Objective To study the morphology of the persistent foramen of Huschke (PHF)and the weakness of the remains of foramen of Huschke (WRHF)in the external auditory canal (EAC)by high resolution computer tomography (HRCT)in vivo. Methods The thin HRCT images of 525 cases elder than 5 years were retrospectively reviewed by two radiologists,to detect the PHF or WRHF,and to depict the precise location,size and the distance to the tympanic membrane.The incidence,sex differences, and morphologic data of PHF and WRHF were statistical analyzed.Results ①PHFs were found in 146 EACs of 40 males and 77 fe-males with the prevalence of 13.91%,and were found on both sides in 29 cases.Mean maximum axial diameter was 2.35 mm± 1.1 6 mm (0.6-5.8 mm)and sagittal diameter was 2.09 mm±1.2 mm (0.5-6.2 mm).Mean distance between the inner edge of PFH and the sulcus tympanicus was 1.61 mm±2.4 mm (0-10 mm).②WRHFs were found in 233 EACs of 58 males and 122 fe-males with the prevalence of 22.1 9%,and were found on both sides in 53 cases.Mean maximum axial diameter was 2.43 mm± 0.89 mm (0.8-5.4 mm)and sagittal diameter was 2.08 mm±0.73 mm (0.6-4.3 mm).Mean distance between the inner edge of WRPFH and the sulcus tympanicus was 1.55 mm±1.2 mm (0 - 9.9 mm).③The distance to the sulcus tympanicus was within 3 mm in 137 cases (90.73%)of PFHs and 221 cases (94.43%)of WRFHs.Conclusion Both PHF and WRFH are common by the CT morphological study in vivo.The medial part of EAC is predominant and female is predominant.The incidence and the location of PHF and WRFH are no significant difference.

Objective To analyze the CT and MRI manifestations of congenital cholesteatoma of petrous bone ,and evaluate the efficacy of it in the clinical practice.Methods Imaging findings in 27 pathological-proved cases were review. Imaging materials included CT scan in 26,MRI scan in 11.Results Petrous bone wall erosion and expanding tumor was observed with CT(n=23),tumor was not oberved with CT(n=3).Congenital choleseatoma signal intensity was intermediate or low on T 1W images and high on T 2W images in 11 cases.Conclusion The role of MRI and CT is affirming in the evaluation of congenital choleseatoma of the petrous bone. MRI is superior to CT for the evaluations of involvement of the membranous labyrinth and intracranial structures.

Objective To study the CT and MRI features of primary middle ear carcinoma invading jugular foramen.Methods CT and MRI images of 7 patients with surgically and pathologically confirmed primary middle ear carcinoma invading jugular foramen were analyzed retrospectively,including high resolution CT (HRCT) scan in 6 cases,CT enhancement scan in 1 case and MR plain and enhancement scan in 7 cases.Results On HRCT,the soft tissue lesions mainly located in tympanum,tympanic sinus,the deep of external auditory canal and jugular foramen,and irregular “moth-eaten” bone destruction could be seen,including the destruction of jugular foramen in 7 cases,eustachian tube in 7 cases,facial nerve canal in 4 cases,carotid artery canal in 4 cases,external auditory canal wall in 3 cases,auditory ossicles in 2 cases,vestibular window and horizontal semicircular canal in 1 case.CT plain scan showed the density of soft tissue mass was uniform in 4 cases with CT value of 30-55 HU,and heterogeneous in 2 cases,in which small pieces high density lesions could be found.CT enhancement scan in 1 case revealed moderate and homogeneous enhancement.On MR plain scan,the soft tissue masses with hazy margins could be seen,and compared to the gray matter of brain,the lesions were isointense or slightly hypointense on T1 WI and isointense or slightly hyperintense on T2 WI.The signal was homogeneous in 5 cases and inhomogeneous in 2 cases with small pieces of hypointensity both on T1WI and T2WI.After enhancement,the lesions were enhanced moderately and homogeneously in 5 cases and inhomogeneously in 2 cases with small pieces of nonenhanced area.MRI also showed the erosion of carotid artery in 4 cases,sigmoid sinus in 1 case.Conclusion The primary middle ear carcinoma can invade the jugular foramen area extensively,which may lead to misdiagnosis.HRCT can precisely depict the bone destruction and the invasion of the important anatomic structures in the primary middle ear carcinoma,and the destruction of eustachian tube can help to reduce misdiagnosis.MRI can more clearly show the extent of tumor and the mass signal and enhancement pattern.

Objective To evaluate the imaging diagnosis value of glomus tympanicum tumors.Methods Images of 10 patients with surgically and pathologically confirmed glomus tympanicum tumors were reviewed.The image characteristics and diagnostic value were summarized.Results In 8 patients with high resolution CT scan and 2 patients with routine CT scan,soft tissue nodules within the tympanic cavity were identified on axial or coronal images in 7 of them.And in 3 patients with chronic tympanitis,glomus tympanicum tumors were not differentiated on CT images.Eight patients had undergone MR examination,on T2WI the tumors were moderate hyperintense(n=6)and hyperintense(n=2),and the tumors were enhanced obviously after contrast.In 3 patients with chronic tympanitis,moderate high signal of the tumor can be differentiated with the high signal of tympanitis on T2WI.On contrast MRI,the signal of enhanced tumor or unenhanced tympanitis was identified clearly.Conclusion On diagnosis of glomus tympanicum tumors,MRI is prior to CT,especially in patient with glomus tympanicum and tympanitis.

