Objective The aim of the study was to investigate the effects of inflammation on the biological be-haviors of the VF -MSCs and provide the theoretic basis for the repair of the vocal folds which were damaged by in-flammation .Methods The inflammatory vocal fold tissues and normal vocal fold tissues were respectively derived from the vocal cord polyp and normal tissues of the hypopharyngeal carcinoma patients .The HE staining ,masson trichrome staining and elastin van gieson (EVG) staining were performed to detect the effects of inflammation on the collagenous fiber and elastic fibers of the vocal fold lamina propria .The cell colony formation analysis and MTT cell growth curve were used to detect the effects of inflammation on the proliferation of VF -MSCs .The effects of in-flammation on the multi-directional differentiation of VF -MSCs were evaluated by inducing the VF -MSCs to dif-ferentiate into osteoblasts and lipoblasts .Results The results of masson trichrome staining and EVG staining showed that in the inflammatory vocal fold lamina propria collagen fibers became thicker and the amount of collagen fibers increased ,while elastic fibers became thinner and the amount of elastic fibers decreased .Compared with the vocal fold mesenchymal stem cell (VF-MSCs) in normal vocal folds ,VF-MSCs in inflammatory vocal folds pro-liferated more significantly ,but the osteogenic differentiation and adipogenic differentiation of VF -MSCs in inflammatory vocal folds were restrained .Conclusion Inflammation enhanced the compressive resistance ,abated the elasticity , and restrained the multi -directional differentiation of VF -MSCs .

Objective To discuss the characteristics of ultrasonic images obtained by color Doppler per rectum after intrarectal pouring and the advantages of this method.Methods 40 cases who were diagnosed as rectal carcinoma prior to surgeries were investigated.The rectum was cleand and then was poured with normal saline before examination.Color Doppler ultrasonography per rectum was performed with intrarectal probe touching the inferior edge of the tumor.The 2-dimensional images and color Doppler images were then analyzed.Results The accurate typing of rectal tumors(detailedly,the ulcerative,intumescent,and confined types)can be obtained with this method.Within the 40 cases,24 were ulcerative,12 were intumescent and 4 were confined.Only one case with ulcerative tumor was misdiagnosed as intumescent.The total accuracy rate was 97.5%.As with rectal tumors less than 5cm,there was no significant difference between the measurement by ultrasonography and that by pathologic methods (P＞0.05).While for tumors larger than 5cm,the measurement by ultrasonography was significantly different from that by pathologic methods (P＜0.05).There was no significant correlation between the bloodstream signal of color Doppler and pathological grading(P＞0.05).The method can be applied for patients who have a narrow rectal duct or are suffering from agonies which prevent the passage of the colonoscope.For cases failing to detect the margin and surface of the tumor with routine method,or ultrasonic probe failing to pass the confined area leading to illegible 2-dimensional images,This method is competent as well.Conclusion Color Doppler ultrasonography per rectum after intrareetal pouring can be applied for the diagnosis of rectal tumors of all types.

Objective To investigate the variance of expression of bcl-2 and bax genes in the genesis of gastric carcinoma as well as their relationship. Methods Thirty-five cases of early-stage gastric carcinoma and Twenty-four cases of chronic atrophic gastritis were studied by immunohistochemical method. Results There were no statistical differences of bcl-2 expression levels between gastric carcinoma and atypical hyperplasia or paracancerous intestinalepithelial metaplasia(IEM)(P＞0. 05). There were statistical differences of bcl-2 expression between normal epithelial tissues (or non-cancerous IEM) and the other three groups (P＜0.05),but no statistical difference between the normal epithelial and the non-cancerous IEM group was observed (P＞0. 05). The expressions of bax protein were found in the normal epithelial and the other groups in varying degrees,but there were no statistical differences between either two of the groups (P＞0.05). The bcl-2/bax ratio was higher in early-stage gastric carcinoma,atypical hyperplasia and paracancerous intestinai-metaplasia than in the non-cancerous intestinal-metaplasia (P＜0. 05) and normal epithelial tissues(P＜0. 01). Conclusion The abnormal expression of bcl-2 protein and bax protein ,especially the increased bcl-2/bax ratio, probably play an important role in the course of carcinogenesis of gastric carcinoma.

