Objective:To investigate the effect of intraoperative ultrasound-guided nasal bone fracture repair on the clinical outcome of pediatric patients with nasal bone fracture. Methods:A total of 83 patients with nasal bone fracture who underwent prosthesis in our hospital from June 2022 to March 2024 were selected and assigned to control group （endoscopic nasal bone fracture repair） and experimental group （ultrasound-guided nasal bone fracture repair） using random number table method. Both groups were treated with the same nursing measures after surgery. There were 41 cases in the control group and 42 cases in the experimental group. The evaluation parameters of nasal bone fracture, nasal ventilation function, nasal appearance and olfactory function score, postoperative complications and satisfaction were compared between the two groups. Results:The operation time and hospital stay were significantly lower in the experimental group than in the control group （P<0.05）, and secondary repair case （n=0） in the experimental group was significantly less than in the control group （P<0.05）. Compared to preoperative status, the minimum nasal cross-sectional area, nasal volume and total nasal expiratory volume of the two groups increased three months post-operatively, and those in the experimental group were higher （P<0.05）, nasal expiratory and inspiratory resistance, nasal appearance and olfactory disorder scores decreased and those in the experimental group were lower （P<0.05）. The postoperative complications incidence in the experimental group was lower than in the control group （7.14% and 14.63%, respectively, P>0.05）. The overall satisfaction in the experimental group was higher than in the control group（90.48% and 82.93%, respectively, P>0.05）. Conclusion:Ultrasound-guided nasal fracture repair can effectively shorten the operation time, improve the success rate, and promote the postoperative recovery of nasal appearance and nasal function, reduce complications, and enhance the overall satisfaction of children and their families.
Humans ; Nasal Bone/surgery* ; Patient Satisfaction ; Child ; Female ; Male ; Postoperative Complications ; Treatment Outcome ; Postoperative Period ; Fractures, Bone/surgery* ; Ultrasonography

Objective:To explore the efficacy and safety of needle knife combined with local injection of compound betamethasone in the treatment of truncal keloids.Methods:A total of 56 patients with truncal keloids were prospectively enrolled from the Affiliated Hospital of Hangzhou Normal University from May 2022 to May 2024. Among them, there were 27 males and 29 females, aged 20-45 (31.5±6.6) years. The disease duration was 12.0 (9.0, 14.0) months. The area of keloids was (6.9±3.0) cm2, and the thickness was (3.8±0.7) mm. The 56 patients had a total of 62 truncal keloids. The etiological factors included injury or surgery (26 keloids), infection (6 keloids), and unknown causes (30 keloids). The locations of keloids were the chest (43 keloids), abdomen (11 keloids), and shoulders/back (8 keloids). Patients were divided into experimental group and control group using a random number table. The experimental group (27 patients with 29 keloids) received combined treatment of local compound betamethasone injection and needle knife therapy. The control group (29 patients with 33 keloids) received local compound betamethasone injection only. The Vancouver scar scale (VSS) was used to score keloids before the treatment and at 1, 3, 6 months after the treatment. Meanwhile, patients were instructed to score the pain and pruritus symptoms of their keloids using the visual analogue scale (VAS). At 6 months after the start of treatment, the incidence of adverse reactions and recurrence rate were calculated, and patient satisfaction was evaluated.Results:Intra-group comparison showed that the VSS and VAS scores of both groups at 1, 3, 6 months after the treatment were statistically significantly different from those before the treatment (all P<0.05). Inter-group comparison revealed no statistically significant differences in VSS and VAS scores between the two groups before the treatment (all P>0.05). At 1 month after the treatment, there was no statistically significant difference in VSS scores between the two groups ( P=0.515), but the VAS score of the experimental group was lower than that of the control group ( P=0.008). At 3 and 6 months after the treatment, both VSS and VAS scores of the experimental group were lower than those of the control group (all P<0.05). In the experimental group, 1 case of hypopigmentation occurred, with an adverse reaction rate of 3.4% (1/29). In the control group, 1 case of hypopigmentation and 1 case of mild depression occurred, with an adverse reaction rate of 6.1% (2/33); the difference between the two groups was not statistically significant ( P=1.000). The recurrence rates of the experimental group and the control group were 58.6% (17/29) and 69.7% (23/33), respectively, with no statistically significant difference ( P=0.363). The satisfaction scores of the experimental group and the control group were (85.6±6.7) and (78.3±9.4) scores, respectively, and the difference was statistically significant ( P=0.002). Conclusion:Needle knife combined with local injection of compound betamethasone has good efficacy in the treatment of truncal keloids, with a low incidence of adverse reactions and high patient satisfaction.

