Objective To study the clinical features,management,and outcomes of benign lesions of the vocal folds in children.Methods A retrospective study was conducted on 686 children diagnosed with benign lesions of vocal folds from 2010 to 2021.The clinical features were analyzed.One hundred children with follow-up records were divided in-to conservative observation group(66 cases)and surgical treatment group(34 cases),and the outcomes was analyzed.Results A total of 455(66.3％)children with benign lesions of vocal folds were boys,and most children(249 cases,36.3％)were within the age group of 6～10 years old.Vocal fold polyps were the most common cases(451 cases,65.7％).The long-term effective rates of the conservative observation and the surgery groups were 63.6％and 79.4％,respectively.The recurrence rate of vocal fold polyps was 31.8％in children aged 3 to 10 years.All the children with vocal fold cyst failed to respond to conservative treatment.Conclusion Benign lesions in children are more common in boys and those aged 6～10 years old,and vocal fold polyps being the most common lesions.Conservative observation is preferred when children with vocal fold polyps are under six years old,and surgical treatment is considered when they are aged 10 and above.Surgery is recommended for children with vocal fold cysts.

Objective To study the clinical features,management,and outcomes of benign lesions of the vocal folds in children.Methods A retrospective study was conducted on 686 children diagnosed with benign lesions of vocal folds from 2010 to 2021.The clinical features were analyzed.One hundred children with follow-up records were divided in-to conservative observation group(66 cases)and surgical treatment group(34 cases),and the outcomes was analyzed.Results A total of 455(66.3％)children with benign lesions of vocal folds were boys,and most children(249 cases,36.3％)were within the age group of 6～10 years old.Vocal fold polyps were the most common cases(451 cases,65.7％).The long-term effective rates of the conservative observation and the surgery groups were 63.6％and 79.4％,respectively.The recurrence rate of vocal fold polyps was 31.8％in children aged 3 to 10 years.All the children with vocal fold cyst failed to respond to conservative treatment.Conclusion Benign lesions in children are more common in boys and those aged 6～10 years old,and vocal fold polyps being the most common lesions.Conservative observation is preferred when children with vocal fold polyps are under six years old,and surgical treatment is considered when they are aged 10 and above.Surgery is recommended for children with vocal fold cysts.

The surveillance data of new cases of acute myocardial infarction (AMI) from January 1, 2013, to December 31, 2021, in Tengzhou City, Shandong Province, were used to analyze the incidence rate of AMI and its change trend among residents. The age and gender standardized incidence rate was calculated based on the 7th National Population Census 2020. The Cochran-Armitage trend test was used to analyze the trend of onset time and age. From 2013 to 2021, the crude and standardized incidence rate of total AMI in Tengzhou City declined from 130.07/100 000 and 161.12/100 000 to 76.15/100 000 and 72.77/100 000 ( Z=-13.785 and -20.822, both P<0.001). The crude and standardized incidence rates of males were higher than those of females. In 2016, males aged 45-54 years old and females aged 35-64 years old increased by 33.33%, 103.65%, 106.30%, and 95.75% compared to 2015, and the differences were statistically significant ( χ2=6.512, 4.965, 25.115, and 46.004, all P<0.05). The incidence rate of AMI in men aged<35 and 35-44 years old had an upward trend. From 2013 to 2021, the incidence rate of AMI decreased by 55.15% in urban areas and 36.59% in rural areas ( Z=-8.529 and -11.235, both P<0.001).

