Objective To investigate the clinical effect of elastic fixation of Endobutton plate with loop in the treatment of lower tibiofibular combined injury.Methods A total of 326 patients with lower tibiofibular joint injury combined with ankle fracture underwent surgical treatment from June 2019 to June 2021 were randomly divided into experimental group(163 cases)and control group(163 cases)by using a random number table.The control group was fixed with traditional steel plate screw,and the experimental group was fixed with elastic steel plate with loop Endobutton.Hospitalization and operation related indexes were compared between the two groups.The American Association of Foot and Ankle Surgery Ankle Function Score(AOFAS)was performed on the two groups at 2 and 6 months after surgery,respectively,and the reseparation rate of the lower tibiofibular union was evaluated and compared between the two groups at 6 months after surgery.Results There were no significant differences in operation time,blood loss,incision length,getting out of bed time and hospital stay between experimental group and control group(P＞0.05).The incidence of postoperative complications in experimental group was 2.45％,lower than that in control group(7.98％),and the difference between the two groups was statistically significant(P＜0.05).The incidence of postoperative complications in experimental group was 2.45％,lower than that in control group(7.98％),and the difference was statistically significant between the two groups(P＜0.05).The AOFAS scores of control group were(74.5±9.2)and(81.3±4.3)at 2 months and 6 months,respectively,and the excellent and good rate was 76.0％.AOFAS of experimental group were(82.3±5.3)points and(91.2±3.8)points at 2 months and 6 months after surgery,respectively,and the excellent and good rate was 93.2％,the above indexes of experimental group were higher than those of control group,and the difference between the two groups was statistically significant(P＜0.05).Reexamination 6 months after surgery the reseparation rate of lower tibiofibular combination was 12.8％in the control group and 2.4％in the experimental group,and the risk of reseparation in the experimental group was lower than that in the control group,with statistical significance(P＜0.05).Conclusion Elastic fixation using Endobutton plate with loop could be used in the treatment of ankle fracture with distal tibiofibular syndesmosis injury,which has a better effect of traditional internal fixation with plate and screws.

Objective To investigate the effects of Esketamine(S-KET)on the proliferation,migration,invasion,and Wnt/β-catenin signaling pathway of liver cancer cells.Methods Hep G2 liver cancer cells were separated into Control group,low,medium,and high concentration treatment groups(S-KET-L,S-KET-M,S-KET-H groups),and high concentration treatment group(S-KET-H+LiCl group);Edu was applied to detect cell proliferation;scratch experiment was applied to detect cell migration;Transwell experiment was applied to detect cell invasion.Western blot was applied to detect the expression of nuclear proliferation antigen markers(Ki-67),Cyclin D1,matrix metalloproteinase 2(MMP-2),matrix metalloproteinase 9(MMP-9),Wnt1,and β-catenin proteins;nude mouse transplanted tumor was applied to detect the effect of Esketamine on the growth of liver cancer transplanted tumors;immunohistochemistry was applied to detect the expression of Wnt1 and β-catenin proteins.Results Compared with the Control group,the Edu positive rate,Ki-67,Cyclin D1,scratch healing rate,number of cell invasions,the expression of MMP-2,MMP-9,Wnt1,and β-catenin proteins in Hep G2 cells in the S-KET-L,S-KET-M,and S-KET-H groups were obviously reduced(P＜0.05);compared with the S-KET-H group,the Edu positive rate,Ki-67,Cyclin D1,scratch healing rate,number of cell invasions,the expression of MMP-2,MMP-9,Wnt1,and β-catenin proteins in Hep G2 cells in Hep G2 cells in the S-KET-H+LiCl group were significantly increased(P＜0.05);the results of nude mouse tumor transplantation experiment showed that compared with the Control group,the S-KET group mice showed slow tumor growth,reduced tumor mass and volume,and significantly reduced expression of Wnt1 and β-catenin proteins(P＜0.05).Conclusion Esketamine can inhibit the proliferation,migration,and invasion of liver cancer cells by inhibiting the Wnt/β-catenin signaling pathway.

