Objectives:To investigate the clinical efficacy of occipitocervical fusion with the occipital screw-rod-multiaxial screw internal fixation system in treating"sandwich"deformity with atlantoaxial disloca tion.Methods:A retrospective analysis was conducted on 62 patients who underwent posterior reduction,bone graft fusion,and occipitocervical internal fixation for"sandwich"deformity with atlantoaxial dislocation from January 2017 to January 2023.There were 19 males and 43 females,aged 51.1±23.5 years(29-72 years).The patients were divided into two groups based on the different fixation methods of the occipital screws used in the two types of occipitocervical internal fixation systems:group A of 38 patients utilized the occipital screw-rod-multiaxial screw system,consisting of 12 males and 26 females,aged 50.9±24.8 years(29-72 years),and the imaging findings revealed brainstem or cervical spinal cord compression in 30 cases,syringomyelia in 6 cases,and Chiari malformation in 2 cases;And group B of 24 cases utilized the occipital plate-rod-multiaxial screw system,consisting of 7 males and 17 females,aged 51.4±22.4 years(32-69 years),and the imaging findings revealed brainstem or cervical spinal cord compression in 16 cases,syringomyelia in 6 cases,and Chiari malformation in 2 cases.Group A was followed up for 36.5±11.8 months and Group B was followed up for 36.1±9.8 months.No statistically significant differences were observed between the two groups in terms of age,sex,imaging findings,or surgery style(P＞0.05).A comparison was performed between the groups regarding intraoperative blood loss,operative time,follow-up period,and complication rates.Clini-cal outcomes were evaluated preoperatively and at the final follow-up using the neck pain visual analog scale(VAS)score,neck disability index(NDI),and Japanese Orthopaedic Association(JOA)score.The cross-sectional and sagittal bone fusion area of the graft site,atlantodental interval(ADI),space available for cord(SAC),clivus canal angle(CCA),and cervico-medullary angle(CMA)were measured preoperatively,1 week postoperatively,and at the final follow-up in both groups.Results:Group A and group B weren't significantly different in intraoperative blood loss(362.4±89.1mL vs 345.1±93.8mL,P＞0.05)and operative time(144.8±35.6min vs 143.7±36.2min,P＞0.05).In group B,rod fractures occurred in 2 cases and loss of reduction was observed in 3 cases,whereas the remaining patients maintained stable screw-rod fixation.Neither group experienced severe complications such as spinal cord injury or cerebrospinal fluid leakage.Both groups demonstrated statistically significant differences between preoperative NDI,VAS,JOA scores and those measured at the final follow-up(P＜0.05),while no statistically significant differences existed between the two groups at the same time points(P＞0.05).Statistically significant differences were observed between preoperative and postoperative(1-week and final follow-up)measurements for ADI,SAC,CCA and CMA in both groups(P＜0.05),while no significant in-tergroup differences were found at corresponding time points(P＞0.05).In group A,the cross-sectional area and the sagittal area of the graft site were 385.44±84.51mm2 and 290.28±1 10.41mm2 in postoperative 1 week,and 267.06±66.13mm2 and 204.54±83.85mm2 at the final follow-up;which in group B were 442.61±76.85mm2 and 267.21±104.63mm2 in postoperative 1 week,and 172.43±37.37mm2 and 124.87±48.10mm2 at final follow-up.Comparisons between groups revealed no statistically significant differences in either cross-sectional or sagittal graft areas at 1 week postoperatively(P＞0.05),however,significant differences were observed at the final fol-low-up(P＜0.05)for both parameters between the two groups.Conclusions:The occipital screw-rod-multiaxial screw internal fixation system presents comparable restoration effects to the occipital plate-rod-multiaxial screw system in treating"sandwich"deformity with atlantoaxial dislocation.It exhibits satisfactory implant fusion postoperatively and achieves reliable occipitocervical fixation.

