[Establishment and validation of a risk prediction model for disseminated intravascular coagulation patients with electrical burns].

Objective: To establish and validate a risk prediction model of disseminated intravascular coagulation (DIC) by the screening independent risk factors for the occurrence of DIC in patients with electrical burns. Methods: The retrospective case series study was conducted. The clinical data of 218 electrical burn patients admitted to Baogang Hospital of Inner Mongolia from January 2015 to January 2023 who met the inclusion criteria were collected, including 198 males and 20 females, with the age of (38±14) years. The patients were divided into DIC group and non DIC group based on whether they were diagnosed with DIC during the treatment period. The following data of patients of two groups were collected and compared, including age, gender, total burn area, full-thickness burn area, injury voltage, whether osteofascial compartment syndrome occurred within 1 day after injury, duration of stay in burn intensive care unit, total length of hospital stay, whether combined with inhalation injury and multiple injuries, whether shock occurred upon admission, the abbreviated burn severity index score, and the acute physiology and chronic health evaluation Ⅱ score. The laboratory examination data of the patients within 24 hours after admission were also collected, including blood routine indexes: white blood cell count (WBC), hemoglobin level, platelet count (PLT), and neutrophil count; coagulation indexes: activated partial thromboplastin time (APTT), prothrombin time, thrombin time, and levels of D-dimer and fibrinogen (FIB); blood biochemistry indexes: aspartic transaminase, alanine transaminase, direct bilirubin, total bilirubin, total protein, albumin, blood glucose, creatinine, and urea nitrogen; blood gas analysis indexes: blood pH value, arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide, bicarbonate, and base excess; and cardiac zymogram indexes: levels of myoglobin, troponin, lactate dehydrogenase, creatine kinase (CK), and α-hydroxybutyrate dehydrogenase. Data were statistically analyzed with chi-square test, Fisher's exact probability test, independent sample t test, and Mann-Whitney U test. For the variables with statistically significant differences in single factor analysis, the least absolute value selection and shrinkage operator (LASSO) regression was used to reduce the dimension, and the predictive factors for DIC in 218 patients with electrical burns were screened. The above-mentioned predictors were included in multivariate logistic regression analysis to find out the independent risk factors for DIC in 218 patients with electrical burns, and to draw the prediction model nomograms. The performance of the prediction model was evaluated by the receiver operating characteristic (ROC) curve and the area under the ROC curve, and the prediction model was validated by the calibration curve and clinical decision curve analysis (DCA). Results: Compared with those in non DIC group, the total burn area, full-thickness burn area, total length of hospital stay, and the proportions of high voltage caused injury, occurrence of osteofascial compartment syndrome within 1 day after injury, combination of inhalation injury, and occurrence of shock upon admission of patients in DIC group were significantly increased/prolonged (with Z values of -2.53, -4.65, and -2.10, respectively, with χ2 values of 11.46, 16.00, 7.98, and 18.93, respectively, P<0.05). Compared with those in non DIC group, the APTT, level of D-dimer, myoglobin, WBC, PLT, and levels of FIB, total bilirubin, and CK of patients within 24 hours after admission in DIC group were significantly prolonged/increased (with Z values of -2.02, -4.51, and -3.82, respectively, with t values of -3.84, -2.34, -2.77, -2.70, and -2.61, respectively), and the level of total protein and blood pH value were significantly reduced (t=-2.85, Z=-2.03), P<0.05. LASSO regression analysis was carried out for the above 17 indicators with statistically significant differences. The results showed that injury voltage, the occurrence of shock upon admission, the occurrence of osteofascial compartment syndrome within 1 day after injury, and levels of D-dimer and total protein within 24 hours after admission were predictive factors for the occurrence of DIC in 218 patients with electrical burns (with regression coefficients of 0.24, 0.52, 0.35, 0.13, and -0.001, respectively). Multivariate logistic regression analysis showed that injury voltage, the occurrence of shock upon admission, the occurrence of osteofascial compartment syndrome within 1 day after injury, and D-dimer level within 24 hours after admission were independent risk factors for DIC in 218 patients with electrical burns (with odds ratios of 3.33, 4.24, 2.68, and 1.38, respectively, with 95% confidence intervals of 1.43-7.79, 1.78-10.07, 1.17-6.13, and 1.19-1.61, respectively, P<0.05). Based on the aforementioned four independent risk factors, the nomogram of prediction model for evaluating the probability of DIC in patients was drawn. The area under the ROC curve of prediction model was 0.88, and the 95% confidence interval was 0.82-0.95, indicating that the model had good predictive ability; the curve of prediction model tended to be near the ideal curve, indicating that the model had a high calibration degree; the clinical DCA of prediction model showed that the threshold probability of patients ranged from 4% to 97%, indicating that the model had good predictive ability. Conclusions: The injury voltage, the occurrence of shock upon admission, the occurrence of osteofascial compartment syndrome within 1 day after injury, and D-dimer level within 24 hours after admission are independent risk factors for the occurrence of DIC in patients with electrical burns. The prediction model established based on the above indicators can provide early warning for the occurrence of DIC in these patients.

