Objective To study the reference values and related factors of tympanometry for children between 2 and 15 year-old .Methods From December 2014 to March 2015 ,a total of 120 children (240 ears total) among 2 to 15 year-old (6 .95-3 .12) with Type A tympanograms received the singe -frequency component tympanometry test ,including acoustic equivalent volume (Vea ) ,peak-compensated static admittance (Ytm ) ,tympanometric peak pressure (TPP) and tympanometric gradient (TG) .With the results of each test ,the relationships were conducted according to the differences of age and gender .The outcomes also were compared with the recent studies abroad .Re-sults The difference of TPP was statistically significant among the gender group ,and the differences of Vea and TPP were statistically significant between different age groups ,2-6 year pre-school children and 7~15 yr school children .Conclusion The normative values of each tests were significantly different between Chinese and western children of 2-15 years .We would speculate that the differences of TPP in the age and gender group have changed with the physiological characteristics of Eustachian tubes and eardrums and the differences among male and female .

Objective To investigate the valuable echocardiographic parameters and to evaluate theright heart function of patients with pulmonary hypertension in ICU. Methods From March 2015 to February 2016,30 patients with pulmonary hypertension in the intensive care unit(ICU) of Dongzhimen hospital were enrolled in the experimental group,and another 33 patients without pulmonary hypertension in ICU were enrolled in the control group. All of the patients were given bedside echocardiography examination. Results Significant differences in the right atrial diameter and area ,the base diameter of the right ventricle ,the intermediate diameter portion ,the distal inner diameter of the proximal end of the right ventricular outflow tract ,the main pulmonary artery diameter ,the Tei index and the E/A were observed between the two groups. However ,no significant differences in the right ventricular free wall thickness,TAPSE,RVFAC,VREF and DT were foundbetween the two groups. Conclusion Tei index,the diameter of the right heart and the main pulmonary artery diameter are proposed to be the promising echocardiographic parameters to evaluate the right heart function of patients with pulmonary hypertension in ICU.

Clinical manifestations of young cerebral infarction patients are similar to those of elderly patients, but the etiology is complicated, and vascular lesions are important pathogenic factors,mainly including atherosclerosis, cervicocerebral artery dissection, moyamoya disease, central nervous system vasculitis and cerebral small vessel disease. High-resolution MRI, which compensates for the insufficiency of traditional imaging examination in detecting vascular lesions, can clearly show vascular wall lesions and therefore having high clinical value in diagnosis of young cerebral infarction. The research progresses in high-resolution MRI of vascular wall lesions in young cerebral infarction patients were reviewed in this paper.

Objective To investigate the effect of functional training on knee pain,functional movement screen (FMS) score and balance in Chinese elite fencing athletes with patellar tendinopathy.Methods Twenty-four fencing athletes with a diagnosed patellar tendinopathy were randomized into a treatment group (TG) and a control group (CG),each of 12.Both groups were given routine physical therapy,while TG received motor function training in addition for eight weeks.Both groups completed the numerical rating scale (NRS),FMS and balance test before and after the intervention.Results After the intervention,the average PRS and FMS of TG were 2.08± 1.24 and 16.25±0.97 respectively,which significantly outperformed those of TG before the intervention and those of CG after the intervention (P＜0.05).Moreover,TG indicated superior results in parameters of static postural balance including center of pressure,total length of swinging pathway,maximal length of swinging pathway,and area of swinging pathway when compared to TG before the intervention and CG after the intervention(P＜0.05).Conclusion The motor functiontraining is effective in improving functional movement and balance in elite fencing athletes with patellar tendinopathy.

