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Complex brain diseases seriously endanger human health, and early diagnostic biomarkers and effective treatments are currently lacking. Due to ethical constraints on human research, establishing monkey models is crucial to address these issues. With the rapid development of technology, transgenic monkey models of a range of brain diseases, especially autism spectrum disorder (ASD), have been successfully established. However, to establish practical and effective brain disease models and subsequently apply them to disease mechanism and treatment studies, there is still a lack of a standard tool, i.e., a system for collecting and analyzing the daily behaviors of brain disease model monkeys. Therefore, with the goal of undertaking a comprehensive and quantitative study of behavioral phenotypes, we established a standard daily behavior collection and analysis system, including behavioral data collection protocols and a monkey daily behavior ethogram (MDBE) for rhesus and cynomolgus monkeys, which are the most commonly used non-human primates in model construction. Then, we used ASD as an application example after referring to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), which is widely used in clinical disease diagnosis to obtain ASD core clinical symptoms. We then established a sub-ethogram (ASD monkey core behavior ethogram (MCBE-ASD)) specifically for quantitative assessment of the core clinical symptoms of an ASD monkey model based on MDBE. Subsequently, we demonstrated the high reproducibility of the system.

Objective: To explore the disease spectrum and corresponding clinical indicators of infantile cholestasis so as to provide a basis for the diagnosis of this type of disease at an early stage. Methods: The clinical data was collected from 203 hospitalized children diagnosed with infantile cholestasis at the Department of Gastroenterology of Maternal and Child Health Care, Guiyang City, from January 2018 to March 2023, including 130 males and 73 females. Patients general condition, personal history, and blood biochemical test indicators, including liver and coagulation function, blood ammonia, blood lipid profile, blood sugar, TORCH, thyroid function, and others, were retrospectively analyzed after admission. Cholangiography and high-throughput gene sequencing were performed in certain patients. The etiology of the enrolled cases were analyzed. Children's clinical data were compared with distinct inherited metabolic liver diseases (Group A) and biliary atresia (Group B). The statistical analysis was conducted using the t-test, Mann-Whitney test, Kruskal-Wallis test, or χ 2 test, according to different data. Results: In 33 cases, infectious factors-primarily CMV infection-were the etiology of cholestasis. Forty cases had aberrant bile duct development, primarily biliary atresia, choledochal cysts, and intrahepatic bile duct dysplasia. In 26 cases, genetic metabolic factors mainly included citrin protein deficiency, sodium-taurocholate co-transporting polypeptide deficiency, and Alagille syndrome. 11 cases had drug/poisoning factors (parenteral nutrition-associated cholestasis). 19 cases had idiopathic infantile cholestasis. Three cases had other factors; however, all of them had Kawasaki disease. 71 cases had an unclear diagnosis. There was no statistically significant difference in terms of gender and age between groups A and B ( P >0.05). The alkaline phosphatase (ALP) and bile acid levels were significantly higher in Group A than Group B, with a P <0.05, while the gamma glutamyltransferase (GGT), direct bilirubin (DBil), and albumin levels were lower than those in Group B, with a P <0.05. The cytomegalovirus infection rate was higher in Group B (62.50%) than Group A (34.62%), and the difference between the two groups was statistically significant ( χ 2 =3.89, P <0.05). The alanine aminotransferase, aspartate aminotransferase, GGT, DBil, and albumin were significantly lower in patients with citrin protein deficiency than those in patients with biliary atresia, while ALP, bile acid, and blood ammonia were higher than those in patients with biliary atresia. Patients with sodium-taurocholate co-transporting polypeptide deficiency had higher bile acid than patients with biliary atresia, while the DBil was lower than that in patients with biliary atresia, and the difference was statistically significant ( P <0.05). Conclusion: Infantile cholestasis etiology is diverse. ALP, bile acids, GGT, DBil, and albumin levels can serve as simple indicators for early-stage differentiation between inherited metabolic liver disease and biliary atresia. The cholestasis etiology should be determined as early as possible following biliary atresia exclusion by actively completing genetic metabolic gene detection.

Objective: To investigate the effect of the number of positive preoperative serological tumor markers on the surgical approach and prognosis of patients with intrahepatic cholangiocarcinoma. Methods: This is a retrospective case-series study. Data from 548 patients with intrahepatic cholangiocarcinoma after radical resection from October 2010 to April 2019 were retrospectively collected in 10 hospitals of China. There were 277 males and 271 females with an age of (57.8±10.2)years(range:23 to 84 years). Four hundred and twenty-six patients(77.7%) had at least one positive preoperative serum tumor marker. The data collection included the results of 4 preoperative serological tumor markers,other preoperative indicators(5 prodromal symptoms, 6 medical history,8 preoperative serological indicators,5 preoperative imaging indicators,and 14 preoperative pathological examination indicators),baseline data (gender and age),surgical methods,and prognostic follow-up data. Four preoperative results of serologic tumor marker and surgical procedure were converted into categorical variables. The number of positive preoperative serum tumor markers was used as the treatment variable,the surgical method was used as the mediating variable,and the survival time was used as the outcome variable. Univariate and multivariate analysis were used to screen for other preoperative indicators which were independent factors that influenced the surgical procedure and the prognosis of patients as covariates to analyze the mediating effect. Results: Of the 548 patients included in the study, 176 patients (32.1%) underwent partial hepatectomy,151 patients(27.5%) underwent hemihepatectomy, and 221 patients(40.3%) underwent partial hepatectomy or hemihepatectomy combined with other treatments. The results of the univariate and multivariate analysis showed that the number of positive serum tumor markers,intrahepatic bile duct dilatation,portal vein invasion,pathological differentiation,pathological type,vascular invasion,T stage,N stage and maximum tumor diameter were independent factors influencing the surgical procedure(all P <0.05). Intrahepatic bile duct dilatation,pathological differentiation and T stage were independent prognostic factors for patients with intrahepatic cholangiocarcinoma(all P <0.05). Intrahepatic bile duct dilatation,differentiation and T stage were included as covariates in the mediation effect model. The results showed that the number of positive serum tumor markers before surgery had a negative predictive effect on the survival time of patients with intrahepatic cholangiocarcinoma ( β =-0.092, P =0.039),and had a positive predictive effect on the surgical method ( β =0.244, P <0.01). The number of positive serum tumor markers had a negative predictive effect on the survival time of patients with intrahepatic cholangiocarcinoma ( β =-0.151, P =0.002). Direct and indirect effects accounted for 71.3% and 28.7% of total effects,respectively. Conclusions: The higher the positive number of preoperative tumor markers,the worse the prognosis of patients with intrahepatic cholangiocarcinoma. The number of positive cells not only directly affects the prognosis of patients,but also indirectly affects the prognosis of patients by affecting the surgical method.

Objective: To describe the road map of the lateral and endoscopic ventral approaches for the pharyngeal segment of the internal carotid artery, propose a sub-segmentation scheme, systematically and comprehensively understand its anatomical details and relationships with the surrounding structures. Methods: Five fresh cadaveric head specimens（10 sides in total） were dissected through lateral and endoscopic ventral approaches to evaluate the anatomical details of the parapharyngeal internal carotid artery and its relationship with the surrounding structures. Results: From the bifurcation of the common carotid artery to the vertical part of the internal carotid artery, alongside the direction of blood flow, the parapharyngeal internal carotid artery passes through four distinct anatomical tissues. Based on this, the parapharyngeal internal carotid artery can be divided into four sub-segments: nerve, muscle, fascia and osseous sub-segments. The boundaries and important adjacent structures of each segment are described in detail. Conclusion: The anatomical road map of the parapharyngeal internal carotid artery and the sub-segmentation scheme serving as a practical guide to navigate modular endoscopic skull base surgery of the parapharyngeal space while reduce the risk of internal carotid artery injury., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the differences in the therapeutic effects of endoscopic surgery combined with chemotherapy and endoscopic surgery combined with radiotherapy in the treatment of early nasopharyngeal carcinoma, and to select individualized treatment strategy for early nasopharyngeal carcinoma. Methods: The clinical data of 68 patients with early nasopharyngeal carcinoma（T1-2N₀M₀） who received surgical treatment in a high-incidence area were retrospectively analyzed. According to different treatment methods, they were divided into the surgery + chemotherapy group（ n =34, treated with endoscopic surgery combined with chemotherapy） and the surgery + radiotherapy group（ n =34, treated with endoscopic surgery combined with radiotherapy）. Propensity score matching was used to match the patient data between the two groups at a 1∶1 ratio. Patients were followed up, and the survival rates and hematological toxicities were compared between the two groups. Results: Twenty-four cases in the surgery + chemotherapy group and 24 cases in the surgery + radiotherapy group were successfully matched. After matching, there was no statistically significant difference in T stage, and clinical stage between the two groups（all P >0.05）. The 3-year OS and DFS in the surgery + chemotherapy group were 100.0% and 95.8%, respectively, while the 3-year OS and DFS in the surgery + radiotherapy group were 100.0% and 100.0%, respectively, with no significant difference in survival rates between the two groups（both P >0.05）. After treatment, there was no statistically significant difference in bone marrow suppression between the surgery + chemotherapy group and the surgery + radiotherapy group （all P > 0.05） Conclusion: Endoscopic surgery combined with chemotherapy and surgery combined with radiotherapy have comparable clinical efficacy in the treatment of early nasopharyngeal carcinoma, but without radiotherapy-related complications, which is worth further investigation., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Intrahepatic cholangiocarcinoma (ICC) is a type of primary liver cancer, which has shown an increasing trend in incidence and mortality in recent years, with a poor prognosis. The clinical diagnosis and treatment of ICC currently face the challenges of low detection rate, high mortality rate, poor treatment outcome, and urgently need more in-depth research to promote the improvement of clinical diagnosis and treatment level. In recent years, ICC diagnosis and treatment related research has made new progress in many aspects, and the knowledge about these new clinical diagnosis and treatment advances should be updated in a timely manner. This article reviewed the latest research results in recent years, summarized some new views on ICC typing, prevention and diagnosis staging that have been proposed recently, as well as the new progress made in surgical treatment and systemic treatment, and briefly discussed the potential of ICC individualized precision treatment and the occurrence of rare complications caused by combined treatment.

