Objective:To compare the differences in postoperative healing rates, hearing improvement, and complication rates between endoscopic butterfly inlay cartilage tympanoplasty and underlay cartilage tympanoplasty in Small-to-Medium-Sized Tympanic Membrane Perforations, and to provide clinical basis for indication of the butterfly inlay cartilage tympanoplasty. Methods:This study enrolled patients with chronic suppurative otitis media or traumatic tympanic membrane perforations who were treated at the Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, between January 2022 and May 2023. Inclusion criteria comprised a dry ear period exceeding 3 months, absence of middle ear or mastoid pathology confirmed by temporal bone CT, and an air-bone gap of less than 40 dB. All surgeries were performed by the same surgeon using tympanoplasty techniques. Based on the surgical approach and perforation size, patients were categorized into four groups: Group A（butterfly cartilage tympanoplasty, perforation ≤3 mm）: 23 cases. Group B（butterfly cartilage tympanoplasty, perforation 3-5 mm）: 17 cases. Group C（full-thickness cartilage underlay tympanoplasty, perforation ≤3 mm）: 12 cases. Group D（full-thickness cartilage underlay tympanoplasty, perforation 3-5 mm）: 22 cases. Data collected included perforation duration, preoperative Eustachian Tube Score（ETS）, pure-tone audiometry, otoscopic findings, and postoperative follow-up data on pure-tone thresholds, otoscopic outcomes, and complications such as graft infection and otorrhea. Results: The mean postoperative follow-up period was 4 months （range: 3-12 months）. A total of 74 patients were enrolled, including 40 undergoing butterfly cartilage tympanoplasty and 34 receiving full-thickness cartilage inlay tympanoplasty. In the <3 mm perforation subgroup, the patients receiving butterfly technique （23 cases） exhibited a postoperative air-bone gap （ABG） improvement of （2.33±8.21） dB, and those receiving the inlay technique （12 cases） showed an ABG improvement of （2.49±7.9） dB, with no statistically significant difference between the two groups （P>0.05）. In the 3-5 mm perforation subgroup, the patients receiving butterfly technique （17 cases） demonstrated an ABG improvement of （8.16±5.69） dB, and those receiving the inlay technique （22 cases） achieved an ABG improvement of （8.08±10.42） dB, which were not significantly different （P>0.05）. Tympanic membrane healing rates across the four subgroups were 95.65%, 94.12%, 100%, and 95.45%, respectively, with no statistically significant differences （P>0.05）. Conclusion:In patients with tympanic membrane perforations ≤3 mm and 3-5 mm, butterfly cartilage tympanoplasty achieves comparable audiological outcomes to full-thickness cartilage underlay tympanoplasty. Compared with the underlay technique, the butterfly method is less invasive, preserves the normal anatomical structure of the tympanic membrane, requires a shorter dry ear period, and yields higher patient satisfaction. Therefore, it can be safely recommended for perforations ≤5 mm that do not require tympanotomy exploration.
Humans ; Tympanic Membrane Perforation/surgery* ; Tympanoplasty/methods* ; Treatment Outcome ; Endoscopy ; Cartilage/transplantation* ; Male ; Female ; Adult ; Middle Aged ; Myringoplasty/methods* ; Otitis Media, Suppurative/surgery* ; Aged

Thyroid hormone receptors (THRs), a crucial nuclear receptor protein family, primarily consist of two categories: α receptors and β receptors. Among them, THRβ is the primary subtype of thyroid hormone that confers benefits to the liver. In the last two decades, there have been efforts to develop THRβ agonists that selectively yield beneficial effects on the liver, such as lowering triglycerides and cholesterol, while reducing adverse effects on the heart, muscle, and bone. This paper systematically reviews strategies to enhance the safety of THRβ agonists for the treatment of MASH, with a focus on improving the selectivity of THRα and increasing the distribution of the drug in the liver. Additionally, we explore the potential application of this target in addressing other medical indications.

With the increasing demand for dental aesthetic outcomes, techniques for composite resin restoration intended for anterior teeth have been widely applied due to their minimally invasive and superior esthetic performance. Despite promising short-term outcomes, the long-term prognosis of anterior resin restorations remains challenging. Frequently reported complications include restoration fractures and decoloration. Material selection, operative procedures, and patient-related factors can affect the long-term outcomes of restorations. This review aims to systematically analyze the long-term clinical performance of resin restorations in anterior teeth. The key factors influencing treatment efficacy are also investigated. The findings are expected to provide a basis for optimizing clinical strategies in procedures for anterior composite resin restoration.
Humans ; Composite Resins ; Dental Restoration, Permanent/methods* ; Prognosis ; Esthetics, Dental ; Treatment Outcome ; Time Factors

Energy metabolism is fundamental for life.It encompasses the utilization of carbohydrates,lipids,and proteins for internal processes,while aberrant energy metabolism is implicated in many diseases.In the present study,using three-dimensional(3D)printing from polycarbonate via fused deposition modeling,we propose a multi-nuclear radiofrequency(RF)coil design with integrated 1H birdcage and interchangeable X-nuclei(2H,13C,23Na,and 31P)single-loop coils for magnetic resonance imaging(MRI)/magnetic resonance spectroscopy(MRS).The single-loop coil for each nucleus attaches to an arc bracket that slides unrestrictedly along the birdcage coil inner surface,enabling convenient switching among various nuclei and animal handling.Compared to a commercial 1H birdcage coil,the proposed 1H birdcage coil exhibited superior signal-excitation homogeneity and imaging signal-to-noise ratio(SNR).For X-nuclei study,prominent peaks in spectroscopy for phantom solutions showed excellent SNR,and the static and dynamic peaks of in vivo spectroscopy validated the efficacy of the coil design in structural imaging and energy metabolism detection simultaneously.

