Evaluation of inner ear damage by mastoid drilling with measurement of serum prestin (SLC26A5) levels

Abstract Objective The objective of this study is to demonstrate any inner ear injury caused by drilling in mastoid surgery with prestin, outer hair cell motor protein specific to the cochlea. Methods The patients with chronic otitis media requiring mastoidectomy (n= 21) and myringoplasty (n= 21) were included. Serum prestin level obtained from blood samples was measured before surgery and on postoperative days 0, 3, and 7 using Human Prestin (SLC26A5) ELISA Kit. All patients underwent the Pure Tone Audiometry (PTA) test before surgery and on the postoperative 7th day. The drilling time was also recorded for all patients who underwent mastoidectomy. Results In both mastoidectomy and myringoplasty groups, the postoperative serum prestin levels increased on days 0 and 7 (pday-0 = 0.002, pday-7 = 0.001 and pday-0 = 0.005, pday-7 = 0.001, respectively). There was no significant difference in the serum prestin levels between the two groups, postoperatively. The PTA thresholds at day 7 did not change in either group. A significant decline at 2000 Hz of bone conduction hearing threshold in both groups and a decline at 4000 Hz in the myringoplasty group were found. There was no correlation between the drilling time and the increase of prestin levels in the postoperative day 0, 3, and 7. Conclusion Our results showed that mastoid drilling is not related to a significant inner ear injury. Although the myringoplasty group was not exposed to drill trauma, there was a similar increase in serum prestin levels as the mastoidectomy group. Also, a significant decline at 2000 Hz of bone conduction hearing threshold in both groups and a decline at 4000 Hz in the myringoplasty group were found. These findings suggest that suction and ossicular manipulation trauma can lead to an increase in serum prestin levels and postoperative temporary or permanent SNHL at 2000 and 4000 Hz. Level of evidence: Level-4.

Detailed analysis of inner ear malformations in CHARGE syndrome patients - correlation with audiological results and proposal for computed tomography scans evaluation methodology

Abstract Objectives The aim was to describe the spectrum of inner ear malformations in CHARGE syndrome and propose a Computed Tomography (CT) detailed scan evaluation methodology. The secondary aim was to correlate the CT findings with hearing thresholds. Methods Twenty ears of ten patients diagnosed with CHARGE syndrome were subjected to CT analysis focusing on the inner ear and internal acoustic canal. The protocol used is presented in detail. ASSR results were analyzed and correlated with inner ear malformations. Results Cochlear hypoplasia type III was the most common malformation found in 12 ears (60%). Cochlear hypoplasia type II, aplasia with a dilated vestibule, and rudimentary otocyst were also identified. In 20%, no cochlear anomaly was found. The lateral Semicircular Canal (SCC) absence affected 100% of ears, the absence of the posterior SCC 95%, and the superior SCC 65%. Better development of cochlea structures and IAC correlated significantly with the lower hearing thresholds. Conclusion This study demonstrated that rudimentary SCC or a complete absence of these SCCs was universally observed in all patients diagnosed with CHARGE syndrome. This finding supports the idea that inner ear anomalies are a hallmark feature of the CHARGE, contributing to its distinct clinical profile. The presence of inner ear malformations has substantial clinical implications. Audiological assessments are crucial for CHARGE syndrome, as hearing loss is common. Early detection of these malformations can guide appropriate interventions, such as hearing aids or cochlear implants, which may significantly improve developmental outcomes and communication for affected individuals. Recognizing inner ear malformations as a diagnostic criterion presents implications beyond clinical diagnosis. A better understanding of these malformations can advance the knowledge of CHARGE pathophysiology. It may also help guide future research into targeted therapies to mitigate the impact of inner ear anomalies on hearing and balance function. Level of evidence: 4.

The Connotation and Clinical Significance of “Spleen Governs Time” based on the Zangxiang （藏象） Time-space View / 中医杂志

There are different views on the theory of “spleen governs time”， which is still a hot spot in the study of Zangxiang （藏象） theory. Based on Zangxiang time-space view， it is found that the thinking mode of the spleen governing time theory follows space-time logic. It is believed that the different time views of the spleen governing time are all formed based on the space view that the spleen belongs to earth and resides in the center， and the zang time theory is developed with the unified time and space logic. Guided by Zangxiang time-space view， the origin of the spleen belonging to earth and residing in the center is traced， and the theoretical connotation and its clinical application of spleen governing time under different time-space logic are explored with reference to the four season and five zang theory， five season and five zang theory， six season and six zang theory， and eight season and eight zang theory.

