Objective:This study aims to investigate the therapeutic efficacy of staged endoscopic surgery for Shin-Ⅲ stage external auditory canal cholesteatoma. Methods:A retrospective analysis was conducted on the clinical data of 25 patients diagnosed with Shin-Ⅲ cholesteatoma of the external auditory canal, who were admitted to the Otology Center of the First People's Hospital of Foshan City from May 2020 to October 2024. All patients initially underwent endoscopic cholesteatoma removal. Based on the outcomes of the first-stage postoperative follow-up, patients were categorized into two groups: the repair type and the non-repair type. The non-repair type was further subdivided into simple and complex types. Of the total cases, 10 patients were of the repair type, with 9 requiring no further surgical intervention. The non-repair type comprised 15 patients, of which 8 were classified as simple type and underwent either tympanoplasty type Ⅰ or external auditory canal wall reconstruction during the second stage. The remaining 7 patients, identified as complex type, received open mastoidectomy or tympanotomy in the second stage, with or without ossicular chain reconstruction. Results:All patients were monitored for a minimum of six months postoperatively. The incidence of dry ear was observed in 22 patients, corresponding to a dry ear rate of 88.0%. Four cases experienced primary complications. Conclusion:Endoscopic phased operation for managing Shin-Ⅲ stage cholesteatoma of the external auditory canal can ensure that the surgical options match the severity of the lesions, reducing unnecessary surgical trauma and achieving good efficacy.
Humans ; Retrospective Studies ; Ear Canal/surgery* ; Endoscopy/methods* ; Cholesteatoma/surgery* ; Male ; Tympanoplasty ; Female ; Treatment Outcome ; Adult ; Middle Aged ; Cholesteatoma, Middle Ear/surgery* ; Mastoidectomy

Objective:To analyze the electroencephalogram(EEG) average relative power spectrum in patients with unipolar and bipolar depression under the eyes-open and eyes-closed resting states.Methods:A total of 38 patients with unipolar depression (UD group), 48 patients with bipolar depression (BD group), and 43 healthy controls (HC group) were recruited from August 2022 to December 2023.The 64-channel EEG was recorded under eyes-open (EO) and eyes-closed (EC) resting states which alternated twice. The Mann-Whitney U test and Kruskal-Wallis H test were performed by SPSS 25.0 software. Results:There were no significant differences in the average relative power of delta and beta bands among the UD, BD and HC groups in all EO and EC states (all P>0.05). The average relative power of theta band in the three groups showed statistically significant differences in all EO and EC states ( H=7.852-12.583, all P<0.05). Further pairwise comparisons showed that in the first EO and EC stage, the average relative power of theta band of the UD and BD groups were significantly higher than that of the HC group (EO1: 0.18(0.17, 0.21), 0.19(0.16, 0.21), 0.16(0.14, 0.18), EC1: 0.15(0.13, 0.21), 0.15(0.13, 0.20), 0.13(0.10, 0.16); all P<0.05).In the second EO and EC stage, the average relative power of theta band of the BD group was significantly higher than that of the HC group (EO2: 0.18(0.15, 0.22), 0.16(0.14, 0.18), EC2: 0.15(0.13, 0.19), 0.13(0.11, 0.16); both P<0.05).There were statistically significant differences in the average relative power of alpha band among the three groups in the first EO and EC stage, as well as the second EC stage ( H=5.027-10.668, all P<0.05). Further pairwise comparisons showed that in the first EO stage, the average relative power of alpha band in the BD group was significantly higher than that in the UD group (0.20(0.16, 0.25), 0.14(0.11, 0.22), P=0.003), and in the following EC stages, the average relative power of alpha band in the UD group was significantly lower than that in the HC group (EC1: 0.40(0.33, 0.46), 0.51(0.40, 0.58), EC2: 0.41(0.35, 0.50), 0.48(0.43, 0.58); both P<0.05). Conclusion:At the initial stage of the resting state, both unipolar and bipolar depression patients demonstrate abnormal theta band activity under the eyes-open and eyes-closed states, while the alpha band activity under the eyes-open condition differs between the two groups of patients. These findings may provide potentially objective biomarkers to assist the diagnosis of unipolar and bipolar depression patients in clinical settings.

