Objective:To investigate the possibility of predicting facial nerve involvement in the pa-tients with parotid tumors using facial electroneurography (ENoG).Methods:In the study, 53 patients with primary parotid tumors were included in the study , 28 were benign tumors and 25 were malignant . There was no significant difference of tumor locations and sizes between the two groups . House-Brackmann facial nerve function evaluation was gradeⅠin all the patients who received examination of fa-cial electroneurography , including stimulation strength , amplitude , and latent time bilaterally .The facial electroneurography results in the affected side were compared with the results of contralateral normal side , intraoperative appearance and postoperative histopathological diagnosis .The facial electroneurography results were analyzed by Wilcoxon signed rank test and receiver operator characteristic ( ROC) curve. Results:During the facial electroneurography examination , the mean stimulation strength in the patients with benign parotid tumor was 20.0 mA.There was significant decrease in the amplitude at the affected side compared with the normal side upon posterior auricular stimulation ( P<0 .05 ) .But there was no significant difference in the latent time between the bilateral sides (P>0.05).However, in the patients with malignant parotid tumor , the mean stimulation strength was higher at 24.5 mA.There was signifi-cant decrease in the amplitude or even no response at the affected side compared to the normal side upon posterior auricular stimulation ( P<0 .05 ) .No response was detected in the multiple branches of facial nerve of affected sides in 36 .0%patients upon posterior auricular stimulation .The amplitude of branchesⅢand Ⅳwas significantly lower at the affected side than that at the normal side upon anterior auricular stimulation (P<0.05).The area under the ROC curve for ENoG was 0.884.Conclusion: When the facial nerve was involved by the parotid tumors , the stimulation strength in the electroneurography was larger .There was significant difference in the amplitude and the latent time of the facial nerve between the affected side and the normal side upon the posterior auricular stimulation .The rate of absence of reac-tion wave was higher in the patients with malignant tumors .It was feasible to predict the facial nerve in-volvement by ENoG for the parotid gland tumor patients without clinical appearances of facial paralysis .

The evaluation of the immunosuppression state in liver transplanted recipients is vital for a correct posttransplantation management and a major step towards the personalized treatment of the immunosuppression.To date,immunological monitoring after liver transplantation relies mainly on clinical judgment and pathological examination of the graft,without a proper assessment of the actual state.Previous studies have ever identified many markers for acute rejection(AR) and immune tolerance after liver transplantation.Many markers for AR are pro-inflammatory or immunoregulatory cytokines and other proteins related to inflammation.However,many markers have been proved to be also able to predict other diseases and only a few of the markers for AR have been validated.Standard liver tests cannot be used as markers for graft rejection due to the low sensitivity and specificity.This review summarized the potential markers for AR and immune tolerance after liver transplantation based on published literatures in recent years and to provide evidence for clinical application.

AIM: To study the mechanism of diabetic cardiomyopathy and abnormality of oxygen free radicals. METHODS: The contents of myocardial cytosolic cytochrome C, mitochondria cytochrome C, mitochondrial calcium, NO, MDA and the activity of SOD and NOS were determined in diabetic rats induced by STZ. The pathological changes were observed under transmission electron microscope. RESULTS: Compared to the normal and ganoderma group, the levels of mitochondrial NO, iNOS, MDA, calcium and plasma Cyt-C in rat myocardium were higher (P<0.05), while mitochondrial Cyt-C and SOD were lowered in model group (P<0.05). The bouncary indistinct, disorganization, a focal loss of muscular fibril, myocardium mitochondria swelling, pulmonary vascular endothelial cellular swelling and obstructed lumen of the capillary were also observed under transmission electronic microscope. CONCLUSION: The findings indicate that oxyradical and lipid peroxidation might be associated with the damage of myocardial mitochondria in NIDDM rats. Cyt-C and mitochondrial calcium is also involved in the process.

