[ABSTRACT]OBJECTIVE To analyze the risk factors for relapse in patients with chronic rhinosinusitis with nasal polyps(CRSwNP)combined with asthm and provide favorable information for precise treatment and healthy prognosis of patients with CRSwNP combined with asthma.METHODS The clinical data of 161 patients with chronic rhinosinusitis with nasal polyps(CRSwNP)combined with asthm who underwent endoscopic surgery at the Department of Otolaryngology Head and Neck Surgery,Yantai Yuhuanding Hospital,affiliated to Qingdao University,from January 2016 to June 2021 were selected.Based on Lasso's Cox regression analysis and multifactorial Cox regression analysis,the associated risk factors were investigated,and the area under curve(AUC)was calculated to determine the performance of the model.Finally,the Kaplan-Meier(K-M)curves were plotted for the relevant influencing factors.RESULTS The Age[HR(95%CI):0.96(0.948-0.98),P<0.001],gender[HR(95%CI):1.94(1.21-3.14),P=0.006],tissue eosinophil percentage[HR(95%CI):1.01(1.01-1.02),P=0.004],and endoscopic nasal polyp score[HR(95%CI):0.86(0.78-0.96),P=0.005]were highly correlated with recurrence in patients with CRSwNP combined with asthma.Patients with CRSwNP combined with asthma had a higher likelihood of relapse after treatment when the tissue Eos%was>21.28%and the endoscopic nasal polyp score was>4.CONCLUSION The age,gender,tissue eosinophil percentage and endoscopic nasal polyp score are independent risk factors for disease recurrence in patients with CRSwNP combined with asthma.

Objective:To analyze the effect of donepezil hydrochloride combined with memantine on cognitive function in patients with Alzheimer's disease (AD).Methods:A randomized controlled trial was conducted among 90 patients with AD who were treated at the Zaozhuang Mental Health Center from January 2021 to March 2023. The patients were divided into a donepezil group and a combination group using a random number table grouping method, with 45 patients in each group. The donepezil hydrochloride group received only oral administration of donepezil hydrochloride tablets, while the combination group received oral administration of both donepezil hydrochloride tablets and memantine tablets. The two groups were continuously treated for 12 weeks. Before and after treatment, the Activities of Daily Living scale (ADL) score, the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) score, the Mini-Mental State Scale (MMSE) score, and biochemical indicators (homocysteine, neuron-specific enolase, and S100 β) were compared between the two groups. Adverse drug reactions were observed in each group.Results:After treatment, the ADL, BEHAVE-AD, and MMSE scores in the combination group were (78.9 ± 6.1) points, (5.2 ± 0.5) points, and (22.8 ± 2.2) points, respectively, and they were (65.2 ± 5.9) points, (9.6 ± 0.9) points, and (19.4 ± 2.4) points, respectively, in the donepezil hydrochloride group. The ADL and MMSE scores in the combination group were significantly higher than those in the donepezil hydrochloride group ( t = 10.83, 7.01, both P < 0.001). The BEHAVE-AD score in the combination group was significantly lower than that in the donepezil hydrochloride group ( t = -28.67, P < 0.001). After treatment, serum levels of homocysteine, neuron-specific enolase, and S100 β in the combination group were (17.8 ± 3.6) μmol/L, (16.8 ± 2.7) μg/L, and (17.4 ± 7.5) μg/L, respectively, which were significantly lower than (21.5 ± 3.3) μmol/L, (20.4 ± 3.7) μg/L, and (23.5 ± 5.1) μg/L in the donepezil hydrochloride group ( t = -5.08, -5.27, -4.51, all P < 0.001). The incidence of adverse drug reactions in the combination group was 13.3% (6/45), which was slightly, but not significantly, higher than 8.9% (4/45) in the donepezil group ( χ2 = 0.45, P = 0.502). Conclusion:The combination of donepezil hydrochloride and memantine can effectively improve the mental and behavioral symptoms and cognitive function of patients with AD, improve daily living ability, and do not increase adverse reactions. The combined therapy has high clinical application value.

