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

Objective To study the effects of amniotic epithelial cells conditioned medium on the differentiation of bone marrow stromal cells into neural cells. Methods Bone marrow stromal cells and amniotic epithelial cells were isolated and cultured in vitro,then the cell surface antigen was detected by flow cytometry and the expressions of nestin and ki67 were detected by immunofluorescence staining method.When the cells were co-cultured with amniotic epithelial cells conditioned medium,the morphological character of cells was observed by inverse phase-contrast microscope,and the expressions of NSE(neurone specific enolase),TH(tyrosine hydroxylase) and DAT(dopamine transporter) were detected by immunofluorescence staining method. Results Amniotic epithelial cells conditioned medium had obvious inductive effect on bone marrow stromal cell's neural differentiation.Conclusion The amniotic epithelial cells conditioned medium may have inductive effect neuron-like cell's differentiation and dopaminergic neuron-like cell's differentiation of bone marrow stromal cells in vitro.

Objective:To investigate and analyze the influencing factors of teachers' teaching input status on teaching effect satisfaction in medical colleges.Methods:A total of 782 teachers of basic medicine and clinical medicine in a local medical college in Hebei Province were selected by multi-stage stratified random sampling method. The (mean ± standard deviation) was used to describe the status quo of teachers' teaching input, and the t- or F-test was used for inter-group comparison. The influence of teaching input on teaching satisfaction was analyzed by multiple linear regression. Results:The teaching input of medical college teachers was affected by different demographic characteristics, among which the teaching time input was affected by gender, age, professional title, teaching age, educational background and category (all P<0.05), the emotional input was affected by age,professional title,teaching age,educational background and category (all P<0.05), and the teaching ability development input was affected by age, professional title, teaching age and category (all P<0.05). There was a correlation between the population characteristics of teachers and the teaching input and the satisfaction of teaching effect, and the teaching age of teachers is negatively correlated with the satisfaction of teaching effect ( β=-0.057, P<0.05). There were positive correlations between teaching satisfaction and teaching effect (all P<0.05), including the number of lesson preparation hours, the number of weekly teaching hours, the degree of teaching attention, the degree of medical teaching research balance, the learning and expansion of teaching skills, and the difference of teaching observation reflecting teaching input. The teaching input of basic medicine teachers was significantly higher than that of clinical teachers (all P<0.05). Conclusion:It is suggested that medical colleges and clinical teaching bases should pay attention to the construction of teacher echelon, optimization of policies and measures to balance the relationship between medical education and research, construction of the support system of teachers' teaching work input to improve teachers' professional efficacy, and the building of a professional development community of teachers integrating basic medical teachers and clinical teachers to improve the training quality of medical students.

Objective: To evaluate the clinical effect of clear aligners in the anterior region in non-extraction cases by establishing a three-dimensional model of crown-root fusion to guide clinical application. Methods: Eleven patients visiting the orthodontic department of Xuzhou Stomatological Hospital from December 2020 to December 2021 were collected, and the orthodontic plan was designed using Maestro 3D Dental Studio scheduling software to obtain the expected three-dimensional model of the patient's orthodontic treatment result. CBCT, intraoral scan, and 3D reconstruction software were used to create a postoperative model of the patient. The crown and root data were aligned in Geomagic Studio 2014, and differences in torque and axial inclination between the actual model after treatment and the predicted model of the anterior teeth before treatment were compared in 3-matic. Results: The actual torque angles of the anterior teeth were all smaller than the predicted angles before treatment, with the highest realization rate of 77.55% for lateral incisors and the lowest of 60.70% for central incisors; the actual axial inclination angles of the anterior teeth were also smaller than the predicted angles before treatment, with the highest realization rate of 81.49% for central incisors and the lowest of 74.95% for cuspids. Conclusion A digital model of crown-root integration based on a combination of 3D reconstruction and intraoral scanning techniques is advantageous in assessing the efficacy of clear aligners. In non-extraction cases with clear aligner, the efficiency of movement is higher for small areas of the anterior region.

Purpose: The incidence rate of breast cancer (BC) has increased annually. Downstream neighbor of son (DONSON) critically affects cell cycle progression and maintains stable genomic properties; however, its relevant effects on BC growth and progression require indepth investigation. Methods: DONSON upregulation was validated in public databases. DONSON expression in matched BC and adjacent tissues and cell lines (MDA-MB-231, BT-549, and HS-578T) was determined using quantitative reverse transcription polymerase chain reaction. In vitro apoptosis, invasion, migration, and proliferation tests were performed to ascertain the functions of DONSON in BC cell lines. Then, using western blot analysis, the levels of DONSON downstream proteins were determined. Results: Compared to the control, DONSON was expressed at higher levels in BC tissues and cell lines. DONSON knockdown facilitated apoptosis and limited proliferation, migration, invasion, and S/G2 transition of BC cells In vitro. Furthermore, DONSON overexpression promoted BC cell proliferation and inhibited apoptosis In vitro. Moreover, DONSON knockdown reduced cyclin A1 and cyclin-dependent kinase 2 levels. Moreover, DONSON knockdown limited the progression of epithelial-mesenchymal transition. Conclusion DONSON critically affects BC growth and serves as a possible target and marker for the efficacy of subsequent therapies.

