Objective:To analyze long-term prognosis and influencing factors of recurrence in vocal fold leukoplakia treated by endoscopic cordectomy with CO 2 laser. Methods:A retrospective review was conducted on 599 patients with vocal fold leukoplakia [566 males and 33 females, aged 17-84 years (median age 55 years)], undergoing endoscopic cordectomy by CO 2 laser under general anesthesia at the Department of Otorhinolaryngology Head and Neck Surgery of Beijing Tongren Hospital, Capital Medical University, from January 2000 to December 2023. The study analyzed the clinical features, pathological grade, surgical methods, postoperative voice function, recurrence, malignant changes and analyzed the long-term efficacy and and its influencing factors. The patients were followed up for a duration of 6-249 months postoperatively, with a median follow-up time of 48 months. SPSS 20.0 software was used for statistical analysis. Results:Among the 599 patients, the histopathological grades included simple squamous cell hyperplasia in ( n=264, 44.08%), mild dysplasia ( n=96, 16.03%), moderate dysplasia ( n=74, 12.35%), severe dysplasia( n=43, 7.81%), carcinoma in situ( n=35, 5.84%), and carcinoma in situ with microinvasion( n=87, 14.52%). The 3-year and 5-year overall recurrence rates were 12.91% and 16.00%, respectively. In patients with precancerous lesion, 3.91% of recurrences presented with an upgraded pathologic grade and 2.34% evolved into carcinoma. The risk of recurrence was higher in lesions involving the anterior commissure, larger lesions, significant reduction/absence of mucosal waves, neovascularization/suspected neovascularization, and pathology of dysplasia/carcinoma in situ/carcinoma in situ with microinvasion( F=44.76,21.54,11.55,8.78,23.20,respectively, P<0.05). Additionally, patients with recurrent disease exhibited higher reflux symptom index scores compared to those without recurrence. Exophytic lesion characteristics and the inability to cease smoking postoperatively were identified as independent risk factors for recurrence with an upgraded pathological grade, with odds ratios of 8.675 and 11.380 times greater than those with non-exophytic lesions and successful smoking cessation, respectively. At the 6-months postoperative assessment, patients who underwent subepithelial cordectomy (typeⅠ) demonstrated a statistically significant increase in fundamental frequency ( t=-3.38, P<0.05), and while other voice acoustic parameters were not significantly different.Conversely, those who underwent transmuscular cordectomy (TypeⅢ) exhibited significant alterations in multiple voice acoustic parameters when compared to preoperative values ( P<0.05). Furthermore, postoperative vocal fold adhesions developed in 84 patients with 13 of these individuals requiring surgical intervention for adhesion release. Conclusions:Lesions involving the anterior commissure, larger lesions, pathology of dysplasia/carcinoma in situ/carcinoma in situ with microinfiltration, significant reduction/absence of vocal fold mucosal waves, and neovascularization visible under NBI are indicative of an increased risk of recurrence, whereas exophytic lesions and the inability to cease smoking postoperatively significantly increase the risk of recurrence with elevated pathologic grade. Recovery of postoperative voice quality is procedure-dependent, underscoring the importance of surgical approach selection in the management of vocal fold leukoplakia.

