The construction and validation of prognostic prediction model for sudden sensorineural hearing loss in middle-aged and elderly people

OBJECTIVE

Idiopathic sudden sensorineural hearing loss (ISSNHL), as an otologic emergency, is commonly encountered and its prevalence has been climbing every year recently. To our knowledge, the prognosis of middle-aged and elderly patients is worse than that of young patients. Previous researches mainly focused on the adult population, which was considered as prognostic models who performed hearing recovery in ISSNHL. However, few studies regarding the middle-aged and elderly population who are regarded as prognostic models have been reported. Therefore, we aim to construct and validate a nomogram-based prognostic prediction model, which can provide a reference for the prognostic assessment in the middle-aged and elderly patients with ISSNHL.

METHOD

A total of 371 middle-aged and elderly ISSNHL patients who were admitted to the Department of Otolaryngology-Head and Neck Surgery, Yanbian Hospital, Yanbian University, from April 2018 to April 2023 were enrolled in the study. All subjects were randomly divided into two groups including training group (n = 263) and validation group (n = 108). Lasso regression and multi-factor logistic regression were jointly utilized to screen out prognosis-related independent risk factors and establish a nomogram-based risk prediction model. The accuracy and clinical application value of the model were evaluated by combining the Bootstrapping method and k-fold cross-validation, plotting the receiver operating characteristic  (ROC)  curve, calculating the area under the ROC curve (AUC), plotting the decision curve analysis (DCA), and the calibrating curve.

RESULT

We used the method of lasso regression combined with multivariate logistic regression and finally screened out eight predictors (including age, number of affected ears, degree of hearing loss, type of hearing curve, duration of disease, presence of vertigo, diabetes, and lacunar cerebral infarction) that were included into the nomogram. The C-index were 0.823 [95% CI (0.725, 0.921)] and 0.851 [95% CI (0.701, 1.000)], and the AUC values were 0.812 and 0.823 for the training and validation groups, respectively. The calibration curve for the validation group was approximately conformed to that for the modeling group, indicating favorable model calibration. The DCA results revealed the modeling group (3%-86%) and the validation group (2%-92%) showed significant net clinical benefit under the majority of thresholds.

CONCLUSION

This study developed and validated a nomogram-based prognostic prediction model which based on the eight independent risk factors mentioned above. The predictors are conveniently accessible and may assist clinicians in formulating individualized treatment strategies.

Bidirectional associations between sensorineural hearing loss and depression and anxiety: a meta-analysis

Background

Recently, the prevalence of sensorineural hearing loss (SNL) has been increasing, and several studies have suggested that depression, anxiety, and SNL may be associated with each other, however, individual findings still have discrepancies. To the best of our knowledge, no scholars have systematically elucidated the bidirectional associations between SNL, depression, and anxiety disorders from the perspective of meta-analysis. In this study, we aimed to systematically evaluate the bidirectional associations between SHL and depressive and anxiety symptoms, and to provide evidence-based medical evidence for reducing SNL, depression, and anxiety disorders.

Methods

We performed systematic review based on priori protocol that was registered with PROSPERO (No. CRD42022365963). Systematic search of PubMed, Embase, and Web of Science databases identified articles published as of June 1, 2023, on the relationship between SNL and depression and anxiety. Meta-analysis was performed to calculate the odds ratios (OR) and 95% confidence intervals (CIs) for the outcome metrics, and the results were combined to assess bivariate associations between the disorders with fixed or random effects. Sensitivity and subgroup analyzes were conducted to analyze sources of heterogeneity, and Egger's and Begg's tests combined with funnel plots were applied to assess publication bias.

Results

Summary analysis of the results of 20 studies covering 675,291 individuals showed that the bidirectional association between SNL and depression and anxiety disorders. The incidence (OR = 0.17, 95% CI: 0.09-0.28) and risk (OR = 1.43, 95% CI: 1.32-1.55) of depression and morbidity were higher in SNL patients than the general population. Elevated prevalence (OR = 0.46, 95% CI: 0.28-0.65) and risk (OR = 1.30, 95% CI: 1.11-1.48) of SNL were also observed in depressed patients. The prevalence of anxiety disorders among SNL patients was about 40% (OR = 0.40, 95% CI: 0.24%-0.57), which was associated with higher risk (OR = 1.83, 95% CI: 1.42-2.24) of development than the general population. Incidence of SNL in patients with anxiety disorders was approximately 31% (OR = 0.31, 95% CI: 0.29-0.33). Additionally, subgroup analyzes showed that the bidirectional associations between SNL, depression, and anxiety disorders was influenced by age, region, and mode of diagnosis of the disorders (SNL, depression, anxiety).

Conclusion

There are bidirectional associations between SNL and depression and anxiety disorders, which was influenced by age and region and the method the disorders (SNL, depression, anxiety) were diagnosed.

[Study on clearance of chlorfenapyr via blood purification (a case analysis)]

This paper analyzed the clinical data of a patient with acute oral emamectin·chlorfenapyr poisoning, and discussed the effect of blood purification therapy on chlorfenapyr poisoning. Chlorfenapyr was detected in the blood, urine, ultrafiltrate and plasma exchange fluid of the patient, and the concentrations of chlorfenapyr poison gradually decreased with time. Blood purification has a certain effect on chlorfenapyr, and early blood purification may be an effective measure to treat chlorfenapyr poisoning.

[Prevalence rate and risk factor analysis of nonalcoholic fatty liver disease in 115 female patients with schizophrenia]

Objective: To investigate the incidence rate and risk factors of nonalcoholic fatty liver disease (NAFLD) in patients with schizophrenia (SCZ). Methods: The incidence rate of NAFLD in 115 females with SCZ over 40 years of age with complete clinical data was analyzed with the consent of the Ethics Committee of Nantong Fourth People's Hospital. A physical examination report of healthy subjects (n = 95, female, age 40 years old or older) was taken as the control group. Natural language processing technology was used to extract relevant data from the patient's electronic medical record system. Body mass index, alanine aminotransferase, triglycerides, low-density lipoprotein, leptin, and adiponectin were used to establish a human NAFLD-related model. Logistic regression analysis was used to evaluate the psychiatric symptoms, and physiological and biochemical indexes for the predictive value of NAFLD in female patients with SCZ. Results: The prevalence of NAFLD was significantly higher in the SCZ group (55.7%, 64/115) than that in the control group (26.3%, 25/95) (χ (2) = 18.335, P < 0.001). The prediction model showed that age, alanine aminotransferase, triglycerides, low-density lipoprotein, leptin, adiponectin, and body mass index were significantly correlated with NAFLD in females with SCZ. In the natural language processing search language model, arousal intensity (movements: uncontrolled running behavior) and emotional apathy were strongly linked to female patients with SCZ with NAFLD. Age, alanine aminotransferase, triglycerides, low-density lipoprotein, leptin, and body mass index were risk factors for SCZ to develop NAFLD, and adiponectin levels and uncontrolled running behavior were protective factors. Conclusion: The incidence rate of NAFLD is high in middle-aged and elderly females with SCZ. Natural language processing can help to automatically identify the risk factors for SCZ combined with NAFLD and has predictive and auxiliary diagnostic value.

Associations between cognition, anxiety, depression, and residual dizziness in elderly people with BPPV

Objective

To investigate the associations between cognition, anxiety, depression, and residual dizziness after successful repositioning maneuvers in the elderly with benign paroxysmal positional vertigo (BPPV).

Methods

We enrolled 40 elderly patients with BPPV in our outpatient department. We used the Dizziness Handicap Inventory (DHI), Visual Analog Scale (VAS), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder Questionnaire-7 (GAD-7) to assess the degree of dizziness, anxiety, and depression of participants before repositioning therapy, respectively. At the 1-week follow-up after BPPV treatment, each participant will be reassessed and divided into a group with residual dizziness (RD) and a group without residual dizziness (NRD) based on the follow-up DHI score. The Mini-Mental State Examination (MMSE) evaluated the cognitive function of the participants.

Results

The age, gender, duration of BPPV, and involved semicircular canals in the two groups did not show a significant difference. The RD group scored significantly higher on the DHI (p = 0.006), GAD-7 (p < 0.001), and PHQ-9 (p = 0.002) before the repositioning treatment than the NRD group. The two groups had no significant difference in MMSE score (p = 0.381). Anxiety and depression scores before repositioning treatment significantly and positively correlated with follow-up DHI scores (r = 0.678 and 0.522, respectively), but the MMSE score did not significantly relate to it. The univariate linear regression showed that the DHI (p < 0.001), GAD-7 (p < 0.001), and PHQ-9 (p = 0.002) scores before treatment could predict residual dizziness. The multivariate linear regression showed that GAD-7 before treatment was the only significant predictor of residual dizziness (p < 0.001).

Conclusion

The level of dizziness, anxiety, and depression before treatment can predict residual dizziness after successful repositioning maneuvers in the elderly with BPPV. Anxiety may be the strongest predictor of residual dizziness after successful repositioning treatment in elderly BPPV patients.

P300 Event-Related Potential Predicts Cognitive Dysfunction in Patients with Vestibular Disorders

OBJECTIVE

Our aim was to determine the correlation between cognitive impairment and P300 event-related potential (ERP) in older adults with vertigo and imbalance, which further provides a reference for clinical diagnosis and patients' rehabilitation.

METHODS

A total of 79 older adult patients with vertigo and imbalance in our outpatient department from January 2022 to December 2022 were selected and divided into the mild group (n = 20), moderate group (n = 39), and severe group (n = 20) according to the Dizziness Handicap Inventory (DHI). The auditory P300 component of event-related potentials (ERPs), Generalized Anxiety Disorder Questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Mini-Mental State Examination (MMSE) were used to evaluate depression, anxiety, and cognitive function in these patients, respectively.