Objective:To analyze long-term prognosis and influencing factors of recurrence in vocal fold leukoplakia treated by endoscopic cordectomy with CO 2 laser. Methods:A retrospective review was conducted on 599 patients with vocal fold leukoplakia [566 males and 33 females, aged 17-84 years (median age 55 years)], undergoing endoscopic cordectomy by CO 2 laser under general anesthesia at the Department of Otorhinolaryngology Head and Neck Surgery of Beijing Tongren Hospital, Capital Medical University, from January 2000 to December 2023. The study analyzed the clinical features, pathological grade, surgical methods, postoperative voice function, recurrence, malignant changes and analyzed the long-term efficacy and and its influencing factors. The patients were followed up for a duration of 6-249 months postoperatively, with a median follow-up time of 48 months. SPSS 20.0 software was used for statistical analysis. Results:Among the 599 patients, the histopathological grades included simple squamous cell hyperplasia in ( n=264, 44.08%), mild dysplasia ( n=96, 16.03%), moderate dysplasia ( n=74, 12.35%), severe dysplasia( n=43, 7.81%), carcinoma in situ( n=35, 5.84%), and carcinoma in situ with microinvasion( n=87, 14.52%). The 3-year and 5-year overall recurrence rates were 12.91% and 16.00%, respectively. In patients with precancerous lesion, 3.91% of recurrences presented with an upgraded pathologic grade and 2.34% evolved into carcinoma. The risk of recurrence was higher in lesions involving the anterior commissure, larger lesions, significant reduction/absence of mucosal waves, neovascularization/suspected neovascularization, and pathology of dysplasia/carcinoma in situ/carcinoma in situ with microinvasion( F=44.76,21.54,11.55,8.78,23.20,respectively, P<0.05). Additionally, patients with recurrent disease exhibited higher reflux symptom index scores compared to those without recurrence. Exophytic lesion characteristics and the inability to cease smoking postoperatively were identified as independent risk factors for recurrence with an upgraded pathological grade, with odds ratios of 8.675 and 11.380 times greater than those with non-exophytic lesions and successful smoking cessation, respectively. At the 6-months postoperative assessment, patients who underwent subepithelial cordectomy (typeⅠ) demonstrated a statistically significant increase in fundamental frequency ( t=-3.38, P<0.05), and while other voice acoustic parameters were not significantly different.Conversely, those who underwent transmuscular cordectomy (TypeⅢ) exhibited significant alterations in multiple voice acoustic parameters when compared to preoperative values ( P<0.05). Furthermore, postoperative vocal fold adhesions developed in 84 patients with 13 of these individuals requiring surgical intervention for adhesion release. Conclusions:Lesions involving the anterior commissure, larger lesions, pathology of dysplasia/carcinoma in situ/carcinoma in situ with microinfiltration, significant reduction/absence of vocal fold mucosal waves, and neovascularization visible under NBI are indicative of an increased risk of recurrence, whereas exophytic lesions and the inability to cease smoking postoperatively significantly increase the risk of recurrence with elevated pathologic grade. Recovery of postoperative voice quality is procedure-dependent, underscoring the importance of surgical approach selection in the management of vocal fold leukoplakia.

The surveillance data of new cases of acute myocardial infarction (AMI) from January 1, 2013, to December 31, 2021, in Tengzhou City, Shandong Province, were used to analyze the incidence rate of AMI and its change trend among residents. The age and gender standardized incidence rate was calculated based on the 7th National Population Census 2020. The Cochran-Armitage trend test was used to analyze the trend of onset time and age. From 2013 to 2021, the crude and standardized incidence rate of total AMI in Tengzhou City declined from 130.07/100 000 and 161.12/100 000 to 76.15/100 000 and 72.77/100 000 ( Z=-13.785 and -20.822, both P<0.001). The crude and standardized incidence rates of males were higher than those of females. In 2016, males aged 45-54 years old and females aged 35-64 years old increased by 33.33%, 103.65%, 106.30%, and 95.75% compared to 2015, and the differences were statistically significant ( χ2=6.512, 4.965, 25.115, and 46.004, all P<0.05). The incidence rate of AMI in men aged<35 and 35-44 years old had an upward trend. From 2013 to 2021, the incidence rate of AMI decreased by 55.15% in urban areas and 36.59% in rural areas ( Z=-8.529 and -11.235, both P<0.001).

