ObjectiveTo observe the effect of Liuwei Dihuangwan on behavioral impairments in the rat model of autism spectrum disorder （ASD） and explore the mechanism of action. MethodsTwelve SD pregnant rats were intraperitoneally injected with valproic acid （VPA） （10 rats） or normal saline （2 rats）， and male offspring were selected to establish the model of ASD and the control rats. Rats were randomly assigned into model， low-dose （0.75 g·kg^-1） and high-dose （1.5 g·kg^-1） Liuwei Dihuangwan， vitamin D （positive drug， 3.7×10^-5 g·kg^-1）， and blank groups. Each group was administrated with the corresponding concentration of drugs or the same volume of normal saline by gavage for 2 weeks. After the intervention， the three-chamber social test was conducted to evaluate social interaction and social preference. The open field test was carried out to observe spontaneous behavior and anxiety state. Hematoxylin-eosin staining （HE） was used to observe the pathological changes of the prefrontal tissue. Transmission electron microscopy was employed to observe the ultrastructure of mitochondria in prefrontal neurons. Immunofluorescence was used to detect the expression of ionized calcium-binding adapter molecule-1 （Iba-1） in the prefrontal tissue. Enzyme-linked immunosorbent assay （ELISA） was adopted to measure the levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6）. Western blot was employed to assess the expression differences of phosphorylated adenosine monophosphate-activated protein kinase （p-AMPK）， adenosine monophosphate-activated protein kinase （AMPK）， phosphorylated Unc-51-like autophagy-activating kinase 1 （p-ULK1）， Unc-51-like autophagy-activating kinase 1 （ULK1）， and FUN14 domain-containing protein 1 （FUNDC1）. ResultsCompared with the blank group， the model group spent less time sniffing stranger 1 and stranger 2 in the three-chamber social test （P<0.01） and showed reductions in the total distance traveled， average speed， distance traveled in the central area， and time spent in the central area in the open field test （P<0.01）. In addition， the model group showed extensive apoptosis of neurons， with shrunken nuclei and red-stained cytoplasm， and extensive necrosis of neurons in the prefrontal tissue， mitochondrial swelling， decreased matrix density， disrupted cristae， and autophagic lysosomes in neurons， increases in the rate of Iba-1 positive cells in the prefrontal area （P<0.01） and the levels of TNF-α and IL-6 （P<0.01）， and down-regulation in the expression of p-AMPK/AMPK， p-ULK1/ULK1， and FUNDC1 （P<0.01）. Compared with the model group， low-dose and high-dose Liuwei Dihuangwan and the vitamin D prolonged the time spent sniffing stranger 1 and stranger 2 in the three-chamber social test （P<0.05， P<0.01）， increased the total distance traveled， average speed， distance traveled in the central area， and time spent in the central area in the open field test （P<0.05， P<0.01）， restored the morphology of neurons in the prefrontal tissue， decreased the number of apoptotic cells， alleviated the swelling of mitochondria in neurons， increased the matrix density， mitigated the fragmentation and disorder of cristae， and increased the number of autophagosomes. Moreover， the drugs decreased the rate of Iba-1 positive cells in the prefrontal area （P<0.01）， lowered the levels of TNF-α and IL-6 （P<0.01）， and up-regulated the expression of p-AMPK/AMPK， p-ULK1/ULK1， and FUNDC1 （P<0.01）. ConclusionLiuwei Dihuangwan ameliorate autism-like behaviors and reduce neuronal apoptosis and neuroinflammatory damage in the rat model of ASD by promoting mitophagy mediated by the AMPK/ULK1/FUNDC1 pathway.

