To develop a novel polyamino acid-based nanohydrogel drug delivery system for dexamethasone to enhance its delivery efficiency to the inner ear.

Objective: To analyze the risk factors of recurrence after transurethral resection of bladder tumor (TURBT) in patients with non-muscle-invasive bladder cancer (NMIBC)，and establish a risk prediction model，so as to optimize the clinical detection and management of NMIBC. Methods: A total of 174 patients with initial diagnosis of NMIBC who underwent TURBT in the First Affiliated Hospital of Xinjiang Medical University during Jan.2020 and Oct.2022 were followed up for 24 months，and were then divided into the recurrence group (n=74) and non-recurrence group (n=100).After univariate analysis and multivariate logistic regression，risk factors of recurrence were identified，a nomogram was established，and the calibration curve was plotted，which was verified with receiver operator characteristic (ROC) curve. Results: The 2-year recurrence rate was 42.53%.Logistic regression showed high body mass index (BMI)，poor differentiation，multiple tumors，and tumor diameter greater than 3 cm were risk factors of recurrence (P<0.05，OR≥1)，while immediate postoperative intravesical instillation was a protective factor (P<0.05).The C-index of the nomogram was 0.893 (95%CI:0.851-0.938)，the area of ROC curve (AUC) was 0.894 (95%CI：0.847-0.941)，the sensitivity was 82.4%，and the specificity was 83.0%. Conclusion: The prediction model based on BMI，tumor stage，grade，number，diameter，and immediate postoperative intravesical instillation fits well and can provide reference for predicting the risk of tumor recurrence.

Objective To compare the clinical effects of arthroscopically-assisted reduction and internal fixation(ARIF)combined with enhanced recovery after surgery(ERAS)and open reduction and internal fixation surgery(ORIF)in the treatment of posterior lateral tibial plateau fractures.Methods Seventy patients with posterior lateral tibial plateau fractures in the Department of Orthopaedics,Xuzhou Central Hospital,from January 2020 to November 2022 were retrospectively selected and divided into ARIF group(with ERAS,n=32)and ORIF group(without ERAS,n=38)according to the treatment methods.All patients were evaluated for fracture type by imaging examination after admission.The operation time,length of hospital stay,early postoperative pain score(evaluated by visual analogue scale[VAS]),knee joint function(evaluated by hospital for special surgery[HSS]scale)at 3 months and thigh circumference difference at 6 months postoperatively were compared between the two groups.Results The operation time in the ARIF group was significantly shorter than that in the ORIF group([67.84±9.89]min vs[85.16±9.18]min,P＜0.001),and the length of hospital stay was significantly shorter in the ARIF group([7.13±1.41]d vs[8.74±1.84]d,P＜0.001).On the third day after operation,the VAS score in the ARIF group was significantly lower than that in the ORIF group([4.00±1.44]vs[5.39±1.24],P＜0.001).ARIF group had better joint function than ORIF group 3 months after operation,and the difference of 10 cm thigh circumference on patella in ARIF group was smaller than that in ORIF group 6 months after operation.Conclusions Compared to ORIF,patients with posterior lateral tibial plateau fractures treated with ARIF combined with ERAS showed faster postoperative recovery,shorter hospital stay,and more precise clinical efficacy.

Objective:To analyze the correlation between drug-induced sleep endoscopy (DISE), results, polysomnography (PSG) indicators, and clinical parameters in patients with obstructive sleep apnea (OSA), and to establish and validate a predictive model for tongue base plane obstruction.Methods:This retrospective study analyzed 117 OSA patients diagnosed via PSG and treated at the Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, between October 2014 and March 2022. The cohort comprised of 114 males and 3 females, with an age range of 20 to 54 years (mean age 38.1±8.4 years). Data on DISE results, PSG results, and clinical indicators were collected for all 117 patients. Logistic regression analysis was performed to identify relevant indicators, and a predictive model for tongue base plane obstruction was constructed and internally validated using the R programming language.Results:Univariate logistic regression analysis identified four independent risk factors for predicting tongue root plane obstruction: tonsil grading, N2, N3, and rapid eye movement sleep(REM) stage [ OR:0.412(0.260~0.652),1.045(1.012~1.079),0.943(0.903~0.984),0.961(0.925~0.998), P <0.05]. Multivariate logistic regression analysis confirmed tonsil grading and N3 sleep stage (12.48±12.22%) as significant predictors. A nomogram model incorporating these factors demonstrated good predictive performance, with an area under curve(AUC) of 0.82 (95% CI: 0.548-1.000), an optimal cutoff of 0.519, a specificity of 80.0%, and a sensitivity of 86.7%. Internal validation of the model in the validation cohort yielded an AUC of 0.751 (95% CI: 0.625-0.876). Conclusions:Tongue base plane obstruction observed during DISE in OSA patients is associated with tonsil grading and N3 sleep stage duration. The predictive model developed for tongue base plane obstruction based on DISE demonstrates good efficacy, as evidenced by its internal validation.

