Objective To observe the effects of pregnancy induced hypertension on lipid metabolism and bilirubin metabolism in term neonates.Methods 200 term neonates were selected and divided into the two groups,100 cases whose mother were healthy were control group and another 100 cases whose mother had gestational hypertension were observation group.Birth weight,measured in cord blood triglyceride (TG),total cholesterol (TC) levels,high density lipoprotein (HDL-C),low density lipoprotein (LDL-C),adiponectin (APN) level were recorded.Results Birth weight of the observation group had significantly lower birth weight (2 927 ± 492) g,than the weight of the control group (3 452 ± 348) g.The incidence of lower birth weight was higher than in the observation group.TG,LDL-C levels of the observation group were (0.6 ± 0.24) mmol/L,(1.95 ± 0.25) mmol/L,were higher than those of the control group[(0.39 ± 0.17) mmol/L,(1.95 ± 0.25) mmol/L].There was a statistically significant difference between the groups (t =12.35,2.35,P ＜ 0.01 or P ＜ 0.05).HL-C and APN of the observation group were lower than those of the control group (t =1.79,7.00,all P ＜ 0.05).Bilirubin after bomed 24 hours,48 hours,72 hours and bilirubin peak of the observation group were (8.64 ± 2.17) mg/L,(11.06 ± 3.12) mg/L,(10.32 ± 2.47) mg/L,(12.04 ± 2.13) mg/L and were higher than those of the control group [(3.06 ± 0.94) mg/L,(6.98 ± 1.56) mg/L,(7.26±1.89)mg/L,(9.64±1.98)mg/L](t=23.48,11.65,9.84,8.27,allP＜0.01).Conclusion Maternal PIH may affect birth weight,lipid metabolism and bilirubin metabolism.

Objective To detect the expression of Cancer-Testis antigen NY-ESO-1 in human laryngeal squamous carcinoma (LSC) and to explore its significance in immunotherapeutic application. Methods The expressions of NY-ESO-1 protein in the LSC and in the pathologically positive lymph nodes were detected by PV-9000 Immunohistochemistry. Western blotting was also employed to measure the expressions of NY-ESO-1 in the tumor core region(TC), the tissues at the sites of 0.5cm, 1.0cm away from LSC periphery and the distant normal larynx tissues. Results NY-ESO-1 protein expression was positive in 30 out of 69 (43.48 %) cases of LSC. The expression level of NY-ESO-1 protein were found to significantly decrease by tums in TC and corresponding adjacent tissues (P ＜0.01). None of the nine normal larynx tissues expressed NY-ESO-1 protein.It did not display an obvious correlation between the expression of NY-ESO-1 with T staging, pathological grading and lymph node metastasis (P ＞0.05). Its positive expression was found in pathologically positive cervical lymph nodes, which were significantly lower than that in the primary site (P ＜0.05). Conclusion NY-ESO-1 protein express at high level in human laryngeal squamous carcinoma, and they may play a role in genesis and development of tumors, which suggests that NY-ESO-1 gene might be used as target antigens for immunotherapy of LSC and the further research is necessary.

Objective To evaluate the changes in the activity of extracellular signal-regulated kinase 5 (ERK5) in the distal cerebrospinal fluid contacting neurons (CSF-CNs) in the mid-brain of morphine dependent rats.Methods Forty-eight male adult Sprague-Dawley rats weighing 230-270 g,were randomly divided into 2 groups (n =24 each) using a random number table:control group (group A) and morphine dependence group (group B).Morphine dependence was induced by increasing doses of subautaneous morphine for 5 consecutive days.The initial dose of morphine was 10 mg/kg twice a day and was increased by 10 mg/kg everyday until 50 mg/kg on 5th dav.The equal volume of normal saline was injected subcutaneously instead of morphine in group A.On 3rd day after morphine dependence was induced,the distal CSF-CNs in the mid-brain was labeled with 30％ cholera toxin subunit B and horseradish peroxidase compound (CB-HRP) 3 μl injected in the lateral cerebral ventricle in the morning.At 4 h after the last injection of morphine,the segments in which CSF-CNs were located were removed,and CB-HRP positive neurons,phosphor-ERK5 (p-ERK5) positive neurons and CB-HRP/p-ERK5 positive neurons were counted.Results Compared with group A,the number of p-ERK5 and CB-HRP/p-ERK5 positive neurons in the mid-brain was significantly increased (P ＜ 0.05),and no significant change was found in CB-HRP positive neurons in group B (P ＞ 0.05).Conclusion The enhanced activity of ERK5 in the distal CSFCNs in the mid-brain may contribute to the development of morphine dependence in rats.

Objective To evaluate the role of extracellular signal-regulated protein kinase 5 (ERK5) in the spinal cord in withdrawal responses in morphine-dependent rats.Methods Ninety-six adult male SpragueDawley rats in which intrathecal catheters were successfully placed,weighing 200-250 g,were randomly divided into 4 groups (n =24 each) using a random number table:normal saline group (group A),withdrawal group (group B),dimethyl sulfoxide (DMSO) group (group C) and ERK5 inhibitor BIX02188 group (group D).Morphine dependence (MD) was induced by increasing doses of subcutaneous morphine for 6 days.The initial dose of morphine was 10 mg/kg once a day and was increased by 10 mg/kg once a day from the 2nd to 5th days until 50 mg/kg on the 6th day in B,C and D groups.Morphine withdrawal response (MW) was induced by intraperitoneal naloxone 4 mg/kg at 4 h after last morphine administration in B,C and D groups.In addition,BIX02188 and 1％ DMSO 10 μl were injected intrathecally at 1 h before naloxone injection in D and C groups,respectively.MW and morphine withdrawal-induced hypemlgesia were scored.The rats were then sacrificed after hyperalgesia was scored and the spinal cord was removed for determination of ERK5 and phosphorylated ERK5 (p-ERK5) expression.Results Compared with group A,MW and hyperalgesia scores were significantly increased and the expression of pERK5 was up-regulated in B,C and D groups (P ＜ 0.05).Compared with group B,MW and hyperalgesia scores were significantly decreased and the expression of p-ERK5 was down-regulated in D group (P ＜ 0.05),and no significant change was found in group C (P ＞ 0.05).Conclusion ERK5 in the spinal cord is involved in withdrawal responses in morphine-dependent rats.

