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A "one-step" strategy has been demonstrated for the tunable synthesis of multifunctional aliphatic polycarbonates (APCs) with ethylene oxide (EO), ethylene carbonate (EC), and cyclohexene oxide (CHO) side groups by the copolymerization of 4-vinyl-1-cyclohexene diepoxide with carbon dioxide under an aminotriphenolate iron/PPNBz (PPN = bis(triphenylphosphine)-iminium, Bz = benzoate) binary catalyst. By adjusting the PPNBz-to-iron complex ratio and incorporating auxiliary solvents, the content of functional side groups can be tuned within the ranges of 53-75% for EO, 18-47% for EC, and <1-7% for CHO. The yield and molecular weight distribution of the resulting multifunctional APCs are affected by the viscosity of the polymerization system. The use of tetrahydrofuran as an auxiliary solvent enables the preparation of narrow-distribution polycarbonates at high conversion. This work presents a novel perspective for the preparation of tailorable multifunctional APCs.
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Dióxido de Carbono , Cemento de Policarboxilato , Polimerizacion , Dióxido de Carbono/química , Cemento de Policarboxilato/química , Compuestos Epoxi/química , Óxido de Etileno/química , Ciclohexenos/química , Catálisis , Viscosidad , DioxolanosRESUMEN
BACKGROUND: Numerous studies have been conducted on the effect of the stapes superstructure after ossicular chain reconstruction, but the findings are not uniform. OBJECTIVE: To compare the hearing outcomes of ossicular chain reconstruction with partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP) under otoendoscopy. MATERIALS AND METHODS: The records of 111 patients diagnosed with chronic suppurative otitis media were retrospectively analyzed. These patients were divided into PORP group (n = 57) and TORP group (n = 54). They were further subdivided into subgroups PORP-a (with a malleus handle) and PORP-b (without a malleus handle), subgroups TORP-a and TORP-b. Pre- and postoperative audiometric results were analyzed. RESULTS: The mean postoperative air conduction hearing thresholds improvement, mean air-bone gap improvement, and the success rate of reconstruction were significantly higher in the PORP group than in the TORP group (p < .05). The mean postoperative air conduction hearing thresholds improvement and the success rate of reconstruction were significantly higher in the PORP-a group than in the TORP-a group (p < .05); and similar results were concluded in comparison of the PORP-b group and the TORP-b group. CONCLUSIONS AND SIGNIFICANCE: The stapes superstructure has an important positive effect on the postoperative outcome of endoscopic ossicular chain reconstruction.
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Prótesis Osicular , Reemplazo Osicular , Humanos , Femenino , Estudios Retrospectivos , Masculino , Persona de Mediana Edad , Adulto , Reemplazo Osicular/métodos , Anciano , Endoscopía/métodos , Otitis Media Supurativa/cirugía , Adulto Joven , Osículos del Oído/cirugía , Adolescente , EstriboRESUMEN
BACKGROUND: The stria vascularis (SV), located in the lateral wall of the cochlea, maintains cochlear fluid homeostasis and mechanoelectrical transduction (MET) activity required for sound wave conduction. The pathogenesis of a number of human inheritable deafness syndromes, age related hearing loss, drug-induced ototoxicity and noise-induced hearing loss results from the morphological changes and functional impairments in the development of the SV. In this study, we investigate the implications of intercellular communication within the SV in the pathogenesis of sensorineural hearing loss (SNHL). We aim to identify commonly regulated signaling pathways using publicly available single-cell transcriptomic sequencing (scRNA-seq) datasets. METHODS: We analyzed scRNA-seq data, which was derived from studying the cochlear SV in mice with SNHL compared to normal adult mice. After quality control and filtering, we obtained the major cellular components of the mouse cochlear SV and integrated the data. Using Seurat's FindAllMarkers and FindMarkers packages, we searched for novel conservative genes and differential genes. We employed KEGG and GSEA to identify molecular pathways that are commonly altered among different types of SNHL. We utilized pySCENIC to discover new specific regulatory factors in SV subpopulation cells. With the help of CellChat, we identified changes in subpopulation cells showing similar trends across different SNHL types and their alterations in intercellular communication pathways. RESULTS: Through the analysis of the integrated data, we discovered new conserved genes to SV specific cells and identified common downregulated pathways in three types of SNHL. The enriched genes for these pathways showing similar trends are primarily associated with the Electron Transport Chain, related to mitochondrial energy metabolism. Using the CellChat package, we further found that there are shared pathways in the incoming signaling of specific intermediate cells in SNHL, and these pathways have common upstream regulatory transcription factor of Nfe2l2. Combining the results from pySCENIC and CellChat, we predicted the transcription factor Nfe2l2 as an upstream regulatory factor for multiple shared cellular pathways in IC. Additionally, it serves as an upstream factor for several genes within the Electron Transport Chain. CONCLUSION: Our bioinformatics analysis has revealed that downregulation of the mitochondrial electron transport chain have been observed in various conditions of SNHL. E2f1, Esrrb, Runx1, Yy1, and Gata2 could serve as novel important common TFs regulating the electron transport chain. Adm has emerged as a potential new marker gene for intermediate cells, while Itgb5 and Tesc show promise as potential new marker genes for marginal cells in the SV. These findings offer a new perspective on SV lesions in SNHL and provide additional theoretical evidence for the same drug treatment and prevention of different pathologies of SNHL.