Effects of low concentration atropine on macular microcirculation in children with different degrees of myopia / 中国临床药理学与治疗学

AIM: To investigate the effects of 0.01% atropine eye drops on macular blood flow density and retinal thickness in children with different degrees of myopia. METHODS: This was a prospective case-control study. Sixty-four patients (112 eyes) diagnosed with myopia for the first time with 0.01% atropine eye drops before and 6 months after medication were investigated with the uncorrected distance visual acuity (UCVA), axial length (AL), spherical equivalent (SE), macular ganglion cell-inner plexiform layer thicknes (mGCIPL) using slit lamp examination and optical coherence tomography (OCT), vascular density in the macular area and the area of the avascular in the fovea using optical coherence tomography angiography (OCTA) . Changes in various indicators before and after medication were compared. RESULTS: Compared with before medication, the AL of the three groups of myopia patients increased significantly (P0.05). The difference was statistically significant between the moderate myopia group and the high myopia group (P0.05). After 6 months of medication, the central circle macular vessel density (cCVD) increased in the low myopia group and moderate myopia group (P0.05). Before and after medication, there was no significant difference in outer circle macular vessel density (oCVD), inner circle macular vessel density (iCVD), and whole circle macular vessel density (wCVD) among the three myopia groups (P>0.05). The increase in mGCIPL was statistically significant in the low myopia group (P0.05). There was no significant difference in foveal avascular zone (FAZ) among the three myopia groups before and after medication (P>0.05). There was no correlation between CVD, AL, and SE in the three myopia groups (P>0.01). There was a low correlation between CVD and mGCIPL in the low myopia group (r=0.442, P0.01). CONCLUSION: 0.01% atropine can significantly reduce the rate of axial and refractive growth in children with low to moderate myopia, increase the density of central macular vessels, and increase the thickness of mGCIPL in children with low to moderate myopia.

cAMP-Epac1 signaling is activated in DDAVP-induced endolymphatic hydrops of guinea pigs

Abstract Objective To explore whether Cyclic Adenosine Monophosphate (cAMP)-Epac1 signaling is activated in 1-Desamino-8-D-arginine-Vasopressin-induced Endolymphatic Hydrops (DDAVP-induced EH) and to provide new insight for further in-depth study of DDAVP-induced EH. Methods Eighteen healthy, red-eyed guinea pigs (36 ears) weighing 200-350 g were randomly divided into three groups: the control group, which received intraperitoneal injection of sterile saline (same volume as that in the other two groups) for 7 consecutive days; the DDAVP-7d group, which received intraperitoneal injection of 10 mg/mL/kg DDAVP for 7 consecutive days; and the DDAVP-14d group, which received intraperitoneal injection of 10 μg/mL/kg DDAVP for 14 consecutive days. After successful modeling, all animals were sacrificed, and cochlea tissues were collected to detect the mRNA and protein expression of the exchange protein directly activated by cAMP-1 and 2 (Epac1, Epac2), and Repressor Activator Protein-1 (Rap1) by Reverse Transcription (RT)-PCR and western blotting, respectively. Results Compared to the control group, the relative mRNA expression of Epac1, Epac2, Rap1A, and Rap1B in the cochlea tissue of the DDAVP-7d group was significantly higher (p< 0.05), while no significant difference in Rap1 GTPase activating protein (Rap1gap) mRNA expression was found between the two groups. The relative mRNA expression of Epac1, Rap1A, Rap1B, and Rap1gap in the cochlea tissue of the DDAVP-14d group was significantly higher than that of the control group (p< 0.05), while no significant difference in Epac2 mRNA expression was found between the DDAVP-14d and control groups. Comparison between the DDAVP-14d and DDAVP-7d groups showed that the DDAVP-14d group had significantly lower Epac2 and Rap1A (p< 0.05) and higher Rap1gap (p < 0.05) mRNA expression in the cochlea tissue than that of the DDAVP-7d group, while no significant differences in Epac1 and Rap1B mRNA expression were found between the two groups. Western blotting showed that Epac1 protein expression in the cochlea tissue was the highest in the DDAVP-14d group, followed by that in the DDAVP-7d group, and was the lowest in the control group, showing significant differences between groups (p< 0.05); Rap1 protein expression in the cochlea tissue was the highest in the DDAVP-7d group, followed by the DDAVP-14d group, and was the lowest in the control group, showing significant differences between groups (p< 0.05); no significant differences in Epac2 protein expression in the cochlea tissue were found among the three groups. Conclusion DDAVP upregulated Epac1 protein expression in the guinea pig cochlea, leading to activation of the inner ear cAMP-Epac1 signaling pathway. This may be an important mechanism by which DDAVP regulates endolymphatic metabolism to induce EH and affect inner ear function. Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence Level 5.