Objectives: To analyze the survival benefit of intrahepatic cholangiocarcinoma (ICC) radical resection based on single cell omics. Methods: This is a retrospective case-series study. ICC single-cell sequencing was integrated from four data sets in the Gene Expression Omnibus Database, with a total of 46 patients undergoing radical resection, to explore the characteristics of the microenvironment. Microarray data of 100 ICC cases was analyzed in the EMBI database with survival data. The infiltration abundance of each epithelial cell cluster was calculated in each microarray data sample using the ssGSEA algorithm. The key epithelial cell cluster associated with poor patient outcomes was explored. The clinical value of key marker genes in this subgroup was studied. Prognostic marker genes were selected using the univariate and multivariate Cox proportional hazards(CoxPH) model. The The CoxPH model was constructed by the target genes and a nomogram was drawn. Kaplan-Meier survival analysis was used to verify the relationship between score and prognosis of patients. The predictive power of the model was evaluated by receiver operating characteristic(ROC) curves, calibration curves, and decision curve analysis (DCA). Results: Epithelial cell clusters infiltrated almost exclusively in tumor tissue. The MT2A + epithelial cell subset was associated with a poorer prognosis for patients with a high invasion abundance and patients characterized by infiltration of this group were defined as antioxidant. After screening marker genes in this cluster using a univariate and multivariate CoxPH model, the following genes were found to be independent prognostic factors: FILPIL , NFKBIA , PEG10 , SERPINB5 . The CoxPH model was constructed using the four gene expression levels, and the survival rate of patients in the high-risk group was significantly lower than those in the low-risk group (all P <0.05). The constructed nomogram had good discrimination and validity. The ROC curve showed that the predicted area under the curve was 0.779, 0.844 and 0.845 at 1, 3 and 5 years, respectively. Compared to clinical indicators, the model had better predictive power using the calibration curve and the DCA test. Conclusions: The MT2A + epithelial cell group may be associated with the prognosis of patients with ICC, and the concept of ICC tissue typing of antioxidant and non-antioxidant types is proposed. The type of antioxidant may predict the poor prognosis of the patients, and postoperative adjuvant therapy and other means could be considered to improve the survival of the patients.

Objective: To investigate the clinical effect of modified suspension reduction method combined with percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar compression fractures., Methods: From February 2020 to October 2021, 92 patients with thoracolumbar osteoporotic compression fracture were treated by percutaneous vertebroplasty. According to different treatment methods, they were divided into the observation group and the control group. The observation group was treated with modified suspension reduction and then percutaneous vertebroplasty, while the control group was treated with percutaneous vertebroplasty alone. The observation group (47 cases), including 20 males and 27 females, the age ranged from 59 to 76 years old with an average of (69.74±4.50) years old, fractured vertebral bodies:T 10 (2 cases), T 11 (7 cases), T 12 (19 cases), L 1 (14 cases), L 2 (5 cases);the control group(45 cases), including 21 males and 24 females, the age ranged from 61 to 78 years old with an average of (71.02±3.58) years old, fractured vertebral bodies:T 10 (3 cases), T 11 (8 cases), T 12 (17 cases), L 1 (12 cases), L 2 (5 cases);The leakage of bone cement were observed, the visual analogue scale (VAS), Oswestry lumbar dysfunction index (ODI), anterior vertebrae height (AVH), Cobb angle of kyphosis and the amount of bone cement injected before and after operation were recorded and compared between the two groups., Results: All patients were followed up, ranged from 6 to10 with an average of (8.45±1.73) months. Two patients ocurred bone cement leakage in observation group and 3 patients in control group. AVH of observation group increased ( P <0.05) and Cobb angle of injured vertebrae decreased ( P <0.05). Cobb angle of injured vertebrae and AVH of the control group were not significantly changed ( P >0.05). Cobb angle of injured vertebrae of the observation group was lower than that of control group ( P <0.05) and AVH was higher than that of the control group ( P <0.05). In the observation group, VAS before operation and 1 week, 3 and 6 months after operation respectively were(7.32±1.05) scores, (3.56±1.18) scores, (1.83±0.67) scores, (1.27±0.34) scores, and ODI were(40.12±14.69) scores, (23.76±10.19) scores, (20.15±6.39) scores, (13.45±3.46) scores. In the control group, VAS before operation and 1 week, 3 and 6 months after operation respectively were(7.11±5.26) scores, (3.82±0.68) scores, (1.94±0.88) scores, (1.36±0.52) scores, and ODI were(41.38±10.23) scores, (25.13±14.22) scores , (20.61±5.82) scores, (14.55±5.27) scores . The scores of VAS and ODI after operation were lower than those before operation ( P <0.05), but there was no significant difference between the two groups ( P <0.05)., Conclusion: Modified suspension reduction method combined with PVP surgery for osteoporotic thoracolumbar compression fractures has achieved good clinical results, which can effectively relieve lumbar back pain, restore vertebral height, correct kyphosis, improve lumbar function and patients' quality of life.

Objective: To investigate the concern about pollen broadcasting in Chinese population from multiple dimensions and to understand the information about allergic rhinitis (AR) in China by analyzing related factors. Methods: From March 1 to September 30, 2022, a large-scale multi-center cross-sectional survey was conducted based on the Questionnaire Star platform in 21 Chinese hospitals. A total of 7 056 subjects from 7 regions in China: Northeast, North, East, Central, South, Southwest, and Northwest China were included. Basic characteristics (including social demographic characteristics and disease characteristics of AR patients), concern about pollen broadcasting, the willingness of pollen-induced AR (PiAR) patients to receive pollen broadcasting, and the treatment satisfaction rate of AR patients were collected. The chi-square test, multivariate linear regression model, and Logistic regression analysis were used to analyze the concern about pollen broadcasting in the Chinese population and related factors from multiple dimensions. Results: Among 7 056 subjects, 23.02% were concerned about pollen broadcasting. Among 3 176 self-reported AR and 1 019 PiAR patients, 25.60% and 39.16% were concerned about pollen broadcasting, respectively, which was higher than that of non-AR or non-PiAR subjects ( χ 2 value was 21.74 and 175.11, respectively, both P <0.001). Among AR patients, the proportion of spring and autumn allergen-positive patients concerned about pollen broadcasting was higher than that in perennial allergen-positive patients ( χ 2 value was 20.90 and 19.51, respectively, both P <0.001). The proportion of AR patients with asthma, sinusitis, allergic conjunctivitis, and cardiovascular and cerebrovascular diseases was higher than those without complications ( χ 2 value was 50.83, 21.97, 56.78, 7.62, respectively, all P <0.05). The proportion of AR patients in North China who could find pollen broadcasting locally was 31.01%, significantly higher than those in other regions (all P <0.05). Multivariate linear regression model analysis showed that among PiAR patients, those with higher per capita household income and higher AR disease cognition levels had been concerned about pollen broadcasting in the past, and those complicated with allergic conjunctivitis had stronger intention to receive pollen broadcasting (B value was 0.24, 0.13, 0.66, 0.47, respectively, all P <0.05). The higher the disease cognition level of PiAR patients, the stronger their willingness to actively participate in treatment ( R 2 =0.72, P <0.001). Only 18.89% of AR patients felt satisfied with the treatment effect. Logistic regression analysis showed that in AR patients, the treatment satisfaction rate was significantly higher among those concerned about pollen broadcasting compared to those who were not ( OR =1.83, P <0.001). Conclusions: Currently, the dissemination of pollen broadcasting in China is hindered by various factors such as disease cognition level. The treatment satisfaction among AR patients remains unsatisfactory.

