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Background Cardiac blunt trauma clinically presents as a spectrum of injuries of varying severity. However, the diagnosis of complications of remote myocardial trauma is often challenging, especially if the patient forgets to mention a remote history of chest trauma. Case summary In this study, we present a patient who recently experienced traumatic myocardial dissection and interventricular septal rupture, alongside three patients exhibiting a mimic double-chambered left ventricle, indicative of prior remote myocardial trauma potentially associated with myocardial dissecting tear. Discussion Patients with recent severe myocardial injury are detectable through cardiac imaging. However, forgotten remote myocardial trauma can lead to adverse myocardial remodelling, heart failure, and arrhythmias. Long-term myocardial remodelling can obscure initial myocardial imaging characteristics, posing challenges in interpretation. Our case series suggests that remote myocardial trauma may be more prevalent than commonly thought of in clinical practice. [ABSTRACT FROM AUTHOR]

Background: The stria vascularis (SV), located in the lateral wall of the cochlea, maintains cochlear fluid homeostasis and mechanoelectrical transduction (MET) activity required for sound wave conduction. The pathogenesis of a number of human inheritable deafness syndromes, age related hearing loss, drug-induced ototoxicity and noise-induced hearing loss results from the morphological changes and functional impairments in the development of the SV. In this study, we investigate the implications of intercellular communication within the SV in the pathogenesis of sensorineural hearing loss (SNHL). We aim to identify commonly regulated signaling pathways using publicly available single-cell transcriptomic sequencing (scRNA-seq) datasets. Methods: We analyzed scRNA-seq data, which was derived from studying the cochlear SV in mice with SNHL compared to normal adult mice. After quality control and filtering, we obtained the major cellular components of the mouse cochlear SV and integrated the data. Using Seurat's FindAllMarkers and FindMarkers packages, we searched for novel conservative genes and differential genes. We employed KEGG and GSEA to identify molecular pathways that are commonly altered among different types of SNHL. We utilized pySCENIC to discover new specific regulatory factors in SV subpopulation cells. With the help of CellChat, we identified changes in subpopulation cells showing similar trends across different SNHL types and their alterations in intercellular communication pathways. Results: Through the analysis of the integrated data, we discovered new conserved genes to SV specific cells and identified common downregulated pathways in three types of SNHL. The enriched genes for these pathways showing similar trends are primarily associated with the Electron Transport Chain, related to mitochondrial energy metabolism. Using the CellChat package, we further found that there are shared pathways in the incoming signaling of specific intermediate cells in SNHL, and these pathways have common upstream regulatory transcription factor of Nfe2l2. Combining the results from pySCENIC and CellChat, we predicted the transcription factor Nfe2l2 as an upstream regulatory factor for multiple shared cellular pathways in IC. Additionally, it serves as an upstream factor for several genes within the Electron Transport Chain. Conclusion: Our bioinformatics analysis has revealed that downregulation of the mitochondrial electron transport chain have been observed in various conditions of SNHL. E2f1, Esrrb, Runx1, Yy1, and Gata2 could serve as novel important common TFs regulating the electron transport chain. Adm has emerged as a potential new marker gene for intermediate cells, while Itgb5 and Tesc show promise as potential new marker genes for marginal cells in the SV. These findings offer a new perspective on SV lesions in SNHL and provide additional theoretical evidence for the same drug treatment and prevention of different pathologies of SNHL. [ABSTRACT FROM AUTHOR]

Problem: Artificial intelligence has been widely investigated for diagnosis and treatment strategy design, with some models proposed for detecting oral pharyngeal, nasopharyngeal, or laryngeal carcinoma. However, no comprehensive model has been established for these regions. Aim: Our hypothesis was that a common pattern in the cancerous appearance of these regions could be recognized and integrated into a single model, thus improving the efficacy of deep learning models. Methods: We utilized a point-wise spatial attention network model to perform semantic segmentation in these regions. Results: Our study demonstrated an excellent outcome, with an average mIoU of 86.3%, and an average pixel accuracy of 96.3%. Conclusion: The research confirmed that the mucosa of oral pharyngeal, nasopharyngeal, and laryngeal regions may share a common appearance, including the appearance of tumors, which can be recognized by a single artificial intelligence model. Therefore, a deep learning model could be constructed to effectively recognize these tumors. [ABSTRACT FROM AUTHOR]

Introduction: The distal end anastomosis is critical to the entire sequential grafts in coronary artery bypass grafting (CABG), but caliber mismatch diminishes the quality of the anastomosis. We aimed to introduce a modified distal end side-to-side (deSTS) anastomosis to handle the size mismatch and compared with classic distal end end-to-side (deETS) anastomosis. Methods: From January 2014 to December 2018, 185 patients who underwent off-pump CABG with size mismatched sequential vein grafts (≥3.5 mm) and target coronaries (1.0–1.5 mm) at the distal end anastomoses were included. We retrospectively reviewed the data of the patients, perioperative and follow-up outcomes were analyzed. Results: The deSTS group (n = 67) showed higher anastomotic flow (19.8 ± 8.0 vs 14.9±6.8 mL/min; p < 0.001) and lower pulsatility index (2.7 ± 0.8 vs 3.2 ± 1.0; p = 0.001) than the deETS group (n = 118). Higher incidence of in-hospital myocardial infarction (MI) was found in the deETS group but without significant difference (9.0% vs. 15.3%; p = 0.220). Kaplan-Meier analysis illustrated a relatively lower MI and major adverse cardiovascular and cerebrovascular events (MACCE) incidence in the deSTS group, and the deSTS group was associated with a reduction in long-term death, MI and MACCE in the adjusted Cox regression model. In addition, relatively higher graft patency was found in the deSTS group. Conclusions: The deSTS anastomosis showed superiority in solving size mismatch in sequential CABG, including better intraoperative flow dynamics, ideal long-term graft patency and reduced the incidence of perioperative and follow-up adverse events especially in MI. [ABSTRACT FROM AUTHOR]

