ObjectiveTo explore the relationship between the occupational noise exposure and arteriosclerosis in mechanical manufacturing workers. Methods A total of 453 employees of a machinery manufacturing enterprise were selected as the study subjects using the judgment sampling method. The noise exposure levels in their workplaces were measured, and their cumulative noise exposure (CNE) was assessed based on the type of job-noise exposure matrix and occupational hazard exposure history. Pure-tone audiometry was performed on the research subjects, and their brachial-ankle pulse wave velocity (baPWV) was measured. Results The CNE was (91±11) dB(A) per year and the median baPWV was 1 278.0 cm/s in the research subjects. The results of the generalized linear regression model analysis showed that for every one dB(A) per year increase in CNE, the baPWV of the general population increased by 0.20% ［95% confidence interval (CI) 0.10%-0.30%, P<0.01］, with an increase of 0.17% in males (95%CI 0.06%-0.28%, P<0.01) and 0.28% in females (95%CI 0.07%-0.49%, P<0.01). Using the hearing loss as an outcome indicator for high intensity noise exposure, the results showed that baPWV increased by 7.04% (95%CI 2.42%-11.87%, P<0.01) in individuals with bilateral hearing loss, and by 9.84% and 6.53% (95%CI 3.07%-17.07% and 2.13%-11.11%, all P<0.01) in individuals with elevated high-frequency hearing thresholds in both ears and in either ear, respectively. There was no significant association in elevated speech-frequency hearing thresholds and arteriosclerosis (P>0.05). Conclusion Occupational noise exposure may increase the risk of arteriosclerosis.

We have adopted various smart tools and applied multiple teaching models to smoothly carry out our on-line teaching. Aiming at encouraging students' self-learning and independent thinking, the first task is to cultivate students' self-learning ability and independent thinking way of clinical microbiology. Our online teaching model is based on the asynchronous small private online course (SPOC) of the Chinese University MOOC, the core part of our teaching model, and supplemented by the Sojump questionnaire test and WeChat, the inter-action channels among teachers and students. All of these build up an integrated teaching system which fully embodies the "student-oriented" teaching concept and pushes forward the promotion and application of online teaching in college specialized courses.

Methods: Total 106 diabetic patients who had undergone PKP and had received anti-osteoporosis treatment for osteoporotic vertebral compression fracture were enrolled and allocated into the following two groups: group I (n=52, zoledronic acid) and group II (n=54, zoledronic acid plus teriparatide). The operating time, bone cement volume, and complications related to anti-osteoporosis treatment or PKP, if any, were recorded. The Visual Analog Scale (VAS) score and Oswestry Disability Index (ODI) were assessed at admission, at discharge, and at the final follow-up. Dual-energy X-ray absorptiometry scan of the hip for the measurement of the bone mineral density (BMD) was performed preoperatively and at the final follow-up for all the patients. Results: There was no significant difference in the age, body mass index, bone cement volume, or follow-up time of the groups. The mean follow-up duration was 22.5±1.6 months. All the patients had improved VAS and ODI, and group II had significantly better clinical outcomes than group I. All the patients had increased BMD at the latest follow-up, while group II exhibited significantly more improvement. The prevalence of NVF was lower in group II (11.5% vs. 7.4%, p=0.523). Male patients had a higher prevalence of NVF although the difference was not statistically significant. Conclusions Combination therapy with zoledronic acid and teriparatide could improve the clinical outcomes, and BMD and had the potential to reduce NVF in diabetic patients following PKP.

