OBJECTIVE To investigate the relationship between the expression level of endotoxin and soluble interleukin-2 receptor(sIL-2R)and the occurrence of suppurative otitis media in patients with nasopharyngeal carcinoma after radiotherapy.METHODS Seventy-nine nasopharyngeal cancer patients who received radiotherapy in Nanyang Downtown Hospital between January 2022 and July 2023 were selected as the study subjects,and they were followed up for a period of 1 year,and then grouped according to the occurrence of suppurative otitis media during the follow-up period,i.e.,21 cases in the occurringgroup and 58 cases in the non-occurring group,and the baseline data of patients in the two groups were compared,and the levels of endotoxin and sIL-2R were detected at the end of radiotherapy and analyze the relationship between endotoxin,sIL-2R and the occurrence of purulent otitis media after radiotherapy for nasopharyngeal carcinoma.RESULTS A total of 21 cases(26.58%)of 79 nasopharyngeal carcinoma patients developed suppurative otitis media after radiotherapy.Compared with the non-occurrence group,the radiotherapy time,endotoxin,sIL-2R,TNM stage Ⅲ,Eustachian tube involvement,nasal cavity structural abnormality,inflammatory reaction,and palatal sail tensor atrophy degree≥30%were high in the occurrence group,and the difference was statistically significant(all P<0.05).The results of logistic multifactorial analysis showed that inflammatory reaction,endotoxin,abnormal nasal structure,TNM stage(Ⅲ),sIL-2R,Eustachian tube involvement,duration of radiotherapy,and degree of atrophy of palatofacial tensor atrophy≥30%were all risk factors for suppurative otitis media.The results of Spearman's rank correlation analysis showed that endotoxin and sIL-2R were positively correlated with the occurrence of septic otitis media(r=0.493,0.516,P<0.001).Analysis using the ROC curve showed that:endotoxin:AUC value:0.657,sensitivity:61.90%,specificity:72.41%,accuracy:69.62%,95%CI=0.523-0.791;sIL-2R:AUC value:0.697,sensitivity:71.43%,specificity:67.24%,accuracy:68.35%,95%CI=0.566-0.829;combined test:AUC value:0.804,sensitivity:95.24%,specificity:65.52%,accuracy:73.42%,95%CI=0.705-0.903,the best value of the two combined tests.CONCLUSION The elevated levels of endotoxin and sIL-2R in patients with nasopharyngeal carcinoma after radiotherapy may be associated with suppurative otitis media.

OBJECTIVE To compare the short-term efficacy of autologous frozen tragus perichondrium and fresh perichondrium in repairing tympanic membrane perforations,and to explore the clinical application value of autologous frozen tragus perichondrium.METHODS Twenty-five patients with bilateral tympanic membrane perforations from March 2021 to October 2023 were selected,including 7 males and 18 females.Bilateral tympanoplasty was completed in stages.The initial operation was set as the control group,in which the ventral perichondrium of the tragus was used for tympanoplasty,and the dorsal perichondrium of the tragus was reserved and stored at-80℃ultra-low temperature in a sterile container.The second operation was set as the observation group,in which the thawed frozen perichondrium was used for contralateral tympanoplasty.The differences in the healing rate of tympanic membrane,postoperative hearing,operation time and surgical bleeding volume were compared between the two groups.RESULTS All patients were followed up for three months.The success rate of tympanic membrane healing in the observation group was 96%(24/25),and that in the control group was 92%(23/25).There was no statistically significant difference between the two groups(χ2=0.36,P>0.05).The operation time and surgical bleeding volume of patients in the observation group were lower than those in the control group[(48.64±4.64)min vs.(67.92±5.69)min,(5.32±1.54)ml vs.(9.65±1.73)ml],and the differences were statistically significant(t=13.93,t=12.09,P all<0.05).The postoperative air conduction hearing thresholds and air-bone conduction gap of the two groups of patients were lower than those before operation(all P<0.05).There was no difference in air conduction hearing threshold,bone conduction hearing threshold and air-bone conduction difference between the groups(all P>0.05).CONCLUSION The application of autologous frozen tragus perichondrium has effectively shortened the operation time of the contralateral ear,avoided the trauma caused by taking materials again,and has the characteristics of minimally invasive and high efficiency.The method is feasible and the curative effect is accurate.