Objective:To investigate the effects of short-term olfactory training and visual stimulation on olfactory recognition function and quality of life in patients following functional endoscopic sinus surgery (FESS).Methods:A total of 80 patients who underwent FESS in the Department of Otorhinolaryngology Head and Neck Surgery at the Affiliated Hospital of Xuzhou Medical University between December 2023 and February 2024 were enrolled in this study. The cohort comprised 67 males and 13 females, aged from 17 to 75 years. Participants were randomly allocated to either a control group ( n=40) or an experimental group ( n=40). The participants in control group received routine postoperative management, including nasal irrigation, oral antibiotics and glucocorticoids, topical budesonide nasal spray, and hypertonic saline solution for 12 weeks. In addition to the standard care, the participants in experimental group underwent olfactory-visual stimulation training starting 24 hours postoperatively, lasting for 2 weeks. The olfactory identification test (OIT), visual analogue scale (VAS) for olfaction and Questionnaire of Olfactory Disorders of Life (QOD-QoL, hereafter referred to as QOD) were administered preoperatively. Follow-up assessments were performed 2 weeks and 3 months postoperatively, with the same tests repeated. Data were analyzed using SPSS 27.0 and GraphPad Prism 7 statistical software. Results:There was no significant difference in preoperative OIT, VAS, and QOD scores between the two groups. The olfactory recognition function of some patients was improved after removing the packing material 24 hours after FESS surgery. The OIT scores of 2 weeks post-surgery were significantly higher than preoperative values in both groups (the experimental group Z=-4.73, P<0.001; the control group Z=-4.73, P<0.001). Participants in both groups showed improvements in olfactory VAS and QOD scores (experimental group Z value was -2.88 and -5.45, P<0.01 and<0.001, respectively; the control group Z value was -4.42 and -5.50, respectively, both P<0.001). However, there was no significant difference in the VAS score between the two groups ( Z=-0.68, P=0.499). The paticipants in experimental group showed greater improvement in OIT and greater reduction in QOD scores compared to the control group ( Z=-2.19, P=0.029; Z=-2.99, P=0.003). There was no significant difference in the decrease of olfactory VAS between the two groups ( Z=-0.02, P=0.988). There were no statistically significant differences of all patients in VAS, OIT and QOD scores at 2 weeks and 3 months after surgery (experimental group Z value was -0.91, -0.90 and -1.43, respectively, all P>0.05; control group Z value was -1.21, -0.84 and -0.91, respectively, all P>0.05). At 3 months post-surgery, the OIT scores in the experimental group were higher, the QOD scores were lower than those in the control group ( Z=-2.89, P=0.004; Z=-2.87, P=0.004). Conclusion:Short-term olfactory-visual stimulation training in the early postoperative period of FESS significantly improves the olfactory recognition function and enhances the quality of life of patients.

Objectives:To investigate the clinical efficacy of occipitocervical fusion with the occipital screw-rod-multiaxial screw internal fixation system in treating"sandwich"deformity with atlantoaxial disloca tion.Methods:A retrospective analysis was conducted on 62 patients who underwent posterior reduction,bone graft fusion,and occipitocervical internal fixation for"sandwich"deformity with atlantoaxial dislocation from January 2017 to January 2023.There were 19 males and 43 females,aged 51.1±23.5 years(29-72 years).The patients were divided into two groups based on the different fixation methods of the occipital screws used in the two types of occipitocervical internal fixation systems:group A of 38 patients utilized the occipital screw-rod-multiaxial screw system,consisting of 12 males and 26 females,aged 50.9±24.8 years(29-72 years),and the imaging findings revealed brainstem or cervical spinal cord compression in 30 cases,syringomyelia in 6 cases,and Chiari malformation in 2 cases;And group B of 24 cases utilized the occipital plate-rod-multiaxial screw system,consisting of 7 males and 17 females,aged 51.4±22.4 years(32-69 years),and the imaging findings revealed brainstem or cervical spinal cord compression in 16 cases,syringomyelia in 6 cases,and Chiari malformation in 2 cases.Group A was followed up for 36.5±11.8 months and Group B was followed up for 36.1±9.8 months.No statistically significant differences were observed between the two groups in terms of age,sex,imaging findings,or surgery style(P＞0.05).A comparison was performed between the groups regarding intraoperative blood loss,operative time,follow-up period,and complication rates.Clini-cal outcomes were evaluated preoperatively and at the final follow-up using the neck pain visual analog scale(VAS)score,neck disability index(NDI),and Japanese Orthopaedic Association(JOA)score.The cross-sectional and sagittal bone fusion area of the graft site,atlantodental interval(ADI),space available for cord(SAC),clivus canal angle(CCA),and cervico-medullary