Objective:To analyze the efficacy of unilateral arytenoid chondroplasty combined with minimally invasive mucosal flap plasty in the management bilateral vocal cord paralysis.Methods:A total of 66 patients with bilateral vocal cord paralysis hospitalized in the First Hospital of Sun Yat-sen University from January 2018 to December 2023 were retrospectively analyzed, among whom there were 8 males and 58 females, with ages ranging from 35 to 86 years old(mean age (57.8±11.6) years). All patients underwent suspension laryngoscopic CO 2 laser unilateral arytenoid chondroplasty and mucosal flap under general anesthesia. Postoperative follow-up period extended from 6 months to 6 years, with a median duration of 28 months. The study compared the degree of dyspnea and voice quality (subjective and objective evaluation) of the patients pre- and post-operatively, and analyzed the clinical differences between patients with and without preoperative or intraoperative tracheotomy, the extubation rate of tracheotomized patients, the recurrence rate, and the complication rate. Continuous variables conforming to normal distribution were tested by t-test and categorical variables by χ2 test,the Wilcoxon rank-sum test was used to analyze the improvement in dyspnea before and after surgery. Results:Compared with the preoperative period, 59 patients showed improvement in postoperative dyspnea ( U=161.5, P<0.01); there was no significant difference in voice disorder index 10, subjective auditory-perceptual assessment, and maximal vocalization time ( P>0.05), all of which remained within the relative normal range. Tracheotomy was performed in 32 out of 66 patients, with predominantly degree Ⅲ- dyspnea (46.9%, 15/32), including 26 patients with preoperative tracheotomy and 6 patients with intraoperative tracheotomy. Among the 34 patients who did not undergo tracheotomy, the majority presented with degree Ⅱ-dyspnea (82.4%, 28/34). All patients achieved successful extubation following surgery, with a mean median time to extubation of 1 month. Conclusions:The combination of unilateral arytenoid chondroplasty and minimally invasive mucosal flap plasty represents a refined and effective therapeutic approach for bilateral vocal cord paralysis. This minimally invasive technique has the potential to reduce the rate of tracheotomy.

Objective:This study aims to explore the changes in brain surface morphology and their association with psychological characteristics in adolescents experiencing their first episode of major depressive disorder.Methods:This study included 48 adolescents with first-episode major depressive disorder (depression group) admitted to the Department of Psychiatry of the First Affiliated Hospital of Chongqing Medical University from October 2021 to July 2022. At the same period,35 healthy controls (control group) were also enrolled,from communities of Chongqing. All participants underwent assessments for depressive symptoms, emotion regulation capacity, impulsiveness, and psychological resilience using the 17-item Hamilton Depression Scale (HAMD 17), the Patient Health Questionnaire-9 (PHQ-9), the Emotion Regulation Questionnaire (ERQ), the Barratt Impulsiveness Scale-11 (BIS-11), and the Connor-Davidson Resilience Scale (CD-RISC). Structure magnetic resonance imaging (sMRI) was utilized to evaluate brain surface morphology. The values of cortical thickness, fractal dimension, sulcus depth, and cortical gyrification index were calculated. The index of brain surface morphology between the two groups was compared using the two-sample t-test, chi-square test, and non-parametric statistical tests with multiple comparisons correction using threshold-free cluster enhancement (TFCE) and false discovery rate (FDR). Pearson correlation analyses were used to analyze the correlation between the scores of each scale (HAMD 17, PHQ-9, ERQ, BIS-11, and CD-RISC) and the cortical thickness values and fractal dimension in the depression group. In addition, multiple linear regression was used to analyze the impact of clinical symptoms on the cortical thickness values in the depression group. Results:Compared with the control group, the depression group exhibited a significant reduction in the cortical thickness of the left occidental (FDR corrected, P<0.05) and an increase of the fractal dimension in the right insula, right superior temporal gyrus, and right transverse temporal gyrus (TFCE uncorrected, P<0.001). Correlation analyses showed that left occipital cortical thickness was positively correlated with the cognitive reappraisal scores of ERQ ( r=0.315, P=0.029), the total score of CD-RISC ( r=0.366, P=0.016), and the unplanned impulsiveness scores of BIS-11 (reverse scoring for this dimension) ( r=0.354, P=0.014). The partial correlation analysis revealed a positive linear correlation between cortical thickness and unplanned impulsiveness scores after controlling for age ( r=0.467, P=0.001). However, after Bonferroni correction, these correlations were not statistically significant. Conclusions:Compared with healthy individuals, adolescents with first-episode depressive disorders demonstrated increased fractal dimension in the right insula, right superior temporal gyrus, and right transverse temporal gyrus and decreased cortical thickness in the left occipital lobe. The decreased cortical thickness in the left occipital lobe was associated with impaired emotion regulation ability and impulse control ability during periods of stress.

