Objective: To discuss how to improve the level of diagnosis and treatment about the firstbranchial fistula. Method:16 cases with the first branchial fistula were analyzed retrospectively. Result :Of all thepatients underwent surgery, 14 cases were free from disease postoperatively within 0.5 years follow-up, 2patients underwent re-operation because of recurrence. Conclusion:Knowing about the disease fully, selectingproper surgical incision and possessing skilled surgical technique is important to improve the level of diagnosisand treatment about the first branchial fistula.

Objective:To investigate whether the combined injection of micronized acellular dermal matrix(mADM) and granular fat can improve the volume retention rate of the graft and the optimal mixture ratio of these two elements.Methods:From November 2022 to March 2023, the inguinal fat of rats was collected from the Animal Experiment Department of the 940th Hospital of the Joint Logistics Support Force of PLA, and then mixed with mADM in different proportions. Subsequently, different mixtures were injected into both sides of the back in another group of 15 rats: granular fat group (control group, C1), mADM group(control group, C2), granular fat+ mADM(1∶1)group(experimental group, E1), granular fat+ mADM(2∶1) group (experimental group, E2), granular fat+ mADM(4∶1) group(experimental group, E3), granular fat + mADM(6∶1) group (experimental group, E4), and 0.5 ml was injected in each group. At the 4th week, 8th week and 12th week, 5 specimens were randomly selected to detect the volume of grafts, histological analysis and neovascularization of grafts. SPSS 25.0 software was used for statistical analysis. Repeated measures analysis of variance was used to compare the data at multiple time points among multiple groups, and one-way analysis of variance was used to compare the data at each time point among multiple groups. P<0.05 was considered statistically significant. Results:The volume of the grafts in the 6 groups changed significantly with time, and the difference was statistically significant ( P <0.05). At the 4th, 8th and 12th week after injection, the volume of C2 group was larger than that of C1 group. The histological analysis showed that there was no obvious inflammatory cell infiltration in the early stage of C2 group, and the inflammatory reaction gradually occurred after 8 weeks. In the C1 group, vacuolization was observed, and the inflammatory cell infiltration was obvious. The larger the proportion of mADM and granular fat mixed injection, the more collagen fibers arranged regularly. There was a significant difference in the number of neovascularization among the 6 groups at the 4th week after transplantation ( P<0.05), but there was no significant difference at the 8th and 12th week ( P>0.05). Conclusion:mADM combined with granular fat injection can effectively maintain the volume of injection for a long time, and more suitable effect is achieved when the two are mixed at a ratio of 1∶1.

Objective:To investigate whether the combined injection of micronized acellular dermal matrix(mADM) and granular fat can improve the volume retention rate of the graft and the optimal mixture ratio of these two elements.Methods:From November 2022 to March 2023, the inguinal fat of rats was collected from the Animal Experiment Department of the 940th Hospital of the Joint Logistics Support Force of PLA, and then mixed with mADM in different proportions. Subsequently, different mixtures were injected into both sides of the back in another group of 15 rats: granular fat group (control group, C1), mADM group(control group, C2), granular fat+ mADM(1∶1)group(experimental group, E1), granular fat+ mADM(2∶1) group (experimental group, E2), granular fat+ mADM(4∶1) group(experimental group, E3), granular fat + mADM(6∶1) group (experimental group, E4), and 0.5 ml was injected in each group. At the 4th week, 8th week and 12th week, 5 specimens were randomly selected to detect the volume of grafts, histological analysis and neovascularization of grafts. SPSS 25.0 software was used for statistical analysis. Repeated measures analysis of variance was used to compare the data at multiple time points among multiple groups, and one-way analysis of variance was used to compare the data at each time point among multiple groups. P<0.05 was considered statistically significant. Results:The volume of the grafts in the 6 groups changed significantly with time, and the difference was statistically significant ( P <0.05). At the 4th, 8th and 12th week after injection, the volume of C2 group was larger than that of C1 group. The histological analysis showed that there was no obvious inflammatory cell infiltration in the early stage of C2 group, and the inflammatory reaction gradually occurred after 8 weeks. In the C1 group, vacuolization was observed, and the inflammatory cell infiltration was obvious. The larger the proportion of mADM and granular fat mixed injection, the more collagen fibers arranged regularly. There was a significant difference in the number of neovascularization among the 6 groups at the 4th week after transplantation ( P<0.05), but there was no significant difference at the 8th and 12th week ( P>0.05). Conclusion:mADM combined with granular fat injection can effectively maintain the volume of injection for a long time, and more suitable effect is achieved when the two are mixed at a ratio of 1∶1.

OBJECTIVETo identify potential mutation in a Chinese family affected with Charcot-Marie-Tooth disease(CMT).

METHODSClinical data of the family was collected, and genomic DNA was extracted from peripheral blood samples of the family members. Seventy-two candidate genes of the proband were captured and sequenced by targeted next-generation sequencing, and the results were confirmed by Sanger sequencing. The protein structure was predicted with PyMOL-1 software.

RESULTSA homozygous missense mutation c.1894G>A(p.E632K) was identified in the exon 11 of the SH3TC2 gene in the proband. Heterozygous c.1894G>A mutation was also detected in the proband's father, mother and daughter, but not in the healthy family members and 300 normal controls. Retrieval of the NCBI, HGMD and 1000 genome databases has verified the c.1894G>A to be as a novel mutation. Computer simulation has suggested that the mutation has altered the 3D structure of the SH3TC2 protein.

CONCLUSIONThe proband was diagnosed as CMT4C, for which the underlying gene was SH3TC2. This finding has expanded the spectrum of SH3TC2 mutation in association with CMT4C.

Adult ; Aged ; Base Sequence ; Charcot-Marie-Tooth Disease ; genetics ; DNA Mutational Analysis ; Exons ; Female ; Heterozygote ; Humans ; Male ; Middle Aged ; Models, Molecular ; Molecular Sequence Data ; Mutation, Missense ; Pedigree ; Proteins ; genetics ; Young Adult

Objective:To develop a monitoring tool for evaluating health literacy level of general practitioners.Methods:The health literacy monitoring questionnaire for general practitioners was preliminarily developed by referring to the National Residents′ Health Literacy Monitoring Questionnaire. The Delphi method was used to conduct two rounds of consultation among 15 experts to improve the questionnaire.Results:The effective response rates of the two rounds of expert consultation were 100.0%, the expert authority coefficients of the two rounds of consultation were 0.87 and 0.86, the mean scores of the two rounds of expert questions were 3.93 -5.00 and 4.47-5.00. The variance coefficients of the two rounds of expert scores were 0-0.32 and 0-0.20, and the Kendall harmony coefficients of the two rounds of expert scores were 0.167 and 0.102, respectively (all P<0.05). Finally, the basic theory literacy dimension (including 8 chronic disease prevention items, 5 maternal and child health items and 5 infectious disease prevention items), and the basic skill literacy dimension (including 6 safety and first aid items, 8 health information items), and the healthy lifestyle and behavior dimension (7 items, including regular physical examination, exercise, diet and so on) were established. A total of 39 items and 3 dimensions were used to monitor the health literacy level of general practitioners. Conclusion:The monitoring tool of health literacy level for general practitioners based on Delphi method has been preliminarily constructed, which can be used to evaluate the health literacy level of general practitioners.