Objective To observe the clinical efficacy of therapy focusing on regulating spleen and stomach for the treatment of acoustic hypersensitivity(AH),which also named as auditory hyperaesthesia,and to explore the relevant factors influencing the efficacy.Methods From January 2018 to December 2023,the patients admitted to the outpatient department of otolaryngology-head and neck surgery of the First Affiliated Hospital of Guangzhou University of Chinese Medicine and diagnosed as AH with complete medical data were included as study subjects.Follow-up through telephone or network was carried out for those patients who with uncertain prognosis.The changes in the pre-and post-treatment scores of Indicators of Acoustic Hypersensitivity Severity(IAHS)were used as the reference index for efficacy evaluation,and the cure rate and effective rate were used as the efficacy analysis indexes for statistical analysis.And then the efficacy of traditional Chinese medicine(TCM)medical care combined with health care focusing on regulating spleen and stomach for the treatment of AH was evaluated.Furthermore,multivariate logistic regression was used to explore the relevant factors influencing the efficacy of AH.Results A total of 298 cases of AH patients meeting the inclusion criteria were collected,among which 151 cases(50.67%)were cured,22 cases(7.38%)were markedly effective,75 cases(25.17%)were effective,and 50 cases(16.78%)were ineffective,with a total effective rate of 83.22%(248/298).The univariate analysis results showed that eight factors(including post-treatment lifestyle score,range of lifestyle adjustment,severity of AH,duration of the disease,presence of tinnitus,presence of hearing drop,presence of vertigo,and age)had an influence on the efficacy,and the differences were statistically significant(P<0.05 or P<0.01).However,the factors of gender,occupation,education level,and history of noise exposure had no influence on the efficacy(P>0.05).The multivariate binary logistic regression analysis showed that five factors,namely post-treatment lifestyle score,range of lifestyle adjustment,severity of AH,presence of vertigo and duration of the disease,had a significant correlation with the cure rate of AH(P<0.05 or P<0.01),and four factors,namely post-treatment lifestyle score,severity of AH,range of lifestyle adjustment and age,had a significant correlation with the effective rate of AH(P<0.05 or P<0.01).Conclusion The method of TCM medical care and health care focusing on regulating spleen and stomach exerts a better efficacy for AH patients.And the lifestyle,severity of AH,duration of the disease,age,and presence of vertigo are the relevant factors affecting the outcomes,which is worthy of further in-depth study.

Objective To investigate the clinical effect of elastic fixation of Endobutton plate with loop in the treatment of lower tibiofibular combined injury.Methods A total of 326 patients with lower tibiofibular joint injury combined with ankle fracture underwent surgical treatment from June 2019 to June 2021 were randomly divided into experimental group(163 cases)and control group(163 cases)by using a random number table.The control group was fixed with traditional steel plate screw,and the experimental group was fixed with elastic steel plate with loop Endobutton.Hospitalization and operation related indexes were compared between the two groups.The American Association of Foot and Ankle Surgery Ankle Function Score(AOFAS)was performed on the two groups at 2 and 6 months after surgery,respectively,and the reseparation rate of the lower tibiofibular union was evaluated and compared between the two groups at 6 months after surgery.Results There were no significant differences in operation time,blood loss,incision length,getting out of bed time and hospital stay between experimental group and control group(P＞0.05).The incidence of postoperative complications in experimental group was 2.45％,lower than that in control group(7.98％),and the difference between the two groups was statistically significant(P＜0.05).The incidence of postoperative complications in experimental group was 2.45％,lower than that in control group(7.98％),and the difference was statistically significant between the two groups(P＜0.05).The AOFAS scores of control group were(74.5±9.2)and(81.3±4.3)at 2 months and 6 months,respectively,and the excellent and good rate was 76.0％.AOFAS of experimental group were(82.3±5.3)points and(91.2±3.8)points at 2 months and 6 months after surgery,respectively,and the excellent and good rate was 93.2％,the above indexes of experimental group were higher than those of control group,and the difference between the two groups was statistically significant(P＜0.05).Reexamination 6 months after surgery the reseparation rate of lower tibiofibular combination was 12.8％in the control group and 2.4％in the experimental group,and the risk of reseparation in the experimental group was lower than that in the control group,with statistical significance(P＜0.05).Conclusion Elastic fixation using Endobutton plate with loop could be used in the treatment of ankle fracture with distal tibiofibular syndesmosis injury,which has a better effect of traditional internal fixation with plate and screws.