Objective:The aim of this study is to analyze the clinical characteristics and genetic variants of a late-onset auditory neuropathy pedigree caused by maternally inherited- mitochondrial mutation.Methods:A male proband who presented with bilateral sensorineural hearing loss at Henan Children′s Hospital in September 2023 was chosen, along with his family members (4 generations, 20 individuals) as the study subjects. Data from this pedigree were collected, organized, and analyzed for clinical genetic characteristics. Medical histories were obtained from family members, pedigree charts were drawn, audiological, imaging, and physical examinations were conducted. Pathogenic genes and mutations were screened using high-throughput sequencing. Sanger sequencing was employed for variant confirmation and segregation validation in the family.Results:In this family, a total of 12 members (10 members collected) had sensorineural hearing loss, characterized by late-onset hearing impairment with an onset age ranging from 9 to 30 years. The patients exhibited poor speech recognition rates, and audiometric examinations are consistent with auditory neuropathy. There was no history of ototoxic drug use. High-throughput sequencing identified the variant NC_012920.1:m.7471dup in the mitochondrial MT-TS1 gene as the pathogenic variant. Sanger sequencing results confirmed that the pathogenic gene mutation site perfectly co-segregated with the auditory neuropathy phenotype in this family. According to the classification criteria and guidelines for genetic variations by the American College of Medical Genetics and Genomics, the variant was classified as a pathogenic mutation. Conclusion:The mitochondrial MT-TS1 gene mutation m.7471dup is considered to be the pathogenic cause in this late-onset auditory neuropathy pedigree.

Objective:To explore the efficacy and safety of needle knife combined with local injection of compound betamethasone in the treatment of truncal keloids.Methods:A total of 56 patients with truncal keloids were prospectively enrolled from the Affiliated Hospital of Hangzhou Normal University from May 2022 to May 2024. Among them, there were 27 males and 29 females, aged 20-45 (31.5±6.6) years. The disease duration was 12.0 (9.0, 14.0) months. The area of keloids was (6.9±3.0) cm2, and the thickness was (3.8±0.7) mm. The 56 patients had a total of 62 truncal keloids. The etiological factors included injury or surgery (26 keloids), infection (6 keloids), and unknown causes (30 keloids). The locations of keloids were the chest (43 keloids), abdomen (11 keloids), and shoulders/back (8 keloids). Patients were divided into experimental group and control group using a random number table. The experimental group (27 patients with 29 keloids) received combined treatment of local compound betamethasone injection and needle knife therapy. The control group (29 patients with 33 keloids) received local compound betamethasone injection only. The Vancouver scar scale (VSS) was used to score keloids before the treatment and at 1, 3, 6 months after the treatment. Meanwhile, patients were instructed to score the pain and pruritus symptoms of their keloids using the visual analogue scale (VAS). At 6 months after the start of treatment, the incidence of adverse reactions and recurrence rate were calculated, and patient satisfaction was evaluated.Results:Intra-group comparison showed that the VSS and VAS scores of both groups at 1, 3, 6 months after the treatment were statistically significantly different from those before the treatment (all P<0.05). Inter-group comparison revealed no statistically significant differences in VSS and VAS scores between the two groups before the treatment (all P>0.05). At 1 month after the treatment, there was no statistically significant difference in VSS scores between the two groups ( P=0.515), but the VAS score of the experimental group was lower than that of the control group ( P=0.008). At 3 and 6 months after the treatment, both VSS and VAS scores of the experimental group were lower than those of the control group (all P<0.05). In the experimental group, 1 case of hypopigmentation occurred, with an adverse reaction rate of 3.4% (1/29). In the control group, 1 case of hypopigmentation and 1 case of mild depression occurred, with an adverse reaction rate of 6.1% (2/33); the difference between the two groups was not statistically significant ( P=1.000). The recurrence rates of the experimental group and the control group were 58.6% (17/29) and 69.7% (23/33), respectively, with no statistically significant difference ( P=0.363). The satisfaction scores of the experimental group and the control group were (85.6±6.7) and (78.3±9.4) scores, respectively, and the difference was statistically significant ( P=0.002). Conclusion:Needle knife combined with local injection of compound betamethasone has good efficacy in the treatment of truncal keloids, with a low incidence of adverse reactions and high patient satisfaction.