RESULTS

The P300 latencies of the different severity groups were 292 ± 10 ms, 301 ± 8 ms, and 328 ± 5 ms, respectively, and the differences were statistically significant (p = 0.010). The P300 amplitudes of the different severity groups were 14.4 ± 2.6 μV, 3.9 ± 0.8 μV, and 5.1 ± 1.4 μV, respectively, and the differences were also statistically significant (p = 0.004). There was no statistically significant difference in the DHI evaluation or VAS visual simulation scoring between the two groups (p = 0.625, and 0.878, respectively). Compared with the short-course group, the long-course group showed prolonged P300 latency and decreased amplitude, higher scores in PHQ-9 and GAD-7, and lower scores in MMSE, and all the differences were statistically significant (p = 0.013, 0.021, 0.006, 0.004, and 0.018, respectively).

CONCLUSION

Older patients with more severe symptoms of vertigo and imbalance are at higher risk of developing abnormal cognitive function. The P300 can be used as an objective neurophysiological test for the assessment of cognitive function relevant to elderly patients with vertigo and imbalance.

[Identification the key factor of pulmonary fibrosis following silica nanoparticles exposure based on bioinformatics analysis]

Objective: To investigate the main mechanisms of pulmonary fibrosis following silica nanoparticles (SiNPs) exposure through constructing the macrophage-fibroblast model in vitro, which simulated the process of pulmonary fibrosis. Methods: In January 2021, human mononuclear leukemia cells (THP-1) were treated with 0, 25, 50, 100 μg/ml SiNPs for 24 h. The supernatant of THP-1 cells was collected and applied to human embryonic lung fibroblast cells (MRC-5) which divided into control and low, medium and high dose groups at the logarithmic growth stage for 24 h. MRC-5 cell viability was detected by CCK8. The hydroxyproline (Hyp), interleukin 6 (IL-6), interleukin 1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) expression were detected in the supernatants of MRC-5. The changed proteins were detected by liquid-phase mass spectrometry in high dose group. GeneCard database were applied to identity the differential pulmonary fibrosis proteins in high dose group. Gene Ontology (GO) was performed to identity the key biological process in differential pulmonary fibrosis proteins of high dose group. The String database was used to construct the protein-protein interactions (PPI) network of differential pulmonary fibrosis proteins. The APP of CytoHubba was applied to calculate the key protein of differential pulmonary fibrosis proteins in PPI network. Correlation coefficients between key differential pulmonary fibrosis proteins were calculated using Pearson correlation analysis. Western blotting was applied to detect the expression of key proteins of differential pulmonary fibrosis proteins in different groups. Results: CCK8 results showed that MRC-5 cell viability was increasing in low, medium and high dose groups compared with control group (P<0.05). The expression levels of Hyp and IL-1β in different group were increased compared with control group, the expression levels of IL-6 and TNF-α were increased in high dose group compared with control group (P<0.05). GeneCard database identified 26 differential pulmonary fibrosis proteins, which were mainly involved in extracellular matrix hydrolysis, cell inflammatory response, tissue repair, cell proliferation, inflammation response by GO analysis. The APP of CytoHubba was calculated that matrix metalloproteinase 9 (MMP9) and tissue inhibitor metalloproteinase 1 (TIMP1) played an important role in PPI network. The results of correlation analysis showed that MMP9 was correlated with the expression of matrix metalloproteinase 1 (MMP1), matrix metalloproteinase 3 (MMP3), TIMP1 and epidermal growth factor receptor (EGFR) (r=0.97, 0.98, 0.94, 0.93, P<0.05). Western blotting results showed that TIMP1 protein expression was increased in low, medium and high dose groups, while MMP9 protein expression was increased only in high dose group (P<0.05) . Conclusion: Differential expression proteins related with pulmonary fibrosis in MRC-5 cells mainly regulate biological processes of extracellular matrix hydrolysis, tissue repair, and cellular inflammation response following SiNPs exposure. MMP9 and TIMP1 may be the key proteins, which affected the fibrosis process in vitro pulmonary fibrosis model.

The functional status of vestibular otolith and conductive pathway in patients with unilateral idiopathic sudden sensorineural hearing loss

Background

The cause of idiopathic sudden sensorineural hearing loss (ISSNHL) remains unknown. It has been found that the functional status of the vestibular otolith is relevant to its prognosis; however, the evaluation of the vestibular otolith (intra-labyrinth) and superior and inferior vestibular nerve pathways (retro-labyrinth) in ISSNHL patients is not well-documented.

Objective

This study aimed to investigate the functional status of the vestibular otolith and conductive pathway in patients with unilateral ISSNHL and analyze the correlations between vestibular evoked myogenic potentials (VEMPs) and hearing improvement after treatment.

Methods

A total of 50 patients with unilateral ISSNHL underwent a battery of audio-vestibular evaluations, including pure tone audiometry, middle ear function, air-conducted sound-cervical VEMP (ACS-cVEMP), ACS-ocular VEMP (ACS-oVEMP), galvanic vestibular stimulation-cervical VEMP (GVS-cVEMP), and GVS-ocular VEMP (GVS-oVEMP). The results of auditory and VEMPs were retrospectively analyzed.

Results

The abnormal rates of ACS-cVEMP, ACS-oVEMP, GVS-cVEMP, and GVS-oVEMP in affected ears were 30, 52, 8, and 16%, respectively. In affected ears, the abnormal rate of ACS-oVEMP was significantly higher than that of ACS-cVEMP (p = 0.025), while it was similar between GVS-cVEMP and GVS-oVEMP (p = 0.218). Compared with GVS-cVEMP, affected ears presented with a significantly higher abnormal rate of ACS-cVEMP (p = 0.005), and the abnormal rate of ACS-oVEMP was significantly higher than that of GVS-oVEMP (p < 0.001). No significant difference existed in latency and amplitude between affected and unaffected ears in ACS-VEMPs or GVS-VEMPs (p > 0.05). The abnormal rate of VEMPs in the poor recovery group was significantly higher than that of the good recovery group (p = 0.040). The abnormality percentages of ACS-oVEMP and GVS-oVEMP in the poor recovery group were significantly higher than that of the good recovery group (p = 0.004 and 0.039, respectively). The good hearing recovery rates were 76.47% in the normal VEMPs group, 58.33% in the intra-labyrinth lesion group, and 22.22% in the retro-labyrinth lesion group. Hearing recovery worsened as a greater number of abnormal VEMPs was presented.

Conclusion

Besides Corti's organ, the impairment of otolithic organs was prominent in patients with ISSNHL. The normal VEMPs group had the highest rate of good recovery, followed by the intra-labyrinth lesion group and the retro-labyrinth lesion group presented with the lowest recovery rate. Abnormalities in ACS-oVEMP and/or GVS-oVEMP were indicators of a poor prognosis.

[Study on the relationship between the age at natural menopause and postmenopausal metabolic syndrome]

To explore the relationship between the early or delayed age at natural menopause and metabolic syndrome (MS) in women. A total of 4 734 natural menopausal women who completed the baseline survey from November 2017 to January 2020 in the Guangzhou Middle-aged and Elderly Chronic Disease Prospective Cohort Study were selected in this cross-sectional study. Data on general demographic characteristics, disease history and female physiological health indicators were collected. Logistic regression model and restricted cubic spline curve were used to analyze the relationship between the age at natural menopause and MS. The results showed that the mean age of the subjects was (60±6) years old. The median (Q₁,Q₃) age at natural menopause was 50 (49, 52) years old, and the prevalence of MS was 14.8%(699/4 734). After adjusting for confounders, the age at natural menopause was closely related to MS in an approximate"U"shape. Compared with the group of normal age at natural menopause, the early age at menopause (OR=1.52, 95%CI: 1.12-2.06) and delayed age at menopause (OR=1.77, 95%CI: 1.36-2.30) had a higher risk of MS. In the group with time since menopause ≤6 years and 7-9 years, the risk of MS in the group with delayed age at menopause was 2.40 times (95%CI: 1.54-3.75) and 2.19 times (95%CI: 1.11-4.31) higher than that in the group with normal menopausal age, respectively. In conclusion, the early and delayed age at natural menopause increased the risk of MS. The increased risk of MS in delayed age at natural menopause mainly occurred within 10 years since menopause.

Abnormal posterior semicircular canal function may predict poor prognosis in patients with severe and profound ISSNHL

Background

Severe and profound idiopathic sudden sensorineural hearing loss (ISSNHL) generally leads to unfavorable prognosis, and has a considerable impact on patient quality of life. However, related prognostic factors remain controversial.

Objective

To elaborate the relationship between vestibular function impairment and the prognosis of patients with severe and profound ISSNHL, and investigated the relevant factors affecting prognosis.

Methods

Forty-nine patients with severe and profound ISSNHL were divided into good outcome group [GO group, pure tone average (PTA) improvement > 30 dB] and poor outcome group (PO group, PTA improvement ≤ 30 dB) according to hearing outcomes. The clinical characteristics and the proportion of abnormal vestibular function tests in these two groups were analyzed by univariate analysis, and multivariable logistic regression analysis was performed for parameters with significant differences.

Results

Forty-six patients had abnormal vestibular function test results (46/49, 93.88%). The number of vestibular organ injuries was 1.82 ± 1.29 in all patients, with higher mean numbers in PO group (2.22 ± 1.37) than in GO group (1.32 ± 0.99). Univariate analysis revealed no statistical differences between the GO and PO groups in terms of gender, age, side of the affected ear, vestibular symptoms, delayed treatment, instantaneous gain value of horizontal semicircular canal, regression gain value of vertical semicircular canal, abnormal rates of oVEMP, cVEMP, caloric test and vHIT in anterior and horizontal semicircular canal, however, significant differences were found in the initial hearing loss and abnormal vHIT of posterior semicircular canal (PSC). Multivariable analysis revealed that only PSC injury was an independent risk factor for predicting the prognosis of patients with severe and profound ISSNHL. Patients with abnormal PSC function had worse initial hearing impairment and prognosis than patients with normal PSC function. The sensitivity of abnormal PSC function in predicting poor prognosis in patients with severe and profound ISSNHL was 66.67%, specificity was 95.45%, and positive and negative likelihood ratios were 14.65 and 0.35, respectively.