[Long-term evaluation and physical and mental effects of residual tinnitus following treatment of sudden hearing loss].

Objective: To clarify the long-term characteristics of tinnitus following treatment of sudden deafness and its long-term physical and mental effects on patients. Methods: A retrospective analysis was performed on 88 patients (46 males and 42 females; Age from 11 to 89 years) with sudden deafness treated in Department of Otoscope Surgery of Peoples's Libration Army General Hospital in Beijing from April 2020 to January 2021, and the occurrence of tinnitus and treatment effect of all patients were analyzed. Follow-up was conducted for patients with residual tinnitus after treatment for more than 1 year by the investigation and filling in the survey information collection form, Tinnitus Evaluation Questionnaire (TEQ) and Tinnitus Handicap Inventory (THI). Descriptive statistics and SPSS 22.0 software were used for statistical data analysis. Results: In this study, 93.2% (82/88) of patients with sudden deafness were accompanied by tinnitus at the onset, and the proportion of long-term tinnitus after treatment was 90.2% (74/82). After 1 year of treatment for sudden deafness, the improvement of tinnitus was significant in low-frequency sudden deafness compared with those of high-frequency, flat and total deafness sudden deafness (χ2 value was 6.801, 4.568 and 4.038, all P<0.05). In patients with residual tinnitus, 9 (12.2%) patients felt minimal loudness or even no loudness, 34 (46.0%) patients felt slight loudness, 28 (37.8%) patients felt tinnitus was relatively loud, and 3 (4.1%) patients felt tinnitus was loud or noisy. Nine (12.2%) patients's sleep was often affected, 41 (55.4%) patients's sleep was sometimes affected, 9 (12.2%) patients's sleep was rarely affected, 15 (20.3%) patients's sleep was almost not affected. Twenty-eight (37.8%) patients basically completely adapted to tinnitus and 46 (62.2%) patients did not completely adapted to residual tinnitus. Eight (10.8%) patients had no impact on life, 39 (52.7%) patients had slight impact, 22 (29.7%) patients had moderate impact, and the other 5 (6.8%) patients had greater impact. According to tinnitus evaluation questionnaire(TEQ), there were 12 cases (16.2%) of grade Ⅰ, 26 cases (35.1%) of grade Ⅱ, 28 cases (37.8%) of grade Ⅲ, 7 cases (9.5%) of grade Ⅳ and 1 case (1.4%) of grade Ⅴ. According to tinnitus handicap inventory(THI), tinnitus disability was classified into grade Ⅰ, 22 cases (29.7%), grade Ⅱ, 14 cases (18.9%), Grade Ⅲ, 27 cases (36.5%) and grade Ⅳ, 11 cases (14.9%). Conclusion: The rate of residual tinnitus following treatment of sudden deafness is high. Some of the patients can completely adapt residual tinnitus after one year, but some of them will be affected when sleep, work and study. Residual tinnitus can lead to tinnitus disability in different degrees.

