Objective:To compare the outcomes of simultaneous versus staged nasal bone reduction and septoplasty in the treatment of traumatic nasal bone fractures with associated septal fractures. Methods:Patients with traumatic nasal bone fractures, with or without septal fractures, were recruited from two hospitals and divided into three groups. Group A underwent simultaneous nasal bone reduction and septoplasty, Group B underwent staged nasal bone reduction and septoplasty, and Group C underwent nasal bone reduction only. Nasal appearance scores and nasal congestion Visual Analogue Scale （VAS） scores were measured preoperatively, at 2 weeks postoperatively, and at 3 months postoperatively. For Group B, scores were also recorded at 2 weeks and 3 months after the second-stage surgery. Differences were analyzed using statistical software. Results:Two weeks post-surgery, the nasal appearance scores significantly decreased in all three groups compared to preoperative scores （P< 0.01）, with no statistically significant differences between the groups （P= 0.43, 0.71, 0.58）. In Group A, the VAS score for nasal congestion decreased significantly following simultaneous surgery （P<0.01）. In Group B, there were no significant differences in nasal congestion VAS scores between pre-surgery and post-first-stage, nor between three months post-first-stage and two weeks post-first-stage （P= 0.61, 0.13）. However, the VAS scores significantly decreased after the second-stage surgery compared to pre-surgery, and three months post-second-stage surgery compared to three months post-first-stage surgery （P<0.01）. The VAS scores for nasal congestion at two weeks post-surgery in Group A were lower than those in Group B after the first-stage surgery （P<0.01）. The incidence rates of nasal adhesions post-surgery in Groups A, B, and C were 0%, 6.9%, and 4.3%, respectively. Conclusion:For traumatic nasal bone fractures with associated septal fractures, performing simultaneous nasal bone reduction and septoplasty under general anesthesia using endoscopy is more time-efficient compared to staged surgery, and it results in a lower occurrence rate of post-surgical nasal adhesions.
Humans ; Nasal Bone/surgery* ; Nasal Septum/injuries* ; Treatment Outcome ; Rhinoplasty/methods* ; Male ; Female ; Adult ; Skull Fractures/surgery* ; Fractures, Bone/surgery* ; Middle Aged ; Adolescent

Purpose/Significance To investigate the application of cutting-edge technologies in predicting the incidence of hemor-rhagic fever with renal syndrome(HFRS),to compile and integrate various time-series analysis methods,evaluate and select the opti-mal model.Method/Process By utilizing national HFRS incidence data from 2004 to 2020,the effectiveness of models is predicted based on statistical methods:SARIMA,STL-ARIMA and TBATS,neural network approaches:NNAR,LSTM and combined models of SARIMA-LSTM with 3 different weighting schemes.The performance of these models is comprehensively assessed using RMSE,MAE and MAPE.Result/Conclusion The SARIMA and LSTM models are identified as the superior individual models.The combined SARI-MA-LSTM model demonstrates enhanced performance compared to individual models.The SARIMA-LSTM model optimized using the reciprocal of error method is deemed the optimal model.The optimal model is expected to provide technical support and references for the early warning system model design of HFRS.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Objective:To compare the efficacy and safety between WangShiBaoChiWan and mosapride in the treatment of functional dyspepsia (FD).Methods:From September 2019 to September 2020, patients with postprandial fullness and early satiation who met the Rome Ⅳ criteria for FD diagnosis were enrolled from 15 hospitals, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical College. The subjects were randomly divided into WangShiBaoChiWan (experimental) group and mosapride (control) group in the ratio of 1∶1. The treatment regimens were WangShiBaoChiWan+ mosapride simulator, WangShiBaoChiWan simulator+ mosapride, respectively with a treatment period of 2 weeks. The primary efficacy outcome was the improvement rates of main symptoms before and after treatment, the secondary efficacy primary efficacy outcome was the total clinical effective rate and the change of the single symptom score. And the safety indicator included adverse events. Independent sample t-test, paired t-test and chi-square test were used for statistical analysis. Results:A total of 251 FD patients were enrolled in the full analysis set, including 124 in the experimental group and 127 in the control group; 241 FD patients were in the per-protocol analysis set, including 117 in the experimental group and 124 in the control group. The analysis of per-protocol analysis set showed that the improvement rates of the main symptoms of the experimental group and the control group were (66±29)% and (60±30)%, respectively, and the difference was not statistically significant ( P>0.05). The improvement rate of the main symptoms of the experimental group reached 117% of that of the control group, which exceeded the expected non-inferiority standard of 80%. The total clinical effective rates of the experimental group and the control group were 76.07% (89/117) and 75.81% (94/124), respectively, and the difference was not statistically significant ( P>0.05). The results of full analysis set showed that the incidence of adverse events of the experimental group and the control group was 1.62% (2/124) and 1.57% (2/127), respectively, and the difference was not statistically significant ( P>0.05). There were no serious adverse events in the two groups. Conclusion:The improvement rate of the main symptoms of WangShiBaoChiWan is not inferior to that of mosapride in the treatment of FD, and it has good safety.