Objective To develop a virtual world integration scale for adolescents and test its reliability and validity within the framework of the Virtual Social Ecology Model. Methods A total of 2543 students from four schools in Wuhan and Xianning were recruited from March to October 2023. The preliminary items of the scale were determined by semi-structured interview, literature review, brainstorming and Delphi expert consultation. The compiled scale was analyzed for validity and reliability using critical ration analysis, homogeneity test, confirmatory factor analysis, correlation related validity test , cronbach α coefficient, and split-half coefficient. Results The scale was preliminarily determined to consist of 20 items in 10 dimensions, including virtual self-identity, emotional interaction, virtual social interaction, cyber bullying, community activities, value identity, community participation, community management, network culture and virtual social capital. In the item analysis, the correlation coefficient of homogeneity test ranged from 0.496 to 0.767 (P<0.001), and there was statistical difference in critical ratio analysis (CR= 21.897-53.546, P<0.001). The fits of the confirmatory factor analysis model in validity analysis were: CFI=0.933, NFI=0.951, IFI=0.927, and RMSEA=0.064. The criterion validity showed a significantly positive association (the coefficient was between 0.450 and 0.855, P<0.01). The overall Cronbach α coefficient was 0.929 and the split-half coefficient was 0.846. The Cronbach α coefficients of sub-questionnaires were between 0.719 and 0.900 , and the split-half coefficients were between 0.729 and 0.913. Conclusion The Virtual World Integration Scale has good reliability and validity, and can be used as an assessment tool for the level of adolescents’ integration in virtual world.

OBJECTIVE To enrich the polymethoxyflavonoid-rich fraction from Citri Reticulatae Pericarpium using D101 macro-porous resin,and further to analyse the chemical constituents using High-Performance Liquid Chromatography Quadrupole-Time-of-Flight Mass Spectrometry(HPLC-Q-TOF-MS).METHODS Citri Reticulatae Pericarpium extract was adsorbed on D101 macro-porous resin and then eluted with different concentrations of ethanol to enrich the polymethoxyflavonoid-rich fraction;the content of the major flavonoid components was determined by high-performance liquid chromatography(HPLC);and the components were further an-alysed by HPLC-Q-TOF-MS.RESULTS The established HPLC method for the simultaneous determination of seven flavonoids in Citri Reticulatae Pericarpium extract was accurate and reliable.The contents of compounds such as nobiletin and tangeritin were signifi-cantly increased in the polymethoxyflavonoid-rich fraction.Using high resolution mass spectrometry(HRMS),70 and 60 compounds were identified from the Citri Reticulatae Pericarpium extract and the polymethoxyflavonoid-rich fraction,respectively,with 53 polyme-thoxyflavonoids being detected in these two extracts.CONCLUSION The results of this study provide an experimental basis for fur-ther identification of the pharmacological substance basis of the polymethoxyflavonoids in Citri Reticulatae Pericarpium and the estab-lishment of quality control methods.

Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder in women of childbearing age. Patients with PCOS are more likely to have psychological disorders such as anxiety and depression.In recent years, researchers have explored the link between PCOS and depression and anxiety. The biochemical changes and psychological stress experienced by PCOS patients caused by different clinical and metabolic phenotypes and long-term complications may account for the high levels of depression and anxiety experienced by women with PCOS risk. The purpose of this review was to summarize the present findings on PCOS phenotype and long-term complications related to depression and anxiety, to clarify the factors that may contribute to depression and anxiety, and to formulate future study directions and clinical practice.

Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder in women of childbearing age. Patients with PCOS are more likely to have psychological disorders such as anxiety and depression.In recent years, researchers have explored the link between PCOS and depression and anxiety. The biochemical changes and psychological stress experienced by PCOS patients caused by different clinical and metabolic phenotypes and long-term complications may account for the high levels of depression and anxiety experienced by women with PCOS risk. The purpose of this review was to summarize the present findings on PCOS phenotype and long-term complications related to depression and anxiety, to clarify the factors that may contribute to depression and anxiety, and to formulate future study directions and clinical practice.