The basic information and clinical application of nutritional risk scales for children with cancer were reviewed, and the strengths and weaknesses of each scale were analyzed. After systematic search and reading, the scales with more clinical applications included universal scales: Pediatric Malnutrition Assessment Screening Tool (STAMP), Nutritional Risk and Stunting Malnutrition Screening Tool (STRONG kids), Pediatric Yorkhill Malnutrition Score (PYMS), Pediatric Subjective Global Nutritional Risk Assessment (SGNA); specific scales: Nutritional Screening Tool for Childhood Cancer (SCAN), Nutritional Risk Screening for Childhood Cancer (NRS-PC). In order to effectively manage the nutritional risk of pediatric cancer patients, we should selectively use and further actively Chinese or develop specific nutritional risk measurement tools adapted to our national conditions.

Objective To investigate the myogenic differentiation of laryngeal mucosal mesenchymal stem cells (LM-MSCs) and the possibility of LM-MSCs as new alternative seed cells for laryngeal tissue engineering.Methods LM-MSCs were separated from normal epiglottis mucosa and the cell surface markers including CD44,CD105,CD90,CD29,CD34 and CD45 were analyzed through flow cytometry.The osteogenesis and adipogenesis differentiation of LM-MSCs were investigated by oil red staining and alizarin red S staining.Immunofluorescence staining and RT-PCR were used to detect the expressions of myogenic differentiation markers including Myod1,Myogenin and myosin heavy chain (MyHc).Results The separated LM-MSCs were in a fibrocyte-like form with long fusiform shape and grew adherently.The expression rates of cell surface markers LM-MSCs were CD44 (100.0％),CD105 (90.4％),CD90 (99.9％),CD29 (93.0％),CD34 (0.4％) and CD45 (1.3％) respectively.A number of beaded lipid drops and mineral deposition were observed after 14 days of adipogenesis differentiation and 21 days of osteogenesis differentiation.Myod1,Myogenin and MyHc genes appeared after 1 week and 3 weeks of myogenesis differentiation respectively.Conclusions The LM-MSCs have the properties of mesenchymal stem cells and could be differentiated into myoblasts,providing with the possibility to repair the damaged vocal cords with LM-MSCs through tissue engineering techniques.

Objective:To analyze the clinical features and surgical outcomes of petrous bone cholesteatomas (PBCs).Methods:Data from 39 PBCs patients treated in the Department of Otorhinolaryngology, Xijing Hospital from September 2011 to December 2017 were reviewed retrospectively, including 23 males, 16 femals, aged 12-71 years old, with the median age of 37. Clinical classifications, surgical methods, facial and hearing function, and intraoperative and postoperative complications were made summary analysis.Results:In this study, five patients were congenital PBCs and 34 patients were acquired PBCs. The common clinical symptoms were hearing loss (100%, 39/39), ear discharge/pus (89.7%, 35/39) and facial paralysis (46.2%, 18/39). According to Sanna′s classification, 14 cases were supralabyrinthine, including three cases underwent transcochlear (TC) approach, six cases underwent transotic (TO) approach and five underwent translabyrinthine (TL) approach. 10 cases were infralabyrinthine, including eight cases underwent subtotal petrosectomy, one case underwent TO approach and one underwent TL approach.10 cases were massive, including seven cases underwent TC approach, three cases underwent TO approach. Five cases were infralabyrinthine-apical, including two cases underwent TC approach, two cases underwent TO approach, and one case underwent endoscope assisted infratemporal fossa type B. The degree of facial nerve (FN) dysfunction from high to low was massive (6/10), supralabyrinthine (8/14), infralabyrinthine-apical (2/5) and infralabyrinthine (2/10). 19 cases involved in facial nerve operation, three cases underwent FN decompression, four cases underwent FN rerouting, four cases underwent nerve grafting, and one case underwent facial-hypoglossal anastomosis. Preoperative FN involvement in 18 cases, and the FN function was improved in 14 cases after surgery. The improved rate of postoperative FN function was 77.8%. The bone conducted hearing retained 50.0% (14/28) postoperatively. Five cases with cerebrospinal fluid leak were managed by inserting free muscle plugs and cavity obliteration. Two cases with the cholesteatomas matrix involved the sigmoid sinus and the jugular bulb, and occlusion of the sigmoid sinus was performed. Postoperatively, two patients presented with synkinesis. The patients were followed up for 40 to 115 months, and there was no recurrence.Conclusions:There are no specific clinical manifestations for PBCs, thus, it is difficult in early diagnosis and treatment. According to Sanna′s classification, preoperative FN and hearing function, the best surgical approach should be selected with minimal recurrences and perioperative morbidity.