Objective To explore the treatment of locally advanced pancreatic cancer(LAPC)by Nanoknife,and the demonstrations on contrast enhanced ultrasonography(CEUS)after the procedures. Methods Four patients were enrolled.Each of them was percutaneously inserted 3-5 Nanoknife electrodes to ablate the lesions with 2-3 sessions under the guidance of ultrasound.After the procedures,CEUS, contrast enhanced CT,contrast enhanced MRI or computed tomography angiography (CTA) were performed to assess the efficacy.Results All patients uneventfully were able to tolerate the high-voltage Nanoknife procedures.However,the endurable pain or discomfort in abdomen was complained.For one patient with obstructive jaundice and mild liver dysfunction,pancreatic amylase in serum increased slightly at the first day after treatment.Furthermore,C response protein in serum elevated,and biliary tract infection happened at the third day.Moreover,thromboses in portal and splenic vein were found at the seventh day.The survival time for all cases were 3-8 months.According to the findings of CEUS,a well-defined no contrast enhancement was detected at ablative zone for all the patients within one week.Yet, contrast enhancement was sporadically detected at the periphery in 3 patients 1-2 months late.Meanwhile, on contrast enhanced CT or MRI,an area of absent enhancement was also depicted at the ablation zone with heterogeneously decreased enhancement at periphery of the lesion.Base on CTA findings,local stenosis of splenic vein and superior mesenteric vein with varices of collateral vascularity were found in one patient at the fiftieth day,and superior mesenteric vein obstruction accompanied by varices of collateral vascularity was also found in another patient at the seventieth day.Conclusions For patients with LAPC,Nanoknife treatment is a safe and convenient procedure that can be percutaneously completed under the guidance of ultrasound.Along with enhanced CT,MRI or CTA,CEUS is a promising way to evaluate the efficacy of this procedure.

Objective:To study the risk factors of Budd-Chiari syndrome (BCS) associated with hepatocellular carcinoma in patients who underwent endovascular recanalization.Methods:The data of 340 patients with BCS who underwent endovascular recanalization at the Affiliated Hospital of Xuzhou Medical University between January 2015 and June 2021 were retrospectively collected. Using propensity score matching, a total of 57 patients (40 males and 17 females) were enrolled into this study, with the age of (50.4±8.7) years. Patients were divided into the hepatocellular carcinoma group ( n=19) and the control group ( n=38) according to whether occurrence of hepatocellular carcinoma after cardovascular recanalization. Preoperative indicators including gender, age, BCS type, and model for end-stage liver disease (MELD) score, and postoperative indicators including alpha fetoprotein, intrahepatic nodule formation, vascular restenosis, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were compared between the two groups after propensity score matching. Multivariate logistic regression analysis was used to analyze the risk factors of BCS associated with after endovascular recanalization in these patients. Results:There were no significant differences in gender, age, BCS type, MELD score and other preoperative data between the two groups (all P>0.05). The proportions of patients with postoperative alpha fetoprotein>9.0 μg/L, AST>40 U/L, ALT>50 U/L, intrahepatic nodules and vascular restenosis after endovascular treatment in the hepatocellular carcinoma group were significantly higher than those in the control group (all P<0.05). Multivariate analysis showed postoperative alpha fetoprotein >9.0 μg/L ( OR=46.778, 95% CI: 3.310-661.140), AST>40 U/L ( OR=36.307, 95% CI: 1.317-1 001.009), intrahepatic nodule formation ( OR=66.254, 95% CI: 4.225-1 038.974) and vascular restenosis ( OR=16.276, 95% CI: 1.712-154.773) to have an increased risk of being associated with hepatocellular carcinoma in these BCS patients (all P<0.05). Conclusion:Postoperative alpha fetoprotein>9.0 μg/L, AST>40 U/L, intrahepatic nodule formation and vascular restenosis were independent risk factors of BCS associated with hepatocellular carcinoma in patients who underwent endovascular recanalization.