Objective:To explore the efficacy and safety of Ganhai Weikang capsule (GWC) in the treatment of functional dyspepsia (FD).Methods:A randomized, double-blind, placebo-controlled parallel, multi-center, superiority clinical trial was conducted. From March 2018 to April 2020, totally 324 patients with dyspepsia symptoms, who were diagnosed as chronic non-atrophic gastritis by endoscopy and pathology and met the Rome Ⅳ diagnostic criteria for FD from 7 top hospitals were enrolled, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Heilongjiang Hospital of Traditional Chinese Medicine, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Qilu Hospital of Shandong University, the First Affiliated Hospital of Zhejiang University, Beijing Hospital of Traditional Chinese Medicine of Capital Medical University and the Third Xiangya Hospital of Central South University. The patients were randomly divided into the GWC group and the placebo group according to the ratio of 1∶1. The patients of GWC group were given GWC and the patients of placebo group were given GWC capsule simulant. The patients of both groups orally took capsules before meals, 2.4 g each time and 3 times per day, and the course of treatment was 4 weeks. The main efficacy index was the total clinical effective rate after 4 weeks, and the secondary efficacy index was the changes of clinical symptom scores of upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety. The safety index included laboratory tests and adverse events. Chi-square test and Wilcoxon rank sum test were used for statistical analysis.Results:A total of 320 FD patients were enrolled in the full analysis set (FAS), which included 161 cases in GWC group and 159 cases in placebo group. A total of 298 cases were in the per-protocol set (PPS), 149 cases each in GWC group and placebo group. The results of FAS and PPS both showed that the total clinical effective rates of the GWC group were higher than those of the placebo group (84.5%, 136/161 vs. 44.0%, 70/159 and 83.9%, 125/149 vs. 46.3%, 69/149), and the differences were statistically significant ( χ2=57.07 and 46.32, both P<0.001). In addition, the differences of the total score of main symptoms and each symptom (upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety) before and after treatment of GWC group were all higher than those of the placebo group (FAS: 10 (7, 14) vs. 5 (3, 11); 3 (2, 4) vs. 2 (0, 3); 2 (0, 4) vs. 1 (0, 3); 3 (1, 4) vs. 2 (1, 3); 2 (0, 4) vs. 1 (0, 3). PPS: 10 (7, 13) vs. 5 (3, 11); 3 (2, 4) vs. 2 (0, 3); 2 (0, 4) vs. 1 (0, 2); 3 (1, 4) vs. 2 (1, 3); 2 (0, 4) vs.1 (0, 3)), and the differences were statistically significant (FAS: Z=5.80, 5.91, 3.19, 3.72 and 3.30; PPS: Z=5.14, 5.11, 2.86, 3.21 and 2.84; all P<0.01). The results of FAS and PPS indicated that the improvement rates of main symptoms and each symptom (upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety) of GWC group were all higher than those of the placebo group (FAS: 77.8% (54.6%, 91.3%) vs. 42.9% (28.6%, 61.5%); 100.0% (60.0%, 100.0%) vs. 50.0% (25.0%, 60.0%); 100.0% (50.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 71.4% (33.3%, 100.0%) vs. 41.4% (25.0%, 66.7%); 100.0% (50.0%, 100.0%) vs. 50.0% (20.0%, 100.0%). PPS: 77.8% (54.2%, 89.5%) vs. 44.0% (28.6%, 65.0%); 100.0% (60.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 100.0% (50.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 71.4% (33.3%, 100.0%) vs. 46.4% (25.0%, 66.7%); 100.0% (50.0%, 100.0%) vs. 50.0% (20.0%, 100.0%)), and the differences were statistically significant (FAS: Z=8.60, 7.72, 4.98, 4.24 and 5.61; PPS: Z=7.90, 7.03, 4.49, 3.88 and 4.83; all P<0.001). After 2 weeks of treatment, the differences of the total score of main symptoms and score of each symptom (upper abdominal pain, upper abdominal burning and early satiety) before and after treatment of GWC group were all higher than those of the placebo group (5.0 (3.0, 8.0) vs. 4.0 (2.0, 6.0); 2.0 (1.0, 2.0) vs. 2.0 (0.0, 2.0); 1.5 (0.0, 2.0) vs. 1.0 (0.0, 2.0); 1.5 (0.0, 2.0) vs. 1.0 (0.0, 2.0)), and the differences were statistically significant ( Z=2.95, 3.44, 2.43 and 2.79, all P<0.05). There was no significant difference in the incidence of adverse events between the GWC group and the placebo group (0.6%, 1/163 vs. 0, 0/159). Conclusion:The clinical total effective rate of GWC in the treatment of FD is superior to that of placebo and it has good safety.