Objective: To study the anatomical characteristics of blood vessels in the lateral segment of the vertebral body through the surgical approach of oblique lumbar interbody fusion (OLIF) using MRI imaging, and evaluate its potential vascular safety zone., Methods: The lumbar MRI data of 107 patients with low back and leg pain who met the selection criteria between October 2019 and November 2022 were retrospectively analyzed. The vascular emanation angles, vascular travel angles, and the length of vessels in the lateral segments of the left vertebral body of L 1 -L 5 , as well as the distance between the segmental vessels in different Moro junctions of the vertebral body and their distances from the edges of the vertebrae in the same sequence (bottom marked as I, top as S) were measured. The gap between the large abdominal vessels and the lateral vessels of the vertebral body was set as the lateral vascular safe zones of the lumbar spine, and the extent of the safe zones (namely the area between the vessels) was measured. The anterior 1/3 of the lumbar intervertebral disc was taken as the simulated puncture center, and the area with a diameter of 22 mm around it as the simulated channel area. The proportion of vessels in the channel was further counted. In addition, the proportions of segmental vessels at L 5 without a clear travel and with an emanation angel less than 90° were calculated., Results: Except for the differences in the vascular emanation angles between L 4 and L 5 , the vascular travel angles between L 1 , L 2 and L 4 , L 5 , and the length of vessels in the lateral segments of the vertebral body among L 1 -L 4 were not significant ( P >0.05), the differences in the vascular emanation angles, vascular travel angles, and the length of vessels between the rest segments were all significant ( P <0.05). There was no significant difference in the distance between vessels of L 1 , L 2 and L 2 , L 3 at Moro Ⅰ-Ⅳ junctions ( P >0.05), in L 3 , L 4 and L 4 , L 5 at Ⅱ and Ⅲ junction ( P >0.05). There was no significant difference in the vascular distance of L 2 , L 3 between Ⅱ, Ⅲ junction and Ⅲ, Ⅳ junction, and the vascular distance of L 3 , L 4 between Ⅰ, Ⅱ junction and Ⅲ, Ⅳ junction ( P >0.05). The vascular distance of the other adjacent vertebral bodies was significant different between different Moro junctions ( P <0.05). Except that there was no significant difference in the distance between L 2 I and L 3 S at Ⅰ, Ⅱ junction, L 3 I and L 4 S at Ⅱ, Ⅲ junction, and L 2 I and L 3 S at Ⅲ, Ⅳ junction ( P >0.05), there was significant difference of the vascular distance between the bottom of one segment and the top of the next in the other segments ( P <0.05). Comparison between junctions: Except for the L 3 S between Ⅰ, Ⅱ junction and Ⅱ, Ⅲ junction, and L 5 S between Ⅰ, Ⅱ junction and Ⅱ, Ⅲ and Ⅲ, Ⅳ junctions had no significant difference ( P >0.05), there were significant differences in the distance between the other segmental vessels and the vertebral edge of the same sequence in different Moro junctions ( P <0.05). The overall proportion of vessels in the simulated channels was 40.19% (43/107), and the proportion of vessels in L 1 (41.12%, 44/107) and L 5 (18.69%, 20/107) was higher than that in the other segments. The proportion of vessels in the channel of Moro zone Ⅰ (46.73%, 50/107) and zone Ⅱ (32.71%, 35/107) was higher than that in the zone Ⅲ, while no segmental vessels in L 1 and L 2 were found in the channel of zone Ⅲ ( χ 2 =74.950, P <0.001). Moreover, 26.17% (28/107) of the segmental vessels of lateral L 5 showed no movement, and 27.10% (29/107) vascular emanation angles of lateral L 5 were less than 90°., Conclusion: L 1 and L 5 segmental vessels are most likely to be injured in Moro zones Ⅰ and Ⅱ, and the placement of OLIF channels in L 4, 5 at Ⅲ, Ⅳ junction should be avoided. It is usually safe to place fixation pins at the vertebral body edge on the cephalic side of the intervertebral space, but it is safer to place them on the caudal side in L 1, 2 (Ⅰ, Ⅱ junction), L 3, 4 (Ⅲ, Ⅳ junction), and L 4, 5 (Ⅱ, Ⅲ, Ⅳ junctions).

Objective: Anthropometric variants in prepubertal boys with hypospadias were assigned and assessed to illustrate anatomical malformation., Methods: A total of 516 prepubertal (Tanner grade Ⅰ) boys with hypospadias who were admitted to three medical centers between March 2021 and December 2021 and met the selection criteria for primary surgery were selected. The age of the boys ranged from 10 to 111 months, with an average of 32.6 months. Hypospadias were classified according to the location of the urethral defect, 47 cases (9.11%) of the distal type (the urethral defect is in the coronal groove or beyond), 208 cases (40.31%) of the middle type (the urethral defect is in the penis body), and 261 cases (50.58%) of the proximal type (the urethral defect is at the junction or proximal side of the penis and scrotum). The following indexes were measured: penis length before and immediately after operation, reconstructed urethral length, and total urethral length. Morphological indicators of the glans area, including preoperative height and width of glans, AB, BC, AE, AD, effective AD, CC, BB, the urethral plate width of the coronal sulcus, and postoperative height and width of glans, AB, BE, and AD. In which point A is the distal endpoint of navicular groove, point B is the protuberance lateral to the navicular groove, point C is the ventrolateral protuberance of the glans corona, point D is the dorsal midline point of the glans corona, and point E is the ventral midline point of the coronal sulcus. The foreskin morphological indicators, including the foreskin width, inner foreskin length, and outer foreskin length. The scrotal morphological indicators, including the left, right, and front penile to scrotum distance. The anogenital distances, including anoscrotal distance 1 (ASD1), ASD2, anogenital distance 1 (AGD1), and AGD2., Results: The penis length of the distal, middle, and proximal types decreased successively before operation, the reconstructed urethral length increased successively and the total urethral length decreased successively, these differences were all significant ( P <0.05). The height and width of the glans of the distal, middle, and proximal types significantly decreased successively ( P <0.05), but the height/width of the glans was generally close; AB value, AD value, and effective AD value significantly decreased successively ( P <0.05); there was no significant difference in BB value, urethral plate width of the coronary sulcus, and (AB+BC)/AD value between the groups ( P >0.05). There was no significant difference in the width of glans between the groups after operation ( P >0.05); AB value and AB/BE value increased successively, and AD value decreased successively, these differences were all significant ( P <0.05). The inner foreskin length in the 3 groups significantly decreased successively ( P <0.05), while the outer foreskin length had no significant difference ( P >0.05). The left penile to scrotum distance of middle, distal, and proximal types significantly increased successively ( P <0.05). ASD1, AGD1, and AGD2 significantly decreased from distal type to proximal type successively ( P <0.05). The other indicators' differences were significant only between some groups ( P <0.05)., Conclusion: The anatomic abnormalities of hypospadias can be described by anthropometric indicators, which can be used as the basis for further standardized surgical guidance.

Objective: To investigate the effects of dopamine on olfactory function and inflammatory injury of olfactory bulb in mice with allergic rhinitis (AR). Methods: AR mouse model was established by using ovalbumin (OVA), and the mice were divided into two groups: olfactory dysfunction (OD) group and without OD group through buried food pellet test (BFPT). The OD mice were randomly divided into 2 groups, and OVA combined with dopamine (3, 6, 9 and 12 days, respectively) or OVA combined with an equal amount of PBS (the same treatment time) was administered nasally. The olfactory function of mice was evaluated by BFPT. The number of eosinophils and goblet cells in the nasal mucosa were detected by HE and PAS staining. Western blotting, immunohistochemistry or immunofluorescence were used to detect the expression of olfactory marker protein (OMP) in olfactory epithelium, the important rate-limiting enzyme tyrosine hydroxylase (TH) of dopamine, and the marker proteins glial fibrillary acidic protein (GFAP) and CD11b of glial cell in the olfactory bulb. TUNEL staining was used to detect the damage of the olfactory bulb. SPSS 26.0 software was used for statistical analysis. Results: AR mice with OD had AR pathological characteristics. Compared with AR mice without OD, the expression of OMP in olfactory epithelium of AR mice with OD was reduced ( F =26.09, P <0.05), the expression of GFAP and CD11b in the olfactory bulb was increased ( F value was 38.95 and 71.71, respectively, both P <0.05), and the expression of TH in the olfactory bulb was decreased ( F =77.00, P <0.05). Nasal administration of dopamine could shorten the time of food globule detection in mice to a certain extent, down-regulate the expression of GFAP and CD11b in the olfactory bulb ( F value was 6.55 and 46.11, respectively, both P <0.05), and reduce the number of apoptotic cells in the olfactory bulb ( F =25.64, P <0.05). But dopamine had no significant effect on the number of eosinophils and goblet cells in nasal mucosa ( F value was 36.26 and 19.38, respectively, both P >0.05), and had no significant effect on the expression of OMP in the olfactory epithelium ( F =55.27, P >0.05). Conclusion: Dopamine can improve olfactory function in mice with AR to a certain extent, possibly because of inhibiting the activation of glial cells in olfactory bulb and reducing the apoptotic injury of olfactory bulb cells.

Objective: To document the effect of surgical steps, including penile degloving, plate transection, dorsal plication, and fasciocutaneous coverage, in primary hypospadias repair on penile length., Methods: A consecutive series of 209 prepubertal boys with primary hypospadias repair was included with the age ranged from 10 to 97 months (mean, 31.7 months). Intraoperative stretched penile length (SPL) was measured before operation ( n =209), and after each step, namely penile degloving ( n =152), plate transection ( n =139), dorsal plication ( n =170), and fasciocutaneous coverage ( n =209). SPLs before and after each steps or the entire operation were analyzed. The SPL was compared between plate transection group and plate preservation group, dorsal plication group and non-plication group, and plate preservation with plication group and plate preservation without plication group, respectively. Differences of SPL between before and after each steps were analyzed with factors including neourethra length, rest dorsal penile length, rest ventral penile length, preoperative SPL, and the degree of penile curvature after penile degloving, with multivariate linear regression analysis., Results: All the four steps resulted in SPL difference. The SPL increased after penile degloving and plate transection ( P <0.05), and decreased after dorsal plication and fasciocutaneous coverage ( P <0.05). The SPL increased after all steps were completed ( P <0.05). In patients with plate transection, postoperative SPL increased when compared with that before operation ( P <0.05). No significant difference was noted in patients without plate transection ( P >0.05). And there was significant difference in the increased length of SPL between patients with and without plate transection ( P <0.05). In patients with dorsal plication, a significant increase of postoperative SPL ( P <0.05) was noted. No significant difference was noted in patients without dorsal plication ( P >0.05). And there was no significant difference in increased length between patients with and without dorsal plication ( P >0.05). When patients with plate transection were excluded, dorsal plication resulted in no significant difference on postoperative SPL ( P >0.05). The increased length of SPL after penile degloving, dorsal plication, or cutanofascial coverage was not related to the neourethra length, the rest dorsal penile length, the rest ventral penile length, the preoperative SPL, and the degree of penile curvature ( P >0.05). However, the neourethra length and preoperative SPL were the influencing factors for the increased length of SPL after plate transection ( P <0.05)., Conclusion: The main steps in primary hypospadias repair can change SPL. The lengthening effect of plate transection would not be counteracted by dorsal plication. Dorsal plication makes no significant difference on postoperative SPL.