Objectives: During clinical practice, we have detected a few cases of neck abscesses in patients diagnosed with esophageal foreign body impaction (EFB) but without the primary inflammatory disease. However, we do not know if neck abscesses caused by an inflammatory source are more like to be associated with a more severe progression or poorer prognosis. In this study, we aimed to identify differences between these two groups of patients by comparing progression and prognosis.Materials and Methods: We retrospectively reviewed all patients who underwent neck abscess incisions between January 2011 and March 2022 and divided these patients into two groups: an EFB group and an inflammation group. Data were described by percentages, means, and standard deviations (SDs). Fisher's precision probability test was used to compare differences between the EFB and inflammation groups. Categorical variables were analyzed by Pearson's Chi-squared test. In addition, three factors including hospital days, intensive care unit (ICU) stay, and drainage-tube removal time were used for multivariate analysis to identify independent correlations separately.Results: We enrolled a total of 33 patients with neck abscesses who received surgical incisions; the EFB group included 14 (42%) cases, while the inflammatory group included 19 (58%) cases. No significant differences were identified between the two groups in terms of surgery type (with or without mediastinotomy) and postoperative management (negative pressure drainage or postoperative irrigation). There were no significant differences between the two groups in terms of hospital stay, the timing of drainage-tube removal, the risk of ICU admission, and the probability of receiving intubation and tracheotomy. The incidence rate of esophageal perforation differed significantly between the two groups (p < 0.001). However, there were no significant differences in terms of other preoperative or postoperative comorbidities. The multivariate analysis revealed that the application of mediastinotomy (HR = 0.216 [0.049, 0.963]; p = 0.044) was correlated with a longer stay in the hospital. The time from symptoms to surgery was associated with a longer drainage tube removal time (HR = 0.392 [0.159, 0.967]; P = 0.042) and longer ICU stay (OR = 79.754[1.513, 4203.182]; P = 0.03).Conclusion: Patients with neck abscesses associated with EFB and inflammation received the same therapeutic management, and there were no significant differences between these two groups in terms of prognosis. Furthermore, esophageal perforation was found to be irrelevant to the aggravation of neck abscesses, and there was no need for additional surgery to repair a perforated esophagus in patients with neck abscesses.Level Of Evidence: Retrospective cohort (2b). [ABSTRACT FROM AUTHOR]

Background: The inner ear organ is a delicate tissue consisting of hair cells (HCs) and supporting cells (SCs).The mammalian inner ear HCs are terminally differentiated cells that cannot spontaneously regenerate in adults. Epithelial non‐hair cells (ENHCs) in the utricle include HC progenitors and SCs, and the progenitors share similar characteristics with SCs in the neonatal inner ear. Methods: We applied single‐cell sequencing to whole mouse utricles from the neonatal period to adulthood, including samples from postnatal day (P)2, P7 and P30 mice. Furthermore, using transgenic mice and immunostaining, we traced the source of new HC generation. Results: We identified several sensory epithelial cell clusters and further found that new HCs arose mainly through differentiation from Sox9+ progenitor cells and that only a few cells were produced by mitotic proliferation in both neonatal and adult mouse utricles. In addition, we identified the proliferative cells using the marker UbcH10 and demonstrated that in adulthood the mitotically generated HCs were primarily found in the extrastriola. Moreover, we observed that not only Type II, but also Type I HCs could be regenerated by either mitotic cell proliferation or progenitor cell differentiation. Conclusions: Overall, our findings expand our understanding of ENHC cell fate and the characteristics of the vestibular organs in mammals over the course of development. [ABSTRACT FROM AUTHOR]

Bending and tension deformations were performed on Mg-1.3wt%Zn-0.2wt%RE-0.3wt%Zr (ZEK100) alloy sheets that initially had a transverse direction (TD)-split texture. The effects of bending and tension deformations on the texture formation and room-temperature formability of specimens were investigated. The specimen subjected to 3-pass bending and tension deformations exhibited an excellent Erichsen value of 9.6 mm. However, the Erichsen value deterioration was observed in the specimen subjected to 7-pass deformations. The rolling direction-split texture developed on the surface with an increasing pass number of deformations. Conversely, the clear TD-split texture remained at the central part. As a result, a quadrupole texture was macroscopically developed with an increasing pass number of deformations. The reduction in anisotropy by the formation of the quadrupole texture is suggested to be the main reason for the improvement in stretch formability. By contrast, the generation of coarse grains near the surface is suggested to be the direct cause for the deterioration of the stretch formability of the specimen subjected to 7-pass deformations. [ABSTRACT FROM AUTHOR]

Background: Esophageal foreign body impaction is the most common cause of endoscopic emergency. However, there are limited available data on delayed endoscopic management of esophageal sharp-pointed food impaction. Aims: To investigate cases of esophageal sharp-pointed food impaction with endoscopic removal findings. Methods: This single-center retrospective study collected medical records to identify patients with esophageal sharp-pointed food impaction who underwent endoscopic removal between April 2018 and April 2020. The patients were divided into the early (endoscopic removal <12 h) and delayed intervention (>12 h) cohorts. Results: Overall, 133 and 696 patients received early and delayed intervention, respectively. The success rate of endoscopic foreign body removal was 96.45%. The most common foreign body was fish bone (66.90%), and the most common shape was "I" (56.26%). Patients from the delayed intervention cohort received general anesthesia with a higher risk for perforation, and no foreign body was identified. The duration of endoscopy, distance between the foreign body/wound and the incisor, and longest diameter of the foreign body were not different between the groups. In multivariate analysis, male sex (odds ratio = 1.792 [1.159, 2.771]; P = 0.009), longer duration of impaction (odds ratio = 2.212 [1.121, 4.365]; P = 0.022) and endoscopy (odds ratio = 1.502 [1.253, 1.800]; P < 0.001), and longest diameter of the foreign body (odds ratio = 1.632 [1.329, 2.003]; P < 0.001) were associated with a higher incidence of perforation in patients with foreign body impaction. Conclusions: Endoscopic removal is a safe and effective treatment method for sharp-pointed food impaction. Delayed endoscopic removal can increase the risk of esophageal perforation. [ABSTRACT FROM AUTHOR]

