Early versus late sphenopalatine ganglion block with ropivacaine in postdural puncture headache: an observational study

Abstract Background Postdural puncture headache (PDPH) is a common complication of neuraxial techniques which delays patients' discharge. Sphenopalatine ganglion block (SPGB) is a safe bedside technique with comparable efficacy to Epidural Blood Patch, the gold-standard treatment. There is no evidence on the ideal timing for SPGB performance. We aimed to evaluate the difference between early versus late SPGB concerning efficacy, symptom recurrence and hospital length of stay. Methods We present an observational study with 41 patients diagnosed with PDPH who were submitted to SPGB with ropivacaine 0,75%. The study sample (n = 41) was divided in two groups: an early (less than 24 hours after diagnosis) and a late (more than 24 hours after diagnosis) SPGB group. Pain was evaluated 15 minutes after the block and follow up occurred daily until patients were discharged. Patients' demographic characteristics, neuraxial technique, timing of SPGB, qualitative pain relief and post-SPGB length of stay were registered and analyzed with SPSS statistics (v26) software. Results Early SPGB resulted in a significant reduction in length of stay (p = 0,009) and symptom recurrence (p = 0,036), showing equally effective pain relief, compared to late SPGB. Conclusions SPGB was equally effective in both groups. Data showed that early SPGB reduces length of hospital stay and symptom recurrence, which potentially allows early resumption of daily activities and a reduction in total health costs.

Comparison of the effect of two disinfectants on the independent waterway disinfection of a periodontal ultrasonic scaler / 口腔疾病防治

Objective @#To compare the disinfection effect of 3% (v/v) hydrogen peroxide and 500 mg/L chlorine-containing disinfectants in the independent waterway of a periodontal ultrasonic scaler to provide a reference for clinical waterway disinfection management in stomatology departments.@*Methods @#The 18 ultrasonic scalers were randomly divided into 3 groups of 6 units: the control group, experimental group 1 (3% hydrogen peroxide disinfectant group), and experimental group 2 (500 mg/L chlorine-containing disinfectant group). The replaceable parts of the independent waterway pipes of the 3 groups of ultrasonic scalers were replaced, and the water supply was supplied with sterile distilled water (DW). In the control group, special treatment was not applied to the nonreplaceable pipe part. In experimental group 1, the 3% hydrogen peroxide was used to disinfect nonreplaceable pipelines. In experimental group 2, the nonreplaceable part was disinfected with the 500 mg/L chlorine-containing disinfectant. The water sample was taken from the outlet of the scaler working part in the three groups for monitoring before disinfection, immediately after disinfection and 10 consecutive days after disinfection. Bacteria in the water samples were cultured for the colony counts. Then, the bacterial culture data were compared between groups. The qualified criterion of the water sample was that the number of bacterial colonies was less than or equal to 100 CFU/mL. After disinfection, a bacterial species mass spectrometry identification analysis was carried out when the number of bacterial colonies in each group exceeded the standard for the first time. Biofilms from the inner wall of the tube in the three groups were observed under an electron microscope on the 10th day after disinfection.@*Results @#There were no significant differences between the three groups before disinfection (F = 2.549, P = 0.111). The number of bacterial colonies in the spout of 6 scalers in the control group all exceeded the standard, and three kinds of bacteria were cultured: Sphingomonas melonis, Herbaspirillum huttiense, and Ralstonia pickettii. Compared with those in the control group, the number of bacterial colonies in experimental group 1 decreased significantly for 1-2 days after disinfection (P<0.05) and reached the standard. On the 3rd day after disinfection, the number of bacterial colonies of group 1 increased rapidly and exceeded the standard, and three kinds of bacteria were cultured: Sphingomonas, Herbaspirillum huttiense, and Ralstonia pickettii. For experimental group 2, the number of bacterial colonies decreased significantly compared to the control group on Days 1 to 6 after disinfection, but the number of bacterial colonies increased slightly from the 7th day after disinfection and exceeded the standard. Two kinds of bacteria were cultured: Herbaspirillum huttiense and Ralstonia pickettii. The average number of bacterial colonies 10-day after disinfection in experimental group 2 was lower than that in experimental group 1(P<0.001). Under an electron microscope, the biofilm thickness of the two experimental groups was significantly lower than that of the control group. @* Conclusion @# There is water pollution in the independent waterway of a periodontal ultrasound scaler. Three percent hydrogen peroxide and 500 mg/L chlorine disinfectant both have effective disinfection effects on the outlet water of scalers, and the effect of 500 mg/L chlorine disinfectant is better than that of 3% hydrogen peroxide. The use of 3% hydrogen peroxide to disinfect periodontal ultrasound scaler-independent waterways is recommended for disinfection every other day, and disinfection once a week is recommended for the use of 500 mg/L chlorine disinfectant.