[Differential diagnosis between pulmonary artery sarcoma and central chronic pulmonary thromboembolism:a preliminary study on CT signs].

Objective: To improve the diagnostic accuracy of pulmonary artery sarcoma, and to distinguish it from central chronic pulmonary thromboembolism using CT scans. Methods: In this retrospective study, two groups of pulmonary artery sarcoma (PAS group) and central chronic pulmonary thromboembolism (central CPTE group) confirmed by pathology at our hospital between August 2009 and July 2019 were enrolled, clinical features and pre-operative CT pulmonary artery manifestation were collected, and the key points of differential diagnosis were summarized. Results: The study was composed of 13 cases in the PAS group including 10 males (76.9%), with an average age of (45.4±15.5) years. There were 19 patients in the central CPTE group including 14 males (73.7%), with an average age of (38.6±14.1) years. There were no significant differences in gender and age between the two groups. Deep venous thrombosis in the lower extremities was significantly higher in the central CPTE group than in the PAS group (7/19 vs. 0/13, P=0.025), and the N-terminal pro-brain natriuretic peptide value was higher in the central CPTE group than in the PAS group [674.50(261.70-1 977.70) vs. 66.00(28.10-505.50),P=0.001]. In CT pulmonary angiography, the involvement of the main pulmonary artery, and the proximal lesion showing an acute angle to the pulmonary artery wall were more common in the PAS group [11(84.6%) vs. 5(26.3%), P=0.003; 11(84.6%) vs. 2(10.5%), P<0.001, respectively]. The swelling index of the main pulmonary and the left/right main pulmonary arteries in the PAS group were significantly higher, as well as the dilatation in the lobar and segmental pulmonary arteries [1.19±0.17 vs. 0.99±0.19,P=0.006, 10(76.9%) vs. 2(10.5%), P<0.001, respectively]. The right ventricular transverse diameter/left ventricular transverse diameter (RVd/LVd) and pulmonary artery diameter/ascending aortic diameter ratio (Pad/Aod) were significantly lower in PAS group than those in the central CPTE group (0.97±0.19 vs. 1.23±0.35,P=0.020; 0.98±0.25 vs. 1.15±0.20,P=0.039). Conclusions: In CT pulmonary angiography, filling defects involving the main pulmonary artery and showing expansive growth were highly suggestive of pulmonary artery sarcoma. The history of deep venous thrombosis of the lower extremities was helpful for the diagnosis of chronic pulmonary embolism.

Contrast medium injection protocols for coronary CT angiography: should contrast medium volumes be tailored to body weight or body surface area?

AIM: To compare the uniformity and image quality between contrast media injection protocols adjusted for patient body weight (BW) versus body surface area (BSA) during coronary computed tomography (CT) angiography (CCTA). MATERIALS AND METHODS: Consecutive patients (n=489) with suspected coronary artery disease were randomised prospectively to one of two CCTA protocols. In the BW protocol (n=245), patients received individualised iodine delivery rates (≤50 kg: 1 g/s; 51-60 kg: 1.2 g/s; 61-70 kg: 1.4 g/s; 71-80 kg: 1.6 g/s; 81-90 kg: 1.8 g/s; 91-100 kg: 2 g/s; >100 kg: 2.2 g/s). In the BSA protocol (n=244), patients received 9,600 mg iodine/m2 of contrast medium over 12 seconds. Attenuation and image noise were measured. Signal-to-noise ratio and contrast-to-noise ratio were calculated. Image quality was scored. Attenuation was assessed for correlation with BW and BSA using linear regression. RESULTS: There were no statistically significant differences in mean arterial attenuation (396.8±47.6 versus 395.8±42.2 HU, p=0.804; 95% confidence interval: -7 to 9), image noise (25.2±5.8 versus 25.5±5.4 HU; p=0.549), signal-to-noise ratio (16.7±4.4 versus 16.6±3.6; p=0.902), contrast-to-noise ratio (25.1±5.8 versus 25.8±7.4; p=0.258) or image quality scores (4.1±0.9 versus 4±0.9; p=0.770) between the BW and BSA protocols. There was no correlation between BW and aortic attenuation or between BSA and aortic attenuation (p=0.324 and 0.932, respectively). CONCLUSION: The average contrast media attenuation and image quality was comparable between BW-adjusted protocol and BSA-adjusted protocol.

