Objective To investigate the expression and clinical significance of miR-34c and miR-29b in peripheral blood of patients with sensorineural hearing loss.Methods 140 patients with neurological deafness admitted to our hospital from June 2020 to June 2023 were included in the study group,and 40 healthy subjects were included in the control group during the same period.SNHL patients were categorized into 63 cases in the mildly deaf group,42 cases in the moderately deaf group,and 35 cases in the severely deaf group according to their hear-ing impairment.The expressions of miR-34c and miR-29b were detected by qRT-PCR,and VEGF,oxidative stress(TAC,SOD,MDA),NO and Cx26 were detected.Correlation analysis was performed by Pearson test,independent risk factors for SNHL severity were calculated by logistics regression algorithm,and the predictive value of miR-34c and miR-29b on the severity of SNHL patients was evaluated by ROC curve.Results Comparing the levels of NO,TAC,SOD,and Cx26 among the four groups,severe deafness groupmoderate deafness group>mild deafness group>control group(P<0.05).Comparison of miR-34c mRNA and miR-29b mRNA expression levels among the four groups,severe deafness group>moderate deafness group>mild deafness group>control group(P<0.05).Pearson's test showed that SNHL patients'peripheral blood miR-34c and miR-29b were positively correlated with VEGF and MDA,and were negatively correlated with NO,TAC,SOD and Cx26(P<0.05).negative correlation(P<0.05).Multifactorial logistic regression analysis showed that VEGF,MDA,NO,Cx26,TAC,SOD,miR-34c,miR-29b were independent factors affecting the severity of SNHL.Conclusion miR-34c and miR-29b are overexpressed in SNHL patients and can be used as serum markers for predictive assess-ment of disease severity in SNHL patients.

The mild-natured and bitter-flavored traditional Chinese medicines (MB-TCMs) are an important class of TCMs that have been widely used in clinical practice and recognized as safe long-term treatments for chronic diseases. However, as an important class of TCMs, the panorama of pharmacological effects and the mechanisms of MB-TCMs have not been systemically reviewed. Compelling studies have shown that gut microbiota can mediate the therapeutic activity of TCMs and help to elucidate the core principles of TCM medicinal theory. In this systematic review, we found that MB-TCMs commonly participated in the modulation of metabolic syndrome, intestinal inflammation, nervous system disease and cardiovascular system disease in association with promoting the growth of beneficial bacteria Bacteroides, Akkermansia, Lactobacillus, Bifidobacterium, Roseburia as well as inhibiting the proliferation of harmful bacteria Helicobacter, Enterococcus, Desulfovibrio and Escherichia-Shigella. These alterations, correspondingly, enhance the generation of protective metabolites, mainly including short-chain fatty acids (SCFAs), bile acid (BAs), 5-hydroxytryptamine (5-HT), indole and gamma-aminobutyric acid (GABA), and inhibit the generation of harmful metabolites, such as proinflammatory factors trimethylamine oxide (TAMO) and lipopolysaccharide (LPS), to further exert multiplicative effects for the maintenance of human health through several different signaling pathways. Altogether, this present review has attempted to comprehensively summarize the relationship between MB-TCMs and gut microbiota by establishing the TCMs-gut microbiota-metabolite-signaling pathway-diseases axis, which may provide new insight into the study of TCM medicinal theories and their clinical applications.