Objective To investigate the effects of Esketamine(S-KET)on the proliferation,migration,invasion,and Wnt/β-catenin signaling pathway of liver cancer cells.Methods Hep G2 liver cancer cells were separated into Control group,low,medium,and high concentration treatment groups(S-KET-L,S-KET-M,S-KET-H groups),and high concentration treatment group(S-KET-H+LiCl group);Edu was applied to detect cell proliferation;scratch experiment was applied to detect cell migration;Transwell experiment was applied to detect cell invasion.Western blot was applied to detect the expression of nuclear proliferation antigen markers(Ki-67),Cyclin D1,matrix metalloproteinase 2(MMP-2),matrix metalloproteinase 9(MMP-9),Wnt1,and β-catenin proteins;nude mouse transplanted tumor was applied to detect the effect of Esketamine on the growth of liver cancer transplanted tumors;immunohistochemistry was applied to detect the expression of Wnt1 and β-catenin proteins.Results Compared with the Control group,the Edu positive rate,Ki-67,Cyclin D1,scratch healing rate,number of cell invasions,the expression of MMP-2,MMP-9,Wnt1,and β-catenin proteins in Hep G2 cells in the S-KET-L,S-KET-M,and S-KET-H groups were obviously reduced(P＜0.05);compared with the S-KET-H group,the Edu positive rate,Ki-67,Cyclin D1,scratch healing rate,number of cell invasions,the expression of MMP-2,MMP-9,Wnt1,and β-catenin proteins in Hep G2 cells in Hep G2 cells in the S-KET-H+LiCl group were significantly increased(P＜0.05);the results of nude mouse tumor transplantation experiment showed that compared with the Control group,the S-KET group mice showed slow tumor growth,reduced tumor mass and volume,and significantly reduced expression of Wnt1 and β-catenin proteins(P＜0.05).Conclusion Esketamine can inhibit the proliferation,migration,and invasion of liver cancer cells by inhibiting the Wnt/β-catenin signaling pathway.

ObjectiveTo demonstrate the long-term effect of Yishi Therapy for primary tinnitus and analyze the factors affecting the effectiveness. MethodsWe conducted long-term follow-ups of primary tinnitus cases treated with Yishi Therapy during 1 January 2017 to 30 June 2023 by face-to-face， online and telephone between 1 July 2023 and 31 January 2024， to understand the final regression of primary tinnitus and lifestyle changes. We retrospectively analysed the basic data of patients before treatment， and statistically analysed the recovery rate and overall effective rate of tinnitus treated by the Yishi Therapy， and the factors affecting the effectiveness such as lifestyle， age， duration of disease， gender， tinnitus location， severity of tinnitus， accompanying symptoms and complications on the overall effective rate. ResultsA total of 496 cases of primary tinnitus completed follow-ups successfully， and the total Tinnitus Evaluation Questionnaire （TEQ） at follow-up was significantly lower than that before treatment （P＜0.001）. Among the 496 cases， 101 （20.36%） cases cured， 189 （38.10%） cases showed significant improvement， 116 （23.39%） cases were effective， 90 （18.15%） cases were ineffective， and the overall effect rate was 81.85% （406/496）. At follow-up， the score of lifestyle was higher than that before treatment （P＜0.001）. Grouped by the score of lifestyle at follow-up， the effective rates of better lifestyle group and poor lifestyle group were 97.53% （237/243） and 66.80% （169/253）， respectively， with statistical significance （P＜0.001）. Grouped by the mean value of the difference in lifestyle scores before and after treatment， the effective rates of the group with greater lifestyle adjustment and the group with smaller adjustment were 97.55% （239/245） and 66.53% （167/251）， respectively， and the differences were statistically significant （P＜0.001）. Binary logistic regression showed that the better lifestyle， the greater lifestyle adjustment and the severity of tinnitus were positively correlated with the total effective rate of tinnitus （P＜0.001）， while older and hearing loss were negatively correlated with the total effective rate of tinnitus （P＜0.05）. ConclusionYishi Therapy on primary tinnitus shows good long-term effect， lifestyle， severity of tinnitus， hearing loss or not， age are the relevant factors affecting the efficacy of tinnitus， lifestyle is the main factor affecting clinical efficacy.