The ear canal (EC) is essential for sound transfer and crucial for hearing. Some pathological conditions may modify its morphology, leading to EC sound pressure redistribution, and stapes footplate displacement (FPD) gain alteration. However, no consensus regarding pathological EC and its impact on sound transfer has yet been achieved. To address the effect of morphology of EC on sound pressure redistribution and FPD gain. Varied pathological EC finite element (FE) models were constructed and analyzed based on FE analysis. The results indicated that canal wall down mastoidectomy decreases the second resonance frequency of the EC. The canal wall down mastoidectomy, with conchaplasty increased the first resonance frequency, but decreased the second along with the interval sound pressure gain increased, following which the FPD gain was altered. Stenosis of the EC at the internal portion decreased the second resonance frequency with minimal effect to the first part. When the stenosis moved to the outer portion of the EC, the first resonance frequency decreased, and the second one increased, along with the interval sound pressure gain decreased and FPD gain. Finally, the simplified EC model exerted a minimal effect on sound transfer. The minimal change in EC, such as simplification, straightening, canal wall down mastoidectomy, or enlargement, moderately affects the sound transfer; however, the EC stenosis deteriorates the sound transfer remarkably. [ABSTRACT FROM AUTHOR]

Stimulating the round window membrane via an active actuator of the middle ear implant, named the reverse stimulation, has become an option to help patients with ossicular chain deformity (OCD) to restore hearing. However, there is still no concise description of how OCD affects reverse stimulation considering the overflow characteristics of third windows. In the present study, an impedance model considering the vestibular and cochlear aqueducts was used to investigate the dynamic response of the cochlea to reverse stimulation under OCD. First, a finite-element (FE) model of the middle ear and the ear canal was used to estimate the changes in reverse middle-ear impedance caused by ossicular chain fixation and ossicular chain interruption. Then, the impedance model was used to predict the reverse transfer function, which characterizes the effect of OCD on the dynamic response of the cochlea. The results show that ossicular chain fixation reduces the reverse stimulation's performance. Moreover, the existence of the third windows complicates the effect of ossicular chain fixation on the reverse stimulation and boosts obviously the reverse stimulation's performance at low frequencies. In contrast, regardless of the existence of third windows, ossicular chain interruption enhances the effect of reverse stimulation. [ABSTRACT FROM AUTHOR]

It is difficult to measure the cochlea directly because of the ethical problems and the complexity of cochlear structure. Therefore, finite element model (FEM) can be used as an effective alternative research method. An accurate FEM of the human ear can not only help people understand the mechanisms of sound transmission, but also effectively assess the effects of otologic diseases and guide research on the treatment of hearing loss. In this paper, a three-dimensional (3D) FEM of the human normal cochlea is proposed to study the changes in the biomechanical behavior of the cochlear sensory structure caused by the anterior fissure sclerosis and bottom-turn and apex-turn ossification of the cochlear window. The degree and harm of hearing loss caused by diseases are quantitatively predicted, which can deepen the understanding of the biomechanical mechanism of cochlea, and provide theoretical basis for clinical medicine. [ABSTRACT FROM AUTHOR]

Many studies have investigated factors contributing to large variations in the outcomes of round-window (RW) stimulation but most have focused on the floating mass transducer (FMT). To determine whether results for the FMT hold for a fixed-type transducer (FTT), this study constructs two coupled finite element models of the transducer and the human ear that incorporate the cochlear third windows and inner structures of these two electromagnetic transducers. We use these FE models of the human ear and transducers to investigate the influence of four design parameters and coupling conditions for the transducers, i.e., the support's Young's modulus, the coupling layer's cross sectional area and Young's modulus, and the transducer's cross sectional area. The results show that an increase in the support's Young's modulus reduces the output of the FMT but increases that of the FTT. Reducing the cross sectional area and Young's modulus of the coupling layer significantly increases the low-frequency response of the FMT but slightly reduces that of the FTT. Reducing the cross sectional area of the transducer increases the output of the FMT but reduces that of the FTT. This shows that inner structures of electromagnetic transducers should be considered in the optimal design parameters and coupling conditions for RW stimulation. [ABSTRACT FROM AUTHOR]

Purpose: Nasopharyngeal carcinoma (NPC) is one of the most common malignant tumors of the head and neck. This study aimed to investigate the crucial genes and regulatory networks involved in the carcinogenesis of NPC using a bioinformatics approach. Methods: Five mRNA and two miRNA expression datasets were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) and miRNAs (DEMs) between NPC and normal samples were analyzed using R software. The WebGestalt tool was used for functional enrichment analysis, and protein–protein interaction (PPI) network analysis of DEGs was performed using STRING database. Transcription factors (TFs) were predicted using TRRUST and Transcriptional Regulatory Element Database (TRED). Kinases were identified using X2Kgui. The miRNAs of DEGs were predicted using miRWalk database. A kinase–TF–mRNA–miRNA integrated network was constructed, and hub nodes were selected. The hub genes were validated using NPC datasets from the GEO and Oncomine databases. Finally, candidate small-molecule agents were predicted using CMap. Results: A total of 122 DEGs and 44 DEMs were identified. DEGs were associated with the immune response, leukocyte activation, endoplasmic reticulum stress in GO analysis, and the NF-κB signaling pathway in KEGG analysis. Four significant modules were identified using PPI network analysis. Subsequently, 26 TFs, 73 kinases, and 2499 miRNAs were predicted. The predicted miRNAs were cross-referenced with DEMs, and seven overlapping miRNAs were selected. In the kinase–TF–mRNA–miRNA integrated network, eight genes (PTGS2, FN1, MMP1, PLAU, MMP3, CD19, BMP2, and PIGR) were identified as hub genes. Hub genes were validated with consistent results, indicating the reliability of our findings. Finally, six candidate small-molecule agents (phenoxybenzamine, luteolin, thioguanosine, reserpine, blebbistatin, and camptothecin) were predicted. Conclusion: We identified DEGs and an NPC regulatory network involving kinases, TFs, mRNAs, and miRNAs, which might provide promising insight into the pathogenesis, treatment, and prognosis of NPC. [ABSTRACT FROM AUTHOR]