Conclusion

Abnormal PSC function is an independent risk factor for poor prognosis in patients with severe and profound ISSNHL. Ischemia in the branches of the internal auditory artery supplying the cochlea and PSC may be the underlying mechanism.

Etiological classification and management of dizziness in children: A systematic review and meta-analysis

Background

Dizziness in children, which could not be diagnosed at an early stage in the past, is becoming increasingly clear to a large extent. However, the recognition of the diagnosis and management remains discrepant and controversial due to their complicated and varied etiology. Central and peripheral vestibular disorders, psychogenic and systemic diseases, and genetic pathogeny constitute childhood etiological entities. Further understanding of the etiology and the prevalence of vertigo disorders is of crucial importance and benefit in the diagnosis and management of pediatric patients.

Methods

This systematic review and meta-analysis were conducted by systematically searching Embase, PubMed, the Cochrane Library, CNIK, the Chinese Wan-Fang database, CBM, the Chinese VIP database, and the Web of Science for literature on childhood vertigo disorders published up to May 2022. The literature was evaluated under strict screening and diagnostic criteria. Their quality was assessed using the Agency for Healthcare and Research Quality (AHRQ) standards. The test for homogeneity was conducted to determine the fixed effects model or random-effect model employed.

Results

Twenty-three retrospective cross-sectional studies involving 7,647 children with vertigo disorders were finally included, with an AHRQ score >4 (high or moderate quality). Our results demonstrated that peripheral vertigo (52.20%, 95% CI: 42.9-61.4%) was more common in children than central vertigo (28.7%, 95% CI: 20.8-37.4%), psychogenic vertigo (7.0%, 95% CI: 4.8-10.0%), and other systemic vertigo (4.7%, 95% CI: 2.6-8.2%). The five most common etiological diagnoses associated with peripheral vertigo included benign paroxysmal vertigo of childhood (BPVC) (19.50%, 95% CI: 13.5-28.3%), sinusitis-related diseases (10.7%, 95% CI: -11.2-32.6%), vestibular or semicircular canal dysfunction (9.20%, 95% CI: 5.7-15.0%), benign paroxysmal positional vertigo (BPPV)(7.20%, 95% CI: 3.9-11.5%), and orthostatic dysregulation (6.8%, 95% CI: 3.4-13.0%). Vestibular migraine (20.3%, 95% CI: 15.4-25.2%) was the most seen etiological diagnosis associated with central vertigo in children. In addition, we found the sex-based difference influenced the outcome of psychogenic vertigo and vestibular migraine, while there was no significant difference in other categories of the etiology. For the management of vertigo, symptomatical management is the first choice for most types of vertigo disorder in pediatrics.

Conclusion

Complex etiology and non-specific clinical manifestations of vertigo in pediatrics are challenging for their diagnoses. Reliable diagnosis and effective management depend on the close cooperation of multiple disciplines, combined with comprehensive consideration of the alternative characteristics of vertigo in children with growth and development.

Characteristics of vestibular migraine, probable vestibular migraine, and recurrent vertigo of childhood in caloric and video head impulse tests

Objective

Vertigo is very common in children, but the specific diagnosis and characteristics are not clear. The main objective of this study was to analyze the characteristics of caloric test (CT) and video head impulse test (vHIT) in vestibular migraine of childhood (VMC), probable vestibular migraine of childhood (PVMC), and recurrent vertigo of childhood (RVC), which can provide a reference value for their clinical diagnosis.

Methods

We selected VMC, PVMC and RVC patients under 18 years of age from the outpatient Department of Otolaryngology–Head and Neck Surgery between May 2021 and August 2022. All patients underwent vestibular function examinations, including eye movement recording CT and vHIT. CT results depended on whether both canal paresis and directional preponderance were under normal limits, and vHIT results depended on the gain values of vestibulo-ocular reflex. The results of both tests were analyzed according to the disease type.

Results

Among the 81 pediatric vertigo patients aged 5–17 years, 44 were females and 37 were males. According to the type of vertigo, 29 patients (25.80%) were diagnosed with VMC, 11 (13.58%) with PVMC, and 41 (50.62%) with RVC. The abnormal rates of the CT in VMC, PVMC, and RVC patients were 24.14%, 36.36%, and 17.07%, respectively. There was no significant difference in the abnormal rates among the three groups (P &gt; 0.05). None of the patients showed abnormal vHIT results (all abnormal rates 0.00%). The abnormal CT rates were significantly higher than those of abnormal vHIT rates (P &lt; 0.05).

Conclusions

VMC, PVMC, and RVC are more likely to be diagnosed by symptoms, as neither CT nor vHIT are specific to any conditions. Due to different clinical presentations of vertigo in pediatric patients, it is critical to further clarify the diagnosis with medical history and clinical characteristics.

Vestibular evoked myogenic potential may predict the hearing recovery in patients with unilateral idiopathic sudden sensorineural hearing loss

OBJECTIVE

This study investigates the association between vestibular function and prognosis in patients with unilateral idiopathic sudden sensorineural hearing loss (UISSNHL).

DESIGN

A retrospective analysis of 64 patients with UISSNHL was performed. Pure tone audiometry and vestibular function tests for otoliths and semicircular canals were performed to assess the influence of vestibular functional status on the outcome of patients with UISSNHL.

RESULTS

Patients with abnormal cervical vestibular evoked myogenic potential (cVEMP) or ocular vestibular evoked myogenic potential (oVEMP) responded less favorably to treatment. In the ineffective group, cVEMP was normal in four patients (6.3%) and oVEMPs in three (4.7%). Meanwhile, cVEMP was abnormal in 32 patients (50.0%) and oVEMP in 33 (51.6%). Better hearing recovery occurred in those with normal cVEMP (33.76 ± 15.07 dB HL improvement) or oVEMP (32.55 ± 19.56 dB HL improvement), but this was not the case in those with normal caloric tests. Patients with abnormalities in both cVEMP and oVEMP were less responsive to treatment and had worse hearing recovery than those with normal results in only one of the two tests.

CONCLUSION

Abnormal oVEMP and/or cVEMP results indicate poor auditory outcomes in patients with UISSNHL. Patients with impaired otolith organ function are likely to have a larger and more severe pathological change in their inner ear.

Evaluating children with vestibular migraine through vestibular test battery: A cross-sectional investigation

Objective

The present study aimed to investigate the status of vestibular function in children with vestibular migraine of childhood (VMC) reflected by vestibular function test battery and explore the pathophysiological implication of these instrument-based findings.

Methods

The clinical data of 22 children (mean age 10.7 ± 2.9 years) with VMC who met the diagnostic criteria of the Barany Society were collected from September 2021 to March 2022. A vestibular function test battery on these children included a caloric test, video head impulse test (vHIT), cervical vestibular-evoked myogenic potential (cVEMP), and ocular vestibular-evoked myogenic potential (oVEMP); these parameters were triggered by air-conducted sound (ACS) and galvanic vestibular stimulation (GVS). The subjects were further divided into two groups: <3 months and >3 months according to the disease duration from symptom onset. The functional abnormalities and their characteristics reflected by the vestibular test battery, as well as the outcomes in children with or without aura, were analyzed.

Results

(1) The abnormal rate of the caloric test was 15.8% and that of vHIT was 0%. The response rates of ACS-cVEMP and ACS-oVEMP were 100% and 90.5%, respectively. The response rates of GVS-cVEMP and GVS-oVEMP were 100% and 88.9%, respectively. (2) No statistical difference was observed in the abnormal rate of the caloric test (P = 0.55) and the response rate of ACS-oVEMP (P = 0.21) between the two groups, irrespective of the course duration. (3) No statistical difference was detected in the abnormal rate of the caloric test (P = 0.53) and the response rate of ACS-oVEMP (P = 1.00) in children with or without aura.

Conclusion

Vestibular function status comprehensively reported by the vestibular test battery did not show an aggravation with the disease duration in children with VMC. Also, it was not affected by the existence of aura in children with VMC. The high abnormal rates of the caloric test and oVEMPs (ACS-oVEMP and GVS-oVEMP) suggested that the lateral semicircular canal (low-frequency function component), the utricle, and the superior vestibular conduction pathway might be involved in VMC.

Vestibular dysfunction in pediatric patients with cochlear implantation: A systematic review and meta-analysis

Objective

Vestibular dysfunction may delay the achievement of balance and perception milestones in pediatric patients after cochlear implantation (CIM).

Methods

A strategic literature search was done following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed, Medline, Embase, Web of Science, and Cochrane Library databases from inception to July 2022. Studies were included on the otoliths, semicircular canals, and balance function changes in children after CIM. Two reviewers independently assessed the level of evidence, methodological limitations, risk of bias, and characteristics of the cases. Matched pre- and postoperative vestibular functional test data, including ocular and cervical vestibular-evoked myogenic potential (oVEMP and cVEMP), caloric test, video head impulse test (vHIT), and Bruininks-Oseretsky Test 2 (BOT-2), were used to calculate the relative risk of vestibular disorders. Subgroup analyses were performed according to surgical approach, CIM device status, and etiology.

Results

Twenty studies that met the inclusion criteria were selected for the meta-analysis. We observed significant vestibular dysfunction in pediatric patients with CIM. The results showed a statistically significant increase in abnormal cVEMP response (RR = 2.20, 95% CI = 1.87, 2.58, P < 0.0001), abnormal oVEMP response (RR = 2.10, 95% CI = 1.50, 2.94, P < 0.0001), and abnormal caloric test results (RR = 1.62, 95% CI = 1.20, 2.19, P = 0.0018) after implantation. Statistically significant differences were not found in the vHIT test results of all three semicircular canals before and after the operation (P > 0.05). Regarding static and dynamic balance, we found significantly poorer BOT-2 scores in children with CIM than in the normal group (mean difference = −7.26, 95% CI = −10.82, −3.70, P < 0.0001).