Objective:To evaluate the teaching effect of multi-disciplinary integrated training program on the open comprehensive training room to improve the post competency of medical imaging students.Methods:A total of 122 residential students of five-year medical imaging from Batch 2014 of The First Affiliated Hospital of Chengdu Medical College were divided into experimental group and control group. The experimental group carried out the multi-disciplinary open comprehensive training program, and the control group carried out open-ended exercises. The comprehensive discipline theory examination, assessment of clinical thinking and comprehensive skill appraisal, and satisfaction questionnaire results were compared between the two groups. SPSS 23.0 was used for t test. Results:①Comprehensive discipline theory examination scores were higher in experimental group than the control group [(80.33±3.70) vs. (74.56±5.09)], with statistical differences ( P<0.05). ②Experimental group scored higher in clinical thinking and comprehensive skills than the control group did, and the difference was statistically significant [(87.58±3.15) vs. (74.52±3.66), P<0.05]. ③The questionnaire investigation showed that the experimental group students did better in improving autonomous learning ability, expression ability, the team cooperation ability, the ability to find and fix problems and the degree of self-esteem than control group, with statistically significant differences ( P<0.05). Conclusion:The multi-disciplinary open comprehensive training program has a good effect on optimizing the open-ended exercises. Students' knowledge of multi-disciplinary comprehensive theoretical knowledge and imaging skills have been improved, and the ability of teamwork, problem-solving ability, self-learning ability and innovation ability required by the core competence of the profession have been developed and improved, which meets the modern medical treatment of education "to create an educational platform of medical education collaboration and multi-disciplinary integration, and to cultivate students' innovative and autonomous learning."

OBJECTIVE: To explore the clinical characteristics and genetic basis for a child with X-linked lissencephaly with abnormal genitalia (XLAG). METHODS: A child with XLAG who had presented at the Third Affiliated Hospital of Zhengzhou University in May 2021 was selected as the study subject. Peripheral blood samples of the child and his parents were collected and subjected to high-throughput sequencing. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the result was analyzed by using bioinformatic software. RESULTS: The child was found to have harbored a hemizygous c.945_948del variant in exon 2 of the ARX gene, which as a frameshifting variant has resulted in a truncated protein. His mother was found to be heterozygous for the variant, whilst his father was of wild type. The variant was unreported previously. CONCLUSION The hemizygous c.945_948del variant of the ARX gene probably underlay the XLAG in this patient. Above finding has provided a basis for the diagnosis and genetic counseling for this family.
Humans ; Child ; Classical Lissencephalies and Subcortical Band Heterotopias ; Exons ; Computational Biology ; Genetic Counseling ; Genitalia ; Transcription Factors ; Homeodomain Proteins

