Local anesthetics (LAs), such as articaine (AT), exhibit limited efficacy in inflammatory environments, which constitutes a significant limitation in their clinical application within oral medicine. In our prior research, we developed AT-17, which demonstrated effective properties in chronic inflammatory conditions and appears to function as a novel oral LA that could address this challenge. In the present study, we further elucidated the beneficial effects of AT-17 in acute inflammation, particularly in oral acute inflammation, where mitochondrial-related apoptosis played a crucial role. Our findings indicated that AT-17 effectively inhibited lipopolysaccharide (LPS)-induced nerve cell apoptosis by ameliorating mitochondrial dysfunction in vitro. This process involved the inhibition of mitochondrial reactive oxygen species (mtROS) production and the subsequent activation of the NRF2 pathway. Most notably, improvements in mitochondria-related apoptosis were key contributors to AT-17's inhibition of voltage-gated sodium channels. Additionally, AT-17 was shown to reduce mtROS production in nerve cells through the Na⁺/NCLX/ETC signaling axis. In conclusion, we have developed a novel local anesthetic that exhibits pronounced anesthetic functionality under inflammatory conditions by enhancing mitochondria-related apoptosis. This advancement holds considerable promise for future drug development and deepening our understanding of the underlying mechanisms of action.

Objective: To analyze the trends in age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR) of extensively drug-resistant tuberculosis (XDR-TB) attributable to tobacco in China from 1993 to 2021, and to evaluate their age, period, and cohort effects, so as to provide the evidence for formulating targeted prevention and control strategies for XDR-TB. Methods: Data on the disease burden of XDR-TB attributable to tobacco in China from 1993 to 2021 were collected from the Global Burden of Disease (GBD) 2021 database, including ASMR and ASDR. The estimated annual percentage change (EAPC) was calculated to analyze trends in ASMR and ASDR from 1993 to 2021. An age-period-cohort model was employed to analyze age, period, and cohort effects on ASMR and ASDR. Results: From 1993 to 2021, the ASMR of XDR-TB attributable to tobacco in China showed an overall declining trend (EAPC=-2.412%, P<0.05), while the trend in ASDR was not statistically significant (EAPC=3.971%, P>0.05). The age-period-cohort model analysis revealed that both the ASMR and ASDR initially increased and then decreased with advancing age. The highest ASMR was observed in the age group of 75-<80 years, at 0.084 5/100 000, and the highest ASDR was observed in the age group of 70-<75 years, at 1.680 1/100 000. The lowest ASMR and ASDR were both found in the age group of 95-<100 years, at 0.039 0/100 000 and 0.365 2/100 000, respectively. Using the 2003-2007 period as the reference, the risks of mortality and disability showed an initial increase followed by a decrease over time. The risks peaked in the 2003-2007 period and subsequently declined, reaching their lowest point in the 2013-2017 period, with corresponding RR values of 0.369 (95%CI: 0.289-0.473) for mortality and 0.382 (95%CI: 0.359-0.408) for disability. Using the 1943-1947 birth cohort as the reference, the risks of mortality and disability exhibited a declining trend with later birth years. The lowest risk was observed in the 1973-1977 birth cohort for mortality, with an RR value of 0.534 (95%CI: 0.311-0.917), and in the 1983-1987 birth cohort for disability, with an RR value of 0.446 (95%CI: 0.386-0.516). Conclusions From 1993 to 2021, the overall disease burden of XDR-TB attributable to tobacco in China demonstrated a declining trend. The disease burden was more pronounced among the elderly, and the risks of mortality and disability showed an initial rise followed by a decline across periods, exhibiting a consistent downward trend across successive birth cohorts.

Objective To explore the clinical efficacy of arc-edge needle therapy based on Zaodian theory in the treatment of refractory tennis elbow.Methods 64 patients with refractory tennis elbow were collected and randomly divided into a control group and an observation group using a random number table method.Among them,32 cases in the control group were treated with local pain point injection.32 patients in the observation group were treated with arc-edge needle therapy once a week,with two treatments per group.The Number rating scale(NRS)Mayo,elbow joint performance score(MEPS)and Disabilities of the arm,shoulder and hand(DASH)score were recorded and compared between the two groups before treatment and at 1,2,4 and 24 weeks of follow-up after treatment,disease efficacy score(WDES)at 24 weeks of follow-up.Results During the treat-ment process,neither group of patients experienced serious adverse reactions.At each stage after treatment,two groups of NRS MEPS,DASH,and WDES at 24 weeks of follow-up all improved compared to before treatment.After one week of treatment,there was no statistically significant difference in NRS scores between the two groups(P>0.05).At follow-up visits at weeks 2,4,and 24,the NRS scores in the observation group were lower than those in the control group.After 1,2,4,and 24 weeks of follow-up after treatment,the DASH score was lower in the observation group than in the control group,and the MEPS score was higher in the observation group than in the control group,with statistically significant differences(P<0.05).After 24 weeks of treatment,the WDES of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Local pain point injection and arc-edge Zaodian release can alleviate pain and improve elbow joint function in the early stage of refractory tennis elbow.However,the long-term effect of local pain point injection treatment is not good,and the treatment effect of the observation group gradually improves.