[Purpose]To investigate the trends of incidence and age at onset of uterine corpus can-cer in Jiangsu cancer registration areas from 2009 to 2019.[Methods]The continuous monitoring data of uterine corpus cancer from 2009 to 2019 were collected from 16 cancer registries in Jiang-su Province.The crude incidence rate,the age-standardized incidence rate by Chinese standard population(ASIRC),crude and adjusted mean age,and standardized age-specific incidence composition were calculated.The average annual percentage change(AAPC)were analyzed by the Joinpoint regression model.The linear regression model was used to analyze the relationship be-tween mean age at onset and year.The standardized age-specific incidence composition in 2009 and 2019 were compared.[Results]The ASIRC of uterine corpus cancer in all registration areas and in rural areas of Jiangsu Province showed upward trends with AAPC of 1.78％and 2.38％,re-spectively(P＜0.05),but not showed in the urban areas(AAPC=1.30％,P＞0.05).The crude mean age at onset increased from 56.48 years old in 2009 to 58.26 years old in 2019 with an average annual growth of 0.173 years old(P=0.001).After the population structure standardized,the trends disappeared in all registration areas.[Conclusion]From 2009 to 2019,the standardized incidence rates of uterine corpus cancer were on rise in Jiangsu cancer registration areas,especially in the age group of 50 to 59 years old.

Objective:This study aims to explore the changes in brain surface morphology and their association with psychological characteristics in adolescents experiencing their first episode of major depressive disorder.Methods:This study included 48 adolescents with first-episode major depressive disorder (depression group) admitted to the Department of Psychiatry of the First Affiliated Hospital of Chongqing Medical University from October 2021 to July 2022. At the same period,35 healthy controls (control group) were also enrolled,from communities of Chongqing. All participants underwent assessments for depressive symptoms, emotion regulation capacity, impulsiveness, and psychological resilience using the 17-item Hamilton Depression Scale (HAMD 17), the Patient Health Questionnaire-9 (PHQ-9), the Emotion Regulation Questionnaire (ERQ), the Barratt Impulsiveness Scale-11 (BIS-11), and the Connor-Davidson Resilience Scale (CD-RISC). Structure magnetic resonance imaging (sMRI) was utilized to evaluate brain surface morphology. The values of cortical thickness, fractal dimension, sulcus depth, and cortical gyrification index were calculated. The index of brain surface morphology between the two groups was compared using the two-sample t-test, chi-square test, and non-parametric statistical tests with multiple comparisons correction using threshold-free cluster enhancement (TFCE) and false discovery rate (FDR). Pearson correlation analyses were used to analyze the correlation between the scores of each scale (HAMD 17, PHQ-9, ERQ, BIS-11, and CD-RISC) and the cortical thickness values and fractal dimension in the depression group. In addition, multiple linear regression was used to analyze the impact of clinical symptoms on the cortical thickness values in the depression group. Results:Compared with the control group, the depression group exhibited a significant reduction in the cortical thickness of the left occidental (FDR corrected, P<0.05) and an increase of the fractal dimension in the right insula, right superior temporal gyrus, and right transverse temporal gyrus (TFCE uncorrected, P<0.001). Correlation analyses showed that left occipital cortical thickness was positively correlated with the cognitive reappraisal scores of ERQ ( r=0.315, P=0.029), the total score of CD-RISC ( r=0.366, P=0.016), and the unplanned impulsiveness scores of BIS-11 (reverse scoring for this dimension) ( r=0.354, P=0.014). The partial correlation analysis revealed a positive linear correlation between cortical thickness and unplanned impulsiveness scores after controlling for age ( r=0.467, P=0.001). However, after Bonferroni correction, these correlations were not statistically significant. Conclusions:Compared with healthy individuals, adolescents with first-episode depressive disorders demonstrated increased fractal dimension in the right insula, right superior temporal gyrus, and right transverse temporal gyrus and decreased cortical thickness in the left occipital lobe. The decreased cortical thickness in the left occipital lobe was associated with impaired emotion regulation ability and impulse control ability during periods of stress.

