Objective:To investigate the pathophysiological mechanism,clinical menifestation and radiographic diagnosis of cholesterol granuloma following chronic supperative otitis media.Method:Six cases of CG following chronic suppurative otitis media, confirmed by surgery and pathology,were reviewed and analyzed.Result:CG frequently accompanied with other middle ear diseases，and was shown as a high signal intensity on both T1-and T2-weighted images in magnetic resonance imaging(MRI).Conclusion:It was postulated that the obstruction of pneumatized temporal bone air cells,caused by other middle ear diseases such as cholesteatoma and tympanosclerosis,might be the pathophsiological mechanism of CG.The evaluations of computed tomography(CT) and clinical manifestation were limited to distinguish CG from cholesteatoma or other neoplasm,while the MRI can be of great value to characteristic diagnosis.

AIM: To explore the characteristic of relaxation of porcine cornea after LASIKMETHODS: Usual LASIK was performed on fresh porcine corneas with stable intraoculer pressure (IOP) maintained through optic nerve irrigation. The ablation depth on stroma is 30%, 50% and 70% respectively. Then the dumbbell-shaped corneal strip specimens were cut and stored in 20% Human Albumin solution for use (4℃).Sip up the Albumin solution on specimens, and fixed them on homemade jig. Stress relaxation tests were erformed on Tytron250 Dynamics Experiment System. the loading speed was 385mm/min,extending ratewas 1.5, and relaxation time was 1 000s. The data werecollected electronically and automatically.RESULTS: In LASIK procedure, though a single flap-cutting can cause a little reduction of corneal stress relaxation (P＜0.05,P=0.49), the cornea may still remain its property of visco-elasticity. When ablation depth was 30% or more, corneal stress relaxation decreased to almost one half (P＜0.01).The change of corneal stress relaxation degree in vertical meridian specimen was lower than that in horizontal specimen, especially when ablation depth was 70%, and it's statistically significant (P＜0.001). In LASIK operation, the more depth the ablation, the more reduce the stress relaxation degree, and it's easy to cause deformation and creep deformation.CONCLUSION: The changes of the stress relaxation in verticai and longitudinal meridian specimens are similar, and slightly obvious in longitudinal specimen, especially in 70%ablation group.

Objective:To investigate the clinical characteristics,treatment and prognosis of primary pe-noscrotal extra-mammary Paget’s disease (PSPD).Methods:The clinical and pathological data of 22 cases of primary PSPD were retrospectively reviewed.Survival rate of the overall patients,the invasive patients,and the patients with positive surgical margin or negative surgical margin were analyzed with Ka-plan-Meier survival curve method.Results:Among all the patients with primary PSPD,the median age of onset was 64.5 (39 -84)years,the median time of disease duration was 40 (2 -300)months,and the median long diameter of lesion was 4.75 (1 -10)cm.In the study,12 patients (54.5%)were in pathological stage A1,6 patients (27.3%)were in pathological stage A2,and 4 patients (18.2%) were in pathological stage B.Scrotum and penile of most patients (n =12,54.5%)were involved,5 patients (22.7%)were scrotum only,and 5 patients (22.7%)were penile only.Erythema (n =18, 81.8%),itchiness (n =16,72.7%),ulcerate (n =12,54.5%),exudation (n =11,50.0%),and pain (n =4,18.2%)were the major manifestations.All the patients with primary PSPD were treated with wide surgical excision.The rate of invasive patients was 77.3% (n =17).Of them,6 patients had positive surgical margin.The surgical margins of non-invasive patients were all negative.Twelve patients exhibited local recurrence or/and metastases,and the status of surgical margins (P =0.015)and the depth of invasion (P =0.010)were important risk factors.Inguinal lymph nodes were generally in-volved.The difference of the delay of diagnosis between metastasis and non-metastasis was significant (P =0.040).The 5-year survival rates of the overall and invasive patients were 33.7% and 27.9%, respectively.The patients with positive surgical margin had poor prognosis.Conclusion:Primary PSPD, with the characteristics of long duration,high invasive tendency and high incidence of local recurrence or metastases,generally occurs in the elderly.Surgery should be performed at first.The delay of diagnosis, positive surgical margins and the involvement of inguinal lymph node are important risk factors.Biopsy, frozen section and inguinal lymph node biopsy (ILNB)can standardize diagnosis and treatment.

BACKGROUNDTo study the effect of DTB against HIV-1, for developing anti-HIV drugs.