Objective:To explore the relevant anatomical factors in the pathogenesis of chronic dacryocystitis based on CT radiomics. Methods:A retrospective analysis was conducted on the general data and sinus CT materials of 85 patients with chronic dacryocystitis（case group） admitted to our department from December 2020 to December 2023, and 85 individuals undergoing physical examination（control group） during the same period. The differences in anatomical parameters between the two groups were compared to study the morphological characteristics of the nasolacrimal duct in patients with chronic dacryocystitis. Univariate and multivariate logistic regression analyses were used to explore the relevant anatomical factors in the pathogenesis of chronic dacryocystitis. Results:There were statistically significant differences（P<0.05） in the proportion of combined nasal septal deviation, the distance between the anterior and posterior ridges of the lacrimal fossa, the angle between the long axis of the nasolacrimal duct and the projection on the midsagittal plane, the maximum transverse diameter of the bony nasolacrimal duct, the maximum cross-sectional area of the bony nasolacrimal duct, and the thickness of the frontal process of the maxilla between the two groups. There were no statistically significant differences（P>0.05） in whether there was a combined high-position nasal septal deviation, whether there was a combined non-high-position nasal septal deviation, and whether there was a combined pneumatized middle turbinate. Multivariate analysis showed that nasal septal deviation, the distance between the anterior and posterior ridges of the lacrimal fossa, the angle between the long axis of the nasolacrimal duct and the projection on the midsagittal plane, and the maximum cross-sectional area of the bony nasolacrimal duct are independent anatomical factors affecting the pathogenesis of chronic dacryocystitis. Conclusion:Nasal septal deviation, a large distance between the anterior and posterior ridges of the lacrimal fossa, a large angle between the long axis of the nasolacrimal duct and the projection on the midsagittal plane, and a small maximum transverse diameter of the bony nasolacrimal duct are important anatomical bases for the pathogenesis of chronic dacryocystitis, providing a basis for an in-depth understanding of the disease occurrence.
Humans ; Retrospective Studies ; Male ; Female ; Dacryocystitis/diagnostic imaging* ; Tomography, X-Ray Computed/methods* ; Nasolacrimal Duct/diagnostic imaging* ; Chronic Disease ; Nasal Septum/diagnostic imaging* ; Middle Aged ; Adult ; Radiomics

The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

Objective:To investigate the surgical technique and the clinical effects of direct posterior approach (DPA) with the fixation of percutaneous tunnel screw and plate for acetabular posterior comminuted fractures.Methods:Thirty-six cases with acetabular posterior comminuted fractures treated by this technique from January 2016 to July 2020 were retrospectively analyzed in this study. There were 28 males and 8 female, aged 42.0±12.1 (range 19-64) years. According to Letournel-Judet classification, there were 28 cases of transverse associated with posterior wall fractures, 6 cases of posterior column with posterior wall fractures and 2 cases of T shape with posterior wall fractures. DPA was adopted in prone position. The anterior and posterior column fractures of the acetabulum were reduced under direct vision and then fixed with percutaneous tunnel screw. Further, the posterior wall fractures of the acetabulum were reduced and fixed with plate and screws. The operation duration, intraoperative blood loss, incision length, fracture union time, fracture reduction quality, postoperative complications and hip function were recorded.Results:The incision was 9.8±1.2 (range 8-12) cm. The operation duration was 102.9±21.4 (range 65-145) min. Intraoperative bleeding was 214.0±116.9 (range 100-640) ml. Postoperative X-ray and CT examinations showed perfect reduction. All the patients were followed up for 20.9±9.2 (range 10-38) months. The fracture healing time was 4.6±1.0 (range 3-6) months. There was no patient with damaged superior gluteal nerve and blood vessel. There were 2 cases of femoral head cystic changes without pain in walking, 1 case of postoperative infection and bacteremia who was cured at 1 month after debridement and anti-infection treatment, 1 case of sciatic nerve injury but recovered at 3 months after operation, and 1 case of heterotopic ossification at 3 months after surgery without affecting hip motion. According to the Matta's criteria, the reduction quality of the acetabular fracture was rated as excellent in 28 cases, good in 6 cases, fair in 2 cases. According to the modified Merle D'Aubigné and Postel scoring system, hip joint function was excellent in 24 cases, good in 10 cases and fair in 2 cases.Conclusion:DPA approach can directly reduce acetabular posterior comminuted fractures through a minimal incision. Combined with the technique of percutaneous tunnel screw, it displays great advantages of less trauma and with good clinical effects.

Objective:To investigate the microsurgical anatomy of thoracodorsal artery perforators, and the clinical effect in repairing the soft tissue defect of hand with the thoracodorsal artery perforator flap (TAP).Methods:From October, 2014 to November, 2014, the axillary arteries in 10 thoracodorsal specimens were perfused with red latex. The number and diameter of the perforators of the thoracodorsal arteries were mearsured. From January, 2015 to February, 2019, 52 cases of soft tissue defects in hand combined with bone and extensor tendon exposure were repaired with TAP. The patients were followed-up in outpatient department to observe the clinical efficacy.Results:The number of perforators of thoracodorsal artery was 2-4 mostly, and 3 perforators was the most. The diameter of perforators was 0.22-0.68 mm, and the distance between the perforating point and the posterior axillary wall was 5.2-11.8 cm. All the operations were completed successfully, and the donor sites were closed directly. In 52 cases, 48 flaps survived, 2 had partially necrosis, and 2 had completely necrosis. The patients were followed-up for 5 to 24 months. The blood supply of the flaps was good with soft texture and good appearance.Conclusion:The TAP is an ideal flap because of its thin in thickness, concealed donor area and no obvious scar after direct suture.

