Objective To investigate the indications,approaches,and essentials of cranio-orbital surgeries for orbital apextumors.Methods The clinical data of 48 patients with orbital apextumors treated by refined transcranial orbitotomy through superolateral approach were analyzed retrospectively,34 tumors were excised with orbitoptenonal approach,while 14 tumors were excised with orbltotrontal approach,orbitozygomatic approach,or zygomatic-ptefional approach.Results Of the 48 orbital apextumors,33 cases were totally resected,7 cases were subtotally resected,and 6 cases were partly resected.The other 2 cases were taken biopsies.The optic functions improved or retained in 40 cases,7 cases suffered from eye-moving disfunction or visual-acuity declines,and 1 case suffered from hemiparalysis.Conclusions Tumors in the posterior and apex part of the orbit,or tumors extended from the orbit to the cranial,can be well treated through transcranial approach.Appropriate methods may help to bring maximum convenience to exposure and excision of the lesion,and to conserve the functions.Unnecessary injuries could be avoided as well.

Objective:To investigate the expression of transmembrane 4 super family 1 (TM4SF1)in breast cancer tissue,and to elucidate its clinical significance and explore the related molecular biological mechanisms. Methods:A total of 190 cases of human breast cancer,110 cases of paracancerous tissue and 110 cases of normal breast tissue were collected.Immunohistochemistry was used to detect the expression levels of TM4SF1 mRNA in breast cancer tissue,paracancerous tissue,and normal breast tissue;Western blotting method was used to detect the expression levels of TM4SF1 in breast cancer tissue,paracancerous tissue,and normal breast tissue;RT-PCR method was used to detect the expression levels of TM4SF1 mRNA in breast cancer tissue,paracancerous tissue, and normal breast tissue.The positive expression rates of TM4SF1 in breast cancer tissue of the breast cancer patients with different clinicopathological features were detected.Results:The positive expression rate of TM4SF1 in the breast cancer tissue was significantly higher than those in paracancerous tissue and normal breast tissue (P <0.05);there was no significant difference in the positive expression rates of TM4SF1 between paracancerous tissue and normal breast tissue (P = 0.531);the expression of TM4SF1 was not correlated with age,but was closely correlated with tumor size,differentiation degree,lymph node metastasis and tumor stage (P <0.05);the positive expression rate of TM4SF1 in basal like breast cancer tissue was higher than those in the other three types of tissues (P <0.05).The results of Western blotting showed that the expression level of TM4SF1 in breast cancer tissue was higher than those in paracancerous tissue and normal breast tissue (P < 0.05 ), but there was no significant difference in the expression level of TM4SF1 between paracancerous tissue and normal breast tissue (P >0.05). The results of RT-PCR showed that the expression level of TM4SF1 mRNA in breast cancer tissue was higher than those in the paracancerous tissue and normal breast tissue (P <0.01);there was no significant difference in the expression level of TM4SF1 mRNA between paracancerous tissue and normal breast tissue (P > 0.05 ). Conclusion:The TM4SF1 is highly expressed in breast cancer tissue. TM4SF1 may affect the occurrence, development and distant metastasis of breast cancer through various mechanisms.TM4SF1 may be a potential target for the treatment of breast cancer.

Objective To develop a diagnostic model based on deep neural network for intelligent discrimination of thyroid function. Methods A total of 1616 patients ( 283 males, 1333 females, average age:52 years) who underwent thyroid imaging between May 2016 and June 2018 were selected. According to the clinical diagnosis, the 1616 cases included 299 normal thyroid cases, 876 hyperthyroidism cases and 441 hypothyroidism cases. Feature extraction and learning training were performed on 1000 training set sam-ples by two deep neural network models ( AlexNet;deep convolution generative adversarial networks ( DCGAN) ) using deep learning algorithm. Performance verifications were implemented on 616 test set samples. The con-sistency between the verification results of the two models and the clinical diagnosis was analyzed by Kappa test. Meanwhile, the time advantage of the intelligent diagnosis models was analyzed. Results The average diagnostic time of AlexNet model was 1 s/case, and the classification accuracy for normal thyroid, hyperthy-roidism, hypothyroidism were 82.29％(79/96), 94.62％(369/390), 100％(130/130), respectively. The Kappa value between results of AlexNet model and clinical diagnosis was 0.886 ( P<0.05) . The average di-agnostic time of DCGAN model was 1 s/case, and the classification accuracy for normal thyroid, hyperthy-roidism, hypothyroidism were 85.42％(82/96), 95.64％(373/390), 99.23％(129/130), respectively. The Kappa value between results of DCGAN model and clinical diagnosis was 0.904 ( P<0.05) . Conclusion The deep neural network intelligent diagnosis model can quickly determine the functional status of thyroid gland in thyroid imaging, and it has a high recognition accuracy, thus providing a new method for thyroid image review.