Objective To investigate the therapeutic efficacy of Erchen Decoction plus Sanzi Yangqin Decoction in the treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)of phlegm-dampness accumulation in lung syndrome,and to explore its possible therapeutic mechanism through the interleukin 33/soluble growth stimulation expressed gene 2(IL-33/ST2)signaling pathway.Methods A prospective trial was conducted on 92 elderly patients with acute exacerbation of COPD of phlegm-dampness accumulation in lung syndrome who were treated in Haikou Hospital of Traditional Chinese Medicine from January 2021 to June 2023.The patients were randomly divided into the control group and the observation group according to the random number table method,with 46 cases in each group.The control group was treated with conventional western medicine,while the observation group was treated with Erchen Decoction plus Sanzi Yangqin Decoction on the basis of treatment for the control group,and the course of treatment covered two weeks.The changes of traditional Chinese medicine(TCM)syndrome scores,lung function indicators,white blood cell count(WBC),neutrophil percentage(Neut%),and serum IL-33,ST2,interleukin 6(IL-6)and interleukin 8(IL-8)levels of patients in the two groups before and after the treatment were observed,and the clinical efficacy and medication safety of the patients in the two groups were evaluated.Results(1)After two weeks of treatment,the total effective rate of the observation group was 86.96%(40/46)and that of the control group was 67.39%(31/46),and the intergroup comparison(tested by chi-square test)showed that the therapeutic effect of the observation group was significantly superior to that of the control group(P<0.05).(2)After treatment,the TCM syndrome scores such as dyspnea,suppression in the chest,cough and expectoration in the two groups were decreased compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.01).(3)After treatment,the lung function indicators such as forced vital capacity(FVC),forced expiratory volume in one second(FEV1),and peak expiratory flow(PEF)of the two groups all improved compared with those before treatment(P<0.05),and the improvement in the observation group was significantly superior to that in the control group(P<0.01).(4)After treatment,the levels of inflammatory indicators such as WBC,Neut%,and serum IL-33,ST2,IL-6 and IL-8 in the two groups were all decreased compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.01).(5)The total incidence of adverse reactions in both groups was all 8.70%(4/46),and the intergroup comparison showed that the difference was not statistically significant(P>0.05).Conclusion The clinical efficacy of Erchen Decoction plus Sanzi Yangqin Decoction in the treatment of elderly patients with acute exacerbation of COPD of phlegm-dampness accumulation in lung syndrome is remarkable,and it is effective on improving the TCM syndromes,related inflammatory indicators and lung function.Its mechanism may be related to the reduction of the patients'serum IL-33 level,the inhibition of IL-33/ST2 signaling pathway and the expression of related inflammatory factors,so as to inhibit inflammatory response and improve the progression of COPD.

A 71-year-old male presented with esophageal cancer and severe aortic valve regurgitation. Treatment strategies for such patients are controversial. Considering the risks of cardiopulmonary bypass and potential esophageal cancer metastasis, we successfully performed transcatheter aortic valve implantation and minimally invasive three-incision thoracolaparoscopy combined with radical resection of esophageal cancer (McKeown) simultaneously in the elderly patient who did not require neoadjuvant treatment. This dual minimally invasive procedure took 6 hours and the patient recovered smoothly without any surgical complications.

Objective:To analyze the trend of ovarian cancer incidence in Qidong City from 1972 to 2021 and evaluate the age, period, and cohort effect.Methods:The ovarian cancer incidence data from 1972 to 2021 were extracted from the Qidong Cancer Registry Database, the crude incidence rate (CR), age standardized rate by Chinese population (ASR-C), age standardized rate by world population (ASR-W), and average annual percent change (AAPC) were calculated. The age-period-cohort model was used to analyze the age, period, and birth cohort effects of the ovarian cancer incidence in Qidong from 1972 to 2021.Results:From 1972 to 2021, a total of 1 007 cases of ovarian cancer occurred in Qidong. The AAPC values of CR, ASR-C, and ASR-W were 7.02% , 5.17%, and 5.12% , respectively (all P＜0.001). The time trends showed that, the AAPC values of the age groups of 0-34, 35-44, 45-54, 55-64, 65-74, and over 75 years old were 4.10%, 4.74%, 6.02%, 4.86%, 4.23%, and 5.18%, respectively (all P＜0.05). The age effect showed that the incidence rate of ovarian cancer increased obviously from the 45-49 year-old group, reaching a peak of 20.67/100 000 in the 75-79 year-old group. Compared with the 1992-1996 group, the period of 2002-2021 had significant effects on the incidence rise of ovarian cancer (all P＜0.05), and the incidence rate ratio ( RR) increased with the period: in 2017-2021 the RR was 3.86 (95% CI: 2.72-5.47). Using births from 1952 to 1956 as the reference group, the RR increased slowly from 0.12 (95% CI: 0.02-0.91) in 1892-1896, and peaked in 2007-2011 with an RR of 18.05 (95% CI: 3.51-92.87). The birth cohorts in 1967-2011 had significant effects on the incidence rise of ovarian cancer (all P＜0.05). The Waldχ 2 test of the age-period-cohort model showed that there were significant differences in the age, period, and birth cohort effects (all P＜0.001). Conclusions:The incidence of ovarian cancer in Qidong was on the rise. Age, period, and cohort were the main factors affecting the incidence of ovarian cancer. The middle-aged and elderly women were the focus of ovarian cancer prevention and control.