Objective:To investigate the effect of repeated freezing and thawing on the clinical outcome of embryo transfer.Methods:A total of 48 cycles of twice frozen-thawed embryo (blastocyst) transfer in the reproductive medicine department, Shenzhen Luohu People′s Hospital from 2015 to 2020 were collected as the observation group, and 98 cycles of one frozen-thawed blastocyst transfer in the same period were randomly selected as the control group. The patient′s age, endometrial thickness, average number of transferred embryos, average number of high-quality embryos transferred, embryo recovery rate, implantation rate, clinical pregnancy rate, abortion rate, ectopic pregnancy rate, and live birth rate were compared.Results:There was no significant difference in age, endometrial thickness, number of embryos transferred and high-quality embryos transferred between the two groups (all P>0.05). There was no significant difference in embryo recovery rate, ectopic pregnancy rate, abortion rate and live birth rate between the two groups (all P>0.05). The embryo implantation rate and clinical pregnancy rate in the observation group were significantly lower than those in the control group (32.47% vs 55.70%, 39.58% vs 66.33%, all P<0.05). Conclusions:The clinical pregnancy rate was significantly lower than that of the control group after repeated vitrification of frozen-thawed embryo transfer, which may affect the subsequent developmental potential of embryos.

ObjectiveTo investigate the clinical effect and safety of robot-assisted laparoscopic hepatectomy (RALH) versus open hepatectomy (OH) in the treatment of liver diseases. MethodsWeb of Science, PubMed, Cochrane Library, Embase, CNKI, CBM, VIP, and Wanfang Data were searched for Chinese and English articles on RALH versus OH in the treatment of liver diseases published up to February 2020. The quality of the articles included was assessed, and RevMan 5.1 was used to perform the meta-analysis. ResultsSeven studies were included, with a total of 754 patients (328 patients in the RALH group and 426 in the OH group). The meta-analysis showed that compared with the OH group, the RALH group had a significantly longer time of operation (mean difference ［MD］=59.41, 95% confidence interval ［CI］: 9.74-109.08, P=0.02), significantly higher blood transfusion rate (relative risk ［RR］=2.24, 95%CI: 1.04-4.82, P=0.04) and rate of hepatic portal occlusion (RR=2.27, 95%CI: 1.37-3.75, P=0.001), a significantly shorter length of hospital stay (MD=-3.87, 95%CI: -5.63 to -2.12,P＜0.001), and significantly lower overall incidence rate of postoperative complications (RR=0.58, 95%CI: 0.41-0.81, P=0.001) and incidence rates of major postoperative complications (RR=0.45, 95%CI: 0.22-0.91, P=0.03). There was no significant difference in intraoperative blood loss between the two groups (P＞0.05). ConclusionFor hepatectomy, RALF can shorten the length of hospital stay and reduce postoperative complications, creating conditions for minimally invasive hepatectomy and rapid recovery.