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Pérdida Auditiva Sensorineural , Estría Vascular , Adulto , Humanos , Animales , Ratones , Estría Vascular/metabolismo , Estría Vascular/patología , Análisis de Expresión Génica de una Sola Célula , Pérdida Auditiva Sensorineural/genética , Pérdida Auditiva Sensorineural/patología , Cóclea , Factores de Transcripción/metabolismoRESUMEN
Despite enormous advances in the generation of organoids, robust and stable protocols of organoids are still a major challenge to researchers. Research for assessing structures of organoids and the evaluations of their functions on in vitro or in vivo is often limited by precision strategies. A growing interest in assessing organoids has arisen, aimed at standardizing the process of obtaining organoids to accurately resemble human-derived tissue. The complex microenvironment of organoids, intricate cellular crosstalk, organ-specific architectures and further complicate functions urgently quest for high-through schemes. By utilizing multi-omics analysis and single-cell analysis, cell-cell interaction mechanisms can be deciphered, and their structures can be investigated in a detailed view by histological analysis. In this review, we will conclude the novel approaches to study the molecular mechanism and cell heterogeneity of organoids and discuss the histological and morphological similarity of organoids in comparison to the human body. Future perspectives on functional analysis will be developed and the organoids will become mature models.
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Organoides , Humanos , Organoides/patologíaRESUMEN
Obesity is an epidemic all around the world. Weight loss interventions that are effective differ from each other with regard to various lipidomic responses. Here, we aimed to find lipidomic biomarkers that are related to beneficial changes in weight loss. We adopted an untargeted liquid chromatography with tandem mass spectrometry (LC-MS/MS) method to measure 953 lipid species for Exercise (exercise intervention cohort, N = 25), 1388 lipid species for LSG (laparoscopic sleeve gastrectomy cohort, N = 36), and 886 lipid species for Cushing (surgical removal of the ACTH-secreting pituitary adenomas cohort, N = 25). Overall, the total diacylglycerol (DG), triacylglycerol (TG), phosphatidylethanolamine (PE), phosphatidylinositol (PI), phosphatidylserine (PS), and sphingomyelin (SM) levels were associated with changes in BMI, glycated hemoglobin (HbA1c), triglyceride, and total cholesterol according to weight loss interventions. We found that 73 lipid species changed among the three weight loss interventions. We screened 13 lipid species with better predictive accuracy in diagnosing weight loss situations in either Exercise, LSG, or Cushing cohorts (AUROC > 0.7). More importantly, we identified three phosphatidylcholine (PC) lipid species, PC (14:0_18:3), PC (31:1), and PC (32:2) that were significantly associated with weight change in three studies. Our results highlight potential lipidomic biomarkers that, in the future, could be used in personalized approaches involving weight loss interventions.