Objective:To investigate the clinical features and therapeutic efficacy of patients with hereditary leiomyomatosis and renal cell carcinoma(RCC) syndrome-associated RCC (HLRCC-RCC) in China.Methods:The clinical data of 119 HLRCC-RCC patients with fumarate hydratase (FH) germline mutation confirmed by genetic diagnosis from 15 medical centers nationwide from January 2008 to December 2021 were retrospectively analyzed. Among them, 73 were male and 46 were female. The median age was 38(13, 74) years. The median tumor diameter was 6.5 (1.0, 20.5) cm. There were 38 cases (31.9%) in stage Ⅰ-Ⅱand 81 cases (68.1%) in stage Ⅲ-Ⅳ. In this group, only 11 of 119 HLRCC-RCC patients presented with skin smooth muscle tumors, and 44 of 46 female HLRCC-RCC patients had a history of uterine fibroids. The pathological characteristics, treatment methods, prognosis and survival of the patients were summarized.Results:A total of 86 patients underwent surgical treatment, including 70 cases of radical nephrectomy, 5 cases of partial nephrectomy, and 11 cases of reductive nephrectomy. The other 33 patients with newly diagnosed metastasis underwent renal puncture biopsy. The results of genetic testing showed that 94 patients had FH gene point mutation, 18 had FH gene insertion/deletion mutation, 4 had FH gene splicing mutation, 2 had FH gene large fragment deletion and 1 had FH gene copy number mutation. Immunohistochemical staining showed strong 2-succinocysteine (2-SC) positive and FH negative in 113 patients. A total of 102 patients received systematic treatment, including 44 newly diagnosed patients with metastasis and 58 patients with postoperative metastasis. Among them, 33 patients were treated with tyrosine kinase inhibitor (TKI) combined with immune checkpoint inhibitor (ICI), 8 patients were treated with bevacizumab combined with erlotinib, and 61 patients were treated with TKI monotherapy. Survival analysis showed that the median progression-free survival (PFS) of TKI combined with ICI was 18 (5, 38) months, and the median overall survival (OS) was not reached. The median PFS and OS were 12 (5, 14) months and 30 (10, 32) months in the bevacizumab combined with erlotinib treatment group, respectively. The median PFS and OS were 10 (3, 64) months and 44 (10, 74) months in the TKI monotherapy group, respectively. PFS ( P=0.009) and OS ( P=0.006) in TKI combined with ICI group were better than those in bevacizumab combined with erlotinib group. The median PFS ( P=0.003) and median OS ( P=0.028) in TKI combined with ICI group were better than those in TKI monotherapy group. Conclusions:HLRCC-RCC is rare but has a high degree of malignancy, poor prognosis and familial genetic characteristics. Immunohistochemical staining with strong positive 2-SC and negative FH can provide an important basis for clinical diagnosis. Genetic detection of FH gene germ line mutation can confirm the diagnosis. The preliminary study results confirmed that TKI combined with ICI had a good clinical effect, but it needs to be confirmed by the results of a large sample multi-center randomized controlled clinical study.

Objective:To compare the clinical efficacy between robot-assisted and free-hand percutaneous cannulated screwing (PCS) in the treatment of femoral neck fractures in the middle-aged and young patients.Methods:A retrospective study was conducted to analyze the clinical data of 53 patients with femoral neck fracture who had been treated with PCS from May 2020 to May 2022 at Department of Traumatic Surgery, Maoming Hospital Affiliated to Southern Medical University. In the robot group of 25 patients subjected to robot-assisted PCS, there were 11 males and 14 females with an age of (48.2 ± 11.9) years; in the free-hand group of 28 patients subjected to free-hand PCS, there were 13 males and 15 females with an age of (48.5 ± 9.8) years. The 2 groups were compared in terms of operation time, intraoperative bleeding, intraoperative guide drills, intraoperative fluoroscopy frequency, fracture union time, Harris hip score at the last follow-up and postoperative complications. Postoperative imaging examination was performed to evaluate distribution accuracy of the cannulated screws in the femoral neck (deviation between the screws and the femoral neck axis, parallelism between the screws and distance between the screws and the neck cortex).Results:There was no statistically significant difference between the robot and free-hand groups in the general clinical data before operation, showing comparability ( P>0.05). The robot group showed significantly shorter operation time [(32.7 ± 4.8) min], significantly less intraoperative bleeding [(14.6 ± 4.8) mL], significantly less intraoperative guide drillings [(3.5 ± 0.7) times] and significantly less intraoperative fluoroscopy frequency [(7.9 ± 1.4) times] than the free-hand group [(56.9 ± 11.3) min, (27.0 ± 7.3) mL, (9.1 ± 1.8) times and (16.3 ± 6.0) times)] (all P<0.05). Postoperative imaging showed that the deviation between the screws and the femoral neck axis was 4.4° ± 1.1° on the anteroposterior X-ray film and 3.2° ± 0.8° on the lateral X-ray film, the parallelism between the screws 4.9° ± 0.8° on the anteroposterior X-ray film and 3.0° ± 0.7° on the lateral X-ray film, and the distance between the screws and the femoral neck cortex (10.4 ± 2.7) mm in the robot group, all significantly smaller than those in the free-hand group [10.5° ± 2.8°, 4.9° ± 1.1°, 12.1° ± 4.0°, 5.1° ± 1.3°, and (15.4 ± 3.2) mm] (all P<0.05). All the 53 patients were followed up for (22.2 ± 8.5) months. All fractures got united. The fracture union time in the robot group [(20.6 ± 4.6) weeks] was insignificantly shorter than that in the free-hand group [(23.7 ± 7.7) weeks] ( P>0.05). At the last follow-up, the Harris hip score in the robot group [(88.6 ± 5.6) points] was significantly higher than that in the free-hand group [(84.8 ± 6.3) points] ( P<0.05). Follow-ups revealed 2 cases of internal fixation loosening, 1 case of screw head cutting and 1 case of femoral head necrosis in the free-hand group but none of such complications in the robot group. Conclusion:In the treatment of femoral neck fractures in the middle-aged and young patients, compared with free-hand PCS, robot-assisted PCS shows advantages of shorter intraoperative time, less bleeding, less fluoroscopic radiation, higher accuracy of screw placement, a lower incidence of postoperative complications and better functional recovery of the hip joint.