Objective To evaluate the correlation between the degree of cochlea endolymphatic hydrops(EH) and hearing loss and symptoms in patients with unilateral Meniere's disease. Methods Fifty seven patients with unilateral Meniere's patients were retrospectively quantitatively analyzed, which evaluated the correlation between the cochlea EH and hearing loss and symptoms. The affected ears in the experimental group(57 ears) and the asymptomatic ears in the control group(57 ears), were confirmed by bilateral intratympanic Gd-DTPA injection and 3D real IR MRI scan after 24 h. The maximum length of endolymph space and labyrinth chamber along the modiolus cochleae and their ratio which represented the endolymph space proportion of each turn(R1, the basal turn;R2, the middle turn;R3, the apical turn) were calculated. And the paired t test was used to compare the differences in EH degree between the experimental and control group;Pearson correlation analysis was used to analyze the correlation between the cochlea EH degree and hearing loss and duration of symptoms. Results R1, R1 and R3 of ipsilateral cochlea were higher than normal cochlea(ipsilateral R1:0.354±0.097 vs. normal R1:0.185±0.031, P<0.01;ipsilateral R2:0.445 ± 0.098 vs. normal R2:0.201 ± 0.046, P<0.01;ipsilateral R3:0.467 ± 0.102 vs. normal R3:0.221 ± 0.053, P<0.01). A positive correlation was found between the degree of EH in each turn and high-frequency hearing loss(r=0.275, 0.281, 0.329, respectively;all P<0.05), whereas no correlation was found between the extent of EH and the time of vertigo, tinnitus and hearing loss(P>0.05). In addition, there was a correlation between the degree of EH in the apical turn and low, medium, high-frequency hearing loss(r=0.271, 0.269, 0.329, respectively; all P<0.05). Conclusions The degree of cochlea EH in the basal and second turn showed great relevance with the high-frequency hearing loss, and the apical turn EH degree was relevant with the low, medium, high-frequency hearing loss, but there was no correlation between the EH degree of each turn, ages and symptoms.

Objective To compare the effect of applying low molecular weight heparin calcium in different periods of reteplase for acute myocardial infarction(AMI).Methods Ninety-one cases of AMI were divided into group A(30 cases),group B(30 cases)and group C(31 cases)by random digits table.The patients in three groups were given reteplase intravenous thrombolysis,and 5000 U low molecular weight heparin calcium was abdominal wall subcutaneous injections once 12 h at intravenous thrombolysis immediately(group A),after intravenous thrombolysis 6 h(group B)and 12 h(group C).They all were treated for 7-10 d.The rate of coronary artery recanalization,acute phase complication and adverse reaction were compared among three groups.Results The rate of coronary artery recanalization in group A,B and C was 76.7％(23/30),96.7％(29/30),74.2％(23/31)respectively.The rate of coronary artery recanalization in group B was significantly higher than that in group A and C(P ＜ 0.05).The rate of acute phase complication and adverse reaction in group B[33.3％(10/30)]was significantly lower than that in group A and C[70.0％ (21/30)and 61.3％(19/31)](P ＜ 0.05).Conclusions After reteplase intravenous thrombolysis in 6 h,applying low molecular weight heparin calcium can significantly improve the rate of coronary artery recanalization and reduce the rate of acute phase complication and adverse reaction.

Glioblastoma(GBM)originates from glial cells,and complete surgical resection followed by radiotherapy and chemotherapy is the current standard treatment.However,gliomas are subjected to not only accelerated cell death after radiotherapy and chemotherapy but also cellular senescence.Senescent cells produce a senescence-associated secretory phenotype(SASP),which has a dual effect on the tumor microenvironment.The"one-two punch"strategy of specifically eliminating senescent cells and inhibiting SASP-derived secretions provides a new direction for tumor therapy.In this article,we review the mechanisms that mediate tumor cellular senescence and SASP,the elimina-tion of senescent cells by senolytics for SASP inhibition,and the current situation of the"one-two punch"strategy for the treatment of glioma.