To assess the effects of ossicular chain malformations on the performance of bone conduction hearing aids, a human ear finite-element model that includes an ear canal, a middle ear, and a spiral cochlea incorporating the third windows was established. This finite element model was built based on micro-computed tomography scanning and reverse modelling techniques, and the reliability of the finite element model was verified by comparison with reported experimental data. Based on this model, two main types of ossicular chain malformations, i.e., the incudostapedial disconnection and the ossicles fixation, were simulated, and their influences on bone conduction were analyzed by comparing the trans-cochlear-partition differential pressures. The results indicate that the incudostapedial disconnection mainly deteriorates the bone conduction response at mid frequencies. The stapes fixation has the largest effect among the ossicles fixation with the bone conduction stimulation, which also mainly decreases the mid-frequency response of the bone conduction, especially at 2 kHz. As the speech intelligibility has the most important frequency range at the range between 1 kHz and 2.5 kHz, the mid-frequency deterioration caused by ossicular chain malformations should be compensated in optimizing the design of the bone conduction hearing aids. For treating patients with the ossicular chain malformations, especially for the patients who suffer from the stapes fixation, the output of bone conduction hearing aids' actuator in the middle frequency band should be improved. [ABSTRACT FROM AUTHOR]

An active actuator of a middle-ear implant coupled to the round window membrane (RWM), which transmits vibration to the cochlea, has been used to compensate for hearing loss in patients. However, various factors affect the coupling condition between the actuator and the RWM, resulting in coupling leakage. In this study, a coupling impedance model of the human ear and the actuator was used to investigate the effect of inefficient coupling during reverse stimulation. First, the three-port circuit network model of the actuator was coupled with the acoustic impedance model of human ear reverse sound transmission. Meanwhile, the inefficient coupling impedance was estimated. Then, the effect of the actuator's coupling on reverse stimulation was studied by comparing the reverse pressure transfer function. Furthermore, the inefficient coupling's influence in the ear with middle-ear disorder was also investigated by simulating two typical forms of middle-ear disorder: otosclerosis and ossicular chain disarticulation. The results show that the change of the inefficient coupling impedance plays a significant role during reverse stimulation. Inefficient coupling of the actuator and the RWM deteriorates the cochlear response of reverse stimulation over the entire frequency range. Additionally, the coupling effect of the actuator does not change the influence tendency of middle-ear disorder on reverse stimulation's performance, but changes the response amplitude of the reverse stimulation. [ABSTRACT FROM AUTHOR]

BACKGROUND: While patients with benign paroxysmal positional vertigo (BPPV) commonly develop residual dizziness (RD) after successful repositioning, the factors predictive of RD remain controversial. OBJECTIVE: To identify factors predictive of RD onset in patients with BPPV following successful repositioning. METHODS: This multi-center prospective cohort study enrolled 243 patients with idiopathic BPPV. Vestibular functional and psychological wellbeing assessments administered before repositioning provided the data used to identify factors predictive of RD with a log-binomial model. The endpoint was RD at 1 week after successful repositioning. RESULTS: Of the enrolled patients, 118 reported RD. After adjusting for cofounders, mild [risk ratio (RR), 2.06; 95% confidence interval (CI), 1.39–3.04] or severe (RR, 3.08; 95% CI, 2.17–4.38) anxiety and abnormal vestibular ratio of sensory organization test (RR, 2.68; 95% CI, 1.82–3.95) were identified as risk predictors. Presence of ocular vestibular evoked myogenic potentials responses, either unilateral (RR, 0.55; 95% CI, 0.44–0.69) or bilateral (RR, 0.49; 95% CI, 0.36–0.68), were protective factors. CONCLUSIONS: Anxiety and abnormal balance are significant predictors of RD, while the presence of ocular vestibular evoked myogenic potentials responses predicts against it. These findings may help to improve BPPV outcomes by informing prognoses and guiding treatment strategies. Trial registration: ChiCTR1800018004 (date of registration: 26 August 2018) [ABSTRACT FROM AUTHOR]

A previous study reported that compound 5A, a caffeic acid phenethyl ester (CAPE) analog, exhibited obvious neuroprotective activity, in particular, compound 5A possessed higher stability and membrane permeability than CAPE. CAPE displays antitumour function; therefore, evaluating the antitumour effect of its analog with higher stability and membrane permeability is worthwhile. We first investigated the antitumour activity of compound 5A. We found that compound 5A significantly inhibited the proliferation of tumor cells and showed low cytotoxicity in normal cells. Furthermore, compound 5A was found to induce the cell cycle arrest and apoptosis of CNE2 cells. Through the prediction of SwissTargetPrediction and subsequent confirmation, epidermal growth factor receptor (EGFR) was identified as a target of compound 5A. Compound 5A also influenced the expression of genes downstream of EGFR in nasopharyngeal carcinoma (NPC) cells. Based on these findings, compound 5A inhibits the proliferation of NPC cells by targeting EGFR and may become a new candidate compound for NPC treatment. [ABSTRACT FROM AUTHOR]

The vestibular and cochlear aqueducts serve as additional sound transmission paths and produce different degrees of volume velocity shunt flow in cochlear sound transmission. To investigate its effect on forward and reverse stimulations, a lumped-parameter model of the human ear, which incorporates the third windows, was developed. The model combines a transmission-line ear-canal model, a middle-ear model, and an inner-ear model, which were developed previously by different investigators. The model is verified by comparison with experiments. The intracochlear differential-pressure transfer functions, which reflect the input force to the organ of Corti, were calculated. The results show that middle-ear gain for forward sound transmission is greater than the gain for reverse sound transmission. Changes in the cochlear aqueduct impedance have little effect on forward and reverse stimulations. The vestibular aqueduct has little effect on forward stimulation, but increasing its impedance causes deterioration on reverse stimulation below 300 Hz. Decreasing its impedance increases the excitation effect during reverse stimulation over the entire frequency, especially below 1000 Hz. Moreover, compared with the case without the third windows, the presence of the third windows has little effect on forward stimulation. Whereas, it boosts the reverse stimulation's performance below 300 Hz. [ABSTRACT FROM AUTHOR]

