Objective:To evaluate surgical strategies and clinical outcomes in supra-labyrinthine cholesteatoma management, providing evidence-based guidance for therapeutic decision-making. Methods:Seven patients with supra-labyrinthine cholesteatoma in our hospital from 2021 to 2023 were enrolled in this study. The clinical manifestations, imaging findings, and surgical outcomes of patients were retrospectively analyzed. A systematic literature review focused on surgical anatomy correlations and imaging-based approach selection. Results:All seven cases of supra-labyrinthine cholesteatoma were unilateral. Preoperative otoendoscopy, CT, and intraoperative findings confirmed that they were classified as supral-abyrinthine cholesteatoma according to Sanna's classification. Two cases were operated entirely with otoendoscopy, three cases used a postauricular approach with microscopic assistance, and two cases involved a combined approach with endoscopy and microscopy. Hearing reconstruction with ossicular prosthesis was performed in five cases, while two cases did not undergo hearing reconstruction due to preoperative anacusis confirmed by both subjective and objective hearing tests. In all seven cases, various segments of the facial nerve were exposed during surgery, but postoperative facial nerve function remained intact, hearing was preserved, no cerebrospinal fluid leakage occurred, and no recurrences have been observed to date（as of June 2024）. Conclusion:With the advancement of imaging techniques and microsurgical technology, early diagnosis and surgical methods for supral-abyrinthine cholesteatoma have significantly improved. Compared to traditional approaches, the newer methods reduce unnecessary complications and offer advantages such as minimal surgical trauma, superior hearing preservation rates, and shorter recovery times with better postoperative neural function. This study reviews recent literature on petroclival cholesteatomas, combined with our own cases, to analyze the classification of supral-abyrinthine cholesteatoma and surgical approach selection. The findings aim to optimize treatment strategies and guide appropriate surgical methods, ultimately improving patient prognosis and quality of life.
Humans ; Cholesteatoma/surgery* ; Ear, Inner/surgery* ; Retrospective Studies ; Treatment Outcome

Psoriasis is a chronic inflammatory skin disease, and its pathogenesis is largely modulated by abnormal angiogenesis. Previous research has indicated that AlkB homolog 5 (ALKBH5), an important demethylase affecting N⁶-methyladenosine (m⁶A) modification, plays a role in regulating angiogenesis in cardiovascular and eye diseases. Our present study found that ALKBH5 was upregulated and co-localized with cluster of differentiation 31 (CD31) in the skin of IMQ group compared with control group. ALKBH5-deficient mice decreased IMQ-induced psoriatic dermatitis and exhibited histological improvements, including decreased epidermal thickness, hyperkeratosis, numbers of dermal capillary vessels and inflammatory cell infiltration. ALKBH5-KO mice alleviated angiogenesis in psoriatic lesions by downregulating the protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway. Additionally, the expression of ALKBH5 was significantly upregulated in IL-17A-induced human umbilical vein endothelial cells (HUVECs), which further promoted the expression of angiogenesis-related cytokines and endothelial cell proliferation. Cell proliferation and angiogenesis were suppressed in ALKBH5 knockdown group, whereas ALKBH5 overexpression promoted these processes. The regulation of angiogenesis in HUVECs by ALKBH5 was facilitated through the AKT-mTOR pathway. Collectively, ALKBH5 plays a pivotal role in psoriatic dermatitis and angiogenesis, which may offer a new potential targets for treating psoriasis.
Animals ; Psoriasis/chemically induced* ; Mice ; Humans ; Neovascularization, Pathologic/genetics* ; Human Umbilical Vein Endothelial Cells/metabolism* ; AlkB Homolog 5, RNA Demethylase/genetics* ; Proto-Oncogene Proteins c-akt/metabolism* ; TOR Serine-Threonine Kinases/metabolism* ; Cell Proliferation ; Mice, Knockout ; Disease Models, Animal ; Signal Transduction ; Male ; Skin/blood supply* ; Mice, Inbred C57BL ; Angiogenesis

