Objective To investigate the changes in serum cortisol and adrenocorticotrophic hormone(ACTH) levels in children with steroid-sensitive nephritic syndrome (SSNS) and the clinical significance of intervention.Methods According to whether a child with SSNS would relapse,48 children with SSNS were divided into non-recurrence group(n =19) and recurrence group(n =29),at the same time 14 age-matched healthy children were enrolled as the healthy control group.Serum cortisol and ACTH were measured in patients with SSNS by using electrochemiluminesence methods.In recurrence group,methylpredisolone or methylprednisolone combined with ACTH injection therapy was used on 15 patients with their serum cortisol and ACTH below normal.Results Before standard glucocorticoid treatment,the serum levels of cortisol and ACTH had no difference among 3 groups (all P ＞ 0.05).By the end of remission phase,the serum levels of cortisol and ACTH in recurrence group were statistically lower than those of the non-recurrence group[(113.03 ± 80.02) μg/L vs (251.54 ± 185.05) μg/L,t =-2.925,P ＜ 0.05 ; (12.81 ± 10.14) ng/L vs (23.53 ± 12.05) ng/L,t =-0.885,P ＜ 0.05].Eight to 12 weeks after being adjusted,the serum level of cortisol and the average monthly time of recurrent were both significantly improved in 15 abnormal children in recurrence group [(168.90 ± 133.43) μg/L vs (73.62 ± 58.04) μg/L,t =3.016,P ＜ 0.05 ; (0.09 ± 0.08) times vs (0.35 ± 0.11) times,t =-7.560,P ＜0.05],but as to the serum level of ACTH,there was no significant difference in abnormal children in recurrence group [(14.05 ± 10.99) ng/L vs (8.72 ± 4.11) ng/L,t =1.991,P ＞ 0.05].Conclusions The concentrations of serum cortisol and ACTH can reveal the risk of recurrence for children with SSNS to some extent,and effective intervention can reduce the recurrence rate and shorten the course of disease.

OBJECTIVE:To review the practicality and effectiveness ofReady-to-useextended mobile Baxter intravenous ad-mixture service(BIVAS)in the application of intravenous medication centralized deployment services. METHODS:Combined with the requirements of Intravenous Admixture Centralized Deployment and Quality Management Practices,and the present establish-ment and management characteristics in pharmacy intravenous admixture services (PIVAS) in our hospital,the development and management methods of BIVAS each link were introduced and summarized from pre-building to post-trial operation. RESULTS &CONCLUSIONS:Specific measures and methods for developing BIVAS in our hospital were introduced from aspects of assess-ment,site selection,building,research,staffing and operation,etc. It had proved that BIVAS can achieve a daily compoundingload of about 600 bags in 8 wards of eastern branch of our hospital. Since BIVAS holds advantages in sterile dispensing equipment and technology that is comparable to PIVAS,and lower space requirements,shorter building periods,more flexible combination, less occupation of funds and other health resources as well as more convenient post-maintenance,it can take the place of PIVAS to effectively complete intravenous drug deployment services under general workload with certain practicality when a hospital couldn't build PIVAS limited by building funds,venues,time and other factors.

Objective:To evaluate the effect of hypothermia on the polarization of microglia and TLR4/NF-κB signaling pathway during oxygen-glucose deprivation/restoration (OGD/R).Methods:BV2 microglia were cultured in vitro and divided into 3 groups ( n=18 each) using the random number table method: control group (group C), group OGD/R and OGD/R plus hypothermia group (group OGD/R+ HT). Group C was cultured normally for 24 h. In group OGD/R, the cells were exposed to 5% CO 2-1% O 2 at 37 ℃ for 2 h in a glucose-free medium, followed by restoration of glucose and oxygen for 24 h. In group OGD/R+ HT, the high-glucose medium was replaced with a glucose-free medium, the cells were exposed to 5% CO 2-1% O 2 for 2 h in a 33 ℃ cryostat, followed by restoration of glucose and oxygen for 24 h. The cell survival rate was measured by CCK-8 assay.The expression of M1 microglia markers CD32 and iNOS protein and mRNA and M2 microglia markers CD206 and Arg-1 and mRNA was detected by immunofluorescence and real-time quantitative polymerase chain reaction.The expression of TLR-4 and NF-κB in cells was detected by Western blot, and the expression of TLR4 and NF-κB mRNA in cells was detected by real-time quantitative polymerase chain reaction.The concentrations of tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β) and interleukin 10 (IL-10) in the cell supernatant were detected by enzyme-linked immunosorbent assay. Results:Compared with group C, the cell survival rate was significantly decreased, the expression of CD32, iNOS, CD206, Arg-1, TLR4 and NF-κB protein and mRNA was up-regulated, and the concentrations of TNF-α, IL-1β and IL-10 in supernatant were increased in OGD/R and OGD/R+ HT groups ( P<0.05). Compared with group OGD/R, the cell survival rate was significantly increased, the expression of CD32, iNOS, TLR4 and NF-κB protein and mRNA was down-regulated, the expression of CD206 and Arg-1 protein and mRNA was up-regulated, the concentrations of TNF-α and IL-1β in supernatant were decreased, and the concentration of IL-10 was increased in group OGD/R+ HT ( P<0.05). Conclusions:Hypothermia can significantly inhibit microglia polarization toward M1 phenotype, increase microglia polarization toward M2 phenotype and inhibit the development of inflammatory responses during OGD/R, and the mechanism may be related to inhibition of TLR4/NF-κB signaling pathway.