angle(CMA)were measured preoperatively,1 week postoperatively,and at the final follow-up in both groups.Results:Group A and group B weren't significantly different in intraoperative blood loss(362.4±89.1mL vs 345.1±93.8mL,P＞0.05)and operative time(144.8±35.6min vs 143.7±36.2min,P＞0.05).In group B,rod fractures occurred in 2 cases and loss of reduction was observed in 3 cases,whereas the remaining patients maintained stable screw-rod fixation.Neither group experienced severe complications such as spinal cord injury or cerebrospinal fluid leakage.Both groups demonstrated statistically significant differences between preoperative NDI,VAS,JOA scores and those measured at the final follow-up(P＜0.05),while no statistically significant differences existed between the two groups at the same time points(P＞0.05).Statistically significant differences were observed between preoperative and postoperative(1-week and final follow-up)measurements for ADI,SAC,CCA and CMA in both groups(P＜0.05),while no significant in-tergroup differences were found at corresponding time points(P＞0.05).In group A,the cross-sectional area and the sagittal area of the graft site were 385.44±84.51mm2 and 290.28±1 10.41mm2 in postoperative 1 week,and 267.06±66.13mm2 and 204.54±83.85mm2 at the final follow-up;which in group B were 442.61±76.85mm2 and 267.21±104.63mm2 in postoperative 1 week,and 172.43±37.37mm2 and 124.87±48.10mm2 at final follow-up.Comparisons between groups revealed no statistically significant differences in either cross-sectional or sagittal graft areas at 1 week postoperatively(P＞0.05),however,significant differences were observed at the final fol-low-up(P＜0.05)for both parameters between the two groups.Conclusions:The occipital screw-rod-multiaxial screw internal fixation system presents comparable restoration effects to the occipital plate-rod-multiaxial screw system in treating"sandwich"deformity with atlantoaxial dislocation.It exhibits satisfactory implant fusion postoperatively and achieves reliable occipitocervical fixation.

Objective:To investigate the effects of short-term olfactory training and visual stimulation on olfactory recognition function and quality of life in patients following functional endoscopic sinus surgery (FESS).Methods:A total of 80 patients who underwent FESS in the Department of Otorhinolaryngology Head and Neck Surgery at the Affiliated Hospital of Xuzhou Medical University between December 2023 and February 2024 were enrolled in this study. The cohort comprised 67 males and 13 females, aged from 17 to 75 years. Participants were randomly allocated to either a control group ( n=40) or an experimental group ( n=40). The participants in control group received routine postoperative management, including nasal irrigation, oral antibiotics and glucocorticoids, topical budesonide nasal spray, and hypertonic saline solution for 12 weeks. In addition to the standard care, the participants in experimental group underwent olfactory-visual stimulation training starting 24 hours postoperatively, lasting for 2 weeks. The olfactory identification test (OIT), visual analogue scale (VAS) for olfaction and Questionnaire of Olfactory Disorders of Life (QOD-QoL, hereafter referred to as QOD) were administered preoperatively. Follow-up assessments were performed 2 weeks and 3 months postoperatively, with the same tests repeated. Data were analyzed using SPSS 27.0 and GraphPad Prism 7 statistical software. Results:There was no significant difference in preoperative OIT, VAS, and QOD scores between the two groups. The olfactory recognition function of some patients was improved after removing the packing material 24 hours after FESS surgery. The OIT scores of 2 weeks post-surgery were significantly higher than preoperative values in both groups (the experimental group Z=-4.73, P<0.001; the control group Z=-4.73, P<0.001). Participants in both groups showed improvements in olfactory VAS and QOD scores (experimental group Z value was -2.88 and -5.45, P<0.01 and<0.001, respectively; the control group Z value was -4.42 and -5.50, respectively, both P<0.001). However, there was no significant difference in the VAS score between the two groups ( Z=-0.68, P=0.499). The paticipants in experimental group showed greater improvement in OIT and greater reduction in QOD scores compared to the control group ( Z=-2.19, P=0.029; Z=-2.99, P=0.003). There was no significant difference in the decrease of olfactory VAS between the two groups ( Z=-0.02, P=0.988). There were no statistically significant differences of all patients in VAS, OIT and QOD scores at 2 weeks and 3 months after surgery (experimental group Z value was -0.91, -0.90 and -1.43, respectively, all P>0.05; control group Z value was -1.21, -0.84 and -0.91, respectively, all P>0.05). At 3 months post-surgery, the OIT scores in the experimental group were higher, the QOD scores were lower than those in the control group ( Z=-2.89, P=0.004; Z=-2.87, P=0.004). Conclusion:Short-term olfactory-visual stimulation training in the early postoperative period of FESS significantly improves the olfactory recognition function and enhances the quality of life of patients.