Papillomacular bundle sparing versus conventional internal limiting membrane peeling for idiopathic macular hole ?400 µm

Purpose: To compare the outcomes of papillomacular bundle (PMB) sparing internal limiting membrane (ILM) peeling (group LP) and conventional ILM peeling (group CP) for treatment of idiopathic macular hole (MH) of ?400 ?m. Methods: Fifteen eyes were included in each group. In group CP, conventional 360° peeling was done, while in group LP, ILM was spared over PMB. The changes in peripapillary retinal nerve fiber layer (pRNFL) thickness and ganglion cell?inner plexiform layer (GC?IPL) thickness were analyzed at 3 months. Results: MH was closed in all with comparable visual improvement. Postoperatively, retinal nerve fiber layer (RNFL) was significantly thinner in the temporal quadrant in group CP. GC?IPL was significantly thinner in the temporal quadrants in group LP, whereas it was comparable in group CP. Conclusion: PMB sparing ILM peeling is comparable to conventional ILM peeling in terms of closure rate and visual gain, with the advantage of less retinal damage at 3 months.

Hipoacusia Neurosensorial en el síndrome de Alport: Una revisión Sistemática / Sensorineural hearing loss in Alport syndrome: A systematic review

El Síndrome de Alport (SA) es un desorden genético originado por mutaciones en el colágeno tipo IV que es el constituyente principal de las membranas basales. Clínicamente, se caracteriza por nefropatía hereditaria progresiva. En el oído interno, el colágeno IV se encuentra ubicado en la membrana basilar y en el ligamento espiral, por lo que las mutaciones en los genes codificadores provocan hipoacusia de tipo neurosensorial. La presente investigación tiene por objetivo caracterizar el comportamiento de la pérdida de audición en personas diagnosticadas con SA, mediante la revisión de estudios de la literatura. Se realizó una búsqueda en bases de datos con los criterios de inclusión establecidos, incorporando un total de siete artículos para su análisis. Teniendo en cuenta los hallazgos de las diversas investigaciones recopiladas, se concluye que la pérdida auditiva secundaria al SA es heterogénea. No hay un patrón común de presentación pues depende del modo de herencia y del tipo de mutación de la enfermedad, además su grado de severidad y progresión va paralelo a la función renal. Sin embargo, independientemente del momento en que se manifieste el deterioro auditivo, es de vital importancia una intervención audiológica oportuna, con el fin de detectar la hipoacusia lo más temprano posible, hacer un seguimiento riguroso de la funcionalidad auditiva y, en caso de ser necesario, adaptar ayudas auditivas de acuerdo con las necesidades comunicativas del paciente

Alport Syndrome (AS) is a genetic disorder originated by mutations in the collagen type IV which is the main constituent of the basal membranes. Clinically, is characterized by progressive hereditary nephropathy. In the inner ear, the collagen IV is ubicated in the basilar membrane and in the spiral ligament, whereby the mutations in the codifier gens, cause neurosensorial hearing loss. The aim of this investigation is to characterize how hearing loss behaves in people diagnosed with AS, by presenting a reviewing of reported studies in the literature. A database search was performed with the established criteria of inclusion and a total of seven articles were incorporated for its analysis. Considering the findings by the several investigations collected the conclusion is that the secondary hearing loss to AS is heterogenous. There is no a common pattern of presentation as it depends on the mode of heredity and the type of mutation of the disease, and besides of the degree of severity and progression that goes along with the renal function. Nevertheless, regardless of the moment that the auditive impair appears, it is of vital importance an opportune audiological intervention, aiming at detecting an alteration as soon as possible, make a rigorous tracking of the auditive functionality and, if necessary, incorporate hearing aids in accordance with the communicative needs of the patients