Efficacy of intrauterine perfusion of peripheral blood mononuclear cells (PBMC) for infertile women before embryo transfer: meta-analysis.

This meta-analysis was intended to evaluate the effects of intrauterine perfusion of peripheral blood mononuclear cells (PBMC) on the pregnancy outcomes including clinical pregnancy rates, embryo implantation rates, live birth rates and miscarriage rates of infertile women who were undergoing in vitro fertilisation (IVF) treatment. By searching Pubmed, Embase database, five articles meeting the inclusion criteria were included, and 1173 women were enrolled (intrauterine PBMC group: n = 514; NO-PBMC group: n = 659). For the entire IVF/ICSI population and one or two embryo transfer failure patients, there was no significant difference in endometrial thickness, embryo implantation rates, live birth rates, and miscarriage rates between the PBMC group and NO-PBMC group. Although the clinical pregnancy rates of the PBMC group were higher than that of the NO-PBMC group, the confidence interval was close to the line of unity. As for the patients with three or more implantation failures, the clinical pregnancy rates, embryo implantation rates and live birth rates were much higher in the PBMC group than that of the NO-PBMC group. In summary, current evidence suggests that intrauterine perfusion of PBMC can significantly improve pregnancy outcomes in patients who have three or more implantation failures.Impact statementWhat is already known on this subject? An increasing number of studies have shown that immune cells play an important role in embryo transfer. There is no reliable evidence to confirm the clinical efficacy of intrauterine perfusion of PBMC.What do the results of this study add? The current evidence suggests that intrauterine perfusion of PBMC can significantly improve pregnancy outcomes in patients who have three or more implantation failures.What are the implications of these findings for clinical practice and/or further research? To the best of our knowledge, this meta-analysis is the first to evaluate the effect of intrauterine perfusion of PBMC on pregnancy outcomes before embryo transfer. Our study indicated that intrauterine perfusion of PBMC significantly increased clinical pregnancy rates, embryo implantation rates, and live birth rates in patients who failed more than three implants.

[Management of 242 patients with middle ear cholesteatoma by otoendoscopic surgery and the postoperative effect analysis].

Objective: To summarize and discuss the characteristics of endoscopic approach to manage the middle ear cholesteatoma, and to evaluate the operative safety and outcomes based on the data from the multicenter study. Methods: The data of 242 cases diagnosed with the middle ear cholesteatoma and received operation through endoscopic approach between June 2016 and June 2017 in six tertiary hospitals in China were analyzed in this work. There were 130 males and 112 females, with the age ranging from 3 to 72 years old. We evaluated the strategy about how to manage the cholesteatoma, discussed the detailed techniques about how to remove the cholesteatoma and to improve the efficiency under endoscopic visualization. Meanwhile, the recurrence rate and residual rate of cholesteatoma as well as the complications in endoscopic approach were summarized. Results: A total of 158 cases were operated in exclusively endoscopic transcanal approach, 72 cases operated in combined approach, and 12 cases operated majorly under microscope and minorly under endoscope. 219 cases were operated in one stage surgery, 23 cases received second look. In the second look, 3 cases were detected with residual cholesteatomas. Among them, 2 cases were found by MRI-DWI examination after the first-stage operation. With endoscopic examination after operation, 17 cases showed retracted pocket recurrence (7%,17/242). With introduction of endoscope in cholesteatoma, 153 cases were achieved canal wall-up operation (63%, 153/242). The complications in endoscopic approach included chord tympani never injury in 27 cases, skin injury of ear canal in 11 cases, tinnitus in 13 cases, vertigo in 7 cases, external ear canal stenosis in 1 case. Conclusions: Using otoendoscope in cholesteatoma surgery would help keeping the normal structures of middle ear as much as possible, benefit to remove the hiding pathologies, help reducing residual cholesteatoma and lowering the rate of canal wall-down operation as well. This study showed good safety of otoendoscopic cholesteatoma surgery, however, strict evaluation of indication and quite good surgical techniques and skills are necessary for avoiding unexpected complication.