Objective To evaluate the practical application of the Media Fill Test(MFT)in assessing aseptic compounding competency of personnel in Pharmacy Intravenous Admixture Services(PIVAS).Methods A multicenter controlled study was conducted across six tertiary hospitals(center ①-⑥)in China.Participants were divided into an inexperienced group(Group A,n=118)and an experienced group(Group B,n=118),each performing five MFT operations.Positive controls validated medium efficacy.Contamination rates and pass rates were analyzed using chi-square and Fisher's exact tests.Results Valid samples included 584 for Group A and 588 for Group B.The sample pass rate was 66.78%(390/584)in Group A and 91.67%(539/588)in Group B,while personnel pass rates were 46.15%(54/117)and 80.51%(95/118),respectively,with significant intergroup differences(both P<0.01).All centers except Center ⑥ showed significantly higher pass rates in Group B(all P<0.05).Conclusion MFT effectively differentiates technical proficiency levels and is suitable for training evaluation of novice PIVAS staff.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective:To investigate the role of Fem-1 homolog C(FEM1C)in breast cancer progression and elucidate its underlying regulat-ory mechanism.Methods:The expression of FEM1C in breast cancer tissues and cells were detected with qPCR.The binding of FEM1C to ELAVL1 protein was predicted with an online database and validated by CoIP analysis;and the binding of ELAVL1 protein to OPA1 mRNA was predicted by using the starBase database and validated by RIP analysis.Next,breast cancer cell MDA-MB-231 was transfected with FEM1C shRNA(sh-FEM1C)or overexpression vector(FEM1C)or/and ELAVL1 overexpression vector(ELAVL1)or/and OPA1 overexpression vector(OPA1),or treated with 100 μM Mdivi-1,an DRP1 inhibitor,or MYLS22,an OPA1 inhibitor.Finally,nude mice were injected with sh-FEM1C lentiviral vectors to construct xenograft tumor models,and tumor growth was monitored.Results:The expression of FEM1C was upregu-lated in breast cancer tissues(P<0.01).Silencing FEM1C inhibited the proliferation,induced apoptosis,promoted the expression of auto-phagy protein LC3 Ⅱ/Ⅰ,inhibited p62 protein expression,upregulated the protein level of PINK1 in mitochondrial,promoted the expres-sion of mitochondrial fission proteins DRP1 and MIEF2,and inhibited the expression of fusion proteins OPA1 and MFN1 in MDA-MB-231 cells(P<0.01).Mdivi-1 treatment inhibited DRP1 expression(P<0.01),but had no effect on cell viability(P>0.05);MYLS22 treatment inhibited OPA1 expression and counteracted the effect of FEM1C overexpression on MDA-MB-231 cells(P<0.01).Mechanistic studies revealed that FEM1C binds to ELAVL1 protein and promotes its expression(P<0.01);ELAVL1 protein stabilizes OPA1 mRNA by binding to it and upregu-lates OPA1 protein levels(P<0.01).Overexpression of OPA1 reversed the effect of FEM1C silencing on MDA-MB-231 cells(P<0.01).In vivo results showed that knockdown of FEM1C inhibited tumor growth in vivo(P<0.01).Conclusions:FEM1C promotes the stability of OPA1 mRNA by upregulation of ELAVL1 protein to promote mitochondrial fusion and inhibit autophagy,thereby promoting breast cancer progression.

Objective:To analyze the effects of doctor-nurse-patient shared decision-making (SDM) and enhanced recovery after surgery (ERAS) nursing in patients undergoing radical gastrectomy for gastric cancer.Methods:A total of 186 patients who underwent radical gastrectomy for gastric cancer at the First Affiliated Hospital of Zhengzhou University from December 2022 to January 2024 were selected using convenience sampling and randomly divided into a control group and an observation group, with 93 patients in each group. The control group received routine ERAS nursing, while the observation group received SDM-based ERAS nursing intervention. Postoperative gastrointestinal function recovery, Self-Management Behavior Scale (SMBS), Shared Decision-Making Questionnaire (SDM-Q-9), Satisfaction with Medical Decision-Making Scale, and Decision Conflict Scale (DCS) scores were compared between the two groups.Results:The observation group had significantly shorter time for first flatus, first defecation, first ambulation, drainage tube removal, and hospitalization compared to the control group ( P<0.05). At 30 days postoperatively, SMBS scores in all dimensions were significantly higher in the observation group than in the control group ( P<0.05). SDM-Q-9 and decision-making satisfaction scores were higher, and DCS scores were lower in the observation group compared to the control group, with statistically significant differences ( P<0.05) . Conclusions:Doctor-nurse-patient SDM-based ERAS nursing promotes postoperative gastrointestinal function recovery in patients undergoing radical gastrectomy, enhances self-management ability, increases shared decision-making participation, and reduces decision-making conflict, demonstrating significant clinical value.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.