OBJECTIVE To investigate the causal relationships between gut microbiota， blood metabolites and antidepressant treatment response from a genetic perspective， and to assess the potential mediating role of blood metabolites. METHODS This study utilized a two-sample Mendelian randomization （MR） design. Exposure data were derived from four large-scale gut microbiome genome-wide association study （GWAS） datasets and two blood metabolite GWAS datasets. The inverse variance weighted method was used as the primary method to evaluate the causal relationships between gut microbiota， blood metabolites and antidepressant effects. The robustness， heterogeneity and horizontal pleiotropy of the results were evaluated through various sensitivity analyses. Additionally， the false discovery rate （FDR） was applied to correct type Ⅰ errors caused by multiple hypothesis testing. Finally， MR mediation analysis was conducted to test the potential mediating effect of blood metabolites. RESULTS The s_ Bilophila was negatively associated with the effectiveness of antidepressant treatment （ P ＝8.030×10 －5 ， then P ＝0.033 after FDR correction）， and the f_Bacteroidales was positively associated with the effectiveness of antidepressant treatment （ P ＝3.275×10 －4 ， then P ＝0.034 after FDR correction）. Over a hundred blood metabolites were also screened out as being associated with antidepressant response， but after FDR correction， no significant causal relationship was observed. The P value of the mediation effect proportion of blood metabolites in the “gut microbiota-blood metabolites-antidepressant efficacy” pathway was greater than 0.05. CONCLUSIONS The s_ Bilophila may represent a risk factor for antidepressant effects， whereas the f_Bacteroidales may serve as a protective factor for antidepressant effects. The correlation between blood metabolites and antidepressant efficacy is not strong， and no genetic evidence is found to support that the investigated blood metabolites play a key mediating role between the gut microbiota and antidepressant response.

Objective:To construct an evaluation index system of perceived service quality for Internet hospitals, and to provide references for scientific evaluation and effective management of such hospitals′ service quality.Methods:Thanks to literature review and expert interviews, an index system was initially built based on the Brady and Cronin model.From August to November 2021, Delphi expert consultation method was used in three rounds of correspondence questionnaire survey, and experts were consulted to assess the importance, familiarity and judgment basis of these indexes. The importance of the indexes was expressed by ± s, and the weight value of each index was calculated using analytic hierarchy process fuzzy comprehensive evaluation method and SPSS Au software. Results:The evaluation index system of perceived service quality for such hospitals included 3 level-1 indexes, namely environmental quality, interaction quality and result quality; and 10 level-2 indexes, namely software platform, service support, social factors, attitude, behavior, professional quality, service effect, service efficiency, service cost, satisfaction; and 30 level-3 indexes. Among these indexes, result quality of level-1 indexes scored the highest weight value(0.337); Software platform, professional quality, service support and attitude of level-2 indexes scored a higher weight values, respectively 0.119, 0.119, 0.109 and 0.109. Of level-3 indexes, reputation of Internet hospitals, service attitude of their doctors and doctor-patient communication skills of doctors online scored a higher weight values, respectively 0.102, 0.057 and 0.055.Conclusions:The index system for Internet hospital perceived service quality evaluation built in this study proved scientific, contributing positively to guiding Internet hospitals to improve their quality and safety management.

Objective To study the clinical effects of different surgical treatments for laryngotracheal steno-sis .Methods The clinical data of 56 patients with laryngotracheal stenosis from July 2006 to July 2014 were ana-lyzed .Of all 56 cases ,7 cases were children ,49 cases were aducts ;9 cases underwent CO2 laser resection ,5 cases underwent temperature controlled radiofrequency ablation and 5 cases received laryngeal mold under self -retaining laryngoscope ,6 cases received Keel placement after laryngofissure ,23 cases received T -shape tube implantation af-ter laryngoplasty or tracheoplasty and 8 cases underwent end-to -end tracheal anastomosis after cervical tracheoto-my .Results All the patients had been followed up for 6 months to 2 years postoperatively .Thirty nine cases of 56 were cured after single-operation ,and 10 of 56 were cured after repeated operations .No one suffered from laryn-gotracheal stenosis again .Five cases failed and survived with tracheal tube .2 cases lost to follow -up .No people die or had complications .Among all cases ,5 cases with laryngeal mold and 8 cases with tracheal anastomosis were cured after single-operation .Among 9 cases with lasere scar removal surgery ,5 cases were cured after an operation ,3 cases were cured after two operations ,1 case failed because of laryngeal cancer recurrence .Among 5 case with tem-perature controlled radiofrequency ablation ,3 cases were cured afrter an operation ,1 case was cured after two opera-tions ,1 case had no effect .Among 6 cases with keel place -ment ,4 cases were cured after one operation ,1 case was cured after two operations ,1 case had no effect .Among 23 cases with T -shape tube implantation ,14 cases were cured after an operstion ,5 cases were cured after two and more operations ,2 cases had no effects and 2 cases were lost .Conclusion In order to improve the therapeutic effects of laryngotracheal stenosis ,the treatment strategy should be personalized according to the degree of stenosis ,the position of stemtis ,and the impairment of laryngotra-cheal framework .

