Objective The main objective of this study is to explore the effect of liver function on the awake BIS value.Methods According to the Child-Pugh classification,65 patients were divid-ed into three groups.Group A (n=27):patients with normal liver function;group B (n=21):pa-tients with Child-Pugh A;group C (n=1 7):patients with Child-Pugh B-C.The awake BIS value at rest was measured.Results Total bilirubin (TBIL),direct bilirubin (DBIL),indirect bilirubin (IBIL),alanine aminotransferase (ALT),aspartate aminotransferase (AST),albumin (ALB)of group B and C were significantly poorer than group A (P <0.05 or P <0.01).The coagulation func-tion of group C was poorer than group A and B (P <0.01).Compared with group A (96.2 ± 1.7) and group B (95.6±0.8),the awake BIS value of group C (94.1±3.0)was significantly reduced (P<0.01).The awake BIS value was negatively correlated with the TBIL value (r = - 0.26,P =0.039).Conclusion The awake BIS value in end-stage liver disease patients was significantly lower than that in patients with normal liver function and mild liver dysfunction.The awake BIS value may be related with the amount of total bilirubin in the blood.

Objective:To probe into effects of Mifepristone on the Th1/Th2 balance at materno-fetal interface.Methods:Sixty three healthy women in early pregnancy were randomized into two groups,30 women used mifepristone 200 mg,and 33 women as control.Their decidual tissue was collected by curettage in 48 hours of taking the drug.The Th1/Th2 cytokine expressions in decidua were analyzed by immunohistochemistry.Results:In the decidual tissue of normal early pregnancy,there were significantly higher densities of Th2 cytokines,IL-4 and TGF-?2,and lower density of Th1-type cytokine,IFN-? and IL-2.After having treated by Mifepristone,the decidual tissue appeared to significantly higher densities of Th1-type cytokines(IL-2, IFN-?).Conclusion:Our findings suggest that Mifepristone can up-regulate expression of the Th1-type cytokines,and cause a shift towards Th1 bias,which leads to abortion.

OBJECTIVE: To evaluate the clinical value of heterogeneous acellular dermalmatrix with autologous bone meal in open tympanoplasty. METHOD: Twenty-eight cases (30 ears) with middle ear cholesteatoma were trea- ted by open tympanoplasty and repaired by heterogeneous acellular dermalmatrix autologous bone meal on study team. Twenty-two cases (22 ears) with middle ear cholesteatoma were treated by open tympanoplasty on control team. All patients were followed up for 12 to 18 months and assessed the fuction postoperatively. RESULT: The re- construction of external auditory canal structure is close to normal, and no narrow happens on study team. The rate of dry ear was about 90%. All cases had no recurrence of cholesteatoma. CONCLUSION Application of decellu- larized dermal matrix with autologous bone meal can rise early to cover the wound, promote wound healing and to reduce the external auditory canal, reduce the effect of granulation and scar formation. It is a kind of method of repair to be promoted.
Acellular Dermis ; Biological Products ; Cholesteatoma, Middle Ear ; surgery ; Cicatrix ; Ear Canal ; surgery ; Humans ; Minerals ; Postoperative Period ; Recurrence ; Tympanoplasty ; methods ; Wound Healing