Objective To investigate the expression of gastric and intestinal phenotypic markers in Siewert typeⅡand Ⅲ early gastroesophageal junction(GEJ) cancer, and to explore its correlation with clinic-pathological features.Methods From April 2010 to July 2015, 53 cases diagnosed as early GEJ cancer were enrolled.The gastric and intestinal phenotypic markers such as mucin5AC(MUC5AC),mucin6(MUC6),mucin2(MUC2),caudal related homeodomain transcription 2(CDX2) and cluster of differentiation 10(CD10) were detected, and then the patients were divided into gastric type, gastrointestinal type, intestinal type and non-classified type according to the results of immunohistochemical staining.Combined with Siewert classification the clinicopathological features were analyzed.Chi square test or Fisher′s exact test was performed for statistical analysis.Results In the cancer tissues of 47 patients with Siewert type Ⅱand Ⅲ early GEJ cancer, the case numbers of positive expression of MUC5AC,MUC6,MUC2, CDX2 and CD10 were 21(44.7%),19(40.4%),31(66.0%),27(57.4%) and 17(36.2%),respectively;the case numbers of gastric type, gastrointestinal type, intestinal type and non-classified type were 11(23.4%),14(29.8%),21(44.7%) and one(2.1%), respectively.The positive expression rates of MUC5AC and MUC6 in Siewert typeⅡwere 55.9%(19/34) and 50.0%(17/34),which were higher than those of Siewert typeⅢ(2/13), and the positive expression rate of MUC2 was 55.9%(19/34), which was lower than that of Siewert typeⅢ(12/13), and the differences were statistically significant (x2=6.240,4.679 and 4.053;all P<0.05).In Siewert typeⅡ, the proportion of intestinal type was 32.4%(11/34), which was lower than that of Siewert typeⅢ(10/13), and the differences were statistically significant (x2=7.142,P=0.010).In patients with Siewert typeⅡand Ⅲ early cancer, males predominated in intestinal type which were mostly well differentiated type with less submucosal carcinoma.The maximum diameter of tumor was less than those of gastric type and gastrointestinal type.In paracancerous mucosal tissues, the incidences of intestinal metaplasia in gastrointestinal type and intestinal type were 11/14 and 81.0%(17/21), which were higher than that of gastric type (3/11);the incidences of atrophy in gastrointestinal type and intestinal type were 12/14 and 85.7%(18/21),which were higher than that of gastric type (4/11),and the differences were statistically significant (Fisher′s exact test,all P<0.05).Conclusions Siewert typeⅡand Ⅲ early GEJ cancer can directly originated not only from gastric mucosa, but also from gastrointestinal and intestinal mucosa.Atrophy and intestinal metaplasia could exist before cancer genesis.

Objective:To assess the value of amide proton transfer weighted (APTw) imaging in the evaluation of pH changes in infarct core (IC) and ischemic penumbra (IP) in subacute cerebral infarction.Methods:The data of twenty-three subacute cerebral infarction patients with unilateral steno-occlusive disease of the middle cerebral artery (subacute infarction group) from April to November 2019 in the First Affiliated Hospital of Dalian Medical University were prospectively analyzed. Fifteen healthy volunteers were enrolled in this study as the control group. All subjects underwent conventional MRI, DWI, 3D-pseudo continuous arterial spin labeling (3D-pCASL) and APTw sequences. Based on DWI images, relative cerebral blood flow (rCBF) and APTw images to determine the region of IC, blood flow penumbra [cerebral blood flow(CBF)-DWI mismatch area, IP CBF] and metabolic penumbra (APTw-DWI mismatched area, IP APT). 3D ROIs were used to semi-automatically measure the APTw signals and the volume of IC and IP CBF of the patients in subacute infarction group. The comparison of APTw signals between the infarct side and the contralateral side in the subacute infarction group, the comparison of bilateral APTw signals in the control group, and the comparison of APTw signals in the IC and IP CBF regions were performed by paired-sample t test or Wilcoxon signed-rank test. The paired-sample t test or Mann-Whitney U test was used to compare the APTw signals between the two groups. The Friedman test was applied to compare the difference of volumes among IP CBF1.5, IP CBF2.5 and IP APT . Results:There was no significant difference of the APTw signals among the IC, the contralateral side in the subacute infarction group and the control group ( P>0.05). The APTw signals of IP CBF and IC of the infarction group were statistically different ( P<0.05). Compared with the contralateral side of IP CBF1.5 (3.7±1.7, -1.84±1.48, 5.57±2.75), the APTwmax (3.07±1.41, t=-3.012, P=0.006), APTw min [-1.30 (-1.74, -0.57), Z=-2.099, P=0.036], and APTwmax-min(4.51±2.58, t=-3.273, P=0.003) signals in the IP CBF1.5 were decreased ( P<0.05). Compared with the contralateral side of IP CBF2.5 [-1.53 (-2.80, -0.91), 5.31±2.61], the APTw min [-1.08 (-1.60, -0.49), Z=-2.616, P=0.009] and APTwmax-min (4.41±2.72, t=-3.228, P=0.004) signals in the IP CBF2.5 were decreased. The volumes of IP CBF1.5 [107.51(50.08, 138.61)mm 3], IP APT [99.00 (53.27, 121.335) mm 3] and IP CBF2.5 [89.91 (51.53, 139.87) mm 3] were successively reduced (χ2=7.913, P=0.019), and the volume of IP CBF2.5 was significantly smaller than that of IP CBF1.5 ( P=0.037). Conclusion:The acid-base metabolism in the IC of subacute cerebral infarction is not obvious, but the blood flow penumbra has local acid-base metabolism imbalance, and the range of metabolic penumbra coincides with the blood flow penumbra.

