EFFECTS OF DIABETES ON HEARING AND COCHLEAR STRUCTURES

Diabetes mellitus (DM) is a chronic systemic disease characterized by hyperglycemia, with various patho-genic mechanisms. From absolute or relative insulin deficiency, patients with DM often demonstrate vari-ous levels of metabolic disorders. Major clinical manifestations of DM include metabolic disorders, vascu-lar lesions, circulatory disturbances and neurologic complications. Along with advances in DM research, re-ports of DM related tinnitus and hearing impairment have increased continuously. Research on DM related auditory system dysfunction has focused on cochlear microcirculation, cellular homeostasis, genetics and ag-ing. Cochlear microcirculation plays an important role in cochlear physiology and its disorders are associat-ed with many inner ear diseases. Ischemia and subsequent reperfusion seen in cochlear microcirculation dis-orders are important factors in hearing damage. Understanding cochlear microcirculation and structural as well as functional changes in DM patients with hearing loss and their causal factors will help reveal patho-genic mechanisms in diabetic hearing loss and provide new ideas in developing interventions and preventing damages caused by diabetes.

Effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia

Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.

Ear ischemia induced by endovascular therapy for arteriovenous fistula of the sigmoid sinus: A case report

BACKGROUND Arteriovenous fistula of the sigmoid sinus is an abnormal connection of arteries with the sigmoid sinus.Endovascular treatments of such lesions are considered safe and with low rates of complications.CASE SUMMARY A 62-year-old female patient underwent endovascular treatment of an arteriovenous fistula of the right sigmoid sinus on February 7,2017,but her tinnitus was not cured.She was admitted to the Beijing Tiantan Hospital,Capital Medical University,on March 20,2017,and her pre-operative diagnosis,by digital subtraction cerebral angiography,was arteriovenous fistula of the sigmoid sinus.She underwent endovascular embolization of the distal occipital artery and posterior auricular artery using Onyx-18.The arteriovenous fistula of the sigmoid sinus was cured,and her tinnitus disappeared,but ischemia of the upper 2/3 of the right auricle occurred without hearing loss.The patient received treatment to improve microcirculation,in addition to fluid supplementation,analgesia,and hyperbaric oxygen,and the swelling due to ischemia in the right auricle did not progress further.The patient reported no tinnitus,and the right auricle had returned to normal 3 years later.CONCLUSION Ischemic complications of vital organs should be considered when performing embolization procedures for arteriovenous fistulas of cerebral sinuses.Compensation of the organs should be evaluated before the operation,and the related treatment regimens should be planned.

Effects of Jiangtang Fanglong Wan on hearing in an animal model of diabetes

Objective ; To study effects of Jiangtang Fanglong Wan （glucose-lowering and deafness-preventing capsule） on hearing in an animal model of diabetes. Methods Wistar rats were used to create a diabetes model by intraperitoneal injection of streptozotocin （STZ, 55 mg/kg）. Forty rats were randomly selected to receive Jiangtang Fanglong Wan （ 10 g/kg/ day） through intragastric garage （treatment group） or normal saline （control group）. Auditory brainstem responses （ABRs） were recorded at Months 1, 2 and 3. Results ABR latencies and wave intervals were similar between the two groups at Month 1 （P 〉 0.05）. ABR latencies and wave intervals were shorter in the treatment group than those of the control group at Months 2 and 3 （P 〈 0.05 and P 〈 0.01, respectively）. Conclusion Our results suggest that Jiangtang Fanglong Wan may have a beneficial effect in preventing and treating hearing impairment associated with diabetes.

EFFECTS OF JIANG TANG FANG LONG FORMULA ON INSULIN PRODUCTION AND FUNCTION IN AN ANIMAL MODEL OF DIABETIC HEARING LOSS

Objective To study the influence of Jiang Tang Fang Long formula on insulin production and function in an animal model of diabetic hearing loss. Methods Wistar rats (n=60) were randomly divided into 6 groups (10 in each) to receive no treatment (the normal control, Group A), or to receive intra-peritoneal 55 mg/kg streptozotocin with (Groups C, D and E) or without (Group B) subsequent Jiang Tang Fang Long formula treatment at various doses or Yu Long Wan treatment (Group F). After 60 days, fasting blood glucose (FBG), body weight (BW) and fasting insulin (FINS) were recorded and the HOMA-IR and HOMA-βcalcu-lated. Insulin expression in pancreatic tissues was measured by radioimmunoassay. Results Compared with animals that received streptozotocin without rescue treatment (Group B), animals that received higher doses of Jiang Tang Fang Long formula(Groups D and E) showed improved indices of diabetes manifestation (P<0.05) and improved HOMA-β(P<0.05) in a dose-dependent manner, as well as improved insulin expression in pancreatic islets (P<0.05). The difference between low dose Jiang Tang Fang Long formula treatment (Group C) and Group B was not significant (P>0.05). Conclusion Our results suggest that Jiang Tang Fang Long formula may improve pancreatic β-cells function which may explain its efficacy in treating diabetic hearing loss.