Objective: To investigate the trends in the disease burden of leukemia in Jiangsu Province from 1990 to 2019, so as to provide insights into leukemia control in Jiangsu Province. Methods: The prevalence, incidence, death and disability adjusted life years (DALYs) of leukemia in Jiangsu Province from 1990 to 2019 were retrieved from the 2019 Global Burden of Disease Study (GBD 2019) database, and standardized by the age structure of Chinese populations in 2000. The trends in the disease burden of leukemia in Jiangsu Province from 1990 to 2019 were analyzed using average annual percent change (AAPC). Results : The average annual standardized prevalence, incidence, mortality and DALY rate of leukemia were 63.63/105, 9.76/105, 4.10/105 and 194.83/105 in Jiangsu Province from 1990 to 2019, respectively. The average annual standardized prevalence (AAPC=1.420%, t=5.644, P<0.001) and incidence (AAPC=0.806%, t=3.505, P<0.001) of leukemia appeared a tendency towards a rise, while the average annual standardized mortality (AAPC=-1.589%, t=-14.714, P<0.001) and DALY rate (AAPC=-1.849%, t=-9.046, P<0.001) of leukemia appeared a tendency towards a decline in Jiangsu Province from 1990 to 2019. Higher average annual standardized prevalence (65.27/105 vs. 62.38/105, P<0.001), incidence (10.32/105 vs. 9.29/105, P<0.001), mortality (4.69/105 vs. 3.57/105, P<0.001) and DALY rate of leukemia (216.94/105 vs. 172.80/105, P<0.001) were estimated among men than among women. The crude prevalence of leukemia peaked among patients at ages of 0 to 14 years and 60 to 74 years, and the crude incidence, DALY rate and mortality of leukemia peaked at ages of 0 to 14 years and 75 years and older. Conclusions The mortality and DALY of leukemia appeared a tendency towards a decline and the prevalence and incidence appeared a tendency towards a rise in Jiangsu Province from 1990 to 2019; however, there were high disease burdens of leukemia among men, children and the elderly.

Objective::Data comparing the outcomes of MiStent (Micell Technologies, Durham, North Carolina, USA) microcrystalline biodegradable polymer (BP) drug-eluting stent (DES) and those of another post-marketing BP-DES, TIVOLI (EssenTech, Beijing, China) are rare. This study sought to compare the angiographic efficacy and clinical outcomes of the microcrystalline BP sirolimus-eluting stent (SES) system MiStent and those of TIVOLI BP-SES.Methods::The DESSOLVE-C trial was a prospective, single-blinded, multicenter, randomized trial (NCT02448524), which randomly assigned patients with de novo coronary lesions to receive MiStent or TIVOLI BP-SES by a 1:1 ratio. The primary endpoint was a non-inferiority comparison of in-stent late lumen loss (LLL) by quantitative coronary angiography at 9 months. The secondary endpoint was device-related clinical cardiovascular composite events (target lesion failure (TLF), composite of cardiac death, target vessel myocardial infarction (MI), and clinically driven target lesion revascularization) and 1-year outcomes. Results::A total of 428 patients (216 patients in the MiStent group and 212 patients in the TIVOLI group) were enrolled and included in an intention-to-treat analysis. MiStent was not only non-inferior but superior to TIVOLI for in-stent LLL at 9 months ((0.23 ± 0.37) mm vs. (0.34 ± 0.48) mm, P for non-inferiority <0.001, P for superiority = 0.02). Although without significant difference, the rate of TLF in MiStent was quantitatively lower than that in TIVOLI (3.70% vs. 6.60%; P = 0.17). Conclusion::Compared with TIVOLI BP-SES, the MiStent system was superior in in-stent LLL at 9 months and had a comparable clinical benefit at 1 year in de novo coronary lesions.

Objective::Data comparing the outcomes of MiStent (Micell Technologies, Durham, North Carolina, USA) microcrystalline biodegradable polymer (BP) drug-eluting stent (DES) and those of another post-marketing BP-DES, TIVOLI (EssenTech, Beijing, China) are rare. This study sought to compare the angiographic efficacy and clinical outcomes of the microcrystalline BP sirolimus-eluting stent (SES) system MiStent and those of TIVOLI BP-SES.Methods::The DESSOLVE-C trial was a prospective, single-blinded, multicenter, randomized trial (NCT02448524), which randomly assigned patients with de novo coronary lesions to receive MiStent or TIVOLI BP-SES by a 1:1 ratio. The primary endpoint was a non-inferiority comparison of in-stent late lumen loss (LLL) by quantitative coronary angiography at 9 months. The secondary endpoint was device-related clinical cardiovascular composite events (target lesion failure (TLF), composite of cardiac death, target vessel myocardial infarction (MI), and clinically driven target lesion revascularization) and 1-year outcomes. Results::A total of 428 patients (216 patients in the MiStent group and 212 patients in the TIVOLI group) were enrolled and included in an intention-to-treat analysis. MiStent was not only non-inferior but superior to TIVOLI for in-stent LLL at 9 months ((0.23 ± 0.37) mm vs. (0.34 ± 0.48) mm, P for non-inferiority <0.001, P for superiority = 0.02). Although without significant difference, the rate of TLF in MiStent was quantitatively lower than that in TIVOLI (3.70% vs. 6.60%; P = 0.17). Conclusion::Compared with TIVOLI BP-SES, the MiStent system was superior in in-stent LLL at 9 months and had a comparable clinical benefit at 1 year in de novo coronary lesions.