Objective:To investigate the prognostic factors of patients with low-frequency type of sudden sensorineural hearing loss.Methods:From February 2017 to February 2019, adult patients with unilateral low-frequency type of sudden sensorineural hearing loss in Department of Otological Medicine, Shandong Provincial ENT Hospital, Shandong University were selected. All patients were examined by audiology, vestibular function evaluation, imaging examination and serum thyroid function test; the same treatment program was given, the curative effect was recorded and followed up for more than 3 months. SPSS 20.0 software was used to analyze concomitant symptoms (tinnitus, ear tightness, echo, rotatory vertigo), degree of deafness, inducement of deafness, basic disease, vestibular function (caloric test), electrocochleogram, inner ear gadolinium enhanced MRI radiography and thyroid function on prognosis of patients.Results:Among the 155 patients, 76 cases were cured (49.0%), 1 case was markedly effective (0.6%), 19 cases were effective (12.3%), and 59 cases were ineffective (38.1%). The total effective rate was 61.9%. Among them, 24 cases (15.5%) had hearing fluctuations during follow-up, and 1 case (0.6%) developed Meniere′s disease. Univariate analysis showed that vestibular function, electrocochleogram and inner ear MRI were correlated with prognosis. Multivariate logistic analysis showed that ear tightness, vestibular function, electrocochleogram and inner ear MRI were correlated with the prognosis of the patients. The two analyses showed that tinnitus, echo, rotational vertigo, degree of deafness, predisposing factors and underlying diseases were not significantly correlated with the prognosis of the patients (all P>0.05). Rotational vertigo was closely related to gender, and women had a high incidence. There was a significant correlation between the degree of deafness and prognosis in patients with course of less than 1 week ( P<0.05). The abnormal rate of vestibular function in patients with course of disease ≤ 1 week was significantly different from that>1-≤2 and>2-≤4 weeks ( P<0.05). The rate of abnormal thyroid function was significantly higher than that of normal people ( P<0.05), but there was no significant correlation between thyroid dysfunction and hearing prognosis (χ 2=0.009, P=0.923) . Conclusions:The prognosis of low-frequency sudden sensorineural hearing loss is not related to clinical symptoms, inducements, underlying diseases and serological abnormalities of thyroid function, but the degree of deafness is positively related to the prognosis within 1 week from onset. Abnormal thyroid function is one of the risk factors of happening with low-frequency descending sudden deafness. Abnormal vestibular caloric test, electrocochleogram and endolymph hydrops are the factors of poor prognosis.

The objective of this study was to investigate the regulatory effects of TGF-β1 on CCL3/4 expression and inflammation-related pain during intervertebral disc degeneration (IVDD). TGF-β1 and CCL3/4 expression patterns in different degenerative human nucleus pulposus (NP) tissues were measured by qPCR and immunohistochemistry (IHC), and the effects of TGF-β1 on CCL3/4 expression were measured by qPCR, ELISA and immunofluorescence. The roles of NF-κB and MAPK in TGF-β1-mediated CCL3/4 promoter activity were studied using siRNAs, western blotting and qPCR. After establishing an IVDD rat model in vivo, we administered intradiscal injections of TGF-β1. The effects of TGF-β1 on IVDD were determined by MRI and histological analyses, and the effects of TGF-β1 on dorsal root ganglion (DRG) inflammation and pain development were determined by IHC staining and pain-behavior testing, respectively. TGF-β1 and CCL3/4 expression was elevated in degenerative NP tissue. CCL4 expression was significantly inhibited by TGF-β1 treatment. Pharmacological inhibition or siRNA knockdown of the ERK1/2 signaling attenuated TGF-β1-mediated suppression of CCL4 expression. In vivo, TGF-β1 injection inhibited the development of degenerative features in the IVDD model. Moreover, TGF-β1 prevented the inflammatory response and pain development. The results of this study show that TGF-β1 downregulates CCL4 expression through ERK1/2 signaling activation in NP cells. Furthermore, TGF-β1 can prevent degenerative processes, inhibit inflammatory responses in the DRG and prevent pain development in the IVDD rat model. The results of this study indicate that TGF-β1 may represent a therapeutic target for the control of inflammation-related pain associated with IVDD.
Animals ; Blotting, Western ; Diagnosis-Related Groups ; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique ; Ganglia, Spinal ; Humans ; Immunohistochemistry ; Inflammation ; Intervertebral Disc Degeneration* ; Intervertebral Disc* ; Magnetic Resonance Imaging ; Models, Animal* ; Rats* ; RNA, Small Interfering

OBJECTIVETo analyze factors relevant to revisional tympanomastoid surgery for chronic otitis media(COM).

METHODSThe clinical data of 159 patients (159 ears), who exhibited either wet ear or relapsed after the initial operation, and were subjected to revisional tympanomastoid surgery, were retrospectively analyzed in this study. Of those 159 consecutive patients, 85 were males and 74 were females, aged 11-64 years, with a median age of 36 years old. The situations in terms of intra-operative findings, surgical procedures, change dressing post-operation, dry ear time, and the improvement of aural ability during the second operation, were recorded and analyzed.