Objective To evaluate the developmental and functional outcome of condylar fractures in children and adolescents after conservative treatment.Methods Eight children and adolescents with unilateral condylar fracture, aged 5-13 were included.A removable occlusal splint, the thickness of which was determined according to the age, the developmental stage of the dentition, the level of the fracture and the degree of dislocation, worn for 1-3 months, and the patients were asked to perform functional exercises.The patients were followed up by clinical observation, panoramic radiograph, temporomandibular joint(TMJ) cone beam computed tomography(CBCT), and surface electromyography(sEMG) of masticatory muscles (superficial masseter, anterior temporalis, and anterior digastric muscles).Ramus height and body length of mandible were measured on panoramic radiograph.The patients were asked to return for follow-up visits at 1, 3, and 6 months after treatment, and then once a year.The patients underwent clinical examination at each follow-up visit, and radiological examinations at 6 months and then annually.Results All the patients showed clinically satisfactory results.CBCT showed smooth and continuous cortex.Panoramic X-ray revealed that the ramus height was shorter in the fractured side than in the contralateral side, while body length was longer.The mean asymmetry index(AI, (x) ± s) for ramus height and body length were (3.29±2.68)％ and (4.01 ± 2.54)％.sEMG showed either hypertension or hypotension in the masticatory muscles of the fractured side and asymmetries were obvious.The mean AI for sEMG activity of the anterior temporalis, masseter, and anterior digastric muscle were masseter: (15.0 ± 16.9)％;anterior temporalis: (21.5 ± 15.9)％;anterior digastric muscles: (11.9 ± 10.7)％.Conclusions Conservative treatment of condylar fracture in children and adolescents had clinically satisfactory results, while mandibular development was slightly interrupted.Asymmetries of EMG activities of masticatory muscles were obvious.EMG could objectively reveal the functional recovery of condylar fracture in children.

Objective To evaluate and analysis facial somatosensory changes of patients with chronic masticatory muscle pain(MMP) quantitatively.Methods The seven parameters of standardized quantitative sensory testing(QST) protocol were used to test the pain sites,contralateral sites of masticatory muscles of 20 chronic MMP patients and the same sites of right masticatory muscles of 20 matched healthy controls.QST thresholds were compared within groups using paired t test and between groups using unpaired t test.Results Compared to the controls,all seven parameters of bilateral sides of patients had changed.Mainly cold detection thresholds[(-1.2±0.5) and (-1.7±0.9) ℃] and cold pain thresholds[(27.6±2.3) and (27.0±2.0) ℃] of pain and contralateral sides increased significantly,while warm detection thresholds[(2.0± 1.1) and (2.1± 1.2) ℃],heat pain thresholds[(37.9±3.2) and (39.7±3.9) ℃],and mechanical pain thresholds [(49.3 ± 34.1) and (111.8 ± 86.3) mN] of pain and contralateral sides decreased significantly(P＜0.05).Mechanical detection thresholds of pain sites[(1.8± 1.4) mN] significantly increased(P=0.01).Conclusions Chronic MMP patients were detected thermal hyperesthesia,thermal hyperalgesia,and mechanical hyperalgesia.Mechanical hypoesthesia was found at the pain sites of masticatory muscles.Chronic MMP might influence the central modulation of trigeminal nerve system.

Objective To evaluate masticatory performance and life quality of children with ectodermal dysplasia(ED) after prosthetic rehabilitation.Methods Six children with ED received denture restoration and 18 healthy children were involved in this study.The surface electromyography(EMG) of masseter(MM) and anterior temporalis(TA) during clenching and chewing movement were recorded.The EMG amplitude,area,asymmetry index of total and activity index of MM/TA were compared at each stage.The masticatory efficiency was measured with spectrophotometer.The life quality was assessed using visual analogue scale questionnaire.Results The EMG amplitude of MM and TA during chewing in ED Group were 41.7％ and 45.6％ of the control group respectively,the area were 35.9％ and 36.0％ respectively.Significant difference in asymmetry index of total during clenching was observed between the two groups (P＜0.05) but not during chewing(P＞0.05).The differences of activity index of MM/TA during clenching and chewing between the two groups were not detected(P＞0.05).The masticatory efficiency of ED group was 67.2％ of the control group.The score of chewing function in children with ED after prosthetic rehabilitation was three times higher than before,and no difference was present between the two groups (P＞0.05).Conclusions Early prosthetic rehabilitation can significantly improve the masticatory performance and life quality of children with ED.