Conclusion

The results showed that vestibular dysfunction might occur after CIM in pediatric patients. Some children experience difficulties with postural control and balance. Our results suggest that a comprehensive evaluation of vestibular function should be performed before and after CIM.

Effects of acoustic stimulation intensity on air-conducted vestibular evoked myogenic potential in children

Objective

To investigate the effects of acoustic stimulation intensity on ocular and cervical vestibular evoked myogenic potential (oVEMP and cVEMP) responses elicited by air-conducted sound (ACS) in healthy children.

Methods

Thirteen healthy children aged 4–10 years and 20 healthy adults aged 20-40 years with normal hearing and tympanometry were enrolled in this study. All subjects received oVEMP and cVEMP tests under different acoustic stimulation intensities (131, 126, 121, 116, 111 and 106 dB SPL). Mean n1 latency, p1 latency, interpeak latency, amplitude and response rate were investigated and analyzed.

Results

As the acoustic stimulation intensity decreased, for oVEMP, the response rate of children decreased from 100% (131, 126 and 121 dB SPL) to 57.69% (116 dB SPL), 26.92% (111 dB SPL) and 11.54% (106 dB SPL). The response rate of adults decreased from 100% (131 and 126 dB SPL) to 95% (121 dB SPL), 55% (116 dB SPL), 12.5% (111 dB SPL) and 2.5% (106 dB SPL). There were lower n1 latency, p1 latency and higher amplitude in children when comparing by acoustic stimulation intensities (p < 0.05). Regarding cVEMP, the response rate of children decreased from 100% (131, 126 and 121 dB SPL) to 88.46% (116 dB SPL), 53.85% (111 dB SPL) and 26.92% (106 dB SPL). The response rate of adults decreased from 100% (131 and 126 dB SPL) to 95% (121 dB SPL), 85% (116 dB SPL), 37.5% (111 dB SPL) and 7.5% (106 dB SPL). A statistically significant difference was found in amplitude at different acoustic stimulation intensities in both children and adults (p < 0.05). When stimulated by 131 dB SPL acoustic stimulation, there were lower n1 latency, p1 latency and higher amplitude in children in oVEMP and cVEMP compared with adults (p < 0.05).

Conclusion

The response rate and amplitude of oVEMP and cVEMP in children and adults presented significant differences with a decrease in acoustic stimulation intensity. In this study, using 121 dB SPL for children and 126 dB SPL for adults during VEMP test could be regarded as safer stimulation intensities and thus reduced sound exposure.

Potential vestibular pathway impairment in children with recurrent vertigo: An investigation through air-conducted sound and galvanic vestibular stimulation-triggered vestibular evoked myogenic potentials

Objective

This study aims to investigate the potential vestibular pathway impairment through vestibular evoked myogenic potentials (VEMPs) and to explore the pathophysiological significance of these instrument-based findings in children with recurrent vertigo.

Materials and methods

The clinical data of 21 children (mean age 4.67 ± 1.39 years) diagnosed as RVC who met the inclusion criteria of the Bárány Society and 29 healthy children (mean age 4.83 ± 1.34 years) enrolled as the control group from February 2021 to December 2021 were collected and analyzed retrospectively. All the subjects underwent both cervical VEMP (cVEMP) and ocular VEMP (oVEMP) triggered by air-conducted sound (ACS) and galvanic vestibular stimulation (GVS), respectively. The elicit rate, latency, and amplitude asymmetry ratio (AAR) of ACS-cVEMP, ACS-oVEMP, GVS-cVEMP, and GVS-oVEMP were analyzed.

Results

(1) The elicit rates of ACS-cVEMP and ACS-oVEMP were similar in the two groups (P > 0.05), as well as GVS-cVEMP and GVS-oVEMP (P > 0.05). (2) P1 and N1 latencies of ACS-cVEMP and GVS-cVEMP in the RVC group were longer than those in the control group (P < 0.05). (3) The N1 latency of ACS-oVEMP in the RVC group was shorter than that in the control group (P < 0.05), while there was no significant difference in the P1 latency of ACS-oVEMP (P > 0.05). The N1 and P1 latencies of GVS-oVEMP were not significantly different (P > 0.05). (4) There was no statistical difference in the AAR of ACS-cVEMP and GVS-cVEMP. Although there was an increased AAR of ACS-oVEMP in the RVC group (P < 0.05), the AAR was within the normal range. However, no statistical difference was found in the AAR of GVS-oVEMP in the two groups (P > 0.05).

Conclusion

The latencies of ACS-cVEMP and GVS-cVEMP in children with recurrent vertigo were significantly prolonged compared with those in healthy children, and there was no difference in elicit rates of ACS-cVEMP and GVS-cVEMP, suggesting that there might be potential impairment in the inferior vestibular nerve and the subsequent nerve conduction pathway in RVC.

[Proliferative lesions with mesonephric features in the gynecologic tract: a clinicopathological analysis of sixteen cases]

Objective: To investigate the clinicopathological features of proliferations with mesonephric features (PMF) of the gynecologic tract. Methods: A retrospective analysis was performed on the clinical and pathological data of 16 cases with PMF that were diagnosed from October 2016 to January 2022 at a single institution. The relevant literature was reviewed. Results: Among the 16 cases, with an average of 53 years (31-68 years), there were 5 cases of mesonephric hyperplasia, 4 cases of mesonephric adenocarcinoma and 7 cases of mesonephric-like adenocarcinoma. The five cases of mesonephric hyperplasia were located in the lateral wall of the cervix and composed of simple tubules with growth patterns of diffuse or lobular clusters, without obvious stromal reaction. Four cases of mesonephric adenocarcinoma consisted of a mixture of papillary, cribriform, solid and other architectures, the nuclei resembling these of papillary thyroid carcinoma, and strong fibroproliferative reaction. They were located deep in the cervical and vaginal stroma. One of the tumors showed atypical mesonephric hyperplasia adjacent to the tumor. Five uterine and two ovarian mesonephric-like adenocarcinoma cases had similar histological morphology with mesonephric adenocarcinoma, but no mesonephric remnants/mesonephric hyperplasia were found near the tumors. In addition, four (4/5) uterine mesonephric-like adenocarcinoma cases originated from the endometrium with secondary involvement of myometrium, including one case with clear demarcation between the normal endometrium and the neoplastic glands. One (1/5) uterine mesonephric-like adenocarcinoma case was mainly located in the deep myometrium, along with adenomyosis around the tumor, without mesonephric remnants. Two ovarian mesonephric-like adenocarcinoma cases were associated with endometriotic cyst/endometrioid cystadenoma, including one case with an abrupt transition between normal epithelium and atypical mesonephric cells within the single individual cyst directly adjacent to tumor. All mesonephric hyperplasia and mesonephric adenocarcinoma cases were positive for GATA3, PAX8 and CD10 in a varying degree, and negative for ER, PR and TTF1. Although mesonephric-like adenocarcinoma showed a considerable overlap of immunohistochemical expression with mesonephric adenocarcinoma, seven mesonephric-like adenocarcinoma cases were positive for TTF1 and negative for GATA3. Conclusions: PMF is a class of rare proliferative lesions with morphological and immunophenotypic characteristics of mesonephric duct. Its commonly involved site, microscopic morphology, associated benign and/or atypical lesions, and immunophenotype may contribute to its diagnosis and differential diagnosis.

Cervical vestibular evoked myogenic potentials in 3-month-old infants: Comparative characteristics and feasibility for infant vestibular screening

Objective

We compared the characteristics of air-conducted sound cervical vestibular evoked myogenic potential (ACS-cVEMP) and bone-conducted vibration cVEMP (BCV-cVEMP) among 3-month-old infants with normal hearing and sensorineural hearing loss (SNHL), and healthy adults to explore the feasibility and optimal strategies for infant vestibular screening.

Methods

29 infants (58 ears) were divided into two groups according to hearing (group I: normal hearing ears; group II: SNHL ears), 20 healthy adults were defined as group III. The results of response rate, P13 and N23 latency, P13-N23 interval, amplitudes, and corrected interaural asymmetry ratio (IAR) were recorded and compared among three groups.

Results

The response rates of ACS-cVEMP in three groups were 88.89, 62.00, 100%, respectively. The P13 and N23 latencies, and P13-N23 interval did not differ significantly between group I and II (p = 0.866, p = 0.190, p = 0.252). A significant difference was found between group I and III (p = 0.016, p &lt; 0.001, p &lt; 0.001). No significant difference was observed in raw or corrected amplitude between group I and II (p = 0.741, p = 0.525), while raw and corrected amplitudes in group III were significantly larger than group I (p &lt; 0.001, p &lt; 0.001). For BCV-cVEMP, the response rates in three groups were 100, 86.36, 100%, respectively, No significant difference existed in the P13 and N23 latency, or P13-N23 interval between group I and II (p = 0.665, p = 0.925, p = 0.806), however, P13 and N23 latencies were significantly longer in group III than group I (p &lt; 0.001, p = 0.018), but not in P13-N23 interval (p = 0.110). There was no significant difference in raw or corrected amplitude between group I and II (p = 0.771, p = 0.155) or in raw amplitude between group I and III (p = 0.093), however, a significant difference existed in corrected amplitude between group I and III (p &lt; 0.001).

