1.Effects of genetic risk of insulin resistance and triglyceride index on risk of cardiovascular disease
Ying PAN ; Shuting LIU ; Haoyu GU ; Mengjie ZHAO ; Zhiping XU ; Yun TANG ; Min HUANG ; Yueqing HUANG ; Kaixin ZHOU ; Jian SHAO ; Shao ZHONG
Chinese Journal of Geriatrics 2025;44(5):643-649
Objective:By analyzing the genetic risk of triglyceride-glucose index(Tyg)and insulin resistance(IR)for cardiovascular disease(CVD), to elucidate the extent to which the contribution of Tyg to the risk of CVD development is influenced by IR genetic risk.Methods:In this study, we selected data from a cohort of elderly people in the Kunshan community, screened 7, 385 individuals with both clinical and genomic data, and calculated the polygenic risk score of insulin resistance(IRPRS)for each participant based on publicly available IR genome-wide association data, and assessed the effect of genetic risk and Tyg level on the risk of developing CVD using a multivariate Cox proportional risk model.Calculating interactions to assess the effects of genetic risk and Tyg levels on the risk of developing CVD, the effects of Tyg tertile grouping and IRPRS on the risk of developing CVD were assessed using a multivariate Cox proportional risk model, and subgroup analyses were performed for gender to assess the effects of Tyg tertile grouping and IRPRS on the risk of developing CVD by gender.Results:In the univariate Cox model, Q3 and IRPRS with the highest TYG levels were significantly associated with the risk of CVD, respectively( HR=1.59, 95% CI: 1.33-1.89; P<0.001; HR=1.61, 95% CI: 1.18-2.20; P=0.003).After adjusting for multiple confounders, the Q3 Group with the highest TYG level was still significantly associated with the risk of CVD( HR=1.28, 95% CI: 1.05-1.57; P=0.014), the Association of TYG with the risk of CVD did not change significantly( HR=1.29, 95% CI: 1.05-1.57; P=0.014).We conducted a subgroup analysis by sex and found that among older men, 13, the highest levels of TYG and IRPRS were significantly associated with CVD risk, respectively( HR=1.70, 95% CI: 1.31.2.20; P<0.001; HR=1.98, 95% CI: 1.24-3.15; P=0.004).After adding IRPRS to the model, the Association of TYG with the risk of CVD remained unchanged( HR=1.69, 95% CI: 1.31-2.19; P<0.001).After adjusting for various confounders, Tyg remained significantly associated with the risk of CVD( HR=1.39, 95% CI: 1.04-1.88; P=0.028), the results showed that TYG remained significantly associated with the risk of CVD( HR=1.41, 95% CI: 1.05-1.90; P=0.023), and the association did not decrease.No Association of IRPRS with CVD risk was found in older women. Conclusions:IRPRS and TYG are the risk factors of CVD, and diet, exercise, drugs and other external factors on TYG are the main risk factors of CVD.For individuals with high genetic factors, the risk of CVD can still be reduced by lifestyle adjustments such as diet, exercise and drug intervention.