Objective:To compare the clinical efficacy of patients with chronic lateral rotational ankle instability(CLRAI) after all-inside arthroscopic lateral ligament augmentation procedure and Brostr?m procedure.Methods:This is a retrospective cohort study. The clinical and imaging data of 106 CLRAI patients were collected at the Xuzhou Central Hospital from January 2021 to December 2022. The patients included 55 males and 51 females with an age of (32.6±8.2) years (range: 16 to 50 years). All patients were treated under all-inside arthroscopic, and were divided into Brostr?m-Gould surgery group ( n=54) and Brostr?m surgery group ( n=52) according to different ligament repair methods. At 3, 6, and 12 months after surgery, ankle inversion stress tests and anterior drawer tests were used to examine the stability of the ankle joint and observe gait. The American Orthopedic Foot and Ankle Society ankle hindfoot scale (AOFAS-AH) and Karlsson ankle function score (KAFS) were used to assess ankle function; Tegner score was used to assess the patient′s level of exercise; the foot and ankle outcome score(FAOS)(including score of symptoms,pain,function, daily living,function, sports and recreational activities (sport); quality of life (QOL) was used to assess the patient′s daily activity ability. Comparisons of data were made using independent sample t test, repeated measures analysis of variance, LSD- t multiple comparison method, χ2 test or Mann-Whitney U test. Results:All operations were successfully accomplished. All incisions healed by first intention, without evidence of postoperative complications of implant rejection, ligation reaction, and nerve and vessel injury. All patients were followed up at 3, 6, and 12 months after surgery. Ankle varus stress test and anterior drawer test were negative. No evidence supporting lateral ankle instability was obtained. All patients eventually regained normal gait. No patients underwent revision surgery. Repeated measurement analysis of variance showed that AOFAS-AH, Tegner, KAFS and FAOS scores in the Brostrom-Gould group and the Brostrom group were significantly higher than those before surgery ( P<0.01). The change trends of Tegner score and FAOS-sport score were significantly different between the two groups ( F=18.839, P<0.01; F=8.169, P=0.005). Multiple comparisons revealed that at 3-, 6-and 12-month follow-up, the Tegner scores (3 months: 3.7±0.5 vs. 3.3±0.5, t=-3.980, P<0.01; 6 months: 4.4±0.6 vs. 3.8±0.7, t=-4.792, P<0.01; 12 months: 5.8±0.9 vs. 5.1±1.0, t=-3.889, P<0.01), sport scores (3 months: 82.5±3.7 vs. 79.3±3.8, LSD- t=-4.316, P<0.01; 6 months: 88.5±4.9 vs. 85.7±3.8, LSD- t=-3.312, P=0.001;12 months: 90.1±4.3 vs. 88.2±5.1, LSD- t=-2.112, P=0.037) in the Brostr?m-Gould surgery group were higher than those in the Brostr?m surgery group, with statistical significances. Conclusions:Both Brostr?m-Gould and Brostr?m procedures under all-inside arthroscopic can make ankle stability and improve ankle function in the treatment of CLRAI. However, the former maybe shorten the time to return to exercise and achieve higher motor function.