METHODSDifferent concentration of DTB was added to cell culture system after viral inoculation, MTT staining method for viable cells (MTT assay) and p24 (ELISA) were used as markers to monitor the viral replication.

RESULTSThe inhibition rates of DTB at concentrations 160, 80, and 40mg/ml were 93.0%, 56.2% and 18.1%, respectively.

CONCLUSIONSDTB could effectively inhibit HIV-1 in vitro.

Anti-HIV Agents ; pharmacology ; Bilirubin ; analogs & derivatives ; pharmacology ; Dose-Response Relationship, Drug ; HIV-1 ; drug effects ; Humans ; In Vitro Techniques

Objective:To understand the situation and distribution of fluoride in rural centralized water supply in Inner Mongolia Autonomous Region (Inner Mongolia for short), and provide a reference for adjustment of prevention and control measures.Methods:From 2014 to 2018, 836, 947, 1 033, 1 068, 1 099 rural centralized water supply monitoring sites were designated in 77 banners (counties, districts) separately in Inner Mongolia, and factory water and tip water samples were collected during plentiful phase and exhausted phase every year, respectively, and fluoride content was tested. Descriptive analysis was done according to time, water period (plentiful phase and exhausted phase), water sample type (factory water and tip water), water treatment method (conventional treatment, sedimentation and filtration, only disinfection and untreated), area distribution [eastern region (Hulunbuir, Xing'an League, Tongliao and Chifeng), central region (Hohhot, Baotou, Ulanqab and Xilinhot) and western region (Ordos, Bayannur and Alashan)], and the results were analyzed visually by ArcMAP 10.2.Results:From 2014 to 2018, 3 251, 3 671, 4 058, 4 087 and 4 395 water samples were collected, the medians fluoride were 0.69, 0.70, 0.69, 0.64 and 0.66 mg/L, and the annual compliance rates of fluoride were 80.31% (2 611/3 251), 81.83% (3 004/3 671), 83.14% (3 374/4 058), 85.91% (3 511/4 087) and 84.57% (3 717/4 395). The difference of compliance rate of fluoride in rural centralized water supply in different years was statistically significant (χ 2=51.748, P < 0.01), and the compliance rate of fluoride showed an increasing trend with the years (χ 2=41.140, P < 0.01). The compliance rates of fluoride in plentiful phase and exhausted phase were 83.36% (8 128/9 750) and 83.29% (8 089/9 712), respectively, and the difference was not significant statistically (χ 2=0.020, P > 0.05). As for water sample type, the compliance rates of fluoride in factory water and tip water were 83.55% (6 583/7 879) and 83.17% (9 628/11 576), and the difference was not significant statistically (χ 2=0.485, P > 0.05). The difference of compliance rate of fluoride in different water treatment methods was statistically significant (χ 2=192.014, P < 0.01). The compliance rates of fluoride in water with conventional treatment and only disinfection were higher [95.51% (404/423) and 94.44% (986/1 044)]; and the untreated water had the lowest compliance rate of fluoride [81.75% (13 073/15 991)]. There was a statistically significant difference in compliance rates of fluoride in the eastern, central and western regions (χ 2=629.256, P < 0.01), with the eastern region had the highest compliance rate of 89.17% (7 337/8 228); the central region had the lowest compliance rate of 74.67% (5 391/7 220). The visualization results showed that the compliance rate of fluoride was obviously low in the central region north of Yin Mountains and west of Greater Higgnan Mountains. Conclusions:From 2014 to 2018, the compliance rates of fluoride in rural centralized water supply increase year by year, and some achievements have been made in fluorine reduction and water improvement project in Inner Mongolia. However, there are still some rural areas with low level of water fluoride compliance rates which mainly distribute in the central region of Inner Mongolia in the north of Yin Mountains and west of Greater Higgnan Mountains. The current focus of prevention and control should be shifted from "general control" to "precise fluorine control". In the future, it is necessary to implement treatment projects in key areas of fluorine pollution from the aspects of policy implementation and technological innovation to ensure the drinking water safety of local rural residents.

Biomechanical factors play a crucial role in the steady-state maintenance of articular cartilage. The primary cilium (PC) is a kind of organelle which can sense mechanical and chemical signals at the same time. It is also distributed on the surface of chondrocyte membrane. It is involved in multiple signal transduction pathways as well as in the process of chondrocyte phenotype maintenance and material metabolism. Abnormalities in PC are also associated with a variety of human bone and joint diseases. This paper mainly discusses the mechanism of PC in mechanical microenvironment of chondrocytes and the interaction with other signaling pathways, and explores its relationship with bone and joint diseases, so as to provide some scientific basis for clinical and basic research in orthopedics.