Objective:To construct and preliminary evaluate a survival prediction model for immunosuppressant treatment of advanced non-small cell lung cancer (NSCLC) patients with KRAS mutations.Methods:A retrospective cohort study was conducted. Eighty-seven KRAS-mutant advanced NSCLC patients treated with immunosuppressants who were admitted to Shanxi Province Cancer Hospital from May 2017 to May 2020 were selected and followed up until May 2023. Kaplan-Meier overall survival curves were plotted. The patients were categorized into survival and death groups based on survival status at the final follow-up, with 31 and 56 cases in each group respectively, and the clinical data were compared between the two groups. Cox proportional hazards model was used to screen the risk factors affecting the death of patients, and a Cox regression prediction model for the survival of such patients was constructed based on the above risk factors. Using survival status at the final follow-up as the gold standard, receiver operating characteristic (ROC) curves for this predictive model to predict survival in immunosuppressant-treated KRAS-mutant advanced NSCLC patients were plotted.Results:Of the 87 patients, 57 (65.5%) were male and 30 (34.5%) were female, aged (62±8) years. Patients had a median overall survival time of 18.5 months (95% CI: 7.5-37.5 months) and a 3-year cumulative survival rate of 35.63% (31/87). Compared with the survival group, the Eastern Cooperative Oncology Group physical status (ECOG-PS) score, carcinoembryonic antigen (CEA), red blood cell distribution width (RDW), fibrinogen (FIB), D-dimer (D-D), lactate dehydrogenase (LDH), and neutrophil-to-lymphocyte ratio (NLR) in the death group were higher, and the differences were statistically significant (all P < 0.05). Cox regression analysis showed elevated ECOG-PS score ( HR = 1.925, 95% CI: 1.745-2.515, P < 0.001), elevated RDW ( HR = 2.012, 95% CI: 1.820-2.619, P < 0.001), elevated FIB ( HR = 2.060, 95% CI: 1.908-2.678, P = 0.009), elevated D-D ( HR = 2.112, 95% CI: 1.885-2.791, P = 0.012), elevated LDH ( HR = 2.104, 95% CI: 1.901-2.643, P < 0.001), elevated NLR ( HR = 1.998, 95% CI: 1.764-2.580, P < 0.001) were all independent risk factors for death in immunosuppressant-treated advanced NSCLC patients with KRAS mutations. A Cox regression prediction model was constructed based on the above risk factors: prognostic index (PI)=-10.342+0.582×ECOG-PS score+0.605×RDW+0.610×FIB+0.599×D-D+0.612×LDH+0.618×NLR. ROC curve analysis showed that the area under the curve of the model for predicting survival of the patients was 0.885, and the optimal cut-off value was 1.252, as well as the sensitivity, accuracy and positive predictive value were 90.50%, 87.09% and 84.32%, respectively. Conclusions:ECOG-PS score, RDW, FIB, D-D, LDH, and NLR are associated with the survival of KRAS-mutated advanced NSCLC patients treated with immunosuppressants, and the Cox regression model constructed on the basis of the above factors has a good efficacy in predicting the survival of patients.

【Objective】 To describe the BMI growth trajectories from birth to 24 months and examine the effects of fully breastfeeding time and breastfeeding duration on the BMI growth trajectories. 【Methods】 We conducted a follow-up study of a cohort of 1 388 eligible births. Height and weight were measured at birth, every 3 months to 12 months, and every 6 months to 24 months. Detailed demographic, feeding, activity and diseases data were also collected prospectively. Latent growth mixture modeling was conducted to model the BMI growth trajectories from birth to 24 months. Mixed-effects logistic regression analyses were made to examine the impacts of breastfeeding on this outcome. 【Results】 We identified six BMI trajectory patterns in the 1 285 infants analyzed and labeled them as follows: "normative growth" (26.6%), "normal-accelerating growth" (8.7%), "normal-decelerating growth" (11.7%), "lower-persistent growth" (6.6%), "rapid growth" (26.8%), and "rapid-accelerating growth" (19.5%). Mixed-effects logistic regression analyses revealed that fully breastfeeding ≥ 3 months could significantly decrease the risk of "rapid growth" (OR=0.71, 95% CI 0.51-0.98) and "rapid-accelerating growth" (OR=0.53, 95% CI 0.37-0.75). After adjustment for confounding factors, the relationship remained significant (OR=0.61, 95% CI 0.41-0.89; OR=0.46, 95% CI 0.31-0.68). Weaning before 6 months could significantly increase the risk of "rapid growth" (OR=1.76, 95% CI 1.19-2.61) and "rapid-accelerating growth" (OR=2.08, 95% CI 1.38-3.14). These associations persisted after adjustment for confounding factors (OR=1.69, 95% CI 1.08-2.71; OR=1.88, 95% CI 1.18-2.99). 【Conclusion】 In rural Western China, the main BMI growth trajectory patterns include "normative growth" , "rapid growth" , and "rapid-accelerating growth" . Prolonging breastfeeding may reduce excess weight gain during infancy.