Objective:To summarize the clinical manifestations of a case of combined oxidative phosphorylation deficiency 28 (COXPD-28) caused by the mutations of the SLC25A26 gene, thus providing references for the diagnosis and genetic counseling of the disease. Methods:Clinical data of a case of COXPD-28 treated in the Third Affiliated Hospital of Zhengzhou University in October 2020 were retrospectively analyzed.In addition, The retrieval words " Combined oxidative phosphorylation deficiency 28, SLC25A26 gene" were used to search domestic and foreign databases.The clinical characteristics of combined phosphorylation deficiency 28 and the variation characteristics of SLC25A26 gene were summarized. Results:(1) A female patient full-term delivered after 30 min presented with groaning breath was admitted.Her main manifestations included pale complexion, groaning breathing, metabolic acidosis, and high lactate and pyruvate levels.Symptomatic support treatment like anti-infection and assisted ventilation were given, but her condition gradually worsened and died of respiratory and circulatory failure on the day of admission.The child was compound heterozygous mutation of SLC25A26 gene, the terminating mutation of exon 5 c. 403G>T caused the protein change to p. E135, and the non-synonymous mutation of exon 4 c. 212A>G caused the protein change to p. Y71C.(2) A total of 3 cases of COXPD-28 were searched in online databases, and no cases were reported in China.Through literature review, clinical features of COXPD-28 mainly included respiratory and circulatory fai-lure, elevations of lactate and pyruvate, and reductions of complexes Ⅰ, Ⅲ and Ⅳ in muscle biopsy.Two types of mutations in the SLC25A26 gene were detected, including 3 cases of missense mutations and 1 case of splicing mutation. Conclusions:COXPD-28 is an autosomal recessive genetic disease involving multiple systems and mitochondrial dysfunction.Mutations in the SLC25A26 gene is the pathological cause of COXPD-28.

Objective:To evaluate the clinical efficacy and safety of a skin care ointment containing oligomeric maltose X in the adjuvant treatment of eczema-related pruritus.Methods:A multicenter, randomized, double-blind, vehicle-controlled clinical study was conducted. From March to September 2021, outpatients with mild to moderate eczema were collected from departments of dermatology of 4 hospitals, including Beijing Friendship Hospital, Hebei Traditional Chinese Medical Hospital, the Third People′s Hospital of Hubei Province, and Taizhou Central Hospital in Zhejiang Province. The patients were randomly divided into two groups by using a random number table: observation group topically treated with a skin care ointment containing oligomeric maltose X, and vehicle control group topically treated with an ointment vehicle. The ointments were applied during the attacks of itching for 14 consecutive days. Visits were scheduled before, 7, and 14 days after the start of the adjuvant treatment. The efficacy was evaluated according to the eczema area and severity index (EASI) and visual analog scale (VAS) , and adverse events were recorded. The efficacy and safety analyses were conducted by using chi-square test and t test. Results:Totally, 232 patients with eczema were enrolled, including 90 males and 142 females, with the age being 40.13 ± 13.36 years; 156 patients were in the observation group, and 76 in the vehicle control group. Before the adjuvant treatment, there were no significant differences in EASI (2.07 ± 2.24 points vs. 2.29 ± 2.28 points) or VAS (6.22 ± 1.78 points vs. 6.20 ± 1.79 points) scores between the observation group and vehicle control group ( t = -0.70, 0.06, P = 0.486, 0.955, respectively) . After one-day treatment, the VAS scores significantly decreased compared with the baseline scores in the two groups ( P < 0.001, P = 0.003, respectively) . After 14-day treatment, the VAS score was significantly lower in the observation group (2.67 points) than in the vehicle control group (3.35 points; t = -2.28, P = 0.024) . After 7- and 14-day treatment, the EASI scores significantly decreased compared with the baseline scores in both the two groups (all P < 0.001) , but there were no significant differences between the two groups ( P = 0.853, 0.731) . No adjuvant treatment-related adverse events were recorded in either of the two groups. Conclusion:The skin care ointment containing oligomeric maltose X is safe and effective in the adjuvant treatment of eczema-related pruritus, and can be applied to clinical practice.