Objective:To investigate the interaction between non-alcoholic fatty liver disease (NAFLD) and overweight/obesity on the risk of mild cognitive impairment (MCI) in elderly individuals.Methods:This cross-sectional study was based on the Hubei Memory and Aging Cohort Study (HMACS). Cluster random sampling was used to select 5 661 elderly individuals aged≥65 years in Wuhan from 2018 to 2023. Standardized neuropsychological assessments and clinical examinations results were collected. The NAFLD was diagnosed by abdominal ultrasound. The logistic regression analysis was used to analyze the association of NAFLD and overweight/obesity with MCI. The impacts of interaction between NAFLD and overweight/obesity on the risk of MCI were analyzed using both multiplicative and additive models.Results:Among the 5 661 elderly individuals included in the analysis, 2 563 were male and 3 098 were female, with a mean age of (72.24±5.51) years. A total of 2 239 participants (39.6%) resided in rural areas, 2 841 (50.2%) were overweight/obesity, 2 390 (42.2%) had NAFLD, and 1 694 (29.9%) were diagnosed with MCI. The risk of MCI in elderly individuals with NAFLD and overweight/obesity was 2.975 times ( OR=2.975, 95% CI: 2.489-3.557, P<0.001) of that in non-overweight/obese individuals without NAFLD. There was a multiplicative interaction between NAFLD and overweight/obesity on MCI ( OR=1.508, 95% CI: 1.169-1.944, P=0.002). NAFLD and overweight/obesity had an additive interaction effect on the risk of MCI, and the relative excess risk of interaction, attributable proportion of interaction and the synergy index was 1.099 (95% CI: 0.630-1.593), 0.369 (95% CI: 0.222-0.487), 2.256 (95% CI: 1.457-3.492), respectively. Conclusion:There is an interaction between NAFLD and overweight/obesity in elderly individuals, and the co-existence of NAFLD and overweight/obesity increases the risk of MCI in this population.

Objective:To investigate the interaction between non-alcoholic fatty liver disease (NAFLD) and overweight/obesity on the risk of mild cognitive impairment (MCI) in elderly individuals.Methods:This cross-sectional study was based on the Hubei Memory and Aging Cohort Study (HMACS). Cluster random sampling was used to select 5 661 elderly individuals aged≥65 years in Wuhan from 2018 to 2023. Standardized neuropsychological assessments and clinical examinations results were collected. The NAFLD was diagnosed by abdominal ultrasound. The logistic regression analysis was used to analyze the association of NAFLD and overweight/obesity with MCI. The impacts of interaction between NAFLD and overweight/obesity on the risk of MCI were analyzed using both multiplicative and additive models.Results:Among the 5 661 elderly individuals included in the analysis, 2 563 were male and 3 098 were female, with a mean age of (72.24±5.51) years. A total of 2 239 participants (39.6%) resided in rural areas, 2 841 (50.2%) were overweight/obesity, 2 390 (42.2%) had NAFLD, and 1 694 (29.9%) were diagnosed with MCI. The risk of MCI in elderly individuals with NAFLD and overweight/obesity was 2.975 times ( OR=2.975, 95% CI: 2.489-3.557, P<0.001) of that in non-overweight/obese individuals without NAFLD. There was a multiplicative interaction between NAFLD and overweight/obesity on MCI ( OR=1.508, 95% CI: 1.169-1.944, P=0.002). NAFLD and overweight/obesity had an additive interaction effect on the risk of MCI, and the relative excess risk of interaction, attributable proportion of interaction and the synergy index was 1.099 (95% CI: 0.630-1.593), 0.369 (95% CI: 0.222-0.487), 2.256 (95% CI: 1.457-3.492), respectively. Conclusion:There is an interaction between NAFLD and overweight/obesity in elderly individuals, and the co-existence of NAFLD and overweight/obesity increases the risk of MCI in this population.