RESULTSThe second surgery found that, of those 159 patients underwent the re-operation, 67 presented with cholesteatoma and 92 had no cholesteatoma. In addition, the inadequate skeletonization and insufficient opening for mastoid cavity accounted for 70.4% (112/159) of all previous operations, the external auditory canal stenosis for 98.7% (157/159), the high facial ridge leading to insufficient drainage for 61.0% (97/159), the lesion in tympanic ostium of Eustachian tube for 34.6% (55/159), the insufficient drainage due to inappropriate post-operating dressing for 5.0% (8/159), the postauricular incision for 30.8% (49/159), and the endaural incision for 69.2% (110/159). As for the re-operation of the canal wall down mastoidectomy, tympanoplasty plus plastic repairing of cavity of concha were performed in 94 cases, the modified Bondy plus plastic repairing of cavity of concha in four cases, the radical mastoidectomy plus plastic repairing of cavity of concha in 59 cases, and the simple cleaning for mastoid cavity in two cases. Since one to two weeks after the revisional operations, the post-operating dressing was performed with aid of microscopy once a week on average. The average dry ear time ranged from 2 to 6 weeks (median=3 weeks). During a period of 6-93 months for the follow-up, all patients presented with dry ears. The epithelialization of the operating cavity was well and the tympanic membranes were integrity. Neither granulation tissue nor cholesteatoma was found to reoccur. Both pure tone hearing thresholds and air-bone gap decreased in 87 cases after the revisional operation, with statistically significant different in comparison to those two parameters before the operation (P<0.05).

CONCLUSIONThe primary causes responsible for the wet ear or reoccurrent cholesteatoma after tympanomastoid surgery may be related to the improper operation procedures and selection of incision, the non-standard operation, inexhaustive removal of pathological tissues, as well as the irregular postoperation change dressing, and other factors.

Adolescent ; Adult ; Child ; Cholesteatoma, Middle Ear ; surgery ; Chronic Disease ; Ear Auricle ; surgery ; Eustachian Tube ; pathology ; Female ; Humans ; Male ; Mastoid ; surgery ; Middle Aged ; Otitis Media ; surgery ; Postoperative Period ; Reconstructive Surgical Procedures ; Reoperation ; Retrospective Studies ; Treatment Outcome ; Tympanic Membrane ; pathology ; surgery ; Tympanoplasty ; Young Adult

Objective To investigate the prognostic factors relevant to acute low-tone sensorineural hearing loss (ALHL).Methods 196 adult ALHL patients,including 82 males and 114 females with mean age of (43.1 ± 14.3)years old were included.All patients received the same therapy and were evaluated the curative effect.To evaluate the impact factors on the prognosis of hearing,inclusive of age,gender,time delay before the first visit,degree of deafness,vestibular function,electrocochleogram,and the serum levels of thyroxines by SPSS 18.0 software.Results Of those 196 patients with ALHL,124 (63.3％) were recovery,5(2.6％) were excellent better,42(21.4％) were better,and 25 (12.8％) were poor,with a total effective rate of 87.2％.Among 15 (12.1％) who recurred the hearing loss,2 developed into Meniere's disease during the follow-up.The mean age of patients with poor hearing effect was significantly older than that of other patients (P ＜ 0.05).No relativity was found between gender and hearing curative effect.There existed a statistical difference in total effective rate among subjects with different histories (P ＜ 0.05).In addition,the recovery rate was significantly different between groups,i.e.,the course of disease was less than 14 days,between 14 days and 6 months,and between 6 months and 2 years (P ＜0.05).There was no statistical significance in total effective rate among different degrees of deafness (P ＞ 0.05).However,in term of the recovery rate,the difference was statistical significance (P ＜ 0.05).The recovery rate in patients with mild hearing loss was higher than that in middle or heavy hearing loss (both P ＜ 0.05).Among patients with mild deafness,the recovery rate in patients whose history was less than 3 months was significantly higher than that more than 3 months (P ＜ 0.05).For moderate deafness patients,the recovery rate in patients whose history was less than 7 days was significantly higher than that more than 1 month (P ＜ 0.05).There were statistical differences in hearing effect of 130 (66.3％) patients with abnormal vestibular function in comparison to that with normal vestibular function (x2 =15.1,P ＜ 0.05).There were 17(8.7％) patients with abnormal electrocochleogram combined with abnormal vestibular function,and the hearing effects were all poor.There were 45 (23.0％) patients with abnormal thyroxine levels in serum,which was significant higher than that in health adults of 5.9％ (x2 =7.26,P ＜ 0.01).There was no significant difference in hearing prognosis between patients with abnormal and normal thyroxine levels (x2 =2.51,P ＞ 0.05).Conclusions With respect to ALHL,the hearing effect is associated significantly with the history.The severity of hearing loss is negative prognostic factor for hearing recovery.Age,vestibular function,and electrocochleogram might predict hearing recovery.Gender and thyroxine levels couldn't predict the hearing prognosis,although there is a high incidence rate in patients with ALHL.