Objective To investigate the effect of type 2 dengue virus(DENV-2)infection on autophagy in human umbilical vein endothelial cells(HUVECs)and the mechanism mediating the inhibitory effect of baicalin against DENV-2 infection.Methods Cultured HUVECs with DENV-2 infection were treated with different concentrations of baicalin,and the changes in autophagy of the cells were detected using transmission electron microscopy.Lyso Tracker Red staining was used to examine pH changes in the lysosomes of the cells,and the expressions of ATG5,beclin-1,LC3,P62,STX17,SNAP29,VAMP8,and PI3K/AKT signaling pathway-related proteins were detected by Western blotting.DENV-2 replication in the cells were evaluated using RT-qPCR.The differentially expressed proteins in DENV-2-infected HUVECs were identified by proteomics screening.Results Treatment with baicalin did not significantly affect the viability of cultured HUVECs.Proteomic studies suggested that the PI3K-AKT pathway played an important role in mediating cell injury induced by DENV-2 infection.The results of RT-qPCR demonstrated that baicalin dose-dependently inhibited DENV-2 replication in HUVECs and produced the strongest inhibitory effect at the concentration of 50 μg/mL.Transmission electron microscopy,Lyso Tracker Red staining,RT-qPCR,and Western blotting all showed significant inhibitory effect of baicalin on DENV-2-induced autophagy in HUVECs.DENV-2 infection of HUVECs caused increased cellular expressions of LC3 and P62 proteins,which were significantly lowered by treatment with LY294002(a PI3K inhibitor).Conclusion Baicalin inhibits DENV-2 replication in HUVECs and suppresses DENV-2-induced cell autophagy by inhibiting the PI3K/AKT signaling pathway.

Objective To investigate the effect of type 2 dengue virus(DENV-2)infection on autophagy in human umbilical vein endothelial cells(HUVECs)and the mechanism mediating the inhibitory effect of baicalin against DENV-2 infection.Methods Cultured HUVECs with DENV-2 infection were treated with different concentrations of baicalin,and the changes in autophagy of the cells were detected using transmission electron microscopy.Lyso Tracker Red staining was used to examine pH changes in the lysosomes of the cells,and the expressions of ATG5,beclin-1,LC3,P62,STX17,SNAP29,VAMP8,and PI3K/AKT signaling pathway-related proteins were detected by Western blotting.DENV-2 replication in the cells were evaluated using RT-qPCR.The differentially expressed proteins in DENV-2-infected HUVECs were identified by proteomics screening.Results Treatment with baicalin did not significantly affect the viability of cultured HUVECs.Proteomic studies suggested that the PI3K-AKT pathway played an important role in mediating cell injury induced by DENV-2 infection.The results of RT-qPCR demonstrated that baicalin dose-dependently inhibited DENV-2 replication in HUVECs and produced the strongest inhibitory effect at the concentration of 50 μg/mL.Transmission electron microscopy,Lyso Tracker Red staining,RT-qPCR,and Western blotting all showed significant inhibitory effect of baicalin on DENV-2-induced autophagy in HUVECs.DENV-2 infection of HUVECs caused increased cellular expressions of LC3 and P62 proteins,which were significantly lowered by treatment with LY294002(a PI3K inhibitor).Conclusion Baicalin inhibits DENV-2 replication in HUVECs and suppresses DENV-2-induced cell autophagy by inhibiting the PI3K/AKT signaling pathway.