Aim To explore the mechanism of oxidized lipoprotein(a)(oxLp(a))inducing pyroptosis of vascu-lar endothelial cells.Methods After incubating human umbilical vein endothelial cells(HUVEC)with 100 mg/L ox-Lp(a)for 24 hours,Western blot and RT-qPCR was used to detect pyroptosis related proteins,pro-inflammatory cytokines,mitochondrial related proteins NRF1,NRF2,PGC-1α and mitochondrial gene cytochrome b(CYTB),ELISA was used to detect the levels of inflammatory factors,scanning electron microscopy was used to detect cell membrane rup-ture,transmission electron microscopy was used to detect mitochondrial morphology,Hoechst33342/PI staining was used to detect cell apoptosis,MitoSOX probe was used to detect mitochondrial reactive oxygen species(mtROS),Flu-4AM probe was used to detect calcium ions,JC-1 probe was used to detect mitochondrial membrane potential(MMP),and Calcein AM staining was used to detect mitochondrial permeability transition pore(mPTP).Transfecting HUVEC with CYTB overexpressing lentivirus and analyzing its effects on oxLp(a)induced pyroptosis and mitochondrial function.Results After treatment with oxLp(a),the expression of NLRP3,pro-Caspase-1,Caspase-1,GSDMD and GSDMD-N proteins re-lated to pyroptosis were significantly increased(P＜0.05);the protein and mRNA levels of CYTB and pro-inflammatory cy-tokine IL-1β,IL-18 were significantly increased(P＜0.05).Small pores appeared on the cell membrane,the percentage of PI stained positive cells significantly increased(P＜0.05).OxLp(a)significantly inhibited the expression of mito-chondrial related proteins NRF1,NRF2 and PGC-1α,and the expression of mitochondrial gene CYTB,promoted an in-crease in mtROS generation,Ca2+overload,a decrease in ATP levels,a decrease in MMP,an increase in mPTP values,and abnormal mitochondrial morphology.After transfection with pHelper 2.0 lentivirus vector overexpressing CYTB,it was found that oxLp(a)induced HUVEC pyroptosis and mitochondrial morphological and functional abnormalities were par-tially reversed by overexpression of CYTB.Conclusion oxLp(a)promotes mitochondrial morphological and functional abnormalities and induces HUVEC pyroptosis by downregulating CYTB.

Objective:To compare the clinical efficacy of patients with chronic lateral rotational ankle instability(CLRAI) after all-inside arthroscopic lateral ligament augmentation procedure and Brostr?m procedure.Methods:This is a retrospective cohort study. The clinical and imaging data of 106 CLRAI patients were collected at the Xuzhou Central Hospital from January 2021 to December 2022. The patients included 55 males and 51 females with an age of (32.6±8.2) years (range: 16 to 50 years). All patients were treated under all-inside arthroscopic, and were divided into Brostr?m-Gould surgery group ( n=54) and Brostr?m surgery group ( n=52) according to different ligament repair methods. At 3, 6, and 12 months after surgery, ankle inversion stress tests and anterior drawer tests were used to examine the stability of the ankle joint and observe gait. The American Orthopedic Foot and Ankle Society ankle hindfoot scale (AOFAS-AH) and Karlsson ankle function score (KAFS) were used to assess ankle function; Tegner score was used to assess the patient′s level of exercise; the foot and ankle outcome score(FAOS)(including score of symptoms,pain,function, daily living,function, sports and recreational activities (sport); quality of life (QOL) was used to assess the patient′s daily activity ability. Comparisons of data were made using independent sample t test, repeated measures analysis of variance, LSD- t multiple comparison method, χ2 test or Mann-Whitney U test. Results:All operations were successfully accomplished. All incisions healed by first intention, without evidence of postoperative complications of implant rejection, ligation reaction, and nerve and vessel injury. All patients were followed up at 3, 6, and 12 months after surgery. Ankle varus stress test and anterior drawer test were negative. No evidence supporting lateral ankle instability was obtained. All patients eventually regained normal gait. No patients underwent revision surgery. Repeated measurement analysis of variance showed that AOFAS-AH, Tegner, KAFS and FAOS scores in the Brostrom-Gould group and the Brostrom group were significantly higher than those before surgery ( P<0.01). The change trends of Tegner score and FAOS-sport score were significantly different between the two groups ( F=18.839, P<0.01; F=8.169, P=0.005). Multiple comparisons revealed that at 3-, 6-and 12-month follow-up, the Tegner scores (3 months: 3.7±0.5 vs. 3.3±0.5, t=-3.980, P<0.01; 6 months: 4.4±0.6 vs. 3.8±0.7, t=-4.792, P<0.01; 12 months: 5.8±0.9 vs. 5.1±1.0, t=-3.889, P<0.01), sport scores (3 months: 82.5±3.7 vs. 79.3±3.8, LSD- t=-4.316, P<0.01; 6 months: 88.5±4.9 vs. 85.7±3.8, LSD- t=-3.312, P=0.001;12 months: 90.1±4.3 vs. 88.2±5.1, LSD- t=-2.112, P=0.037) in the Brostr?m-Gould surgery group were higher than those in the Brostr?m surgery group, with statistical significances. Conclusions:Both Brostr?m-Gould and Brostr?m procedures under all-inside arthroscopic can make ankle stability and improve ankle function in the treatment of CLRAI. However, the former maybe shorten the time to return to exercise and achieve higher motor function.