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Lipidómica , Espectrometría de Masas en Tándem , Humanos , Cromatografía Liquida , Pérdida de Peso , Triglicéridos , Fosfatidilcolinas , BiomarcadoresRESUMEN
The global epidemic of obesity is tightly associated with numerous comorbidities, such as type II diabetes, cardiovascular diseases and the metabolic syndrome. Among the key features of obesity, some studies have suggested the abnormal expansion of adipose-tissue-induced local endogenous hypoxic, while other studies indicated endogenous hyperoxia as the opposite trend. Endogenous hypoxic aggravates dysfunction in adipose tissue and stimulates secretion of inflammatory molecules, which contribute to obesity. In contrast, hypoxic exposure combined with training effectively generate exogenous hypoxic to reduce body weight and downregulate metabolic risks. The (patho)physiological effects in adipose tissue are distinct from those of endogenous hypoxic. We critically assess the latest advances on the molecular mediators of endogenous hypoxic that regulate the dysfunction in adipose tissue. Subsequently we propose potential therapeutic targets in adipose tissues and the small molecules that may reverse the detrimental effect of local endogenous hypoxic. More importantly, we discuss alterations of metabolic pathways in adipose tissue and the metabolic benefits brought by hypoxic exercise. In terms of therapeutic intervention, numerous approaches have been developed to treat obesity, nevertheless durability and safety remain the major concern. Thus, a combination of the therapies that suppress endogenous hypoxic with exercise plans that augment exogenous hypoxic may accelerate the development of more effective and durable medications to treat obesity and comorbidities.
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Diabetes Mellitus Tipo 2 , Hiperoxia , Humanos , Diabetes Mellitus Tipo 2/metabolismo , Obesidad/metabolismo , Hipoxia/metabolismo , Tejido Adiposo/metabolismo , Hiperoxia/complicacionesRESUMEN
The present study aimed to assess the changes in muscle strength and plasma metabolites in athletes with ß-glucan supplementation. A total of 29 athletes who met the inclusion criteria were recruited for this study (ChiCTR2200058091) and were randomly divided into a placebo group (n = 14) and ß-glucan group (n = 15). During the trial, the experimental group received ß-glucan supplementation (2 g/d ß-glucan) for 4 weeks and the control group received an equal dose of placebo supplementation (0 g/d ß-glucan), with both groups maintaining their regular diet and exercise habits during the trial. The athletes' exercise performance, muscle strength, and plasma metabolome changes were analyzed after 4 weeks of ß-glucan supplementation. The results showed a significant increase in mean grip strength (kg), right hand grip strength (kg), left triceps strength (kg), and upper limb muscle mass (kg) in the experimental group after the 4-week intervention compared to the preintervention period (p < 0.05). A comparison of the difference between the two groups after the intervention showed that there were significant differences between the control group and the experimental group in mean grip strength (kg) and right-hand grip strength (kg) (p < 0.05). Athletes in the experimental group showed significant improvements in 1 min double rocking jump (pcs), VO2max (ml/kg-min) (p < 0.05). The ß-glucan intake increased the creatine-related pathway metabolites in plasma. Overall, these results suggest that 4 weeks of ß-glucan supplementation can improve muscle strength in athletes, with the potential to increase aerobic endurance and enhance immune function, possibly by affecting creatine-related pathways.
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The causative gene family of Parkinson's disease, PARK, plays important roles in the regulation of skeletal myopathy and is also involved in multiple biological processes, such as the modification of motor neurons, the transmission of nerve signals at the nerve-muscle junction, the regulation of skeletal muscle energy metabolism and mitochondrial quality, and the expression of myogenesis factors. PARK gene family regulates skeletal muscle mass, functions through a multi-level regulatory system, and plays a key role in the occurrence and development of skeletal myopathy. In this review, we summarize the structural characteristics, functions, and research of the PARK gene family in skeletal myopathy, providing a theoretical foundation and future research direction for in-depth study of the molecular mechanism for skeletal myopathy and giving references to further study on the role of PARK family in the development, the pathology, clinical diagnosis, and treatment of skeletal myopathy.
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Enfermedades Musculares , Metabolismo Energético , Humanos , Músculo Esquelético/metabolismo , Enfermedades Musculares/genéticaRESUMEN
Targeted delivery by either systemic or local targeting of therapeutics to the bone is an attractive treatment for various bone metabolism diseases such as osteoporosis, osteoarthritis, osteosarcoma, osteomyelitis, etc. To overcome the limitations of direct drug delivery, the combination of bone-targeted agents with nanotechnology has the opportunity to provide a more effective therapeutic approach, where engineered nanoparticles cause the drug to accumulate in the bone, thereby improving efficacy and minimizing side effects. Here, we summarize the current advances in systemic or local bone-targeting approaches and nanosystem applications in bone diseases, which may provide new insights into nanocarrier-delivered drugs for the targeted treatment of bone diseases. We envision that novel drug delivery carriers developed based on nanotechnology will be a potential vehicle for the treatment of currently incurable bone diseases and are expected to be translated into clinical applications.