Medicinal plant resources in Inner Mongolia autonomous region of China and Mongolia: a comparative study / 中国中药杂志

Inner Mongolia autonomous region of China and Mongolia are the primary regions where Chinese and Mongolian medicine and its medicinal plant resources are distributed. In this study, 133 families, 586 genera, and 1 497 species of medicinal plants in Inner Mongolia as well as 62 families, 261 genera, and 467 species of medicinal plants in Mongolia were collected through field investigation, specimen collection and identification, and literature research. And the species, geographic distribution, and influencing factors of the above medicinal plants were analyzed. The results revealed that there were more plant species utilized for medicinal reasons in Inner Mongolia than in Mongolia. Hotspots emerged in Hulunbuir, Chifeng, and Tongliao of Inner Mongolia, while there were several hotspots in Eastern province, Sukhbaatar province, Gobi Altai province, Bayankhongor province, Middle Gobi province, Kobdo province, South Gobi province, and Central province of Mongolia. The interplay of elevation and climate made a non-significant overall contribution to the diversity of plant types in Inner Mongolia and Mongolia. The contribution of each factor increased significantly when the vegetation types of Inner Mongolia and Mongolia were broadly divided into forest, grassland and desert. Thus, the distribution of medicinal plant resources and vegetation cover were jointly influenced by a variety of natural factors such as topography, climate and interactions between species, and these factors contributed to and constrained each other. This study provided reference for sustainable development and rational exploitation of medicinal plant resources in future.

Exploration of the theory of Renying Cunkou pulse method recorded in the Yellow Emperor's Inner Canon / 中国针灸

Renying Cunkou pulse method is one of the classical pulse methods of acupuncture-moxibustion in the Yellow Emperor's Inner Canon, which is also a classical clinical paradigm for diagnosing and treating meridian diseases in the ancient times. Based on comprehensive review of literature and clinical practice, this paper reveals that this method compares the size of the neck Renying pulse with hand Cunkou pulse to determine the change of yin-yang and excess-deficiency identifying the affected meridians. The jing-well, xing-spring, and shu-stream points of the surface and interior meridians of affected meridians are mainly selected to regulate deficiency and excess through reinforcing and reducing methods. The Renying Cunkou pulse method possesses a simple and practical medical theory, easy diagnostic procedure, and clear meridian selection for acupuncture-moxibustion treatment, warranting further exploration of its essence and diagnostic therapeutic principles.

Clinical Treatment Ideas of “Treatment with Combination of Diverse Methods and Prescriptions” in TheInner Canon of Yellow Emperor （《黄帝内经》） / 中医杂志

As a basic source for the theoretical system of traditonal Chinese medicine （TCM）， the Inner Canon of Yellow Emperor （《黄帝内经》） made the point of “treatment with combination of diverse methods and prescriptions”，which is one of the characteristics of TCM in treating diseases. This paper discussed the therapeutic idea of “diverse methods and prescriptions” from five dimensions， including time， population， regions， diseases， and treatments， and proposed that “combined treatment” is an effective measure to embody the idea of “diverse methods and prescriptions”. That is to say， by taking the combination of the concept of holism and syndrome differentiation and treatment as the starting point， combining pharmacological and non-pharmacological therapies， and treating both internal and external diseases through multiple ways and methods， the goal to treat the disease at the root， and keep yin at peace and yang compact can be achieved. Finally， it is suggested to guide the clinical practice with “treatment with combination of diverse methods and prescriptions”， providing new ideas for clinical diagnosis and treatment.

