Objective To determine the diagnostic value of two and three dimensional ultrasound in detecting fetal hand malformations. Methods In the retrospectively analysis,the severe fetal hand malformations detected by prenatal ultrasound during the recent three years in our hospital were classified according to the prenatal sonographic characteristics,family history,karyotype analysis and autopsy results,etc.Results Fourteen fetuses with hand-anomaly were detected during the 16-28th week of gestation,both hands were affected in 10 cases,with the same morphology bilaterally in 8 cases.Thirteen cases had other abnormal sonographic findings.They were detected and classified into three categories,Wrist deformity (9 cases),three fetuses were associated with total absence of radius and radial clubhand,and six fetuses had palmar deviated hands,with various etiologies including familial hereditary arthrogryposis multiplex congenita,distal type 1 (AMCD1),amniotic band syndrome,body stalk anomaly,trisomy18 and micromelia.Hand (figer) hypoplasia or aphasia (3 cases),one hand was absent in one fetus without associated anomaly,absence of five fingers with ipsilateral multicystic dysplastic kidney in the second fetus,and the third fetus had split hand/foot malformation (SHFM).Overlapping fingers (4 cases),three of them were trisomy18,and two fetuses had both wrist deformity and overlapping fingers.Conclusions Prenatal two and three dimensional ultrasound play an important role in detecting and diagnosing severe type of fetal hand malformations.

Objective To investigate the diagnostic value of prenatal ultrasonography in the fetal hemivertebra. Methods The ultrasonographic findings of three fetuses with hemivertebra diagnosed in our hospital were reviewed and compared with those of postnatal ultrasonography,other image modalities,and autopsy. Results In all fetuses,a distortion of the spine was observed where only one half of the vertebra could be identified. The parents opted for termination of the pregnancy in one case and the deformity was confirmed by autopsy. The other two fetuses were delivered and in one fetus the diagnosis was confirmed by radiological assessment. Conclusions Hemivertebra can be diagnosed accurately by second-trimester ultrasonography. The prognosis is mostly favorable when no other anomalies are associated. Meticulous examination may disclose the lesion and help decide the fate of pregnancy.

OBJECTIVE: To study the relative factors of the changes of preoperative and postoperative bone conduction thresholds in chronic suppurative otitis media. METHOD: The preoperative and postoperative bone conduction thresholds were prospectively investigated in 45 patients with unilateral chronic suppurative otitis media after tympanoplasty. Preoperatively (within 3 days before operation), 10 dB or more depression of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was considered to be significant. Similarly in the postoperative period (3 months after operation), 10 dB or more improvement or impairment of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was regarded as significant. RESULT: Thirty-five of 45 cases (77.8%) were found to have depressed bone conduction threshold before operation, 6 of 35 cases (17.1%) had improved bone conduction thresholds and 5 of 45 cases (11.1%) had depressed bone conduction thresholds after tympanoplasty. CONCLUSION In cases with chronic suppurative otitis media, successful results could be achieved after tympanoplasty disregarding air conduction threshold, the air-bone gap and deteriorated bone conduction threshold. Impairment of bone conduction thresholds could be induced by chronic suppurative otitis media itself and could also be induced by touching the ossicle chain crudely and by the noise of drilling during the operation.
Adolescent ; Adult ; Auditory Threshold ; Bone Conduction ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Otitis Media, Suppurative ; physiopathology ; surgery ; Postoperative Period ; Tympanoplasty ; Young Adult

OBJECTIVE: To study the efficacies of intratympanic prednisolone and dexamethasone injection for the subjective tinnitus. METHOD: A prospective study was designed to compare the efficacies of intratympanic prednisolone injection, intratympanic dexamethasone injection and carbamazepine by oral administration for subjective tinnitus. Seventy-three cases (78 ears) with subjective tinnitus for more than one month and treated by conservative therapy (such as vasodilator agent, Vitamin B, etc. by oral intake. ) were involved. The patients were randomized into 3 groups. Thirty-four cases (35 ears) were included in prednisolone group, 18 cases (18 ears) in dexamethasone group with intratympanic injection of prednisolone or dexamethasone, and 21 cases (25 ears) in carbamazepine group as a control group with oral administration of carbamazepine. All of the cases in intratympanic perfusion group were injected twice in the first week, then once a week consecutively. The patients were acupunctured 4-5 times in the whole course of treatment. All of the cases accepted Betahistine Mesylate, Mecobalamin and Vitamin B1 by oral intake at the same time. Pure tone audiogram and tinnitus matching were tested before the treatment immediately after the course of treatment, and were tested again after half a year's following up. RESULT: All of the cases accepted the whole treatment and were followed up for half a year successfully. The effective rate of the prednisolone group, dexamethasone group and the carbamazepine group was 48.6%, 33.3%, 44.0%, respectively; the control rate half a year after the treatment was 45.7%, 27.8%, 36.0%, respectively. There was no statistically significant difference in the effective rate and control rate between intratympanic perfusion group and carbamazepine group. There is a statistically significant difference both in the effective rate and the control rate between the prednisolone group and the dexamethasone group. Prednisolone may be better than dexamethasone in intratympanic perfusion for subjective tinnitus. CONCLUSION Intratympanic steroid injection has a positive effect on subjective tinnitus and may be considered to be an alternative treatment to subjective tinnitus.
Adolescent ; Adult ; Aged ; Carbamazepine ; administration & dosage ; therapeutic use ; Dexamethasone ; administration & dosage ; therapeutic use ; Drug Administration Routes ; Female ; Humans ; Male ; Middle Aged ; Prednisolone ; administration & dosage ; therapeutic use ; Prospective Studies ; Tinnitus ; drug therapy ; Treatment Outcome ; Young Adult