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Hearing loss is often caused by death of sensory hair cells (HCs) in the inner ear. HCs are vulnerable to some ototoxic drugs, such as aminoglycosides(AGs) and the cisplatin.The most predominant form of drug-induced cell death is apoptosis. Many efforts have been made to protect HCs from cell death after ototoxic drug exposure. These mechanisms and potential targets of HCs protection will be discussed in this review.And we also propose further investigation in the field of HCs necrosis and regeneration, as well as future clinical utilization.
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Apoptosis/efectos de los fármacos , Células Ciliadas Auditivas/efectos de los fármacos , Fármacos Neuroprotectores/uso terapéutico , Ototoxicidad/prevención & control , Células Ciliadas Auditivas/metabolismo , Humanos , Ototoxicidad/metabolismo , Estrés Oxidativo/efectos de los fármacos , Especies Reactivas de Oxígeno/metabolismoRESUMEN
OBJECTIVES: Chronic suppurative otitis media (CSOM) induced tympanic membrane perforation (TMP) can be accompanied by anterior mallear ligament (AML) calcification. So far, comparative evaluations of TMP with and without AML calcification have rarely been reported. The aim of the current study is to compare the hearing outcomes of TMP with and without calcification of AML under transcanal endoscopic type I tympanoplasty. METHODS: Records of 67 patients diagnosed with CSOM and receiving transcanal endoscopic type I tympanoplasty were divided into the AML calcification group (Cal group, n = 31) and the non-AML calcification group (non-Cal group, n = 36). The 31 patients in the Cal group were divided into subgroup A and B according to the severity of calcification. The operation time, closure rate, and pre- and postoperative audiometric results were retrospectively collected and analyzed. RESULTS: Preoperatively, the Cal group had higher mean air-bone gap (ABG; P = .022), and ABGs at 250 Hz (P = .017) and 500 Hz (P = .008) compared with the non-Cal groups. The Cal group showed higher improvements of ABGs at 250 Hz (P = .039) and 500 Hz (P = .021) compared with the non-Cal groups postoperatively. CONCLUSIONS: The TMP with AML calcification leads to higher ABGs at low frequencies. The hearing outcomes are similar for TMP both with and without AML calcification after surgery. Our results suggest that transcanal endoscopic type I tympanoplasty is an appropriate surgical method for TMP with AML calcification, if the lesion can be detected and completely eliminated.
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Calcinosis/cirugía , Audición , Otitis Media Supurativa/patología , Perforación de la Membrana Timpánica/cirugía , Timpanoplastia/métodos , Adulto , Audiometría , Conducción Ósea , Calcinosis/etiología , Calcinosis/fisiopatología , Enfermedad Crónica , Endoscopía/métodos , Femenino , Humanos , Ligamentos/patología , Masculino , Martillo/patología , Persona de Mediana Edad , Otitis Media Supurativa/complicaciones , Periodo Posoperatorio , Estudios Retrospectivos , Resultado del Tratamiento , Perforación de la Membrana Timpánica/etiología , Perforación de la Membrana Timpánica/fisiopatologíaRESUMEN
PURPOSE: To compare the anatomical and audiological outcomes of endoscopic type I tympanoplasty using cartilage-perichondrium, with or without a customized 3D-printed guiding template. MATERIALS AND METHODS: A total of 60 patients with tympanic membrane perforation receiving endoscopic type I tympanoplasty were divided into the non-template group (group 1, n = 30) and template group (group 2, n = 30). Closure rate, hearing outcomes and operating time were compared between the two groups. RESULTS: Group1 had a significant higher operation time compared with group2 (77.73 ± 10.63 min vs. 66.23 ± 14.92 min, p = 0.001). The overall closure rate of group1 was lower than that of group2 (83.33% vs. 100%, p = 0.052). The postoperative air-bone gaps (ABGs) were significantly lower than preoperative ones in each group (p < 0.001, respectively). CONCLUSIONS: Improvements in hearing outcomes were comparable for the two groups. The applying of customized 3D-printed guiding template resulted in a higher closure rate and a shorter operation time. Our results suggest that the customized 3D-printed guiding template can be recommended as a useful aid for endoscopic type I tympanoplasty.