Influence of Recent Trial History on Interval Timing / 神经科学通报·英文版

Interval timing is involved in a variety of cognitive behaviors such as associative learning and decision-making. While it has been shown that time estimation is adaptive to the temporal context, it remains unclear how interval timing behavior is influenced by recent trial history. Here we found that, in mice trained to perform a licking-based interval timing task, a decrease of inter-reinforcement interval in the previous trial rapidly shifted the time of anticipatory licking earlier. Optogenetic inactivation of the anterior lateral motor cortex (ALM), but not the medial prefrontal cortex, for a short time before reward delivery caused a decrease in the peak time of anticipatory licking in the next trial. Electrophysiological recordings from the ALM showed that the response profiles preceded by short and long inter-reinforcement intervals exhibited task-engagement-dependent temporal scaling. Thus, interval timing is adaptive to recent experience of the temporal interval, and ALM activity during time estimation reflects recent experience of interval.

Association between early-life factors and pubertal timing in girls / 中国当代儿科杂志

OBJECTIVES@#To study the association between early-life factors (including birth weight, method of birth, gestational age, and history of gestational metabolic disorders) and pubertal timing in girls.@*METHODS@#The stratified cluster sampling method was used to select the girls in grades 2-3 and 7-8 from three primary schools and three middle schools in Guangzhou, China from March to December, 2019, and breast development was examined for all girls. A questionnaire survey was performed to collect the information on early-life factors. The multivariate logistic regression model was used to evaluate the association of gestational metabolic disorders, birth weight, method of birth, and gestational age with pubertal timing in girls. The Bootstrap method was used to assess the mediation effect of body mass index (BMI) (Z score) between high birth weight (≥4 000 g) and pubertal timing.@*RESULTS@#A total of 1 665 girls were enrolled, among whom 280 (16.82%) were judged to have early pubertal timing. The multivariate logistic regression analysis showed that high birth weight was associated with the increased risk of early pubertal timing (OR=2.12, 95%CI: 1.19-3.66, P=0.008). Nevertheless, no significant association was observed between other early-life factors and pubertal timing (P>0.05). The OR for the mediation effect of BMI (Z score) between high birth weight and early pubertal timing was 1.25 (95%CI: 1.09-1.47), accounting for 29.33% of the total effect of high birth weight on early pubertal timing.@*CONCLUSIONS@#High birth weight is associated with the increased risk of early pubertal timing in girls, and overweight/obesity may play a partial mediating role in the association between high birth weight and early pubertal timing in girls.

Better timing for HoLEP: a retrospective analysis of patients treated with HoLEP over a 10-year period with a 1-year follow-up / 亚洲男科学杂志(英文版)

The aim of this study was to explore the optimal timing of holmium laser enucleation of the prostate (HoLEP) in patients presenting benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS). A retrospective analysis was conducted based on the perioperative and postoperative outcome data of 1212 patients who underwent HoLEP in Shanghai Ninth People's Hospital (Shanghai, China) between January 2009 and December 2018. According to the preoperative International Prostate Symptom Score (IPSS), all patients whom we analyzed were divided into Group A (IPSS of 8-18) and Group B (IPSS of 19-35). Peri- and postoperative outcome data were obtained during the 1-year follow-up. IPSS changes were the main postoperative outcomes. The postoperative IPSS, quality of life, peak urinary flow rate, postvoid residual, and overactive bladder symptom score (OABSS) improved significantly. The IPSS improved further in the group with severe LUTS symptoms, but the postoperative IPSS was still higher than that in the moderate LUTS group. OABSSs showing moderate and severe cases after follow-up were more frequent in Group B (9.1%) than in Group A (5.2%) (P < 0.05). There were no significant intergroup differences in the intraoperative American Society of Anesthesiologists or hospitalization expense scores, and the medication costs, as well as the total costs, were significantly higher in Group B. In this retrospective study, HoLEP was an effective treatment for symptomatic BPH. For patients with LUTS, earlier surgery in patients with moderate severity may result in a marginally better 12-month IPSS than that in men with severe symptoms.