Conclusions

Compared with adults, 3-month-old infants with normal hearing presented with equivalent response rates, shorter P13 and N23 latencies, smaller corrected amplitudes, and a wider IAR range for both ACS and BCV-cVEMP. SNHL infants had equivalent response rates of BCV-cVEMP, lower response rates of ACS-cVEMP than normal hearing infants. When responses were present, characteristics of ACS and BCV-cVEMP in SNHL infants were similar with normal hearing infants. ACS combined with BCV-cVEMP are recommended to improve the accuracy of vestibular screening.

B81 Bone Vibrator-Induced Vestibular-Evoked Myogenic Potentials: Normal Values and the Effect of Age

Objective

To define the normal values and examine the influence of aging on B81 bone vibrator-induced cervical vestibular-evoked myogenic potentials (B81-cVEMPs) and ocular vestibular-evoked myogenic potentials (B81-oVEMPs).

Methods

Seventy healthy subjects, divided into seven groups according to their ages, were enrolled in this study. The 4–9-, 10–19-, 20–29-, 30–39-, 40–49-, 50–59-, and 60–70-year-old participants were divided into groups I–VII, respectively. B81-cVEMP and B81-oVEMP were recorded in each group.

Results

The B81-cVEMP response rates for groups I–VII were 100, 100, 100, 100, 95, 95, and 75%, respectively, with significant differences only between groups I–VI and group VII (p = 0.047, p &lt; 0.05). The B81-oVEMP response rates for groups I–VII were 100, 100, 100, 100, 70, 65, and 40%, respectively, with significant differences only between groups I–IV and groups V–VII (p = 0.020, p = 0.008, p = 0.000; p &lt; 0.05). The threshold, P13, and N23 latencies of B81-cVEMP positively correlated with age (r = 0.756, p = 0.000; r = 0.357, p = 0.003; r = 0.316, p = 0.009; p &lt; 0.05). The raw amplitudes and corrected amplitudes negatively correlated with age (r = −0.641, p = 0.000; r = −0.609, p = 0.000, p &lt; 0.05). For B81-oVEMP, the corrected amplitudes negatively correlated with age (r = −0.638, p = 0.000, p&lt;0.05), but the threshold and N10 latency positively correlated with age (r = 0.768, p = 0.000; r = 0.334, p = 0.009, p &lt; 0.05). Moreover, the interaural asymmetry ratio did not significantly correlate with age for B81-cVEMP and B81-oVEMP.

Conclusion

As age increased, the B81-cVEMP response rate decreased, the thresholds increased, P13 and N23 latencies were prolonged, and the raw amplitude and corrected amplitude decreased. The B81-oVEMP response rate and corrected amplitude decreased, the thresholds increased, and N10 latency was prolonged with age. These changes are probably due to the occurrence of morphological and functional changes in the vestibular system with aging. Therefore, we suggest establishing different reference values according to different age groups when evaluating the VEMP results in patients with vestibular diseases.

Pseudo-Temporal Analysis of Single-Cell RNA Sequencing Reveals Trans-Differentiation Potential of Greater Epithelial Ridge Cells Into Hair Cells During Postnatal Development of Cochlea in Rats

The hair cells of the cochlea play a decisive role in the process of hearing damage and recovery, yet knowledge of their regeneration process is still limited. Greater epithelial ridge (GER) cells, a type of cell present during cochlear development that has the characteristics of a precursor sensory cell, disappear at the time of maturation of hearing development. Its development and evolution remain mysterious for many years. Here, we performed single-cell RNA sequencing to profile the gene expression landscapes of rats’ cochlear basal membrane from P1, P7, and P14 and identified eight major subtypes of GER cells. Furthermore, single-cell trajectory analysis for GER cells and hair cells indicated that among the different subtypes of GER, four subtypes had transient cell proliferation after birth and could transdifferentiate into inner and outer hair cells, and two of them mainly transdifferentiated into inner hair cells. The other two subtypes eventually transdifferentiate into outer hair cells. Our study lays the groundwork for elucidating the mechanisms of the key regulatory genes and signaling pathways in the trans-differentiation of GER cell subtypes into hair cells and provides potential clues to understand hair cell regeneration.

[The clinical application of mobile internet remote guidance platform for vestibular rehabilitation]

Objective: To guide the patients with vertigo who are suitable for vestibular rehabilitation therapy (VRT), and to evaluate the curative effect through a remote guidance platform based on mobile internet. Methods: Adult outpatients, who were diagnosed as vestibular disorders and required VRT, were selected and conducted baseline evaluation and formulated vestibular rehabilitation plan according to their symptoms, diagnosis and vestibular function examination results. These patients downloaded and installed the mobile internet remote guidance platform app for VRT, and then registered and uploaded medical records. According to the VRT plan formulated by clinicians for patients, the platform launched corresponding exercise guidance videos to guide them to complete 4-week VRT exercise at home. Before and after VRT, the patients were scored with Visual Analogue Scale (VAS), Activities-specific Balance Confidence (ABC), Dizziness Handicap Inventory (DHI) and Self-rating Anxiety Scale (SAS). The rehabilitation effects were statistically analyzed by SigmaStat 4.0 software. Results: From October 2019 to October 2021, 233 patients with vertigo completed the registration of vestibular rehabilitation guidance platform, of whom 187 patients insisted on 4-week rehabilitation training and completed the scale evaluation. Among 187 patients, 65 were male and 122 were female; Age was (49.8±16.0) years; The medical history ranged from one to 192 months, with a median of eight months. Compared with that before rehabilitation exercise, the subjective feeling of vertigo in 170 patients was improved, and the overall effective rate was 90.9% (170/187). The subjective symptoms of vertigo were basically improved after rehabilitation training in patients with unilateral vestibular dysfunction, vestibular neuritis, sudden deafness with vertigo, Hunt syndrome and acoustic neuroma. There were significant differences in ABC, DHI and SAS scores before and after VRT (P<0.05). Of those patients with Meniere's disease in the intermittent period and the patients with Meniere's disease who underwent surgical treatment, more than 90% of their subjective symptoms of vertigo or dizziness improved after VRT, and there were significant differences in the scores of ABC, DHI and SAS before and after VRT exercise (P<0.05). In patients with vestibular migraine, 36.7% (11/30) had no improvement or even aggravation of subjective symptoms of vertigo after VRT, however, the DHI score after rehabilitation exercise was lower than that before exercise, and the difference was statistically significant (P<0.05). In patients with bilateral vestibular dysfunction, although most (6/8) subjective symptom scores were improved compared with those before exercise, there was no significant difference in ABC, DHI and SAS scores before and after rehabilitation (P>0.05). Conclusion: VRT with the help of vestibular rehabilitation mobile internet remote guidance platform can effectively improve the subjective symptoms of vertigo, balance ability and anxiety in patients with unilateral vestibular lesions.

A Comparison of Local Endolymphatic Sac Decompression, Endolymphatic Mastoid Shunt, and Wide Endolymphatic Sac Decompression in the Treatment of Intractable Meniere's Disease: A Short-Term Follow-Up Investigation

Background

Meniere's disease (MD) is an inner ear disorder, characterized by recurrent attacks of vertigo, low-frequency sensorineural hearing loss, tinnitus, and aural fullness. Endolymphatic sac surgery is an effective treatment to control vertigo attacks but without causing a hearing loss for intractable MD. However, the methods and effects of endolymphatic sac surgery have been controversial for many years, and the relationship between the vertigo control rates of different endolymphatic sac surgery methods is not well-documented.

Objectives

This study compared the vertigo control rate, hearing outcome, and quality of life (QOL) among different endolymphatic sac surgery, such as local endolymphatic sac decompression (LESD), endolymphatic sac mastoid shunt (ESMS), and wide endolymphatic sac decompression (WESD).

Materials and Methods

We retrospectively analyzed the patients who underwent endolymphatic sac surgery from January 2008 to June 2019. The control rate of vertigo and QOL scores were compared after 2 years of follow-up. The QOL was scored with validation of the MD patient-oriented symptom-severity index (MDPOSI). The pure tone thresholds of all patients at pre- and postoperation were also compared.

Results

In total, 83 MD patients with complete follow-up data were included in the study, i.e., 20 patients with LESD, 28 patients with ESMS, and 35 patients with WESD. Results showed a better vertigo control with WESD than the other groups (70% with LESD, 71.4% with ESMS, and 88.6% with WESD). The QOL was improved after surgery in all groups in which the difference was statistically significant (QOL, preoperative vs. postoperative, 38.2 vs. 10.1 with LESD, 37.8 vs. 9.6 with ESMS, and 37.6 vs. 8.3 with WESD), respectively. After endolymphatic sac surgery, the hearing was well-preserved in the three groups [pure tone averages (PTAs), dB, preoperative vs. postoperative, 41.0 ± 19.3 vs. 40.8 ± 17.9 with LESD, 39.7 ± 16.4 vs. 40.8 ± 18.2 with ESMS, and 38.5 ± 18.7 vs. 36.6 ± 19.5 with WESD].

Conclusion

Wide endolymphatic sac decompression has a higher vertigo control rate, better improvement of QOL, and relatively higher hearing stability or improvement rate after surgery in patients with MD compared with LESD and ESMS.

Dammarane-type saponins from Gynostemma pentaphyllum and their cytotoxicities

Heat-processed Gynostemma pentaphyllum has shown strong activity against human lung carcinoma A549 cells. In this study, two dammarane-type saponins together with two known compounds were isolated from the ethanol extract of the heat-processed leaves of G. pentaphyllum. They were identified as 2α,3β,12β-trihydroxydammar-20(22),24-diene-3-O-β-D-glucopyranoside (1, namely damulin E), 2α,3β,12β-trihydroxydammar-20,24-diene-3-O-β-D-glucopyranoside (2, namely damulin F), damulin A (3) and damulin B (4), respectively, using NMR and mass spectra. Damulin E and damulin F showed moderate activity against A549, H1299, T24, SH-SY5Y and K562 cell lines in vitro using CCK-8 assay.