Equity analysis and policy suggestions for medical and health resource allocation in Inner Mongolia Autonomous Region / 上海预防医学

ObjectiveTo analyze the equity of medical and health resource allocation in 12 cities of Inner Mongolia Autonomous Region and to provide policy suggestions for further optimizing the allocation of medical and health resources. MethodsBased on two dimensions of geography and population， a comprehensive evaluation of the equity of medical and health resource allocation was conducted using location entropy， health resource density index （HRDI）， entropy-weighted TOPSIS method， and GIS spatial analysis. ResultsLocation entropy showed that the allocation of medical resources in each league city exceeded or approached 1 in the population dimension， but less than 1 in the geography dimension. HRDI revealed that the number of health institutions in Tongliao City was 8.3 times that of Alxa League； the number of beds， health technical personnel， practicing （assistant） physicians， and registered nurses in Wuhai City was 20.3 times， 18.2 times， 15.2 times， and 22.7 times that of Alxa League. The entropy-weighted TOPSIS method showed that the top three weighted indicators were registered nurses （24.14%）， health technical personnel （22.63%）， and practicing （assistant） physicians （21.13%）. Allocation of medical resources in Hulunbuir City， Xilinguole League， and Alashan League was significantly inequitable； GIS spatial analysis showed that the equity of medical resource allocation exhibited a decreasing distribution pattern from the central region to the western and eastern regions. ConclusionThere is a significant disparity in the equity of medical and health resource allocation among various leagues and cities， with resource allocation in the population dimension being better than in the geographical dimension. Allocation of medical and health human resources should be strengthened.

A case report of middle ear cholesteatoma complicated with labyrinthine fistulaand delayed endolymphatic hydrops / 临床耳鼻咽喉头颈外科杂志

Delayed endolymphatic hydrops （DEH） is a rare disease that causes vertigo and is often misdiagnosed as other vertigo diseases. This article reports on a patient with vertigo who was easily misdiagnosed. The patient was a middle ear cholesteatoma complicated by labyrinthine fistula （LF）; however, his vertigo was episodic vertigo, which could not be explained solely by LF causing labyrinthitis. The possibility of endolymphatic hydrops was suspected, which was confirmed by inner ear magnetic resonance gadolinium imaging. This is the first reported case of middle ear cholesteatoma complicated by LF and DEH. The patient underwent surgical resection of the cholesteatoma and three semicircular canal obstructions at the same time. During two years postoperative follow-up, the patient did not experience a recurrence of vertigo. When diagnosing vertigo diseases, a careful history of vertigo is of utmost importance.

Fgf8P2A-3×GFP/+: A New Genetic Mouse Model for Specifically Labeling and Sorting Cochlear Inner Hair Cells / 神经科学通报·英文版

The cochlear auditory epithelium contains two types of sound receptors, inner hair cells (IHCs) and outer hair cells (OHCs). Mouse models for labelling juvenile and adult IHCs or OHCs exist; however, labelling for embryonic and perinatal IHCs or OHCs are lacking. Here, we generated a new knock-in Fgf8P2A-3×GFP/+ (Fgf8GFP/+) strain, in which the expression of a series of three GFP fragments is controlled by endogenous Fgf8 cis-regulatory elements. After confirming that GFP expression accurately reflects the expression of Fgf8, we successfully obtained both embryonic and neonatal IHCs with high purity, highlighting the power of Fgf8GFP/+. Furthermore, our fate-mapping analysis revealed, unexpectedly, that IHCs are also derived from inner ear progenitors expressing Insm1, which is currently regarded as an OHC marker. Thus, besides serving as a highly favorable tool for sorting early IHCs, Fgf8GFP/+ will facilitate the isolation of pure early OHCs by excluding IHCs from the entire hair cell pool.

The fenrou zhijian theory in The Inner Canon of Huangdi and the stratified treatment of painful bi syndrome of meridian tendons / 中国针灸

The fenrou zhijian is defined as potential gap between different layers in the three-dimensional network structure formed by the twelve meridian tendons. Various pathological changes of the meridian tendons lead to the adhesion and closure of fenrou zhijian, causing abnormal mechanical conduction of the meridian tendon system, which in turn leads to painful bi syndrome of meridian tendons. As such, restarting the fenrou zhijian is the key to acupuncture treatment for painful bi syndrome of meridian tendons. Under the guidance of musculoskeletal ultrasound, the level and the angle of needle insertion of acupuncture at fenrou zhijian could be accurately controlled, the efficacy of acupuncture is improved.