Objective To investigate the clinical manifestations,molecular genetics and gonadal pathol-ogy characteristics of patients with disorders of sex development(DSD),and to summarize the clinical experi-ence of identifying rare diseases from common symptoms.Methods The clinical data of 416 patients with DSD diagnosed and treated in the multidisciplinary center of DSD of Guangzhou Women and Children's Medical Cen-ter from May 2018 to August 2023 were retrospectively analyzed,summarized and discussed.Results Accord-ing to chromosome karyotype,416 cases of DSD were classified into three types:92 cases(22.1％)of abnormal sex chromosome karyotype,285 cases(68.5％)of 46,XY karyotype and 39 cases(9.4％)of 46,XX karyotype.Among the 92 patients with abnormal sex chromosome karyotype,59 cases were raised as males,18 cases(30.5％)complained of short penis with hypospadias and cryptorchidism.The most common karyotype was 45,X/46,XY(58 cases,63.0％).Among the 285 patients with 46,XY karyotype,238 cases were raised as males,and 63 cases(26.5％)complained of short penis and hypospadias;47 cases were raised as females,and 13 ca-ses(27.7％)complained of inguinal mass.A total of 216 patients with 46,XY karyotype were subjected to whole exome gene detection,and 155 cases(71.8％)were found to have molecular pathogenesis with the clinical phe-notype.Among the 39 patients with 46,XX karyotype,19 cases were raised as males,and 8 cases(42.1％)com-plained of short penis and hypospadias.In the 18 cases of gonad biopsy,17 cases showed testicular tissue in go-nads.Whole exome sequencing was performed in 14 cases.NR5A1 gene heterozygous mutation,SRY gene muta-tion and SOX3 gene mutation were found in 2 cases,respectively(14.3％).Twenty cases were raised as females,and 14 cases(70.0％)complained of clitoral hypertrophy.Gonad biopsy was performed in 8 cases,with 7 cases of ovotestis(87.5％)and 1 case of NR5A1 gene heterozygous mutation(14.3％).Conclusions The etiologies of DSD are complex and diverse,and the clinical manifestations are various,which can be manifested as hypospa-dias,micropenis,cryptorchidism and other common symptoms of the urinary system.Different etiologies have dif-ferent treatment options.Therefore,chromosome karyotype,molecular genetic testing and gonadal pathology can be used to clarify the cause of disease,especially for rare diseases,improve the detection rate,reduce the rate of missed diagnosis,and ensure reasonable treatment,especially sex selection.

Objective:To quantitatively analyze and explore the characteristics, influencing factors, reference value range, and variability of electromyography and nerve evoked potential in normal laryngeal muscles.Methods:The study included 480 patients diagnosed with unilateral vocal fold immobility and underwent laryngeal electromyography (LEMG) at Beijing Tongren Hospital from June 2012 to June 2022, including 259 males and 221 females, with an average age of (44.4±14.9) years. Characteristics of the motor unit potential (MUP), recruitment pattern, and evoked potential in the thyroarytenoid muscle (TA), the posterior cricoarytenoid muscle (PCA) and the cricothyroid muscle (CT) of the normal side were analyzed, with the coefficient of variation (CV), reference value range of each parameter, and differences in different genders and age groups analyzed simultaneously. SPSS 24.0 software was used to analyze the data.Results:The amplitudes of MUP in TA, PCA, and CT muscles were (129.52±24.95) μV, (240.67±88.25) μV, and (125.88±21.36) μV, respectively. The durations were (3.67±0.17) ms, (3.82±0.29) ms and (3.68±0.17) ms, respectively. The numbers of MUP phase were 1.94±0.28, 2.16±0.38, and 1.98±0.25, respectively. The per second numbers of turns in TA, PCA, and CT muscles were 565.76±193.88, 520.94±170.99, and 523.29±159.58, respectively. The amplitudes of the recruitment pattern were (1 038.00±368.65) μV, (1 269.91±434.75) μV, and (919.64±240.54) μV, respectively. The latencies of laryngeal nerve evoked potentials in TA, PCA, and CT muscles were (1.69±0.08) ms, (1.70±0.08) ms, and (1.70±0.11) ms, with durations of (6.20±1.30) ms, (6.41±1.34) ms, and (7.05±1.67) ms, respectively. The amplitudes were (7.42±3.62) mV, (6.05±2.83) mV, and (5.54±2.62) mV, respectively. The duration of MUP in male laryngeal muscles was higher than that in females, with statistical differences in TA ( t=5.70, P<0.01) and CT ( t=2.41, P<0.05) muscles, and the duration of evoked potentials was higher than that in females (TA: t=3.63; PCA: t=3.21; CT: t=2.98; all P<0.01). The duration of PCA evoked potentials was weakly negatively correlated with age ( r=-0.17, P<0.01). The reference ranges for MUP duration in TA, PCA, and CT muscles were (3.30-3.90) ms, (3.40-4.30) ms, and (3.30-3.90) ms, respectively, and the latencies of the evoked potential were concentrated at 1.70 ms, the CVs were all less than 10%. Conclusions:This study analyzes the parameters of MUP, recruitment pattern, and evoked potential in laryngeal muscles of the normal side in patients with unilateral vocal fold immobility, as well as the normal reference range. Among them, the duration of MUP and the latency of evoked potential are relatively small, which can be used as characteristic indicators for normal laryngeal muscles and nerves. MUP of TA and CT muscles in male patients, as well as the duration of all the evoked potentials, are higher than those in females, and the trend of changes in the parameters with age is not significant.