[A multi-center retrospective study of ossiculoplasty surgery under oto-endoscope in 45 cases of conductive hearing loss with intact tympanic membrane].

Objective: To explore the efficacy of ossiculoplasty surgery under oto-endoscope in patients of conductive hearing loss with intact tympanic membrane. Methods: A retrospective study was conducted. The clinical data of 45 patients with conductive hearing loss who had undergone simple ossiculoplasty surgery between October 2015 and December 2017 from five hospitals in China (West China Hospital of Sichuan University, General Hospital of the People's Liberation Army, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Xijing Hospital, Fourth Military Medical University and Shenzhen Sixth People's Hospital) were collected. There were 28 males and 17 females, with the age ranging from 12 to 69 years old. The tympanic membranes of those patients were intact before surgery. The lesion only occurred in the ossicular chain from CT and intraoperative exploration. The cases of otosclerosis, tympanosclerosis, cholesteatoma of middle ear, chronic suppurative otitis media, and tumor of middle ear were excluded. The postoperative complications, hearing improvements and operation time were observed. SPSS 23.0 software was used for statistic analysis. Results: There was neither sensorineural hearing loss nor facial paralysis after surgery in this group. Seven patients had transient mild tinnitus after surgery and gradually relieved during the follow-up period. Nine patients developed dysgeusia after surgery. Two patients developed dizziness after surgery, and the symptoms were mild and relieved during 1 week without special intervention. The air-bone gap (ABG) range of pre-operation was 22.5-45.7 dB, and the average ABG was (25.3±8.6) dB. The ABG range in the third month after surgery was 5.7-26.8 dB, and the average ABG was (9.3±8.6) dB. The mean value of ABG was significantly lower in the third month after surgery compared with that of pre-operation (t=2.31, P<0.05). The operation time of the surgeons in each research center was similar. The overall average of operation time was (43.56±18.25) min. There was no significant difference in the duration of operation between the centers (F=3.26, P>0.05). Conclusion: The ossiculoplasty surgery under oto-endoscope has good efficacy.

[Evaluation of the safety and effect of the endoscopic stapes surgery: a multi-center study].