Objectives:To investigate the clinical value of contrast echocardiography in the detection of right heart space-occupying lesions. Methods:The imaging and clinical data of 39 patients with right heart space-occupying lesions confirmed by surgery,pathology and clinical treatment in Yanbian University Hospital from January 2019 to January 2023 were retrospectively analyzed.All patients underwent contrast echocardiography and cardiac magnetic resonance(CMR)examinations.The contrast echocardiography features of right heart neoplastic from non-neoplastic occupying lesions were summarized.The diagnostic efficacy of contrast echocardiography and CMR in right heart space-occupying lesions was compared. Results:Among the 39 patients,12 patients(30.8%)were confirmed as thrombus and vegetation,6 patients(15.4%)as benign tumors and 21 patients(53.8%)as malignant tumors.There were 8,4,4 and 17 patients of thrombus,vegetation,benign tumor and malignant tumors located in right atrium,respectively.Contrast echocardiography was used to diagnose thrombus and vegetation in 12 patients(30.8%),benign tumors in 5 patients(12.8%),malignant tumors in 22 patients(56.4%).CMR was used to diagnose thrombus and vegetation in 18 patients(46.2%),benign tumors in 5 patients(12.8%),malignant tumors in 16 patients(41.0%).The Kappa coefficient between contrast echocardiography and clinical diagnosis was 0.956(P<0.001).The Kappa coefficient between CMR and clinical diagnosis was 0.754(P<0.001). Conclusions:Contrast echocardiography can dynamically observe the degree of vascularization in the lesion tissue in real-time,accurately distinguishing the nature of the right heart space-occupying lesions.

Chronic myeloid leukemia (CML) is a myeloproliferative tumor whose pathogenesis is related to the BCR/ABL fusion gene. Tyrosine kinase inhibitors (TKIs) can significantly improve the survival and prognosis of CML patients. Nilotinib is effective in first-line treatment of CML patients with rapid response, deep remission and high safety. After achieving a sustained deep molecular response, it is a new therapeutic goal for CML to stop the use of nilotinib and achieve treatment-free remission. In addition, due to disease resistance and mutations, how to start new treatments after nilotinib treatment failure is worth further research.

OBJECTIVETo observe the effects of acupuncture at opposite acupoints on expression of hepatocyte growth factor (HGF) in rats with skeletal muscle contusion, and to explore the mechanism of acupuncture at opposite acupoints on skeletal muscle contusion.

METHODSFifty-four Sprague Dawley (SD) rats were randomly divided into a blank group (6 rats), a model group (24 rats) and an opposing needling group (24 rats). The model group and opposing needling group were further divided into 1-day subgroup, 3-day subgroup, 5-day subgroup and 7-day subgroup, 6 rats in each one. No intervention was given in the blank group, while the model of skeletal muscle contusion was established in the model group and opposing needling group by self-made contusion device. 24 hours after contusion, electroacupuncture (EA) was applied at "Zusanli" (ST 36) and the corresponding points ofpoints at health side for 15 min, once a day. The subgroups of opposing needling group were treated for 1 day, 3 days, 5 days and 7 days, respectively. No treatment was given in the model group. Samples were collected in the subgroups 1 day, 3 days, 5 days and 7 days after treatment. The morphological change of injured gastrocnemius muscle was observed by using microscope after HE staining. The positive cell rate of proliferating cell nuclear antigen (PCNA) was detected by immunohistochemistry. The expression levels of HGF protein and PCNA protein were observed by Western blot.

RESULTS① The results of HE staining showed that, 1 day after contusion, the inflammatory cells of gastrocnemius muscle in the opposing needling group were less than those in the model group; 3 days and 5 days after contusion, myoblasts and myotubes in the opposing needling group were more than those in the model group; 7 days after contusion, the neonatal muscle cells in the opposing needling group were more than those in the model group. ② The results of immunohistochemistry showed that, 1 day, 3 days and 5 days after contusion, the positive cell rate of PCNA in the opposing needling group was significantly higher than that in the model group (all<0.001); 7 days after contusion, the positive cell rate of PCNA in the opposing needling group was significantly less than that in the model group (<0.001). ③ The results of Western blot showed that, 1 day, 3 days and 5 days after contusion, the expression of HGF protein and PCNA protein in the opposing needling group was significantly higher than that in the model group (all<0.05); 7 days after contusion, the expression of HGF protein and PCNA protein in the opposing needling group was significantly lower than that in the model group (all<0.05).

CONCLUSIONAcupuncture at opposite acupoints could regulate the expression of HGF and promote the activation, proliferation, migration and differentiation of muscle satellite cells in rats with skeletal muscle contusion, which could speed up the process of skeletal muscle injury repair.