Objective To observe the value of multi-sequence magnetic resonance imaging(MRI)radiomics in predicting the efficacy of concurrent chemoradiotherapy(CCRT)in locally advanced cervical squamous cell carcinoma(CSCC)patients.Methods Clinical data of 100 CSCC patients underwent CCRT treatment were selected.In order to better validate the performance of the model,patients were randomly divided into the training set(70 cases)and the validation set(30 cases)in a 7∶3 ratio.According to the efficacy criteria for solid tumors,patients were divided into the complete response(CR)group(n=16)and the partial response(PR)group(n=14).Examination images of cross-sectional DWI,T2WI and enhanced T1WI were collected from all patients before treatment.ITK-SNAP software package combined with three sequences were used to outline ROI,and the open source software PyRadiomics was used to extract image omics features.For MRI omics features,the minimum redundancy maximum correlation(mRMR)algorithm was used to analyze and screen out the first 30 main features,and then the minimum absolute contraction and selection method(Lasso)based on 10-fold cross-validation was used to reduce dimensionality to screen the non-zero coefficient features.According to the weighting coefficient of Lasso-Logistic regression model in the training set,patient omics labels were calculated.Logistic regression analysis was used to construct a prediction model based on DWI,T2WI and T1WI sequence prediction models and multiple sequenomics labels.Receiver operating characteristic(ROC)curves evaluated the predictive value of each omics model for CCRT treatment in patients with locally advanced CSCC.Results There were 38 cases in the CR group and 32 cases in the PR group in the training set.There were 16 cases in the CR group and 14 cases in the PR group in the validation set.There were no significant differences in patient age,FIGO stage,differentiation degree,maximum lesion diameter and menstrual status between the CR group and the PR group in the training and validation sets.A total of 851 imaging features were extracted from the ROI target area.After the first 30 features were retained by mRMR algorithm,3 CR-related features were selected from the 851 imaging omics features of each individual sequence by Lasso algorithm and 10-fold cross-validation.Eight CR related features were selected from 2 553 features after the combination of the three sequences.ROC curve results showed that in the training set and validation set,the AUC of multiple sequences combined to predict the therapeutic effect of CCRT in patients with locally advanced CSCC was 0.971 and 0.946,respectively,which was higher than that of T1WI,T2WI and DWI single sequence prediction(training set Z=2.683,2.046,2.817,P＜0.05;verification set Z=2.075,2.117,2.005,P＜0.05).Conclusion The multi sequence MRI radiomics model has high predictive value for the efficacy of CCRT treatment in locally advanced CSCC patients.

Objective:To analyze the electroencephalogram(EEG) average relative power spectrum in patients with unipolar and bipolar depression under the eyes-open and eyes-closed resting states.Methods:A total of 38 patients with unipolar depression (UD group), 48 patients with bipolar depression (BD group), and 43 healthy controls (HC group) were recruited from August 2022 to December 2023.The 64-channel EEG was recorded under eyes-open (EO) and eyes-closed (EC) resting states which alternated twice. The Mann-Whitney U test and Kruskal-Wallis H test were performed by SPSS 25.0 software. Results:There were no significant differences in the average relative power of delta and beta bands among the UD, BD and HC groups in all EO and EC states (all P>0.05). The average relative power of theta band in the three groups showed statistically significant differences in all EO and EC states ( H=7.852-12.583, all P<0.05). Further pairwise comparisons showed that in the first EO and EC stage, the average relative power of theta band of the UD and BD groups were significantly higher than that of the HC group (EO1: 0.18(0.17, 0.21), 0.19(0.16, 0.21), 0.16(0.14, 0.18), EC1: 0.15(0.13, 0.21), 0.15(0.13, 0.20), 0.13(0.10, 0.16); all P<0.05).In the second EO and EC stage, the average relative power of theta band of the BD group was significantly higher than that of the HC group (EO2: 0.18(0.15, 0.22), 0.16(0.14, 0.18), EC2: 0.15(0.13, 0.19), 0.13(0.11, 0.16); both P<0.05).There were statistically significant differences in the average relative power of alpha band among the three groups in the first EO and EC stage, as well as the second EC stage ( H=5.027-10.668, all P<0.05). Further pairwise comparisons showed that in the first EO stage, the average relative power of alpha band in the BD group was significantly higher than that in the UD group (0.20(0.16, 0.25), 0.14(0.11, 0.22), P=0.003), and in the following EC stages, the average relative power of alpha band in the UD group was significantly lower than that in the HC group (EC1: 0.40(0.33, 0.46), 0.51(0.40, 0.58), EC2: 0.41(0.35, 0.50), 0.48(0.43, 0.58); both P<0.05). Conclusion:At the initial stage of the resting state, both unipolar and bipolar depression patients demonstrate abnormal theta band activity under the eyes-open and eyes-closed states, while the alpha band activity under the eyes-open condition differs between the two groups of patients. These findings may provide potentially objective biomarkers to assist the diagnosis of unipolar and bipolar depression patients in clinical settings.

