ObjectiveTo study a practical individualized computer-aided design project for cranioplasty in Chinese mainland. Methods6 patients with cranial defect was performed superthin skull CT,three-dimension reconstruction. The template for the skull defected was made simulating the shape and contour of cranial defect. after patient,s consent,silicone rubber terylene patch was made as a substrate for the repair of cranial defect. ResultsThis project provides a good result,especial an excellent cosmetic result. No side-effect appears,operation time is shorter than ever.ConclusionAn individual project for computer-assisted cranioplasty has been finished,which can be popularized for its value.

Bladder cancer (BC) is a common malignant tumor of the urinary system. Common white light cystoscopy is the most important method in the diagnosis and treatment of BC, but its ability to identify small tumors and residual tumors at surgical sites is limited, so it is urgent to develop new diagnosis and treatment techniques. With the rise of the concept of precision medicine, a group of targeted molecules that can specifically bind to BC at the cellular and molecular levels have been discovered in recent years, and the molecular image and targeted therapy based on them can significantly improve the diagnosis and treatment efficiency of BC, with a great potential for clinical application. Based on the latest progress and the research work of our research group, this paper comprehensively analyzes and systematically summarizes the application of targeted molecular carriers in the diagnosis and treatment of BC.

Objective:Bioinformatics method was used to screen out prognostic model constructed by the tumor microenvironment (TME)- related genes of adrenocortical carcinoma (ACC), and the prognostic model was verified to provide clinical guidances and related biomarkers for the diagnosis and treatment of ACC.Methods:Transcriptome and clinicopathological data of 79 ACC patients were collected from the Cancer Genome Atlas (TCGA) database. ESTIMATE algorithm was used to calculate immune score, stromal score (both reflect TME) and ESTIMATE score; VennDiagram was used to select differentially expressed genes among immune score, high and low stromal score groups (grouped by median value); Gene Ontology (GO) database and Kyoto Encyclopedia of Genes and Genome (KEGG) database were used to perform functional enrichment analysis on selected genes and to explore the potential function and pathway of genes. Univariate Cox analysis, lasso regression analysis and multivariate Cox analysis were used to screen out genes related to ACC TME and to establish risk score (RS) model for ACC patients. The receiver operating characteristic (ROC) curve was used to evaluate the prognostic value of RS. The data sets GSE33371 and GSE19750 of Gene Expression Omnibus (GEO) were used as external validation sets to validate the prognostic model. The data of 79 ACC patients were extracted from the TCGA database, and the clinicopathological factors and the RS of the established prognostic model were included in the Cox regression analysis to obtain the prognostic factors of ACC patients.Results:According to the immune score and stromal score, 1 205 differentially expressed genes from intersection of both scores were screened out by using VennDiagram, including 833 up-regulated genes and 372 down-regulated genes. After continuing the regression analysis and screening of differentially expressed genes, the ACC prognostic model containing 9 TME-related genes (GREB1, POU4F1, HIC1, HOXC9, CACNB2, RAB27B, ZIC2, C3, CYP2D6) was finally constructed, that was, RS = GREB1×0.223 6+POU4F1×0.671 7+HIC1×0.167 5+HOXC9×0.211 3+CACNB2×0.156 0+RAB27B×0.956 5+ZIC2×0.582 7+C3×(-0.003 1)+CYP2D6×0.819 3. The area under the curve (AUC) of ROC for the 1, 3, and 5-year overall survival of 79 ACC patients predicted by the model in the TCGA database was 0.876, 0.919, 0.917, respectively. In the GEO validation set, the AUC of the 1, 3, and 5-year overall survival for 45 ACC patients predicted by the model was 0.689, 0.704, and 0.708, respectively, indicating that the model had a high prediction accuracy for survival results of ACC patients. Cox regression analysis on the data of 79 ACC patients in the TCGA database showed that the TME-related gene prognostic model RS was an independent factor influencing the prognosis of ACC patients ( HR = 1.011, 95% CI 1.005-1.016, P < 0.01). Conclusions:The established ACC TME-related gene prognostic model can be used to predict the prognosis of ACC patients. The model including 9 genes may become a new target for studying the pathogenesis and immunotherapy of ACC, and it is worthy of further research.

TCM for the improvement of nasal mucosa remodeling after chronic sinusitis endoscopy is the key to the effective prevention of new lesions and recurrence in the surgical cavity mucosa.This article reviewed the mechanism of the nasal mucosa remodeling phenomenon after chronic sinusitis endoscopy and the unique advantages of TCM treatment.Deficiency,phlegm and blood stasis leading to"lung loss"is the perennial root of nasal mucosa remodeling.The treatment is"tonifying deficiency and removing phlegm,invigorating qi and promoting blood circulation",using acupuncture and medicine,and both internal and external treatment to regulate Th17/Treg balance and reduce the inflammatory infiltration;blocking the phosphorylation of MAPK and NF-κB pathway to inhibit TGF-β1-induced myofibroblasts,reduce collagen deposition and inhibit their remodeling,and promote the process of mucosal epithelialization,which can provide ideas for the theoretical and clinical treatment of TCM prevention and treatment of nasal mucosa remodeling.