2.Effects of genetic risk of insulin resistance and triglyceride index on risk of cardiovascular disease
Ying PAN ; Shuting LIU ; Haoyu GU ; Mengjie ZHAO ; Zhiping XU ; Yun TANG ; Min HUANG ; Yueqing HUANG ; Kaixin ZHOU ; Jian SHAO ; Shao ZHONG
Chinese Journal of Geriatrics 2025;44(5):643-649
Objective:By analyzing the genetic risk of triglyceride-glucose index(Tyg)and insulin resistance(IR)for cardiovascular disease(CVD), to elucidate the extent to which the contribution of Tyg to the risk of CVD development is influenced by IR genetic risk.Methods:In this study, we selected data from a cohort of elderly people in the Kunshan community, screened 7, 385 individuals with both clinical and genomic data, and calculated the polygenic risk score of insulin resistance(IRPRS)for each participant based on publicly available IR genome-wide association data, and assessed the effect of genetic risk and Tyg level on the risk of developing CVD using a multivariate Cox proportional risk model.Calculating interactions to assess the effects of genetic risk and Tyg levels on the risk of developing CVD, the effects of Tyg tertile grouping and IRPRS on the risk of developing CVD were assessed using a multivariate Cox proportional risk model, and subgroup analyses were performed for gender to assess the effects of Tyg tertile grouping and IRPRS on the risk of developing CVD by gender.Results:In the univariate Cox model, Q3 and IRPRS with the highest TYG levels were significantly associated with the risk of CVD, respectively( HR=1.59, 95% CI: 1.33-1.89; P<0.001; HR=1.61, 95% CI: 1.18-2.20; P=0.003).After adjusting for multiple confounders, the Q3 Group with the highest TYG level was still significantly associated with the risk of CVD( HR=1.28, 95% CI: 1.05-1.57; P=0.014), the Association of TYG with the risk of CVD did not change significantly( HR=1.29, 95% CI: 1.05-1.57; P=0.014).We conducted a subgroup analysis by sex and found that among older men, 13, the highest levels of TYG and IRPRS were significantly associated with CVD risk, respectively( HR=1.70, 95% CI: 1.31.2.20; P<0.001; HR=1.98, 95% CI: 1.24-3.15; P=0.004).After adding IRPRS to the model, the Association of TYG with the risk of CVD remained unchanged( HR=1.69, 95% CI: 1.31-2.19; P<0.001).After adjusting for various confounders, Tyg remained significantly associated with the risk of CVD( HR=1.39, 95% CI: 1.04-1.88; P=0.028), the results showed that TYG remained significantly associated with the risk of CVD( HR=1.41, 95% CI: 1.05-1.90; P=0.023), and the association did not decrease.No Association of IRPRS with CVD risk was found in older women. Conclusions:IRPRS and TYG are the risk factors of CVD, and diet, exercise, drugs and other external factors on TYG are the main risk factors of CVD.For individuals with high genetic factors, the risk of CVD can still be reduced by lifestyle adjustments such as diet, exercise and drug intervention.
3.Jianwei Xiaozhang Tablets Improves Precancerous Lesions of Gastric Cancer in Rats via Regulating PI3K-Akt-eNOS Pathway
Hai-Yang HUANG ; Shao-Wen ZHONG ; Yun AN ; Yu-Xin WANG ; Shu-Min ZHU ; Jie GAO ; Xiao-Min LU ; Ming-Guo DONG
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(3):709-718
Objective To investigate the therapeutic effect and mechanism of Jianwei Xiaozhang Tablets on rats with precancerous lesions of gastric cancer(PLGC).Methods Forty male SD rats were randomly divided into the normal group,the model group,the folic acid group and the Jianwei Xiaozhang Tablets group,with 10 rats in each group.In addition to the normal group,the other three groups of rats were prepared by gavage with Ranitidine Aqueous Solution combined with N-methyl-N'-nitro-N-nitrosoguanidine(MNNG)solution drinking method for the preparation of PLGC model.After successful modeling,drugs were administered accordingly for 7 weeks.The changes in body mass of rats during modeling and drug administration were recorded,the gross view of the stomach was observed and scored