Management of acute testicular pain in children: changing trends with improvements in scrotal ultrasonography over 18 years

INTRODUCTION@#Doppler scrotal ultrasonography (US) is the modality of choice in diagnosing testicular torsion. We aimed to evaluate the performance of scrotal US in diagnosing testicular torsion over the past 18 years in our institution and determine the factors contributing to the length of wait times for it.@*METHODS@#A retrospective review was conducted of boys who presented with acute scrotal pain from 2014 to 2015. US reports, operative findings, final diagnosis and key time points of the patients' journey (time to emergency department consultation, time to admission, time to US and time to operating theatre [OT]) were collected. US performance results were compared with those observed in a historical cohort from 1998 to 2004. Wait times were compared between operated and non-operated patients.@*RESULTS@#Data from 519 boys with a mean age of 9.15 years was collected. Of these, 438 (84.4%) boys had undergone initial scrotal US; of these scrotal US cases, 28 were surgically explored, with 23 confirmed to have torsion. Another five cases were explored without prior US, and all were confirmed to have torsion. Performance analysis of US showed a sensitivity of 100% and a specificity of 98.8%. There was no significant difference between wait times of operated and non-operated patients. Time to US (P < 0.0001, r = 0.96) and time to OT (P < 0.0001, r = 0.64) correlated significantly with the total time from presentation to surgery.@*CONCLUSION@#There has been an improvement in the diagnostic performance of scrotal US for testicular torsion over the past 18 years. Quality improvement programmes targeted at reducing wait times for patients presenting with acute scrotum should target time to US and time to OT.

The infection control of post-and-core crown restoration / 华西口腔医学杂志

Post-and-core crown is one of the most common forms of restoration of tooth after root canal therapy (RCT). Infection control is the core objective of RCT, which is usually well realized by endodontists. However, many prosthodontists often neglect the infection control of the tooth and the maintenance of the curative effect of RCT during the process of post-and-core crown, which may lead to the failure of the final restoration. The concept of integrated crown-root treatment advocated recently requires clinicians to consider the RCT and final restoration as a whole, rather than simply divided into two parts-endodontic treatment and restorative treatment. As the core content of integrated crown-root treatment, infection control should be taken seriously by clinicians and implemented throughout the whole treatment process, especially in the restorative treatment that is easily overlooked after RCT. Therefore, this article describes the infection control of post-and-core crown restoration, classifies the tooth requiring post-and-core crown restoration, and puts forward the measures of infection control before and during post-and-core crown restoration, in order to provide reference and guidance for clinical practice.

Effect of electroacupuncture at different time points on postoperative urination function in patients with mixed hemorrhoids surgery / 中国针灸

OBJECTIVE@#To observe the effect of preoperative, intraoperative and postoperative electroacupuncture (EA) intervention on postoperative urination function in patients with mixed hemorrhoid surgery.@*METHODS@#A total of 240 patients with mixed hemorrhoid surgery under lumbar anesthesia were randomly divided into an EA preconditioning group (group A, 60 cases, 9 cases dropped off), an intraoperative EA group (group B, 60 cases, 4 cases dropped off), a postoperative EA group (group C, 60 cases, 6 cases dropped off), and a non-acupuncture group (group D, 60 cases, 3 cases dropped off). In the groups A, B and C, EA was exerted at Zhongliao (BL 33) and Huiyang (BL 35) , with disperse-dense wave, 4 Hz/20 Hz in frequency, and lasting 30 min, at 30 min before lumbar anesthesia, immediately after lumbar anesthesia and 6 h after surgery, respectively. No EA intervention was performed in the group D. The postoperative urination smoothness score in each group was observed 24 h after surgery. The first urination time, first urination volume, urine residual volume after first urination were recorded, and incidence of indwelling catheterization, postoperative visual analogue scale (VAS) score, number of remedial analgesia, and the incidence of postoperative nausea and vomiting were observed in each group.@*RESULTS@#In the groups A, B and C, the postoperative urination smoothness scores were superior to the group D (P<0.05), and the time of first urination was earlier than the group D (P<0.05). In the group C, the time of first urination was earlier than the group A and the group B (P<0.05), the first urination volume was higher than the group D (P<0.05), and the urine residual volume after first urination was lower than the group D (P<0.05). There was no significant difference in the incidence of indwelling catheterization and postoperative nausea and vomiting among the 4 groups (P>0.05). The VAS scores of the group A, B and C were lower than that in the group D (P<0.05), and the number of remedial analgesia cases was lower than that in the group D (P<0.05).@*CONCLUSION@#EA intervention could promote the recovery of urination function and relieve postoperative pain in patients with mixed hemorrhoids surgery. Early postoperative EA intervention is more conducive to the recovery of urination function.