Objective: To explore whether peripheral blood CD8(+)T lymphocyte dysfunction is correlated with the programmed death receptor-1 (PD-1) expression in patients with acute-on-chronic liver failure (HBV-ACLF). Methods: Peripheral blood mononuclear cells (PBMC) were collected from patients with HBV-ACLF and healthy controls. CD8(+)T lymphocytes number and PD-1 expression condition in CD8(+)T lymphocytes were detected by flow cytometry. CD8(+)T lymphocytes isolated from peripheral blood of HBV-ACLF patients were further cultured in vitro. One group was added with PD-L1-IgG fusion protein (ACLF+PD-1 group), and the other group was added with IgG fusion protein (ACLF group). Proliferation ability (ki67), cell viability (CD69), and secretion ability of effector cytokines (IL-2, IFN-γ, TNF-α) were analyzed. Results: 30 cases with HBV-ACLF and healthy controls were enrolled. CD8(+)T lymphocytes absolute number was significantly lower in the peripheral blood of patients with ACLF group (333.88 ± 147.74)/μl than healthy controls (872.50 ± 206.64)/μl ( P < 0.001). PD-1 expression in peripheral blood CD8(+)T lymphocytes were significantly increased in ACLF group (13.33% ± 2.52%), ( P = 0.027) than healthy controls (7.02% ± 2.12%). In in vitro culture, compared with healthy controls, the peripheral blood CD8(+)T lymphocytes cell viability (CD69), proliferation ability (ki67) (all P ​​< 0.001), and the level of cytokine production (IL-2, IFN-γ, TNF-α) (all P < 0.05) were equally weakened in patients with ACLF group. Compared with ACLF group, CD8(+)T cell viability (CD69), proliferation ability (KI67) (all P < 0.05), and the level of cytokine production were weakened in ACLF+PD-1 group (all P < 0.05). Conclusion: HBV-ACLF patients have CD8(+)T lymphocyte dysfunction. Therefore, PD-1 may have correlation in the regulation of CD8(+)T lymphocyte dysfunction in ACLF patients.

Objective: To explore the pathological type, clinical features and their relationship with prognosis of chronic rhinosinusitis（CRS）. Methods: A retrospective study of 135 patients with CRS who underwent surgical treatment in the Affiliated Jiangning Hospital of Nanjing Medical University from January 2017 to December 2018. Review the pathological slices retrospectively and divide the CRS into 4 types, eosinophilic type（eCRS）, lymphocyte or（and） plasma cell type, neutrophil type and mixed type, the latter three are collectively referred to as "non-eosinophil type（non-eCRS）". Follow-up was conducted between January and February 2021 to analyze the distribution, clinical features, and differences in prognosis of the different endotypes. Results: ①Among the 135 CRS patients, 42 cases（31.1%） were eCRS and 93 cases（68.9%） were non-eCRS（76 cases[56.3%] of lymphocyte or plasma cell type, 4 cases[3.0%] of neutrophil type and 13 cases[9.6%] of mixed type）. The difference in composition ratio between the groups was statistically significant（ n =135, P <0.001）. ②The absolute value and percentage of preoperative peripheral blood eosinophils（EOS） in eCRS patients were higher than those of non-eCRS patients, and the difference was statistically significant（ n =125, P （absolute value） =0.030, P （percentage） =0.033）. The results of receiver operating characteristic curve showed that both absolute value and percentage have predictive value, and cut-off value was 0.325×10⁹/L（absolute value） or 2.750%（percentage）. There was no statistically significant difference in preoperative peripheral blood procalcitonin among the groups（ n =69, P =0.647）. ③The ratio（E/M value） of the bilateral ethmoid sinus scores and bilateral maxillary sinus scores of the preoperative paranasal sinus CT in eCRS patients was 2.03±1.23, while the non-eCRS patients was 1.47±0.96, and the difference was statistically significant（ n =112, P =0.009）. ④In total, 101 cases were effectively followed up, including 34 cases of eCRS（7 cases[20.6%] of control, 18 cases[52.9%] of partial control）, 9 cases[26.5%] of non-control and 67 cases of non-eCRS（32 cases[47.8%] of control, 26 cases[38.8%] were partially controlled, 9 cases[13.4%] were not controlled）, and the efficacy of the non-eCRS group was significantly better than that of the eCRS group（ χ ²=7.499, P =0.024）. Conclusion: When the absolute value of EOS in the preoperative blood examination is greater than 0.325×10⁹/L or the percentage is greater than 2.750%, eCRS can be predicted, but the accuracy is low. CT of patients with eCRS is mostly characterized by inflammation of the ethmoid sinus and usually E/M>2. The efficacy of eCRS group is worse than that of the non-eCRS group 2-4 years after surgery., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the caries status of the first permanent molars in urban and rural children aged 10-
12 in Chongqing and analyze the related factors in order to provide a theoretical basis for the prevention and treatment of children's caries and targeted suggestions for oral health education., Methods: A multi-stage, stratified, cluster, and random sampling method was used to extract 5 057 children from 18 schools in three districts and three counties in Chongqing for oral health examination and questionnaire survey from March to May 2018., Results: The total caries rate of the first permanent molar was 39.2%. The decayed-missing-filled tooth was 0.84±1.20. The rate of filling teeth was 3.4%. The rate of pit and fissure sealing was 6.1%. The prevalence of the first permanent molars was significantly different between men and women, between urban and rural areas, between only children and non-only children, and between ethnic minorities and Han nationality (P<0.001). The gap between the pit and fissure sealing was significantly different between urban and rural areas (P<
0.001). Multiple logistic regression analysis showed that many independent factors influence the occurrence of caries, including the frequency of brushing teeth every day, the frequency of eating desserts, the habit of eating dessert/drinking milk before going to bed, whether only-children or not, and parents' education background, among others., Conclusions: The first permanent molars of children aged 10-12 in Chongqing have a high rate of caries but low rates of pit and fissure sealing and dental caries filling. The difference between urban and rural areas is large, children's oral health knowledge is scarce, and children have bad oral hygiene behaviors and eating habits. Children's oral health education must be strengthened, oral health preaching must be implemented in schools, the oral health knowledge of children in school must be improved, and urban-rural differences must be minimized.

Smart dressings, which show obvious advantage and potential in wound treatment and real-time monitoring, attract widespread attention in recent years. Real-time and dynamic acquiring wound information is vital to the treatment and prognosis of wound. Further research on smart dressings is helpful for wound management, personalized treatment, and realization of medical application translation of health monitoring technology. In the article, we categorize smart dressings and conclude their functions according to the type of micro-environment information of wound gathered by smart dressings.

Objective: To investigate the effect of NACHT-LRR-PYD- containing proteins 3 (NLRP3) mediated pyroptosis in myocardial cells undergoing hypoxia/deoxygenation (H/R) injury. Methods: In order to observe whether H/R-treatment could cause pyroptosis, H9c2 cells were divided into 2 groups randomly using the lottery method: control group(without H/R-treatment) and H/R group (in which the H9c2 cells were underwent H/R-treatment). In order to clarify the role of pyroptosis in H/R-injury, H9c2 cells were divided into 4 groups randomly using the lottery method: control group(in which the H9c2 cells were cultivated with normal medium); YVAD group(in which the H9c2 cells were pretreated with z-Val-Ala-Asp(Ome)-fluoromethylketone (Z-YVAD-FMK) 20 μm for 4 hours, then replaced with normal medium); H/R group(H9c2 cells underwent H/R-treatment); YVAD+H/R group (in which the H9c2 cells were pretreated with 20 μm Z-YVAD-FMK for 4 hours before H/R-treatment). To determine whether H/R-induced cell pyroptosis is associated with NLRP3, H9c2 cells were divided into 4 groups randomly using the lottery method: control group (in which cells were transfected with a control nonspecific siRNA); si-NLRP3 group (in which cells were transfected with NLRP3-targeting siRNA); H/R group(in which cells were transfected with a control nonspecific siRNA before H/R-treatment); si-NLRP3+H/R group(in which the H9c2 cells were transfected with NLRP3-targeting siRNA before H/R-treatment). Pore formation on cell membrane was detected by propidium iodide (PI) staining. Cell viability was detected by CCK8 reagent. The protein expression of Caspase-1, interleukin-1β (IL-1β) and NLRP3 was detected by Western blot. Results: (1) The positive rate of PI staining ((26.46±5.15)% vs. (1.69±0.73)%, P< 0.01), expression of NLRP3 (0.57±0.16 vs. 0.23±0.06, P< 0.01), expression of Caspase-1 (1.07±0.13 vs. 0.37±0.08, P< 0.01), and expression of IL-1β (0.38±0.08 vs. 0.16±0.05, P< 0.01) were significantly higher in H/R group than in control group. (2)The cell vitality was significantly higher in YVAD+H/R group than in H/R group ((87.31±9.05)% vs. (73.30±7.19)%, P< 0.05).The positive rate of PI staining was significantly decreased in YVAD+H/R group than in H/R group ((18.12±4.36)% vs. (26.45±4.60)%, P< 0.05). The expression of Caspase-1 (0.72±0.12 vs. 1.07±0.15, P< 0.05) and IL-1β(0.29±0.07 vs. 0.39±0.06, P< 0.05) were significantly lower in YVAD+H/R group than in H/R group. (3) The cell vitality was significantly increased in si-NLRP3+H/R group than in H/R group ((85.46±7.71)% vs. (72.41±5.53)%, P< 0.05). The positive rate of PI staining was significantly lower in si-NLRP3+H/R group than in H/R group ((18.22±4.20)% vs. (26.73±3.26)%, P< 0.05). The expression of Caspase-1(0.87±0.07 vs. 1.15±0.15, P< 0.05) and IL-1β(0.41±0.07 vs. 0.58±0.10, P< 0.05) were significantly decreased in si-NLRP3+H/R group than in H/R group. Conclusion: NLRP3 mediated pyroptosis is involved in H/R injury of myocardial cells.