Advances in bacterial adsorption and transport of aromatic compounds / 生物工程学报

Aromatic compounds are a class of organic compounds with benzene ring(s). Aromatic compounds are hardly decomposed due to its stable structure and can be accumulated in the food cycle, posing a great threat to the ecological environment and human health. Bacteria have a strong catabolic ability to degrade various refractory organic contaminants (e.g., polycyclic aromatic hydrocarbons, PAHs). The adsorption and transportation are prerequisites for the catabolism of aromatic compounds by bacteria. While remarkable progress has been made in understanding the metabolism of aromatic compounds in bacterial degraders, the systems responsible for the uptake and transport of aromatic compounds are poorly understood. Here we summarize the effect of cell-surface hydrophobicity, biofilm formation, and bacterial chemotaxis on the bacterial adsorption of aromatic compounds. Besides, the effects of outer membrane transport systems (such as FadL family, TonB-dependent receptors, and OmpW family), and inner membrane transport systems (such as major facilitator superfamily (MFS) transporter and ATP-binding cassette (ABC) transporter) involved in the membrane transport of these compounds are summarized. Moreover, the mechanism of transmembrane transport is also discussed. This review may serve as a reference for the prevention and remediation of aromatic pollutants.

Health risk assessment of eight chemicals in urban drinking water in Inner Mongolia Autonomous Region in 2021 / 环境与职业医学

Background The safety of drinking water is closely related to people's health. In recent years, relevant studies have identified some health related problems with drinking water in Inner Mongolia Autonomous Region. The complex and diverse natural environment embraced by the vast jurisdiction of the region may lead to uneven drinking water quality across the region. Objective To evaluate eight chemicals including arsenic, cadmium, chromium (hexavalent), lead, mercury, fluoride, trichloromethane, and carbon tetrachloride in urban drinking water in Inner Mongolia Autonomous Region in 2021, and to provide reference for optimizing urban water supply system and ideas for further developing strategies to promote population health. Methods A total of 1228 monitoring sites were set up in urban areas of Inner Mongolia, and water samples were collected once in dry season (May) and once in wet season (August−September). Eight chemicals of interest in drinking water were detected according to the Standard examination methods for drinking water, and assessed for health risks using the health risk assessment model recommended by the United States Environmental Protection Agency (USEPA) and following the Technical guide for environmental health risk assessment of chemical exposure. Mann-Whitney U test was used to compare the concentrations of eight chemicals in urban drinking water by water seasons and water sample types. Results In 2021, a total of 2381 samples of urban drinking water were tested in the Inner Mongolia Autonomous Region, including 1195 samples in wet season and 1186 samples in dry season; 389 samples of finished water and 1992 samples of tap water. The positive rates of arsenic and fluoride were 26.25% and 96.77%, respectively. The positive rates of cadmium, chromium (hexavalent), lead, mercury, trichloromethane, and carbon tetrachloride were 6.22%, 16.63%, 6.09%, 16.67%, 18.98%, and 8.36%, respectively. The exceeding standard rate of fluoride was 4.87%. Trichloromethane and carbon tetrachloride were qualified in all samples. There were statistical differences in the concentrations of arsenic, cadmium, chromium (hexavalent), lead, and carbon tetrachloride in urban drinking water between water seasons (Z=−3.847, P<0.05; Z=2.464, P=0.014; Z=−3.129, P=0.002; Z=4.341, P<0.05; Z=4.342, P<0.05). Only fluoride concentration was found statistically different among different water sample types (Z=−2.287, P=0.022). The non-carcinogenic risks of ingestion and dermal exposure to each chemical in drinking water by water seasons and water sample types were all less than 1, but the P95 total non-carcinogenic risks of oral exposure were greater than 1. The P95 carcinogenic risks of oral exposure to some chemicals in drinking water by water seasons and water sample types were>10−4, which suggested carcinogenic risks, while the carcinogenic risks of dermal explore to chemicals were all less than 10−6. Conclusion In 2021, urban drinking water in Inner Mongolia Autonomous Region is generally safe, but arsenic, cadmium, chromium (hexavalent), lead, mercury, and fluoride still exceed the national limits, posing certain health risks.