Objective:To explore the clinical manifestations, recurrence factors, and outcomes of revision surgery for recurrent thyroglossal duct cysts and fistulas in children. Methods:A retrospective study was conducted on the clinical manifestations, the relationship between cysts/ fistulas and residual hyoid bone of 10 patients with recurrent thyroglossal cysts and fistulas admitted to our hospital from July 2015 to July 2023, as well as the methods and effects of revision surgery. Results:The recurrence time after the initial surgery was between 7 months and 6 years, with an average of 2 years and 1 month.Clinical manifestations: 50%（5 cases） of patients have recurrent cysts near the incision, 40%（4 cases） had recurrent infections at the incision and eventually form fistulas, and 10%（1 case） experienced sleep snoring and pharyngeal trouble, were diagnosed with lingual thyroglossal duct cyst through laryngoscopy. All cysts or fistulas are connected to residual hyoid bodies, and three cases have intact hyoid bodies.Revision surgery: Nine cases underwent modified Sistrunk surgery, removing cysts, fistulas, and residual hyoid bodies. Suspension laryngoscopy and coblation were employed to treat the lingual thyroglossal duct cyst. After the revision surgery, follow-up was conducted for 8 months to 3 years, and no recurrence was found. Conclusion:All recurrences of thyroglossal duct cysts in this study were associated with residual hyoid bodies. Therefore, for thyroglossal duct cysts or fistulas, whether it is the first surgery or a revision surgery, it is recommended to choose the optimized Sistrunk operation, with the key point being complete resection of the hyoid body. Cases with lingual thyroglossal duct cyst can be treated with suspension laryngoscopy by coblation. Whether to remove the residual hyoid body requires further observation.
Humans ; Thyroglossal Cyst/surgery* ; Retrospective Studies ; Recurrence ; Reoperation ; Fistula/surgery* ; Child ; Hyoid Bone/surgery* ; Male ; Female ; Treatment Outcome ; Laryngoscopy ; Child, Preschool

Objective:To explore the clinical efficacy of the coblation resection of lingual thyroglossal duct cysts under self-retaining laryngoscopy. Methods:A retrospective analysis was conducted on the clinical data of 22 patients with lingual thyroglossal duct cysts admitted to our hospital from December 2016 to December 2023. There were 16 males and 6 females, aged 2 years to 12 years and 3 months（mean: 4 years 1 month; median: 3 years 3 months）. The lingual thyroglossal duct cysts were removed by coblation under self-retaining laryngoscopy. If the cysts could not be removed completely, the epithelial cells of the remaining cysts would be ablated. Results:There were 22 cases of lingual thyroglossal duct cysts，13 cases （59.1%） of lingual thyroglossal duct cysts had laryngeal stridor and dyspnea. The postoperative follow-up period is 3 months to 7 years. 11 cases （50.0%） underwent secondary laryngoscopic evaluation.There were 4 cases of recurrence （18.2%）, with no laryngeal obstruction,bleeding, or nerve damage. Conclusion:Laryngeal stridor and dyspnea are the main clinical symptoms of lingual thyroglossal duct cysts in children. The coblation resection of lingual thyroglossal duct cysts under self-retaining laryngoscopy is safe and effective. Cyst recurrence correlates strongly with residual cyst walls, emphasizing the need for enhanced intraoperative visualization and refined surgical precision.
Humans ; Thyroglossal Cyst/surgery* ; Male ; Female ; Child ; Retrospective Studies ; Child, Preschool ; Laryngoscopy/methods* ; Treatment Outcome ; Catheter Ablation/methods*

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Objective To analyze the clinical outcomes of early invasive fungal disease(IFD)in patients after allogenetic hematopoietic stem cell transplantation(allo-HCST)with metagenomic next-generation sequencing(mNGS).Methods A retrospective analysis was conducted on patients undergoing allo-HCST in our Bone Marrow Transplantation Center between July 2021 and October 2022.These patients experienced one of the following conditions within 100 d after transplantation:① Patients with persistent fever and negative blood culture after empiric antimicrobial therapy for 72 h or longer;② Hyperpyrexia of unknown origin occurred again after effective anti-infection in the past;③ Symptoms in lower respiratory tract associated with lung lesions on CT scan,and empiric anti-infective therapy was ineffective.Peripheral blood or bronchoscopic alveolar lavage fluid were tested with mNGS,and overall survival(OS)and non-relapse mortality(NRM)were analyzed.Results There were 60 patients enrolled in this study.For the peripheral blood samples of 47 cases and bronchoalveolar lavage fluid samples of 13 cases,mNGS found that 19 cases were negative to pathogens,30 cases were non-fungal positive,and 11 case were fungal positive,including 3 cases of aspergillus,5 cases of mucor,2 cases of Candida tropicalis,and 1 case of Trichosporon asahii.Of the 11 patients with fungal positive,8 achieved complete remission after antifungal therapy according to the mNGS results.The 1-year OS and NRM of the 60 patients were 70.0％(95％CI:64.1％～75.9％)and 20.0％(95％CI:11.9％～32.5％),respectively,while those of the fungal infection patients were 54.5％(95％CI:49.5％～69.5％)and 36.4％(95％ CI:15.5％～70.3％),respectively.No significant differences were seen in 1-year OS(P=0.487)and 1-year NRM(P=0.358)among the negative,fungal infection and non-fungal infection patients,neither OS(P=0.238)and NRM(P=0.154)between the fungal infection and the non-fungal infection patients.Conclusion mNGS can rapidly diagnose the early IFD after allo-HSCT,which is helpful for timely and effective treatment and improves the prognosis of patients.