Objective To observe the value of multi-sequence magnetic resonance imaging(MRI)radiomics in predicting the efficacy of concurrent chemoradiotherapy(CCRT)in locally advanced cervical squamous cell carcinoma(CSCC)patients.Methods Clinical data of 100 CSCC patients underwent CCRT treatment were selected.In order to better validate the performance of the model,patients were randomly divided into the training set(70 cases)and the validation set(30 cases)in a 7∶3 ratio.According to the efficacy criteria for solid tumors,patients were divided into the complete response(CR)group(n=16)and the partial response(PR)group(n=14).Examination images of cross-sectional DWI,T2WI and enhanced T1WI were collected from all patients before treatment.ITK-SNAP software package combined with three sequences were used to outline ROI,and the open source software PyRadiomics was used to extract image omics features.For MRI omics features,the minimum redundancy maximum correlation(mRMR)algorithm was used to analyze and screen out the first 30 main features,and then the minimum absolute contraction and selection method(Lasso)based on 10-fold cross-validation was used to reduce dimensionality to screen the non-zero coefficient features.According to the weighting coefficient of Lasso-Logistic regression model in the training set,patient omics labels were calculated.Logistic regression analysis was used to construct a prediction model based on DWI,T2WI and T1WI sequence prediction models and multiple sequenomics labels.Receiver operating characteristic(ROC)curves evaluated the predictive value of each omics model for CCRT treatment in patients with locally advanced CSCC.Results There were 38 cases in the CR group and 32 cases in the PR group in the training set.There were 16 cases in the CR group and 14 cases in the PR group in the validation set.There were no significant differences in patient age,FIGO stage,differentiation degree,maximum lesion diameter and menstrual status between the CR group and the PR group in the training and validation sets.A total of 851 imaging features were extracted from the ROI target area.After the first 30 features were retained by mRMR algorithm,3 CR-related features were selected from the 851 imaging omics features of each individual sequence by Lasso algorithm and 10-fold cross-validation.Eight CR related features were selected from 2 553 features after the combination of the three sequences.ROC curve results showed that in the training set and validation set,the AUC of multiple sequences combined to predict the therapeutic effect of CCRT in patients with locally advanced CSCC was 0.971 and 0.946,respectively,which was higher than that of T1WI,T2WI and DWI single sequence prediction(training set Z=2.683,2.046,2.817,P＜0.05;verification set Z=2.075,2.117,2.005,P＜0.05).Conclusion The multi sequence MRI radiomics model has high predictive value for the efficacy of CCRT treatment in locally advanced CSCC patients.