Objective:The aim of this study is to analyze the clinical characteristics and genetic variants of a late-onset auditory neuropathy pedigree caused by maternally inherited- mitochondrial mutation.Methods:A male proband who presented with bilateral sensorineural hearing loss at Henan Children′s Hospital in September 2023 was chosen, along with his family members (4 generations, 20 individuals) as the study subjects. Data from this pedigree were collected, organized, and analyzed for clinical genetic characteristics. Medical histories were obtained from family members, pedigree charts were drawn, audiological, imaging, and physical examinations were conducted. Pathogenic genes and mutations were screened using high-throughput sequencing. Sanger sequencing was employed for variant confirmation and segregation validation in the family.Results:In this family, a total of 12 members (10 members collected) had sensorineural hearing loss, characterized by late-onset hearing impairment with an onset age ranging from 9 to 30 years. The patients exhibited poor speech recognition rates, and audiometric examinations are consistent with auditory neuropathy. There was no history of ototoxic drug use. High-throughput sequencing identified the variant NC_012920.1:m.7471dup in the mitochondrial MT-TS1 gene as the pathogenic variant. Sanger sequencing results confirmed that the pathogenic gene mutation site perfectly co-segregated with the auditory neuropathy phenotype in this family. According to the classification criteria and guidelines for genetic variations by the American College of Medical Genetics and Genomics, the variant was classified as a pathogenic mutation. Conclusion:The mitochondrial MT-TS1 gene mutation m.7471dup is considered to be the pathogenic cause in this late-onset auditory neuropathy pedigree.

Objective:To investigate the clinical significance of intraoperative prepositioning of dual mediastinal drains in elderly patients developing anastomotic leakage(AL)after a total endoscopic Ivor-Lewis procedure.Methods:This retrospective case-control study analyzed the clinical data of 500 elderly patients who underwent total endoscopic Ivor-Lewis surgery for esophageal or cardia cancer from January 2020 to December 2022.In the control group, one mediastinal drainage tube was placed intraoperatively, while in the study group, two mediastinal drainage tubes were placed.Both groups had a chest tube placed conventionally.The study compared the incidence of anastomotic leak(AL)at 1 month postoperatively, inflammatory indexes in patients with AL, grading of AL, rate of nasal fistula placement, incision infection, anastomotic stenosis, and incidence of hoarseness.Additionally, it compared ICU occupancy, ventilator use, and ICU length of stay between the two groups.Results:The analysis included clinical data from 455 elderly patients.Among the patients who developed AL, the study group had significantly lower peak body temperature[(39.58±1.03)℃ vs.(38.05±0.56)℃, t=4.298, P<0.05], white blood cell count[(18.63±3.35)×10 9/L vs.(14.28±2.78)×10 9/L, t=3.450, P<0.05], and C-reactive protein(CRP)levels[(154.66±41.64)mg/L vs.(122.19±31.29)mg/L, t=2.131, P<0.05]. The study group also had a significantly lower grading of AL and rate of nasal fistula placement(82.4% vs.30.0%, P<0.05). In terms of ICU indicators, the study group had a significantly lower ICU admission rate(64.7% vs.10.0%, P<0.05), shorter period of ventilator use[(6.47±8.15)days vs.(0.90±2.23)days, t=2.62, P<0.05], and shorter ICU stay[(11.70±8.89)days vs.(4.70±6.27)days, t=2.184, P<0.05]. Conclusions:Double mediastinal drainage tubes, have been found to significantly alleviate inflammation, decrease the rate of nasal fistula placement and ICU admission, and shorten the length of ICU stay in elderly patients.Therefore, they are considered safe and deserving of clinical promotion.

