Objective:To compare and analyze the efficacy of bilateral and unilateral posterior vocal cord resection with CO 2 laser under endoscopy in the treatment of bilateral vocal cord paralysis. Methods:This case series study retrospectively analyzed the data of 110 patients with bilateral vocal cord paralysis who underwent endoscopic CO 2 laser posterior cordotomy at the Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Naval Medical University, from October 2016 to January 2023. The cohort consisted of 36 males [mean age (45.5±9.1) years, range 24-72 years] and 74 females [mean age (47.2±10.1) years, range 22-67 years]. Among them, 47 patients underwent simultaneous bilateral posterior cordotomy (bilateral cordotomy group), while 63 patients underwent unilateral posterior cordotomy (unilateral cordotomy group). Pre-and postoperative indicators, including swallowing function, glottal size, and vocal function (subjective and objective assessments), were compared between the two surgical approaches. The Wilcoxon signed-rank test was used to analyze changes in swallowing function, glottal size, and vocal function (subjective and objective assessments) within each group before and after surgery, whereas the Mann-Whitney U test was utilized to assess differences between groups. Results:Postoperative follow-up was 1-5 years [median follow-up time was 1.6 (1.3, 2.0) years].The one-time extubation rate was 71.4%(45/63)in the unilateral posterior vocal cord resection group and 87.2%(41/47)in the bilateral posterior vocal cord resection group, significantly higher in the bilateral group ( χ2=3.94, P<0.05). One week after surgery, the swallowing function score of unilateral cordotomy group was 2 (1, 2.5) points, which was significantly better than that of bilateral cordotomy group [2 (1.5, 3) points, Z=-2.118, P<0.05], and the swallowing function score of both groups returned to normal 3 months after surgery. There were no significant differences in preoperative glottic closure during inhalation, auditory perceptual evaluation (GRBAS), objective voice analysis, and Voice Handicap Index-10 (VHI-10) between the two groups ( P>0.05). Postoperatively, the maximum transverse diameter of the posterior glottis during inspiration in the unilateral cordotomy group was 4.49 (4.24, 4.77) mm, significantly smaller than that in the bilateral cordotomy group, which was 5.05 (4.52, 5.62) mm ( Z=-4.103, P<0.05). Among the GRBAS parameters, G (grade of hoarseness), B (breathiness), and A (asthenia), as well as VHI-10 scores and objective voice analysis parameters [jitter, shimmer, harmonic-noise ratio (HNR), and maximum phonation time (MPT)], were significantly better in the unilateral cordotomy group compared to the bilateral cordotomy group, with statistically significant differences ( P<0.05). Conclusions:Unilateral posterior vocal cord resection using CO 2 laser is simple and feasible for the treatment of bilateral vocal cord paralysis, with shorter recovery time, maximal preservation of laryngeal phonatory function, and fewer complications compared to bilateral resection. However, the one-time extubation rate is higher with bilateral resection, reducing the need for a second surgery and associated patient discomfort. This study offers guidance for clinical decision-making in the surgical management of bilateral vocal cord paralysis.

Objective:To compare and analyze the efficacy of bilateral and unilateral posterior vocal cord resection with CO 2 laser under endoscopy in the treatment of bilateral vocal cord paralysis. Methods:This case series study retrospectively analyzed the data of 110 patients with bilateral vocal cord paralysis who underwent endoscopic CO 2 laser posterior cordotomy at the Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Naval Medical University, from October 2016 to January 2023. The cohort consisted of 36 males [mean age (45.5±9.1) years, range 24-72 years] and 74 females [mean age (47.2±10.1) years, range 22-67 years]. Among them, 47 patients underwent simultaneous bilateral posterior cordotomy (bilateral cordotomy group), while 63 patients underwent unilateral posterior cordotomy (unilateral cordotomy group). Pre-and postoperative indicators, including swallowing function, glottal size, and vocal function (subjective and objective assessments), were compared between the two surgical approaches. The Wilcoxon signed-rank test was used to analyze changes in swallowing function, glottal size, and vocal function (subjective and objective assessments) within each group before and after surgery, whereas the Mann-Whitney U test was utilized to assess differences between groups. Results:Postoperative follow-up was 1-5 years [median follow-up time was 1.6 (1.3, 2.0) years].The one-time extubation rate was 71.4%(45/63)in the unilateral posterior vocal cord resection group and 87.2%(41/47)in the bilateral posterior vocal cord resection group, significantly higher in the bilateral group ( χ2=3.94, P<0.05). One week after surgery, the swallowing function score of unilateral cordotomy group was 2 (1, 2.5) points, which was significantly better than that of bilateral cordotomy group [2 (1.5, 3) points, Z=-2.118, P<0.05], and the swallowing function score of both groups returned to normal 3 months after surgery. There were no significant differences in preoperative glottic closure during inhalation, auditory perceptual evaluation (GRBAS), objective voice analysis, and Voice Handicap Index-10 (VHI-10) between the two groups ( P>0.05). Postoperatively, the maximum transverse diameter of the posterior glottis during inspiration in the unilateral cordotomy group was 4.49 (4.24, 4.77) mm, significantly smaller than that in the bilateral cordotomy group, which was 5.05 (4.52, 5.62) mm ( Z=-4.103, P<0.05). Among the GRBAS parameters, G (grade of hoarseness), B (breathiness), and A (asthenia), as well as VHI-10 scores and objective voice analysis parameters [jitter, shimmer, harmonic-noise ratio (HNR), and maximum phonation time (MPT)], were significantly better in the unilateral cordotomy group compared to the bilateral cordotomy group, with statistically significant differences ( P<0.05). Conclusions:Unilateral posterior vocal cord resection using CO 2 laser is simple and feasible for the treatment of bilateral vocal cord paralysis, with shorter recovery time, maximal preservation of laryngeal phonatory function, and fewer complications compared to bilateral resection. However, the one-time extubation rate is higher with bilateral resection, reducing the need for a second surgery and associated patient discomfort. This study offers guidance for clinical decision-making in the surgical management of bilateral vocal cord paralysis.