Investigation and analysis of the current usage status of OTC drug among Inner Mongolian residents / 中国药房

OBJECTIVE To investigate the current usage status of OTC drug among residents in Inner Mongolia Autonomous Region， and to provide evidence for the science popularization of rational drug use. METHODS By approximate random sampling， the questionnaire survey was conducted with the mini-apps Questionnaire Star among the residents aged 19 and above from 7 league or cities of Inner Mongolia Autonomous Region， in order to investigate the current situation of OTC drug use in the region. RESULTS A total of 611 people filled in the questionnaire， and 571 people filled in the questionnaire effectively， with an effective filling rate of 93.45%. According to the results， 18.7% of residents said they did not understand the concept of OTC drugs， 36.1% of residents said they did not know the OTC drug label， and 65.3% of residents did not know the difference between class A and B OTC drugs in terms of OTC drug awareness. And there were statistically significant differences in the scores of OTC drug awareness among different genders， education levels， monthly income and places of residence （P＜0.05）. When choosing OTC drugs， 23.5% of residents still believed in advertisements or friends’ recommendations； 14.5% of the residents did not read the drug instructions carefully before taking drugs. In terms of drug risk， 5.1% of residents had long-term use of OTC drugs； 8.6% of residents reported taking three or more OTC drugs； 2.1% of residents often added other drugs with the same effect or increased the dosage by themselves. They took traditional Chinese medicine， Mongolian medicine and other preparations while taking OTC drugs， accounting for 19.6%， 22.6% and 13.0% respectively. CONCLUSIONS Residents in Inner Mongolia have low awareness of OTC drugs， and their habits of drug use need to be improved. Repeated drug use and overdose drug use are serious， it is necessary to strengthen the publicity and popularization of rational use of OTC drugs.

The clinical and imaging presentations of the stapical footplate hernia related to inner ear malformation / 中华放射学杂志

Objective:To summarize the clinical and imaging presentations of stapical footplate hernia related to inner ear malformation (SFH-Re-IEM).Methods:The clinical and imaging data of 19 patients (24 ears) with SFH-Re-IEM from Shandong Provincial ENT Hospital between June 2014 to June 2022 were retrospectively analyzed. The clinical presentations and headache and the high resolution CT (HRCT) and MRI findings including associated inner ear malformation (IEM) type, internal auditory canal (IAC) malformation, bony defect of the stapical footplate, the extent, margin, density and signal of the herniation cysts, the density and signal of ipsilateral intratympanic, cochlear osseous labyrinthitis were recorded.Results:Among 19 SFH-Re-IEM patients, including 14 males and 5 females, 3 (1, 12) years old. All of the affected ears presented sensorineural or mixed hearing loss, 1 ear for moderate, 7 ears for severe and 16 ears for extremely severe. Besides this, the vertigo in 1 case, otalgia and ear fullness in 2 cases were found, and the others were detected accidentally. Among 24 ears with SFH-Re-IEM, 9 ears (37.5%) consisting with incomplete partition type Ⅰ, 3 ears (12.5%) with common cavity, 7 ears (29.2%) with cochlear aplasia, 3 ears (12.5%) with cochlear dysplasia type Ⅱ, and 2 ears (8.3%) with Mondini deformity were found respectively. Four ears (16.7%) were associated with IAC enlargement and the bony defect of IAC fundus, 19 ears (79.2%) were accompanied with dysplasia in the IAC fundus. In all the 24 ears with SFH-Re-IEM, the focal bony defect of the affected stapical footplate and the hemispherical soft-tissue-density herniating cysts protruding into the tympanium were presented on HRCT, and the herniating cysts presenting the cerebrospinal fluid-like signal with the well-defined margin and the ipsilateral normal tympanium were shown on the MRI hydrographic sequence. Two ears underwent the perilymphaticum gadolinium based on MRI, which demonstrated the hypersignal gadolinium in the perilymphatic space entered into the herniating cysts. Two ears were accompanied with the cochlear osseous labyrinthitis.Conclusion:The ears with IEM-Re-SFH usually present the serious hearing loss. The ipsilateral severe IEM, focal bony defect of the stapical footplate and perilymph herniating are characteristic imaging appearances.