Objective The aim of this study was to explore the impact of implant robots on the oral func-tion and aesthetic effects of immediate implant patients in the aesthetic area of anterior teeth.Methods A total of 68 patients with single anterior tooth defects admitted to the hospital from January 2021 to January 2023 were enrolled and divided into a study group of 34 cases and a control group of 34 cases randomly.In the study group,anterior tooth immediate implantation was performed with the assistance of an oral implantation robot,while the control group underwent conventional immediate anterior tooth implantation.The implantation accuracy,postopera-tive bite function,aesthetic restoration,and occurrence of complications were compared between the two groups,and complications were all recorded.Results After final restoration,all patients were followed up for 2 years,and the implant success rate was 100%(68/68 cases).The study group exhibited significantly lower postoperative apical point error and implant angle error compared to the control group(P＜0.05).There was no significant differ-ence in speech clarity,bite pressure,and pain intensity between the two groups(P＞0.05).The ratio of implant bite pressure to that of the contralateral homonymous tooth was higher in the study group than in the control group(P＜0.05).The postoperative pink esthetic score(PES)and white esthetic score(WES)in the study group were higher than those in the control group(P＜0.05).There was no statistically significant difference in the incidence of complications between the two groups(P＞0.05).Patient satisfaction in the study group was higher than that in the control group(P＜0.05).Conclusion The use of oral implantation robots for immediate implantation in the aesthetic zone of anterior teeth resulted in higher intraoperative positioning accuracy and yielded favorable outcomes in postoperative restoration of bite function and aesthetics.

Objective To investigate the mechanism of inducing macrophage polarization induced by acupoint effect of electroacupuncture to promote the repair of acute skeletal muscle injury.Methods 45 SD rats were randomly divided into blank group,model group,electroacupuncture group(EA group),sodium chrominate group (DSCG group) and electroacupuncture+sodium chrominate group (hereinafter referred to as EA+DSCG group),with 9 rats in each group. The rats in the EA group and the EA+DSCG group were subjected to EA intervention at the right "Chengshan" (BL57) and "Yanglingquan"(GB34),with a frequency of 2 Hz/100 Hz. The gait changes of rats were recorded by animal gait analyzer. The morphological changes of the right gastrocnemius were observed by HE staining. The changes of mast cell aggregation and degranulation in local skin muscles of "chengshan" point were observed by toluidine blue staining. The expressions of Pax7,MyoD and skin mast cells and 5-HT in the right gastrocnemius were detected by immunofluorescence method. The positive expressions of CD68 and CD206 in right gastrocnemius macrophage was observed by immunohistochemical staining.Results Compared with blank group,the wiggle time of the right hind leg in model group and DSCG group increased,stride length decreased,HE staining showed inflammatory cell infiltration,myocyte enlargement,degeneration and necrosis. The degranulation rate of local skin mast cells in "Chengshan" (BL57) area increased,and the expressions of mast cell tryptase,5-HT,Pax7,MyoD,CD68 and CD206 increased (P<0.05). Compared with model group,the wiggle time of the right hind leg in EA group and EA+DSCG group decreased,stride length increased,HE staining showed that inflammatory cell infiltration was reduced,muscle cells were uniform in size and arranged neatly. Mast cell degranulation rate increased significantly in EA group,and the expressions of mast cell tryptase,5-HT,Pax7,MyoD and CD206 increased (P<0.05),while CD68 expression decreased (P<0.05). Compared with EA+DSCG group,the degranulation rate of mast cells and the expressions of mast cell tryptase,5-HT,Pax7,MyoD and CD206 increased (P<0.05),while CD68 expression decreased in EA group (P<0.05). Conclusion EA "Chengshan" (BL57) and "Yanglingquan" (GB34) can stimulate acupuncture points to locally induce mast cell degranulation,promote the polarization of macrophages,and then activate muscle satellite cells to play the regulatory process of repairing skeletal muscle injury.