The beneficial effects of hypoxic preconditioning are abolished in the diabetes. The present study was designed to investigate the protective effects and mechanisms of repeated episodes of whole body hypoxic preconditioning (WBHP) in db/db mice. The protective effects of preconditioning were explored on diabetesinduced vascular dysfunction, cognitive impairment and ischemia-reperfusion (IR)-induced increase in myocardial injury. Sixteen-week old db/db (diabetic) and C57BL/6 (non-diabetic) mice were employed. There was a significant impairment in cognitive function (Morris Water Maze test), endothelial function (acetylcholineinduced relaxation in aortic rings) and a significant increase in IR-induced heart injury (Langendorff apparatus) in db/db mice. WBHP stimulus was given by exposing mice to four alternate cycles of low (8%) and normal air O2 for 10 min each. A single episode of WBHP failed to produce protection; however, two and three episodes of WBHP significantly produced beneficial effects on the heart, brain and blood vessels. There was a significant increase in the levels of brain-derived neurotrophic factor (BDNF) and nitric oxide (NO) in response to 3 episodes of WBHP. Moreover, pretreatment with the BDNF receptor, TrkB antagonist (ANA-12) and NO synthase inhibitor (LNAME) attenuated the protective effects imparted by three episodes of WBHP. These pharmacological agents abolished WBHP-induced restoration of p-GSK-3β/GSK-3β ratio and Nrf2 levels in IR-subjected hearts. It is concluded that repeated episodes of WHBP attenuate cognitive impairment, vascular dysfunction and enhancement in IRinduced myocardial injury in diabetic mice be due to increase in NO and BDNF levels that may eventually activate GSK-3β and Nrf2 signaling pathway to confer protection.

The beneficial effects of hypoxic preconditioning are abolished in the diabetes. The present study was designed to investigate the protective effects and mechanisms of repeated episodes of whole body hypoxic preconditioning (WBHP) in db/db mice. The protective effects of preconditioning were explored on diabetesinduced vascular dysfunction, cognitive impairment and ischemia-reperfusion (IR)-induced increase in myocardial injury. Sixteen-week old db/db (diabetic) and C57BL/6 (non-diabetic) mice were employed. There was a significant impairment in cognitive function (Morris Water Maze test), endothelial function (acetylcholineinduced relaxation in aortic rings) and a significant increase in IR-induced heart injury (Langendorff apparatus) in db/db mice. WBHP stimulus was given by exposing mice to four alternate cycles of low (8%) and normal air O2 for 10 min each. A single episode of WBHP failed to produce protection; however, two and three episodes of WBHP significantly produced beneficial effects on the heart, brain and blood vessels. There was a significant increase in the levels of brain-derived neurotrophic factor (BDNF) and nitric oxide (NO) in response to 3 episodes of WBHP. Moreover, pretreatment with the BDNF receptor, TrkB antagonist (ANA-12) and NO synthase inhibitor (LNAME) attenuated the protective effects imparted by three episodes of WBHP. These pharmacological agents abolished WBHP-induced restoration of p-GSK-3β/GSK-3β ratio and Nrf2 levels in IR-subjected hearts. It is concluded that repeated episodes of WHBP attenuate cognitive impairment, vascular dysfunction and enhancement in IRinduced myocardial injury in diabetic mice be due to increase in NO and BDNF levels that may eventually activate GSK-3β and Nrf2 signaling pathway to confer protection.

Objective:To investigate the clinical significance of inflammatory factors in bacterial infection children with glucose-6-phosphate dehydrogenase (G6PD) deficiency in PICU.Methods:A prospective cohort study was carried out from June 2014 to December 2017. 77 bacterial infection children with pediatric critical illness score less than 80 who were admitted to the PICU, were recruit in the study.The patient diagnosed as other basic diseases,with history of high-dose glucocorticoid use, discharged or died within 24 hours were excluded.The recruited patients were divided into G6PD deficiency group (observation group with 36 cases) and non-G6PD deficiency group (control group with 41 cases) according to the presence or absence of G6PD deficiency.Blood samples were taken at admission, 12 hand 24 h after hospitalization to detect the concentrations of tumor necrosis factor (TNF-α), interleukin 6 (IL-6), interleukin 10 (IL-10) andC-reactive protein (CRP). T test, χ2 test and Fisher exact test were used to analyze the changes of the above inflammatory factors, complications, prognosis, PICU stay time and hospitalization costs. Results:The levels of inflammatory factors in the observation group were significantly higher than those in the control group at admission, 12 and 24 hours after hospitalization, the differences were statistically significant (all P< 0.05). There was no statistically significant difference in thechangerate of inflammatory factors between the two groups during treatment; The PICU stay time of observation group was longer [(7.98 ± 6.55) vs (5.01 ± 6.21)] and the hospitalization cost (yuan) was higher [(36 634.09 ± 11 876.67) vs (31 571.42 ± 10 245.80)], P<0.05; Compared to the control group, the incidence ofsevere sepsis, septic shock, MODS increased significantly, and the curative rate decreasedsignificantly in observation group( P<0.05). Conclusions:G6PD-deficient children with bacterial infections had serious inflammatory reactions with poor prognosis and higher hospitalization costs and were susceptible to the occurrence of severe sepsis, septic shock and MODS.