Objective: To discuss the reoperation methods of urethral stricture after urethroplasty of hypospadias and their effectiveness., Methods: Between September 2010 and April 2018, 169 patients with urethral stricture after urethroplasty of hypospadias, who underwent ineffective conservative treatments first, were accepted. The age ranged from 1 year and 7 months to 41years with a median age of 5 years and 8 months. The stricture located at the external urethral orifice in 80 cases, internal anastomosis connection in 87 cases, and constructed urethra in 2 cases. The symptoms of urethral stricture occurred at 2 weeks to 52 months after urethroplasty, with a median time of 4.5 months. The patients with external urethral orifice stenosis were treated with urethral meatus augmentation (74 cases) and urethral advancement (6 cases). The patients with internal anastomosis connection stenosis were treated with internal urethrotomy with urethroscopy (10 cases), urethrotomy and one-stage urethroplasty (26 cases), and urethrostomy (51 cases) including 43 cases of two-stage urethroplasty. The patients with constructed urethral stricture were treated with urethrolysis., Results: One hundred and fifty-four patients were followed up 6-86 months with an average of 47 months. The stenosis was relieved in 137 cases, and re-stenosis in 12 cases, urethral fistula in 4 cases, all of which were treated successfully. In addition, 1 case with mild urethral diverticulum did not need to be treated., Conclusion: If it is ineffective for the conservative treatment of urethral stricture after urethroplasty of hypospadias, appropriate surgical treatments could be selected according to the location and length of the stricture, local tissue conditions, complications, and so on.

Objective: To investigate the application of cavernosum reduction technology in glanuloplasty during the repair of moderate-severe hypospadias and evaluate the effectiveness., Methods: The clinical data of 192 patients with moderate-severe hypospadias between November 2015 and May 2017 were retrospectively analyzed. Among them, 103 patients were treated with the cavernosum reduction technology in glanuloplasty during the repair (observation group), 88 patients were treated with repair and glanuloplasty without the cavernosum reduction technology (control group). There was no significant difference in maximum transverse diameter of glans and the height of glans between 2 groups ( t =1.652, P =0.152; t =1.653, P =0.077). The length of reconstructed urethra, complications (e.g. glans dehiscence and fistula), and the maximum flow rate at 3 months after operation in 2 groups were recorded., Results: The length of reconstructed urethra were (35.51±7.79) mm in observation group and (32.17±6.37) mm in control group. In observation group, the meatus location after the correction of chordee was proximal in 24 cases and scrotum-perineum in 79 cases. In control group, the meatus location after the correction of chordee was proximal in 21 cases and scrotum-perineum in 67 cases. There was no significant difference in the meatus location between 2 groups ( χ 2 =0.008， P =0.920). All patients were followed up 6-12 months after operation (mean, 9 months). There were 3 cases of urethral fistula, 2 cases of glans dehiscence, and 3 cases of urethral orifice stricture in observation group, with the incidence of complications of 7.8%. There were 7 cases of urethral fistula, 3 cases of glans dehiscence, and 4 cases of urethral orifice stricture in control group, with the incidence of complications of 15.9%. There was a significant difference in the incidence of complications between 2 groups ( χ 2 =4.027, P =0.040). The appearance of the penis was satisfactory, and the urethral orifice was fissured, which was close to the appearance of the normal urethral orifice. At 3 months after operation, the maximal flow rates were (6.23 ± 0.54) mL/s in observation group and (5.44±0.92) mL/s in control group. There was significant difference in the maximum flow rate between 2 groups ( t =1.653, P =0.000)., Conclusion: Cavernosum reduction technology being applied in the repair of moderate-severe hypospadias can reduce the probability of glans dehiscence, urethral fistula, urethrostenosis, and other postoperative complications, and improve the success and satisfaction of surgery.

Objective: To form a new assessment method to evaluate postural workload comprehensively analyzing the dynamic and static postural workload for workers during their work process to analyze the reliability and validity, and to study the relation between workers' postural workload and work-related musculoskeletal disorders (WMSDs)., Methods: In the study, 844 workers from electronic and railway vehicle manufacturing factories were selected as subjects investigated by using the China Musculoskeletal Questionnaire (CMQ) to form the postural workload comprehensive assessment method. The Cronbach's α, cluster analysis and factor analysis were used to assess the reliability and validity of the new assessment method. Non-conditional Logistic regression was used to analyze the relation between workers' postural workload and WMSDs., Results: Reliability of the assessment method for postural workload: internal consistency analysis results showed that Cronbach's α was 0.934 and the results of split-half reliability indicated that Spearman-Brown coefficient was 0.881 and the correlation coefficient between the first part and the second was 0.787. Validity of the assessment method for postural workload: the results of cluster analysis indicated that square Euclidean distance between dynamic and static postural workload assessment in the same part or work posture was the shortest. The results of factor analysis showed that 2 components were extracted and the cumulative percentage of variance achieved 65.604%. The postural workload score of the different occupational workers showed significant difference (P<0.05) by covariance analysis. The results of nonconditional Logistic regression indicated that alcohol intake (OR=2.141, 95%CI 1.337-3.428) and obesity (OR=3.408, 95%CI 1.629-7.130) were risk factors for WMSDs. The risk for WMSDs would rise as workers' postural workload rose (OR=1.035, 95%CI 1.022-1.048). There was significant different risk for WMSDs in the different groups of workers distinguished by work type, gender and age. Female workers exhibited a higher prevalence for WMSDs (OR=2.626, 95%CI 1.414-4.879) and workers between 30-40 years of age (OR=1.909, 95%CI 1.237-2.946) as compared with those under 30., Conclusion: This method for comprehensively assessing postural workload is reliable and effective when used in assembling workers, and there is certain relation between the postural workload and WMSDs.

Objective: To investigate mRNA expression of dopamine receptor subtypes in the rat cochlear spiral ganglion neurons (SGN) following exposure to the sodium salicylate. In addition, we observed the effect of sodium salicylate on N methyl-D-aspartic acid (NMDA) receptor subunit NR1 and gamma aminobutyric acid (GABA)a receptor subunit GABRα2 mRNA under the circumstance of DR activation or blocking. Moreover, we also focused on the the interaction between receptors mediated by SS. Method: Immunofluorescence techniques were applied to detect DR (DR1 and DR2) expression in cultured rat SGN. Moreover, RT-PCR was performed to assess NR1 and GABRα2 subunit mRNA. Result: Immunofluorescence images showed co-localization of DR1/DR2 and βⅢ-tubulin protein in SGN bodies and axons. RT-PCR results illustrated that ①DR subtypes of DRd1-5 were detected in the SGN. ②The mRNA expression of all subtypes of DR and GABRα2, NR1 subunits were obviously upregulated except DRd3 after treatment with sodium salicylate. Among them, DRd1 expression increased 34.64%( t =-5.123, P =0.007),DRd2 expression increased 34.60%( t =-5.206, P =0.006),DRd4 expression increased 20.87%( t =-3.337, P =0.029),DRd5 expression increased 26.42%( t =-6.054, P =0.004),GABRα2 expression increased 30.41%( t =-2.839, P =0.047),NR1 expression increased 39.22%( t =-6.243, P =0.003).③After exposure to sodium salicylate (5 mmol/L), dopamine (100 μmol/L), DR1 agonist (SKF38393,20 μmol/L), DR2 agonist (Quinpirole,20 μmol/L), GABRα2 expression increased 21.78%,27.45%,33.02%,33.42% respectively ( F =12.399, P =0.001),and NR1 expression increased 28.70%,26.82%,29.03%,35.05%( F =50.395, P =0.000) respectively.④Compared with the group of sodium salicylate treatment alone, both sodium salicylate + DR1 antagonist (SCH23390,20 μmol/L) group and sodium salicylate + DR2 antagonists (Eticlopride,20 μmol/L) group had a suppression on GABRα2 and NR1 mRNA expression.GABRα2 mRNA reduced 29.56%,37.10%( F =22.101, P =0.000) and NR1 mRNA expression decreased 37.62%,32.83% respectively( F =72.933, P =0.000). Conclusion: Most of the DR subtypes mRNA expression in SGN were increased following exposure to sodium salicylate. DR may be involved in the effect of sodium salicylate on GABAaR and NMDAR mRNA expression., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Background: Radiofrequency ablation (RFA) combined with chemotherapy has a certain short-term therapeutic effect for the treatment of advanced non-small cell lung cancer (NSCLC), but whether it can improve the long-term survival rate of patients is still controversy. This study retrospectively analyzed the difference of long-term efficacy between RFA combined with chemotherapy and chemotherapy alone in the treatment of patients with advanced NSCLC., Methods: A total of 77 patients with stage IIIb and stage IV NSCLC who underwent radiofrequency ablation and chemotherapy in the Department of Thoracic Surgery, Xuanwu Hospital, Capital University of Medical Sciences from September 2009 to December 2015 were enrolled as the treatment group. Chemotherapy with no radiofrequency ablation was performed in 56 patients with stage IIIb and stage IV NSCLC as the control group. Two groups of patients were followed up by telephone about their living conditions. "Survival" package of R software version 3.4.1 was used for statistical analysis. Two sets of data baseline levels were tested by chi-square test. The bias was processed by Cox regression model and the survival curve was plotted using covariate mean substitution method., Results: The first-year survival rate of the treatment group was 70.74%, the two-year survival rate was 39.31% and the median survival time was 22.1 months. The one-year survival rate was 54.54% in the control group, the two-year survival rate was 19.49%, the median survival for 18.1 months. The long-term survival rate of the treatment group was better than that of the control group (P<0.05, OR=0.571)., Conclusions: Radiofrequency ablation of lung cancer combined with chemotherapy can significantly improve the 2-year survival rate of patients with stage IIIb and stage IV NSCLC.