Objective To investigate the effect of adenotonsillectomy on immune function and sleep structure in children with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 94 children with OSAHS treated at Children's Hospital Affiliated to Zhengzhou University from November 2020 to June 2022 were selected as the observation group,and another 80 healthy children who underwent physical examinations at the same hospital during the same period were selected as the control group.Children in the observation group underwent bilateral tonsillectomy combined with endoscopic adenoidectomy.Changes in the sleep structure of children in the observation group were detected before surgery and at discharge by using a multi-channel sleep monitoring system.Venous blood samples were collected from children in the observation group before surgery,one month after surgery,and six months after surgery,while venous blood samples of children in the control group were collected on the day of physical examination.The serum levels of IgA,IgG and IgM were measured by using immunoturbidimetry,the percentages of CD3+,CD4+and CD8+in the plasma were measured by using flow cytometry,and the CD4+/CD8+ratio was calculated.Results Compared with before surgery,the proportion of non-rapid eye movement sleep(NREM)1,apnea-hypopnea index and obstructive apnea-hypopnea index of children in the observation group decreased at discharge,the proportions of NREM2,NREM3 and rapid eye movement sleep(REM),sleep efficiency and the lowest oxygen saturation increased,and REM time extended(P＜0.05).The preoperative serum levels of IgA,IgG and IgM in the observation group were significantly higher than those in the control group(P＜0.05).One month after surgery,the serum levels of IgA,IgG and IgM in the observation group were significantly lower than those in the control group(P＜0.05).There was no statistically significant difference in the serum levels of IgA,IgG and IgM between the observation group and the control group at six months after surgery(P＞0.05).One and six months after surgery,the serum levels of IgA,IgG and IgM in the observation group were significantly lower than those before surgery(P＜0.05),and the serum levels of IgA,IgG and IgM at six months after surgery were significantly higher than those one month after surgery(P＜0.05).The preoperative CD3+and CD4+percentages and the CD4+/CD8+ratio in the observation group were significantly lower than those in the control group,while the CD8+percentage was significantly higher than that in the control group(P＜0.05).One month after surgery,the CD3+and CD4+percentages and the CD4+/CD8+ratio in the observation group were significantly lower than those in the control group,while the CD8+percentage was significantly higher than that in the control group(P＜0.05).There was no statistically significant difference in the CD3+,CD4+and CD8+percentages and the CD4+/CD8+ratio between the observation group and the control group at six months after surgery(P＞0.05).One month after surgery,the CD3+and CD4+percentages and the CD4+/CD8+ratio in the observation group were significantly lower than those before surgery,while the CD8+percentage was significantly higher than that before surgery(P＜0.05);six months after surgery,the CD3+and CD4+percentages and the CD4+/CD8+ratio in the observation group were significantly higher than those before surgery,while the CD8+percentage was significantly lower than that before surgery(P＜0.05).The CD3+and CD4+percentages and the CD4+/CD8+ratio at six months after surgery were significantly higher than those at one month after surgery,while the CD8+percentage was significantly lower than that at one month after surgery in the observation group(P＜0.05).Conclusion Adenotonsillectomy can effectively prolong the REM time of OSAHS children and improve their sleep efficiency,sleep structure and the immune regulation function of the body.The immune function of the body decreases briefly after adenotonsillectomy,and then gradually returns to the normal level.