Objective:To quantitatively analyze and explore the characteristics, influencing factors, reference value range, and variability of electromyography and nerve evoked potential in normal laryngeal muscles.Methods:The study included 480 patients diagnosed with unilateral vocal fold immobility and underwent laryngeal electromyography (LEMG) at Beijing Tongren Hospital from June 2012 to June 2022, including 259 males and 221 females, with an average age of (44.4±14.9) years. Characteristics of the motor unit potential (MUP), recruitment pattern, and evoked potential in the thyroarytenoid muscle (TA), the posterior cricoarytenoid muscle (PCA) and the cricothyroid muscle (CT) of the normal side were analyzed, with the coefficient of variation (CV), reference value range of each parameter, and differences in different genders and age groups analyzed simultaneously. SPSS 24.0 software was used to analyze the data.Results:The amplitudes of MUP in TA, PCA, and CT muscles were (129.52±24.95) μV, (240.67±88.25) μV, and (125.88±21.36) μV, respectively. The durations were (3.67±0.17) ms, (3.82±0.29) ms and (3.68±0.17) ms, respectively. The numbers of MUP phase were 1.94±0.28, 2.16±0.38, and 1.98±0.25, respectively. The per second numbers of turns in TA, PCA, and CT muscles were 565.76±193.88, 520.94±170.99, and 523.29±159.58, respectively. The amplitudes of the recruitment pattern were (1 038.00±368.65) μV, (1 269.91±434.75) μV, and (919.64±240.54) μV, respectively. The latencies of laryngeal nerve evoked potentials in TA, PCA, and CT muscles were (1.69±0.08) ms, (1.70±0.08) ms, and (1.70±0.11) ms, with durations of (6.20±1.30) ms, (6.41±1.34) ms, and (7.05±1.67) ms, respectively. The amplitudes were (7.42±3.62) mV, (6.05±2.83) mV, and (5.54±2.62) mV, respectively. The duration of MUP in male laryngeal muscles was higher than that in females, with statistical differences in TA ( t=5.70, P<0.01) and CT ( t=2.41, P<0.05) muscles, and the duration of evoked potentials was higher than that in females (TA: t=3.63; PCA: t=3.21; CT: t=2.98; all P<0.01). The duration of PCA evoked potentials was weakly negatively correlated with age ( r=-0.17, P<0.01). The reference ranges for MUP duration in TA, PCA, and CT muscles were (3.30-3.90) ms, (3.40-4.30) ms, and (3.30-3.90) ms, respectively, and the latencies of the evoked potential were concentrated at 1.70 ms, the CVs were all less than 10%. Conclusions:This study analyzes the parameters of MUP, recruitment pattern, and evoked potential in laryngeal muscles of the normal side in patients with unilateral vocal fold immobility, as well as the normal reference range. Among them, the duration of MUP and the latency of evoked potential are relatively small, which can be used as characteristic indicators for normal laryngeal muscles and nerves. MUP of TA and CT muscles in male patients, as well as the duration of all the evoked potentials, are higher than those in females, and the trend of changes in the parameters with age is not significant.