ObjectiveThrough a randomized， double-blind， double-simulation， positive-control， multicenter design， this study aimed to analyze the relationship between the dosage， efficacy， and safety of Pudilan anti-inflammatory oral liquid in treating acute pharyngitis/tonsillitis in adults caused by bacterial infection and validate the regulatory effect of Pudilan anti-inflammatory oral liquid on inflammatory markers such as serum amyloid A （SAA）， C-reactive protein （CRP）， white blood cells （WBC）， neutrophil percentage （NE%）， and erythrocyte sedimentation rate （ESR）， thereby exploring the feasibility of using Pudilan anti-inflammatory oral liquid as a substitute for antibiotics in the treatment of infectious diseases and providing a basis for rational clinical medication. MethodUsing a stratified randomized， double-blind， double-simulation， positive-control， multicenter design， 220 participants were enrolled from nine centers. The participants were randomly divided into three groups at 1∶1∶1 — a Pudilan anti-inflammatory oral liquid 20 mL group （73 cases）， a Pudilan anti-inflammatory oral liquid 10 mL group （73 cases）， and a control group （amoxicillin group， 74 cases）. The treatment course was 7 days. The study observed parameters including the total effective rate of sore throat， onset and disappearance time of sore throat， health status score， treatment time， and inflammation markers. Result①Dataset division： The 211 cases were included in the full analysis dataset （FAS）， 208 cases were included in the per-protocol dataset （PPS）， and 218 cases were included in the safety dataset （SS）. ② Efficacy evaluation： There were statistically significant differences （P<0.05） in the comparison of the three groups regarding the total effective rate of sore throat， disappearance time of sore throat， and health status. Both the 20 mL and 10 mL groups were non-inferior to the control group， and there was a statistically significant difference between the 20 mL and 10 mL dosage groups （P<0.05）. There was no statistically significant difference in the comparison of onset time of sore throat among the groups. CRP， WBC， and NE% of patients in all three groups significantly decreased on the 7^th day of treatment compared with those before treatment （P<0.01）. ③Safety evaluation： Adverse events mainly occurred in various examination indicators. There were no statistically significant differences in the comparison between groups， and no adverse reactions or serious adverse events occurred. ④Economic evaluation： The increased cost of the 10 mL and 20 mL dosage groups was entirely justified as compared with that in the control group. When comparing the 10 mL and 20 mL dosage groups， the 10 mL dosage group was deemed less advantageous. ConclusionPudilan anti-inflammatory oral liquid can be used alone as an alternative to antibiotics in the treatment of acute pharyngitis/tonsillitis caused by bacterial infection. It demonstrates good safety and can lower inflammation markers such as CRP， WBC， and NE%， suggesting its potential to reduce the body's inflammatory response. Its mechanism of action may be related to its multi-target regulatory mechanism.

AIM: To observe the anesthetic effect of nalbuphine used in ultrasound-guided transvaginal oocyte retrieval and its effect on embryo quality and pregnancy outcome. METHODS: Four-hundred patients who underwent ultrasound-guided transvaginal oocyte retrieval were randomly divided into two groups (n=200): nalbuphine group (N group) and control group (C group). The patients were in the bladder lithotomy position. Patients in N group were given nalbuphine 0.1 mg/kg intravenously 2 minutes before induction of anesthesia, patients in C group were given normal saline intravenously, and patients in both groups were induced with propofol 1.5 mg/kg. The patients were kept breathing spontaneously, and they were given intravenous injections of propofol (2 mg•kg

Objective To investigate the epidemiology of chronic kidney disease (CKD) in patients with hypertension and diabetes mellitus in Kunming urban area.Methods A multistage cluster randomized sampling method was used to collect 400 randomly selected patients (community managed hypertension and diabetes mellitus) in community service centers in the 4 main urban districts of Kunming,Yunnan province.The subjects were screened for CKD by questionnaires,physical examinations,and microalbuminuria tests.Results A total of 343 people were surveyed.The prevalence of albuminuria,proteinuria by routine urinalysis,decreased glomerular filtration rate,and CKD prevalence were respectively 37.3％,12.2％,5.0％ and 39.1％.A total of 134 patients with CKD (134/343) were screened.Logistic regression analysis showed male (OR=2.312,95％CI 1.325-4.037,P=0.003),hyperuricemia (OR=1.751,95％ CI 1.109-2.765,P=0.016) and obesity (OR=2.150,95％ CI 1.115-4.146,P=0.022) were related to CKD.Conclusions The prevalences of CKD and albuminuria are 39.1％ and 37.3％ in patients with chronic diseases (hypertension and diabetes) in the main urban community of Kunming,Yunnan.Hyperuricemia,male and obesity are independent risk factors for CKD.