Objective:To explore the serum levels of inflammatory cytokines and prognosis in severe acute infection children with glucose-6-phosphate dehydrogenase(G6PD) deficiency.Methods:A total number of 160 children with severe acute infections admitted to PICU of Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital from June 2014 to December 2017 were selected as subjects in this study, including 80 children with G6PD deficiency(observation group) and 80 children without G6PD deficiency(control group). The changes of TNF-α, IL-6, IL-10 and CRP were dynamically monitored at 0-hour, 12-hour and 24-hour after admision, and the occurrences of sepsis, multiple organ dysfunction syndrome(MODS) were prospectively analyzed.Results:The levels of serum cytokines and CRP in the observation group were significantly higher than those in the control group at admission[TNF-α: (65.57±19.09) pg/ml vs.(46.53±20.34) pg/ml; IL-6: (98.90±29.02) pg/ml vs.(89.89±25.54) pg/ml; IL-10: (87.66±21.84) pg/ml vs.(76.34±19.01) pg/ml; CRP: (60.18±22.24) mg/L vs.(41.43±19.51) mg/L, respectively], and the differences between two groups were statistically significant( P<0.05). The levels of cytokines and CRP in the observation group were higher than those in the control group at 12 h and 24 h after treatment( P<0.01). Compared with the control group, the incidences of sepsis(82.50% vs 67.50%) and MODS(73.75% vs 58.75%) in the observation group increased, and the recovery rate(81.25% vs 92.50%) decreased, with statistical significance between two groups( P<0.05). Conclusion:Children with G6PD deficiency need to be paid more attention to inflammation, sepsis, MODS and the difficulty of treatment when they are infected.The potential mechanism may be related to oxidative stress.

Objective To investigate the clinical effects of Compound Biejia Ruangan Tablet (CBRT) combined with entecavir in patients with chronic hepatitis B with hepatic fibrosis.Methods Totally 92 cases of patients with hepatic fibrosis of chronic hepatitis B in Ankang people's hospital from January 2013 to May 2016 were divided into observation group (n =45) and control group (n =47),patients in observation group were treated with CBRT combined with entecavir,and patients in the control group were treated with entecavir.Treatment was for 48 weeks.The liver function,liver fibrosis,serum inflammatory factors,and adverse reactions were compared between two groups.Results After treatment,the ALT,AST,TBIL,and ALB/GLB levels of two group were significantly lower than those before treatment (P ＜ 0.05),but there was no significant difference between two groups after treatment.After treatment,the PCⅢ,IV-C,HA,LN,IL-6,IL-4,IL-10,and TNF-α levels of two group were significantly lower than those before treatment (P ＜ 0.05),and the PCⅢ,IV-C,HA,LN,IL-6,IL-4,IL-10,and TNF-α levels of observation group were significantly lower than those of control group (P ＜ 0.05);there was no statistically significant difference in the incidence of adverse reactions between two groups (P ＜ 0.05).Conclusion CBRT combined with entecavir is safe and effective to treat liver fibrosis of chronic hepatitis b,and it could significantly improve liver function,improve the degree of liver fibrosis,and reduce the level of serum inflammatory factors.