Impact of aerobic exercise on cognitive function in patients with schizophrenia during daily nursing: A protocol for systematic review and meta-analysis

OBJECTIVES

To assess the effect of aerobic exercise (AE) on cognition function in people with schizophrenia (SZ) during daily nursing.

METHODS

The literature search will be conducted via PubMed, Embase, Cochrane Library, and Web of Science. Weighted mean difference (WMD) or standardized mean difference (SMD) and 95% confidence intervals (CIs) will be adopted to calculate the association between AE and cognitive function in patients with SZ. Publication bias will be performed by Begg test. When there is publication bias, "cut-and-fill method" will be adopted to adjust publication bias. Sensitivity analysis will be used to test the stability of the result. When the heterogeneity is large (I2 ≥ 50%), meta regression will be used to explore the source of inter-study heterogeneity. When the heterogeneity is large (I2 ≥ 50%) and the results are statistically significant (P < .05), age, sex, duration of disease, duration of intervention, amount of exercise per week, improvement of cardiopulmonary health, and other factors will be sub-analyzed.

CONCLUSION

This meta-analysis will evaluate the impact of aerobic exercise on cognitive function in patients with SZ during daily nursing on the basis of existing evidence.

OSF REGISTRATION NUMBER

10.17605/OSF.IO/C8ABX.

[Clinical characteristics of connective tissue disease associated interstitial lung disease in children]

Objective: To elucidate the clinical features of connective tissue disease associated interstitial lung disease (CTD-ILD) in children. Methods: A total of 24 children diagnosed with CTD-ILD and treated in Department of Rheumatology and Immunology, Shanghai Children's Medical Center from January 2010 to December 2019 were included in the study. Their medical data including clinical features, lab test, imaging, pulmonary function test, treatment and outcome were analyzed statistically. Results: In these 24 patients, 4 were males and 20 females. Their main clinical presentations were cough (10/24, 42%), shortness of breath (10/24, 42%), tachycardia in quiet state (8/24, 33%), fatigue with activity (7/24, 29%), and fever (6/24, 25%). The main abnormal physical examination findings were moist rales (4/24, 17%) and acropachy (2/24, 8%). There were various abnormal findings in the patients' lab test. All the patients (100%) had pulmonary interstitial changes on chest CT. Eight patients had spirometry test, and all (100%) showed decreased diffusion capacity. After immunosuppressive treatment, 15 cases (63%) improved, 4 cases (17%) gave up or died, while 5 cases (21%) had no significant improvement on the imaging examination. Conclusions: The onset of pediatric CTD-ILD could be insidious. Early diagnosis and aggressive treatment may change the prognosis, but are both difficult and need further studies.

[Application of molecular analysis in differential diagnosis of ovarian adult granulosa cell tumors]

Objective: To investigate the application value of molecular detection in the differential diagnosis of ovarian adult granulosa cell tumors (AGCT) by analyzing FOXL2, AKT1 and DICER1 mutations in these tumors. Methods: A total of 48 cases of ovarian sex cord-stromal tumor (SCST) were selected from July 2012 to June 2019 in Beijing Obstetrics and Gynecology Hospital, including 21 adult granulosa cell tumors (AGCT), 15 fibromas/fibrothecomas, 8 Sertoli-Leydig cell tumors (SLCT) and 4 other types of ovarian SCST. Genomic DNA was extracted from the formalin-fixed paraffin-embedded tissue sections. Polymerase chain reaction amplification for FOXL2, AKT1 and DICER1 genes was performed, followed by sequencing using capillary electrophoresis. Fisher exact test was used to compare the prevalence difference of FOXL2, AKT1 and DICER1 mutations among the groups. P<0.05 was considered significant. Results: Eighteen of the 21 (85.7%) AGCT harbored FOXL2 mutation. Compared with other SCST (13.0%, 3 of 23; including fibromas/fibrothecomas and SLCT), FOXL2 mutation was significantly higher in AGCT (P<0.001). In addition, FOXL2 mutation was also detected in one fibrothecoma, two SLCT and two gynandroblastomas. DICER1 mutation was identified in four of eight SLCT, and these cases were moderately to poorly differentiated. FOXL2 mutation was found in one SLCT with DICER1 mutation. There was no DICER1 mutation in other ovarian SCST. No AKT1 mutation was detected in all the patients. Conclusions: FOXL2 mutation is a highly specific biomarker for adult AGCT and may be helpful to resolve problematic cases. Diagnosis should also be taken into consideration of the clinical and histological features as FOXL2 mutation is also found in other SCST. The detection of DICER1 mutation is helpful for the differential diagnosis of ovarian SLCT. Synchronous DICER1 and FOXL2 mutation in the SLCT has been observed, and its significance needs to be further studied.

[The network investigation on knowledge, attitude and practice about Novel coronavirus pneumonia of the residents in Anhui Province]

Objective: To analyze the current situation of the knowledge, attitudes and practice about Novelcoronavirus pneumonia (NCP) of the residents in Anhui Province. Methods: Anonymous network sampling survey was carried out with an electronic questionnaire that designed by the questionnaire star, and a total of 4016 subjects from Anhui province were investigated. The content of the survey includes that the basic information of subjects,the residents' knowledge, attitudes and practice about NCP, as well as their satisfaction with the prevention and control measures adopted by the government and health authorities and the suggestions on future prevention. The questionnaire doesn't involve any privacy information, and all questions were mandatory to ensure the response rate. Results: The M (P(25), P(75)) age the 4016 subjects was 21 (19, 24), and the ranging from 7 to 80 years old. The number of males was1431(35.6%). Social networking tools such as WeChat and QQ were the main sources of epidemic information for residents (97.8%, 3 929 respondents). Residents have a high awareness rate of the main symptoms, transmission routes, using of masks, hand washing and treatment information of NCP, while a low awareness rate of the atypical symptoms. 92.6% of the subjects (n=3 720) think that the outbreak was scary. In terms of psychological behavior scores, the results showed that female (9.38±4.81), the urban (9.37±5.02) and the medical workers (10.79±5.19) had a poorer mental health than the male (8.45±5.00) , the rural (8.71±4.75) and the non-medical workers (the students: 8.85±4.83; public institude workers: 9.02±5.08; others: 8.97±5.39) (P < 0.05). 71.9% of the residents (n=2 887)were satisfied with the local epidemic control measures. The residents took various of the measures to prevent and control the epidemic. The ratio of residents that could achieve "no gathering and less going out" , "wear masks when going out" and "do not go to crowded and closed places" was up to 97.4% (n=3 913), 93.6% (n=3758) and 91.5% (n=3 673) respectively. Conclusion: The residents in Anhui province have a good KAP about NCP, yet it is necessary to strengthen the community publicity, the mental health maintenance of residents and students' health education.

[Application of three methods in occupational health risk assessment of automobile 4S shop]

Objective: To choose various occupational health risk assessment of the mature methods at home and abroad respectively occupational health risk assessment was carried out on the 4s stores, to explore different risk assessment methods on the 4 s shop the applicability of the occupational health risk assessment. Methods: Chemical was applied on the harmful factors of occupational health risk assessment technology guideline in the composite index method, quantitative cancer risk assessment method using the guidelines for the harmful factors of occupational health risk assessment of chemical technology of composite index method, quantitative cancer risk assessment method, international commission on mining and metals (ICMM) occupational health risk assessment quantitative method and the occupational-disease-inductive operation classification to evaluate chemical factors in 4S store, Combined with on-site occupational health investigation to compare with the result of risk assessment and analysis of international mining and metals (ICMM) committee occupational health risk assessment quantitative method and the occupational-disease-inductive operation classification of 4S store to evaluate chemical factors, combined with on-site occupational health investigation comparison and analysis the result of the risk assessment. Results: Except for 6 times, the results of ICMM matrix method and comprehensive index method were consistent, which were all higher than job classification. The other results were job classification of >of ICMM matrix method >comprehensive index method or job classification of >of ICMM matrix method. Conclusion: When the concentration of occupational-disease-inductive factors is lower than 1/2 limit, the risk assessment results tend to be ICMM quantitative >composite index method >operation classification. When the occupational-disease-inductive factors were involved with triphenyl, the quantitative non-carcinogenic risk assessment method was more likely to reach the conclusion that the occupational health risk was unacceptable.

[Relationship between occupational stress, psychological capital and depressive symptoms among female workers in five electronic manufacturing enterprises]

Objective: To explore the relationship between occupational stress, psychological capital and depressive symptoms among electronic manufacturing female workers in the Pearl River Delta region. Methods: Using cluster sampling method, 845 female workers from 5 electronic manufacturing enterprises in the Pearl River Delta region were selected as research subjects from June to August 2017. The Effort Reward Imbalance questionnaire (ERI) , Psychological Capital questionnaire-24 (PCQ-24) and Patient Health questionnaire-9 (PHQ-9) were applied to measure the level of occupational stress, psychological capital and depressive symptoms in female workers. Results: Effort (r=0.197, P<0.01) and over commitment (r=-0.260, P<0.01) were positively correlated with the score of depressive symptoms, and the rewards was negatively correlated with depressive symptoms (r=-0.211, P<0.01) . The reward and over-commitment for depressive symptoms were accounted for 8.2%. Psychological capital was negatively correlated with depressive symptoms, and plays a partly mediating role in the relationship between occupational stress and depressive symptoms of female workers. The psychological capital for depressive symptoms was accounted for 8.7%. Conclusion: Occupational stress can affects the depressive symptoms of electronic manufacturing female workers, or indirectly affect depressive symptoms through psychological capital, reduce occupational stress and improve psychological capital as a way to relieve the depressive symptoms of female workers.