Objective To detect the expression of matrix metalloproteinase-9 (MMP-9) gene in peripheral blood of patients with oral paraquat (PQ) poisoning and evaluate its predictive value for their prognosis.Methods Thirty-seven cases of oral PQ poisoning admitted to Linyi People's Hospital from January 2013 to June 2014 were enrolled,and they were divided into survival group (26 cases) and death group (11 cases) according to the survival sitnation in 28 days after poisoning;a healthy control group included 10 healthy people selected in the same period.The peripheral blood 3 mL was collected from each PQ patient on the 1st and 3rd day after admission,and in the healthy control group,3 mL peripheral venous blood was obtained under fast on the day for physical examination.The MMP-9 gene expression of peripheral blood mononuclear cells (PBMCs) was detected by reverse transcription-polymerase chain reaction (RT-PCR) methods;the serum MMP-9 concentration was determined by using enzyme-linked immunosorbent assay (ELISA);the serum PQ level was detected by high performance liquid chromatography (HPLC),and the amount of poison orally taken was recorded.The correlations between PQ amount orally taken,serum PQ level and MMP-9 expression were analyzed by Spearman correlation analysis.A receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of peripheral blood MMP-9 level for the 28-day prognosis of PQ poisoning patients.Results After admission the 1 day serum PQ level was (2.60 ± 1.29) mg/L,and the amount of poison taken was 50.0 (7.5,60.0) mL in the 37 patients with oral PQ poisoning.The MMP-9 gene expression level in PBMCs and serum MMP-9 protein level of both PQ poisoning groups were significantly higher than those of healthy control group,and the levels were gradually increased with the extension of poisoning time;the degrees of elevation in death group were more significant [the PBMCs' MMP-9 gene expression (A value):2.84± 1.16 vs.0.95 ± 0.23 on the 1st poisoning day,4.22± 1.75 vs.1.29 ±0.30 on the 3rd poisoning day;serum MMP-9 concentration (μg/L):2791.48± 1 230.88 vs.807.81±279.86 on the 1st poisoning day,4384.21 ± 1 781.97 vs.1 131.14±291.76 on the 3rd poisoning day,all P ＜ 0.05].Correlation analysis showed:there were significant positive correlations of oral PQ amount,serum PQ concentration to the MMP-9 gene expression in PBMCs and serum MMP-9 protein concentration in patients with oral PQ poisoning (all P =0.000).ROC curve analysis showed:the MMP-9 gene expression in PBMCs on the 1st day and the serum MMP-9 content on the 3rd day after admission had predictive value for 28-day prognosis in patients with oral PQ poisoning,and the ROC areas under the curve (AUC) was 0.820 and 0.776 respectively.When the cutoff value of MMP-9 gene expression level on the 1st day after admission was 0.90,the predictive sensitivity and specificity were 80.00％ and 63.64％ respectively;when the cutoff value of serum MMP-9 protein content on the 3rd day after admission was 904.36 μg/L,the predictive sensitivity and specificity were 80.00％ and 72.73％ respectively.Conclusion Oral PQ poisoning can lead to the MMP-9 gene expression in PBMCs and elevation of serum MMP-9 protein level in the body,and the MMP-9 gene expression has predictive value for the prognosis of patients with oral PQ poisoning.

Purpose To study the relationship between Epstein-Barr virus ( EBV) and breast cancer. Methods 246 cases of breast lesions at different development stages were selected and EBV DNA, RNA and protein was used by polymerase chain reaction ( PCR) , in situ hybridization ( ISH) , laser capture microdissection ( LCM) , immunohistochemistry ( IHC) EnVision technology. Results No expression of EBV latent membrane protein LMP1 was detected in all 246 cases of benign and malignant breast lesions. In 12 cases of breast cancer of EBV DNA, carcinoma in situ and breast lesions not EBV DNA was detected by PCR. However, using digoxigenin la-beled EBV DNA probe for the 48 cases ( including 12 cases of breast cancer specimens of positive PCR amplification) of benign and malignant breast lesions, no positive hybridization signal was detected in cancer cells, mammary epithelial cells and stromal lympho-cytes. Using laser capture microdissection and PCR amplification, cancer cells and stromal cells were captured respectively from 12 ca-ses of PCR positive and 12 cases of PCR negative of breast cancer specimens, we found EBV DNA was only amplified in mesenchymal cells. In the detection of the EBER expression with EBV RNA probe and in situ hybridization, the results of 75 cases of benign and malignant breast lesions ( including 12 cases of breast cancer by positive PCR amplification) were all negative. Conclusions The re-sults indicate that the tumorigenesis and development of breast cancer have nothing to do with EBV infection in all cases were chosen.