Objective To investigate the clinical significance of Epstein-Barr virus EBV DNA in children with Epstein-Barr virus infection realated diseases.Methods A retrospective cohort study was performed.Totally 222 blood samples were collected from children who were diagnosed as EBV infection in Shandong Provincial Hospital from June 2012 to August 2013.Fluorescent quantitative PCR( FQ-PCR) was used to analyze the EBV DNA in peripheral blood lymphocytes.ELISA was used to analyze the four EBV serology antibodies in the serum.Two groups of tested results were compared.Heart, hepatic impairment and renal function were analyzed through detecting AST, ALT, BUN, CREA, CK, CKMB.The results were grouped by EBV DNA copy number, and then non-parametric test together with correlation analysis was performed using SPSS21.0 analytics software.Results The positive rate of EBV-CA IgM and EBV DNA was 51.35%(114/222) and 72.97% (162/222) respectively, χ2 =24.01, P<0.001.The EBV DNA copy number was significant difference (χ2 =11.79,P<0.05) in children at different stages of infection ( no previous infection:6.30 ×103 -1.20 ×104 copies/ml;early infection:5.56 ×103 -3.92 ×106 copies/ml;acute infection:6.58 ×103 -1.73 ×106 copies /ml;chronic infection or recurrent infection:8.92 ×103 -2.34 ×104 copies/ml;late infection or recovery:5.20 ×103 -1.12 ×107 copies/ml;past infection:5.46 × 103 -1.33 ×104 copies/ml).Each biochemical targets were divided into five groups by EBV DNA copy number (Ⅰ>1 ×106 copies/ml,Ⅱ1 ×105 -1 ×106 copies/ml, Ⅲ1 ×104 -1 ×105 copies/ml, Ⅳ5 × 103 -1 ×104 copies/ml, Ⅴ<5 ×103 copies/ml), and ALT(χ2 =10.14,P<0.05), BUN(χ2 =18.17, P<0.05), CK(χ2 =13.09,P<0.05), CKMB(χ2 =17.93,P<0.01) had a statistically significant difference between each group.Well, the log value of EBV DNA copy number had a positive correlation relationship with AST(r=0.357,P=0.001), ALT(r=0.376,P=0.001), BUN(r=0.329,P=0.000), CK(r=0.235,P=0.035).Conclusions Detection of EBV DNA can be used for the early diagnosis and assessment of process of the EBV infection related disease in children.The detection of liver, kidney function and myocardial enzymes can be used for evaluating the severity of EBV infection.

Objective:To investigate the status of the vestibular function of the patients with chronic positional symptoms after peripheral acute vestibular syndrome (AVS) and the curative effect of the vestibular rehabilitation therapy (VRT). Method:Using caloric test (CT), head shaking nystagmus test (HST), cervical vestibular evoked myogenic potentials as well as ocular vestibular evoked myogenic potentials to estimate the function of semicircular canal and otolith organs. The patients with normal VEMPs are divided as Group A. Otherwise are as Group B. Both groups are treated with VRT. The curative effect is estimated by vestibular symptom index (VSI) and Berg balance scale (BBS). Result:Thirty-three of 37 patients (86.5%) had an abnormal result of CT and HST, with 23 of these patients (65.7%) had an abnormal of both test. Twenty-two patients (59.5%) were in Group A and 15 (40.5%) in Group B. Before the therapy, Group B had a higher score of the balance and dizziness symptoms of VSI (P<0.05), and Group A had a higher score of the BBS (P<0.05). After the therapy, the VSI scores of both groups dropped and scores of the BBS raised. Conclusion:Patients with chronic positional symptoms after peripheral AVS have dynamic vestibular lesions to different extents. Those with otolith organs lesions tend to have a worse function of balance. Nevertheless, patients have a better off after VRT.

