OBJECTIVE To study the effect of age on tympanoplasty. METHODS The preoperative pure tone hearing threshold was 55dB in the aged group and 39 dB in the medium aged group. All patients, includ-ing 24 with chronic suppurative otitis media, 29 with cholesteatoma otitis media and 27 with chronic silent otitis media and/or tympanosclerosis, underwent radi-cal mastoidectomy and tympanoplasty (typeⅠfor 25 ears, modified type Ⅱfor 23 ears and modified type Ⅲ for 32 ears) under general anesthesia. RESULTS The average air-conductive hearing threshold was 46dB in the aged group (healing rate was 67 %) and 33dB in the medium aged group (healing rate was 70 %). With aging, the average air-conductive hearing threshold in-creased (P

This study was aimed to analyze the medication rules of AIDS fever by Professor Li Fazhi, in order to pro-vide the corresponding medication reference basis for Chinese medicine treatment of AIDS fever. The complex net-work analysis method was used. This study was conducted among AIDS fever patients treated by Professor Li Fazhi from September 2007 to June 2012 in Weishi County, Henan Province. The analysis was made on the etiology and pathogenesis of AIDS fever, syndrome differentiation and treatment as well as medication of senior famous Chinese medicine doctors. The results showed that through a multidimensional query analysis, the core medication in the treatment of AIDS fever included harmonization and heat-clearing herbs such as Bupleurum, Licorice, Scutellaria, as well as qi-supplementing and healthy qi reinforcing herbs such as Codonopsis and Astragalus. The core prescriptions were modified Xiaochaihu Decoction and Buzhong Y iqi Decoction. It was concluded that the treatment rules of AIDS fever by Professor Li Fazhi was to clear heat in combination with supplementing the center and boost qi.

Objective To evaluate the consistency of psoriasis-involved body surface area (BSA) measurement among raters from different clinical centers after training in a new standard operating procedure (SOP) for involved BSA measurement,so as to provide a method for the evaluation of psoriasis with high accuracy and operability.Methods Firstly,two raters from Guangdong Provincial Hospital of Chinese Medicine (GPHCM) independently and alternately assessed the disease severity in 40 patients with psoriasis after systematic training in the BSA-SOP.Then,one of the raters from GPHCM and 11 raters from 11 subcenters separately assessed the disease severity in 209 patients with psoriasis by using the BSA-SOP,and the consistency was evaluated by using intraclass correlation coefficient (ICC).Results There was a very high degree of consistency in involved BSA values between the 2 raters from GPHCM (ICC =0.989,95％ confidence interval:0.979-0.994).The consistency of involved BSA values for the assessment of psoriasis severity was also high among the rater from GPHCM and the raters from 11 subcenters (ICC ranging from 0.849 to 0.998).Conclusion The raters from different centers showed high consistency of involved BSA measurement for the assessment of psoriasis severity after training in the new BSA-SOP,so the BSA-SOP can serve as a reliable reference for multicenter clinical studies.

OBJECTIVE To investigate the efficacy and safety of local lauromacrogol injection in the treatment of laryngopharyngeal hemangioma. METHODS A total of 10 patients suffering from hemangioma of pharynx and larynx from Aug 2015 to Mar 2018 were collected. Endoscope assisted local lauromacrogol injection under topical was used. The therapeutic effects were observed and analyzed.RESULTS All patients were followed up for 3 months to 1 year. Among them, 9 cases were cured and 1 was obviously effective for totally 1 to 4 (mean 1.9) injections. All patients complained of postoperative pain or foreign body sensation, 3 patients were significantly affected by local swelling of the injection site. 2 patients underwent tracheostomy and 1 patient returned to ward with endotracheal intubation postoperatively. No complications such as mucosal ulceration, fever, allergies occurred. CONCLUSION Lauromacrogol injection is a safe and effective method to treat hemangioma of pharynx and larynx.

BACKGROUNDAlcohol dependence (AD) is a serious and common public health problem. The identification of genes that contribute to the AD variation will improve our understanding of the genetic mechanism underlying this complex disease. Previous genome-wide association studies (GWAS) and candidate gene genetic association studies identified individual genes as candidates for alcohol phenotypes, but efforts to generate an integrated view of accumulative genetic variants and pathways under alcohol drinking are lacking.

METHODSWe applied enrichment gene set analysis to existing genetic association results to identify pertinent pathways to AD in this study. A total of 1 438 SNPs (P < 1.0 × 10(-3)) associated to alcohol drinking related traits have been collected from 31 studies (10 candidate gene association studies, 19 GWAS of SNPs, and 2 GWAS of copy number variants).

RESULTSAmong all of the KEGG pathways, the calcium signaling pathway (hsa04020) showed the most significant enrichment of associations (21 genes) to alcohol consumption phenotypes (P = 5.4 × 10(-5)). Furthermore, the calcium signaling pathway is the only pathway that turned out to be significant after multiple test adjustments, achieving Bonferroni P value of 0.8 × 10(-3) and FDR value of 0.6 × 10(-2), respectively. Interestingly, the calcium signaling pathway was previously found to be essential to regulate brain function, and genes in this pathway link to a depressive effect of alcohol consumption on the body.

CONCLUSIONSOur findings, together with previous biological evidence, suggest the importance of gene polymorphisms of calcium signaling pathway to AD susceptibility. Still, further investigations are warranted to uncover the role of this pathway in AD and related traits.