Determination of the ideal timing of delivery among growth- restricted fetuses at less than 32 weeks age of gestation using a stage-based doppler protocol for admitted patients at the Philippine Children’s Medical Center

OBJECTIVES@#Early onset fetal growth restriction substantially contributes to neonatal mor-bidities and mortalities. The main dilemma lies on the timing of delivery, especially for pre- and peri-viable fetuses, due to the challenge in creating an ideal balance of minimized in-utero hy- poxia-induced fetal injury or death versus the risks of iatrogenic preterm delivery. We wished to determine the ideal timing of delivery among growth-restricted fetuses <32 weeks gestation us- ing a stage-based doppler protocol.@*MATERIALS AND METHODS@#A retrospective-cohort study of 67 singleton-pregnant wom- en with growth restriction at <32 weeks gestation and hospitalized from January 2010 to Sep- tember 2021 was conducted. Medical records were reviewed, and the outcomes were extracted. The primary outcomes were arterial pH at birth and mortality, while secondary outcomes includ- ed neonatal morbidities.@*RESULTS@#Fetal growth restriction progressed by an average of 3 stages (41.79%) within a 2- to 3.5-week period. More than half had arterial pH <7.20, which was lowest at Stage II FGR (50.00%). The prevalence of neonatal mortality was 16.42% and was lowest at Stage I (8.70%) and Stage II FGR (18.75%).@*CONCLUSION@#Doppler studies may be conducted weekly for Stage I, biweekly for Stage II, every 1-2 days for Stage III and every 12 hours for Stage IV. Delivery is ideal at Stage II as this resulted in the least number of acidosis and neonatal mortalities.

Research progress in the timing of thoracic surgery after SARS-CoV-2 infection / 中国胸心血管外科临床杂志

@#Since the outbreak of COVID-19 pandemic, a large number of elective or limited operations, including tumor treatment, have been postponed. With the deepening of the understanding of the virus and the change of the prevention policy, the impact of the pandemic is gradually shrinking, and a large number of operations delayed by the pandemic will be rescheduled. However, there is no consensus on the best time to perform surgery for patients infected with SARS-CoV-2, and the consensus on thoracic surgery is more limited. This article reviews the research progress in the timing of surgical operations, especially thoracic surgery, after SARS-CoV-2 infection.

Timing and safety of lung cancer surgery after SARS-CoV-2 infection: A multicenter retrospective study / 中国胸心血管外科临床杂志

@#Objective     To explore the timing and safety of limited-period lung cancer surgery in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods     Clinical data of of patients infected with COVID-19 undergoing lung cancer surgery (an observation group) in the Department of Thoracic Surgery of Guangdong Provincial People's Hospital, the Department of Thoracic Surgery of General Hospital of Southern Theater Command of PLA, and the Department of Cardiothoracic Surgery of the First Affiliated Hospital of Guangdong Pharmaceutical University from December 2022 to January 2023 were retrospectively analyzed and compared with patients who underwent surgery during the same period but were not infected with COVID-19 (a control group), to explore the impact of COVID-19 infection on lung cancer surgery. Results     We finally included 110 patients with 73 patients in the observation group (28 males and 45 females at age of 52.62±12.80 years) and 37 patients in the control group (22 males and 15 females at age of 56.84±11.14 years). The average operation time of the observation group was longer than that of the control group, and the incidence of anhelation was higher than that of the control group (P<0.05). There were no statistcal differences in blood loss, length of hospital stay, moderate or above fever rate, degree of cough and chest pain, or blood routine between the two groups. Conclusion    It is safe and feasible to perform lung cancer surgery early after recovery for COVID-19 patients with lung cancer.

Clinical efficacy and outcome analysis of early abdominal paracentesis drainage for treating patients with severe acute pancreatitis / 中华胰腺病杂志