Objective: To explore the indication and effectiveness of urogenital sinus surgery in feminizing genitoplasty of disorder of sex development (DSD)., Methods: A retrospective analysis was made on clinical data from 22 patients with DSD who underwent one stage feminizing genitoplasty between October 2010 and December 2015. The patients' age ranged from 1 year and 2 months to 21 years, with the median age of 2 years and 1 month. According to the Prader classification criteria, the appearance of vulvas were rated as grade Ⅰ in 7 cases, grade Ⅱ in 6 cases, grade Ⅲ in 8 cases, and grade Ⅳ in 1 case. Cystoscopy was applied before feminizing genitoplasty in all patients. Low confluence of vagina and urethra was found in 19 patients, while high confluence was found in 3 patients. The mean length of urogenital sinus was 1.6 cm (range, 0.5-3.0 cm). The mean length of water-filled vagina was 4.4 cm (range, 3.5-5.5 cm). Cervix was detected at the end of vagina in 16 patients, meanwhile absence of cervix was detected in 6 patients. The same procedures of clitoroplasty and labioplasty were used in all patients. Three procedures of urogenital sinus surgery were applied, as the "cut-back" vaginoplasty in 6 patients, the "flap" vaginoplasty in 11 patients, and the partial urogenital sinus mobilization (PUM) in 5 patients., Results: All procedures were completed successfully and the incisions healed by stage Ⅰ. All patients were followed up 12-74 months, with the average of 30.5 months. The outcome of appearance evaluation was excellent in 13 patients (59.1%), good in 6 patients (27.3%), and poor in 3 patients (13.6%). Urinary incontinence, post-void residual, urinary infection, and urethrovaginal fistula were not found in 17 toilet trained patients., Conclusion: Urogenital sinus surgery is the most critical step in feminizing genitoplasty of DSD. It can be finished in one stage procedure with clitoroplasty and labioplasty before puberty. If thoroughly evaluation before surgery is completed and the principle of different procedures is handled, the outcome will be satisfactory.

Objective: Recombinant human leucine-rich amelogenin peptide (LRAP) was studied by cryogenic transmission electron microscopy (TEM); evaluation focused on its self-assembly and crystal growth in vitro., Methods: Human LRAP was recombined through prokaryotic expression vector pCold-SUMO and transformed into Escherichia coli BL21plys to acquire purified proteins. Cryogen TEM recorded assembly and self-assembling of LRAP from pH 3.5 to pH 8.0, and the hydroxyapatite crystal growth in the mixture of LRAP protein solution and artificial saliva was observed using TEM and selected area electron diffraction., Results: More than 90% purity LRAP was expressed, purified and identified as described in methods. LRAP linked into oligomers, nanospheres, nanochains, and microribbons, whereas pH value increased from 3.5 to 8.0. Mature hydroxyapatite crystal growth was guided in artificial saliva filled with calcium phosphate., Conclusions: LRAP is simplified amelogenin functional domain and conserved the basic characters of amelogenin such as self-assembling and inducing crystallization along c axis. In the area of acellular synthesis of hydroxyapatite using extracellular enamel matrix protein, LRAP is one of candidate repair materials for irregular hard tissue defection.
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Objective: To observe the effect of Tripterygium wilfordii polycoride (TWP) on ulcerative colitis (UC), and its intervention effect on toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88) signaling pathway, thus to investigate its possible mechanism., Methods: Trinitrobenzene sulfonic acid (TNBS)/ethanol enema method was used to set up the UC rat model. With random number table, 90 male Wistar rats were divided into normal control group, model group, TWP low, medium and high dose group (3, 6, 12 mg/kg, respectively) and azathioprine (AZA) group (6 mg/kg), with 15 rates in each group. Four days after enema, rates in each group were given corresponding drug lavage for 14 consecutive days. Disease activity index (DAI), colon gross morphological damage and histological grading of each group were observed. Using Western blot and reverse transcription (RT)-PCR method, the TLR4/MyD88 signaling pathway-related proteins in UC rat intestinal tissue were detected, namely TLR4, MyD88, tumor necrosis factor receptor related factor 6 (TRAF-6), nuclear factor kappa B (NF-κB), tumor necrosis factor alpha (TNF-α), and interleukin-1 beta (IL-1β)., Results: The DAI, colon gross morphological damage, and histological grading of the model group were significantly higher than that of the normal control group (all P<0.01), indicating successful establishment of UC model. The DAI, colon gross morphological damage and histological grading of the TWP high dose group were lower than those of the model group (0.87±0.25 vs 1.60±0.76, 3.93±1.94 vs 5.40±2.21, 5.45±2.73 vs 13.27±3.50, P<0.05). Compared with the normal control group, the mRNA and protein expressions of TLR4, MyD88, TRAF-6, NF-κB, TNF-α, and IL-1β in the model group rats were significantly increased (all P<0.01); which were significantly decreased in the TWP high dose group compared with model group rats (mRNA: 2.166±0.475 vs 5.647±0.275, 1.295±0.087 vs 3.774±0.418, 1.125±0.188 vs 2.535±0.320, 1.201±0.152 vs 2.082±0.077, 1.525±0.218 vs 3.094±0.022, 1.797±0.257 vs 17.152±0.145; protein: 0.252±0.010 vs 0.277±0.008, 0.172±0.002 vs 0.213±0.005, 0.233±0.006 vs 0.248±0.003, 0.099±0.003 vs 0.122±0.007, 0.238±0.002 vs 0.252±0.005, 0.235±0.003 vs 0.245±0.006, all P<0.05), also decreased in the AZA group (all P<0.01); and there were no significant differences between the TWP high dose group and the AZA group (all P>0.05)., Conclusions: TWP can alleviate intestinal inflammation, promote healing of mucosa, showing a therapeutic effect for UC. One of its mechanisms may be through inhibiting the expression of TLR4, affecting the expression of TRAF-6, which is downstream to MyD66 signaling pathway, thus to suppress the activation of NF-κB and reduce the release of inflammatory factor such as TNF-α and IL-1β.

A steroidal hormone degrading bacterium, named MH-B5, was isolated from saline lagoon. Several steroidal hormones including estrone, 17-β-estradiol, estriol and testosterone could be utilized as sole carbon source by strain MH-B5. Analysis of 16S rRNA gene sequence showed that it belonged to genus Altererythrobacter. Growth of strain MH-B5 was observed at salinities of 0-7% and at pH of 5.5-9.0. The main degradation metabolites of testosterone by strain MH-B5 were identified as 4-androstenedione, 1-dehydrotestosterone and androstadienedione using ultra performance liquid chromatography (UPLC) coupled to quadrupole time-of-flight mass spectrometry (Q-TOF MS). Mono-carrier and multi-carrier cell immobilization techniques were successfully applied to this steroid-degrading bacterium. Batch estrogen degradation study showed that immobilized strain MH-B5 could effectively degrade 2 mg · L⁻¹ of 17β-estradiol and its metabolite estrone. The results mentioned above demonstrated the capability of MH-B5 to degrade both estrogens and testosterone and the potential application of using immobilized MH-B5 cells in bioremediation of steroidal hormone pollution in saline environment.

Objective: Diagnosis and prenatal diagnosis to a family of hemoglobin variant with α-thalassemia., Methods: Whole blood cell analysis, hemoglobin analysis by capillary zone electrophoresis (CZE), Gap-PCR, polymerase chain reaction-reverse dot blot (PCR-RDB) assay and DNA sequencing., Results: Hb Zurich Albisrieden with α°-thalassemia lead to severe anemia. The genotype of fetus is also Hb Zurich Albisrieden with α°-thalassemia., Conclusion: Abnormal hemoglobin with α-thalassemia may lead to severe anemia, Prenatal diagnosis of thalassemia has the vital significance for eugenic birth.

Orally disintegrating tablets (ODT), a kind of new solid tablet that rapidly disintegrates to work in the mouth, has became the hot form of new drug research in recent years with many advantages, such as the convenient taking, a widely applicable people, fast acting, high bioavailability, good compliance, and so on. ODT has been widely used in chemical medicines, while the application of it in traditional Chinese medicines (TCMs) is still in the stage of development The development of TCMs ODT provides a new direction for the research of Chinese medicine new dosage, accelerates the pace of connecting to the world and modernization of Chinese medicine. This dosage has a broad market prospect, and its quality control and assessment standards, taste, the disintegration time in vitro and evaluation method are the key factors that affect the industrialization, standardization of Chinese medicine ODT. Therefore, this paper reviewed the characteristics, preparation, taste masking technology and quality evaluation with new technology of ODT. Meantime, numerous application examples of ODT used in traditional Chinese medicine were described. We expect to provide the reference and utilization for the development of traditional Chinese medicine orally disinteeratine tablets.

Objective: To investigate the treatment for benign tumor of external auditory canal by carbon dioxide laser under microscope., Method: Ten cases of benign tumor of external auditory canal were treated by carbon dioxide laser under microscope. The curative effects and complications were observed., Result: Ten cases of benign tumor of external auditory canal were satisfied after operation without any complications. There were no recurrences during 3 months to 2 years of follow up., Conclusion: The operation for benign tumor of external auditory canal by carbon dioxide laser under microscope was easy, safe and effective.

Objective: To modify biomacromolecules, such as chitosan and collagen, to synthesize a mineralized template that will induce self-growing remineralization of tooth enamel., Methods: Natural polycation polysaccharide chitosan was modified through phosphorylation to synthesize the polyanion derivative ofphosphorylated chitosan. Parent hydrogels com- bined with chitosan and collagen I were built through peptide binding reaction using genipin as a crosslinker. The gels self- assembled on the tooth's inert surface, which was stimulated by ultraviolet radiation. The bionic saliva provided mineralized ion, and then the hydroxyapatite assembled and grew in situ on the tooth., Results: The functional group P04(3-) (3,446 cm(-1)) was grafted on chitosan as confirmed by the Fourier transform infrared spectroscopy. The porous polyelectrolyte complex hydrogel formed by the interaction between the polycation chitosan and the polyanion phosphorylated chitosan could induce hydroxyapatite crystal nucleation and growth on the hydrogel fiber surfaces. The neonatal crystal was hydroxyapatite as confirmed by X-ray diffraction and was tightly connected to the tooth. A continuous structure of column crystals with sizes ranging from 30 nm to 60 nm was observed. The structure was in parallel direction similar to the direction of the enamel rod, and its hardness was close to dentin., Conclusion: The parent hydrogels that were easily obtained and controlled could mimic the template of the enamel mineralization and induce a self-growing hydroxyapatite, which is an important step in the structural bionics of enamel.