Objective To investigate the effect of intrarectal local anesthesia (IRLA) with heated oxybuprocaine gel on pain during transrectal ultrasound guided prostate biopsy (TRUSPB).Methods A total of 150 cases patients who underwent TRUSPB in Huzhou Central Hospital from January to June 2023 were prospectively taken into.The patients were randomly divided into group A (routine group),group B (oxybuprocaine gel for IRLA at room temperature) and group C (oxybuprocaine gel for IRLA at 40℃),with 50 cases in each group.Nurses who were unaware of the anesthesia type used visual analog scale (VAS) to score the pain level of patients at each stage (VAS Ⅰ:when the ultrasound probe was inserted into the rectum;VAS Ⅱ:during the biopsy;VAS Ⅲ:30 minutes after biopsy),and the incidence of complications after biopsy were compared.Results The VAS Ⅱ score of group C was lower than that of group A and group B,and the difference was statistically significant (P<0.05).There was no statistically significant difference (P>0.05) in the VAS Ⅰ,VAS Ⅲ scores,and incidence of complications after biopsy among the three groups.There was no allergic reaction to oxybuprocaine gel.Conclusion In TRUSPB,IRLA with heated oxybuprocaine gel can effectively control pain without increasing incidence of complications.

Objective To analyze the chemical compounds of Shenqi Dihuang decoction by the ultraperformance liquid chromatography coupled with linear quadrupole ion trap-orbitrap mass spectrometry (UPLC-LTQ-Orbitrap-MS). Methods Warters ACQUITY UPLC HSS T3 (2.1 mm ×100 mm, 1.8 μm) was used as chromatographic column with mobile phase: 0.1% formic acid water (A)-0.1% formic acid acetonitrile (B) with gradient elution, and flow rate was 0.3 ml/min. Electrospray ion source (ESI) and an electrostatic field orbital ion trap mass analyzer were adopted, which was used to collect mass spectrometry fragment information with positive and negative ion modes, by comparing with the relative retention time of the reference substance. In addition, the fragment information of the mass spectrum was used to identify the compounds. The accurate identification of the chemical components in Shenqi Dihuang decoction was confirmed with literature. Results The study found that UPLC-LTQ-Orbitrap-MS technology could be used to identify 62 chemical components, including 13 aromatic acids, 9 flavonoids, 8 saponins, and 5 aromatic amines, 3 keto acids, 2 phenols, 1 aromatic quinone and other ingredients in Shenqi Dihuang decoction. Conclusion The identification analysis method in this study was efficient and accurate, which could be applied to the identification and analysis of chemical components in Shenqi Dihuang decoction and provided the important experimental data for the research on the material basis and mechanism.

ObjectiveTo evaluate the efficacy and safety of 7 atypical antipsychotics combined with selective serotonin reuptake inhibitors（SSRIs） in the treatment of refractory obsessive-compulsive disorder by network Meta-analysis. MethodsRandomized controlled trials （RCTs） about atypical antipsychotics and SSRIs in the treatment of refractory obsessive-compulsive disorder were searched in CNKI， Wanfang Data， VIP， CBM， PubMed， Embase and Cochrane Library databases from inception to June 2020. Based on inclusion and exclusion criteria， the literature screening， date extraction and assessing risk of bias were performed by two researchers independently. Then all statistical analyses were performed using Stata 15.0 software. ResultsA total of 36 RCTs covering 7 atypical antipsychotics and 2 362 patients were included. Network Meta-analysis showed that the surface under the cumulative ranking （SUCAR） of total response rate was the largest in Olanzapine + SSRIs， followed by Paliperidone + SSRIs， Amisulpride + SSRIs， Risperidone + SSRIs， Quetiapine + SSRIs， Ziprasidone + SSRIs， Aripiprazole + SSRIs， SSRIs， and Placebo + SSRIs in turn. In terms of Hamilton Anxiety Scale （HAMA） score， the SUCAR was the largest in Amisulpride + SSRIs， followed by Aripiprazole + SSRIs， Quetiapine + SSRIs， Risperidone + SSRIs， and SSRIs in turn. In terms of Treatment Emergent Symptom Scale （TESS） score， the SUCAR was the largest in Amisulpride + SSRIs， followed by SSRIs， Paliperidone + SSRIs， Quetiapine + SSRIs， Ziprasidone + SSRIs， Risperidone + SSRIs， Aripiprazole + SSRIs， and Placebo + SSRIs in turn. ConclusionCompared with single application of SSRIs， its combination with atypical antipsychotics achieves better efficacy and higher safety in treating refractory obsessive-compulsive disorder， with Olanzapine+SSRIs being the most effective and Amisulpride+SSRIs the safest.