Objective:To analyse the clinical efficacy and outcome of early abdominal paracentesis drainage (APD) in the treatment of severe acute pancreatitis (SAP).Methods:The clinical data of 107 SAP patients with massive abdominal fluid in Shanghai General People Hospital from May 2017 to December 2021 were collected and analyzed. Patients were divided into APD group ( n=56) and NO-APD group ( n=51) according to whether they underwent APD or not within 3 days after admission. The APD group was then divided into abdominal compartment syndrome (ACS) subgroup ( n=29) and NO-ACS subgroup ( n=27) according to whether ACS had occurred or not at the time of puncture. Patients' general data, the duration of systemic inflammatory response (SIRS), length of ICU stay, the trends of intra-abdominal pressure and inflammatory indicators (white blood cell count and the content of C-reactive protein) within 1-3 days after admission, incidence of infection complication, step-up therapy, discharge or death were recorded. Results:The intra-abdominal pressure were 18.6±5.6mmHg , 13.7±4.2mmHg (1 mmHg=0.133 kpa) in APD group and NO-APD group, respectively. The intra-abdominal pressure of APD group was significantly higher than that of NO-APD group, and the difference was statistically significant ( P=0.000). Compared with NO-APD group, the duration of SIRS was significantly shortened in APD group [3(2, 4) days vs 4(3, 6) days, P=0.029]. On day 1, 2 and 3 after admission, the intra-abdominal pressure was 18.6±5.6 mmHg, 16.4±4.7 mmHg and 13.5±3.9 mmHg in APD group, and was 13.7±4.2 mmHg, 12.3±3.6 mmHg and 11.0±2.6 mmHg in NO-APD group, respectively. The intra-abdominal pressure of the APD group dropped faster than the NO-APD group ( P=0.004). The white blood cell count was (14.8±4.8), (10.5±4.5) and (9.0±3.8)×10 9/L in APD group, and was (14.2±5.4), (12.3±7.3), (11.7±5.3)×10 9/L in NO-APD group, respectively. Compared with the NO-APD group, the decrease rate of white blood cell count was faster in APD group ( P=0.006). The C-reactive protein content was (153.6±47.1), (150.4±10.5) and (108.8±49.4)mg/L in APD group, and were (174.8±31.1), (191.6±29.4) and (186.8±45.5)mg/L in NO-APD group . The content of C-reactive protein in APD group decreased significantly, while that in NO-APD group did not decrease. There was a significant difference between the two groups ( P=0.009). In the subgroup comparisons, the duration of SIRS in the ACS subgroup was significant longer than that in the NO-ACS subgroup [4(3, 5) days vs 2(1, 3)days, P=0.000]. Compared between the two groups and two subgroups respectively, there were no statistically significant differences on length of ICU stay, infection complication rate, advanced treatment rate and mortality. Conclusions:For SAP patients with abdominal fluid, APD in the early stage could shorten the duration of SIRS, decrease intra-abdominal pressure rapidly, improve inflammatory indicators, but could not improve the clinical outcome.

Effect of extraction timing of mesiodens on orthodontic treatment duration for abnormal eruption of permanent teeth in children / 口腔疾病防治

Objective@# To discuss the correlation between the extraction timing of mesiodens and the orthodontic treatment duration of its eruption-related complications in children to provide a reference for the clinic.@*Methods @#The mesiodentes of 187 children were classified as eruption type (typeⅠ), dental crown impacted type (type Ⅱ), interdental impacted type (type Ⅲ), and dental root impacted type (type Ⅳ). According to the timing of extraction, mesiodentes in typeⅠ, type Ⅲ, and type Ⅳ were divided into Groups A: before the eruption of the adjacent central incisor and B: after the eruption of the adjacent central incisor. Mesiodentes in type Ⅱ were divided into Group A: before the eruption of the contralateral central incisor and B: after the eruption of the contralateral central incisor. Eruption-related complications and orthodontic treatment durations caused by mesiodens were statistically analyzed. @*Results @# There were 106 cases of displacement, 28 cases of failed eruption, 27 cases of tooth rotation, and 26 cases of individual cross-bite among the eruption-related complications caused by mesiodens. The mean orthodontic treatment cycle in Group A of type Ⅰ (7.07 ± 2.45 month), Group A of type Ⅱ (6.57 ± 1.12 month), and Group A of type Ⅲ (6.95 ± 2.52 month) were lower than that in Group B of type Ⅰ (9.67 ± 3.04 month), Group B of type Ⅱ (10.25 ± 1.29 month), and Group B of type Ⅲ (9.33 ± 3.26 month), and the differences were statistically significant (P<0.01). Meanwhile, there was no significant difference in the mean orthodontic treatment duration between Groups A (6.00 ± 0.94 month) and B (6.33 ± 0.80 month) of type Ⅳ (P>0.05).@*Conclusion@# In most cases, the mesiodens are removed before the eruption of the adjacent central incisor, which can reduce the duration of orthodontic treatment for eruption-related complications in children.

Clinical Profile and Predictors of In-Hospital Mortality in Septic Shock Patients in a Tertiary Care Hospital.