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Endoscopía/métodos , Impresión Tridimensional , Perforación de la Membrana Timpánica/cirugía , Membrana Timpánica/cirugía , Timpanoplastia/métodos , Adolescente , Adulto , Anciano , Femenino , Audición , Humanos , Masculino , Persona de Mediana Edad , Tempo Operativo , Perforación de la Membrana Timpánica/fisiopatología , Adulto JovenRESUMEN
Reactive oxygen species (ROS) are the key signaling molecules in many physiological signs of progress and are associated with almost all diseases, such as atherosclerosis, aging, and cancer. Bone is a specific connective tissue consisting of cells, fibers, and mineralized extracellular components, and its quality changes with aging and disease. Growing evidence indicated that overproduced ROS accumulation may disrupt cellular homeostasis in the progress of bone modeling and remodeling, leading to bone metabolic disease. Thus, ROS-responsive biomaterials have attracted great interest from many researchers as promising strategies to realize drug release or targeted therapy for bone-related diseases. Herein, we endeavor to introduce the role of ROS in the bone microenvironment, summarize the mechanism and development of ROS-responsive biomaterials, and their completion and potential for future therapy of bone-related diseases.
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Teriparatide, also known as 1-34 parathyroid hormone (PTH (1-34)), is commonly used for the treatment of osteoporosis in postmenopausal women. But its therapeutic application is restricted by poor metabolic stability, low bioavailability, and rapid clearance. Herein, PTHG2, a glycosylated teriparatide derivative, is designed and synthesized to improve PTH stability and exert more potent antiosteoporosis effect. Surface plasmon resonance (SPR) analysis shows that PTHG2 combines to PTH 1 receptor. Additional acetylglucosamine covalent bonding in the first serine at the N terminal of PTH (1-34) improves stability and increases protein hydrolysis resistance. Intermittent administration of PTHG2 preserves bone quality in ovariectomy- (OVX-) induced osteoporosis mice model, along with increased osteoblastic differentiation and bone formation, and reduced marrow adipogenesis. In vitro, PTHG2 inhibits adipogenic differentiation and promotes osteoblastic differentiation of bone marrow mesenchymal stem cells (BMSCs). For molecular mechanism, PTHG2 directs BMSCs fate through stimulating the cAMP-PKA signaling pathway. Blocking PKA abrogates the pro-osteogenic effect of PTHG2. In conclusion, our study reveals that PTHG2 can accelerate osteogenic differentiation of BMSCs and inhibit adipogenic differentiation of BMSCs and show a better protective effect than PTH (1-34) in the treatment of osteoporosis.
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BACKGROUND: There are many reports on the role of the malleus handle in ossicular chain reconstruction (OCR). However, the effect of the presence of the malleus handle is not clear. AIM/OBJECTIVES: To compare the hearing outcomes of using a partial ossicular replacement prosthesis (PORP) to reconstruct the ossicular chain under otoendoscopy with and without a malleus handle. METHODS: Records of 57 patients requiring OCR were retrospectively analyzed. They were divided into the malleus handle-present group (group 1) and the malleus handle-absent group (group 2). The audiometric results were analyzed pre- and postoperatively. A postoperative air-bone gap (ABG)≤20 dB was considered successful. RESULTS: The mean improvement in air conduction hearing thresholds was 19.80 dB in group 1 and 16.70 dB in group 2. The mean ABG improvement was 18.09 ± 12.79 dB for group 1 and 17.20 ± 16.44 dB for group 2. The malleus handle-present group achieved higher success (65.63%) than the malleus handle-absent group (52%; p> .05). CONCLUSIONS AND SIGNIFICANCE: Improvements in hearing outcomes were similar for the two groups. However, the malleus handle-present group showed a better reconstruction success rate. Our results suggest that if there is no lesion in the malleus handle, it is recommended to be retained.