Background: The etiology of Takayasu arteritis (TA) is unknown; however, a possible relationship between streptococcal infection and TA has been proposed. This study aimed to identify the clinical features and cardiac valvular involvement in untreated TA patients with an elevated antistreptolysin O (ASO) titer.Methods: In this retrospective study, the clinical characteristics and features of valvular involvement were compared in TA patients with or without an elevated ASO titer.Results: Of the 74 untreated TA patients, 13 patients were found have elevated ASO titers (17.6%). Mitral insufficiency was the most common in patients with elevated ASO (69.2%, 9/13), followed by aortic valve insufficiency (46.2%, 5/13) and tricuspid insufficiency (46.2%, 5/13), which were no significantly different than that in normal ASO group. The proportions of moderate to severe mitral (30.8% vs 1.6%, p = 0.000) and tricuspid valve (15.4% vs 1.64%, p = 0.023) insufficiency in the ASO positive group were significantly higher than those in the ASO negative group. The odds of mitral regurgitation in patients with elevated ASO titers were 3.9 times higher than those in the group with normal ASO titers (p = 0.053, OR = 3.929, 95% confidence interval [CI]: 0.983-15.694). Furthermore, the risk of moderate to severe mitral insufficiency in patients with elevated ASO titers was 41.6 times higher than that in patients with normal ASO titers (p = 0.002, OR = 41.600, 95% CI: 3.867-447.559).Conclusions: An increase in ASO titer is related to valvular involvement in TA and is closely linked to mitral insufficiency. [ABSTRACT FROM AUTHOR]

Osteoporosis (OP) is common with advancing age. Several studies have shown a strong correlation between OP and otosclerosis. However, no studies have investigated OP of the malleus, incus or stapes in the human middle ear, its effect on middle ear transfer function. Here, we investigate whether these three ossicles develop OP, and how this affects middle ear transfer function. The effect of OP on middle ear transfer function was investigated in simulations based on a finite element (FE) method. First, the FE model used in our previous study was refined, and optimized by introducing viscoelastic properties to selected soft tissues of the middle ear. Then, the FE model was used to simulate OP of the three ossicles and assess its influence on middle ear transfer function. Other possible age-related changes, such as stiffness of the joints or ligaments in the middle ear, were also investigated. The results indicated that OP of the ossicles could increase the high frequency displacement of both the umbo and stapes footplate (FP). However, the stiffness of the middle ear soft tissue can lead to the decrease of middle ear gain at lower frequencies. Furthermore, loosening of these joints or ligaments could increase displacement of the umbo and stapes FP. In conclusion, although age-related hearing loss is most commonly conceived of as sensorineural hearing loss (SNHL), we found that age-related changes may also include OP and changes in joint stiffness, but these will have little effect on middle ear transfer function in elderly people. [ABSTRACT FROM AUTHOR]

A large linearly graded structure on atomic scale up to 88 at. %/mm with oriented grown crystals was formed in selenium-tellurium (Se-Te) semiconductor using a strong gravitational field of one million G level at 260 °C. The lattice constants and the binding energies of Se and Te 3d electrons continuously changed along the direction of gravity accordingly, which indicated the formation of the graded band gap structure. The grown crystals showed the crystalline orientation with the c axis of hexagonal structure roughly perpendicular to the direction of gravity. It was found that the diffusion coefficient of sedimentation was larger than that of normal diffusion by more than 100 times, which suggested a different diffusion mechanism from the normal vacancy mechanism. [ABSTRACT FROM AUTHOR]

An atomic-scale graded structure has been formed previously in a Bi70Sb30 (at. %) alloy that is miscible in all proportions, by sedimentation of substitutional solute atoms under an ultrastrong gravitational field up to 1×106 G at 220–240 °C [T. Mashimo, T. Ikeda, and I. Minato, J. Appl. Phys. 90, 741 (2001)]. In this study, additional megagravity field experiments were performed on the Bi70Sb30 alloy and pure Bi at different temperatures below their melting points, to investigate the change in crystalline state under the ultrastrong gravitational field. For the Bi70Sb30 alloy ultracentrifuged at 191–205 °C, no change in composition was observed, and the grain sizes of the crystals decreased from several millimeters to tens of micrometers, while no distinct change in grain size was observed for the pure Bi ultracentrifuged under the same experimental conditions. The Bi70Sb30 alloy ultracentrifuged at 220–240 °C consisted of two regions with different morphologies–fine-grained crystals with grain sizes in the range of tens of micrometers in the low gravity region, and large crystals with grain sizes several millimeters long and hundreds of micrometers wide along the direction of gravity in the high gravity region, where sedimentation of atoms was confirmed. The large crystals with hexagonal structures were formed by preferential crystal growth roughly along the c axes, and a large strain that increased as the gravitational field increased existed inside these crystals. Formation of this anomalous crystal state might be correlated with the sedimentation of atoms. © 2004 American Institute of Physics. [ABSTRACT FROM AUTHOR]

As a novel application of implantable middle ear hearing device, round-window stimulation is widely used to treat hearing loss with middle ear disease, such as ossicular chain malformation. To evaluate the influence of ossicular chain malformations on the efficiency of the round-window stimulation, a human ear finite element model, which incorporates cochlear asymmetric structure, was constructed. Five groups of comparison with experimental data confirmed the model's validity. Based on this model, we investigated the influence of three categories of ossicular chain malformations, that is, incudostapedial disconnection, incus and malleus fixation, and fixation of the stapes. These malformations' effects were evaluated by comparing the equivalent sound pressures derived from the basilar membrane displacement. Results show that the studied ossicular chain malformations mainly affected the round-window simulation's performance at low frequencies. In contrast to the fixation of the ossicles, which mainly deteriorates round-window simulation's low-frequency performance, incudostapedial disconnection increases this performance, especially in the absence of incus process and stapes superstructure. Among the studied ossicular chain malformations, the stapes fixation has a much more severe impact on the round-window stimulation's efficiency. Thus, the influence of the patients' ossicular chain malformations should be considered in the design of the round-window stimulation's actuator. The low-frequency output of the round-window simulation's actuator should be enhanced, especially for treating the patients with stapes fixation. [ABSTRACT FROM AUTHOR]