strong>Background: Sepsis and Septic shock contributes to significant morbidity and mortality in hospitalized patients. Early detection and initiation of early and appropriate antibiotic therapy determines the outcome in septic shock. The objective of this research was to describe clinical profile of septic shock patients and to determine various predictors of in-hospital mortality in septic shock patients which could be assessed from simple hematological parameters. Methods: This was a prospective observational study done over a period of one year in which a total of 145 adult patients with septic shock diagnosed as per American College of Chest Physicians (ACCP) and the Society for Critical Care Medicine (SCCM) criteria (2016) admitted in medicine ward in a tertiary care hospital were included. Detailed history and clinical examination was done and various routine investigations such as Complete hemogram, Neutrophil to lymphocyte ratio(NLR), Platelet to lymphocyte ratio(PLR), Liver function tests, Renal function tests, C-reactive protein and Blood gases including lactate levels at admission were determined and compared among survivors and non-survivors to assess in hospital mortality predictors. Results: A total of 145 patients with septic shock were studied. Most of the patients were males (55.2%). Majority were from rural areas (59.31%). Major co-morbidities included diabetes mellitus (24.8%), COPD (13.1%) and hypertension (11%). Fever was the most common presentation (34.5%). Mortality in septic shock was 30.3%. The most common source of infection leading to septic shock was scrub typhus (33.8%) followed by respiratory infections and skin infections. The highest mortality was seen in the age group of 60-69 years. Patients who were given primary care and stabilized in a primary or secondary health centre and then referred had a better survival (77.2%) as compared to those who directly visited the tertiary care centre in a sick state. Out of various mortality predictors studied, a strong positive correlation of mortality was seen among patients with thrombocytopenia i.e. platelet count (86.4%), hypoalbuminemia (78.6%), high neutrophil to lymphocyte ratio, high C-reactive protein values(74%) and high mean platelet volume. Conclusion: There is high prevalence of tropical infections such as Scrub typhus in Himachal and even simple investigations like Complete haemogram, Serum albumin levels, C-reactive protein and Total serum bilirubin levels which are routinely done in health care centers correlate significantly with mortality in septic shock. These investigations can guide appropriate antibiotic therapy and appropriate timing of referral of patients to higher centers, hence can improve the outcome among septic shock patients.

The circadian timing of noise exposure influences noise-induced inflammatory responses in the mouse cochlea

Abstract Introduction: Noise-induced hearing loss is one of the most common forms of sensorineural hearing loss. Nevertheless, the mechanisms of noise-induced hearing loss are still not fully understood. Objective: To investigate the dynamics of inflammatory responses in the mammalian cochlea following noise trauma at two different times, once during the light cycle and once during the dark. Methods: We challenged C57BL/6J mice with moderate, continuous noise trauma at either 9 a.m. or 9 p.m. Auditory function, histological changes in hair cells, and modifications in gene expression levels of inflammatory mediators were assessed at specific time points. Shifts in auditory brainstem response thresholds were measured at 1, 3, 7 and 14 days after noise exposure to measure potential noise-induced hearing loss. Cochlear basilar-membrane immunofluorescent staining was performed at 3 and 14 days after noise exposure. The mRNA levels of several inflammatory mediators were measured via quantitative real-time polymerase chain reaction before (pre) and after (0, 3, 12, 24 and 72 h) noise exposure. Results: We found that all noise-exposed mice developed a temporary threshold shift and that there were no significant differences between daytime and nighttime noise exposures in terms of inducing hearing-threshold shifts. Similarly, we did not detect significant histological changes in hair cells between these two groups. However, we discovered an interesting phenomenon in that the peak mRNA levels of IL-1β, IL-6, CCL2 and TNF-α were higher in day noise-exposed mice compared to those in night noise-exposed mice, and these mRNA levels subsided more slowly in day noise-exposed mice. Conclusion: Overall, these observations suggest that the circadian timing of noise exposure has a significant effect on noise-induced inflammatory responses in the mouse cochlea and that a greater inflammatory response might occur after daytime exposure.

Surgical timing for acute traumatic central cord syndrome / 中华创伤骨科杂志

Objective:To investigate the effects of different surgical time points on the treatment efficacy of acute traumatic central cord syndrome (ATCCS).Methods:Retrospectively analyzed were the 84 ATCCS patients who had been treated at Department of Spinal Surgery, Henan Provincial People's Hospital from January 2013 to February 2021. According to the surgical timing, the patients were divided into 3 groups. In group A (surgery < 48 hours) of 16 cases, there were 11 males and 5 females, aged from 43 to 76 years; in group B (surgery within 3 to 7 days) of 41 cases, there were 31 males and 10 females, aged from 41 to 78 years; in group C (surgery within 8 to 14 days) of 27 cases, there were 15 males and 12 females, aged from 46 to 83 years. Anterior, posterior or combined anterior and posterior approaches were used according to their specific condition. The American Spinal Injury Association (ASIA) motor scores and Japanese Orthopaedic Association (JOA) scores at admission, 7 days and 12 months after operation, postoperative ICU duration, and complications were compared among the 3 groups.Results:There were no significant differences in the preoperative general information or surgical approaches among the 3 groups, showing they were comparable ( P> 0.05). In all patients, the ASIA motor scores and JOA scores at 7 days and 12 months after operation were significantly better than those at admission, and the ASIA motor scores and JOA scores at 12 months after operation were significantly better than those at 7 days after operation ( P<0.01). There was no significant difference in the ASIA motor score or JOA score between the 3 groups at 7 days or 12 months after operation ( P>0.05). The postoperative ICU duration in group A was 42 (26, 61) h, significantly longer than 23 (16, 35) h in group B and 24 (14, 38) h in group C ( P<0.05). There were no deaths in the 84 patients; there was no significant difference in the overall incidence of serious complications or in that of general complications among the 3 groups ( P>0.05). Conclusions:Surgery is safe and effective for ATCCS. However, decompression surgery within 2 weeks may achieve better outcomes.

