Objective To evaluate the feasibility of endoscopic transoral-transpharyngeal approach to the upper cervical. Methods Anatomic characteristics were observed and measured in the anterior column of 50 dry atlas and axis specimens. Conventional and endoscopic methods to decompress the spinal cord and excise the cartilage surface of the atlantoaxial joint by transoral-transpharyngeal approach were taken respectively in two groups of cadaveric heads and necks. All the cadaveric specimens were then open dissected to evaluate endoscopic operation methods, decompression size and the "safe zone". Results The anterior arch of atlas was of a length of (19.8?2.3) mm, the height of odontoid was (15.9?1.9) mm, the width (10.5?0.6) mm, and the thickness (11.5?1.9) mm; the maximal transverse diameter of superior facet of axis was (15.1?1.6) mm, and the anteroposterior one was (17.7?1.3) mm. The anterior tubercle of the atlas could be acted as landmark leading to the endoscopic atlantoaxis surgery. The arch could be drilled either from the tubercle to the lateral side or broken from the junction to the lateral mass. Endoscopic odontoid dissection should begin at the apex of the odontoid, and proceed inferiorly. It was necessary to move or slope the working tube to explore atlantoaxial lateral joint and dissect its cartilage, but the width and depth of cartilage dissection should be limited to 12 mm and 10 mm in order to avoid damage to vertebral artery and spinal cord. Measurements after postoperative open dissection showed that endoscopic decompression size were not significantly different from that of conventional method. There was a "safe zone" in the front of atlantoaxis of transoral-transpharyngeal approach, with (45.9?3.6) mm wide and (29.4?2.5) mm high. Conclusion Endoscopic transoral-transpharyngeal approach to the upper cervical is technically feasible, which had a good exploration and could get the same decompressing size with conventional transoral-transpharyngeal approach.

Objective : To examine the association between intrinsic capacity and falls in older adults, so as to provide insights into the risk assessment of falls. Methods: Older adults aged 60 years and above were selected from two districts and one county in Bengbu City, Anhui Province from September 2022 to June 2023 using convenience sampling method. Demographic information, health-related behaviors and incidence of falls among participants were collected through questionnaire surveys. The intrinsic capacity included five dimensions: sensory, motor, vitality, cognition and psychology, which were investigated by the sensory dimension screening scale recommended by the World Health Organization, the Simple Physical Functioning Battery (SPPB), the Micro Nutritional Assessment Scale (MNAS-SF), the Brief Intelligent Mental State Examination Scale (MMSE), and the Center for Evaluation of Streamlined Depression Levels 10-entry scale (CESD-10), respectively. A total score of 1 or more indicated a decrease in intrinsic capacity. The association between intrinsic capacity and falls in older adults was analyzed by a multivariable logistic regression model. Results: A total of 1 950 questionnaires were allocated, and 1 917 were valid, with an effective rate of 98.30%. There were 934 men (48.72%) and 983 women (51.28%), with a mean age of (68.15±3.42) years. There were 1 352 rural residents (70.53%) and 1 431 illiterate and primary school-educated residents (74.65%). In the past year, 347 residents fell, accounting for 18.10%. The median comprehensive score for intrinsic capacity was 1.00 (interquartile range, 2.00) points, and 1 320 had a decrease in intrinsic capacity, accounting for 68.86%. Multivariable logistic regression analysis showed that decline in intrinsic ability was associated with the risk of falls after adjustment for age, gender, educational level, marital status, alcohol consumption and self-rated health status (OR=1.531, 95%CI: 1.408-1.721). Conclusion Decreased intrinsic capacity in older adults may contribute to an increased risk of falls.

Objective: To investigate the association between self-rated health status and mortality risk, and to evaluate the predictive value of self-rated health status for mortality risk among the elderly. Methods: Based on the China Health and Retirement Longitudinal Study (CHARLS) database, data of sociodemographic information, self-rated health status and mortality of the elderly aged 60 years and older were collected from 2011 to 2018. The association between self-rated health status and mortality risk among the elderly was analyzed using a multivariable Cox proportional risk regression model. Results: Totally 4 850 individuals were included, with an median age of 65 (interquartile range, 8) years. There were 2 485 males (51.24%) and 2 365 females (48.76%). There were 877 individuals (18.08%) rated their health as good, 2 078 individuals (42.85%) as general, 1 895 individuals (39.07%) as poor. A total of 28 955 person-years were followed up, with an average follow-up of 5.97 years per person. There were 855 deaths by the end of follow-up in 2018, and the median survival time was 7 (interquartile range, 3) years. Multivariable Cox proportional risk regression analysis showed that there were interactive effects of age, sex and self-rated health status on mortality, respectively (both P<0.05). The results of gender-stratified analysis showed that there was no significant association between self-rated health status and mortality risk in old women (P>0.05). The mortality risk was higher in old men with poor self-rated health than with good self-rated health (<70 years, HR=5.382, 95%CI: 3.263-8.876; 70 to 79 years, HR=3.536, 95%CI: 1.070-11.686; ≥80 years, HR=3.043, 95%CI: 1.827-5.066). Conclusion There is an association between self-rated health status and mortality risk among the elderly, the old men with poor self-rated health had a higher mortality risk.