Objective: To analyze the safety of endoscopic stapes surgery, and to compare the results with stapes surgery under microscopic approach. Methods: This was a retrospective study. One hundred and thirty seven patients from Eye Ear Nose and Throat Hospital of Fudan University and other seven hospitals were enrolled in this study. Eighty eight patients, in whom 29 were male, and 59 were female, aged from 29 to 66 years old, with an average of 40.1±10.7, underwent endoscopic stapedotomy and 49 patients, in whom 17 were male, and 33 were female, aged from 32 to 64 yeas old, with an arerage of 38.7±9.2, underwent microscopic stapedotomy for otosclerosis. Interventions included endoscopic and microscopic stapes surgeries. Main outcome measures consisted of operating time, preoperative and postoperative hearing, intraoperative findings, and postoperative complications. SPSS 16.0 software was used to analyzed the date (t test and χ(2) test) . Results: Patients in the group who underwent endoscopic stapes surgery showed a mean operative time of (74.1±26.0) min. Patients in the group treated by microscopic approach had a mean operative time (66.5±15.9) min. Statistical difference was evident (t=1.279, P<0.05) . The average operative time of endoscopic surgery became shorter as the cases increased. The average duration of the last 10 cases was shorter than that of the first 10 cases in both groups. The differences were significant (t value was 3.028, 3.610, both P<0.05). No statistical difference was found in air conduction threshold improvement (t=1.074, P=0.289) , air-bone gap closure (t=-0.135, P=0.893) and bone conduction improvement (t=1.222, P=0.228) between the two groups. No difference regarding the incidence of the postoperative complications (chorda tympanum damage: 6 cases vs 2 cases, χ(2)=0.08,P>0.05; vertigo:18 cases vs 9 cases,χ(2)=0.09, P>0.05; facial paralysis: 0 case vs 0 case) between the two groups was found. Conclusion: Audiological outcomes achieved by endoscopic surgery are similar to the results obtained through a microscopic approach. Endoscopic stapes surgery is safe.

[Progress in middle ear dysventilation research].

Disfunction of Eustachian tube will cause negative pressure of middle ear, which may result in tympanic membrane retraction pocket. Severe pocket can consequently cause cholesteatoma. In clinical practice it is not uncommon to find a cholesteatoma limited to epitympanum, with an otherwise normal pars tensa and mesotympanum. This review explains the theory of "selective epitympanic dysventilation syndrome" developed by endoscopic technique. In the majority of the patients, the only ventilation pathway to the epitympanum is through the tympanic isthmus. Even if Eustachian tube function has recovered, an isthmus blockage with selective epitympanic dysventilation may lead to common attic cholesteatoma.

[Temporal bone anatomy via transcanal endoscopy].

Based on anatomy and clinical operation, this article discussed the anatomical structure of temporal bone and its contiguous relationship under oto-endoscope, through two approaches: the natural external auditory canal and the enlarged external auditory canal. To give an account of the anatomical characteristics of temporal bone under oto-endoscope.

[Comparison of aortic valve dysfunction and ascending aorta dimension between patients with different bicuspid aortic valve morphology].

Objective: To compare the characteristics of aortic valve dysfunction and ascending aorta dimension in patients with different bicuspid aortic valve (BAV) morphology. Methods: A total of 197 patients who underwent aortic valve replacement between April 2014 and March 2015 and were diagnosed with BAV by pathology were included, and their clinical data were retrospectively analyzed. Patients were divided into raphe(+) group(109 cases) and raphe(-) group(88 cases) according to the presence or absence of raphe, and L-R group(fusion of left and right cusp, 125 cases) and L/R-N group(fusion of left or right and noncoronary cusp, 72 cases) according to fusion type of the cusps. The characteristics of aortic valve dysfunction and ascending aorta dimension in patients with different BAV morphology were compared. Results: (1) Aortic stenosis incidence was lower in raphe(+) group than in raphe(-) group(22.9%(25/109) vs. 69.3%(61/88), P<0.001). Aortic regurgitation incidence was higher in raphe(+) group than in raphe(-) group (61.5%(67/109) vs. 22.7%(20/88), P<0.001). Incidence of type 1 of aortic root dilation was higher in raphe(+) group than in raphe(-) group (23.9%(26/109)vs.10.2%(9/88), P=0.024). (2) Aortic stenosis incidence was lower in L-R group than in L/R-N group(29.6%(37/125) vs. 68.1%(49/72), P<0.001). Aortic regurgitation incidence was higher in L-R group than in L/R-N group (59.2%(74/125) vs. 18.1%(13/72), P<0.001). Incidence of type 3 of aortic root dilation was lower in L-R group than in L/R-N group(10.4%(13/125) vs. 37.5%(27/72), P=0.006). (3) Aortic stenosis incidence was lower in L-R patients than in L/R-N patients(15.1%(13/86)vs. 52.2%(12/23), P=0.001), and aortic regurgitation incidence was higher in L-R patients than in L/R-N patients in raphe(+) group(73.3%(63/86)vs. 17.4%(4/23), P<0.001). Conclusion: There is significant difference in the type of valvular dysfunction and ascending aorta dilatation in patients with different morphological characteristics of BAV.