Application effect of timing theory in educational intervention for mothers of premature infants / 中国实用护理杂志

Objective:To explore the effect of educational intervention based on timing theory on mothers of premature infants.Methods:Using the convenience sampling method, 80 mothers of premature infants hospitalized in the Neonatology Department of Affiliated Hospital of Youjiang Medical University for Nationalities from May 2019 to October 2020 were included in this study. According to the time of admission, they were divided into the control group (42 cases) and the observation group (38 cases). The mothers in the control group were given routine educational guidance during the hospitalization of premature infants, while the mothers in the observation group were given comprehensive educational intervention based on timing theory on the basis of the control group. The mothers′ caring ability during the transition period, breastfeeding self-efficacy and breastfeeding rate at a month after discharge, and mother′s coping ability at 3 months after discharge were compared between the two groups.Results:There were 35 cases in each group completed the study. The observation group scored (100.86 ± 6.22) on the maternal care ability of premature infants in transition period, and the control group scored (89.51 ± 4.17), the difference between the two groups was statistically significant ( t=-8.97, P<0.05). The breastfeeding self-efficacy score of the observation group a month after discharge from hospital was (47.83 ± 2.54) points, which was higher than (41.20 ± 1.97) points of the control group, and the difference was statistically significant ( t=-12.21, P<0.05). The breastfeeding rate a month after discharge in the observation group was 62.9% (22/35), which was higher than 37.1% (13/35) in the control group, and the difference was statistically significant ( χ2=4.63, P<0.05). The maternal coping ability scores of the premature infants in the observation group and control group 3 months after discharge were (119.29 ± 6.03) and (113.66 ± 6.59) points respectively, and the difference between the two groups was statistically significant ( t=-3.73, P<0.05). Conclusions:The educational intervention based on timing theory can help mothers of premature infants master the nursing knowledge and skills, strengthen the mother′s transitional care ability and post-discharge coping ability, improve the breastfeeding self-efficacy and breastfeeding rate of premature infants, promote and development the growth of premature infants, worthy of clinical application.

Changes of sex hormones in children with cryptorchidism of different ages after laparoscopic treatment and analysis of risk factors affecting the timing of surgery / 中华内分泌外科杂志

Objective:To explore the changes of sex hormones in children with cryptorchidism of different ages after laparoscopic treatment and the risk factors that affect the timing of surgery, so as to improve the surgical effect of the treatment of children with cryptorchidism.Methods:A total of 80 children with cryptorchidism admitted to our hospital from Jun. 2018 to Aug. 2021 were selected as the study subjects, and all children underwent laparoscopic surgery. Twenty-six children aged 6 to 12 months were included in the younger group, 42 children aged 1 to 2 years were included in the middle age group, and 12 children >2 years old were included in the over-age group. Surgical data of the children were recorded, and the levels of follicle-stimulating hormone (FSH) , Luteinizing hormone (LH) and Testosterone (T) were detected. Logistic analysis was used to analyze the independent risk factors affecting the timing of operation in children with cryptorchidism, and ROC curve analysis was used to analyze the diagnostic value of factors affecting the timing of operation in children with cryptorchidism.Results:The level of T (the younger group (7.36±1.63) vs (7.48±1.67) ng/ml; the middle-age group (7.03±1.26) vs (7.11±1.07) ng/ml; the over-age group (4.81±1.37) vs (4.92±1.63) ng/ml) , occult testicular volume (the younger group (0.30±0.01) vs (0.32±0.03) cm3; the middle-age group (0.45±0.14) vs (0.47±0.11) cm 3; the over-age group (0.45±0.09) vs (0.61±0.08) cm 3) and occult testicular minimum blood flow velocity (the younger group (3.42±0.87) vs (4.26±0.94) cm/s; the middle-age group (3.51±0.26) vs (5.69±0.35) cm/s; the over-age group (8.41±0.34) vs (23.64±0.19) cm/s) increased in all three groups,In terms of intraoperative blood loss, postoperative time to get out of bed, and incision pain time, the over-age group > the middle age group > the younger group; FSH and LH decreased in the young age group and increased in the middle age group and over-age group ( P < 0.05) . Age, family income, primiparas, smoking or passive smoking during pregnancy, gestational diabetes mellitus, and protein supplementation during pregnancy were independent risk factors affecting the timing of surgery in children with untorchidism. The areas under ROC curve were 0.884, 0.704, 0.785, 0.842, 0.904, and 0.845, respectively. The area under ROC curve to evaluate the differentiation was 0.866. Conclusion:The range of sex hormone changes in children with cryptorchidism of different ages after laparoscopic treatment is related to age, family income, primipara, smoking or passive smoking during pregnancy, diabetes mellitus during pregnancy, and no protein supplement during pregnancy are the factors affecting the timing of surgery.