Objective To study the application of extracellular laccase from endophytic fungi to total flavonoid extraction. Methods The extracellular laccase vitality of an endophytic Fusarium sp.C-8 from Artemisa annua reached 36.1 U/mL when the fungus was cultivated in revised PDA medium with initial pH 7.0 at 20℃ on a rotary shaker incubator for 6 d. The crude laccase from the cultural medium was applied for extraction of flavonoid from the buds of Sophara japonica. The optimization on the ratio of dry buds to crude enzyme liquid,temperature,time,and pH value was carried out during the process of laccase-assistant treatment. Results After incubation with 40∶1 of crude enzyme (pH 7.0) at 20℃ to dry buds for 1 h,the extraction rate of total flavonoids was 11.4 %,a more increase of 28.7 % than that in regular extraction process. Conclusion The results present a practical method of laccase-assistant extraction process on total flavones in S. japonica buds.

Objective:To explore the effect of Dachengqi Decoction and enteral nutrition on the recovery of gastrointestinal function in patients with gastric cancer.Methods:From September 2018 to September 2019, 100 patients with gastric cancer undergoing radical gastrectomy in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were selected as the research objects, and were divided into observation group and control group according to the random number table method, each group contained 50 cases. Among them, the control group was given routine diet before operation to provide pre adaptation of enteral nutrient solution; the observation group was added with Dachengqi Decoction on the basis of routine diet. The recovery of gastrointestinal function, plasma motilin (MTL), serum gastrin (GAS) and gastrointestinal complications were observed and compared between the two groups.Results:There were 3 cases of abdominal distention and diarrhea in the control group, 1 case of diarrhea and 1 case of nausea and vomiting in the control group. The total incidence of gastrointestinal complications was 16% (8/50). There was 1 case of abdominal distention and 1 case of diarrhea in the observation group, and the total incidence of gastrointestinal complications was 4%(2/50). The difference between the two groups was statistically significant ( χ2 value was 4.000, P<0.05). In the observation group, the time of first bowel sounds, exhaust time and defecation time were (26.12 ± 5.32) h, (25.49 ± 4.49) h, (32.63 ± 4.31) h, respectively, which were significantly shorter than those in the control group (32.24 ± 6.41) h, (46.74 ± 6.14) h, (49.51 ± 6.28) h, and the difference was statistically significant ( t value was 5.195, 19.754, 15.671, P<0.05). The plasma MTL and serum gas in the observation group were (346.54 ± 18.58) ng/L, (123.44 ± 6.19) ng/L. After operation, the results were (247.24 ± 11.40) ng/L, (85.46 ± 5.12) ng/L. The difference was statistically significant ( t value was 97.793, 250.990, P<0.05). The plasma MTL and serum gas of the control group before operation were (344.63±16.65) ng/L and (122.53 ± 6.35) ng/L respectively. After operation, the results were (205.84±10.21)ng/L, (64.79±5.24) ng/L. The difference was statistically significant ( t value was 152.390, 367.823, P<0.05). The levels of plasma MTL and serum gas in the observation group were significantly higher than those in the control group ( t value was 19.129, 19.95, P<0.05). Conclusions:The modified Dachengqi Decoction and the pre adaptation of enteral nutrition solution are helpful to reduce the occurrence of various gastrointestinal complications after gastric cancer operation and promote the rapid recovery of gastrointestinal function, which may be related to the promotion of the secretion of MTL and gas.

ranches of portal vein were found in 3 cases. Conclusion The multi-slice spiral CT findings of eosinophilie hepatic infiltration are relatively specific, and three-phase dynamic CT studies can be a valuable tool for the diagnosis of this disease.