Objective:To analyze the changing trend of intracerebral hemorrhage (ICH) incidence among residents with different characteristics during 9 years of comprehensive hypertension prevention and control (hypertension prevention and control) in Tengzhou from 2013 to 2021.Methods:From January 1, 2013 to December 31, 2021, the new ICH cases collected by the Center for Disease Control and Prevention in Tengzhou City were analyzed to calculate the incidence of ICH, and the trend of its distribution was analyzed among residents with different ages, sexes, and between urban and rural areas. The registered population information came from Tengzhou Public Security Bureau. Age and sex standardized incidence was calculated based on the 7th National Population Census in 2020. The Cochran-Armitage test was used to analyze the time and age trends of the incidence.Results:The overall ICH crude and standardized incidence in Tengzhou City decreased from 97.30/100 000 to 52.13/100 000 ( Z=-9.93, P<0.001) and 119.30/100 000 to 50.69/100 000 ( Z=-15.40, P<0.001) from 2013 to 2021, and both elevated to form a single peak in 2020, with 22.58% ( χ 2=24.02, P<0.001) and 18.09% ( χ 2=17.08, P<0.001) higher than in 2019, respectively. The trends in male and female incidence over the same period were similar to the overall trends, and the incidence was higher in males than in females in all years. The incidence of ICH increased with age in all years. The difference of increase in male incidence rate in 2020 was statistically significant in three age groups ≥45 years compared with 2019 (36.29%, 23.57% and 16.18%, respectively, χ 2=6.73, 4.65, 4.00, P<0.001). The incidence of ICH decreased by 70.07% and 36.23% ( Z=18.44, 5.22, P<0.001) in urban and rural areas respectively from 2013 to 2021, whereas increased by 34.15% ( χ 2=10.88, P<0.01) and 22.08% ( χ 2=18.63, P<0.001) in 2020 compared with 2019 separately. Conclusions:The incidence of ICH in Tengzhou from 2013 to 2021 showed a significant downward trend, with the decrease in the incidence of ICH in women exceeding that in men. The decrease in the incidence of ICH in urban areas exceeded that in rural areas, and male morbidity seemingly had a younger trend.

Objective: To investigate the expression of marker proteins in vocal cord leukoplakia, and to find markers for the early stage of diagnosis and prognosis of precancerous lesions. Methods: The study included 119 cases, 68 cases of vocal cord leukoplakia (22 cases with epithelial simple hyperplasia, 46 cases with epithelial dysplasia), and 51 cases of vocal cords benign lesions(31 cases of vocal cord polyps, 20 cases of Reinke′s edema). The expression of p53, Ki-67, p21, Survivin, p16, p27, PTEN, c-Myc and vascular endothelial growth factor (VEGF) in vocal cords leukoplakia were detected, vocal cord benign lesions (vocal cord polyps and Reinke′s edema) acted as controls, comparing the expression differences of different pathological tissue. Data was analyzed by SPSS 22.0 software. Results: The expression of p53, p16, Ki-67, VEGF in vocal cord benign lesions and vocal cords leukoplakia with epithelial simple hyperplasia did not show significant differences. There was a grading increase in the positive expression of p53, Ki-67 in the vocal cord leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions and vocal cords leukoplakia with epithelial simple hyperplasia (p53: χ²=13.340, P=0.002, Ki-67: χ²=53.386, P=0.000). The expression of p27, PTEN, c-Myc in vocal cord benign lesions and vocal cords leukoplakia with epithelial dysplasia did not show significant differences. There was a grading increase in the positive expression of p21 Survivin in vocal cords leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions (P<0.05). Expression of Survivin in vocal cords leukoplakia with mild-moderate epithelial dysplasia showed a significant increase than those in vocal cord benign lesions (P<0.05). The positive expression grade of p21 showed a rising trend (P=0.073) between the different grades of dysplasia. Conclusion The positive expression grade of p53, Ki-67, p21 Survivin showed an increase in vocal cords leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions, which might be an implication for evaluating the diagnosis and prognosis of precancerous lesions. Expression of p21 was correlated to the degrees of dysplasia and expression of Survivin showed a significant difference in early stage of epithelial dysplasia contrasting to benign lesions.