Comparison of second molar protraction using different timing for piezocision application: A randomized clinical trial

ABSTRACT Objective: To compare second molar protraction between early, late and no piezocision groups. Material and Methods: Forty subjects with bilaterally extracted mandibular first molars were selected to participate in the study. Subjects were subdivided into two groups: piezocision and no piezocision. The piezocision group was further subdivided into two subgroups: early piezocision (piezocision performed immediately before second molar protraction) and late piezocision (piezocision performed three months after starting molar protraction). In the no piezocision group, molar protraction was done without surgery. The intervention (piezocision group and timing of piezocision/side within group) was randomly allocated using the permuted random block size of 2, with 1:1 allocation ratio. The amount of second molar protraction, duration of space closure and anterior anchorage loss were measured. A repeated measures analysis of variance was conducted to define the differences between the measured variables at the different time intervals. Differences between groups were assessed using ANOVA test. Results: No difference was detected between early and late piezocision groups in the amount of molar protraction at the end of space closure. Duration of complete space closure was 9 and 10 months in the piezocision and no piezocision groups. Anchorage loss was similar between the three studied groups. Conclusions: Early and late piezocision have similar effect and both increased the amount of second molar protraction temporarily in the first 2-3 months after surgery. Duration of mandibular first molar space closure was reduced by one month when piezocision was applied. Anchorage loss was similar in the three groups.

RESUMO Objetivo: Comparar o efeito dos tempos de aplicação precoce, tardia e sem piezocisão, na protração de segundos molares. Métodos: Quarenta indivíduos com os primeiros molares inferiores extraídos bilateralmente foram selecionados para participar do estudo, sendo divididos em dois grupos: piezocisão e sem piezocisão. O grupo de piezocisão foi subdividido em dois subgrupos: piezocisão precoce (piezocisão realizada imediatamente antes da protração de segundos molares) e piezocisão tardia (realizada três meses após o início da protração dos molares). No grupo sem piezocisão, a protração de molares foi feita sem cirurgia. A intervenção (grupo de piezocisão e momento da piezocisão/lado dentro do grupo) foi alocada aleatoriamente usando o tamanho de bloco aleatório permutado de 2 com proporção de alocação de 1:1. A quantidade de protração de segundos molares, tempo para fechamento de espaços e perda de ancoragem anterior foram medidos. Uma análise de variância para medidas repetidas foi realizada para definir as diferenças entre as variáveis medidas nos diferentes intervalos de tempo. As diferenças entre os grupos foram avaliadas pelo teste ANOVA. Resultados: Não foi detectada diferença entre os grupos de piezocisão precoce e tardia, em relação à quantidade de protração de molares ao fim do fechamento dos espaços. O tempo para o fechamento completo do espaço foi de nove e dez meses nos grupos piezocisão e sem piezocisão, respectivamente. A perda de ancoragem foi semelhante nos três grupos avaliados. Conclusões: As piezocisões precoce e tardia têm efeito semelhante e ambas aumentaram temporariamente a quantidade de protração dos segundos molares nos primeiros dois a três meses após a cirurgia. A duração do fechamento de espaço dos primeiros molares inferiores foi reduzida em um mês quando a piezocisão foi aplicada. A perda de ancoragem foi semelhante nos três grupos.

Efficacy of noninvasive correction on congenital auricle deformities at different time points: a meta analysis / 中华医学美学美容杂志

Objective:To evaluate the efficacy and safety of nonsurgical methods in early postnatal correction of congenital auricle malformation.Methods:The clinical trials regarding non-surgical treatment for congenital ear deformity published before May 2021 were searched in databases of Cochrane Library, PubMed, Medline, CNKI, VIP and Wanfang. The information of included studies was extracted. The Meta-analysis was performed by using RevMan 5.3 software.Results:A total of 15 trials were included, involving 1 349 patients. The Meta-analysis results showed that the effect of the group <6 weeks was better than the group over 6 weeks ( OR=4.67, 95% CI: 3.21, 6.78, Z=8.09, P<0.001); The complications incidence of the group < 6 weeks was lower than the group over 6 weeks ( OR=0.27, 95% CI: 0.08, 0.88, Z=2.18, P=0.03); The correction time required of the group <6 weeks was shorter than the group over 6 weeks ( MD=-11.81, 95% CI: -18.36, -5.26, Z=3.54, P=0.001). Conclusions:Non-surgical correction of congenital ear malformation within 6 weeks after birth has better efficacy and safety.