Objective: To investigate the Effects of entinostat on the expression of NKG2D ligands in the non-small cell lung cancer (NSCLC) cell lines, A549 and HCC-827, and to detect the effect of entinostat-mediated NK cell killing of A549 and HCC-827 cells. Meth-ods: The effect of entinostat on A549 and HCC-827 cell proliferation was measured by MTT assay. Flow cytometry was used to detect the expression of NKG2D ligands. mRNA levels of the ligands were detected by RT-PCR . The level of soluble MICA in cell culture super-natant was evaluated by ELISA. The cytotoxicity of NK cells against A549 and HCC-827 cell lines (treated with entinostat) was assessed using lactate dehydrogenase release assay. Results: Entinostat showed a time-and dose-dependent inhibition effect on the prolifera-tion of A549 and HCC-827 cell lines. The expression of NKG2D ligands and mRNA transcription levels of MICA and MICB were en-hanced after treatment with 0.5, 1μmol/L entinostat for 48 h. The soluble MICA level in A549 cell culture supernatant was increased by 1μmol/L entinostat. The sensitivity of HCC-827 cells to NK cells was enhanced upon treatment with 0.5, 1μmol/L entinostat. Con-clusions: entinostat enhanced the killing effect of NK cells on non-small cell lung cancer cells by up-regulating the expression of NKG2D ligands. This provides a new method and theory for the treatment of NSCLC.

Objective:To observe the influence of methylprednisolone in the respiratory mechanical parameters in the elderly patients undergoing major surgeries with general anesthesia intubation after mechanical ventilation,and to investigate whether methylprednisolone can improve the respiratory system degenerative diseases and benefit the mechanical ventilation. Methods:Sixty patients undergoing elective line laparotomy were divided into experimental group and conrol group (n=30) according to their wishes.The patients in experimental group receieved intravenous injection of methylprednisolone 1 mL (40 mg) after endotracheal intubation,and the patients in control group receieved 1 mL intravenous saline water injection.The airway peak pressure (Ppeak), airway platform (Pplat), lung compliance (Compl), and airway resistance (Raw) of the patients in two groups were recorded at the time of immediately before administration and 10,20,30,40 min after administration.The arterial blood oxygen partial pressure(PaO2),arterial blood CO2 partial pressure(PaCO2),CO2 partial pressure at the end of breathe out(PetCO2) of the patients were detected at the time of immediately before administration and 20 min after administration.Results:Compared with before administration, the respiratory mechanics parameters of the patients in control group 10,20,30,40 min after administration had no statistically significant differences (P>0.05);the Comple of the patients in experimental group was singnificantly increased (P<0.05), and the Ppeak, Pplat,and Raw were significantly decreased (P<0.05).Compared with control group, the Compl of the patients in experiment group 10,20,30,and 40 min after administration were significantly increased (P<0.05),and the Ppeak, Pplat, and Raw were decreased (P<0.05).Compared with before administration,the PaO2,PaCO2,and PetCO2 of the patients in control group 20 min after administration had no significant differences(P>0.05);the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Compared with control group,the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Conclusion:Methylprednisolone can obviously reduce PaCO2,Peak, and Pplat and increase PaO2 and Compl;methylprednisolone has possibility in improving the adverse effects of degenerative disease of respiratory system on general anesthesia in the elderly patients.