Adeno-associated virus (AAV) is the preferred vector for gene therapy of hereditary deafness, and different viral serotypes, promoters and transduction pathways can influence the targeting of AAV to different types of cells and the expression levels of numerous exogenous genes. To determine the transduction and expression patterns of AAV with different serotypes or promoters in hair cells and supporting cells in the neonatal mouse cochlea, we examined the expression of enhanced green fluorescent protein (eGFP) for five different types of AAV vectors [serotypes 2, 9, and Anc80L65 with promoter cytomegalovirus (CMV)-beta-Globin and serotypes 2 and 9 with promoter chicken beta-actin (CBA)] in in vitro cochlear explant cultures and we tested the transduction of AAV2/2-CBA, AAV2/9-CBA, and AAV2/Anc80L65-CMV by in vivo microinjection into the scala media of the cochlea. We found that each AAV vector had its own transduction and expression characteristics in hair cells and supporting cells in different regions of the cochlea. There was a tonotopic gradient for the in vitro transduction of AAV2/2-CBA, AAV2/9-CBA, AAV2/2-CMV, and AAV2/9-CMV in outer hair cells (OHCs), with more OHCs expressing eGFP at the base of the cochlea than at the apex. AAV2/2-CBA in vitro and AAV2/Anc80L65-CMV in vivo induced more supporting cells expressing eGFP at the apex than in the base. We found that AAV vectors with different promoters had different expression efficacies in hair cells and supporting cells of the auditory epithelium. The CMV-beta-Globin promoter could drive the expression of the delivered construct more efficiently in hair cells, while the CBA promoter was more efficient in supporting cells. The in vitro and in vivo experiments both demonstrated that AAV2/Anc80L65-CMV was a very promising vector for gene therapy of deafness because of its high transduction rates in hair cells. These results might be useful for selecting the appropriate vectors for gene delivery into different types of inner ear cells and thus improving the effectiveness of gene therapy. [ABSTRACT FROM AUTHOR]

Nasopharyngeal carcinoma (NPC) is a common cancer occurring primarily in East Asia and Africa. The high rate of recurrence and metastasis of NPC continuously endangers the health of patients. The present study aimed to identify the underlying mechanisms involved in the progression of NPC and provide experimental basis to develop a novel and efficient agent against NPC. The present study measured the expression level of tripartite motif containing 24 (TRIM24) in tumor tissues from NPC patients using reverse transcription quantitative polymerase chain reaction. Subsequently, Cell Counting kit-8 and flow cytometry were used to detect the cell proliferation and apoptosis of NPC cell lines HONE1 and CNE1 cells where the TRIM24 gene was knocked-down with small interfering RNA (siRNA). Further, caspase kits and western blot analysis were used to detect the expression of apoptosis and angiogenesis-associated proteins. The present study detected a higher expression level of TRIM24 in tumor tissues and NPC cell lines and lower cell viability and higher apoptotic rate were observed when TRIM24 was silenced. Meanwhile, upregulated caspase-3 and caspase-9 indicated induced cell apoptosis in HONE1 and CNE1 cells following the treatment with TRIM24 siRNA. Additionally, the downregulated expression level of vascular endothelial growth factor (VEGF) and VEGF receptor 2 suggested inhibited angiogenesis of NPC cells. Additionally, the reduced levels of janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3) indicated a blocked JAK2/STAT3 signaling pathway. However, there was no direct evidence that inactivation of the JAK2/STAT3 signaling pathway was involved in regulation of siTRIM24, these results suggested that TRIM24 has an important role in the growth of NPC. Additionally, silenced TRIM24 may lead to inhibited cell proliferation and induced cell apoptosis in NPC cells. The limitation of this study was that HONE1, CNE1 and CNE2 cells may have been contaminated with other cells. Further experiments with validated NPC cells may be needed. [ABSTRACT FROM AUTHOR]

Background. Coronary artery stenosis is the major pathological change of coronary heart disease (CHD). Within the framework of traditional Chinese medicine (TCM) theory, some kinds of TCM Zheng could exist in patients with CHD; accordingly, TCM practitioners could provide appropriate TCM therapy. However, little is known about the association between TCM Zheng and types of coronary artery stenosis. Such knowledge could help improve the accuracy and effectiveness of efforts to combine CHD treatment with TCM therapy. Therefore, the aim of this study is to determine the association between TCM Zheng and types of coronary artery stenosis. Methods and Design. This is a multicenter, large sample, case series study in 4 tertiary A hospitals from 3 provinces in China. A total of 3,000 eligible patients diagnosed with atherosclerosis or CHD and selected to undergo coronary angiography (CAG) will be enrolled in this study. We will use electronic case report forms (eCRF) to collect information, including baseline characteristics, TCM symptoms, CAG results, and GRACE scores according to standard operating procedures (SOP). Data will be analyzed by SPSS 20.0. Ethics. This study is approved by the Ethics Committee of Guang’anmen Hospital of the China Academy of Chinese Medical Sciences (no. 2017-058-KY-01) and is registered with chictr.org (registration number ChiCTR-ROC-17013221). [ABSTRACT FROM AUTHOR]

Conclusion: A tentative conclusion was made that the finite element method can be used to investigate the fatigue life of the tympanic membrane after ossiculoplasty; the main reason of the extrusion of the tympanic membrane may not be blamed to the fatigue mechanism under normal sound pressure. Objective: This study was to investigate the extrusion of the prosthesis from the tympanic membrane at post-ossiculoplasty by finite element method. Methods: A finite element model of the human middle ear has been constructed and used as the model of the constructed middle ear at post-ossiculoplasty. Then the fatigue life of the tympanic membrane was calculated under different sound pressure level using this model. Results: The tympanic membrane would not be extruded under normal sound pressure level. The sound pressure level which caused the tympanic membrane to crack in less than 3 years was higher than 145.17 dB (362.5 Pa). [ABSTRACT FROM AUTHOR]