Objective:To observe the physiological effect of bi-level positive airway pressure (BiPAP) ventilation among stable chronic obstructive pulmonary disease (COPD) patients.Methods:This was a small sample size, exploratory, interventional study. A total of 10 outpatients with stable COPD were included from Department of Pulmonary and Critical Care Medicine of Zhujiang Hospital, Southern Medical University between January 2018 and December 2018. The BiPAP mode of noninvasive mechanical ventilation was adopted. The inspiratory positive airway pressure was gradually increased from 10 cmH 2O (1 cmH 2O=0.098 kPa) to 24 cmH 2O, and each time by 2 cmH 2O. The expiratory positive airway pressure remained unchanged at 4 cmH 2O. Baseline and test data were collected before and during the ventilation for comparison, including total respiratory cycle time (T tot), inspiratory time (T i), inspiratory time (T e), inspiratory tidal volume (V Ti); mouth pressure (P mo), esophageal pressure (P eso), transdiaphragmatic pressure (P di), esophageal pressure time product (PTP es), diaphragm pressure time product (PTP di), root mean square of electromyography of diaphragm (RMS), V e/RMS, inspiratory capacity (IC), the change in end-expiratory lung volume (ΔEELV) and dynamic PEEPi (PEEPi dyn). Results:All the 10 patients completed the trial. Compared to calm breathing, V Ti, V e, P mo, IC, ΔEELV score and V e/RMS increased significantly with increasing pressure levels (all P<0.05); T e only increased significantly at 20-22 cmH 2O pressure levels compared to calm breathing ( P<0.05). P di, PTP es, PTP di, RMS and RMS/RMS max decreased significantly with increasing levels (all P<0.05). PTP es and PTP di converged to 0 and no longer showed significant changes after the 18 cmH 2O pressure level. RMS and RMS/RMS max flattened out at pressure level greater than 16 cmH 2O. T i/T tot only significantly decreased at the 20 cmH 2O pressure level compared to calm breathing. PEEPi dyn showed a tendency to decrease and then increase with increasing pressure levels. Conclusion:BiPAP ventilation, at appropriate pressure levels, significantly relieves pulmonary ventilation disorders and reduces the load of respiratory muscle in patients with stable COPD.