For the past few years, viral diseases such as Coronavirus Disease 2019, Influenza, and Ebola hemorrhagic fever have become more severe and more frequent. For people’s health and the stable operation of the national economy, it is of increasing importance to research the pathogenesis of virus and host immune regulation mechanism, analyze the regulation of gene expression between virus and host, and surveil pathogenic viruses and prevent virus diseases. Transcriptome sequencing is a kind of technology at the RNA level that focuses on the expression characteristics of genes in a specific space-time state, and it is an indispensable tool for analyzing differential gene expression and researching differential splicing of mRNA. With the progress of molecular biology experimental technology and the maturity of bioinformatics analysis platforms, transcriptomics is developing towards the low-cost and low technical threshold, which is gradually transitioning from the research field to the clinical laboratory and changing the traditional cognition of clinical staff in viruses and viral diseases. It has been increasingly used in the research of viral transcription mechanisms, immune interaction between virus and host, tracking disease progression, and antiviral drug development. In order to provide a methodological reference for the research of virus mechanism and prevention and control of virus disease, here, we mainly review meta-transcriptome from three aspects: technical process, common software and application scenarios of virus and virus diseases, and briefly mention the method and applications of other transcriptomes, including a population of cells RNA sequencing (Bulk RNA-seq), Single-cell RNA sequencing (ScRNA-seq), Single-nuclear RNA sequencing (SnRNA-seq), and Spatial Transcriptome (ST).

MicroRNAs(miRNAs)are important regulators in gene expression.The dysregulation of miRNA expression is widely reported in the transformation from physiological to pathological states of cells.A large number of differentially expressed miRNAs(DEMs)have been identified in various human cancers by using high-throughput technologies,such as microarray and miRNA-seq.Through mining of published studies with high-throughput experiment information,the data-base of DEMs in human cancers(dbDEMC)was constructed with the aim of providing a systematic resource for the storage and query of the DEMs.Here we report an update of the dbDEMC to version 3.0,which contains two-fold more data entries than the second version and now includes also data from mice and rats.The dbDEMC 3.0 contains 3268 unique DEMs in 40 different cancer types.The current datasets for differential expression analysis have expanded to 9 generalized cat-egories.Moreover,the current release integrates functional annotations of DEMs obtained by using experimentally validated targets.The annotations can be of great benefit to the intensive analysis of the roles of DEMs in cancer.In summary,dbDEMC 3.0 provides a valuable resource for charac-terizing molecular functions and regulatory mechanisms of DEMs in human cancers.