Alcoholism ; genetics ; Calcium Signaling ; genetics ; physiology ; Genetic Predisposition to Disease ; genetics ; Genome-Wide Association Study ; methods ; Humans ; Polymorphism, Single Nucleotide ; genetics

Autophagy is a lysosome-mediated catabolic process that captures and degrades dysfunctional organelles and useless proteins during cellular stress process， which plays a dual role in cervical cancer. In the early stage of cervical cancer， autophagy inhibits the occurrence and development of cervical cancer by prohibiting the accumulation of oncogenic p62 protein. In the advanced stage of cervical cancer， inhibition of autophagy of cancer cells enhances the sensitivity of cancer cells to chemotherapeutic drugs， thus inhibiting their proliferation. In recent years， the research on Chinese medicine monomers regulating autophagy in the treatment of cervical cancer has attracted extensive attention from scholars at home and abroad. Chinese medicine monomers regulate the autophagy of cervical cancer cells through multiple pathways and multiple targets， so as to increase the apoptosis rate and reduce the resistance of cancer cells to chemotherapeutic drugs. Therefore， this paper reviewed the mechanism of Chinese medicine monomers in inhibiting cervical cancer through autophagy， expecting to find new breakthroughs in the discovery and development of preventive and therapeutic drugs for cervical cancer. By reviewing the literature， it was found that in the early stage of cervical cancer， Chinese medicine monomers activated autophagy to promote apoptosis of cancer cells， and the main mechanism was to increase lysosomal membrane permeability and chemotherapeutic sensitivity and activate intact autophagy flow. In the advanced stage of cervical cancer， inhibition of autophagy reduced the sensitivity of cancer cells to chemotherapy drugs by inhibiting the formation of autophagosomes and autolysosomes. The treatment of cervical cancer by Chinese medicine monomers regulating autophagy has achieved certain effect， but there are few clinical experimental studies and lack of reliable clinical theoretical basis. Therefore， it is essential to carry out more clinical experimental studies on Chinese medicine monomers regulating autophagy to treat cervical cancer， thus finding more reliable theoretical basis for the treatment of tumors.

Objective:To construct the prediction model of death risk of Stanford type A aortic dissection (AAD) based on Cox proportional risk regression model.Methods:AAD patients who were diagnosed and received surgical treatment admitted to the department of cardiothoracic surgery of Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from January 1st, 2019 to April 30th, 2020 were enrolled. The general situation, clinical manifestations, pre-hospital data, laboratory examination and imaging examination results of the patients were collected. The observation period was up to the death of the patients or ended on April 30th, 2021. They were divided into the model group and the verification group according to the ratio of 7∶3. Lasso method was used to screen prognostic variables from the data of the modeling group, and multivariate Cox regression analysis was included to construct the AAD death risk prediction model, which was displayed by nomogram. The receiver operator characteristic curve (ROC curve) was used to evaluate the discrimination of the model, the calibration curve to evaluate the accuracy of the model, and the clinical decision curve (DCA) to evaluate the effectiveness of the model.Results:A totel of 454 patients with AAD were finally included, and the mortality was 19.4% (88/454). Lasso regression analysis was used to screen out 10 variables from the data of 317 patients in the model group, and the prediction model of death risk was constructed: 0.511×abdominal pain+1.061×syncope+0.428×lower limb pain/numbness-0.365×emergency admission-1.933×direct admission-1.493×diagnosis before referral+0.662×preoperative systolic blood pressure (SBP) < 100 mmHg (1 mmHg = 0.133 kPa)+0.632×hypersensitivity cardiac troponin I (hs-cTnI) > 34.2 ng/L+1.402×De Bakey type+0.641× pulmonary infection+1.472×postoperative delirium. The area under the ROC curve (AUC) and 95% confidence interval (95% CI) of the AAD death risk prediction model were 0.873 (0.817-0.928), and that of the verification group was 0.828 (0.740-0.916). DCA showed that the net benefit value of the model was higher. The calibration curve showed that there was a good correlation between the actual observation results and the model prediction results. Conclusion:The AAD death risk prediction model based on abdominal pain, syncope, lower limb pain/numbness, mode of admission, diagnosis before referral, preoperative SBP < 100 mmHg, hs-cTnI > 34.2 ng/L, De Bakey type , pulmonary infection, and postoperative delirium can effectively help clinicians identify patients at high risk for AAD, evaluate their postoperative survival and timely adjust treatment strategies.

Objective To investigate the feasibility and clinical value of using acicular electrosurgical knife for coniza-tion of cervix in the diagnosis and treatment of cervical intraepithelial neoplasia(CIN).Methods A retrospective analysis was conducted on the surgical data,pathological findings,and pregnancy-related complications of 60 patients who underwent acicular electrosurgical knife conization(AEKC)from January 2016 to December 2019.Results The operation time ranged from 10 to 140 minutes(median,26 minutes),and the amount of bleeding during surgery was minimal to 100 mL(median,10 mL).The cone cutting width is between 1-3 cm,the cone cutting depth is between 0.5-2.5 cm.No hemorrhoeaoccur within 14 days after surgery.The pathological concordance rate before and after surgery was 68.3%,the margins were clear and negative,and the ex-cision rate was 100%.The incidence of cervical incompetency,preterm birth and premature rupture of membranes during preg-nancy after AEKC was 3.3%,18.6%and 23.7%respectively.Conclusion By selecting acicular electrosurgical knife,suffi-cient excision and intraoperative hemostasis were ensured during conization.At the same time,it does not affect the pathological diagnosis of margin.Moreover,it has a low incidence of pregnancy-related complications such as cervical incompetency,preterm birth and premature rupture of membranes.