Objective To explore the relationship between changes in white matter fiber tracts and executive function impairment in patients with Alzheimer's disease (AD). Methods A total of 118 patients with AD admitted to our hospital from December 2019 to January 2022 were divided into executive dysfunction group(n=46) and normal executive function group(n=72) based on their executive function. General data and the fractional anisotropy (FA) values of white matter fiber tracts in different brain regions were compared between the two groups. Multivariable logistic regression analysis was performed to determine influencing factors for executive dysfunction in patients with AD. Pearson analysis was used to analyze the correlation between the FA values of white matter fiber bundles in various brain regions and the Behavioral Assessment of the Dysexecutive Syndrome (BADS) score. Spearman analysis was used to analyze the correlation between the FA values of white matter fiber bundles in various brain regions and executive dysfunction. A Bayesian network model was constructed and evaluated for its effectiveness. Results Severe dementia and the volume of white matter lesions (WMLs) were independent risk factors for executive dysfunction in patients with AD(P<0.05). BADS score and the mean FA value of white matter fiber bundles were protective factors against executive dysfunction (P<0.05).The FA value of white matter fiber bundles in each region was significantly positively correlated with BADS score(P<0.05) and significantly negatively correlated with executive dysfunction (P<0.05). For the constructed Bayesian network model,the area under the curve was 0.839 (95% confidence interval [CI]:0.822-0.853,P<0.001), indicating high predictive value. Conclusion The FA value of white matter fiber bundles is an independent protective factor against executive dysfunction in patients with AD,which is significantly negatively correlated with executive dysfunction. Measuring white matter fiber bundle changes may be an objective examination method of executive function decline in patients with AD.

OBJECTIVETo compare the clinical effect of the double eyelid blepharoplasty with central minimal incision and with three minimal incisions. Methods: From Jul. 2010 to May 2012, 268 cases (Group A) received double eyelid blepharoplasty with central minimal incision, while 102 cases (Group B) underwent double eyelid blepharoplasty with three minimal incisions. Photos were taken immediately, and 1,2, 4, 8,12 weeks after operation. Operation time, recovery time and postoperative complications were evaluated and recorded. The operation time and recovery time were analyzed by Wilcoxon rank sum test. The postoperative complications were analyzed by chi square test. The satisfactory degree was analyzed by t test.

RESULTSThe operation time in Group A was (25.63 ± 3.74) min, compared with that (29.90 ± 4.13) min in Group B (Z = -8.011, P <0.01). Meanwhile, the recovery time in Group A was shorter than that in Group B (Z = -15.887, P <0.01). The occurrence rate of postoperative complications,including hematoma,recurrence and scar hyperplasia in Group A was also lower than that in Group B. At the same time, the satisfactory degree in Group A was(97.302 ± 1.764), which was higher than that(88.628 10.880) in Group B (t = 12.650, P <0.05).

CONCLUSIONSThe double eyelid blepharoplasty with central minimal incision, which is suitable for all cases except those who has serious blepharochalsais, has more advantages than double eyelid blepharoplasty with three minimal incisions.

Blepharoplasty ; adverse effects ; methods ; Cicatrix ; pathology ; Eyelids ; surgery ; Hematoma ; Humans ; Hyperplasia ; Photography ; Postoperative Complications ; Prospective Studies ; Recurrence

BACKGROUND:The main treatment of lumbar isthmic spondylolisthesis is the surgery, in a broader attempt to decompression, reduction, fixation and fusion of the lesioned segments. The golden standard of the treatment is biological fusion, while internal fixation is a reliable assistance for fusion therapy. ＜br> OBJECTIVE:To discuss the clinical value and curative effect of intervertebral fusion cage combined with pedicle screw systems for the treatment of lumbar isthmic spondylolisthesis. ＜br> METHODS:From March 2010 to March 2013, 21 cases of isthmic spondylolisthesis were treated with intervertebral fusion cage combined with pedicle screw systems, including 18 cases of spondylolisthesis of degree II and 3 cases of spondylolisthesis of degree III. Al patients were fol owed up regularly, taking JOA lumbago score and visual analog scale score as the objective evaluation criteria of pain in postoperative fol ow-ups. The curative effect was assessed by Macrab standard, and the functional recovery was evaluated based on indicators such as Prolo, and the spinal fusion rate was assessed according to Lenke criteria. Changes of slippage rate, slippage angle, sacral inclination angle and intervertebral space post height in preoperative and postoperative periods were evaluated by iconography data. ＜br> RESULTS AND CONCLUSION:Al the 21 patients with isthmic spondylolisthesis were fol owed up for 12-16 months. JOA lumbago score and vasual analog scale score of al patients were improved after treatment, and the difference was statistical y significant compared with before treatment (P=0.000). According to Macrab evaluation criteria, there were 17 excellent cases and 4 good cases. Each indicator evaluated by preoperative Prolo activities and symptom grading showed significant differences in preoperative and postoperative periods (P=0.003). Postoperative lumbar spondylolisthesis was basical y reset, the slippage angle was significantly reduced, the sacral inclination angle was increased, and the height of the intervertebral space was recovered basical y. Intervertebral fusion cage combined with pedicle screw systems was one of the effective strategies to treat lumbar isthmic spondylolisthesis.