Objective:To investigate the risk factors for ruptured saccular intracranial aneurysms in young adults.Methods:Young patients with saccular intracranial aneurysm admitted to the First People's Hospital of Kashgar Region from February 2017 to November 2022 were retrospectively included. The demographic and clinical data from patients were collected. Risk factors of ruptured intracranial aneurysm were determined by univariate and multivariate regression analysis.Results:A total of 151 young patients with saccular intracranial aneurysm were enrolled, including 94 in the ruptured group (62.2%) and 57 in the unruptured group (37.8%). There were 70 males (46.4%) and 81 females (53.6%), with a median age of 41 years (interquartile range, 36-42 years). Univariate analysis showed that there were statistically significant differences in the proportion of male and triglycerides level between the ruptured group and the unruptured group (all P<0.05). Multivariate logistic regression analysis showed that males (odds ratio [ OR] 5.546, 95% confidence interval [ CI] 1.946-15.807; P=0.001), lower triglycerides ( OR 0.244, 95% CI 0.219-0.511; P<0.001), and aneurysms located in the anterior cerebral artery/anterior communicating artery ( OR 4.207, 95% CI 1.361-13.004; P=0.013) and middle cerebral artery ( OR 3.277, 95% CI 1.091-9.848; P=0.034) were the independent risk factors for intracranial aneurysm rupture. Conclusions:Male and lower triglycerides are the risk factors for ruptured saccular intracranial aneurysms in young adults. In addition, intracranial aneurysms located in the anterior cerebral artery/anterior communicating artery and middle cerebral artery are more prone to rupture.

The RECK protein is highly expressed in normal cells and tissues,however,down-regulated in transformed cells or tumor tissues.Subsequent functional studies have demonstrated that RECK owns the tumor suppressor activity.Hence,it is urgent and important to unmask the mechanisms involved in regulation of RECK expression.Epigenetic regulation plays a vital role in modulating gene expression,besides,multiple research also suggested the involvement of epigenetic regulation in RECK expression.The epigenetic regulation mechanisms of controlling the gene expression currently known will be reviewed in this paper.

Cochlear implantation has gradually been accepted as an effective treatment for many patients with severe to pround sensorineural hearing loss. The traditional cochlear implantation does not exist up to expectations in some respects. With the soft surgery technique brought forward, the idea of minimally invasive cochlear implantation is deely rooted among the people. Now many institutions are carring out a series of clinical researches and practices to improve the results of cochlear implantation surgery and reduce the complications around the world. It includes minimally invasive approach, cochleostomy and electrode insertion techniques, especially the latter two affect the preservation of residual hearing. This article is a review of the advances in minimally invasive cochlear implantation from the above three aspects.
Cochlear Implantation ; methods ; Cochlear Implants ; Electrodes, Implanted ; Hearing ; Humans ; Minimally Invasive Surgical Procedures ; methods

Objective: To explore the effect of salinomycin on the metastasis and invasion of bladder cancer cell line T24 by regulating the related protein expression in the process of epithelial-mesenchymal transition (EMT), and to provide experimental basis for the treatment of urological tumors. Methods: The bladder cancer cell line T24 was cultured in vitro. The rat bladder tumor model was established in vivo. The rats were randomized into two groups, among which the rats in the experiment group were given intraperitoneal injection of salinomycin, while the rats in the control group were given intraperitoneal injection of normal saline. The change of tumor cells in the two groups was observed. Transwell was used to detect the cell migration and invasion abilities, Real-time PCR was used to detect the expression of mRNA, while Western-blot was utilized for the determination of the expressions of E-cadherin and vimentin proteins. Results: The metastasis and invasion abilities of serum bladder cancer cell line T24 after salinomycin treatment in the experiment group were significantly reduced when compared with those in the control group, and the tumor metastasis lesions were decreased from an average of 1.59 to 0.6 (P < 0.05). T24 cell proliferation in the experiment group was gradually decreasing. T24 cell proliferation at 48 h was significantly lower than that at 12 h and 24 h (P < 0.05). T24 cell proliferation at 24 h was significantly lower than that at 12 h (P < 0.05). T24 cell proliferation at each timing point in the experiment group was significantly lower than that in the control group (P < 0.05). The serum mRNA level and E-cadherin expression in the tumor tissues in the experiment group were significantly higher than those in the control group, while vimentin expression level was significantly lower than that in the control group (P < 0.05). Conclusions: Salinomycin can suppress the metastasis and invasion of bladder cancer cells, of which the mechanism is probably associated with the inhibition of EMT of tumor cells.