The study on the pharmacokinetics of traditional Chinese medicines (TCMs) is a linking science during the modernization of TCMs, and plays an important role in the studies on the complex material base of TCMs, the in vivo process of ingredient/ component and the pharmacokinetics-pharmacodynamics correlation. However, because of the multi-ingredient/component system of TCMs, how to scientifically reveal the pharmacokinetics that is consistent with TCMs' characteristics has long been a hotspot and difficulty for the exploration. The optimal composition structure of the material basis of TCMs shows the best efficacy, while the difference between the multi-ingredient/component composition structures in the efficacy is closely related to their absorption, transport, metabolism and excretion in vivo. In this article, the authors systematically review the study methods for pharmacokinetics of TCMs and their compounds, and explore the pharmacokinetics of TCMs based on the "component structure theory". As a result, the method for integrating TCM component structure and the TCM pharmacokinetics was proposed to be adopted to intensively study the effect of the component structure on the in vivo TCM multi-ingredient/component pharmacokinetic characteristics, in order to promote the TCM modernization and innovation in China.

Ossifying fibromyxoid tumor is an uncommon neoplasm with uncertain histogenesis. This tumor is usually characterized by a small, painless mass in the subcutaneous tissue or limb muscles. In this case, an ossifying fibromyxoid tumor of the mandible was reported, and relevant literature was reviewed.

Tongue osteocartilaginous choristoma is the disease that there are well-developed bone and cartilage in the tongue. This article reported a case of tongue osteocartilaginous choristoma in the oral-cavity,which is rare.

The non-coding DNA sequences refer to non-protein-coding DNA sequences in genome. These sequences can bind with transcription factors or be transcribed as functional RNAs, thus participating in the regulation of many physiological activities and pathological processes. Aiming at gene expression regulation, this review focuses on the recent progress of non-coding DNA and illustrates their structures, functions and potential acting mechanisms. Meanwhile, some computational and experimental methods of identifying functional elements in the non-coding DNAs are introduced. Finally, further studies in this field are proposed.

A case diagnosed as adenolymphoma and pleomorphic adenoma in unilateral parotid gland was reported. The clinic pathological features, possible mechanism, diagnosis and treatment were discussed based on previously reports in the literature.

Objective: To investigate the effect of retrovirus mediated heme oxygenase (HO)-1 gene on chronic myeloid leukemia (CML) resistance cell apoptosis induced by nilotinib (AMN107)., Methods: High titer viral particles of pQCXIP-EGFP-HO-1 were prepared, and K562/A02 cells stably transfected with HO-1 gene was established. The expression of HO-1 in K562/A02 cells was detected by RT-PCR. After treated with AMN107 for 24 h, HO-1 mRNA and protein expression by RT-PCR and Western blot, respectively; Cell proliferation by MTT assay; bcr-abl fusion gene by RQ-PCR, and the apoptosis and cell cycle by flow cytometry., Results: Recombinant retrovirus vector was constructed successfully and K562/A02/HO-1 cells were successfully set up. The expression of HO-1 in K562/A02 cells was expressed clearly. After three groups cells treated with AMN107 for 24 h, the expression of HO-1 mRNA and protein was significantly higher in gene-transfected group than in either empty vector or no-transfected group. The difference was statistically significant (P < 0.05). The cell proliferation ofs was inhibited, but the cell viability was significantly higher in gene-transfected group than in other two groups. The difference was statistically significant(P < 0.05); After treated with 10 µmol/L AMN107 for 24 h, the CT values of bcr-abl fusion gene were (18.15 ± 0.18) in K562/A02/HO-1 group, being significantly higher than that in K562/A02/LXSN (20.32 ± 0.20) and K562/A02 (20.51 ± 0.21) group, the difference was statistically significant (P < 0.05); the apoptosis rate were (17.26 ± 0.23)%, (39.47 ± 0.17)%, and (41.84 ± 0.09)%, respectively in three groups, and were (3.74 ± 0.03)%, (5.91 ± 0.08)% in K563/A02/HO-1 untreated with drug and K562/A02 untreated with drug group. The number of G(0)/G(1) phase and S phase cells markedly decreased. The cells were arrested in G(2)/M phase. But cell cycle in gene-transfected group did not change significantly., Conclusion: AMN107 inhibits proliferation of CML resistance cells and induces cell apoptosis. HO-1 gene can protect CML resistance cells to apoptosis. There was a relationship between HO-1 gene and the growth of CML resistance cells.

Objective: To study the effect of Shenfu Injection (SI) on the post-operative cognitive dysfunction in senile patients receiving the orthopedic surgeries after general anesthesia., Methods: 100 patients, 60-89 years old, waiting for selective surgery at the orthopedics department, were randomly assigned to two groups, the SI group (50 cases) and the control group (50 cases), who met the standard of the American Society of Anesthesiologists (ASA) II-III. After surgical incision, patients in the SI group were transfused with SI 200 mL (50 mL SI was added in 200 mL normal saline), while those in the control group were transfused with 200 mL normal saline at the same time. The mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO2) were compared between the two groups before anesthesia, after intubation, 30 min and 60 min after anesthesia, 5 min and 30 min after extubation. The time for surgery, the time of intra-operative hypotension, the volume of hemorrhage, the time for post-operative consciousness recovery, the liver function, the kidney function, and the fasting blood glucose of patients before surgery, 3 days and 7 days after operation were compared. The cognitive functions of patients were tested before surgery, 3 days and 7 days after operation. The incidence of post-operative cognitive dysfunction of patients was compared between the two groups., Results: There was insignificant difference in MAP, HR, and SpO2 between the two groups at each time point (P > 0.05). There was insignificant difference in the pre-operative cognitive function score, the time for surgery, the time of intra-operative hypotension, the volume of hemorrhage, the liver function, the kidney function, and the fasting blood glucose between the two groups ( P > 0.05). The time for post-operative consciousness recovery was obviously shorter in the SI group than in the control group, showing significant difference (P < 0.05). The post-operative 3-day and 7-day cognitive function scores were obviously better in the SI group than in the control group, showing significant difference (P < 0.05). The incidence of post-operative cognitive dysfunction of the SI group [3 days: 12% (6 cases); 7 days: 8% (4 cases) ] was significantly lower than that of the control group [3 days: 20% (10 cases); 7 days: 14% (7 cases) ] ( P < 0.05)., Conclusion: SI could improve the post-operative cognitive function of senile patients receiving the orthopedic surgeries after general anesthesia, lower the incidence of post-operative cognitive dysfunction rate, and shorten the time for post-operative consciousness recovery.

Objective: To investigate the effects of total flavonoids of Malus hupehensis on hepatic fibrosis in mice induced by Schistosoma japonicum., Methods: The mice model of hepatic fibrosis which infected by cercariae of S. japonicum were randomly divided into 6 groups: Group A as a blank control, Group B as a model, Group C as a positive control by complex liver soften tablet of turtle, Group D, E, F treated with a high dose of 114 mg/(kg x d), middle dose of 57 mg/(kg d), and low dose of 28.5 mg/(kg x d) of total flavonoids of Malus hupehensis, respectively. Every group had 10 mice. Each group of C, D, E, F was orally given praziquantel at a dose of 500 mg/(kg x d) for 2 d, on 42 d after the infection, and then administered with total flavonoids of Malus hupehensis for 60 d. Group A and B were orally given with sodium chloride. All the mice were killed at the end of the administration. Serum hyaluronic acid (HA), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected; hydroxyproline in liver tissues was detected; areas of egg granuloma and degrees of hepatic fibrosis were observed via HE and Masson staining., Results: Compared with the blank control Group A, the egg granuloma appeared obviously, the collagen deposit and fibrosis occurred in liver tissues of Group B, C, D, E, F. The levels of ALT, AST, HA in sera and HYP in liver tissues were significantly higher (P < 0.05 or P < 0.01). However, the levels of ALT, AST, HA and HYP in the high, middle and low dose groups of total flavonoids were significantly lower than those in the model Group B (P < 0.05 or P < 0.01), the areas of egg granuloma, the collagen deposits and the degrees of hepatic fibrosis in Group C, D, E, F were significantly lower than those in the model Group B., Conclusion: The total flavonoids of Malus hupehensis have an obviously inhibitory effect on the hepatic fibrosis induced by Schistosomajaponicum infection.

Objective: To study effects of polysaccharide of Radix Ranunculi Ternati (PRT) on immunological function and anti-oxidation activity of mouse., Method: Cell proliferations of splenocyte, thymocyte and peritoneal macrophage were measured by MTT colorimetry. The phagocytic function of peritoneal macrophage was measured by neutral red colorimetric method. The disoxidation power of PRT was measured by Prussian blue method. The clearing effect of PRT on hydroxyl radical was measured by salicylic acid capture method. The clearing effect of PRT on superoxide anion free radical was measured by pyrogallol auto oxidation method., Result: PRT among 25-400 mg x L(-1) could enhance thymocytes and spleen lymphocyte proliferation and macrophage phagocytosis. PRT(200 mg x L(-1)) has the strongest macrophage proliferation. PRT in different concentration has shown some disoxidation effects. PRT in 8 g x L(-1) has nearly the same ability of clearing x OH by Vit C with the same concentration. The clearance rate of PRT on O2*- is 95.39%., Conclusion: PRT can enhance the cell proliferation capability of thymocytes, spleen lymphocytes and peritoneal macrophages. PRT can enhance macrophage phagocytosis in a dose-response relationship. PRT has saome disoxidation power and strong ability of clearing x OH and O2*-.