[Effects of statin intervention on mild coronary plaque progression assessed by serial coronary CT angiography].

OBJECTIVE: To assess the effects of statin treatment on mild coronary plaque progression by serial coronary CT angiography. METHODS: A total of 120 consecutive patients (74 men, ages(58.9±8.1)years) with mild (≤50%luminal narrowing and lesion length<20 mm) non-calcified plaque detected by coronary CT angiography during September 2012 and December 2013 were prospectively enrolled in this study.Subjects were divided into three groups: no statin (n=36), statin lowering LDL-C <50% (n=43), and statin lowering LDL-C ≥50%(n=41). Serial scans were performed after a median interval of 705 (interquartile range: 467, 803) days.Total plaque volume, percent plaque volume for both baseline and follow-up were measured.Baseline and follow-up data were compared. RESULTS: Compared with baseline, total plaque volume in no statin group showed increasing trend by the end of follow-up ((97.3±57.8) mm(3) vs. (82.2±57.7) mm(3,) P=0.075). However, no significant change was observed as for total plaque volume ((78.5±45.2) mm(3) vs.(77.6±50.5) mm(3), P=0.910) in the statin lowering LDL-C <50% group.Total plaque volume was significantly reduced by the end of follow-up ((61.5 ± 46.1) mm(3) vs.(77.7±48.1) mm(3), P=0.024) in the statin lowering LDL-C ≥50% group.Percent plaque volume in no statin group was significantly increased by the end of follow-up ((51.9±16.5)% vs.(45.9±12.8)%, P=0.036). However, no significant change was observed as for percent plaque volume ((49.1±13.7)% vs.(47.5±14.9)%, P=0.554) in the statin lowering LDL-C <50% group. Percent plaque volume was significantly reduced by the end of follow-up ((39.1±17.1)% vs.(48.2±15.0)%, P=0.003) in the statin lowering LDL-C ≥50% group. Multivariable linear regression analysis showed that both higher baseline total plaque volume(ß=-0.50, P<0.001) and statin lowering LDL-C ≥50%(ß=-0.32, P=0.001) were independent determinants of plaque regression. CONCLUSION: This study suggests that LDL-C reduction ≥50% post statin treatment can retard plaque progression, and even induce regression of mild non-calcified coronary plaque, patients with greater baseline coronary plaque volume are more likely to benefit from statin therapy.

[Analysis of the diagnosis and treatment of cerebrospinal fluid otorrhea].

Objective:To analyze the etiology and clinical symptoms and to investigate the therapeutic strategies of cerebrospinal fluid otorrhea. Method:A retrospective analysis of 37 cases of patients with cerebrospinal fluid otorrhea.The clinical symptoms, auxiliary examination, intraoperative findings, surgical methods and postoperative follow-up were analyzed. Result:In 37 cases, 35 patients underwent the plugging surgery once and cured, 1 patient with inner ear malformation underwent another operation and cured, 1 patient didn't have the operation. No cerebrospinal fluid leakage or meningitis recurrence was reported by the followed up from 1 months to 7 years after operation. Conclusion:Surgical repair is an effective method to treat the cerebrospinal fluid otorrhea. It is significant to take appropriate surgical approach to expose and to find the leak, according to the etiological factor and imaging examination.

Cyclosporine induces up-regulation of immunoglobulin-like transcripts 3 and 4 expression on and activity of NKL cells.