Objective:To evaluate the follow-up clinical results of W-shaped acetabular angular plate for the treatment of acetabular posterior wall fractures through a direct posterior approach (DPA).Methods:Fifteen cases (10 males and 5 females, average aged 42.1±10.0 years) were involved in this study, with acetabular posterior wall fractures treated by using the W-shaped acetabular angular plate through a DPA between March 2017 and June 2019. Nine patients with fractures were injured by traffic accidents and the other 6 cases by falling. Based on the three-column classification for acetabular fractures, all of the cases belonged to posterior wall fractures (A2.1), which included 6 cases of simple fractures and 9 cases of comminuted fractures. The mean time interval between injury and surgery was 5.6±1.1 (range, 4-8) days. The DPA was adopted in all cases. The posterior wall fractures of the acetabulum were reduced and fixed with W-shaped acetabular angular plates. The reduction quality of the acetabulum was evaluated by X-ray and CT scan during follow-up visits according to the criteria proposed by Matta. The function of the hip joint was assessed by the Merle d'Aubigné-Posteal score modified by Matta.Results:The length of the surgical incision was 9.5±1.1 (range, 8-12) cm. The operation time was 45.3±10.1 (range, 35-75) mins. The amount of intraoperative blood loss was 248.0±94.7 (range, 100-380) ml. All the patients who were followed up for 20.5±6.3 (range, 16-38) months. All cases were evaluated according to Matta's reduction quality criteria, the satisfactory ratio of reduction was 100%. Among cases, 10 cases were matched the anatomic reduction, and the other 5 cases have belonged to satisfy. All cases of fractures had healed (the mean of healing time was 9.4±1.3 (range, 8-12 weeks). At the final follow-up visit, the mean of modified Merle d'Aubigne-Postel score was 16.9±1.6 (range, 13-18). Excellent clinical outcomes were obtained in 10 cases, good in 3 cases, and fair in 2 cases. One case had deep venous thrombosis of the lower extremities. The clots disappeared after anticoagulation treatment. One case had the heterotopic ossification, Brooker grade I, without any special treatment due to not affecting the hip joint activity in the follow-up visits. One patient had incision fat liquefaction and the wound healed after intensive dressing change. No internal fixation loosening or losing of fracture reduction was found at the follow-up visits.Conclusion:This study shows that using W-shaped acetabular angular plate for the treatment of acetabular posterior wall fractures through the DPA could obtain early satisfactory clinical outcomes.

Objective To compare the effects of ticagrelor and clopidogrel on platelet aggregation rate, myocardial perfusion and prognosis in patients with acute myocardial infarction. Methods One hundred and sixty-nine patients with acute ST segment elevation myocardial infarction (STEMI) and emergency percutaneous coronary intervention (PCI) were recruited and randomly divided into ticagrelor group (85 cases) and clopidogrel group (84 cases). The TIMI blood flow before and after PCI was recorded, and the ST segment fall rate of 1 h ECG after PCI was calculated. The platelet aggregation rate was measured. After 12 months' follow-up, the incidence of major adverse cardiac events (MACE) was recorded. The Logistic regression analysis was used to discover the factors of MACE. Results One hundred and sixty-nine patients with acute STEMI were recruited including 85 cases treated with ticagrelor and 84 cases in clopidogrel group. The ECG ST segment fall rate after PCI in ticagrelor group was significantly higher than that in clopidogrel group: (61.3 ± 30.7)％ vs. (47.8 ± 26.6)％, P<0.05. The platelet aggregation rate 2 h, 24 h and 7 d after PCI in ticagrelor group was significantly lower than that in clopidogrel group (P<0.05). MACE occurred in 19 cases (22.4％) in ticagrelor group and in 21 cases (25.0％) in clopidogrel group, and there was no significant difference (P > 0.05). Multiple Logistic regression analysis revealed that age and ECG ST segment fall rate were independent risk factors for MACE (P<0.05). Conclusions Compared with clopidogrel, ticagrelor can effectively reduce platelet aggregation rate and accelerate ST segment fall in STEMI patients, but their long-term prognosis is similar.

Objective To investigate the predictive value of serum adiponectin level on morbidity of acute myocardial infarction, and to evaluate its impact on prognosis in patients with acute myocardial infarction after percutaneous coronary intervention (PCI). Methods We prospectively recruited patients with acute ST segment elevation myocardial infarction (STEMI) who had underwent primary PCI. Their serum adiponectin levels were measured. The TIMI blood flow classification of culprit vessel was recorded after PCI. Echocardiography was performed in 24 h after PCI to evaluate left ventricular ejection fraction (LVEF). Major adverse cardiac events (MACE) were recorded including cardiac death, recurrent nonfatal myocardial infarction, target vessel reascularization, and readmission for heart failure after 18 months′ followed-up. Results 108 consecutive patients with STEMI and 38 control patients without coronary artery stenosis were recruited. The serum adiponectin level in STEMI group was significantly lower than that in control: (1 413.9 ± 218.8) ng/L vs.(1 756.3 ± 205.5) ng/L (P<0.01). STEMI patients with LVEF < 50% had lower serum adiponectin level compared with LVEF ≥50%: (1 334.1 ± 226.3) ng/L vs. (1 453.0 ± 213.8) ng/L , P<0.01. The serum adiponectin level in the TIMI 0-2 group after PCI was significantly lower than that in the TIMI 3 group:(1 350.7 ± 214.9) ng/L vs. (1 430.6 ± 218.5) ng/L, P < 0.01. Multiple logistic regression analysis revealed that lower serum adiponectin level was an independent predictor of STEMI ( OR=0.992, 95% CI 0.987-0.996, P<0.01). MACE occurred in 22 patients (20.4% ). Cox regression analysis revealed that lower serum adiponectin level remained an independent predictor of MACE ( OR=0.996, 95% CI 0.993-0.999, P < 0.01). Conclusions Lower serum adiponectin level is significantly associated with morbidity of STEMI and adverse prognosis in patients with acute myocardial infarction.