Antibodies, Neutralizing ; Antibodies, Viral/isolation & purification* ; B-Lymphocytes/virology* ; COVID-19/virology* ; Humans ; Immunity/genetics* ; RNA, Viral/immunology* ; SARS-CoV-2/pathogenicity* ; Single-Cell Analysis

PURPOSE: MicroRNAs (miRs) were recently recognized to be important for immune cell differentiation and immune regulation. However, whether miRs were involved in allergen-specific immunotherapy (SIT) remains largely unknown. This study sought to examine changes in miR-146a and T regulatory cells in children with persistent allergic rhinitis (AR) after 3 months of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). METHODS: Twenty-four HDM-sensitized children with persistent AR were enrolled and treated with SCIT (n=13) or SLIT (n=11) for 3 months. Relative miR-146a and Foxp3 mRNA expression, the TRAF6 protein level, and the ratio of post-treatment to baseline IL-10+CD4+ T cells between the SCIT and SLIT groups were examined in the peripheral blood mononuclear cells (PBMCs) of AR patients using quantitative reverse transcription polymerase chain reaction (qRT-PCR), flow cytometry, and Western blot analysis, respectively. Serum levels of IL-5 and IL-10 were determined using ELISA. RESULTS: After 3 months of SIT, both the TNSS and INSS scores were significantly decreased compared to the baseline value (P<0.01). The relative expression of miR-146a and Foxp3 mRNA was significantly increased after both SCIT and SLIT (P<0.01). The ratio of post-treatment to baseline IL-10+CD4+ T cells and the serum IL-10 level were significantly increased in both the SCIT and SLIT groups (P<0.01), whereas the TRAF6 protein level and serum IL-5 level were significantly decreased (P<0.01). No significant differences in these biomarkers were observed between the SCIT and SLIT groups. CONCLUSIONS: Our findings suggest that miR-146a and its related biomarkers may be comparably modulated after both SCIT and SLIT, highlighting miR-146a as a potential therapeutic target for the improved management of AR.
Biomarkers ; Blotting, Western ; Cell Differentiation ; Child* ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Immunotherapy* ; Interleukin-10 ; Interleukin-5 ; MicroRNAs ; Polymerase Chain Reaction ; Reverse Transcription ; Rhinitis* ; RNA, Messenger ; Sublingual Immunotherapy ; T-Lymphocytes ; TNF Receptor-Associated Factor 6

PURPOSE: Chronic rhinosinusitis (CRS) is characterized by the excessive production of mucus. However, the molecular mechanism underlying mucin overproduction in CRS with or without nasal polyps (CRSwNP and CRSsNP, respectively) is poorly understood. This study was conducted to assess the importance of the transcription factor FoxA2 in mucin production and to investigate the targeting of FoxA2 as a potential therapeutic strategy for mucus hypersecretion in CRS patients. METHODS: We enrolled 15 CRSwNP patients, 15 CRSsNP patients, and 10 normal controls in this study. The expression levels of FoxA2, MUC5AC, and MUC5B in inflamed and healthy nasal tissues were examined via immunohistochemistry and quantitative reverse transcription-polymerase chain reaction, and the levels of several proinflammatory cytokines in nasal secretions were measured via FlowCytomix analysis. In addition, the expression of MUC5AC and FoxA2 was determined in polyp-derived epithelial cells and NCI-H292 cells after in vitro stimulation. RESULTS: FoxA2 was significantly down-regulated, and MUC5AC and MUC5B were significantly up-regulated in both the CRSwNP and CRSsNP patients compared to the controls (P<0.05), and the protein level of FoxA2 was negatively associated with the IL-6 level in the CRS patients (P<0.05). IL-6 significantly increased MUC5AC expression but inhibited FoxA2 expression in vitro (P<0.05). Transfection with a FoxA2 expression plasmid significantly decreased MUC5AC promoter activity (P<0.05) and inhibited IL-6-induced MUC5AC production (P<0.05). In addition, clarithromycin significantly alleviated IL-6-induced FoxA2 suppression and decreased MUC5AC expression in vitro (P<0.05). CONCLUSIONS: Our findings suggest that FoxA2 may be considered a therapeutic target for the modulation of mucus hypersecretion in CRS patients.
Clarithromycin ; Cytokines ; Epithelial Cells ; Humans ; Immunohistochemistry ; Interleukin-6 ; Mucins ; Mucus ; Nasal Polyps* ; Plasmids ; Transcription Factors* ; Transfection