Objective: Combining the aluminium content data of food in Henan Province with the data of children s food consumption, to evaluate probability of dietary aluminum exposure among primary school students. Methods: Database of nine types of aluminum containing food and their consumption among primary school students in Henan Province were established. The probability distribution of dietary aluminum exposure was calculated by Monte Carlo simulation using Crystal Ball 11.1.2.4 software, and the sensitivity analysis of exposure was conducted. Results: The average content of aluminum in fried bread stick was the highest, with the value of 150.89 mg/kg. The consumption of dietary aluminum was highest in steamed bun, with the value of 0.15 g. The average dietary aluminum exposure per kilogram of body weight was 1.99 mg per week of primary school students in Henan Province, accounting for 99.7% of the provisional tolerable weekly intake (PTWI). The 95th percentile of aluminum exposure per kilogram of body weight per week was 6.16 mg, which was three times of that of PTWI. Nearly 13.22% of primary school students had dietary aluminum exposure higher than PTWI. Among all kinds of food, the average aluminum exposure of fried bread stick per kilogram of body weight per week was the highest 1.19 mg. Aluminum content in fried bread stick accounted the highest proportion of average dietary aluminum exposure among primary school students. Conclusion The average dietary aluminum exposure level of primary school students in Henan Province is close to the PTWI established by JECFA, with the high consumption population exceeds the PTWI. Measures should be taken to reduce the dietary aluminum exposure risk of primary school students.

Objective: To analyze the epidemiological characteristics of school foodborne disease outbreaks in Henan Province from 2011 to 2020 and to provide the basis for effective prevention and control of school foodborne disease outbreaks. Methods: The outbreaks of foodborne diseases in schools in Henan Province reported by the foodborne disease outbreak surveillance system from 2011 to 2020 were statistically analyzed. Results: A total of 47 outbreaks of school foodborne diseases were reported in Henan province in the past 10 years, with a total of 1 258 cases, 701 hospitalizations and 1 death. Zhengzhou, Zhumadian, Xinyang and Xinxiang were the top 4 cities in Henan Province in terms of the number of school foodborne disease outbreaks reported. The peak of foodborne illness incidents in schools was in June and September. The largest number of incidents occurred in middle school canteens and primary school canteens(all 12). The number of reported incidents (12) and the number of cases of foodborne diseases (371) in schools caused by cereals and their products were the largest. Pathogenic bacteria and their toxins were the main pathogenic factors that caused the outbreaks of foodborne diseases in schools, accounting for 78.26% of the identified causes. Bacillus cereus was the top pathogens causing foodborne diseases outbreaks in schools. The pathogenic factor that caused the largest number of cases was Diarrheogenic Escherichia Coli, and the pathogenic factor that caused the death cases was poisonous mushrooms. Apart from unexplained incidents, improper processing was the main link leading to foodborne diseases outbreaks in schools. Conclusion The primary and middle school students are the group with high incidence of foodborne diseases in schools. The supervision and management of school canteen should be strengthened in summer to prevent the outbreak of bacterial foodborne diseases caused by improper processing and storage of grain food.