Objective:To investigate the prognostic factors associated with unresectable (stage Ⅲa-Ⅳ, according to the 7th edition of the AJCC cancer staging manual) lung squamous cell carcinoma.Methods:We retrospectively analyzed 350 patients with inoperable locally advanced, recurrent or metastatic lung squamous cell carcinoma who were admitted to the First Affiliated Hospital of Chinese Medical University from January 2005 to June 2018. The clinical pathological data, treatment and survival follow-up information of the patients were collected. Kaplan-Meier survival was used to compare the overall survival rate of different risk groups. Univariate analysis and multivariate Cox regression analysis were used to determine the independent prognostic factors.Results:A total of 350 patients were enrolled. The median overall survival (OS) of these patients was 16.7 months. Univariate analysis showed the stage, Eastern Cooperative Oncology Group(ECOG), first-line chemotherapy evaluation (RECIST version 1.1), radiation therapy, number of systemic chemotherapy lines, carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), C reactive protein (CRP), lactate dehydrogenase (LDH), whether liver, brain, boneor metastasis were associated with the OS of patients with advanced lung squamous cell carcinoma (all P<0.05). Multivariate analysis showed that ECOG score ( HR=1.855, 95% CI: 1.063-3.239, P=0.030), whether underwent lung resection ( HR=0.476, 95% CI: 0.302-0.751, P=0.001), first-line chemotherapy evaluation [stable disease (SD): HR=0.293, 95% CI: 0.159-0.540, P<0.001; complete response (CR)+ partial response (PR): HR=0.223, 95% CI: 0.120-0.413, P<0.001], CRP ( HR=1.715, 95% CI: 1.080-2.723, P=0.042), LDH ( HR=1.116, 95% CI: 0.780-1.596, P=0.002) and CEA ( HR=1.855, 95% CI: 1.361-2.528, P<0.001) before chemotherapy, liver metastasis ( HR=2.453, 95% CI: 1.461-4.120, P=0.001) are independent prognostic factors for patients with unresectable lung squamous cell carcinoma. Conclusion:The ECOG score, surgical treatment history, first-line chemotherapy, LDH, CEA and CRP before chemotherapy, liver metastasis are independent prognostic factors for patients with advanced lung squamous cell carcinoma.

Objective:To investigate the prognostic factors associated with unresectable (stage Ⅲa-Ⅳ, according to the 7th edition of the AJCC cancer staging manual) lung squamous cell carcinoma.Methods:We retrospectively analyzed 350 patients with inoperable locally advanced, recurrent or metastatic lung squamous cell carcinoma who were admitted to the First Affiliated Hospital of Chinese Medical University from January 2005 to June 2018. The clinical pathological data, treatment and survival follow-up information of the patients were collected. Kaplan-Meier survival was used to compare the overall survival rate of different risk groups. Univariate analysis and multivariate Cox regression analysis were used to determine the independent prognostic factors.Results:A total of 350 patients were enrolled. The median overall survival (OS) of these patients was 16.7 months. Univariate analysis showed the stage, Eastern Cooperative Oncology Group(ECOG), first-line chemotherapy evaluation (RECIST version 1.1), radiation therapy, number of systemic chemotherapy lines, carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), C reactive protein (CRP), lactate dehydrogenase (LDH), whether liver, brain, boneor metastasis were associated with the OS of patients with advanced lung squamous cell carcinoma (all P<0.05). Multivariate analysis showed that ECOG score ( HR=1.855, 95% CI: 1.063-3.239, P=0.030), whether underwent lung resection ( HR=0.476, 95% CI: 0.302-0.751, P=0.001), first-line chemotherapy evaluation [stable disease (SD): HR=0.293, 95% CI: 0.159-0.540, P<0.001; complete response (CR)+ partial response (PR): HR=0.223, 95% CI: 0.120-0.413, P<0.001], CRP ( HR=1.715, 95% CI: 1.080-2.723, P=0.042), LDH ( HR=1.116, 95% CI: 0.780-1.596, P=0.002) and CEA ( HR=1.855, 95% CI: 1.361-2.528, P<0.001) before chemotherapy, liver metastasis ( HR=2.453, 95% CI: 1.461-4.120, P=0.001) are independent prognostic factors for patients with unresectable lung squamous cell carcinoma. Conclusion:The ECOG score, surgical treatment history, first-line chemotherapy, LDH, CEA and CRP before chemotherapy, liver metastasis are independent prognostic factors for patients with advanced lung squamous cell carcinoma.