Objective To investigate the epidemiology characteristics of crawfish related rhabdomyolysis (RM) in Nanjing, 2016.Methods Outpatient and inpatient electronic medical system of 21 hospitals in Nanjing during 2016 were retrospectively searched, and all the patients diagnosed with RM were selected. The patients with none crayfish-related RM was excluded. The epidemiology characteristics were depicted. The geographic information system (GIS) was used to collect, manage and analyze the spatial data, to visualize it, to analyze the spatial distribution features of the disease, and to explore the cause of disease prediction. GeoDa 1.8 software was used to analyze the global and local spatial auto-correlation.Results A total of 1183 patients with crawfish related RM were initially screened, excluding 59 patients with RM caused by trauma, severe exercise, heat stroke, myositis, poisoning, drugs, and genetic diseases, and 1124 patients were enrolled. The proportion of men was 36.48% (410/1124) with an incidence of 12.54/100 thousands; while of women was 63.52% (714/1124) with an incidence of 21.86/100 thousands. The median age at onset was 34 (28, 43) years. From July to August, the incidence of crawfish related RM was the highest, accounting for 96.53% of the total number of cases. The top four incidence areas were Pukou (41.54/100 thousands), Jianye (25.94/100 thousands), Qixia (25.73/100 thousands), Gulou (25.04/100 thousands), all of which were adjacent to the Yangtze River. Global spatial autocorrelation analysis showed: MoranI = 0.427,Z = 2.646,P = 0.003, suggesting that the crawfish related RM had positive spatial autocorrelation. The results showed that the spatial structure of crawfish related RM existed in Nanjing in 2016. Local spatial autocorrelation analysis showed that the high-high concentration areas were Pukou, Jianye and Liuhe. The incidences of above three areas which were the Nanjing section of the lower reaches of the Yangtze River flowed through the region and surrounding areas were higher than the overall incidence of Nanjing.Conclusion The prevalence of crawfish related RM in Nanjing during 2016 had an obvious region-concentrated character and global spatial autocorrelation with the high prevalent regions mainly concentrated in the urban areas adjacent to the Yangtze River.

Objective: To investigate the effect with its possible mechanisms of zacopride on vasodilatation of isolated coronary arterial rings in experimental rats.
Methods: The tension of vasodilatation of isolated coronary arterial rings of male SD rats was recorded by Powerlab and DMT system. The rats were divided into 4 groups: +Endo (vehicle) group, +Endo (zacopride) group and -Endo (vehicle) group, –Endo (zacopride) group.n=6 in each group. The vasodilatation effects of zacopride on KCl (60 mmol/L) and U46619 (10-6 mol/L) pre-constricted arterial ring were recorded; the effects of different agents on zacopride caused vasodilatation were studied.
Results: In both +Endo (zacopride) and –Endo (zacopride) groups, zacopride showed a dose dependent vasodilatation effect on coronary ring pre-constricted by KCl and U46619. The maximum vasodilatation effect of zacopride in KCl treated+Endo (zacopride) group was (90.15 ± 6.38) %, in U46619 treated-Endo (zacopride) group was (81.67 ± 4.97 ) %; the maximum vasodilatation effect of zacopride in KCl treated-Endo (zacopride) group was (85.48±5.04) %, in U46619 treated–Endo (zacopride) group was (79.65 ± 3.51) %, compared to each corresponding vehicle group, allP<0.05. The inhibitor of IK1 channel, BaCl2 could signiifcantly reduce the vasodilatation effect of zacopride in KCl and U46619 pre-constricted coronary ring,P<0.05. However, the inhibitor of eNOS (L-NAME), the blocker of KCa channel (TEA), blocker of Kv channel (4-AP) and blocker of KATP channel (Glib) had no such signiifcant effects, allP>0.05.
Conclusion: Zacopride had vasodilatation effect on coronary arterial ring which was pre-constricted by KCl and U46619, which might be related to the channel of IK1.

Objective:To explore the characteristics of immunological reconstitution of T-cell subsets and the role of Cornus,a Chinese medicinal herb on T lymphocytes in mice after irradiation (IR). Methods:Irradiated model mice were exposed to a single dose of X-ray radiation (2. 6 Gy) with or without Cornus treatments. Bloodroutine was examined before or after irradiation. CD3+,CD4+, CD8+ T cells and Th1, Tc1, Th2, Th17, Treg from spleen or peripheral blood were determined by flow cytometry. Results: Total lymphocytes and CD3+T cells including CD4+T and CD8+T cells,were significantly reduced 3 days after irradiation (P<0. 05). The re-constitution of CD3+ T cells ( especially CD8+T cells ) started from 5 days post irradiation, CD4+T cells increased 8 days after irradiation. However,the production of IFN-γ by Th1 or Tc1 cells were evidently decreased compared with control group even 8 days post irradiation (P<0. 05). In contrast to Th1,Th2/Th17/Treg were observably increased in irradiation group (P<0. 05). But the percentage of Th1 was obviously increased, and Th2, Th17, Treg were markedly decreased in cornus treated mice compared with irradiated mice (P<0. 05). Conclusion: The immunological reconstitution of T lymphocytes started from 5 days after total irradiation with rapid recovery of CD8+ T cells but not CD4+T cells. Cornus effectively improved the imbalance of T cell subsets by promoting the proliferation of Th1 and suppressing Th17 and Treg.