[Expression of type 1 and type 2 cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis at earlier stage]

Objectives: To explore the expression regulation of type 1 and type 2 (Th1 and Th2) cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis, 630 coal miners were studied. Methods: A total of 90 male patients diagnosed as coal workers' pneumoconiosis (CWP) in a institute for occupational health and 19 male workers newly diagnosed as CWP patients was chosen as CWP group with simple random sampling method from a coal mine group from January 2013 to December in 2015. 180 male coal miners with abnormal but not diagnosed as CWP were selected as CWP suspected group with simple random sampling methods, meanwhile 180 male coal miners with normal chest X-ray photograph was as dust-exposed group by 1∶1 matched as age. And 161 healthy males accepted pre-employed examination were selected as control group, CWP suspected group, dust-exposed group and control group called as non-CWP group. According to screening test and diagnosis test, the basic information and occupational history of all subjects were collected, and cytokines including IL-1β, IL-8, IFN-γ, IL-6 and IL-10 of serum were detected. Receiver operator characteristic (ROC) curve was used to determine the optimal cutoff value of each cytokine. Area under curve (AUC), the validity and reliability were calculated and judged. Results: The average age of control group, dust-exposed group, CWP suspected group and CWP group were (27.4±5.0) , (43.4±10.7) , (48.2±6.2) , (64.7±7.0) years old, respectively. The median level of IL-1β, IL-8, IFN-γ and IL-6 in cases group (1 638.30, 2 099.49, 815.18,140.32 pg/ml) were higher than that of non-cases group (1 445.57, 1 402.26, 736.38, 95.73 pg/ml) (P<0.05) . The level of IL-8 (1 503.99 pg/ml) in CWP suspected group was higher than that of control group (1 295.67 pg/ml) and dust-exposed group (1 376.94 pg/ml) , but the level of IL-10 (654.08 pg/ml) was lower than that of control group (596.64 pg/ml) . The ratio of IFN-γ/IL-6 ranged from 5 to 8, and the ratio in CWP group (5.87) was lower than that of non-CWP group (7.61) . The IL-6 and IL-8 among the subjects of dust-exposed group in terms of the age distribution of among had reached statistical significance. According to ROC, the cutoff value of IL-1β, IL-6, IL-8, IL-10 and INF-γ reached 1 582.65, 116.53, 1 791.54, 581.08 and 792.69 pg/ml, respectively. The AUC was 0.668, 0.895, 0.859, 0.716 and 0.637, respectively. It was found that IL-6 and IL-8 could be used as biomarkers in detecting CWP, the sensitivity and specificity was 82.6% and 84.6%, 78.0% and 84.8%, respectively; Youden's index was 0.674 and 0.628 and the consistency rate was 84.3% and 83.7%, while Kappa value was 0.55 and 0.52. Conclusion: There was Type 1 and type 2 cytokine dysregulation in CWP patients. IL-6 and IL-8 can be used as effective biomarkers to forecast lung injury before X-ray changes.

[Mediating effect of hemoglobin and hematocrit on the association between alcohol consumption and blood pressure among middle-aged and elderly male residents in Guangzhou]

Objective: To explore the mediating effect of hemoglobin (Hb) and hematocrit (HCT) on the association between alcohol consumption and blood pressure, and provide evidence for the prevention and control of alcohol-attributed hypertension. Methods: 1 091 male (age >50 years old) participants with drinking habit were selected from the Guangzhou biobank cohort study (GBCS). Mediation analysis was used to evaluate the mediating effect of Hb and HCT on the association of alcohol consumption (unit/day) with systolic blood pressure (SBP), diastolic blood pressure(DBP), pulse pressure(PP) and mean arterial pressure (MAP). Results: After adjusting for age, body mass index, education level, personal annual income, smoking, occupation and physical activity, the associations of alcohol consumption with SBP, DBP, PP and MAP were partly mediated by Hb, the proportion of mediating effect was 11.8% (95%CI 4.8%-24.7%), 15.3% (95%CI 6.5%-32.0%), 8.4% (95%CI 2.2%-22.5%) and 13.5% (95%CI 5.9%-27.5%), respectively. The associations of alcohol consumption with SBP, DBP, and MAP were also partly mediated by HCT, the proportion of mediating effect was 6.3% (95%CI 1.0%-16.0%), 8.7% (95%CI 1.4%-21.4%), and 7.5% (95%CI 1.0%-18.6%), respectively. Conclusion: There is a significant mediating effect of Hb and HCT on the association between alcohol consumption and blood pressure. Besides efforts on alcohol control, the potential effects of alcohol-induced increase on Hb and HCT, which might also increase the blood pressure, need to be considered to achieve optimal monitoring and prevention of alcohol-related hypertension.

[Foreign bodies of external nose and forehead:a case report]

Foreign bodies of external nose and forehead are rarely seen.In this case the patient stuck an acupuncture needle into the middle of two sides of the superliliary arch 3 months ago. Patient complains of slight pain in that region because of the infection.The X-ray and 3D CT examination present 4 abnormal high-density shadows in the subscutaneous tissue of external nose and forehead.Foreign bodies in maxillofacial region have the quality of being changeable when the muscles are contracting. The key point to the successful operation is finding the accurate location of the foreign bodies with feasible image examination and designing reasonable incisions.

[Association between body weight change during early and middle adulthood and the risk of type 2 diabetes in middle aged and elderly population]

Objective: To examine the association between weight changes during early and middle adulthood and the risk of type 2 diabetes mellitus in middle aged and elderly population. Methods: Based on the Guangzhou Biobank Cohort Study (GBCS), 28 736 residents aged ≥50 years were included in Guangzhou. Multivariate logistic regression was used to analyze the association between body weight changes during early or middle adulthood and age when the heaviest weight reaching the threshold on the risk of type 2 diabetes mellitus in middle age or elderly population. Adjustments on age, smoking, alcohol consumption, physical activity, education level, occupation, district of residence and body mass index etc., were made. Results: The mean age was 64.3 (standard deviation=6.7) years in men and 61.0 (standard deviation=7.0) years in women, with the prevalence rates of diabetes as 13.1% and 13.7% in men and women, respectively. Compared to those with stable body weight, the risk of diabetes increased with weight gain during early and middle adulthood in both men and women (both P values for trend<0.01). Participants who gained more than 20 kg during early and middle adulthood were associated with the highest risk of diabetes in men (OR=2.83, 95%CI:1.99-4.02) and women (OR=3.13, 95%CI: 2.47-3.96). Compared to those who reached the highest weight at age 20, those who reaching the highest weight at 40 to 49 years were associated with the highest risk of diabetes, with OR being 5.32 (95%CI: 1.92-14.8) in men and 3.41 (95%CI: 2.49-4.67) in women, respectively. Weight loss in adulthood was associated with self-reported but not newly diagnosed diabetic cases in both middle and older aged men and women. Conclusion: Weight gain during early and middle adulthood may increase the risk of diabetes in middle and older aged population. The detrimental effect of obesity on diabetes might become significantly visible in the next decades.

Adiposity and incident diabetes within 4 years of follow-up: the Guangzhou Biobank Cohort Study

AIM

Whether different adiposity measures predict incident diabetes differentially in general Chinese populations is unclear. We investigated this in Chinese people aged 50+ years in the Guangzhou Biobank Cohort Study.

METHODS

Waist circumference and BMI were measured at baseline, and fasting glucose was measured at both baseline and follow-up examinations. Incident diabetes was defined as fasting glucose ≥ 7.0 mmol/l, glucose after 2-h oral glucose tolerance test ≥ 11.1 mmol/l, and/or self-reported physician-diagnosed diabetes during the follow-up period.

RESULTS

Of 15 752 people without diabetes at baseline from 2003 to 2008, 1779 (11.3%) developed incident diabetes during the follow-up from 2008 to 2012 (mean = 3.6 years, sd = 1.0). After mutually adjusting each other and adjusting for other potential confounders, waist circumference showed a higher predictive value than BMI. The odds ratio (OR) (95% confidence interval (CI) was 1.50 (95% CI 1.37-1.64) for a 1 sd increment in waist circumference and 1.21 (95% CI 1.11-1.33), for a 1 sd increment in BMI. Similarly, after mutual adjustment, abdominal obesity was associated with an almost twofold odds of incident diabetes (OR 1.93, 95% CI 1.71-2.17), which was higher than that for general obesity (OR 1.76, 95% CI 1.50-2.06). The area under receiver operating characteristic curve (AUC) for waist circumference was higher than that for BMI [AUC = 0.676 (95% CI 0.660-0.686) vs. 0.665 (95% CI 0.651-0.678), P = 0.02].

CONCLUSION

Abdominal obesity predicted incident diabetes in older people better than general obesity. Our findings may be an early warning signal for local government or public health practitioners to develop and investigate more effective intervention programmes for diabetes, and should also be disseminated to the public to pay more attention to this important public health issue.

Establishment of a cell line with high transfection efficiency from zebrafish Danio rerio embryos and its susceptibility to fish viruses

A cell line ZBE3 isolated from a continuous cell culture derived from zebrafish Danio rerio blastomeres by clonal growth was characterized. ZBE3 cells had been subcultured for >120 passages since the initial primary culture of the blastomeres. The ZBE3 cells grow stably at temperature from 20 to 32° C with an optimum temperature of 28° C in ESM2 or ESM4 medium with 15% foetal bovine serum (FBS). The optimum FBS concentration for ZBE3 cell growth ranged from 15 to 20%. Cytogenetical analysis indicated that the modal chromosome number of ZBE3 cells was 50, the same as the diploid chromosome number of D. rerio. Significant cytopathic effect was observed in ZBE3 cells after infection with redspotted grouper nervous necrosis virus, Singapore grouper iridovirus and grass carp reovirus, and the viral replication in the cells was confirmed by real-time quantitative PCR and transmission electron microscopy, indicating the susceptibility of ZBE3 cells to the three fish viruses. After transfected with pEGFP-N3 plasmid, ZBE3 cells showed a transfection efficiency of about 40% which was indicated by the percentage of cells expressing green fluorescence protein. The stable growth, susceptibility to fish viruses as well as high transfection efficiency make ZBE3 cells be a useful tool in transgenic manipulation, fish virus-host cell interaction and immune response in fish.