Objective To investigate the relationship between telomerase reverse transcriptase (TERT) gene expression and astrocyte activation.Methods Twenty neonatal 3-day-old male SD rats were used for culture of the astrocytes.The astrocytes were divided into Group A (activated,non-transfected astrocytes),Group B (activated,transfected astrocytes),Group C (unactivated astrocytes) and Group D (activated,empty plasmid transfected astrocytes) according to the random number table,with 5 rats per group.The cell proliferation rate in each group was detected by cell counting kit-8 (CCK-8) ;TERT expression by immunocytochemical method; expressions of TERT and glial fibrillary acidic protein (GFAP) genes by RT-PCR assay.Results Astrocytic proliferation ability in Group B lowered significantly as compared with that in Groups A,D and C (F =43.418,P ＜ 0.01).Expressions of TERT and GFAP mRNAs in Groups A and D were significantly higher than those in Group B and C,and no significant difference was found between Groups A and D.Besides,there was a linear correlation between mRNAs expressions of both genes in Groups A and D (r =0.701,0.704,P ＜ 0.01),while no significant linear correlation was observed in Groups B and C (r =0.260,P ＞ 0.05).Expressions of TERT and GFAP proteins in Groups A and D were markedly higher than those in Groups B and C and no significant difference was found between Groups A and D.Conclusion TERT genes are involved in the activation of astrocytes and exert effect on promoting the activation of astrocytes.

Objective To observe the antimicrobial effect of a kind of Chinese medicine Qingre compound preparation on the common pathogenic bacteria of upper respiratory tract infection (URTI). Methods A total of 163 common pathogen?ic bacteria of URTI was selected in this study, including 74 non extended-spectrum β- lactamases (ESBLs)-producing Gram-negative bacteria (33 Escherichia coli, 24 Klebsiella pneumonia and 17 Pseudomonas aeruginosa), 10 ESBLs-produc?ing Gram-negative bacteria (6 Escherichia coli and 4 Klebsiella pneumoniae) and 79 Gram-positive bacteria [11 methicil?lin-resistant Staphylococcus aureus (MRSA), 46 methicillin-sensitive Staphylococcus aureus and 22 Streptococcus pneu?moniae]. Agar dilution method was adopted to perform the quantitative drug sensibility test. Agar plates that contained differ?ent concentrations of Qingre compound preparation were prepared. The bacterial suspension was planted on the plates. Then we observed the plates after incubation, and recorded the minimum inhibitory concentration (MIC). Results The antimicro?bial rates of Qingre compound preparation were 88, 176 and 22 g/L for MIC90 of Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. The antimicrobial effects of Qingre compound preparation were coincident on the MIC 90 of ES?BLs-producing strains and non ESBLs-producing strains. The accumulated antibacterial rates of different concentrations of medicine to Pseudomonas aeruginosa were the highest. The MIC90 values of Qingre compound preparation were 11, 11 and 22 g/L for MSSA, MRSA and Streptococcus pneumoniae. The MIC90 of MRSA was coincident with MSSA, but MIC50 of MRSA was slightly higher than that of MSSA. The accumulated antibacterial rates of different concentrations of medi cine to MSSA and MRSA were all higher than those of Streptococcus pneumonia. The accumulated antibacterial rate of MSSA was similar with that of MRSA. Conclusion The Chinese medicine Qingre compound preparation could restrain common patho?genic bacteria of URTI except Klebsiella pneumoniae. The antibacterial effect of Qingre compound preparation is significant?ly better in Ggram-positive bacteria than that of Gram-negative bacteria.