Progress in research on correlation among STAT3, CyclinD1, P21 genes and tumors

Objective Along with changes in the ecology system and under the influence of various environmental factors, the incidence of tumor has been increasing year after year. There is a trend in cancer therapy to move to combined therapies involving surgery, radiation chemotherapy and gene therapy. Cancer gene therapy in recent years has brought new opportunities for treatment of tumor. Its advantages include low rate of tolerance, insensitivity to cell cycles, high specificity and coverage for both primary and metastatic tumors1＇2. However, this is a new field of clinical research. Regarding the correlation among the STAT3, CyclinD1 and P21 genes and tumors, research has focused on their expression and regulation. This article provides a summary of related research.

Effect of hypoglycemic anti-deafness capsules in diabetic patients with deafness and toxicological assessment in rats

OBJECTIVE:Through experiment on animals and clinical trials to explore the safety and efficacy of hypoglycemic anti-deafness capsules on diabetic patients with deafness.METHODS:Total 296 patients with non-insulin dependent diabetes mellitus(NIDDM)were randomly divided into two groups.A treatment group of 164patients(208 ears)was treated with hypoglycemic anti-deafness capsules based onTCM syndrome differentiation.A control group of 132 patients(184ears)was treated with glibenclamide and conventional drug treatment for deafness.The following were observed:hearing,fasting plasma glucose(FPG),2 h postprandial plasma glucose(2hPG),24 h urine glucose(24hUG),improvement of main symptoms,platelet function,and changes in superoxidedismutase(SOD)and lipid peroxide(LPO)levels.In animal studies,Kunming mice,weighing 18-22 g were used.Half of the mice were males and half were females.Wistar rats,weighing 80-120 g were used.Half of the rats were males and half were females.Male Wistar rats,weighing 200-220 g,were also used.Their acute and chronic toxicity was studied.RESULTS:The hearing improvement was 56.7%in the treatment group and 26.6%in the control group.FPG,2hPG,and 24hUG were improved significantly(P<0.05,P<0.01,P<0.01,respectively)in the treatment group and 2hPG and 24hUG improved significantly in the control group(P<0.05,P<0.05).The improvement in 2hPG and 24hUG in the treatment group was significantly greater than that in the control group P<0.01).There was no significant difference in FPG between the two groups(P<0.05).Main symptoms in the treatment group were significantly more improved than those in the control group(P<0.05,P<0.01).In the treatment group,platelet adhesion and aggregation,SOD,and LPO were all significantly improved from before treatment(P<0.05,P<0.01).However,in the control group,except LOP(P<0.05),there were no significant differences from before treatment to after(P<0.05).In animal studies,no obvious acute or long-term toxicity was observed from capsule administration.CONCLUSION:Through experiment on animals and clinical trials,we can found that hypoglycemic anti-deafness capsules could decrease blood glucose and serum triglycerides of alloxan-induced diabetic rats.This herbal capsule is effective for safely treating diabetic patients with deafness.

Sintilimab versus docetaxel as second-line treatment in advanced or metastatic squamous non-small-cell lung cancer:an open-label,randomized controlled phase 3 trial(ORIENT-3)

Background:Treatment options for Chinese patients with locally advanced or metastatic squamous-cell non-small-cell lung cancer(sqNSCLC)after failure of first-line chemotherapy are limited.This study(ORIENT-3)aimed to evaluate the efficacy and safety of sintilimab versus docetaxel as second-line treatment in patients with locally advanced or metastatic sqNSCLC.Methods:ORIENT-3 was an open-label,multicenter,randomized controlled phase 3 trial that recruited patients with stage IIIB/IIIC/IV sqNSCLC after failure with first-line platinum-based chemotherapy.Patients were randomized in a 1:1 ratio to receive either 200 mg of sintilimab or 75 mg/m^(2) of docetaxel intravenously every 3 weeks,stratified by the Eastern Cooperative Oncology Group performance status.The primary endpoint was overall survival(OS)in the full analysis set(FAS).Secondary endpoints included progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),duration of response(DoR)and safety.Results:Between August 25,2017,and November 7,2018,290 patients were randomized.For FAS,10 patients fromthe docetaxel armwere excluded.Themedian OS was 11.79(n=145;95%confidence interval[CI],10.28-15.57)months with sintilimab versus 8.25(n=135;95%CI,6.47-9.82)months with docetaxel(hazard ratio[HR]:0.74;95%CI,0.56-0.96;P=0.025).Sintilimab treatment significantly prolonged PFS(median 4.30 vs.2.79 months;HR:0.52;95%CI,0.39-0.68;P<0.001)and showed higher ORR(25.50%vs.2.20%,P<0.001)and DCR(65.50%vs.37.80%,P<0.001)than the docetaxel arm.The median DoRwas 12.45(95%CI,4.86-25.33)months in the sintilimab arm and 4.14(95%CI,1.41-7.23)months in the docetaxel arm(P=0.045).Treatment-related adverse events of grade≥3were reported in 26(18.1%)patients in the sintilimab arm and 47(36.2%)patients in the docetaxel arm.Exploratory biomarker analysis showed potential predictive values of expression levels of two transcription factors,including OVOL2(HR:0.35;P<0.001)and CTCF(HR:3.50;P<0.001),for sintilimab treatment.Conclusions:Compared with docetaxel,sintilimab significantly improved the OS,PFS,and ORR of Chinese patients with previously treated locally advanced or metastatic sqNSCLC.