Objective To use the "three-dimensional quality structure" model as a theoretical basis, based on multiple evidence-based evidence, to construct ICU nursing sensitivity quality indicators, and to provide reference for the evaluation and monitoring of ICU department nursing safety quality. Methods Evidence-based and Delphi methods were used to complete 3 rounds of inquiry among 27 experts to obtain consensus opinions of experts and to determine nursing quality indicators. Results Of the 30 articles included, 17 wereⅢA, 10 wereⅣA, 2 wereⅤA, and 1 wasⅤB. According to the"three-dimensional structure theory"model, the included indicators were sorted out and a total of 12 items were obtained. The effective recovery rate of 3 rounds of questionnaires was 96.6％, 100.0％, and 96.4％. The authoritative coefficients were 0.899, 0.895, and 0.909, and the coordination coefficients of the first, second, and third indexes were 0.340, 0.379, and 0.403, respectively,with significance (P<0.01). The final ICU nursing sensitivity quality indicator consists of 3 first-level indicators, 15 second-level indicators and 69 third-level indicators. The selection of indicators at all levels gradually converges. Conclusions The established ICU nursing sensitivity quality index accords with the principle of scientificity and practicality, and can be used for ICU department nursing quality assessment.

OBJECTIVE To compare the influence of age on the recovery of sudden sensorineural hearing loss.METHODS Detailed medical data of patients were reviewed.The patients were diagnosed as sudden sensorineural hearing loss from Jan 2010 to June 2018 and accepted treatments with neurotrophic drugs,steroid or hyperbaric oxygen.Age grouping was performed by every 5 years'interval.The treatment efficacy and hearing improvement were compared according to the age.RESULTS There were one hundred and sixty-three patients in this study.The majority of patients had moderate or above hearing loss,and most of the hearing curve was flat and profound type.The overall recovery rate was 56.44%,hearing gain was averaged 21.88 dB.55-60 years group had largest number of patients in the 11 age groups.Even with different treatment,the patients aged 57-66 years had the bad recovery,including the hearing gain data and total effective rate.CONCLUSION Ages has influence on the recovery of sudden sensorineural hearing loss,it maybe correlated with the etiology and patients'condition.

ObjectiveTo establish a polymerase chain reaction（PCR） method to accurately discriminate the crude materials of Murrayae Folium et Cacumen， Murraya exotica and M. paniculata. MethodBased on the difference in chloroplast genome sequences of M. exotica and M. paniculata， species-specific identification primers P03 and P04 of M. exotica and M. paniculata were designed according to single nucleotide polymorphism （SNP） on the chloroplast genome. A multiplex allele-specific PCR identification method was established for the identification of M. exotica and M. paniculata following the optimization of annealing temperature， number of cycles， and primer concentration ratio. The established PCR method for identification was explored and verified in terms of tolerance and feasibility by investigating the type of Taq polymerases and PCR system model. ResultIn this multiplex allele-specific PCR identification method， about 330 and 230 bp of specific fragments were amplified from DNA templates of M. exotica and M. paniculata， respectively， under the following conditions：cycle number of 31， annealing temperature of 60 ℃， and primer concentration ratio of P03 and P04 of 1∶2. Consistent results were obtained for samples from different sources. ConclusionThe multiplex allele-specific PCR identification method established in this study can accurately identify the origin of Murrayae Folium et Cacumen， which can be used for the simultaneous identification of M. exotica and M. paniculata by the length of fragments in a single identification assay.

Alcoholic liver disease (ALD) is a growing global health concern, and its early pathogenesis includes steatosis and steatohepatitis. Inhibiting lipid accumulation and inflammation is a crucial step in relieving ALD. Evidence shows that puerarin (Pue), an isoflavone isolated from Pueraria lobata, exerts cardio-protective, neuroprotective, anti-inflammatory, antioxidant activities. However, the therapeutic potential of Pue on ALD remains unknown. In the study, both the NIAAA model and ethanol (EtOH)-induced AML-12 cell were used to explore the protective effect of Pue on alcoholic liver injury in vivo and in vitro and related mechanism. The results showed that Pue (100 mg·kg^-1) attenuated EtOH-induced liver injury and inhibited the levels of SREBP-1c, TNF-α, IL-6 and IL-1β, compared with silymarin (Sil, 100 mg·kg^-1). In vitro results were consistent within vivo results. Mechanistically, Pue might suppress liver lipid accumulation and inflammation by regulating MMP8. In conclusion, Pue might be a promising clinical candidate for ALD treatment.