Objective: To explore the feasibility of 3D DSA in guidance of uterine artery catheterization (UAE). Methods: A total of 20 patients, including symptomatic uterine leiomyoma (n=8), postpartum hemorrhage (n=5), scar pregnancy (n=3), adenomyosis (n=1) and advanced cervical cancer (n=3) underwent UAE guided by 3D DSA (3D group, n=10) or 2D DSA (2D group, n=10). The relevant clinical indexes of 2 groups were compared. Results: UAE was successfully performed in all 20 patients (40 uterine arteries).No blood supply from ovarian artery was found. The operation time, catheterization time and fluoroscopy time were both shorter, and the dosage of contrast agent and radiation doses were all lower in 3D group than those in 2D group (all P<0.05). Conclusion: 3D DSA can be used to guid UAE, with shorter operation time and lower radiation dose than traditional 2D DSA.

Epilepsy mostly starts in childhood and can cause severe mental disorders.Treatment with antiepileptic drugs is effective in most patients, but 20%-30% of the patients continue to have uncontrolled seizures despite medical therapy, these are called drug-resistant epilepsy and need surgical treatment.Critical to discussion of surgical therapy are detailed presurgical evaluation and the lateralization and localization of epileptogenic zone.With deepening of the knowledge of epilepsy and progress of imaging technology, the evaluation of epilepsy surgery is changing gradually.Now, some methods and advances of surgical evaluation for children with drug-resistant epilepsy are reviewed.

Objective To determine the angles of trochlear line(TL), antero-posterior line (APL) and posterior condylar line (PCL) with clinical epicondylar axis (CEA), analyze the variability difference in 3 axes relative to CEA. Methods The right knees in 36 patients with knee osteoarthritis (gradeⅣ) and who had underwent total knee arthroplasty were enrolled in this study, 11 male patients aged 60-81 (69.1 ± 6.3) years and 25 female patients aged 33- 85(67.7 ± 12.2) years. All of right knees were scanned using computed tomography. The angles between the CEA and each of the 3 axes (TL, PCL, APL) were measured using software. Results The angles of TL-CEA, APL-CEA and PCL-CEA was (6.10 ± 3.22)°, (85.80 ± 2.86)°and (2.70 ± 1.80)°. The F tests showed that the angel invariability between the TL and CEA the APL axis (α=0.58) or the PCL (α=0.28) for referencing the CEA had no significant differences. Conclusions The TL can be a relatively reliable reference axis to determine rotational alignment of the femoral component similar to PCL and APL.

OBJECTIVETo observe the effect differences among the comprehensive therapy, acupuncture and oral mecobalamine for senile sensorineural hearing loss.

METHODSA total of 126 senile sensorineural hearing loss patients were randomized into a comprehensive group, an acupuncture group and a western medication group, 42 cases in each group. After removing and discontinuing cases, 40 cases in each group were included in the analysis. Acupuncture, acupoint injection and auricular point pressing were used in the comprehensive group. Acupuncture for 2 courses was at the affected Tinggong (SI 19), Tinghui (GB 2), Yifeng (TE 17), etc, once every other day, 10 times as a course with one week rest between 2 courses, 3 times a week. Acupuncture as the comprehensive group was applied in the acupuncture group. Mecobalamin tablet was prescribed orally for 2 courses in the western medication group, 3 times a day, 0.5 mg a time, 3 weeks as a course, one week at the interval. Pure tone hearing threshold value and tinnitus grading were observed before and after intervention in the three groups. The clinical effects were compared.

RESULTSAfter treatment, pure tone hearing threshold value and tinnitus grading were better than those before treatment in the three groups (all <0.05), with better results in the comprehensive group than those in the other two groups (all <0.05). The total effective rate of pure tone hearing threshold value was 82.5% (33/40) in the comprehensive group, which was superior to 67.0% (27/40) in the acupuncture group and 62.5% (25/40) in the western medication group (both <0.05). The total effective rate of tinnitus was 83.3% (30/36) in the comprehensive group, which was superior to 69.7% (23/33) in the acupuncture group and 57.1% (20/35) in the western medication group (both <0.05).

CONCLUSIONThe clinical effects of comprehensive therapy on senile sensorineural hearing loss are superior to those of simple acupuncture and oral administration of mecobalamin in terms of pure tone hearing threshold value and tinnitus grading.