Background:Previous studies have proved that neutrophil gelatinase-associated lipocalin(NGAL)plays an important role in the progression of Crohn's disease(CD),and may serve as a potential biomarker for disease activity prediction,severity assessment,treatment response evaluation and prognosis monitoring.However,the diagnostic value of NGAL in perianal fistulizing Crohn's disease(pfCD)is still unclear.Aims:To investigate the serum level of NGAL and its diagnostic value in patients with active pfCD.Methods:A total of 66 patients diagnosed as pfCD from July 2021 to June 2023 at Longhua Hospital,Shanghai University of Traditional Chinese Medicine were enrolled,including 36 active pfCD patients and 30 inactive pfCD patients.The disease activity and perianal fistula activity were assessed by Crohn's disease activity index(CDAI)and perianal disease activity index(PDAI),respectively.Serum NGAL,fecal calprotectin(FC),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),as well as CDAI score and PDAI score were compared between the active and inactive pfCD patients,and the correlations of NGAL with the other parameters in active pfCD patients were analyzed.ROC curve was drawn to evaluate the values of serum NGAL,FC,CRP and ESR for diagnosis of active pfCD.Results:The serum NGAL,FC,CRP,ESR,CDAI score and PDAI score in active pfCD patients were significantly higher than those in inactive pfCD patients(all P＜0.001).NGAL was positively correlated with FC(r=0.64,P＜0.001),CRP(r=0.55,P＜0.001),ESR(r=0.53,P＜0.001),CDAI score(r=0.59,P＜0.001)and PDAI score(r=0.54,P＜0.001)in active pfCD patients.The optimal cut-off values of NGAL,FC,CRP and ESR were 220.5 μg/L,146.0 μg/g,7.9 mg/L and 23.5 mm/h,respectively,for the diagnosis of active pfCD,and the area under the curve were 0.922(95％CI:0.850-0.995),0.888(95％CI:0.806-0.970),0.853(95％CI:0.763-0.944)and 0.830(95％CI:0.731-0.930),respectively.Conclusions:Serum NGAL level is associated with the disease activity of pfCD,and can be used as a non-invasive biomarker for the clinical diagnosis of active pfCD.

Objective:To observe the clinical effect of initiating continuous blood purification (CBP) treatment at different times for patients with severe acute pancreatitis (SAP), and to explore the optimal timing for starting CBP treatment for SAP, so as to provide evidence for clinicians to start CBP treatment.Methods:A retrospective cohort study was used to select patients with SAP who received CBP treatment in People's Hospital of Hunan Province from January 2020 to December 2023. According to the timing of CBP initiation, the patients were divided into early initiation group (diagnosis of SAP to the first CBP treatment time < 24 hours) and late initiation group (diagnosis of SAP to the first CBP treatment time of 24-48 hours). The general data, acute physiology and chronic health evaluationⅡ(APACHEⅡ), bedside index for severity in acute pancreatitis (BISAP) score and laboratory indicators, local complications and systemic complications, intensive care unit (ICU) treatment time, hospital stay, treatment cost, and clinical outcome of the two groups were collected and compared.Results:A total of 130 patients with SAP who received CBP treatment were enrolled, including 90 patients in the early initiation group and 40 patients in the late initiation group. Before treatment, there were no significant differences in gender, age, APACHEⅡscore, BISAP score, etiology and laboratory examination indexes between the early initiation group and late initiation group. At 48, 72, 96 hours after treatment, the blood calcium level of the two groups was significantly higher than that before treatment, and the levels of white blood cell count (WBC), C-reactive protein (CRP), lactic acid, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), APACHEⅡscore and BISAP score were significantly lower than those before treatment. The WBC level, APACHEⅡscore and BISAP score of the late initiation group were significantly lower than those of the early initiation group at 72 hours and 96 hours after treatment [WBC (×10 9/L): 10.96 (8.68, 13.04) vs. 12.45 (8.93, 16.30) at 72 hours after treatment, and 10.18 (8.68, 12.42) vs. 11.96 (8.81, 16.87) at 96 hours after treatment; APACHEⅡscore: 9.50 (5.75, 12.00) vs. 11.00 (6.25, 14.00) at 72 hours after treatment, and 10.00 (4.00, 12.00) vs. 12.00 (7.00, 14.75) at 96 hours after treatment; BISAP score: 2.35±1.03 vs. 2.76±1.10 at 72 hours after treatment, and 2.08±1.21 vs. 2.70±1.11 at 96 hours after treatment], the differences were statistically significant (all P < 0.05). In terms of complications, the incidence of pancreatic abscess in the late initiation group was significantly lower than that in the early initiation group [5.00% (2/40) vs. 20.00% (18/90)], but the incidence of abdominal compartment syndrome was significantly higher than that in the early initiation group [42.50% (17/40) vs. 13.33% (12/90)], the differences were statistically significant (all P < 0.05). In addition, the ICU treatment time in the early initiation group was significantly shorter than that in the late initiation group [days: 11.00 (6.00, 20.00) vs. 15.00 (9.75, 25.00), P < 0.05], and there were no statistically significant differences in hospitalization costs, length of stay and mortality between the two groups. Conclusions:CBP can effectively increase the level of blood calcium and decrease the level of lactic acid and inflammatory factors. Starting CBP within 24-48 hours after diagnosis of SAP can reduce WBC level and disease severity score faster, and reduce the occurrence of pancreatic abscess. Initiation of CBP within 24 hours after diagnosis of SAP can reduce the incidence of abdominal compartment syndrome and shorten the duration of ICU treatment.

Severe acute pancreatitis (SAP) is a common gastrointestinal disease, often accompanied by systemic inflammatory reactions and organ dysfunction. SAP has an acute onset, severe condition, rapid progression, and poor prognosis. The development of SAP is closely related to the excessive release of inflammatory factors. In the comprehensive treatment of SAP, continuous blood purification (CBP) can clear inflammatory mediators, improve the stability of Internal environment, improve organ function, reduce blood lipids, regulate immunity, and significantly improve the condition of SAP patients. It is an important means of treating SAP. This article reviews the research progress of CBP in the treatment of SAP.