pathologically,the coefficients of spleen and liver were determined,the pathological changes in gastric tissue were observed by hematoxylin-eosin(HE)staining,enzyme-linked immunosorbent assay(ELISA)was used to measure serum gastrin(GAS),motilin(MTL)and glucagon(GC),Alisin Blue-Periodic Acid Schiff's(AB-PAS)staining was used to observe the thickness of the mucosal layer of gastric tissues,the expressions of phosphatidylinositol 3-kinase(PI3K),phosphorylated PI3K(p-PI3K),protein kinase B(Akt),phosphorylated Akt(p-Akt),and endothelial-type nitric oxide synthase(eNOS)proteins in gastric tissues were detected by protein immunoblotting(Western Blot),and the expression of vascular endothelial growth factor A(VEGFA)protein in gastric tissues was detected by immunofluorescence staining.Results Compared with the normal group,the body mass of rats in the model group grew slowly during the experimental period,gastric macroscopic pathological scores were significantly increased(P<0.01),splenic coefficient and hepatic coefficient were significantly decreased(P<0.01),the gastric tissues showed cuprocyte hyperplasia and intestinal chemotaxis,gastric tissues'inflammation scores were significantly increased(P<0.01),the serum GAS content was significantly increased(P<0.01),and the MTL,GC contents were significantly reduced(P<0.05),and the thickness of the mucous membrane layer of gastric tissue was significantly reduced(P<0.05),the protein expression levels of PI3K,p-PI3K,Akt,p-Akt and eNOS were reduced(P<0.01),and the protein expression level of VEGFA was reduced(P<0.01);compared with the model group,the above indexes of the Jianwei Xiaozhang Tablets group and the folic acid group were all significantly improved(P<0.05 or P<0.01),among which,the Jianwei Xiaozhang Tablets group had a better improvement effect in the proliferation of cup cells and intestinal chemotaxis in gastric tissues,the content of serum GAS,and the thickness of the mucous layer in gastric tissues.Conclusion The mechanism of the improvement of PLGC in rats by Jianwei Xiaozhang Tablets may be related to the activation of the PI3K-Akt-eNOS pathway,which in turn promotes the angiogenesis and repair of gastric damaged tissues.
4.Downregulation of MUC1 Inhibits Proliferation and Promotes Apoptosis by Inactivating NF-κB Signaling Pathway in Human Nasopharyngeal Carcinoma
Shou-Wu WU ; Shao-Kun LIN ; Zhong-Zhu NIAN ; Xin-Wen WANG ; Wei-Nian LIN ; Li-Ming ZHUANG ; Zhi-Sheng WU ; Zhi-Wei HUANG ; A-Min WANG ; Ni-Li GAO ; Jia-Wen CHEN ; Wen-Ting YUAN ; Kai-Xian LU ; Jun LIAO
Progress in Biochemistry and Biophysics 2024;51(9):2182-2193
ObjectiveTo investigate the effect of mucin 1 (MUC1) on the proliferation and apoptosis of nasopharyngeal carcinoma (NPC) and its regulatory mechanism. MethodsThe 60 NPC and paired para-cancer normal tissues were collected from October 2020 to July 2021 in Quanzhou First Hospital. The expression of MUC1 was measured by real-time quantitative PCR (qPCR) in the patients with PNC. The 5-8F and HNE1 cells were transfected with siRNA control (si-control) or siRNA targeting MUC1 (si-MUC1). Cell proliferation was analyzed by cell counting kit-8 and colony formation assay, and apoptosis was analyzed by flow cytometry analysis in the 5-8F and HNE1 cells. The qPCR and ELISA were executed to analyze the levels of TNF-α and IL-6. Western blot was performed to measure the expression of MUC1, NF-кB and apoptosis-related proteins (Bax and Bcl-2). ResultsThe expression of MUC1 was up-regulated in the NPC tissues, and NPC patients with the high MUC1 expression were inclined to EBV infection, growth and metastasis of NPC. Loss of MUC1 restrained malignant features, including the proliferation and apoptosis, downregulated the expression of p-IкB、p-P65 and Bcl-2 and upregulated the expression of Bax in the NPC cells. ConclusionDownregulation of MUC1 restrained biological characteristics of malignancy, including cell proliferation and apoptosis, by inactivating NF-κB signaling pathway in NPC.
