OBJECTIVE Aimed at investigating whether reflux pharyngitis is an independent risk factor for the failure of type Ⅰ tympanoplasty for chronic otitis media.This is achieved by analyzing the relationship between the postoperative tympanic membrane healing in patients who underwent type Ⅰ tympanoplasty and pharyngolaryngeal reflux finding score(RFS).METHODS Patients who underwent type Ⅰ tympanoplasty in the Department of Otolaryngology Head and Neck Surgery,Nanshan People's Hospital,Shenzhen,China,from January 2023 to July 2024 were retrospectively included.All the patients received preoperative perfect nasal endoscopy,laryngoscopy,evaluation by the RFS questionnaire,preoperative otoscopy for tympanoplasty,pure tone hearing threshold,and temporal bone thin-layer CT examination.Postoperative otoscopic examination was performed to observe tympanic membrane healing and followed up for 3 months.The patients were divided into surgery success group and failure group based on the criterion of whether a complete tympanic membrane was formed by endoscopic examination within 3 months.The RFS scores of the two groups were statistically analyzed.RESULTS A total of 135 patients with an average age of 44.78 years(±12.22 years)took part in this study,with 60 males and 75 females included,and 68 left ears and 67 right ears involved.There were 120 patients in the surgery success group,and 15 patients in the failure group.Statistical analysis revealed that the RFS score of the patients in the tympanoplasty failure group was remarkably higher than that of the patients in the tympanoplasty success group.Moreover,there were significantly more cases with suspected reflux pharyngitis in the surgery failure group(P=0.007).Reflux-induced tympanic membrane lesion and reperforation mostly occurred in the central part of the tympanic membrane graft.CONCLUSION Reflux pharyngitis has been implicated with tympanoplasty failure,and thus may be a causative factor.Additionally,the RFS can be used to screen patients with chronic suppurative otitis media for suspected reflux pharyngitis.Findings from this work indicate that perioperative anti-reflux therapy,combined with dietary and lifestyle counselling for the patients who suffer from reflux pharyngitis and are about to undergo the tympanoplasty surgery may improve surgical success rate.

Cognitive impairment is one of the important clinical manifestations in depression. The particularly vulnerable cognition domains included executive function, attention, memory, and processing speed. Depression with cognitive impairment is not only a predictor of poor efficacy, but also closely related to dementia. Previous studies have suggested that multiple physiological mechanisms may be altered between depression and cognitive impairment. With the rapid development of neuroimaging technology, resting state functional magnetic resonance imaging has been widely used to explore the neurobiological mechanisms of depression and cognitive impairment. After reviewing the resting-state functional MRI manifestations of the comorbidity, it was found that the default mode network, cognitive control network, and salience network were activated or weakened in the brain. In addition, the inter-network functional connectivity was altered with the co-existence of impairment and compensation. The aforementioned changes of brain function are expected to be the therapeutic targets for depression with cognitive dysfunction.

Objective To investigate the association of smoking status with incident cardiovascular disease (CVD) and its subtypes among the middle-aged and older male populations. Methods This study included 13 940 males from Dongfeng-Tongji (DFTJ) cohort who were free of coronary heart disease (CHD), stroke, cancer or severely abnormal electrocardiogram (ECG) at baseline. All participants completed baseline questionnaires, physical examinations, clinical biochemical tests and blood sample collection. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confident intervals (CI) for the association analyses. Results Compared with never smokers, current smokers had significant higher risks of CVD, CHD and stroke, the adjusted HRs of current smokers who smoked for more than 40 pack-years were 1.49 (95% CI: 1.32-1.68, Ptrend=0.001), 1.40 (95% CI: 1.22-1.62, Ptrend=0.026) and 1.59 (95% CI: 1.26-2.00, Ptrend=0.029) for CVD, CHD and stroke, respectively; and the adjusted HRs of current smokers who started smoking before 20 years old were 1.29 (95% CI: 1.06-1.58, Ptrend=0.007) and 1.30 (95% CI: 1.03-1.64, Ptrend=0.010) for CVD and CHD, respectively. Former smokers who had quitted smoking for 10 or more years had significant lower risks of CVD (HR: 0.80, 95% CI: 0.71-0.91, Ptrend=0.017) and stroke (HR: 0.65, 95% CI: 0.50-0.84, Ptrend=0.207) when comparing to current smokers. Conclusions Smoking is significantly associated with higher risks of CVD, CHD and stroke, and greater amount of smoking and earlier age at smoking initiation are associated with a higher risk of CVD. Smoking cessation can reduce the risk of CVD.

Objective To investigate values of Wb -dwi on diagnosis of osseous metastases compared with Spect materials.Methods 20 cases with osseous metastases underwent Wb -dwi and Spect.The bones were divided into 6 groups:skull,collarbone,trunk bone,haunch bone,upper limb bone,lower limb bone.the high uptake regions on Spect and high signal on Wb -dwi for positive groups or positive lesions were recorded.Meanwhile,the total num-bers of positive groups and positive lesions in different groups were also recorded.Finally,the diagnostic sensitivity and specificity of Wb -dwi and Spect were calculated,which was based on the total numbers of positive groups. Results Wb -dwi showed 69 positive groups,the numbers of positive lesions in each group were 2,1,85,55,22,12. Spect showed 66 positive groups,the numbers of positive lesions in each group were 4,3,79,47,20,18.The diagnostic sensitivity and specificity on Spect were 81.1%,80.3%.The diagnostic sensitivity and specificity on Wb -dwi were 86.9%,84.3%.No statistical difference was assessed between the sensitivity and specificity of two methods. Conclusion Compared with Spect,the Wb -dwi can show more osseous metastasis lesions and has higher sensitivity on diagnosis osseous metastases.In additional,it can demonstrate primary tumors and extraskeletal metastasis lesions.

Objective To study the construction and function of platelet (PL) and the protection of PL by blood anesthesia during the eardiopulmonary bypass (CPB). Methods Bovine serum albumin (BSA) was immobi-lized on the surface of polyethylene terephthalate(PET) which was used as artificial vascular materials,to obtain the samples of PET-BSA. (1) The quantity of PL adhesion of PET and PET-BSA samples were investigated by lactate de-hydrogenase(LDH) test. (2) The quantity of PL activation was investigated by a-granule membrane protein-140 (GMPI40) test. (3)PL adhesion test was conducted on the surface of the samples and the morphology of the adhered PL was examined by scanning electron microscopy (SEM). (4)30 patients undergoing cardiac surgery under CPB were randomly divided into aprotinin group and control group,quantities of FDP, PK, PLG and thromboxance B2 (TXB2) in the blood were measured in various time, PLs were observed by electron microscopy, and postoperative blood loss from chest and medium were recorded during first 24 hours. Results Compared with the control group,the quantity of PL adhesion on the PET-BSA samples significantly decreased and the quantity of PL activation of the PET-BSA group was only 20% of the control group. The results of SEM showed PL on PET-BSA surface was few,whereas on the PET sur-face overlaped and had pseudopodium. The decomposition of PLG is fewer in blood anaesthesia group,indicated the fi-brinolytie system was inhibited and construction of PL was protected. Conclusion During CPB,plasma proteins com-pete against each other to adhere on the tube of CPB,then PL interact to the adhered proteins,and PL combine with conformation changed fibrin at its C extreme of γ chain. At the same time,PL is activated and its GPⅡb/Ⅲa point is ex-posed. The function of blood anesthesia of aprotinin is to inhibit the activation of PIg; and PK,protect the GPⅡb of PL from being destroyed, and protect the coagulation funeion of PL of postoperation.