OBJECTIVETo investigate effects of glucose excursion on the oxidative/antioxidative system in subjects with different types of glucose regulation.

METHODSA total of 30 individuals with normal glucose regulation (NGR), 27 subjects with impaired glucose regulation (IGR) and 27 subjects with newly diagnosed type 2 diabetes mellitus (T2DM) were selected and recruited for 3 days' continuous glucose monitor system (CGMS) assessment. The data from CGMS was used to calculate the mean amplitude of glycemic excursion (MAGE), mean blood glucose (MBG) and its standard deviation (SDBG), area under the ROC curve when the blood glucose >5.6 mmol/L within 24 h (AUC 5.6), mean of daily differences (MODD), and mean postprandial glucose excursion (MPPGE). In all groups, the content or activity of malondialdehyde (MDA), total antioxidation capacity (TAOC) and glutathione peroxidase (GSH-Px) were detected.

RESULTSGlucose excursion parameters of subjects with T2DM or IGR were higher than those of NGR subjects (P<0.05 or 0.01). Moreover, Glucose excursion parameters of T2DM subjects were higher than those of IGR subjects (P<0.05 or 0.01). Subjects with T2DM or IGR had significant higher MDA levels and lower GSH-Px/MDA and TAOC/MDA levels compared to NGR subjects (P<0.01). T2DM subjects had even higher MDA levels and lower GSH-Px/MDA levels than IGR (P<0.05 or 0.01). According to the median of normal population for MAGE, T2DM and IGR subjects were divided into MAGE>2.6mmol/L Group and MAGE ≤ 2.6mmol/L Group. MAGE>2.6mmol/L Group had higher levels of MDA and lower levels of GSH-Px/MDA than MAGE ≤ 2.6mmol/L Group (P<0.05). There was no significant difference between the two groups (P>0.05) in terms of the levels of TAOC/MDA. Pearson correlation analysis showed that MDA was positively correlated with FPG, 2hPG, MAGE, and SBP. GSH-Px/MDA was negatively correlated with MAGE and TC. TAOC/MDA was negatively correlated with FPG. Partial correlation analysis showed that the relationship between MDA and MAGE, GSH-Px/MDA, and MAGE remained significant after adjustments for the other differences among groups.

CONCLUSIONGlucose excursion contributed significantly to promoting lipid peroxidation and decreasing antioxidation capacity than chronic sustained hyperglycemia did in the subjects with different types of glucose regulation.

Adult ; Antioxidants ; metabolism ; Blood Glucose ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Oxidation-Reduction

Objective To explore the clinical characteristics,causes,diagnosis and treatment of pelvic mass in adolescents caused by gynecologic diseases. Methods One hundred and twenty-six adolescents with gynecologic diseases presented as pelvic mass were retrospectively reviewed. Results The average age of all patients was 17. 6 years,ranging from 10. 0 to 19. 0 years. Ectopic pregnancy was found in 38 patients(30. 2%) ,the average age of the patients was 18.6 ±0.5 years, ranging from 17.0 to 19.0 years. Ovarian neoplasm was found in 35 patients (27. 8%) ,the average age of the patients was 17. 1 ± 2. 1 years, ranging from 10. 0 to 19. 0 years. Twenty cases (57. l%)had germ cell tumor, eighteen with mature teratomas, one with endodermal sinus tumor and one with immature teratoma. Thirteen cases(37. 2%)had epithelial ovarian tumors;eight with serous cystadenomas,three with mucinous cystadenoma, one with mucinous cystadenoma complicated with serous cystadenoma and one with borderline mucinous cystadenoma. Two cases had simple cyst of the ovary (5. 7%) . Congenital abnormality of reproductive tract was found in 14 patients (11. 1%), the average age was 14. 7 ±2. 2 years, ranging from 13.0 to 19. 0 years. Seven had imperforate hymens, two had rudimentary horn of uterus,four had atresia of vagina,one had atresia of vagina complicated with rudimentary horn of uterus,and one had oblique septum of vagina. Corpus luteum rupture was found in 11 patients (8. 7%) , the average age was 18. 1 ± 1. 9 years, ranging from 13. 0 to 19. 0 years. 116 patients underwent operative treatment and 10 patients underwent conservative therapy. Conclusions According to the stage of adolescents, main causes of pelvic mass in adolescents are different Main causes of pelvic mass in early adolescents are tumorous disease. Congenital abnormalities of reproductive tract are usually in middle adolescents. The gonads develop closely mature in late adolescent period; main causes of pelvic mass are ectopic pregnancy, ovarian neoplasm and physiologic ovarian cyst Surgery is the main therapy of pelvic mass in adolescents.