=0.010) and during 1st to 12th month (71.5% (221/309) vs. 63.6% (393/618), P=0.016). There were no statistical differences in the all-cause deaths, stroke, aortic related adverse events, and repeat TEVAR between the two groups (All P>0.05) during above follow-up periods. When the cutoff value was 150 mmHg, the rate of target SBP achievement was 89.3% (881/987) at one month, 85.2% (790/927) during 1st to 12th month and 85.6%(712/832) from the first year to the third year after TEVAR. The incidence of clinical total adverse events (8.8% (12/137) vs. 4.2% (33/790), P=0.021) and repeat TEVAR (4.4% (6/137) vs. 1.0% (8/790), P=0.003) in target blood pressure non-achievement group were significantly higher than the target blood pressure achievement group during 1st to 12th month after TEVAR. The incidence of all-cause deaths (5.8% (7/120) vs. 2.4% (17/712), P=0.037) in the target blood pressure non-achievement group was significantly higher than the target blood pressure achievement group from the first year to the third year follow-up period, but there were no statistical differences in the incidence of clinical total adverse events between the two group (P>0.05). Conclusion: Among TEVAR treated AAS patients complicated with hypertension, the average SBP more than 150 mmHg post discharge is associated with increased risk of adverse events. Ideal blood pressure control should be encouraged to improve the outcome of these patients.
Humans ; Male ; Blood Pressure ; Acute Aortic Syndrome ; Retrospective Studies ; Aftercare ; Treatment Outcome ; Blood Vessel Prosthesis Implantation/adverse effects* ; Aortic Dissection ; Aortic Aneurysm, Thoracic/surgery* ; Endovascular Procedures/adverse effects* ; Patient Discharge ; Hypertension ; Prognosis ; Stroke ; Hospitals

Abstract：Objective To improve the replication level of varicella⁃zoster virus（VZV）in human diploid cell line MRC⁃5 and increase the yield of VZV vaccine by reducing the expression of interferon（IFN）related genes via optimizing the cell line MRC⁃5. Methods Interferon receptor 1（IFNAR1）silenced MRC⁃5 cell line（MRC⁃5IFNAR1⁃）was constructed by CRISPR／Cas9 gene editing technology，which was determined for the relative expression of IFNAR1 mRNA，and for those of mRNA of IFN related genes IFNβ and OAS1 after VZV infection by qRT⁃PCR to evaluate the effect of gene silencing. Gene mutation sequences were further identified by sequencing of the silenced sites. The replication of VZV in MRC⁃5 and MRC⁃5IFNAR1⁃ cell lines was compared 168 h after VZV infection by using qRT⁃PCR and plaque formation unit（PFU）assay， to evaluate the effect of MRC⁃5IFNAR1⁃cell line on VZV replication. Results The growth status of MRC⁃5IFNAR1⁃ cell line wasconsistent with that of MRC ⁃ 5 cells，and the relative expression of IFNAR1 mRNA decreased by 73%；The relative expressions of IFNβ and OAS1 mRNA in MRC⁃5IFNAR1⁃ cell line were 61% and 90% lower than those in MRC⁃ 5 cells respectively after VZV infection；In addition，168 h after VZV infection，the level of DNA replication and the titer of VZV increased by 5. 7 folds and 4 folds respectively. Conclusion The successful establishment of MRC⁃5IFNAR1⁃ cell line may be a potential scheme to increase the yield of vaccines based on human diploid cells，and provided a reference for expanding production of VZV vaccine.