Objective To explore the predictive value of soluble growth STimulation expressed gene 2(sST2) on major adverse cardiovascular events(MACE) of acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods The study included 148 patients with first episode of AMI admitted from January 2015 to May 2016 in the heart center of the First Hospital of Lanzhou University.Serum sST2 level before PCI was tested and all patients were followed up clinically for 6 months after PCI.Results 1.MACEs were found in 23 patients during follow up.The sST2 leveles were significantly higher in patients with MACEs than the non-MACE group [(44.50 ±5.32) ng/ml vs.(23.59±1.15) ng/ml, P=0.001].Pearson correlation analysis showed that serum sST2 were positively correlated with MACE and type Ⅲ procollagen amine terminal peptide (PⅢNP) but was not correlated with NT-proBNP.2.Serum sST2 found to be correlated with the body mass index, blood pressure, triglycerides, aspartate aminotransferase, left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF).3.The area under the ROC curve of sST2 to predict the occurrence of MACE after PCI was 0.787 which was higher than that of NT-proBNP.The area under curve of sST2 combined with NT-proBNP was 0.820.4.The survival rate of patients with serum sST2 level ≤29 ng/ml was higher than patients with sST2>29 ng/ml in 6 months after PCI.Conclusions sST2 is affected by a variety of factors.sST2 combined with NT-proBNP can improve the predictive value of MACE after PCI, and higher the level of sST2, higher the mortality rate in 6 months after PCI.

Objective The overexpression lung cancer1( OLC1) protein is overexpressed in a variety of human tumors.The purpose of the present study is to determine whether increased expression of OLC1 is associat-ed with colorectal cancer.Methods OLC1 expression was assayed in 150 colorectal cancer tissues by immuno-histochemical staining(IHC).Multivariate and univariate analyses were performed to determine the association between OLC1 expression and prognosis.Results Immunohistochemical results revealed that 107 out of 150 colorectal cancer patients had increased levels of OLC1.OLC1 expression was significantly correlated with UICC stage(P<0.001)and histological differentiation(P<0.001)in colorectal cancer patients.The 5-year overall survival( OS) rates in patients with strong positive and less OLC1 staining were 16.6%and 95.3%,respectively (P<0.0001).Conclusion OLC1 overexpression is an important factor in colorectal carcinoma prognosis and can be an interesting potential novel biomarker for colorectal cancer.

Objective To study and analyze the CT and MRI findings of hepatic eosinophilic infiltration. Methods Twenty nine patients of hepatic eosinophilic infiltration who were confirmed by biopsy or clinical diagnosis were retrospectively analyzed. All the patients underwent CT and/or MRI scan. Twenty seven cases underwent upper abdominal CT plain scan and three phase enhanced scan, and 5 cases underwent upper abdominal MR plain scan and three phase enhanced scan, of which 3 cases underwent CT and MRI scan. Evaluations were made regarding to the numbers of lesion, distribution, size, shape, margin, density or signal characteristic, enhancement parttern and other special features. Pearson correlation analysis was used to analyze the correlation between the number of hepatic lesions and the number of eosinophils in peripheral blood. Results A total of 108 lesions of eosinophilic hepatic infiltration were observed in 29 cases, including 2 cases with single lesion and 27 cases with multiple lesions. Ninety five of the lesions were located in subcapsular parenchyma or surrounding the portal vein. Most subcapsular lesions were wedge-shaped(n=28). Lesions surrounding portal vein were round-shaped(n=32), while the hepatic parenchymal lesions were irregular or round-shaped(n=13). The mean size of lesion was 34 mm, ranging from 3 to 61 mm. The margin of all the lesions were obscure. The lesions showed slightly low density or isodensity on CT pre-contrast images. On MR pre-contrast images, lesions showed slightly low signal or isointense on T1WI, and hyperintense on T2WI. Branches of portal vein were found infilrated by all lesions. Tueleve cases showed“stripe sign”along the portal vein branches, 16 cases showed“halo ring sign”around the portal vein. Pearson analysis indicated a significant correlation between the number of eosinophilic hepatic infiltrated lesions and the increase of eosinophils in peripheral blood (r=0.783, P<0.05). Conclusion The imaging features of EHI had certain characteristics, especially in the three phase dynamic enhanced scanning, from which we can mainly find“progressive enhancement”,“portal vein sign”,“stripe sign”and“halo ring sign”.

Gastric cancer(GC)is one of the most common tumors and the fourth leading cause of cancer-related death worldwide.Due to the lack of specific signs in early GC,most cases are diagnosed at an advanced stage,often accompanied by infiltration and distant metastasis.Although chemotherapy is the most commonly used treatment for gastric cancer,due to the emergence of drug resistance,many patients will still relapse after chemo-therapy,resulting in poor prognosis.Exosome(EXOs)in the Tumor micro environment(TME)can participate in intercellular communication and play an important role in GC distant metastasis and drug resistance.At present,the detailed mechanism of GC distant metastasis and drug resistance is still unclear.Identifying the exosome-induced mechanism involved in GC distant metastasis and drug resistance can help us find more reliable treatment methods for GC metastasis and drug resistance.This article reviews the mechanism of exosome in GC distant metastasis and drug resistance,in order to provide help for the diagnosis,treatment and research of GC.