Objective To evaluate the feasibility,safety and efficacy of ESD for precancerous lesions and early cancer of remnant stomach after partial gastrectomy.Methods ESD was performed in 11 cases of high grade intraepithelial neoplasia/early cancer of remnant stomach.The short-term and long-term indices including time of procedure,complication,En Bloc resection rate,R0resection rate,local recurrence rate as well as lymph node metastasis were recorded and analysed.Results ESD was completed in all patients with only one case of delayed massive bleeding which was controlled by endoscopy successfully.Average procedure time,En Bloc resection rate,R0 resection rate were 85.5 minutes,100％ and 90％,respectively.No local recurrence or lymph node metastasis was detected during post-ESD surveillance (15 ～ 51 months).Conclusion High grade intraepithelial neoplasia and early cancer of remnant stomach after partial gastrectomy might be indication for ESD because of its safety and definite effect.Additionally,careful management of the fibre tissue is the key to procedure success.

Objective We aimed to determine whether blood lipid parameters were related to the severity and the prognosis of idiopathic sudden sensorineural hearing loss(ISSNHL) patients.Methods A retrospective cohort study of 258 patients with ISSNHL from December 2013 to February 2015.The distribution characteristics of lipids [total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), Non-high-density lipoprotein cholesterol (Non-HDL-C), et al] in different degree of deafness (mild, moderate, severe, and profound), hearing curve types (low frequency, high frequency, full range frequency, and completely deafness type) and prognosis of recovery (complete, partial, slight, and no recovery) were analyzed by IBM SPSS 22.0 ANOVA analysis, chi square test and multiple regression analysis.Results TG level in mild hearing loss group was significantly lower than that in severe and profound hearing loss group (P =0.017 and P =0.007).There were no correlation between curve types and lipid indexes (P ＞ 0.05).Non-HDL-C level was elevated in no recovery and slight recovery groups (P =0.026 and 0.021).TC levels in partial recovery group and no recovery group were significantly higher than that in the complete recovery group (P =0.049 and 0.042) ,TG was higher in slight recovery group (P =0.014).Conclusions TG has significant correlation with the severity of hearing loss.There are negative correlations between hearing recovery and Non-HDL-C, TC and TG levels.Non-HDL-C, TC and TG might be a prognostic factor for treatment outcome in ISSNHL patients.

ObjectiveTo explore the role of activation and expression of absent in melanoma 2 (AIM2) in pathogenesis of hepatitis B virus (HBV) associated glomerulonephritis (HBV-GN).MethodsFifty-four patients with HBV-GN were recruited into the investigational group,and 25 patients with chronic glomerulonephritis (CGN) and 6 patients with chronic hepatitis B (CHB) were included as negative control group and positive control group,respectively.Immunohistochemistry was used to detect AIM2,Caspase-1 and interleukin (IL)-1β expressions in both kidney tissues from the investigational group and negative control group and liver tissues from positive control group.The differences between groups were compared by chi-square test,and the correlation analysis was conducted by Spearman correlation test.ResultsThe positive expression rates of AIM2 in 54 patients of HBV-GN group and 25 of CGN group were 81.4 ％ and 4.0％,respectively (x2 =38.746,P＜ 0.01).AIM2 was found to be expressed in all 6 CHB patients.In HBV-GN group,the expression of AIM2 was positively correlated with Caspase-1 (rs =0.444,P＜0.01),and the expression of IL-1β was also positively correlated with Caspase-1 (rs =0.515,P＜0.01 ).In HBV-GN group,the expression of AIM2 in patients with HBV DNA≥1 ×105 copy/mL was significantly higher than that in those with HBV DNA＜1 × 105 copy/mL (x2 =6.097,P＜0.05).ConclusionThe activation of AIM2 may play a role in the pathogenesis of HBV-GN through Caspase-1 activation and inflammatory factor IL-1β release.