5.Association between variability of triglyceride glucose index and risk of type 2 diabetes
Ying PAN ; Shuting LIU ; Xiaohua CHEN ; Min HUANG ; Yueqing HUANG ; Yun TANG ; Qianqian WANG ; Kaixin ZHOU ; Jian SHAO ; Shao ZHONG
Chinese Journal of General Practitioners 2024;23(11):1162-1167
Objective:To explore the association between the variability of triglyceride glucose index (TyG) and the risk of type 2 diabetes mellitus(T2DM).Methods:This study was a retrospective cohort study. A total of 22 929 community-dwelling elderly (aged≥60 years) who received annual health check-ups in Kunshan city of Suzhou Municipality during 2014 to 2021 were enrolled in the study. Fasting triglycerides and blood glucose were measured during annual physical check-ups and the TyG was calculated, the standard deviation of TyG measurements in three consecutive physical check-ups was used as the indicatior of TyG long-term variability. According to the quartile of TyG long-term variability, the study subjects were divided into four groups, namely Q 1 (0-0.14), Q 2 (>0.14-0.22), Q 3 (>0.22-0.33), Q 4 (>0.33-1.90). The outcome variable was the occurrence of T2DM. The relationship between TyG variability and T2DM incidence was analyzed by multivariate Cox regression. Results:In the study cohort 11 518 (50.2%) were females and the mean age was (67.42±5.35) years. By the end of follow-up, 2 934 cases of new T2DM were diagnosed, with an oveall incidence rate of 12.8%. After adjusting for multiple confounders and average TyG, long-term variability of TyG was significantly associated with T2DM risk ( HR=1.83, 95% CI: 1.51-2.20). The risk of T2DM in Q 4 group was significantly higher than that in Q 1 group ( HR=1.33, 95% CI: 1.19-1.47). Kaplan-Meier survival curve showed that long-term variability of TyG was significantly correlated with the cumulative risk of T2DM incidence ( P<0.001). Conclusions:TyG variability is an independent risk factor for T2DM, suggesting that attention should be paid not only to specific time-point TyG levels but also to TyG fluctuation for early identification of T2DM risk.
6.Distribution and antimicrobial resistance profiles of clinical isolates from blood samples:results from China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021
Min ZHONG ; Xiangning HUANG ; Hua YU ; Yang YANG ; Fupin HU ; Demei ZHU ; Yi XIE ; Mei KANG ; Shanmei WANG ; Yafei CHU ; Wenen LIU ; Yanming LI ; Dawen GUO ; Jinying ZHAO ; Yuanhong XU ; Ying HUANG ; Yunzhuo CHU ; Sufei TIAN ; Ziyong SUN ; Zhongju CHEN ; Yunsong YU ; Jie LIN ; Jihong LI ; Yingchun XU ; Xiaojiang ZHANG ; Hui LI ; Ping JI ; Fang DONG ; Zhiyong LÜ ; Han SHEN ; Wanqing ZHOU ; Sufang GUO ; Zhidong HU ; Jin LI ; Chuanqing WANG ; Pan FU ; Hong ZHANG ; Chun WANG ; Chao ZHUO ; Danhong SU ; Bin SHAN ; Yan DU ; Lixia ZHANG ; Juan MA ; Yuxing NI ; Jingyong SUN ; Jinju DUAN ; Jianbang KANG ; Yan JIN ; Chunhong SHAO ; Wei JIA ; Gang LI ; Xuesong XU ; Chao YAN ; Yunjian HU ; Xiaoman AI ; Jinsong WU ; Yuemei LU ; Fangfang HU ; Lianhua WEI ; Fengmei ZOU ; Lei ZHU ; Jinhua MENG ; Shuping ZHOU ; Yan ZHOU ; Shifu WANG ; Xiaobo MA ; Yanping ZHENG ; Kaizhen WEN ; Yirong ZHANG ; Yunsheng CHEN ; Qing MENG ; Xuefei HU ; Ruizhong WANG ; Hua FANG ; Ruyi GUO ; Yan ZHU ; Jilu SHEN ; Wenhui HUANG ; Bixia YU ; Jiao FENG ; Yong ZHAO ; Ping GONG ; Shunhong XUE ; Hongqin GU ; Wen HE ; Jiangshan LIU ; Chunlei YUE ; Longfeng LIAO ; Lin JIANG