OBJECTIVE To establish the quality standard of Triadica cochinchinensis and to perform the acute toxicity study. METHODS Appearance properties, powder microscopic identification, and thin-layer chromatography(TLC) identification were researched. The specific chromatogram was established by HPLC. The content of cadmium(Cd), lead(Pb), arsenic(As), copper(Cu), and mercury(Hg) was determined by inductively coupled plasma-mass spectrometry(ICP-MS). Acute toxicity was studied by maximum dose. RESULTS The outer skin of herbs was dark brown, and the inner surface was light yellow brown and fibrous. Besides, crystal sheath fiber was common, and calcium oxalate clusters arranges in rows. In the TLC diagram of the test product, the fluorescent spots of the same color were displayed at the corresponding position of the control product(scopoletin, isofraxidin). Five common peaks were calibrated in the characteristic map and the three characteristic peaks(scopoletin, isofraxidin, dimethylfraxetin) were recognized. The content of the measured heavy metal elements was lower than the national limit standard. The linear correlation coefficient was R2 > 0.999. The precision, stability, repetitive RSD were < 10%. The average recovery rate of the added sample was 80%−120%, and the RSD was < 10%. The maximum dose of the acute toxicity test was 184.09 g·kg−1. The 14 d internal body mass, food intake, organ-body ratios, the serum glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, blood urea nitrogen, and creatinine were not significantly different by comparing with the normal controls. Therefore, no significant toxicity was observed. CONCLUSION The established standard can provide a reference for evaluating the quality of Triadica cochinchinensis. The heavy metal content of ten batches of medicinal materials is within the safe range. Acute toxicity test show that there is no obvious significant adverse teactions after oral administration, and the safe dose range is large, which can provide a reference for the subsequent development and utilization.

Objective: This study examined the function of EP0 to provide a direction for its in-depth analysis. Methods: In this study, the EP0-deleted PRV mutant was obtained, and Tandem Mass Tagbased proteomic analysis was used to screen the differentially expressed proteins (DEPs) quantitatively in EP0-deleted PRV- or wild-type PRV-infected porcine kidney 15 cells. Results: This study identified 7,391 DEPs, including 120 and 21 up-regulated and downregulated DEPs, respectively. Western blot analysis confirmed the changes in the expression of the selected proteins, such as speckled protein 100. Comprehensive analysis revealed 141 DEPs involved in various biological processes and molecular functions, such as transcription regulator activity, biological regulation, and localization. Conclusions and Relevance: These results holistically outlined the functions of EP0 during a PRV infection and might provide a direction for more detailed function studies of EP0 and the stimulation of lytic PRV infections.

Objective:To investigate the pathogenic variants and function of a pedigree with syndromic hearing loss using high-throughput sequencing.Methods:Detailed medical history and pedigree history were inquired, and a pedigree chart was drawn. Hearing examinations were performed on this pedigree, and whole-exome sequencing and bioinformatics analysis were performed to screen for suspected pathogenic variants. Then, Sanger sequencing was used to test co-segregation in the family, and transcriptome sequencing was used to investigate the effect of a variant on splicing.Results:The proband has auditory neuropathy combined with symptoms such as development delay, muscle weakness, and seizure. The patient carries two variants in NARS2 (NM_024678.6), namely: c.779A>C (p.Glu260Ala) and c.372+3A>G (intronic variant), of which c.779A>C is inherited from the father and c.372+3A>G from the mother. Both variants have not been reported in the literature or included in any databases. Transcriptome sequencing results indicate that the c.372+3A>G variant leads to the skipping of the third exon during transcription. According to the American College of Medical Genetics and Genomics(ACMG) guidelines, the c.779A>C variant and c.372+3A>G are classified as likely pathogenic. Based on the patient′s phenotype and genetic testing results, the proband has been diagnosed with combined oxidative phosphorylation deficiency 24(COXPD24). Conclusions:The pathogenic variants in the NARS2 gene are the underlying cause of the patient′s disease. The identification of novel variants enriches the mutational spectrum of the NARS2 gene, providing evidence for further clarification of the relationship between NARS2 and COXPD24.