Objective To explore the effects of different endometrial preparation regimens on the pregnancy and obstetrical outcomes of single euploid blastocyst transfer after preimplantation genetic testing for aneuploidies(PGT-A).Methods The clinical data on patients with single euploid blastocyst transfer after PGT-A in our center from September 2015 to July 2021 were analyzed retrospectively.According to the different preparation regimens,the patients were divided into a natural cycle group(n = 80 cycles)and a hormone replacement cycle group(n = 259 cycles).The differences of pregnancy and obstetrical outcomes between the two groups were com-pared.Binary logistic regression was used to explore the influencing factors of pregnancy and obstetrical outcomes after PGT-A.The pregnancy outcomes of different endometrial preparation regimens were further explored by age stratification.Results As compared with that in the natural cycle group,the rate of high-quality blastocyst was significantly higher in the hormone replacement cycle group,but the live birth rate was lower and the abortion rate was higher(P<0.05).There was no statistical difference in the clinical pregnancy rate between the two groups.The incidence of cesarean section and macrosomia was higher in the hormone replacement cycle group than that in the natural cycle group,while the rate of low birth weight was lower,but there were no significant differences(P>0.05).Binary logistic regression showed that female age was an independent influencing factor of abortion.Female age and the days of blastocyst development were independent influencing factors of live birth.However,endometrial prepa-ration regimen was not a factor affecting pregnancy and obstetrical outcomes(P>0.05).The results of further analysis showed that the live birth rate in the natural cycle group was significantly higher than that in the hormone replacement cycle group,while the abortion rate in the natural cycle group was significantly lower than that in the hormone replacement cycle group for female patients aged over 35(P<0.05).Conclusions The endometrial preparation regimens did not affect the pregnancy and obstetrical outcomes of patients receiving single euploid blas-tocyst transfer after PGT-A.However,in the older patients,the natural cycle regimen can obtain a higher live birth rate and a lower abortion rate.

OBJECTIVE: To explore the biomarkers of tinnitus in vestibular schwannoma patients using electroencephalographic (EEG) microstate technology. METHODS: The EEG and clinical data of 41 patients with vestibular schwannoma were collected. All the patients were evaluated by SAS, SDS, THI and VAS scales. The EEG acquisition time was 10-15 min, and the EEG data were preprocessed and analyzed using MATLAB and EEGLAB software package. RESULTS: Of the 41 patients with vestibular schwannoma, 29 patients had tinnitus and 12 did not have tinnitus, and their clinical parameters were comparable. The average global explanation variances of the non-tinnitus and tinnitus groups were 78.8% and 80.1%, respectively. The results of EEG microstate analysis showed that compared with those without tinnitus, the patients with tinnitus had an increased frequency (P=0.033) and contribution (P=0.028) of microstate C. Correlation analysis showed that THI scale scores of the patients were negatively correlated with the duration of microstate A (R=-0.435, P=0.018) and positively with the frequencies of microstate B (R=0.456, P=0.013) and microstate C (R=0.412, P=0.026). Syntax analysis showed that the probability of transition from microstate C to microstate B increased significantly in vestibular schwannoma patients with tinnitus (P=0.031). CONCLUSION EEG microstate features differ significantly between vestibular schwannoma patients with and without tinnitus. This abnormality in patients with tinnitus may reflect the potential abnormality in the allocation of neural resources and the transition of brain functional activity.
Humans ; Neuroma, Acoustic/complications* ; Electroencephalography ; Patients ; Probability

Metastasis is the main cause of cancer-related death. Growing evidence has shown that changes in glucose metabolism in nasopharyngeal carcinoma cells affect the invasion and metastasis of nasopharyngeal carcinoma through many pathways. This review summarizes the molecular mechanism underlying abnormal glucose metabolism in nasopharyngeal carcinoma cells and analyzes its relationship with the invasion and metastasis of nasopharyngeal carcinoma, including aerobic glycolysis, aerobic oxidation, and pentose phosphate pathway. The aim is to provide novel approaches using the relationships among glucose metabolism, invasion, and metastasis in the targeted therapy of nasopharyngeal carcinoma.