OBJECTIVE: To study the expressions of FSCN1 and HGF in nasal inverted papilloma (NIP) and explore their role in occurrence and development of this disease. METHOD: Immunohistochemical method was used to determine the expression of FSCN1 and HGF in 12 cases of chronic hypertrophic rhinitis, 40 cases of NIP and 14 cases of NIP with malignant transformation. RESULT: FSCN1 was expressed in 52.5% of NIP, 78.6% of NIP with malignant transformation and 8.3% of inferior turbinate of chronic hypertrophic rhinitis. Expression of FSCN1 was significantly higher in NIP and NIP with malignant transformation than in inferior turbinate (P<0.05). HGF was expressed in 85.7% of NIP with malignant transformation and 8.3% of inferior turbinate. Expression of HGF was significantly higher in NIP with malignant transformation than in inferior turbinate (P<0.05). HGF was expressed in 40.0% of NIP,which was higher than that of inferior turbinate. Expression of HGF was positively related to expression of FSCN1 in NIP and NIP with malignant transformation. CONCLUSION The abnormal expression of FSCN1 and HGF may be closely correlated with NIP and its malignant process. Analysis of FSCN1 and HGF expression in NIP may be useful in predicting malignant transformation.
Carrier Proteins ; genetics ; metabolism ; Hepatocyte Growth Factor ; genetics ; metabolism ; Humans ; Microfilament Proteins ; genetics ; metabolism ; Nasal Mucosa ; metabolism ; pathology ; Nose Neoplasms ; genetics ; metabolism ; pathology ; Papilloma, Inverted ; genetics ; metabolism ; pathology ; Turbinates ; metabolism ; pathology

OBJECTIVE: To detect the expression of c-myc in the tissue of laryngeal squamous cell carcinoma. RNA interference(RNAi) was employed to inhibit the expression of c-myc in Hep-2 cells and to evaluate the effects of c-myc as a target for gene therapy in laryngeal carcinoma. METHOD: Immunohistochemistry was used to determine the protein levels of c-myc and Rb in 80 cases of laryngeal squamous cell carcinoma and 30 cases of polyp of vocal cord. Hep-2 cells were transfected with c-myc siRNA, c-myc protein and mRNA levels were detected using Western Blotting and RT-PCR. Cell viability was detected by MTT after the Hep-2 cells were transfected with c-myc siRNA for different times or transfected with different concentrations c-myc siRNA. The sensitivity of Hep-2 cells to 5-Fu transfected with or without c-myc siRNA was evaluated also by MTT. Hep-2 cells were transfected with c-myc siRNA in combination with 5-Fu for 48 h and then analyzed cell apoptosis by flow cytometry. RESULT: Immunohistochemical analysis showed that c-myc was highly expressed in the tissues of laryngeal squamous cell carcinoma while the expression of Rb was lower. The protein and mRNA levels of c-myc decreased after transfected with c-myc siRNA. The results of MTT showed that the c-myc siRNA inhibited Hep-2 cells growth in a concentration-dependent manner. When transfected with c-myc siRNA(50 nmol/L), the cells were inhibited in a time-dependent manner. Compared with the untransfected cells, the viability of transfected Hep-2 cells was significantly suppressed at the same concentration of 5-Fu (P < 0.05). C-myc siRNA combination with 5-Fu could obviously increase cell apoptosis, even in the low concentration of 5-Fu (P < 0.05). CONCLUSION The protein level of C-myc has highly expressed in tumor tissues. C-myc siRNA can effectively inhibit the expression of c-myc and has anti-proliferation effects, increasing the sensitivity of Hep-2 cells to 5-Fu. Therefore,c-myc might be a good target for cancer treatment.
Adult ; Aged ; Apoptosis ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Female ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Proto-Oncogene Proteins c-myc ; genetics ; metabolism ; RNA Interference ; RNA, Messenger ; genetics ; RNA, Small Interfering ; genetics

OBJECTIVE: To evaluate the clinical feature and treatment of Mediastinal Abscess caused by removal foreign bodies in esophagus. METHOD: Retrospective analysis 12 patients of the last ten years, to observe the clinical manifestation and curative effect. RESULT: Ten patients were cured and 2 patients died. CONCLUSION The clinical manifestation of mediastinal abscess caused by removal foreign bodies in esophagus is characteristic, should be operated in general anesthesia.
Abscess ; etiology ; therapy ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Esophagus ; surgery ; Female ; Foreign Bodies ; surgery ; Humans ; Male ; Mediastinal Diseases ; etiology ; therapy ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVE To investigate the opportunity and method of surgery for removing tracheobronchial foreign bodies. METHODS A retrospective study was carried out among 500 children with tracheobronchial foreign bodies treated in our hospital from June, 2005 to June, 2009. RESULTS The foreign bodies were successfully removed in 4(0.8%) patients with fiberoptic-bronchoscopy, 2(0.4%) patients with thoracotomy, 20(4%)patients with endoscope or rigid bronchoscopy via tracheostomy, 32(6.4%) patients with direct laryngoscopy, 436(87.2%)patients with rigid bronchoscopy . There were 6 patients (1.2%) need another operation to fully remove the foreign bodies. CONCLUSION Proper method should be choose for removing tracheobronchial foreign bodies according to the history, location and kind of the foreign bodies.