Objective To explore the risk factors of inguinal metastasis in squamous cell carcinoma of the penis, screening lymph node metastasis high-risk patients. Methods The clinical and pathological data of 81 consecutive patients with squamous cell carcinoma of the penis were analyzed retrospectively. Age at presentation ranged from 27 to 81 years with a median of 49 years. Course of disease within one year of patients with 46 cases (56.8%), 1 year above 35 eases (43.2 %). Seventyfive patients underwent bilateral inguinal lymph node dissection, and 6 patients had unilateral inguinal lymph node dissection. Clinical stage of the primary tumor was assigned according to the 2002 TNM staging system. Variables included patients' age, redundant prepuce and/or phimosis, tumor site,size, number, macroscopic growth pattern, histological grade, inguinal physical examination and the size of inguinal lymph nodes. Results Of the 81 patients, 42 (51.9%) were staged as pN+ and 39 (48. 1%) as pN0. Metastases occurred in 32.0% (16/50) of G1, 78.3% (18/23) of G2 and 100. 0%(8/8) of G3 cases, with significant differences among them (P= 0. 015). According to the inguinal lymph node physical examination results, 63 were staged as clinically node-positive (cN+) and 18 as clinically node-negative (cN0). Metastases occurred in 63. 5% (40/63) of cases of cN+, as compared with 11.1% (2/18) of cases of cN0(P=0. 012). At a median follow up of 40 months (ranged 2-127 months), the 5-year disease free survival rates for positive and negative inguinal lymph nodes metastasis were 71.4% and 92.3%, respectively (P=0. 005) , and the 5-year cancer specific survival rates were 79.0% and 91.4%, respectively (P=0.001). Conclusions Inguinal physical examination and histological grade were the strongest predictors of inguinal metastasis. The patients with inguinal lymph nodes metastasis have lower 5-year disease free survival rates and cancer specific survival rates,and should receive positive treatment measures.

Objective:To investigate the factors influencing the success of external cephalic version.Methods:Pregnant women who underwent an external cephalic version due to breech or transverse presentation by the same operator in the Third Affiliated Hospital of Zhengzhou University from July 2015 to July 2021 were selected as the study objects. Univariate analysis and logistic regression analysis were used to explore the clinical factors influencing the success of the external cephalic version. The receiver operating characteristic (ROC) curve was used to analyze the best cut-off value of gestational week and amniotic fluid index at the time of operation and to evaluate the predictive value of the influencing factors on the success of the external cephalic version.Results:(1) A total of 118 cases finally entered this study. Among the 118 cases,77 cases (65.3%) succeeded in the external cephalic version, among which the success rate was 49.1% (27/55) for primipara and 79.4% (50/63) for multipara. The vaginal delivery rate was 56.8% (67/118). (2) Complications occurred in 19 (16.1%) of the 118 cases. The main complications were abnormal fetal heart rate (13 cases, 11.0%), umbilical cord presentation, and fetal position reversion (two cases and 1.7% in each), and the serious complications were intrauterine fetal death and placental abruption (one case and 0.8% in each).The complication rate of patients with successful external cephalic version was 7.8% (6/77), which was lower than that of those who failed the external cephalic version [31.7%(13/41)] ( χ 2=11.33, P=0.001). (3) Multivariate analysis showed that gestational week at surgery before 38, amniotic fluid index >11.10 cm, and multipara were the factors affecting the success of the external cephalic version [ OR(95% CI)=0.561(0.351-0.897), 1.173(1.018-1.351) and 4.201(1.547-11.404), all P<0.05]. (4) The area under the ROC curve of the combination of the gestational week at surgery, amniotic fluid index, and parity was 0.744 (95% CI: 0.640-0.848, P<0.001), and the Youden index was 0.518, with a sensitivity of 70.0% and a specificity of 81.8%. Conclusion:Gestational weeks, amniotic fluid index, and multipara are related to the success of the external cephalic version, and the combination of the three has certain predictive power for the success of the surgery.