[Objective] To investigate the clinical application of microscope-assisted subinguinal hierarchical dissection in the treatment of varicocele (VC), so as to provide reference for clinicians. [Methods] The clinical data of 113 VC patients admitted to our hospital during Jul.2021 and Jun.2022 were retrospectively analyzed.All patients were treated with microscope-assisted hierarchical anatomical spermatic vein ligation under the external ring, with layered isolation.The number of intraoperative ligations of the internal spermatic veins and external spermatic vein, preserved arteries as well as the number of lymphatic vessels were recorded. [Results] Among the 13 patients with a mean age of (28.7±6.0) years, 98 had left-side lesion and 15 had bilateral lesion.The degree of varicocele: degree Ⅱ in 44 cases and degree Ⅲ in 69 cases.Intraoperative ligation of the internal spermatic veins: (9.18±3.21) on the left side and (9.02±3.39) on the right side.Intraoperative ligation of the external spermatic veins: (1.47±0.93) on the left side and (1.41±1.10) on the right side.Preservation of the internal spermatic arteries: (2.03±1.07) on the left side, (1.97±0.99) on the right side.Preservation of the external spermatic arteries: (1.42±0.50) on the left side and (1.40±0.50) on the right side.Preservation of lymphatics: (3.87±2.07) on the left and (3.89±1.99) on the right. [Conclusion] Hierarchical dissection ensures the integrity of the vas deferens and its vascular system, and tubular isolation aids in intraoperative reference identification, avoid omission of tiny veins and injury to lymphatic vessels, which helps to improve the surgical skills of beginners or less experienced surgeons.

[摘 要] 目的：检测lncRNA LOC440173在NSCLC组织和细胞中的表达及探讨其对癌细胞恶性生物学行为的影响。方法：选取河北医科大学第四医院生物标本库中2014至2017年手术切除的72例NSCLC患者的癌及癌旁组织标本，应用qPCR法检测NSCLC组织和癌旁组织中，以及6种NSCLC细胞株（H520、H358、A549、HCC827、H1703和H1299）中LOC440173的表达水平；构建LOC440173的敲低及过表达载体，分别转染H520和H1703细胞，应用MTS、克隆形成及Transwell小室迁移和侵袭实验分别检测敲低及过表达LOC440173对NSCLC细胞增殖、迁移及侵袭能力的影响，qPCR法检测LOC440173对于EMT过程相关标志物（E-cadherin、N-cadherin及vimentin）mRNA表达水平的影响，WB法检测其对E-cadherin、N-cadherin蛋白表达的影响。结果：LOC440173在NSCLC组织中的表达明显高于癌旁组织（P<0.01），并与淋巴结转移、组织学分化程度、TNM分期和肿瘤大小有关联（P<0.05或P<0.01）。敲低LOC440173可以抑制H520细胞的体外增殖、迁移和侵袭（P<0.05或P<0.01），过表达LOC440173可显著促进H1703细胞的增殖、迁移和侵袭（P<0.05或P<0.01）。在转录水平上，敲低LOC440173后，E-cadherin的表达水平升高，间充质相关标志物N-cadherin、vimentin的表达水平降低（P<0.05或P<0.01）；而过表达LOC440173后，E-cadherin的表达水平降低，间充质相关标志物N-cadherin、vimentin的表达水平升高（P<0.05或P<0.01）。在转录后水平上，LOC440173负向调节E-cadherin蛋白的表达、正向调节N-cadherin的蛋白表达（均P<0.05）。结论：LOC440173在NSCLC组织中的异常高表达可能与NSCLC的发生发展有关，LOC440173可显著提高NCSCL细胞的体外增殖、迁移、侵袭能力，且其作用机制可能与调控EMT相关基因表达有关。

In order to promote the innovative application of Sanjiao theory and Yingwei theory， this paper tries to apply the ''Sanjiao-Yingwei'' Qi transformation theory to the treatment of tumor diseases， integrating it with T cell exhaustion mechanism to elaborate on its scientific connotation and using network pharmacology and bioinformatics to elucidate the correlation between the anti-tumor mechanism of ''Sanjiao-Yingwei'' Qi transformation and T cell exhaustion. The ''Sanjiao-Yingwei'' Qi transformation function is closely related to the immunometabolic ability of the human body， and the ''Sanjiao-Yingwei'' Qi transformation system constitutes the immunometabolic exchange system within and outside the cellular environment. Cancer toxicity is generated by the fuzzy Sanjiao Qi， and the long-term fuzzy Sanjiao Qi is the primary factor leading to T cell exhaustion， which is related to the long-term activation of T cell receptors by the high tumor antigen load in the tumor microenvironment. Qi transformation malfunction of the Sanjiao produces phlegm and collects stasis， which contributes to T cell exhaustion and is correlated with nutrient deprivation， lipid accumulation， and high lactate levels in the immunosuppressed tumor microenvironment， as well as with the release of transforming growth factor-β and upregulated expression of programmed death receptor-1 by tumor-associated fibroblasts and platelets in the tumor microenvironment. Ying and Wei damage due to Sanjiao Qi transformation malfunction is similar to the abnormal manifestations such as progressive loss of exhausted T cell effector function and disturbance of cellular energy metabolism. Guizhi decoction， Shengming decoction， and Wendan decoction can correct T cell exhaustion and exert anti-tumor effects through multi-target and multi-pathways by regulating ''Sanjiao-Yingwei'' Qi transformation， and hypoxia inducible factor-1α （HIF-1α） may be one of the main pathways to correct T cell exhaustion. It was found that HIF-1α may be one of the important prognostic indicators in common tumors by bioinformatics. The use of the ''Sanjiao-Yingwei'' Qi transformation method may play an important part in improving the prognosis of tumor patients in clinical practice.