BACKGROUND: Immunoglobulin-like transcripts (ILTs), which belong to a kind of receptor family discovered recently, are differentially expressed on myeloid and lymphoid cells. Most of them play important roles to regulate human immune responses by interacting with ligands. Cyclosporine (CsA) is frequently used to prevent graft-versus-host disease and treat autoimmune diseases. There are some studies about the effects of CsA on various human immunologic reactions, but its impact on ILT3 and ILT4 expression on natural killer (NK) cells is less well understood. METHODS: An NKL cell line was exposed to CsA (5, 10, 15, or 20 mg/L) for 12, 24, or 36 hours before real-time quantitative polymerase chain reaction and flow cytometry were used to detect alterations in ILT3 and ILT4 mRNA and protein expressions. NKL cells treated for 36 hours with or without CsA (15 mg/L) and then coincubated with BGC-823 or JEG-3 cells, in cytolytic and proliferative systems measured by Thiazoyl blue tetrazolium bromide assays. RESULTS: After CsA treatment both RNA and protein levels of ILT3 and ILT4 on NKL cells were increased for 12, 24, or 36 hours. CsA at various concentrations inhibited the proliferation of NKL cells to varying degrees; at 36 hours CsA (15 mg/L) showed greater effects on ILT3 and ILT4 expression and less influence on NKL growth. The ability of NKL cells primed with CsA (15 mg/L) for 36 hours to kill tumor cells was decreased markedly. CONCLUSIONS: CsA up-regulated the expression of ILT3 and ILT4 on NKL cells, which influenced their cytotoxicity against tumor cells with different expression of HLA-G and proliferation of NKL cells.

latheo encodes a subunit of the origin recognition complex and disrupts neuronal proliferation and adult olfactory memory when mutant.

The Drosophila latheo (lat) gene was identified in a behavioral screen for olfactory memory mutants. The original hypomorphic latP1 mutant (Boynton and Tully, 1992) shows a structural defect in adult brain. Homozygous lethal lat mutants lack imaginal discs, show little cell proliferation in the CNS of third instar larvae, and die as early pupae. latP1 was cloned, and all of the above mentioned defects of hypomorphic or homozygous lethal lat mutants were rescued with a lat+ transgene. lat encodes a novel protein with homology to a subunit of the origin recognition complex (ORC). Human and Drosophila LAT both associate with ORC2 and are related to yeast ORC3, suggesting that LAT functions in DNA replication during cell proliferation.

ORC5L, a new member of the human origin recognition complex, is deleted in uterine leiomyomas and malignant myeloid diseases.

A new member of the human origin recognition complex (ORC) was cloned and identified as ORC5L. HsORC5p is a 50-kDa protein whose sequence is 38% identical and 62% similar to ORC5p from Drosophila melanogaster. Two alleles of ORC5L were identified, one with and one without an evolutionarily conserved purine nucleotide binding motif. HsORC5p is precipitated from cell extracts with HsORC2p and HsORC4p, indicating that it is part of the putative human ORC. The bulk of HsORC5p is in an insoluble nuclear fraction, whereas the other known human ORC subunits (HsORC1p, HsORC2p, and HsORC4p) are easily extracted in the nuclear-soluble fractions and in S100 (HsORC1p). In addition, we identified an alternatively spliced mRNA from the same locus (HsORC5T). HsORC5Tp also formed a complex with HsORC4p but not with HsORC2p, suggesting it may play a regulatory role in the assembly of different ORC subcomplexes. HsORC5, HsORC5T, and HsORC4 transcripts are abundant in spleen, ovary, and prostate in addition to tissues with high levels of DNA replication like testes and colon mucosa, implicating the human ORC proteins in functions besides DNA replication. Finally, the gene for ORC5L is located at chromosome 7, band q22, in the minimal region deleted in 10% of uterine leiomyomas and in 10-20% of acute myeloid leukemias and myelodysplastic syndromes.