OBJECTIVE: To investigate the effect of Eustachian tube balloon dilation (ETBD) in treatment of eustachian tube related diseases. METHOD: Fifteen cases (20 ears) of otitis media with effusion and 22 cases (30 ears) of symptomatic Eustachian tube dysfunction were recruited. Technique of tubomanometry (TMM) showed obstructive Eustachian tube dysfunction in all patients. All the patients were received ETBD and followed up with VAS evaluation of ear fullness, muffled hearing, poping sound in the ear and tinnitus. And also the TMM change and middle ear effusion. RESULT: Ear fullness, muffled hearing released with 1 week (ear fullness: 8.2 ± 1.4 vs. 2.0 ± 1.2, P < 0.05, muffled hearing: 6.2 ± 1.2 vs. 3.1 ± 0.8, P < 0.05). No recurrence was seemed within 6 months. The eustachian function test turned better. Symptomatic Eustachian tube dysfunction had an effective rate of 96.6% while otitis media with effusion was 95.0%. CONCLUSION ETBD have good short-term effect in obstructive eustachian tube dysfunction related middle ear dysfunction, which might provide a good way to solve the eustachian tube related diseases.
Catheterization ; Ear Diseases ; Ear, Middle ; Eustachian Tube ; physiopathology ; Humans ; Otitis Media ; Otitis Media with Effusion ; Recurrence

Objective To explore the characteristics and clinical significance of CD+4 CD+25 Regulatory T lymphocytes and T cell subsets in peripheral blood and malignant pleural effusion from lung cancer patients. Methods Flow cytometry was used to detect the percentage of CD+4 CD+25 regulatory T cells and T cell subsets in peripheral blood from 68 lung cancer patients and 56 healthy persons, and in pleural effusion from 32 lung cancer patients with malignant effusion. Results T lymphocyte subsets in peripheral blood of lung cancer patients in different periods were expressed differently. The percentage of CD+4 CD+25 regulatory T cells in peripheral blood were (19.52±3.32)%, (27.28±8.26)% and (32.31±15.60)% in Ⅰ+Ⅱ, Ⅲ and Ⅳ period lung cancer patients, respectively, and were higher than that of healthy volunteers (11.12±3.32) % (t =31.0040, -7.9688, -4.9770, P ＜0.05). In the lung cancer patients with malignant effusion, the percentage of CD+4 CD+25 regulatory T cells in the pleural effusion was higher than that in the peripheral blood [(34.12±18.63) % vs (26.36± 16.25)%, t =21.164, P＜0.05]. In the lung cancer patients with malignant effusion ,the percentages of CD+4 in peripheral blood and pleural effusion were (25.32±13.45) % and (34.68±12.34) %, were lower than that in healthy volunteers (t =7.3104, 4.8818, P＜0.05), the percentages of CD+56 were (8.24±7.38) % and(11.23± 7.65) %, CD+4/CD+8 were (1.02±0.56) % and (1.32±0.82)%, were lower than (18.23±9.23) % and (1.89± 0.32) % in healthy volunteers, respectively, (CD+56: t =-14.7549, -11.7216; CD+4/CD+8: t =-24.78,-4.4564, P＜0.05). Conclusion The relative increase of CD+4 CD+25 Regulatory T cells may be related to immunosuppression and tumor progression in patients with lung cancer. Conclusion The relative increase of CD+4 CD+25 regulatory T cells may be related to immunosuppression and tumor progression in patients with lung cancer.

Objective To explore the micresurgical techniques and outcome of tumors in jugular foramen and its around. Methods Eleven patients with jugular foramen tumors were operated through suboccipital-retrosigmoid approach (2 cases), jugular foramen approach (2 cases), temporal fossa approach (4 cases) and mastoid-cervical combined approach (3 cases). Results Nine tumors were totally removed and 2 were subtotally removed. Of those cases, there were 4 neurinoma, 4 paragangliome, I meningioma, 1 mucochondrosarcoma, and 1 low-differentiated carcinoma. Postoperative complications included transient cerebrespinal fluid leak(1 case) and new lower cranial nerve injury (2 cases). All cases were followed up for mere than 8 months. The postoperative hearing was improved in 1 case, stable in 6 cases, deteriorated in 4 cases. Postoperative facial paralysis of grade Ⅱ- Ⅲ occurred in 3 of 9 patients without facial paralysis, which recovered in half a year. Of 2 patients with facial paralysis before surgery, facial function was improved in 1 case and stable in 1 case. Conclusion Proper surgical approaches and micrceurgical techniques, which were adopted according to the types, the location, and the expansion of tumors, the function of facial nerve and lower cranial nerves, and hearing level, are good for reducing complications, exposing and removing jugular foramen tumors.