Sj?gren syndrome(SS)is an immune disease mainly characterized by lymphocytes infiltrate in salivary and lacrimal glands,leading to glandular secretion disorders and dryness in the mouth and eyes.In recent years,clinical application of ultrasound elastography(USE)increased widespread,providing a new imaging method for diagnosis of SS.The research progresses of USE in SS were reviewed in this article.

Sj?gren syndrome(SS)is an immune disease mainly characterized by lymphocytes infiltrate in salivary and lacrimal glands,leading to glandular secretion disorders and dryness in the mouth and eyes.In recent years,clinical application of ultrasound elastography(USE)increased widespread,providing a new imaging method for diagnosis of SS.The research progresses of USE in SS were reviewed in this article.

Objective:To analyse the clinical significance of selective single embryo transfer by time-lapse mo-nitoring(TLM)or conventional morphology assessment(CMA)in vitro fertilization/intracytoplasmic sperm in-jection and embryo transfer(IVF/ICSI-ET),and to initially explore the predictive value of Raman spectral analy-sis of embryo culture medium for clinical pregnancy rate.Methods:The study is a prospective randomized con-trolled clinical trial.We assigned 139 patients treated with IVF/ICSI-ET in Reproductive and Genetics Center of Suzhou Municipal Hospital from April 2019 to July 2020,which were randomly assigned to either the CMA or the TLM group.We performed selective single-embryo transfer(fresh cycle and FET)after selecting the optimal em-bryos with TLM or CMA respectively.If the patient's first embryo transfer was unsuccessful,a second one would be performed to compare the differences in the cumulative live birth rate of embryo transfer and other pregnancy outcomes between the two groups.Meanwhile,we collected 15 μl of embryo culture medium at day 3 after IVF/ISCI fertilization for Raman spectroscopy analysis.Results:There were no differences in cumulative live birth,cu-mulative clinical pregnancy,cumulative premature birth,cumulative early spontaneous abortion,cumulative ectopic pregnancy and LGA or SGA between TLM and CMA groups(P＞0.05).The Neonatal sex ratio in the TLM group was lower than that in the CMA group,but the difference was not significant(P＞0.05).Raman spectros-copy analysis of embryo culture medium predicted the clinical pregnancy rate with 67.21％accuracy.Conclu-sions:In young women with a good ovarian reserve,the advantage of using TLM to evaluate embryos is not obvi-ous,so we should remain vigilant that embryo selection based on morphokinetic parameters may affect the sex ratio.Raman spectroscopic analysis of embryo culture medium is not yet able to effectively predict the planting ability of embryos.

Objective To investigate the clinical value of otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal.Methods A C-shaped incision was made in the external auditory canal and then the external auditory canal flap was separated to expose the tympanic anulus.If the flaccid part of the eardrum was perforated,the tympanic anulus was lifted.If the pars tensa membranae tympani was perforated,the anterior inferior tympanic anulus was preserved to expose the tympanic cavity,and the granulation tissue was removed within the tympanic cavity.Under the continuous perfusion,the bone of the lateral wall of the upper tympanic cavity was grinded,the cholesteatoma around the attic and auditory ossicles was removed,the bone of the mastoid was grinded,and the mastoid cavity cholesteatoma was removed.Gelatin sponge support was placed in mastoid cavity and tympanic cavity.According to the degree of destruction of the auditory ossicles,different types of artificial ossicles were placed.Tragus cartilage covered with perichondrium or biofilm was placed on the surface of mastoid cavity and attic.The tympanic membrane was repaired by tragus perichondrium built-in method or tragus cartilage-perichondrium dissection method.Finally,the external auditory canal flap was paved and the surgical cavity was filled.Results The median threshold of airway hearing was 52.0 dB HL (range,33.8-67.5 dB HL) before surgery,which was significantly higher than that at 6 months after surgery[25.0 dB HL (range,15.0-50.0 dB HL),Z=-6.454,P=0.000].The median threshold of airway bone conduction hearing before the operation was 35.0 dB HL (range,21.2-52.5 dB HL),which was significantly higher than that at 6 months after surgery[15.0 dB HL (range,3.8-27.5 dB HL),Z=-6.453,P=0.000].All the patients were followed up at 2 weeks,and 1,3,and 6 months after surgery.Afterwards,follow-ups were performed every 3 months until 24 months after surgery.All the patients had good tympanum healing,and 2 patients had recurrence at 1 year after surgery.All the patients had no complications such as facial paralysis or sensorineural deafness.Conclusions Combining continuous and non-continuous perfusion,otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal has a high healing rate of eardrum,few complications,and significant postoperative hearing improvement.It is a minimally invasive,safe,and effective surgical method.

Objective To investigate the clinical value of otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal.Methods A C-shaped incision was made in the external auditory canal and then the external auditory canal flap was separated to expose the tympanic anulus.If the flaccid part of the eardrum was perforated,the tympanic anulus was lifted.If the pars tensa membranae tympani was perforated,the anterior inferior tympanic anulus was preserved to expose the tympanic cavity,and the granulation tissue was removed within the tympanic cavity.Under the continuous perfusion,the bone of the lateral wall of the upper tympanic cavity was grinded,the cholesteatoma around the attic and auditory ossicles was removed,the bone of the mastoid was grinded,and the mastoid cavity cholesteatoma was removed.Gelatin sponge support was placed in mastoid cavity and tympanic cavity.According to the degree of destruction of the auditory ossicles,different types of artificial ossicles were placed.Tragus cartilage covered with perichondrium or biofilm was placed on the surface of mastoid cavity and attic.The tympanic membrane was repaired by tragus perichondrium built-in method or tragus cartilage-perichondrium dissection method.Finally,the external auditory canal flap was paved and the surgical cavity was filled.Results The median threshold of airway hearing was 52.0 dB HL (range,33.8-67.5 dB HL) before surgery,which was significantly higher than that at 6 months after surgery[25.0 dB HL (range,15.0-50.0 dB HL),Z=-6.454,P=0.000].The median threshold of airway bone conduction hearing before the operation was 35.0 dB HL (range,21.2-52.5 dB HL),which was significantly higher than that at 6 months after surgery[15.0 dB HL (range,3.8-27.5 dB HL),Z=-6.453,P=0.000].All the patients were followed up at 2 weeks,and 1,3,and 6 months after surgery.Afterwards,follow-ups were performed every 3 months until 24 months after surgery.All the patients had good tympanum healing,and 2 patients had recurrence at 1 year after surgery.All the patients had no complications such as facial paralysis or sensorineural deafness.Conclusions Combining continuous and non-continuous perfusion,otoendoscopic surgery for cholesteatoma of middle ear mastoid process through external auditory canal has a high healing rate of eardrum,few complications,and significant postoperative hearing improvement.It is a minimally invasive,safe,and effective surgical method.

Objective To explore the results of non-compliance of fluid intake in maintence hemodialysis patients.Methods The qualitative phenomenological research method was adopted in this study.Self-structured in-depth interviews were conducted with 13 maintenance hemodialysis patients.Data were analyzed by content analysis.Result Four themes were extracted including allotrigeusia,have a smattering of fluid intake knowledge,self-condemned and guilty,muddling along.Conclusions Fuild restriction is the most difficuilt prescribed treatment schedule among maintence hemodialysis patients.Nurses should pay attention to those people and provide multilevel,continual,individual and comprehensive measures.