[Progress in the role of neurotrophin-3 and its receptors in the development of cochlear spiral ganglion in rats]

Neurotrophin-3 (NT-3) attracted increasing attention about NTFs researches in recent years. But the mechanism of promoting the development of neurons and neurite extension is not clear. Recombinant human NT-3 or NT-3 gene is commonly used in the treatment of peripheral and central neurons system damage. When rats are born, the cochlear is not mature yet. It is a suitable experimental animal for studying the morphological and functional development of the peripheral auditory pathway. It was found that NT-3 could promote the survival, growth, division and extension of the cochlear neurons in rats. To make clear the role of NT-3 in the development of spiral ganglion in the rat cochlear will be of significance for the treatment of nervous hearing loss by NT-3 in the future.

[Influence of extreme weather on years of life lost due to diabetes death in Chongqing and Harbin, China]

Objective: To understand the associations between extremely low and high air temperature and the years of life lost (YLL) due to diabetes deaths in Chongqing and Harbin with different climatic characteristics in China. Methods: A double threshold B-spline distributed lag non-linear model (DLNM) was used to investigate the lag and cumulative effects of extremely low and high air temperature on YLL due to diabetes for lag 0-30 days by using the urban meteorological and diabetes mortality data of Chongqing (2011-2013) and Harbin (2008-2010). The effects were expressed as relative risk (RR). Results: In Chongqing, the cold effects on YLL due to diabetes were delayed by four days and lasted for three days (lag4-6) with the highest RR of 1.304 (95%CI:1.033-1.647) at lag5. The hot effects were delayed by one day (lag1) with RR of 1.321 (95%CI:1.061-1.646). In Harbin, the extreme cold effects on YLL were delayed by four days and lasted for seven days (lag4-10) with the highest RR of 1.309 (95%CI: 1.088-1.575) at lag6. The hot effects were delayed by one day and lasted for four days (lag1-4) with the highest RR of 1.460 (95%CI:1.114-1.915) at lag2. The unit risk for cold and hot effects was 43.7% (P=0.005 5) and 18.0% (P=0.000 2) in Chongqing and 15.0% (P=0.000 8) and 29.5% (P=0.001 2) in Harbin, respectively. Conclusions: Both extremely low air temperature and extremely high air temperature might increase the years of life lost due to diabetes in cities with different climate characteristics. Health education about diabetes prevention should provide information about the effects of extreme weather events.

[Correlation between body fat percentage and general obesity indexes in middle aged and old people in Guangzhou]

Objective: To examine the correlation between body fat percentage (BFP) and general obesity indexes, including body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR) and calculate the corresponding BFP cutoff values in the middle aged and old people in Guangzhou. The corresponding cut-point of optimal body fat percentage for Guangzhou older population. Methods: Based on the Guangzhou Biobank Cohort Study (GBCS), 3 490 relatively healthy Guangzhou residents aged ≥50 years were selected and were randomly divided into 2 groups. The equations between BFP and BMI, WC, WHR were set up with Curve fitting analysis in one group. The multiple regression analysis was undertaken to establish predictive equations between BFP and BMI, WC, WHR with stepwise model for adding gender, age, physical activity, drinking and smoking. Then, the optimal cut-points of BFP corresponding to BMI, WC and WHR to reflect the degree of obesity were calculated. The equations were then validated with another group. Results: BFP increased with the increase of WHR, WC and BMI. BMI was a better predictor of body fat percentage than WC and WHR. The final regression equation was BFP=(-23.47 -8.87×sex) +2.94× (BMI) - 0.024 × (BMI)²,the coefficient of determination was 0.805. Based on the equation, the BFP corresponding to overweight/obesity (24 kg/m²≤BMI<28 kg/m²) were 24.3% ≤BFP<31.1% in men and 33.2%≤BFP<40.0% in women, respectively. BMI had a better consistency with BFP in identify obesity compared with WC and WHR, obtained the area of ROC 0.909 in men and 0.919 in women respectively. The sensitivity and specificity were 70.3% and 85.5% in men; and 75.2% and 93.0% in women respectively. Conclusion: BFP has a better correlation with BMI. The study results indicated that BFP for middle aged and old males and females in Guangzhou corresponding to overweight/obesity (BMI≥24 kg/m²) were <24.0% and <33.0% respectively.

[Clinicopathological analysis of lymph node metastasis in colorectal adenocarcinoma]

OBJECTIVE

To analyze the correlation of lymph node metastasis with clinicopathological parameters and outcomes of colorectal adenocarcinoma, and to explore its clinicopathological significance.

METHODS

The lymph node metastasis and clinicopathological features of 133 colorectal adenocarcinoma patients whose specimens were interpreted in Department of Pathology of Beijing Tongren Hospital between February 2011 and August 2015 were retrospectively analyzed. The relationship between the lymph node metastasis and clinicopathological features as well as outcomes was also analyzed according to the follow-up data of these patients.

RESULTS

Among the 133 cases, 69 had lymph node metastasis, and the other 64 had no lymph node metastasis. Compared with the non-lymph node metastasis group, the lymph node metastasis group had higher prevalence of neural invasion (20.29% vs 3.13%) and vascular invasion (36.23% vs 3.13%), deeper tumor invasion (beyond the serosa: 1.45% vs 0), lower tumor differentiation (poorly differentiated: 26.09% vs 14.06%), higher mortality (11.59% vs 1.56%) and distant metastasis (17.39% vs 4.69%) (all P<0.05). In the lymph node metastasis group, intra-group comparison among patients of different lymph node N staging (N0, N1a, N1b, N2a, N2b) also showed statistically significant differences in neural invasion, vascular invasion, circumferential resection margin, maximum diameter of the tumor, depth of tumor invasion, tumor differentiation, survival, and distant metastasis (all P<0.05). There were no statistically significant differences between the patients with lymph node metastases <12 and those with lymph node metastases ≥12 in these clinicopathological parameters(all P>0.05).

CONCLUSIONS

Presence/absence of lymph node metastasis and lymph node stage may be correlated with neural invasion, vascular invasion, depth of tumor invasion, tumor differentiation, survival, and distant metastasis. However, no marked relationship was detected of the number of lymph node metastases (<12 or ≥12) with clinicopathological parameters and outcomes.

Smoking and serum vitamin D in older Chinese people: cross-sectional analysis based on the Guangzhou Biobank Cohort Study

OBJECTIVE

Studies on serum vitamin D in smokers showed conflicting results. We examined the association of smoking status with serum vitamin D in older Chinese men, taking advantage of a community-based sample with natural exposure to vitamin D.

DESIGN

Cross-sectional study based on the Guangzhou Biobank Cohort Study (GBCS).

SETTING

Community-based sample from the Guangzhou Biobank Cohort Study.

PARTICIPANTS

612 male participants aged 50+years recruited from 2009 to 2011.

RESULTS

The mean (SD) of vitamin D concentration was 58.3 (17.2), 57.0 (15.0) and 54.7 (15.4) nmol/L for never, former and current smokers, respectively. Adjusted for multiple confounders, vitamin D decreased from never to former, then to current smokers (P for trend 0.02). Compared to never smokers, current smokers had lower serum concentrations of vitamin D, and the concentrations decreased with the increasing number of cigarettes per day (-3.11 (95% CI -9.05 to 2.82), -3.29 (-8.3 to 1.72) and -4.61 (-8.89 to -0.33) for 1-9, 10-19 and 20+cigarettes per day, respectively; p for trend 0.01), duration of smoking (-1.39 (-6.09 to 3.30) and -5.39 (-9.42 to -1.35) for 1-39 and 40+years, respectively; p for trend 0.008) as well as pack-years (-2.89 (-6.78 to 1.01) and -5.58 (-10.48 to -0.67) for 1-39 and 40+pack-years, respectively; p for trend 0.009). Longer duration of quitting smoking was associated with higher vitamin D than was current smoking (P for trend 0.04).

CONCLUSIONS

Current smokers had lower vitamin D than never smokers, and the association showed a dose-response pattern.

MR spectroscopy for assessing the effects of oxytocin on marrow adipogenesis induced by glucocorticoid in rabbits

BACKGROUND

Previous studies suggest that oxytocin (OT) negatively modulates adipogenesis while promoting osteogenesis in vitro. Because of its effects on marrow stromal cells, OT might have potential utility in therapy for glucocorticoid-induced osteoporosis (GIO).

PURPOSE

To explore the effects of OT on marrow adipogenesis in a rabbit model of GIO.

MATERIAL AND METHODS

Thirty-six-month-old female New Zealand rabbits were randomly assigned to the control, GIO, and GIO + OT groups. Magnetic resonance (MR) spectroscopy and multi-detector computed tomography (MDCT) were performed to detect marrow fat content (MFC) and bone mineral density (BMD) at baseline, and 1, 2, and 3 months. After 3 months of treatment, marrow adipocytes were quantitatively evaluated by histopathology.

RESULTS

In the GIO group, MFC substantially increased from 34.1% to 43.2% at month 1, and it was maintained until month 3 (by 59.2%, all P <0.01). MFC values in the GIO group were significantly different from the control and OT-treated groups over time. Early OT treatment reversed marrow adiposity to levels of the controls. BMD values were significantly lower in the GIO group at months 2 and 3 compared to the controls; however, partial recovery of vertebral BMD (87.1% of baseline) and femoral BMD (89.3% of baseline) in the OT-treated group were observed. The mean diameter and density of adipocyte and percentage of adipocyte area increased by 30.0%, 70.1%, and 88.9%, respectively (all P <0.05) in the GIO group, but remained unchanged in the OT-treated group.

CONCLUSION

Early OT treatment was sufficient to eliminate glucocorticoid-induced marrow adiposity.