Ultrasound findings and related factors of lower extremity arterial disease in patients with type 2 diabetes mellitus / 中国基层医药

Objective:To investigate the value of ultrasound findings in the diagnosis of lower extremity arterial disease in patients with type 2 diabetes mellitus and correlate it with clinical factors.Methods:A total of 535 patients with type 2 diabetes mellitus who received treatment in Taiyuan Second People's Hospital from January 2016 to June 2019 underwent color Doppler ultrasound examination (T2DM group). Vascular inner diameter, intima-media thickness, atherosclerotic plaque formation, lumen stenosis or occlusion, and hemodynamic characteristics were determined in patients with type2 diabetes mellitus compared with those in 107 patients with non-type 2 diabetes mellitus (non-T2DM group). These parameters were correlated with the course of the disease, blood glucose level, concomitant hypertension or not, and clinical Wagner grade.Results:The incidences of intima-media thickening, atherosclerotic plaque, stenosis, and occlusion of lower extremity arteries were 69.9%, 89.0%, 77.0% and 11.6% respectively, in the T2DM group, which were significantly higher than 41.1%, 78.5%, 72.0%, and 1.9% respectively in the non-T2DM group ( χ2 = 32.52, P < 0.001; χ2 = 8.76, P = 0.003; χ2 = 27.77, P < 0.001). With the prolongation of the course of T2DM, the incidence of arterial lesions in the lower extremities increased ( P < 0.001). The incidences of intima-media thickening, atherosclerotic plaque, stenosis, and occlusion of lower extremity arteries were significantly greater in the poor blood glucose control group and non-hypertension group compared with the good blood glucose control group and hypertension group (all P < 0.05). The degree of lower extremity arterial stenosis in T2DM patients was related to Wagner's grade. As the degree of stenosis increased, Wagner's grade increased correspondingly and significantly ( P < 0.001). Conclusion:Color Doppler ultrasound examination has an important value in evaluating lower extremity arterial lesions in patients with T2DM. The degree of arterial lesions in the lower extremities of T2DM patients is correlated with the course of the disease, blood glucose levels, concomitant hypertension, and clinical Wagner grade. Color Doppler ultrasound examination has an important clinical significance in evaluating the degree of vascular lesions and guiding early interventions in the clinic.

Neovascularización coroidea asociada a coroiditis punteada interna / Choroidal Neovascularization Associated with Punctate Inner Choroidopathy

Las membranas neovasculares coroidea representan el crecimiento de nuevos vasos sanguíneos originados de la coriocapilar hacia el epitelio pigmentario de la retina o el espacio subretinal por una disrupción de la membrana de Bruch ocasionado por la inflamación prolongada. El desarrollo de las membranas neovasculares coroidea está estrechamente conectado a la morbilidad asociada con la coroidopatía punteada interna y puede ser su primera forma de presentación. La coroidopatía punteada interna es clasificada como una de las enfermedades de los síndromes de puntos blancos evanescentes, es una enfermedad infrecuente, bilateral y de origen desconocido. Se presenta un caso clínico de un paciente al cual se le diagnostica membranas neovasculares coroidea en el curso de una coroidopatía punteada interna con una presentación atípica o previa a las lesiones de coroiditis. La coroidopatía punteada interna complicada con membranas neovasculares coroidea compromete la visión central de forma considerable en pacientes jóvenes(AU)

Choroidal neovascular membranes represent the growth of new blood vessels originating from the choriocapillaris into the retinal pigment epithelium or subretinal space due to disruption of Bruch's membrane caused by prolonged inflammation. The development of choroidal neovascular membranes is closely connected to the morbidity associated with punctate inner choroidopathy and may be its first form of manifestation. Punctate Inner choroidopathy is classified as one of the evanescent white dot syndromes diseases, is a rare, bilateral disease of unknown origin. We present a case report of a patient diagnosed with choroidal neovascular membranes while suffering from punctate inner choroidopathy with an atypical manifestation or prior to choroiditis lesions. Punctate Inner choroidopathy when complicated with choroidal neovascular membranes compromises significantly the central vision in young patients(AU)