Chinese Journal of Infection and Chemotherapy 2024;24(6):664-677
Objective To investigate the distribution and antimicrobial resistance of bacterial isolates from blood samples in the hospitals participating in China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021.Methods Bacterial strains isolated from blood samples were collected from 52 medical centers participating in CHINET from 2015 to 2021 for analysis of bacetrial distribution and antimicrobial resistance.Results A total of 153591 isolates were collected,48.8% of which were gram-positive bacteria and 51.2% were gram-negative bacteria.The top five bacterial strains were coagulase negative Staphylococcus (28.2%),Escherichia coli (20.7%),Klebsiella (13.7%),Enterococcus (7.2%),and Staphylococcus aureus (6.6%).Compard to female patients,male patients showed lower proportion of E.coli and higher proportions of other bacterial species in all the bacterial isolaets from blood samples.The proportions of Streptococcus pneumoniae and Salmonella in all the bacterial isolaets from blood samples were higher in children compared to adults.Enterobacterales species showed various resistance rates to antimicrobial agents.Overall,≥58.0%,≥36.8% and ≥56.8% of E.coli strains were resistant to cefotaxime,gentamicin and levofloxacin respectively over the 7-year period.However,less than 2.5% of the E.coli strains were resistant to carbapenems.K.pneumoniae showed higher resistance rates to imipenem and meropenem than other Enterobacterales species.During the 7-year period,the prevalence of imipenem-resistant and meropenem-resistant K.pneumoniae increased from 21.4% and 19.9% in 2015 to 25.7% and 26.6% in 2021,respectively.However,carbapenems still maintained good antibacterial activity against other Enterobacterales,associaetd with lower resistance rates.In the 7-year period,Acinetobacter baumannii showed a dwonward trend in the resistance rates to imipenem and meropenem,but remained 72.9% and 73.2% respectively in 2021.The prevalence of imipenem-resistant and meropenem-resistant P.aeruginosa decreased from 26.7% and 22.9% in 2015 to 18.5% and 14.7% in 2021,respectively.The prevalence of PRSP was 1.5% in the isolaets from adults and and 0.8% in the isolates from children.Less than 3.0% of the Enterococcus faecium and Enterococcus faecalis strains were resistant to vancomycin,teicolanin,or linezolid.The prevalence of methicillin-resistant S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) was 32.1% and 81.0%,respectively.The prevalence of MRSA was relatively stable,28.5% in 2015 and 28.0% in 2021.Conclusions Coagulase negative Staphylococcus,E.coli and K.pneumoniae were the main bacterial species isolated from blood samples in the hospitals participaing in the CHINET from 2015 to 2021.Significant sex and age differences were found in the distribution of bcterial isolates from blood samples.The overall resistance rates of the top bacetrial strains from blood samples to antimicrobial agents showed a downward trend.Ongoing surveillance of antimicrobial resistance for the isolates from blood samples is still essential for prescribing rational antimicrobial therapies and curbing bacterial resistance.