Single cell RNA sequencing technique provides a strong technical support for the analysis of cell heterogeneity in biological tissues, and has been widely used in biomedical research. In recent years, considerable scRNA-seq data have been accumulated in the research of ocular fundus diseases. The ocular fundus is abundant for the network of vessel and neuron, which leads to the complicated pathogenesis of fundus diseases. Through single cell RNA sequencing technique, the expression of thousands of genes of certain cell types or even subtypes can be obtained in the disease environment. Single cell RNA sequencing technique accurately reveals the pathogenic cell types and pathogenic mechanisms of ocular fundus diseases such as neovascular retinopathy, which provides a theoretical basis for the birth of new diagnosis and treatment targets. The construction of multi-omics single-cell database of ocular fundus diseases will enable high-quality data to be further explored and provide an analysis platform for ophthalmic researchers.

Objective:To evaluate the clinicopathological features of primary retroperitoneal paragangliomas.Methods:Data of 24 patients with retroperitoneal paragangliomas who underwent surgical treatment in our hospital from Jan 2015 to Dec 2018 was collected and analyzed.Results:Hypertension, abdominal pain/discomfort and headache were the most common complaints while 10 patients were asymptomatic and were diagnosed accidently in routine body examination. Tumor size ranged from 3.4-13.0 cm (6.9±2.5) cm, and all the tumors were located in the vicinity of abdominal aorta and inferior vena cava. All the patients received surgical treatment. Intraoperative blood pressure fluctuations were significantly correlated with prolonged operation time, more blood loss, more blood transfusion and prolonged length of stay (all P<0.05). The median follow-up time was 29 months and 1 patient died from tumor recurrence and progression. The other patients have had a tumor free survival. Conclusions:Surgical resection was the principal treatment of primary paraganglioma. Preoperative assessment was very important for perioperative safety.

Objective:To investigate the pathogeny, diagnosis and treatment of solitary fibrous tumors of the abdomen and pelvis.Methods:Retrospective analysis was made on the clinical data of 12 SFT patients undergoing surgical resection in Peking University International Hospital from Jul 2015 to Jul 2019.Results:All patients underwent radical resection. After operation, complications in clued pelvic hemorrhage in 1 case and ureteral fistula in 1 case, all improved after conservative treatment.According to pathological and immunohistochemical results, 7 cases were MSFT and 5 cases were SFT. All patients were followed up for 2-53 months. 5 cases were recurrent, among which 1 case died of intestinal obstruction caused by tumor compression.Conclusion:The clinical manifestations of solitary fibrous tumors are mostly nonspecific.Imaging examination and puncture pathology are of great significance for preoperative diagnosis. Radical resection is an important means to improve the prognosis of patients.

In order to promote the development of hair transplantation, particularly the establishment of standards, the Hair Transplantation Expert Group of Plastic and Aesthetic National Medical Quality Control Center invited experts in the field of hair transplantation across China and formed a draft of the Expert Consensus on Standard Terminology for Hair Transplantation based on the collation of relevant literature and monographs. By combining Delphi methodology and consensus meetings, the expert group conducted several rounds of consultations on issues such as follicular unit anatomy, harvesting, dissection, and implantation, ultimately presenting 54 terminologies. This consensus considers the original Chinese and English meanings as well as the professional characteristics of terms used in hair transplantation, highlights the unique features and advantages of hair transplantation, and preserves its essence while promoting innovation, with the hope of providing valuable reference for clinical researchers engaged in hair transplantation both domestically and internationally, and better facilitating the standardization and advancement of the field.