Objective: To study the clinical features of infantile hemangioma and vascular malformation, to find out a proper strategy of dealing with them., Methods: From March 2000 to August 2007, 2957 cases of infantile hemangioma and vascular malformation were treated, including 860 operative cases and 2097 non-operative cases. There were 441 male and 419 female patients in operation group, aging 6 months to 18 years (median 5 years). In 1950 hemangioma patients of non-operation group, there were 575 male and 1 375 female patients, aging 1 month to 14 years (median 6 months); in 147 vascular malformation patients of non-operation group, there 67 male and 80 female patients, aging 2 years to 17 years (median 7 years). In non-operative group, 147 vascular malformation patients and 1 525 infantile hemangioma patients were followed up without any medical intervention, while other 425 hemangioma patients received triamcinolone plus dexamethasone intralesional injection treatment. All the treatments and outcomes were recorded., Results: Vascular malformation cases and infantile hemangioma cases presented totally different clinical features. To the deadline of this study, 522 (34%) of 1 525 un-intervened hemangioma cases turned into involuted phase and 383 (90%) of 425 cases receiving triamcinolone plus dexamethasone intralesional injection treatment turned into involuted phase after injection treatment; no regression was noted in 147 cases of vascular malformation. The constituent ratio of infantile hemangioma in 860 operative cases was decreased gradually and the constituent ratio of vascular malformation was increased gradually as the age increasing., Conclusion: Infantile hemangioma has a distinct life pattern. Except several specific cases need medical intervention for their special location or large ambit and unacceptable growth, most infantile hemangioma need no medical intervention. Most vascular malformations can not regress spontaneously, proper intervention is in need.

Objective: To assess the efficacy and summarize the treatment experience in correction of recurrent pectus excavatum by the non-thoracoscopic minimally invasive Nuss procedure., Methods: From July 2003 to November 2007, 21 patients with recurrent pectus excavatum were treated with surgical repairs. Among them, there were 15 patients who underwent a Nuss procedure (the recurrent Nuss group), 13 males and 2 females, aged (13.31 +/- 4.21) years old, and the preoperative CT scan showed the mean Haller index was 3.98 +/- 0.94. The recurrence time of the depression after the primary operation was different: 2 patients with less than 1 year, 4 with 1-3 years, 7 with 3-5 years and 2 with over 5 years. There were 6 patients who underwent a modified Ravitch procedure (the recurrent Ravitch group), 5 males and 1 female, aged (13.67 +/- 2.23) years old, and the mean Haller index was 3.92 +/- 1.01. The recurrence time of the depression after the primary operation was as follows: 2 patients with less than 1 year, 1 with 1-3 years and 3 with 3-5 years. Another 119 patients had a primary Nuss procedure in the same period (the primary Nuss group), 95 males and 24 females, aged (7.79 +/- 3.59) years old, and the mean Haller index was 4.61 +/- 1.36. In terms of the age and the Haller index, there was significant difference between the recurrent Nuss group as well as the recurrent Ravitch group and the primary Nuss group (P < 0.05), but there was no significant difference between the recurrent Nuss group and the recurrent Ravitch group (P > 0.05)., Result: s All the patients were performed with the surgery successfully without any severe complications. The operation time, blood loss and postoperative hospitalization time of the recurrent Nuss group and the primary Nuss group were significantly less than those of the recurrent Ravitch group (P < 0.05), but there was no significant difference between the recurrent Nuss group and the primary Nuss group (P > 0.05). All the patients were followed up for 1.5-37.0 months (11.2 months on average). Except for 1 with plate displacement and 2 with suture reaction in the primary Nuss group who were readmitted to hospital, the other patients recovered well. The patients had perfect thoracic appearances with increased exercise tolerance and had a significantly improved psychological condition and an active social participation because of their improved appearances. The postoperative mean Haller index was 2.58 +/- 0.31, 2.77 +/- 0.48 and 2.52 +/- 0.34 in the recurrent Nuss group, the recurrent Ravitch group and the primary Nuss group, respectively, with significant difference compared with the preoperative mean Haller index in each group (P < 0.05)., Conclusion: Although the recurrent pectus excavatum repairs are technically more challenging than the primary surgery, the non-thoracoscopic Nuss procedure for reoperative correction is a safe, effective and reliable method.

Objective: To investigate the clinical feature, diagnosis and endoscopic surgery of choanal polyps (CP) from posterior ethmoid sinus., Method: Eleven cases with CP from posterior ethmoid sinus treated by endoscopic endonasal surgery between January 2002 to June 2007 were retrospectively reviewed. Clinical manifestation, intranasal and intrasinus lesions, methods and attentions of endoscopic surgery and therapeutic effects were analysed., Result: All cases were treated by endoscopic surgery and CP were found originated from posterior ethmoidal ostium. Lesions in posterior ethmoid sinus included 3 (27.3%) cyst, 5 (45.4%) polyp and 3 (27.3%) mucosal edema. No operation complications were observed. The follow-up period ranged from 6 months to 3 years (mean 1.2 years) and no recurrence was founded., Conclusion: Most of CP originated from posterior ethmoidal ostium and its formation might be related to the cyst in the sinus. Endoscopic surgery represents a minimally invasive and highly successful procedure, complete removal of CP and lesions in the sinus can reduce the recurrence.

Objective: To evaluate the effect of over-under myringoplasty technique on repairing tympanic membrane perforation regarding with the rate of perforation closure, the frequency of postoperative complications occurrence and the level of hearing improvement., Method: In this retrospective study, a total of 74 patients (77 ears) underwent myringoplasty and had been followed up for over 6 months, which was performed by means of the underlay technique in 44 patients (45 ears) and over-under technique in 30 patients (32 ears) from Jan 2002 to Jan 2007. In the underlay group, the grafted membrane was placed medial to the remaining drum and the manubrium of the malleus. In the over-under group, the grafted membrane was placed under the remaining drum and over the malleus. Comparatively evaluate the effect of the underlay technique and that of the over-underlay technique on repairing tympanic membrane perforation., Result: The rate of perforation closure and hearing improvement in the underlay group of 45 ears was 89.0% and 57.5% respectively, while that in the over-under group of 32 ears were 87.5% and 71.9% respectively. The air-bone gap decreased by 4.9 dB in the underlay group, while it decreased by 9.7 dB in over-under group. After more than 6 months of following-up, the frequency of postoperative atelectasis of the underlay group and the over-under group was 17.8% and 6.25% respectively. Meanwhile, the frequency of postoperative reperforation of these two groups was 5.9% and 6.25% respectively. Blunting of the anterior angle of the tympanic membrane occurred in 3 ears in the over-under group. Lateralization of the graft was not observed in either group., Conclusion: Over-under technique could reduce the occurrence of the adhesions between the grafted membrane and promontorium tympani by placing the grafted membrane between the remaining drum and the malleus. Furthermore, the level of hearing improvement in over-under group was higher than that in underlay group. Over-under myringoplasty is a more effective technique as comparison to underlay myringoplasty for repairing middle to large tympanic membrane perforations.

Germ cells exist in an environment created by Sertoli cells. The differentiation of germ cells from spermatogonia to sperm in the seminiferous epithelium is controlled by many factors such as hormones, growth factors, temperature and interaction with Sertoli cells. Paracrine signaling between these intimately associated cells also regulates the process of germ cell death. Sertoli cells' products play an important role in the process of germ cell differentiation in the testis, in which both the spontaneous and induced germ cell apoptosis often occur.

Since industrial revolution, a large amount of anthropogenic CO2 from fossil fuel combustion and deforestation has been emitted into atmosphere, and thus, the atmospheric CO2 concentration increased rapidly, while the delta 13C in atmospheric CO2 became lower and lower due to Suess effect. Therefore, the prediction of delta 13C is crucial for studying global changes. In order to make an accurate prediction, it is necessary to understand its historical variation. The dynamics of delta 13C in plants can sensitively reflect it. In this paper, the dynamics of delta 13C in atmospheric CO2 in the past 440 years in Aleitai, Xinjiang were reconstructed by using tree-ring delta 13C series and plant stable carbon isotope fractionation model. The results showed that atmospheric delta 13C value was relatively constant before 1,850 (R2 = 0.052), which was about -6.60@1000, while a sharp decrease in atmospheric delta 13C with an average of -7.02@1000 was found since 1,850 (R2 = 0.65). Compared with those from ice core bubbles, more fluctuations were found in atmospheric delta 13C derived from tree-ring series, possibly due to the higher resolution of the latter, and the difference of real atmospheric delta 13C between the growth site of the tree and the globe.

Objective: To establish digitized virtual Chinese No.1 female (VCH-F1) image database., Methods: A 19 years old female cadaver was scanned by CT, MRI, and perfused with red filling material through formal artery before freezing and em- bedding. The whole body was cut by JZ1500A vertical milling machine with a 0.2 mm inter-spacing. All the images was produced by Fuji FinePix S2 Pro camera., Results: The body index of VCH-F1 was 94%. We cut 8 556 sections of the whole body, and each image was 17.5 MB in size and the whole database reached 149.7 GB. We have totally 6 versions of the database for different applications., Conclusions: Compared with other databases, VCH-F1 has good representation of the Chinese body shape, colorful filling material in blood vessels providing enough information for future registration and segmentation. Vertical embedding and cutting helped to retain normal human physiological posture, and the image quality and operation efficiency were improved by using various techniques such as one-time freezing and fixation, double-temperature icehouse, large-diameter milling disc and whole body cutting.