7.Distribution and antimicrobial resistance profiles of clinical isolates from blood samples:results from China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021
Min ZHONG ; Xiangning HUANG ; Hua YU ; Yang YANG ; Fupin HU ; Demei ZHU ; Yi XIE ; Mei KANG ; Shanmei WANG ; Yafei CHU ; Wenen LIU ; Yanming LI ; Dawen GUO ; Jinying ZHAO ; Yuanhong XU ; Ying HUANG ; Yunzhuo CHU ; Sufei TIAN ; Ziyong SUN ; Zhongju CHEN ; Yunsong YU ; Jie LIN ; Jihong LI ; Yingchun XU ; Xiaojiang ZHANG ; Hui LI ; Ping JI ; Fang DONG ; Zhiyong LÜ ; Han SHEN ; Wanqing ZHOU ; Sufang GUO ; Zhidong HU ; Jin LI ; Chuanqing WANG ; Pan FU ; Hong ZHANG ; Chun WANG ; Chao ZHUO ; Danhong SU ; Bin SHAN ; Yan DU ; Lixia ZHANG ; Juan MA ; Yuxing NI ; Jingyong SUN ; Jinju DUAN ; Jianbang KANG ; Yan JIN ; Chunhong SHAO ; Wei JIA ; Gang LI ; Xuesong XU ; Chao YAN ; Yunjian HU ; Xiaoman AI ; Jinsong WU ; Yuemei LU ; Fangfang HU ; Lianhua WEI ; Fengmei ZOU ; Lei ZHU ; Jinhua MENG ; Shuping ZHOU ; Yan ZHOU ; Shifu WANG ; Xiaobo MA ; Yanping ZHENG ; Kaizhen WEN ; Yirong ZHANG ; Yunsheng CHEN ; Qing MENG ; Xuefei HU ; Ruizhong WANG ; Hua FANG ; Ruyi GUO ; Yan ZHU ; Jilu SHEN ; Wenhui HUANG ; Bixia YU ; Jiao FENG ; Yong ZHAO ; Ping GONG ; Shunhong XUE ; Hongqin GU ; Wen HE ; Jiangshan LIU ; Chunlei YUE ; Longfeng LIAO ; Lin JIANG
Chinese Journal of Infection and Chemotherapy 2024;24(6):664-677
Objective To investigate the distribution and antimicrobial resistance of bacterial isolates from blood samples in the hospitals participating in China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021.Methods Bacterial strains isolated from blood samples were collected from 52 medical centers participating in CHINET from 2015 to 2021 for analysis of bacetrial distribution and antimicrobial resistance.Results A total of 153591 isolates were collected,48.8% of which were gram-positive bacteria and 51.2% were gram-negative bacteria.The top five bacterial strains were coagulase negative Staphylococcus (28.2%),Escherichia coli (20.7%),Klebsiella (13.7%),Enterococcus (7.2%),and Staphylococcus aureus (6.6%).Compard to female patients,male patients showed lower proportion of E.coli and higher proportions of other bacterial species in all the bacterial isolaets from blood samples.The proportions of Streptococcus pneumoniae and Salmonella in all the bacterial isolaets from blood samples were higher in children compared to adults.Enterobacterales species showed various resistance rates to antimicrobial agents.Overall,≥58.0%,≥36.8% and ≥56.8% of E.coli strains were resistant to cefotaxime,gentamicin and levofloxacin respectively over the 7-year period.However,less than 2.5% of the E.coli strains were resistant to carbapenems.K.pneumoniae showed higher resistance rates to imipenem and meropenem than other Enterobacterales species.During the 7-year period,the prevalence of imipenem-resistant and meropenem-resistant K.pneumoniae increased from 21.4% and 19.9% in 2015 to 25.7% and 26.6% in 2021,respectively.However,carbapenems still maintained good antibacterial activity against other Enterobacterales,associaetd with lower resistance rates.In the 7-year period,Acinetobacter baumannii showed a dwonward trend in the resistance rates to imipenem and meropenem,but remained 72.9% and 73.2% respectively in 2021.The prevalence of imipenem-resistant and meropenem-resistant P.aeruginosa decreased from 26.7% and 22.9% in 2015 to 18.5% and 14.7% in 2021,respectively.The prevalence of PRSP was 1.5% in the isolaets from adults and and 0.8% in the isolates from children.Less than 3.0% of the Enterococcus faecium and Enterococcus faecalis strains were resistant to vancomycin,teicolanin,or linezolid.The prevalence of methicillin-resistant S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) was 32.1% and 81.0%,respectively.The prevalence of MRSA was relatively stable,28.5% in 2015 and 28.0% in 2021.Conclusions Coagulase negative Staphylococcus,E.coli and K.pneumoniae were the main bacterial species isolated from blood samples in the hospitals participaing in the CHINET from 2015 to 2021.Significant sex and age differences were found in the distribution of bcterial isolates from blood samples.The overall resistance rates of the top bacetrial strains from blood samples to antimicrobial agents showed a downward trend.Ongoing surveillance of antimicrobial resistance for the isolates from blood samples is still essential for prescribing rational antimicrobial therapies and curbing bacterial resistance.