Objective To investigate the learning curve of cochlear implantation and its guiding significance for clinical surgery.Methods A retrospective analysis of the clinical data of two otologists in early cochlear implant surgeries,including 98 cases of Dr.A and 54 cases of Dr.B.Statistics of the two doctors incidence of complications and operating time.Operation time as index were drawing a,b two groups of cases of scatter plot,the oscillating sine curve model Y =sin(X)-P/2 and logarithmic curve model Y =b1 ln (X) + b0 curve fit were analyzed.Then,extract the early 90 cases of surgery by Dr.A which was divided into a,b,c three groups with 30 cases a group.The operating time and complications were further compared and analyzed (SPSS 16.0).Results From the operation sequence,A and B physicians,early operation cases cost more operating time,and more complications.Learning curve before and after about 30 cases appeared inflection point,showing a rapid decline in period (learning phase) and slow decline period (consolidation phase) in two stages.Group contrast to Dr.A's early 90 consecutive cases,the operating time of Phase b and Phase c decreased significantly than Phase a (Pa-b ＜0.01,Pa-c ＜0.01),while there was no significant difference between group Phase b and Phase c (Pb-c =0.68),the complication rate of Phase b and Phase c decreased significantly than Phase a (Pa-b ＜ 0.01,Pa-c ＜ 0.01),while there was no significant difference between group Phase b and Phase c (Pb-c =0.15).Conclusions Our department of cochlear implantation followed the learning curve rule.The minimum number of cases that should accumulate in the learning phase needs about 30 cases.

Objective To observe effect of laryngeal function reconstruction of sternohyoid mus-cle inversion for treatment of glottic carcinoma.Methods A total of 106 patients with glottic carcino-ma admitted to the Department of Otolaryngology in our hospital from January 2020 to December 2023 were selected and randomly divided into control group and observation group,with 53 patients in each group.The control group underwent vertical partial laryngectomy,while the observation group re-ceived vertical partial laryngectomy combined with thyrohyoid muscle inversion laryngeal reconstruc-tion.Both groups were assessed for voice-related parameters[normalized noise energy(NNE),har-monic-to-noise ratio(HNR),jitter,shimmer],swallowing function[videofluoroscopic swallowing study(VFSS)score],quality of life[voice handicap index(VHI)score],improvement in phona-tion function,and incidence of complications(irritative cough,pharyngeal pain,dyspnea,laryngeal stenosis,local adhesion).Results Three months postoperatively,both groups showed significant decrease in NNE,jitter,and shimmer,and an increase in HNR compared to preoperative levels(P＜0.05).The observation group demonstrated lower NNE,jitter,and shimmer,and higher HNR than the control group at 3 months postoperatively(P＜0.05).Both groups had improved VFSS scores and reduced VHI scores at 3 months compared to preoperation(P＜0.05).The observation group showed higher VFSS scores and lower VHI scores than the control group at 3 months after operation(P＜0.05).The control group achieved an excellent or good rate of phonation function improvement was significantly lower than the observation group(88.68％versus 71.70％,P＜0.05).The incidence of complications in the observation group was significantly lower than that in the control group(9.43％versus 24.53％,P＜0.05).Conclusion The combination of vertical partial laryngecto-my and laryngeal function reconstruction of sternohyoid muscle inversion for glottic carcinoma effec-tively improves voice-related parameters,swallowing function,quality of life,and phonation func-tion,with a lower incidence of complications.

Objective To compare the efficacy and safety of intravenous infusion and intratym-panic injection of dexamethasone in the treatment of sudden deafness(SD)in middle-aged and elder-ly patients.Methods A total of 115 middle-aged and elderly SD patients in the hospital from July 2018 to November 2023 were randomly divided into group A(n=57)and group B(n=58).Group A received intravenous infusion of dexamethasone,while group B received intratympanic injection of dexamethasone.The symptom improvement time(tinnitus disappearance time,vomiting disappear-ance time,vertigo disappearance time,and hearing recovery time),hearing thresholds(high and low frequencies),sleep quality[the Pittsburgh Sleep Quality Index(PSQI)],vascular endothelial func-tion[nitric oxide(NO),lipid peroxide(LPO)and superoxide dismutase(SOD)],clinical effica-cy,and adverse reactions(transient vertigo,mild ear pain,rash)were compared between the two groups.Results The tinnitus disappearance time,vomiting disappearance time,vertigo disappear-ance time,and hearing recovery time in group B were significantly shorter than those in group A(P＜0.05).The hearing thresholds at high and low frequencies after treatment in both groups were significantly lower than those before treatment,and the hearing thresholds in group B were significant-ly lower than those in group A after treatment(P＜0.05).The PSQI scores after treatment in both groups were significantly lower than those before treatment,and the PSQI score in group B was signifi-cantly lower than that in group A after treatment(P＜0.05).After treatment,NO and SOD in group B were significantly higher than those in group A,while LPO was significantly lower than that in group A(P＜0.05).The total effective rate in the group B was 93.10％,which was significantly higher than 78.95％in the group A(P＜0.05).The incidence of adverse reactions was 12.07％in group B and 10.53％in group A,with no significant between-group difference(P＞0.05).Conclusion Intra-tympanic injection of dexamethasone is more effective than intravenous infusion in the treatment of SD in middle-aged and elderly patients,with faster symptom relief,improved hearing thresholds,better sleep quality,and endothelial function,without increasing adverse reactions,demonstrating high efficacy and safety.