Intratumoral bacteria are a group of bacteria that exist within tumors and make up the tumor microenvironment. They play a significant role in tumorigenesis and progression, as well as in influencing the response of tumors to chemotherapy and immunotherapy through various mechanisms. This article primarily discusses the sources and mechanisms of action of intratumoral bacteria, with a specific focus on their composition and functions in the digestive system. Further-more, it explores the potential application of intratumoral bacteria in anti-tumor therapy, aiming to provide valuable references for future clinical use.

This article reviews the concept and research tools of social distancing, the current situation and influencing factors of social distancing in elderly diabetic patients, in order to provide a basis for the development of targeted intervention strategies for elderly diabetic patients, reduce the sense of social alienation in elderly diabetic patients, and promote their social participation and sense of meaning in life.

Objective To investigate the basic clinical features in 371 cases of colorectal polyps and its relationship with fecal occult blood and carcinoembryonic antigen(CEA).Methods The retrospective analysis was performed on 371 inpatients with colo-rectal polyps.The relationship among gender,number of polyps and polyps anatomical site in different ages of patients was investi-gated,and the relationship between fecal occult blood and CEA with polyp canceration was analyzed by 1.5?3.0 years follow-up. Results Among 371 cases of colorectal polyps,the female patients were gradually increased and single polyp was gradually de-creased along with the age increase;due to different ages,there was the statistically significant difference in the polyp locations (χ2 =9.759,P=0.045);the distribution difference of the patients with polyp canceration among three age groups was statistically significant(χ2 =5.138,4.107,13.153,P<0.05).The cases of fecal occult blood positive and CEA abnormal increase were gradual-ly increased with age increasing(χ2 =15.544,11.959,P<0.01);with the number of polyps increasing,the cases of fecal occult blood positive showed the increasing trend(χ2 =14.043,P=0.001);the canceration rate in colorectal polyp cases of fecal occult blood positive and CEA abnormal increase was significantly higher than that in the cases of fecal occult blood negative and CEA normal range(χ2 =40.165,43.249,all of P< 0.001).Conclusion The fecal occult blood test and CEA detection results have a certain significance to the follow up for preventing colorectal polyps canceration.

Objective:To investigate the prevalence and molecular characteristics of Escherichia coli ( E. coli) producing a novel Shiga toxin 2k subtype in goat in Lanling county, Shandong province. Methods:In November 2019, 512 goat fecal samples were collected from different households in Lanling county, Shandong province. After enriched with EC broth, stx-positive samples were detected by PCR and inoculated in CHROMagar? ECC agar and CHROMagar? STEC agar. The whole genomes of stx-positive strains were sequenced. Based on the genomic senquences, the stx subtype, serotype, multi-locus sequence type and virulence genes of each strain were analyzed. Results:Eighty-six strains of Shiga toxin-producing E. coli (STEC) were isolated from 512 goat fecal samples. Five stx subtypes were identified and 37 strains were positive for stx2k. The 86 STEC strains belonged to 20 O∶H serotypes and 18 different sequence types (STs). Conclusions:STEC strains circulating in goats in Lanling county, Shandong province were heterogeneous in stx subtypes, serotypes and virulence gene profiles, and a certain proportion of strains producing a novel Shiga toxin 2k subtype were detected.