Objective To evaluate the role of spinal neuronal extracellular signal-regulated protein kinases 5/cAMP response element binding protein (ERK5/CREB) signaling pathway in withdrawal responses in morphinedependent rats.Methods Ninety-six adult male Sprague-Dawley rats in which intrathecal catheters were successfully placed,weighing 200-250 g,were randomly divided into 4 groups (n =24 each):normal control group (group A),morphine withdrawal group (group B),dimethyl sulfoxide (DMSO) + morphine withdrawal group (group C) and ERK5 inhibitor BIX02188 + morphine withdrawal group (group D).Morphine dependence (MD) was induced by increasing doses of subcutaneous morphine for 6 days.The initial dose of morphine was 10 mg/kg once a day and was increased by 10 mg/kg once a day from 2nd to 5th days until 50 mg/kg on 6th day in B,C and D groups.Morphine withdrawal response (MW) was induced by intraperitoneal naloxone 4 mg/kg at 4 h after last morphine administration in B,C and D groups.In addition,BIX02188 10 μg and 1％ DMSO 10 μl were injected intrathecally at 1 h before naloxone injection in D and C groups,respectively.MW and morphine withdrawal-induced hyperalgesia were scored.The rats were then sacrificed after hyperalgesia was scored and the spinal cord was removed for determination of CREB and phosphorylated CREB (p-CREB) expression.Results Compared with group A,MW and hyperalgesia scores were significantly increased and the expression of p-CREB was up-regulated in B,C and D groups.Compared with group B,MW and hyperalgesia scores were significantly decreased and the expression of p-CREB was down-regulated in D group,and no significant change was found in group C.Conclusion The spinal neuronal ERK5/CREB signaling pathway is involved in withdrawal responses in morphine-dependent rats.

OBJECTIVE To observe the submucosal infiltrating extent of laryngeal carcinoma tissue by different location,different T staging and external appearance and to analyze the impact of laryngeal carcinoma submucosal infiltrating extent on surgical margin.METHODS Forty-three laryngeal en bloc specimens coming from 43 cases with laryngeal carcinoma were vertically cut-down along tumor long axis,and were slivered into sections by which laryngeal carcinoma submucosal infiltrating distance was measured under microscope.Laryngeal carcinoma latent submucosal infiltrating extent was compared among different location,different T staging and external appearance.RESULTS Basing on tumor external appearance and infiltrating extent,laryngeal carcinoma was classified into three types:exogenic type,ulcerating infiltrating type and mixed infiltrating type.Of 43 specimens,the three types were 10,8 and 25 cases respectively.There was a significant difference in submucosal infiltrating extent between T1～T2 and T3～T4 laryngeal carcinoma.There was also significant difference in submucosal infiltrating extent between exogenic type and ulcerating infiltrating type or mixed infiltrating type.CONCLUSION The submucosal infiltrating extent of laryngeal carcinoma tissue plays an important role in the surgical margin. As laryngeal carcinoma T stage developing,tumor submucosal infiltrating extent is becoming more extensive.Laryngeal carcinoma submucosal infiltrating extents in ulcerating infiltrating and mixed infiltrating type are more extensive than that in exogenic type.The partial laryngectomy should be prudent to be performed in cases with local advanced ulcerating infiltrating and mixed infiltrating laryngeal carcinoma.

Objective:To evaluate the reliability and validity of the Chinese version of HEMO-FISS-QoL(HF-QoL) questionnaire (HF-QoL-C) in the Chinese population with hemorrhoids.Methods:From November 2021 to November 2022, a self-constructed general information questionnaire, HF-QoL-C, and the 36-item short form health survey (SF-36), Goligher classification, and Giordano severity of hemorrhoid symptom questionnaire (GSQ) were used to conduct a questionnaire survey on 760 hemorrhoid patients in the anorectal department of six hospitals. The data was analyzed for reliability and validity using SPSS 21.0 and AMOS 26.0 software.Results:The Cronbach's α coefficient of HF-QoL-C and its dimension ranged from 0.831 to 0.960, and the split coefficient was 0.832-0.915. Four common factors were extracted through principal component exploratory factor analysis. Confirmatory factor analysis indicated acceptable structural validity( χ2/ df=8.152, RSMEA=0.097, CFI=0.881, IFI=0.881, NFI=0.867). HF-QoL-C was correlated with SF36 and GSQ( r=-0.694, 0.501, both P<0.01). There were differences in the total score and dimensional scores of HF-QoL-C between surgical and drug treated patients, different grades of Goligher classification for hemorrhoidal disease, and different ranges of hemorrhoid prolapse (all P<0.001). No ceiling effect was found in the total score and the scores of each dimension(0.3%-2.0%). There was a floor effect in both psychological function and sexual activity dimensions (16.7%, 35.1%). Conclusion:HF-QoL-C has good reliability and validity, which can be used to measure the quality of life of Chinese hemorrhoid patients.

With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.