8.New progress and challenges in the diagnosis and treatment of cosmetic allergy-related adverse reactions.
Chong ZHANG ; Shao Min ZHONG ; Yan WU ; Jia Hui ZHAO ; Zuo Tao ZHAO ; Yan TIAN ; Hang LI
Chinese Journal of Preventive Medicine 2023;57(4):591-596
In China, the current standard for cosmetic adverse reactions related skin disease (GB/T 17149.1-1997) was jointly issued by the Ministry of Health and the State Bureau of Technical Supervision in 1997, cosmetic-allergic adverse reactions include allergic contact dermatitis and photo-allergic contact dermatitis according to this standard. The increasing use and changes in cosmetic ingredients or formula lead to a significant increase for the incidence of adverse reactions as the cosmetics industry is developing rapidly in the last 20 years. In the meantime, the clinical manifestations have become more diverse. In recent years, there have been many reports on the special manifestations for cosmetic allergy and allergen test, which provide a reference for the subsequent improvement of the diagnosis and prevention.
Humans
;
Patch Tests/adverse effects*
;
Dermatitis, Allergic Contact/therapy*
;
Cosmetics/adverse effects*
;
China
;
Incidence
;
Allergens/adverse effects*
10.Imaging evaluation of cerebrospinal fluid otorrhea associated with inner ear malformation in children.
Min CHEN ; Jun GAO ; Wei LIU ; Zhong Long HAN ; Yang YANG ; Jian Bo SHAO ; Jun ZHENG ; Jie ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(5):452-459
Objective: To explore the imaging evaluation of cerebrospinal fluid (CSF) otorrhea associated with inner ear malformation (IEM) in children. Methods: The clinical data of 28 children with CSF otorrhea associated with IEM confirmed by surgical exploration in Beijing Children's Hospital, from Nov, 2016 to Jan, 2021, were analyzed retrospectively,including 16 boys and 12 girls, aged from 8-month to 15-year and 8-month old, with a median age of 4-year old. The shapes of stapes were observed during the exploration surgery, and the imaging features of temporal bone high resolution CT(HRCT) and inner ear MRI pre- and post-operation were analyzed. Results: In 28 children with CSF otorrhea, 89.3%(25/28) had stapes footplates defect during exploration. Preoperative CT showed indirect signs such as IEM, tympanic membrane bulging, soft tissue in the tympanum and mastoid cavity. IEM included four kinds: incomplete partition type I (IP-Ⅰ), common cavity (CC), incomplete partition type Ⅱ (IP-Ⅱ), and cochlear aplasia (CA); 100%(28/28) presented with vestibule dilation; 85.7%(24/28) with a defect in the lamina cribrosa of the internal auditory canal. The direct diagnostic sign of CSF otorrrhea could be seen in 73.9%(17/23) pre-operative MRI: two T2-weighted hyperintense signals between vestibule and middle ear cavity were connected by slightly lower or mixed intense T2-weighted signals, and obvious in the coronal-plane; 100%(23/23) hyperintense T2-weighted signals in the tympanum connected with those in the Eustachian tube.In post-operative CT, the soft tissues in the tympanum and mastoid cavity decreased or disappeared as early as one week. In post-operative MRI, the hyperintense T2-weighted signals of tympanum and mastoid decreased or disappeared in 3 days to 1 month,soft tissues tamponade with moderate intense T2-weighted signal were seen in the vestibule in 1-4 months. Conclusions: IP-Ⅰ, CC, IP-Ⅱ and CA with dilated vestibule can lead to CSF otorrhea. Combined with special medical history, T2-weighted signal of inner ear MRI can provide diagnostic basie for most children with IEM and CSF otorrhea.HRCT and MRI of inner ear can also be used to evaluate the effect of surgery.
Male
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Female
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Child
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Humans
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Aged
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Infant
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Child, Preschool
;
Cerebrospinal Fluid Otorrhea/surgery*
;
Retrospective Studies
;
Vestibule, Labyrinth
;
Temporal Bone
;
Ear, Middle

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