Objective To investigate the clinical features of gynecological malignant tumor related multiple primary malignant neoplasms (MPMN).Methods Apply retrospective and comprehensive analysis to the clinical data of 30 patients with gynecological malignant tumor related MPMN.Results Synchronous MPMN were found in 9 patients.Their average age was 50.2 years old and their median age was 49 years old.The neoplasms were located at ovary,uterus,cervix,breast and intestine.Metachronous MPMN were found in 21 patients.Their average age was 57.7 and their median age was 57 years old.The median interval between the first and the second primary malignant neoplasm was 4.0 years.The neoplasms were located at breast,ovary,uterus,gastrointestinal tract,uterine cervix,lung etc.In 30 cases,26 of them were treated by surgical operation and further adjunctive treatment of chemotherapy and (or) radiotherapy was conducted as per the neoplasm staging and its pathological results.The rest 4 patients (first primary malignant neoplasms were excised from 3 of them and another one was not treated by surgical operation) received adjunctive treatment of chemotherapy and (or) radiotherapy.Followed ups,which varied from 6 to 60 months,were made to 29 patients and 20 out of the 29 were alive.5-year survival rate of patients with gynecological malignant tumor related MPMN was 47.8％,2-year survival rate was 73.9％,and 1-year survival rate was 88.6％.Conclusion Pay more attention to the patients with gynecological malignant tumor related MPMN,examine the high-risk patients with malignant tumor comprehensively,identify whether it is recurrence,metastasis or new growth of malignant neoplasm,and further ensure early diagnosis and proper treatment,avoiding misdiagnosis and missed diagnosis.

OBJECTIVE: To study clinical characteristics, diagnosis, pathological types and therapy methods of nonsquamous cell neoplasm in subglottis, in order to improve comprehension of this rare disease. METHOD: To analysis 3 patients' clinical data with noosquamous cell neoplasm in subglottis by reviewing related literature, and to generalize the symptoms, differentiation and treatment experience of nonsquamous cell neoplasm in subglottis. RESULT: Among the 3 patients, one's main complain was hoarseness and the other two's main symptom was inspiratory dyspnea. As diagnosis was definite and acute obstruction of airway was relieved, the neoplasms were removed totally. Two patients were undergone operation through oral cavity by using suspended laryngoscope, and one patient was done surgery by neck approach. Paraffin wax result showed that one patient suffered epithelial-myoepithelial carcinoma, who received radiotherapy after surgery. There is no recurrence in all patients by following up more than 1 year. CONCLUSION The occurrence of nonsquamous cell neoplasm in subglottis is relatively low, and the subglottis should be inspected carefully to avoid missed diagnosis. Operation is the preferred method to treat this kind of disease. To choose a suitable operational manner according to size, location of the neoplasm is crucial.
Female ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; diagnosis ; pathology ; surgery ; Male ; Middle Aged

Objective To investigate the situation of diabetes self-management and its influencing factors.Methods From January 2011 to January 2013,totals of 160 patients in endocrinology outpatient of affiliated hospital of Guilin Medical Hospital were divided into good blood glucose control group named group A ( n=80 ) and poor glucose control group named group B ( n=80 ) .They were investigated with questionnaires , which including general information table , self-management questionnaire and so on .Results In group A, management of diet, exercise, medicine, blood sugar monitoring, hypoglycemia, and master of complications of patients was respectively higher than that in group B , and the difference of self-management between group A and group B was statistically significant (χ2 =28.951,20.625,32.456,35.472,22.727,47.479,respectively;P<0.01).And analysis results showed that degree of education ,payment,courses of disease, inpatient visits , complication, health education,social support,emotion,and diabetes knowledge master were the influencing factors for diabetes self-management (χ2 =24.571,19.126,12.010,12.890,16.242,34.450,25.126,30.126, 39.126,respectively;P <0.05).While no statistically significant difference was found in the patients with different age,gender,profession,martial status and family history (χ2 =1.026,9.010,6.564,1.976,3.337, respectively;P>0.05).Conclusions Diabetes self-management situation is not ideal ,and influencing factors analysis of patient self-management situation can improve the standards rate of glucose control in patients with diabetes , so as to improve the patients ’ quality of life .