Online object tracking is a challenging issue because the appearance of an object tends to change due to intrinsic or extrinsic factors. In this paper, we propose a tracking algorithm based on probabilistic hypergraph ranking. First, three types of hypergraphs are constructed to encode local affinity information. Then, a probabilistic hypergraph is built by combining three distinct hypergraphs linearly. Second, an adaptive template constraint is proposed to effectively use the discriminative information of different templates. Third, object tracking is formulated as a transductive learning issue, and the optimal target location is determined by maximum a posteriori estimation on the ranking scores. Finally, a dynamic updating scheme of positive and negative template sets provides the proposed tracker with robustness against appearance variations. A series of experiments and evaluations on various challenging image sequences is performed, and the results show that the proposed algorithm performs favorably against other state-of-the-art methods. [ABSTRACT FROM PUBLISHER]

Consisting of the actuator and coupling layer, a finite element model of the human middle ear was used to analyze the effect of the actuator and its coupling conditions on the performance of the eardrum-stimulated middle ear implants. This model which was based on the right ear of a healthy adult was built via microcomputed tomography imaging and the technique of reverse engineering. Based on this finite element model, the linear viscoelasticity of the human middle ear soft tissues and three-layer structure of the eardrum pars tensa which was orthotropic were considered. The validity of the model was verified by comparing the model calculated results with experimental data. After that, the influence of the three main design parameters of the actuator and two aspects of the coupling layer were investigated by the finite element model. The results show that (1) the manubrium tip is the optimal position for the actuator to stimulate; (2) the increased cross-section of the actuator would worsen its hearing compensation performance, especially in the low frequencies; (3) both the patients’ residual hearing and the actuator’s hearing compensation performance at high frequencies will be deteriorated with the increase in the actuator’s mass; and (4) a coupling layer with a small Young’s modulus and an area approximating 80% of the eardrum would reduce the stress of the eardrum effectively. [ABSTRACT FROM AUTHOR]

Finite element method was employed in this study to analyze the change in performance of implantable hearing devices due to the consideration of soft tissues' viscoelasticity. An integrated finite element model of human ear including the external ear, middle ear and inner ear was first developed via reverse engineering and analyzed by acoustic-structure-fluid coupling. Viscoelastic properties of soft tissues in the middle ear were taken into consideration in this model. The model-derived dynamic responses including middle ear and cochlea functions showed a better agreement with experimental data at high frequencies above 3000 Hz than the Rayleigh-type damping. On this basis, a coupled finite element model consisting of the human ear and a piezoelectric actuator attached to the long process of incus was further constructed. Based on the electromechanical coupling analysis, equivalent sound pressure and power consumption of the actuator corresponding to viscoelasticity and Rayleigh damping were calculated using this model. The analytical results showed that the implant performance of the actuator evaluated using a finite element model considering viscoelastic properties gives a lower output above about 3 kHz than does Rayleigh damping model. Finite element model considering viscoelastic properties was more accurate to numerically evaluate implantable hearing devices. [ABSTRACT FROM AUTHOR]

The lever ratio, the vibration mode and the stiffness of the ossicular joints were studied using the finite element (FE) analysis of the response of human ear under the outer ear sound excitation. The three-dimensional FE model was constructed based on serial micro CT images of a temporal bone block, and validated through comparison with the experimental data from previous literatures. The displacements of the umbo and stapes footplate and the vibration mode of the ossicles under different grades of stiffness of middle ear components were derived. It is suggested that the flexible ossicular joint combined with the shift of rotation axis causes the increase of lever ratio at high frequency. In addition, the flexible incudostapedial joint (ISJ) can reduce sound transmission especially at high frequency, meanwhile it also permits more vibration energy transmitted to the piston-like directions. [ABSTRACT FROM AUTHOR]

Several types of middle ear implants (MEIs) have been invented as an alternative to conventional hearing aids for the rehabilitation of sensorineural hearing loss. Temporal bone and clinical studies have shown that the implantation of MEIs' transducers influences middle ear transfer function. But there is little comparative data available about these influences. We conducted comparative studies on the influences of three principal types of MEI transducers in respect to their attachment points on the ossicular chain. To aid the investigation, a human middle ear finite element model was constructed. The model was built based on a complete set of micro-computerized tomography section images of a human ear by reverse engineering technology. The validity of the developed model was verified by comparing the motions obtained by this model with published experimental measurements on human temporal bones. The results show that the eardrum driving transducer (EDT) and the floating mass transducer (FMT) decrease stapes displacement prominently at high frequencies. The greater these transducers' mass, the smaller is the displacement of the stapes footplate. In contrast, the incus body driving transducer (IBDT) decreases stapes displacement severely at low frequencies, and its adverse effect on residual hearing increases with increasing stiffness of the IBDT's driving rod. [ABSTRACT FROM AUTHOR]