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Conducción Ósea/fisiología , Osículos del Oído/cirugía , Pérdida Auditiva/cirugía , Prótesis Osicular , Reemplazo Osicular/métodos , Timpanoplastia/métodos , Adulto , Anciano , Audiometría , Femenino , Pérdida Auditiva/fisiopatología , Pruebas Auditivas , Humanos , Masculino , Martillo/cirugía , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
Isocitrate dehydrogenase 2 (IDH2) is a key enzyme in the regulation of cell metabolism. Its mutated type can lead to the accumulation of 2-hydroxyglutarate, which is often related to malignancies such as acute myeloid leukemia. Therefore, it is necessary to find new inhibitors targeting mutant IDH2. Discriminatory analysis-based molecular docking was employed to screen the ChemDiv compound library, which resulted in the identification of three new IDH2R140Q inhibitors with moderate-to-good IC50 values. Among them, compounds 1 and 3 displayed good selectivity against other mutant or wild-type IDH proteins. The most potent compound 1, bearing the [1,2,4]triazolo[1,5-a]pyrimidin scaffold, was subjected to dynamic simulations to provide more information on the binding mode with IDH2R140Q , providing structural clues to further optimize compound 1 as a new mutant IDH2 inhibitor.
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Inhibidores Enzimáticos/farmacología , Isocitrato Deshidrogenasa/antagonistas & inhibidores , Simulación del Acoplamiento Molecular , Pirimidinas/farmacología , Línea Celular , Supervivencia Celular/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Inhibidores Enzimáticos/síntesis química , Inhibidores Enzimáticos/química , Humanos , Isocitrato Deshidrogenasa/genética , Isocitrato Deshidrogenasa/metabolismo , Estructura Molecular , Pirimidinas/síntesis química , Pirimidinas/química , Relación Estructura-ActividadRESUMEN
Cisplatin is an anti-cancer drug that causes oxotoxic side effects such as impairment of inner ear function and hearing loss. We aimed to investigate the effects of allicin against cisplatin-induced stria vascularis damage in mice, and to clarify the mechanism underlying the protective effects of allicin against ototoxicity. Stria vascularis injury was induced in mice by intraperitoneal injection of cisplatin, which was significantly prevented by pretreatment with allicin. Allicin not only reduced cisplatin-activated expression of cleaved caspase-3 in marginal cells, PVM/Ms (perivascular resident macrophage-like melanocytes), and basal cells of the stria vascularis, but also decreased the expression of poly(ADP-ribose) polymerase-1 (PARP-1) and apoptosis-inducing factor (AIF) nuclear translocation in the stria vascularis cells. Our results demonstrate that allicin plays an effective role in protecting stria vascularis injury induced by cisplatin by inhibiting caspase-dependent, as well as caspase-independent PARP-1-AIF-mediated apoptotic pathways. Therefore, allicin may be useful in preventing cisplatin-induced ototoxicity.
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Apoptosis , Caspasa 3/efectos de los fármacos , Pérdida Auditiva/prevención & control , Poli(ADP-Ribosa) Polimerasa-1/antagonistas & inhibidores , Estría Vascular/efectos de los fármacos , Ácidos Sulfínicos/farmacología , Animales , Antioxidantes/farmacología , Caspasa 3/metabolismo , Cisplatino/toxicidad , Modelos Animales de Enfermedad , Disulfuros , Femenino , Pérdida Auditiva/inducido químicamente , Pérdida Auditiva/patología , Masculino , Ratones , Ratones Endogámicos C57BL , Microscopía Electrónica de Transmisión , Poli(ADP-Ribosa) Polimerasa-1/metabolismo , Estría Vascular/metabolismo , Estría Vascular/ultraestructuraRESUMEN
Background: Acellular dermal allograft (AlloDerm) and cartilage perichondrium are two common materials used for repair of tympanic membrane perforations (TMPs). To date, comparative evaluations of their efficacy have rarely been reported. Aim/objectives: To compare anatomical and audiological outcomes between AlloDerm and cartilage perichondrium in type I tympanoplasty. Methods: A total of 61 patients of TMP were studied. In total, 27 patients (Group 1) underwent AlloDerm myringoplasty, and the remaining 34 patients (Group 2) underwent perichondrium myringoplasty. Operating time, closure rate and hearing gain were compared between Groups 1 and 2. Results: Successful closure rates at 6-month follow-up were 88.9% (Group 1) and 82.4% (group 2). The average improvement of air-bone gap (ABG) was 13.5 ± 11.8 dB for Group 1 and 13.1 ± 13.1 dB for Group 2. The difference in between preoperative and 6 months postoperative ABG values was statistically significant (p < .001). Conclusions and significance: Success rates and improvement of hearing level were similar for the AlloDerm (Group 1) and the cartilage perichondrium (Group 2) groups. However, AlloDerm requires shorter operative time and avoids the incisions in the harvest of allografts. Our results suggest that AlloDerm can be recommended as an attractive alternative to cartilage grafts.