Objective To explore the protective effect of polypeptide Apelin on podocyte mitochondria in diabetic nephropathy and underling mechanisms.Methods Human renal podocytes were divided into four experimental groups:control group,high glucose(HG)group(glucose 25 mmol/L,48 h),Apelin intervention HG group(Ape-lin-13 1 μmol/L,48 h)and Apelin group(Apelin-13 1 μmol/L,48 h).The podocyte apoptosis was observed by TUNEL staining,the expression of mitochondrial membrane protein FUNDC1 was detected by Western blot,and the binding of mitochondrial fission protein DRP1 to FUNDC1 was examined by immunoprecipitation.The 8-week-old male mice were divided into three experimental groups:control group,diabetes group(intraperito-neal injection of streptozotocin 150 mg/kg,only one time)and Apelin intervention DM group(intraperitoneal injection of Apelin-13 0.3 μmol/kg,daily).The morphology of renal was observed by PAS staining and trans-mission electron microscopy.Plasma creatinine(Cr),urea nitrogen,urinary albumin and creatinine were de-tected by ELISA kit.The level of creatinine clearance rate(Ccr)and urinary albumin/creatinine(ACR)was calculated.Results Compared with the control group,the podocyte apoptosis and expression of FUNDC1 in the HG group increased significantly(P＜0.05),and the combination of mitochondrial fission division protein DRP1 to FUNDC1 raised.Meanwhile,compared with the HG group,the number of apoptosis,the expression of FUNDC1(P＜0.05),and the combination of DRP1 to FUNDC1 all reduced in Apelin intervention HG group.Animal experiments showed that the kidney structure of the control group was intact.In the DM group,the num-ber of podocytes decreased significantly,the foot processes were fused and dropped off.In the Apelin intervention DM group,podocyte lesions were less severe than those in the DM group.Compared with the control group,the level of plasma Cr,BUN and urine ACR in the DM group increased,while the level of Ccr decreased significantly(P＜0.05).However,compared with the DM group,the level of above biomarkers in the Apelin intervention DM group was improved(P＜0.05).Conclusions Apelin keeps mitochondrial homeostasis and reduces podocyte ap-optosis by inhibiting the expression of mitochondrial membrane protein FUNDC1,which may contribute to allevia-tion of diabetic nephropathy.

Objective To explore the effect of hematoma aspiration device combined with low posterior osteotomy and small bone window craniotomy on neurological function and prognosis in patients with hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 132 patients with HICH in the Department of Neurosurgery,Gansu Provincial people's Hospital from February 2020 to February 2022 were collected and divided into small bone window group(n=52)and aspiration group(n=80).The levels of serum neuron specific enolase(NSE)and interleukin-6(IL-6)were detected by enzyme linked immunosorbent assay(ELISA).The intraoperative condition(duration of operation and intraoperative blood loss),intracranial pressure,complete clearance rate of intracranial hematoma and the incidence of postoperative complications were compared.The prognosis of the patients was evaluated by activity of daily living scale(ADL).Results There was no significant difference in the levels of serum NSE and IL-6 between the two groups before operation(P>0.05).The levels of NSE and IL-6 in serum after operation were significantly lower than those before operation,and the intracranial pressure was improved after treatment,the difference has statistic significance(P<0.05).The postoperative serum NSE and IL-6 levels,operation duration,postoperative intracranial pressure and the total incidence of complications in aspiration group were lower than those in small bone window group(P<0.05),but there was no significant difference in intraoperative blood loss and the total incidence of long-term complications between the two groups(P>0.05).During the 6-month follow-up after surgery,the good prognosis rate of aspiration group was higher than that of small bone window group,and the difference was statistically significant(P<0.05);There was no statistically significant difference in the complete clearance rate of intracranial hematoma between the two groups of patients(P>0.05).Conclusion Low posterior osteotomy combined with hematoma aspiration can effectively treat HICH,promote the recovery of neurological function in patients.

Objective:To analyze characteristics and trends of histopathological diagnosis of adult renal biopsy in Beijing from 2008 to 2020.Methods:A total of 4 652 cases of adult renal biopsy were collected from three hospitals in Beijing between 2008 and 2020. The patients were divided into three age groups: 18-40 years, 40-65 years and≥ 65 years; and also divided into three period: 2008-2011, 2012-2015, and 2016-2020. The pathological characteristics and changes of renal biopsy were analyzed in three age groups at different periods.Results:Among 4 652 cases primary glomerular disease accounted for 81.8%, the membranous nephropathy (MN, 32.4%, 1 509/4 652), IgA nephropathy (IgAN, 29.2%, 1 356/4 652) and minor glomerular abnormalities (MGA, 11.3%, 526/4 652) were the top three pathological types. The overall proportion of MN and diabetic nephropathy (DN) increased from 20.3% and 2.3% in 2008-2011 to 37.3% and 10.1% in 2016-2020) (χ2=99.9 and 96.1, both P<0.01), respectively. For age group 18-40 years, the MN and DN increased from 11.2% and 1.6% in 2008-2011 to 24.7% and 5.5% in 2016-2020 (χ2=32.7 and 20.7, both P<0.01), respectively. For age group 40-65 years the MN and DN increased from 26.6% and 3.2% in 2008-2011 to 41.5% and 13.1% in 2016-2020 (χ2=39.1 and 57.3, both P<0.01), respectively. For age group≥65 years the MN was the most common pathological type in the three periods, fluctuating between 41.3% and 55.0% (χ2=5.2, P=0.08); and DN increased from 0(0/63) in 2008-2011 to 7.5%(22/292) in 2016-2020 (χ2=8.1, P=0.02). Conclusion:The renal biopsy data show that membranous nephropathy and diabetic nephropathy are the most common primary and secondary adult glomerular diseases in Beijing recently.