Objective To investigate the values of serum thymidine kinase 1 (TK1) and soluble NKG2D (natural killer cell group 2D) ligand (soluble major histocompatibility complex class Ⅰ-related chain A,sMICA) in predicting the prognosis of colorectal cancer patients undergoing radical resection.Methods 45 patients and 45 healthy subjects were included.Perioperative serum TK1 and NKG2D ligand levels were measured in 45 patient and 45 healthy controls.Patients were divided into high TK1 group and low TK1 group,and high sMICA group and low sMICA group according to the ROC.Results Perioperative TK1 were (4.42 ± 1.42) and (2.98 ± 0.54) pmol/L,sMICA were (135 ± 79) and (100 ± 81)pg/ml,which were significantly higher than those in healthy controls (P =0.000).The postoperative TKI and sMICA levels decreased significandy (P =0.000 and 0.042).The 3 and 5 years cumulative survival rates in the high TK1 group were 84％ and 34％,compared with that of 90％ and 75％in the low TK1 group (P =0.023).The 3 year and 5 year cumulative survival rates in high sMICA group were 61％ and 31％,compared with 71％ and 52％ in low sMICA group (P =0.148).Conclusion Patients serum thymidine kinase levels were negatively corelated with the prognosis of colorectal cancer after radical resection.

OBJECTIVE To investigate the cytotoxicity of cyflumetofen for SH-SY5Y cells and the mechanism. METHODS SH-SY5Y cells treated with cyflumetofen 0.03, 0.06, 0.125, 0.25, 0.5, 1, 2, 2.6, 4, 6, 8 and 16 mmol·L-1 for 48 h. Cell survival was measured with MTT assay. The reactive oxygen species (ROS) was determined with the DCFH- DA probe, and mitochondrial membrane potential (MMP) was detected by JC-1 staining. The morphological changes in cell nuclei were observed with Hoechst33258 staining. Cell cycle and apoptosis were determined by flow cytometry. The protein levels of phosphorylated Jun Kinase (p-JNK) and p-P38 were measured by Western blotting. RESULTS Compared with solvent (DMSO) control group, cyflumetofen (≥0.06 mmol · L- 1) inhibited the proliferation of SH- SY5Y cells obviously (P<0.05), and the IC50 was 2.6 mmol·L-1. MMP declined and ROS levels increased significantly in cyflumetofen 1, 2, 4 and 6 mmol·L- 1 groups (P<0.01). Cyflumetofen 2, 4 and 6 mmol·L- 1 induced nucleic accumulation, nuclear shrinkage and disintegration in SH-SY5Y cells. Apoptosis rates of cyflu? metofen 2, 4 and 6 mmol·L- 1 groups increased from (0.7±0.1)% in DMSO control group to (6.7±0.1)%, (72.4±8.6)% and (90.7±3.2)% (P<0.01). Cyflumetofen 4 and 6 mmol·L- 1 induced G1 phase cell cycle arrest (P<0.01). In addition, Western blotting showed that cyflumetofen 4 and 6 mmol·L-1 up-regulated the expression of p-JNK (P<0.01), while the level of p-P38 in SH-SY5Y cells was increased in cyflumetofen 6 mmol · L- 1 group (P<0.01). CONCLUSION Cyflumetofen induces cell damage, apoptosis and G1 phase cell cycle arrest in SH- SY5Y cells. The mechanism may be associated with oxidative damage, and activation of P38 and JNK stress-response pathways.