Objective To compare the outcomes between interstitial cystitis/bladder pain syndrome (IC/BPS)patients treated with three-drug combination (M blockers + alpha blockers + Amitriptyline) and Sodium hyaluronate intravesical instillation.Methods The patients who came to Second Affiliated Hospital of Nanjing Medical University during October 2014 to September 2015 were investigated if they had IC/BPS.According to the treatment plan,27 patients (group A) received three-drug combination (M blocker + alpha blockers + Amitriptyline)therapy.Thirty-eight patients recelved instillation of sodium hyaluronate (40 mg/50 ml) therapy (group B).Intravesical instillations were performed weekly in the first 6 weeks,and monthly until sixth month.Interstitial cystitis symptom index,interstitial cystitis problem index,overactive bladder symptom score,visual analogue scale/score,the maximum urination and self-rating depression scale were assessed at baseline and the sixth month.Measurement data were expressed as ((x) ±s),t test was used for comparison between groups,and paired t-test was used for comparison of paired data.Results There were 65 patients.Age range was 25-73 years,course of disease (2-99 months),average age (51.4 ± 13.5),average duration (39.8 ± 31.0) months,of which 9 male (13.8％) and 56 female (86.2％) patients.The group A variation of ICSI、ICPI、OABSS、VAS、SDS and maximum urination were 3.7 ± 2.4、1.3 ± 1.5、1.2 ± 1.3、2.1 ± 1.5、3.1 ± 4.5、74.6 ± 52.4,The variation of group B ware 6.8 ± 3.6、5.0 ± 3.8、2.5 ± 1.8、2.8 ± 1.7、8.9 ± 6.4、109.0 ± 81.1.The improvement in ICSI,ICPI,OABSS,SDS of group B were higher than group A (P ＜ 0.05).Conclusion IC/BPS seriously affect the quality of life and the patients are prone to depression.The sodium hyaluronate intravesical instillation therapy could achieve more effect than the three-drug combination therapy.

Objective Little is known about the effects of antioxidant on the micturition function in diabetic cystopathy .In this study, we investigated the effects of antioxidant sulforaphane on bladder micturition function in diabetes mellitus ( DM)mice with bladder underactivity . Met hods We established DM models in mice by intraperitoneal injection of a single dose of streptozotocin (STZ)at 65 mg/kg and randomly divided them into three groups , sulforaphane treatment (n=10), vehicle treatment (n=10), and DM model (n=10), with another 10 normal healthy mice included as blank controls.At 24 weeks of the experiment, we obtained and analyzed such indexes of mice as the body weight , fasting blood glucose (FBG), 24-hour urine volume (24 h UV) and bladder wet weight ( BWW ) , results of cystometrography , and cystometric parameters including intercontraction interval ( ICI ) , maximum bladder pressure during micturition ( Pmax ) , maximum cystometric capacity (MCC), void volume (VV), post-void residual urine vol-ume (PVR) and residual urine rate (RUR). Results Compared with the blank controls , the DM models with bladder underactivity showed significantly increases in BWW ([67.96 ±2.35]mg), 24 h HU ([22.47 ±1.93]mL), MCC ([0.70 ±0.03]mL), VV (0[.23 ±0.01]mL), PVR ([0.49 ±0.02]mL), RUR ([70.10 ± 0.80]%), and ICI, but a remarkable decrease in Pmax .Sulforaphane treatment significantly reduced BWW ([576.9 ±2.41]mg), 24 h HU ([16.27 ±1.51] mL), MCC ([0.54 ±0.03]mL), PVR ([0.34 ±0.02]mL), RUR ([62.71 ±1.26]%), and ICI of the diabetic mice . Conclusion Sulforaphane could improve bladder micturition function in mice with STZ-induced DM , which might be related to its action mechanism of antioxidative stress damage .

Objective To search for differentially expressed proteins in normal ovaries,benign,borderline and malignant ovarian tumor protein. Methods The protein from ovarial carcinoma tissue and benign ovary was drawn, and analyzed with SELDI-TOF MS. Results There are some high expression proteins in ovarian cancer tissues: M/Z 15 112.15, 15 296.79, 7560.78, 16 049.39, 7682.06, 7932.30,15 851.32, 4619.68 and 8052.10. Borderline ovarian tumor protein peak were between benign and malignant:M/Z 15 112.15, 15 851.32, 7560.78, 7682.06 and 7932.30. Conclusion There were some differentially expressed proteins in different ovarian tissue. They might lay the molecular basis for the clinical diagnosis and therapy of ovarian cancer.