Provirus integration site Moloney murine leukemia virus (Pim-1) is a proto-oncogene reported to be associated with cell proliferation, differentiation and survival. This study was to explore the neuroprotective role of Pim-1 in a rat model subjected to optic nerve crush (ONC), and discuss its related molecules in improving the intrinsic regeneration ability of retinal ganglion cells (RGCs). Immunofluorescence staining showed that AAV2- Pim-1 infected 71% RGCs and some amacrine cells in the retina. Real-time PCR and Western blotting showed that retina infection with AAV2- Pim-1 up-regulated the Pim-1 mRNA and protein expressions compared with AAV2-GFP group. Hematoxylin-Eosin (HE) staining, γ-synuclein immunohistochemistry, Cholera toxin B (CTB) tracing and TUNEL showed that RGCs transduction with AAV2-Pim-1 prior to ONC promoted the survival of damaged RGCs and decreased cell apoptosis. RITC anterograde labeling showed that Pim-1 overexpression increased axon regeneration and promoted the recovery of visual function by pupillary light reflex and flash visual evoked potential. Western blotting showed that Pim- 1 overexpression up-regulated the expression of Stat3, p-Stat3, Akt1, p-Akt1, Akt2 and p-Akt2, as well as βIII-tubulin, GAP-43 and 4E-BP1, and downregulated the expression of SOCS1 and SOCS3, Cleaved caspase 3, Bad and Bax. These results demonstrate that Pim-1 exerted a neuroprotective effect by promoting nerve regeneration and functional recovery of RGCs. In addition, it enhanced the intrinsic regeneration capacity of RGCs after ONC by activating Stat3, Akt1 and Akt2 pathways, and inhibiting the mitochondrial apoptosis pathways. These findings suggest that Pim-1 may prove to be a potential therapeutic target for the clinical treatment of optic nerve injury.

Chromosomal region maintenance 1 (CRM1) is associated with an adverse prognosis in glioma. We previously reported that CRM1 inhibition suppressed glioma cell proliferation both in vitro and in vivo. In this study, we investigated the role of CRM1 in the migration and invasion of glioma cells. S109, a novel reversible selective inhibitor of CRM1, was used to treat Human glioma U87 and U251 cells. Cell migration and invasion were evaluated by wound-healing and transwell invasion assays. The results showed that S109 significantly inhibited the migration and invasion of U87 and U251 cells. However, mutation of Cys528 in CRM1 abolished the inhibitory activity of S109 in glioma cells. Furthermore, we found that S109 treatment decreased the expression level and activity of MMP2 and reduced the level of phosphorylated STAT3 but not total STAT3. Therefore, the inhibition of migration and invasion induced by S109 may be associated with the downregulation of MMP2 activity and expression, and inactivation of the STAT3 signaling pathway. These results support our previous conclusion that inhibition of CRM1 is an attractive strategy for the treatment of glioma.

Chromosomal region maintenance 1 (CRM1) is associated with an adverse prognosis in glioma. We previously reported that CRM1 inhibition suppressed glioma cell proliferation both in vitro and in vivo. In this study, we investigated the role of CRM1 in the migration and invasion of glioma cells. S109, a novel reversible selective inhibitor of CRM1, was used to treat Human glioma U87 and U251 cells. Cell migration and invasion were evaluated by wound-healing and transwell invasion assays. The results showed that S109 significantly inhibited the migration and invasion of U87 and U251 cells. However, mutation of Cys528 in CRM1 abolished the inhibitory activity of S109 in glioma cells. Furthermore, we found that S109 treatment decreased the expression level and activity of MMP2 and reduced the level of phosphorylated STAT3 but not total STAT3. Therefore, the inhibition of migration and invasion induced by S109 may be associated with the downregulation of MMP2 activity and expression, and inactivation of the STAT3 signaling pathway. These results support our previous conclusion that inhibition of CRM1 is an attractive strategy for the treatment of glioma.