【Objective】 To investigate the effect of two different oral calcium supplementation methods(method 1: bone health basic supplements in the interval plus routine calcium supplement; method 2: only routine calcium supplement on the day of donation)on platelet donors, to improve some biochemical indexes of the body caused by citrate anticoagulant. 【Methods】 A total of 252 long-term regular platelet donors in our station from January 2019 to December 2020 were selected and randomly divided into two groups: experimental group (n=126) were given 10% calcium gluconate oral solution 20 mL before platelet collection, orally. Oral caltrate D3 (containing 600 mg calcium carbonate and 125 international units of vitamin D3) was administered in the interval (20±2 days), 1 tablet per day. Oral alfacalcidol soft capsule (containing alfacalcidol 0.25 μg), 1 tablet per day; control group (n=126) were given routine administration of 10% calcium gluconate oral solution 20 mL before platelet collection. Serum PTH and serum concentrations of calcium, magnesium, phosphorus and 25 hydroxyvitamin D of the two groups were detected at 0 min after injection and 0 min after the end of the last circulation, respectively. Meanwhile, the occurrence of blood donation reactions was observed in the two groups. 【Results】 In the experimental group and control group, serum PTH concentration both increased significantly after donation, while serum calcium, inorganic phosphorus, magnesium and 25 hydroxyvitamin D decreased significantly(P<0.01). After donation, 4 donors in the experimental group and 8 in the control group showed citrate reaction, with the incidence of adverse reactions at 3.17%(4/126)and 6.34%(8/126), respectively. Before blood collection, serum calcium concentration in the experimental group was higher than that in the control group, while PTH concentration was lower than that in the control group (P<0.01), but no significant differences were noticed in serum magnesium, inorganic phosphorus and 25 hydroxyl vitamin D concentrations (P>0.05), and so was in the control group after blood collection. 【Conclusion】 Method 1 can further slow down the increase of serum PTH and the decrease of serum calcium, and can effectively reduce the citrate response of blood donors compared with method 2, which is of great significance to prevent osteoporosis in long-term regular blood donors.

The prevalence of osteoporosis， osteoarthritis， gouty arthritis， rheumatoid arthritis， and intervertebral disc degeneration is increasing year by year with the growing number of elderly people， and the common clinical manifestations of these diseases include severe pain in different areas， which seriously affects the daily life of the patients. Therefore， how to relieve the pain and reduce the prevalence of bone and joint diseases and improve the quality of life of the patients is a hot spot in the medical field. Studies have confirmed that NOD-like receptor family， pyrin domain-containing protein 3 （NLRP3） inflammasomes， as pattern recognition receptors， are involved in the inflammation， chondrocyte proliferation， osteoblast and osteoclast differentiation， intervertebral disc cell inflammation and scorching， extracellular matrix degradation and apoptosis， mitochondrial dysfunction， endoplasmic reticulum stress， and reactive oxygen species damage， demonstrating close link with the development of bone and joint diseases. Chinese medicine has a long history and demonstrates remarkable therapeutic effects in the treatment of bone and joint diseases. It can mitigate the pathological changes of bone and joint diseases by inhibiting NLRP3 inflammasomes to alleviate the pain， playing a role in preventing and treating these diseases. Therefore， this paper briefly describes the relationship between NLRP3 inflammasomes and the development of bone and joint diseases by reviewing the latest research progress at home and abroad. We summarize the latest studies about the active components， extracts， and compound prescriptions of Chinese medicines in the treatment of bone and joint diseases via regulating NLRP3 inflammasomes. This review is expected to offer new insights into the in-depth research on the pathogenesis and drug treatment of bone and joint diseases and provide a basis for the clinical application of Chinese medicine in the prevention and treatment of such diseases.