microRNA-129-5p may have a relationship with laryngeal squamous cell carcinoma (LSCC), but the expression and function of miRNA-129-5p are not fully understood. This study was performed to investigate the expression and function of miRNA-129-5p in LSCC and its effects on STAT3. HBE and Hep-2 cells were cultured and analyzed by western blotting and real-time PCR. miR-129-5p expression was detected by real-time PCR. Hep-2 cells were transfected with a miR-129-5p expression vector. Cell proliferation, invasion, migration, cell cycle, and apoptosis assays were used to determine the role of miRNA-129-5p in the growth, invasion, and migration of LSCC cells and to determine the importance of STAT3 in these effects. STAT3 mRNA expression in Hep-2 cells was significantly higher than that in HBE cells ( P < 0.05). miR-129-5p expression detected by real-time PCR showed that it was expressed at a lower level in Hep-2 cells than in HBE cells ( P < 0.05). Compared with the control cells, the transfected cells showed lower STAT3 mRNA expression. For up to 7 days in culture, the transfected cells showed lower proliferation than the control cells ( P < 0.05). After 24 h in culture, the apoptosis rate in miR-129-5p-transfected cells was 3.48 ± 0.38 %, while the rate in control cells was 0.92 ± 0.09 % ( P = 0.0028), but the statistical significance was lost after 72 h in culture ( P = 0.3180). The invasion and migration of the cells were inhibited after 24 and 72 h in culture when the miR-129-5p expression in Hep-2 cells was upregulated ( P = 0.0037 and 0.00383, respectively), while there was no statistically significant difference at 48 h ( P = 0.0712). STAT3 expression could be suppressed by the upregulation of miR-129-5p expression. Both the proliferation and migration of tumor cells were suppressed when the level of STAT3 expression was decreased. The apoptosis rate of tumor cells was also increased. Based on these data, we suggest that miR-129-5p may directly inhibit STAT3 expression and play an important role in the development of LSCC. [ABSTRACT FROM AUTHOR]

Cancer neovascularization is essential for metastasis of thyroid carcinoma. However, the underlying molecular mechanisms are ill-defined. Recently, placental growth factor (PLGF) has been shown to play critical roles in the pathological angiogenesis through regulating matrix metalloproteinases (MMPs); here, we were prompted to examine the role of PLGF in the metastasis of thyroid carcinoma. We found that the PLGF and MMP9 levels strongly correlated in the thyroid carcinoma specimen. Higher PLGF and MMP9 levels were detected in the thyroid carcinoma with metastasis. Using a human thyroid carcinoma cell line, TT, we found that overexpression of PLGF in TT cells increased expression of MMP9, while inhibition of PLGF in TT cells decreased expression of MMP9. However, modification of MMP9 levels in TT cells did not affect PLGF levels, suggesting that PLGF may regulate MMP9 in thyroid carcinoma cells. Moreover, application of a specific MAPK p42/p44 inhibitor, but not the application of a specific MAPK p38 inhibitor or specific Akt or JNK inhibitors, substantially abolished the effect of PLGF on MMP9 activation, suggesting that PLGF may increase expression of MMP9 via p42/p44 signaling pathway. Together, these data suggest that antagonizing PLGF in thyroid carcinoma cells may be a promising therapy to suppress cancer metastasis. [ABSTRACT FROM AUTHOR]

Lymph node metastasis of rabbit VX2 pyriform sinus carcinoma can be enhanced by MR scanning after injecting ultra-small superparamagnetic iron oxide (USPIO) into the submucosa beside the tumor. The metastasis lymph node which fit in with the diagnostic criteria will be placed into the alternating magnetic field after MR scanning. Then, magnetic particles can be heated to the effective therapeutic temperature. And it evaluates the possibility of diagnosis together with therapy in cervical metastasis of pyriform sinus carcinoma. Twenty rabbits bearing VX2 tumor in pyriform sinuses were randomly divided into hyperthermia group and control group after USPIO MR scanning; each group contained 10 rabbits. The hyperthermia for the experimental group was conducted by the alternating magnetic field. After hyperthermia, the detection of apoptosis for the two groups was tested by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL), transmission electron microscopy (TEM), and the expression of Bcl-2 and Bax evaluated by immunohistochemical analysis. The apoptosis rate detected by TUNEL in hyperthermia group was 100 %, while the control group was only 20 % ( p < 0.05). TEM observation showed that cell chromatin condensation and clumping, condensed cytoplasm, endoplasmic reticulum membrane fusion with loose change, and the formation of a bubble could be seen in the hyperthermia group. However, the control group showed a more complete cytoplasm and nucleus. Bcl-2 protein expression in the hyperthermia group was lower than the control group, and Bax protein expression in hyperthermia group was higher ( p < 0.05). USPIO indirect lymphography could localize the metastatic lymph nodes for hyperthermia. And it could make the metastatic cervical lymph nodes apoptosis when placed into the alternating magnetic field. [ABSTRACT FROM AUTHOR]

The finite element (FE) method was used to analyze the effect of coupling conditions between the actuator and the round window membrane (RWM) on the performance of round window (RW) stimulation. A FE model of the human ear consisting of the external ear canal, middle ear and cochlea was firstly developed, and then validation of this model was accomplished through comparison between analytical results and experimental data in the literature. Intracochlear pressure were derived from the model under normal forward sound stimulation and reverse RW stimulation. The equivalent sound pressure of RW stimulation was then calculated via comparing the differential intracochlear pressure produced by the actuator and normal ear canal sound stimulus. The actuator was simulated as a floating mass and placed onto the middle ear cavity side of RWM. Two aspects about the actuator coupling conditions were considered in this study: (1) the cross-section area of the actuator relative to the RWM; (2) the coupling layer between the actuator and the RWM. The results show that smaller actuator size can improve the implant performance of RW stimulation, and size requirements of the actuator can also be reduced by introducing a coupling layer between the actuator and RWM, which will benefit the manufacture of the actuator. [ABSTRACT FROM AUTHOR]

In this paper, a 3D finite element (FE) model of human cochlea is developed. This passive model includes the structure of oval window, round window, basilar membrane (BM) and cochlear duct which is filled with fluid. Orthotropic material property of the BM is varying along its length. The fluid-structure interaction (FSI) method is used to compute the responses in the cochlea. In particular, the viscous fluid element is adopted for the first time in the cochlear FE model, so that the effects of shear viscosity in the fluid are considered. Results on the cochlear impedance, BM response and intracochlear pressure are obtained. The intracochlear pressure includes the scala vestibule and scala tympani pressure are extracted and used to calculate the transfer functions from equivalent ear canal pressures to scala pressures. The reasonable agreements between the model results and the experimental data in the literature prove the validity of the cochlear model for simulating sound transmission in the cochlea. Moreover, this model predicted the transfer function from equivalent ear canal pressures to scala pressures which is the input to the cochlear partition. [ABSTRACT FROM AUTHOR]