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Dermis Acelular , Cartílago/trasplante , Colágeno/uso terapéutico , Miringoplastia/métodos , Perforación de la Membrana Timpánica/cirugía , Timpanoplastia/métodos , Adulto , Femenino , Audición , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: To explore the effectiveness of proximal femoral nail antirotation (PFNA) assisted by mesh locator in treatment of intertrochanteric fracture in the elderly. METHODS: Ninety-four elderly patients with intertrochanteric fractures admitted between August 2014 and July 2017 were selected as the study subjects. They were randomly divided into trial group (48 cases) and control group (46 cases). In trial group, PFNA was implanted assisted by mesh locator after closed reduction; while in control group, PFNA was implanted by conventional method. There was no significant difference between the two groups in terms of gender, age, cause of injury, time from injury to admission, fracture side and classification, and medical complications ( P>0.05). The operation time, intraoperative blood loss, fluoroscopy times, hospital stay, incision length, and complications were recorded. Visual analogue scale (VAS) was used to evaluate the degree of pain at 3 days after operation, and Harris score was used to evaluate hip function before operation and at 3, 6, and 9 months after operation. RESULTS: Compared with control group, the operation time and incision length of trial group shortened, the blood loss and fluoroscopy times reduced, the pain after operation alleviated obviously; the differences between the two groups were significant ( P<0.05). There was no significant difference in hospital stay between the two groups ( P>0.05). The patients in both groups were followed up 9-12 months, with an average of 10.6 months. X-ray films showed that the fractures healed in both groups, and the healing time in control group was (11.2±3.2) weeks, while that in trial group was (11.6±2.9) weeks, showing no significant difference between the two groups ( t=1.262, P=0.120). There was no significant difference in Harris score between the two groups before operation and at 3, 6, and 9 months after operation ( P>0.05). There was 1 case of incision infection, 2 cases of coxa vara, and 1 case of pressure ulcer in trial group, and the incidence of complications was 8.3%. There was 1 case of coxa vara, 2 cases of pressure ulcer, and 1 case of internal fixation loss in control group, and the incidence of complications was 8.7%. There was no significant difference in the incidence of complications between the two groups (χ 2=0.783, P=0.112). CONCLUSION: It is feasible to implant PFNA assisted by mesh locator in treatment of intertrochanteric fracture in the elderly. Compared with the traditional operation, it can shorten the operation time, shorten the incision, and relieve the pain after operation.
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Fijación Intramedular de Fracturas , Fracturas de Cadera , Anciano , Clavos Ortopédicos , Fémur , Fracturas de Cadera/cirugía , Humanos , Mallas Quirúrgicas , Resultado del TratamientoRESUMEN
BACKGROUND: Staphylococcus aureus is the most commonly isolated bacterium from patients with surgically recalcitrant chronic rhinosinusitis (CRS). Understanding the immune responses to S aureus biofilms will provide insights into how the host response may be manipulated by therapeutic agents to improve the chances of successfully preventing and treating these infections. In this study, we investigated the inflammatory immune response in a rabbit model of S aureus biofilm-related sinusitis by analyzing the levels of some major inflammatory cytokines. METHODS: Eighteen New Zealand white rabbits were randomly divided into 3 groups: a blank-control group; a negative-control group; and a model group. Four weeks after the biofilm-associated sinusitis models were established, the sinus mucosa was harvested and examined using hematoxylin-eosin (H&E) staining, scanning electron microscopy (SEM), reverse transcription polymerase chain reaction (RT-PCR), and western blotting. The expression levels of inflammatory cytokines were analyzed statistically. RESULTS: Interleukin (IL)-1ß, IL-8, and tumor necrosis factor (TNF)-α expression levels were significantly higher in the model group than in the blank-control group (p < 0.05); mRNA levels were increased by 1600%, 230%, and 130%, respectively, and the protein levels were increased by 180%, 100%, and 100%, respectively. In contrast, IL-4 and IL-5 mRNA levels were reduced by 44% and 70%, respectively, compared with the blank-control group (p < 0.05). CONCLUSION: S aureus biofilms in the rabbit maxillary sinus mucosa were associated with increased IL-1ß, IL-8, and TNF-α expression, and decreased IL-4 and IL-5 expression.