Objective:To investigate the etiology of epilepsy onset before 6 months old and improve clinical understanding.Methods:The medical history, electroencephalogram, brain imaging, genetic examination and other clinical data of 340 patients who were diagnosed with epilepsy with onset under 6 months of age and were hospitalized in the Department of Neurology, Beijing Children′s Hospital, Capital Medical University between January 2017 and December 2018 were retrospectively analyzed. Rank sum test was used to compare the ages of onset of different etiologic groups.Results:Of the 340 patients, 196 were males and 144 were females. The age of onset was 90.5 (48.0, 135.5) days. In the 250 (73.5%) underwent genetic test, 103 (41.2%) had pathogenic or likely pathogenic variants, involving 43 single gene variants and 2 chromosomal abnormalities. Seventy-nine patients (23.2%) had genetic etiology, 66 (19.4%) had structural etiology, 19 (5.6%) had metabolic etiology, 13 (3.8%) had multiple etiologies, and 163 (47.9%) had unknown etiology. In the 79 cases with genetic etiology, 30 single gene variants were detected, including 19 cases of PRRT2, 10 cases of KCNQ2, 7 cases of SCN1A, 6 cases of SCN2A, 6 cases of STXBP1, 5 cases of CDKL5, 2 cases of ARX, and 1 case of each of 23 gene variants. Two cases had chromosomal abnormalities which were 21-trisomy and 16p11.2 microdeletion syndrome respectively. Among the 66 cases with structural etiologies, 37 cases had acquired factors such as perinatal brain injury, 28 cases had congenital factors such as cortical malformation and 1 case was perinatal brain injury combined megalencephaly. The onset age of genetic etiology was 95 (26, 128) days, that of structural etiology was 90 (58, 30) days, and that of metabolic etiology was 57 (30, 90) days. The onset age of metabolic etiology was earlier than that of structural etiology ( U=436.500, P=0.044). Conclusions:Genetic etiology is the most common defined etiology of infants with early-onset epilepsy aged 0-6 months, and there are certain differences in the age of onset between different etiologies. Proper application of genetic test is helpful to identify the etiology and guide treatment.

Objective:To summarize the clinical characteristics of children carrying the m.8344A>G variant of MT-TK gene.Methods:A case series study was conducted to retrospectively collect data of 22 children with mitochondrial disease caused by MT-TK gene m.8344A>G variation who were treated at the Department of Neurology of Beijing Children′s Hospital of Capital Medical University from January 2012 to January 2024. Their clinical data, laboratory tests, muscle pathology, genetic testing, and the follow-up results were analyzed. Pearson correlation analysis was used for correlation analysis.Results:Among the 22 children, there were 13 boys and 9 girls. The age of onset was 5.00 (2.75, 9.00) years. Fifteen children had myoclonic epilepsy with ragged-red fibers (MERRF), 3 had Leigh syndrome (LS), and 4 had LS-MERRF overlap syndrome (LS-MERRF). Myoclonus presented and worsened progressively in all 15 MERRF children, with 10 as the initial symptom and 5 developing progressively during the disease course. Myoclonus was predominantly focal, worsening with fine motor tasks or stress. Electroencephalogram monitoring in the 15 MERRF children revealed myoclonic seizures in 10 children, with 6 classified as myoclonic epilepsy, and 4 as subcortical myoclonus. Two children had generalized myoclonic seizures, and 1 each had absence seizures and generalized seizures. Twelve children had cerebellar ataxia, 10 children exhibited exercise intolerance, and 8 children had muscle weakness. Magnetic resonance imaging (MRI) revealed periventricular white matter involvement in 1 child and bilateral hippocampal involvement in 1 child, likely due to frequent seizures. All 3 children with LS exhibited developmental regressions, accompanied with 2 symptoms include cerebellar ataxia, muscle weakness, and dysphagia. The clinical manifestations of 4 LS-MERRF overlap children presented with combined features of MERRF and LS. Cranial MRI in the 7 LS and LS-MERRF children showed brainstem involvement (all affecting the midbrain) in 6 children and basal ganglia involvement in 4 children. Among the 22 children, 12 had m.8344A>G variant levels >90%, 3 had >80%-90%, 4 had >70%-80%, and 3 had >60%-70%. Higher variant level correlated with the LS phenotype and earlier onset age ( r=0.47, -0.50; P=0.018 and 0.029, respectively). Sanger sequencing in 19 mothers revealed m.8344A>G variations in 18, with 4 showing exercise intolerance. Follow-up of 13 children on antimyoclonic treatment showed>75% reduction in seizures with levetiracetam monotherapy in 2 children, with combination therapy required in others. Most achieved >50% seizures reduction within 2 years, but the effectiveness declined with disease progression. Conclusions:The m.8344A>G variant is rare, with MERRF being the most common phenotype, while LS and LS-MERRF are less common. Children with higher ratio of the m.8344A>G variant are more likely to present LS phenotype. Myoclonus, primarily focal, is a key feature, with levetiracetam as the first-line treatment and benzodiazepines recommended for refractory cases.