Objective:To build a medical service experience system based on role play of hospital staff, and explore its contribution to upgrading medical service, elevating medical service quality, and improving patients′ satisfaction.Methods:An indicator system for medical service experience was developed via literature review. 20 newly recruited hospital employees in 2019 were sampled randomly to form a service experience team, who were arranged to experience the full medical service process of outpatients and inpatients based on role play. The questionnaire for service quality based on patient perception and expectation was used to survey the expectation and perception values of those role players on their medical service experiences, and summarize the defects found on such six dimensions as hospital reliability, responsiveness, tangibility, assurance, empathy and cost-effectiveness. After due corrections of these defects, further experiences and patient satisfaction survey were made to assess the effects of such actions taken. Paired t test was used respectively in statistical analysis of service experience value and actual perception value, as well as the perception values before and after the actions taken, and χ2 test was used for a statistical analysis of patient satisfaction. Results:Role players experienced respectively at the emergency, outpatient and inpatient departments of the hospital for a week in August 2019. Statistics of their experiences indicated≥0.50 points difference between the mean expectation and perception values on doctor-patient communication, patient help responsiveness, outpatient process, examination report delivery duration, service attitude, patient trust on medical workers, medical environment and patient privacy protection.Following a 3-month reform, role players found improvements in such aspects as hospital reliability, responsiveness, tangibility, assurance, empathy and cost-effectiveness; patient satisfaction improved sizably in December 2019 over January of the same year( P<0.05). Conclusions:The construction and application of the medical service experience system based on role play of hospital staff prove highly useful in upgrading medical service actions, improving medical service quality, and improving patient satisfaction.

OBJECTIVE：To study the intervention eff ects and pot ential m echanism of celastrol on non-alcoholic steatohepatitis （NASH）induced by methionine-choline deficiency （MCD）diet. METHODS ：Male C 57BL/6J mice were randomly divided into normal control group ，model group ，celastrol low-dose and high-dose groups [ 0.5，1 mg/（kg·d）]，with 7 mice in each group. The normal control group was given a methionine-choline sufficient diet ，while the model group and administration groups were fed an MCD diet to induce NASH model. At the same time ，normal control group and model group were given polyoxyethylene castor oil intragastrically；administration groups were given relevant drugs intragastrically ；the volume of gavage was 0.1 mL/g，once a day ， for consecutive 4 weeks. The liver morphology was observed ，and the pathological changes of liver tissue were observed by HE staining and oil red O staining. The levels of serum liver enzymes （AST，ALT），and the levels of lipid indexes （TC，TG）in serum and liver tissue were detected by enzyme method. The protein expression of NF-κB p65，TNF-α and IL-6 in liver tissue were determined by Western blotting assay. RESULTS ：Compared with normal control group ，the volume of the liver was reduced and the color was yellow ，and the surface was rough in model group ；inflammatory cell infiltration ，fat vacuoles and lipid droplets aggregation were found in the liver tissue ；the serum levels of TC and TG were significantly decreased ，the levels of serum liver enzymes and protein expression of NF-κB p65，TNF-α and IL-6 in liver tissue were significantly increased （P＜0.01）. Compared with model group ，the liver surface of each administration group was ruddy and smooth without brown spots ，the inflammatory cells and fat vacuoles in liver tissue were reduced ，and the coverage area of lipid droplets was reduced ；the levels of serum TC and TG were significantly increased ，the levels of serum liver enzymes ，the levels of TG and protein expression of NF-κB，TNF-α and IL-6（except for celastrol low-dose group ）in liver tissue were significantly decreased （P＜0.05 or P＜0.01）. CONCLUSIONS ： Celastrol can improve the liver injury of NASH model mice induced by MCD diet ，which is related to the reduction of TG accumulation in liver tissue and inhibition of the expression of inflammatory related factors.

Objective:To analyze the three-dimensional radiographic characteristics of calcifying odon-togenic cyst and calcifying epithelial odontogenic tumor using spiral computed tomography(CT)and cone-beam computed tomography(CBCT).Methods:Clinical records,histopathological reports,and CBCT or non-enhanced spiral CT images of 19 consecutive patients with calcifying odontogenic cyst(COC)and 16 consecutive patients with calcifying epithelial odontogenic tumor(CEOT)were retrospec-tively acquired,and radiographic features,including location,size,expansion,internal structure and calcification,were analyzed.Results:Among the 19 COC cases(12 males and 7 females,with an average age of 27 years),89.5％(17/19)of the lesions originated from the anterior and premolar areas,100.0％of them exhibited cortex expansion,and 78.9％had discontinued cortex.Among the 16 CEOT cases(3 males and 13 females,with an average age of 36 years),81.3％(13/16)of the lesions were in the premolar and molar areas,56.3％of them exhibited cortex expansion,and 96.8％had discontinued cortex.According to the distribution of internal calcifications,these lesions were divided in-to:Ⅰ(non-calcification type):absence of calcification;Ⅱ(eccentric marginal type):multiple calcifi-cations scattered along one side of the lesion;Ⅲ(diffused type):numerous calcifications diffusely dis-tributed into the lesion;Ⅳ(plaque type):with a ≥ 5 mm calcified patch;V(peri-coronal type):multiple calcifications clustered around impacted teeth.Calcifications were present in 73.7％of COC le-sions,including 9 type Ⅱ,3 type Ⅲ and 2 type Ⅳ lesions,and 42.8％of CEOT lesions had calcifica-tion images,including 2 type Ⅲ and 5 type V lesions.Six COC lesions had odontoma-like images.Moreover,8 of 9 type Ⅰ CEOTs were histologically Langerhans cell-rich subtype,which had a smaller size(with an average mesiodistal diameter of 17.8 mm)and were not associated with impacted teeth.Conclusion:COC lesions tended to originate from the anterior part of the jaw and exhibit cortex expan-sion,and were sometimes associated with odontoma.CEOT commonly occurred in the posterior jaw and had discontinued cortex.Two lesions had significantly different calcification map.Over 70％of COC le-sions had calcification images,which were mostly scattered along one side of the cysts,far from the im-pacted teeth.Approximately 60％of CEOT lesions exhibited smaller size and non-calcification,and the remaining CEOT cases often had calcification images clustered around the impacted teeth.