Objective:To investigate the predictive value of Doppler ultrasonography combined with cytokeratin fragment 19 (Cyfra21-1) and soluble interleukin-2 receptor (sIL-2R) in cervical lymph node metastasis of thyroid micropapillary carcinoma.Methods:102 patients with minimal papillary carcinoma of thyroid confirmed by surgery and pathology admitted to Ultrasound Department, Shanxi Cancer Hospital from Aug. 2020 to Aug. 2023 were selected and treated with thyroidectomy plus central region and at least one cervical lymph node dissection. Among them, There were 24 cases in the LLNM group and 78 cases in the non-LLNM group.Results:There were significant differences in age, shape, nodular and capsule contact area, tumor shape aspect ratio > 1, blood flow, microcalcification, serum Cyfra21-1 and serum sIL-2R levels between the two groups (Cyfra21-1: P<0.001, sIL-2R: P=0.001). Logistic regression analysis showed that age ≥50 years old ( OR=0.443, 95% CI: 0.217-0.904), microcalcification ( OR=2.787, 95% CI: 1.491-5.208), Cyfra21-1>3.3ng/ml ( OR=3.117, 95% CI: 1.404-6.922) and sIL-2R > 110.45pmol/L ( OR=3.408, 95% CI: 1.473-7.884) were independent risk factors for cervical lymph node metastasis in PTMC patients ( P < 0.05). The ROC curve results showed that the area under the curve of cervical lymph node metastasis predicted by Doppler ultrasound combined with Cyfra21-1 and sIL-2R was 0.82, and the sensitivity and specificity were 83.67% and 70.56%, respectively. Conclusions:The calcification features of Doppler ultrasound and the elevation of serum Cyfra21-1 and sIL-2R are closely related to cervical lymph node metastasis of thyroid micropapillary carcinoma. The combination of Doppler ultrasound with serum Cyfra21-1 and sIL-2R has important reference value in predicting cervical lymph node metastasis.

Objective:To describe the distribution of lipoprotein (a) [Lp(a)] levels in non-arteriosclerotic cardiovascular disease (ASCVD) population in China and explore its influencing factors.Methods:This study was based on a nested case-control study in the CKB study measured plasma biomarkers. Lp(a) levels was measured using a polyclonal antibody-based turbidimetric assay certified by the reference laboratory and ≥75.0 nmol/L defined as high Lp(a). Multiple logistic regression model was used to examine the factors related to Lp(a) levels.Results:Among the 5 870 non-ASCVD population included in the analysis, Lp(a) levels showed a right-skewed distribution, with a M ( Q1, Q3) of 17.5 (8.8, 43.5) nmol/L. The multiple logistic regression analysis found that female was associated with high Lp(a) ( OR=1.23, 95% CI: 1.05-1.43). The risk of increased Lp(a) levels in subjects with abdominal obesity was significantly reduced ( OR=0.68, 95% CI: 0.52-0.89). As TC, LDL-C, apolipoprotein A1(Apo A1), and apolipoprotein B(Apo B) levels increased, the risk of high Lp(a) increased, with OR (95% CI) for each elevated group was 2.40 (1.76-3.24), 2.68 (1.36-4.93), 1.29 (1.03-1.61), and 1.65 (1.27-2.13), respectively. The risk of high Lp(a) was reduced in the HDL-C lowering group with an OR (95% CI) of 0.76 (0.61-0.94). In contrast, an increase in TG levels and the ratio of Apo A1/Apo B(Apo A1/B) was negatively correlated with the risk of high Lp(a), with OR (95% CI) of 0.73 (0.60-0.89) for elevated triglyceride group, and OR (95% CI) of 0.60 (0.50-0.72) for the Apo A1/B ratio increase group (linear trend test P≤0.001 except for Apo A1). However, no correlation was found between Lp(a) levels and lifestyle factors such as diet, smoking, and physical activity. Conclusions:Lp(a) levels were associated with sex and abdominal obesity, but less with lifestyle behaviors.