Objective: To understand current situation epidemiology and associated factors of suicidal ideation among high school students in Yixing, so as to provide basis for targeted intervention. Methods: From March to May 2019, a questionnaire survey was conducted on 12 799 students from 3 junior high schools and 4 senior high schools in Yixing City, Jiangsu Province, using a stratified cluster random sampling method. Latent profile analysis was used to classify suicidal ideation among high school students, the chi square test was used to compare the differences in suicidal ideation among different characteristics of students, multiple Logistic regression was used to analyze influencing factors, a risk predictive nomogram model was constructed and then verified. Results: Three latent classes of suicidal ideation among high school students was divided into three categories were observed: none or mild, moderate, and severe. Among them, 3 034 (23.7%) had moderate suicidal ideation and 753 (5.9%) had severe suicidal ideation. The Logistic regression results showed that gender was female, academic performance was lower midrange, smoking, drinking, popularity with classmates(less popular and unpopularity), family member relationships(general/occasional contradictions/contradictions), trust in others(more trusted/less trusted/less trusted at all), past or current relationships, physical bullying, relationship bullying, verbal bullying, and sexual bullying were the influencing factors for severe suicidal ideation among students ( OR =3.27； 2.18 ；1.63；1.72；2.66, 6.05；3.00,3.29, 6.38；1.71, 6.04, 12.48； 2.50； 1.59； 2.16； 1.45； 1.63, P <0.05). The nomogram prediction model had good discrimination. Conclusions Suicide ideation is influenced by multiple factors. Family and peer situations, as well as being bullied, are all related to the degree the severity of suicidal ideation. Efforts can be made to improve students family and interpersonal relationships, control bullying, then reduce their suicidal ideation which might help prevent suicide ideation among students.

Objective:To discuss the improvement effect of uric acid(UA)on the postoperative cognitive dysfunction(POCD)in the mice anesthetized with isoflurane for a long duration,and to clarify its possible mechanism.Methods:Twenty-four healthy male C57BL/6 mice were randomly divided into blank control group,anesthesia group,and UA group,and there were eight mice in each group.The mice in UA group were injected intraperitoneally with 200 μL UA solution daily for 2 d before anesthesia.The mice in blank control group and anesthesia group were given the same volume of saline;the mice in anesthesia group and UA group were used to prepare the models of long-duration isoflurane anesthesia,while the mice in blank control group were untreated.Y-maze tests was used to detect the alternation success rate,movement distances,and movement speeds of the mice in various groups;situational fear experiment was used to detect the percentages of freezing time;Western blotting method was used to detect the expression levels of interleukin(IL)-1β,IL-10,and mature brain-derived neurotrophic factor(mBDNF)proteins in hippocampus tissue of the mice in various groups.Results:The Y-maze test results showed that compared with blank control group,the alternation success rate of the mice in anesthesia group was significantly decreased(P<0.01);compared with anesthesia group,the alternation success rate of the mice in UA group was significantly increased(P<0.01).The situational fear experiment results showed that compared with blank control group,the percentage of freezing time of the mice in anesthesia group was significantly decreased(P<0.01);compared with anesthesia group,the percentage of freezing time of the mice in UA group was significantly increased(P<0.05).The cued memory experiment resutls showed that there were no significant differences of the percentage of freezing time of the mice between various groups(P>0.05).The Western blotting results showed that compared with blank control group,the expression level of IL-1β protein in hippocampus tissue of the mice in anesthesia group was increased(P<0.01),while the expression levels of IL-10 and mBDNF proteins were decreased(P<0.01);compared with anesthesia group,the expression level of IL-1β protein in hippocampus tissue of the mice in UA group was decreased(P<0.05),and the expression levels of IL-10 and mBDNF proteins were increased(P<0.05 or P<0.01).Conclusion:UA can improve the POCD in the mice,and its mechnasim may be related with its anti-inflammatory activity inhibiting the central inflammation and upregulating the mBDNF protein expression.

With the development of molecular biology, biomaterials and tissue engineering, regenerative treatment of pulpal and periradicular diseases is facing new opportunities. At present, a large number of studies on dental pulp regeneration reveal that cytokines are essential for promoting migration, proliferation and osteogenic differentiation of dental pulp stem cells. In this paper, we review several kinds of cytokines related to dental pulp regeneration, and analyze their roles and regulatory mechanisms in dental pulp regeneration.

Objective: To explore cyberbullying and risk factors of middle school students, and to provide a reference for cyberbullying prevention in school settings. Methods: A stratified cluster random sampling method was used to select 12 940 students from three junior high schools and four senior high schools in Yixing City of Jiangsu Province, China, to conduct a questionnaire survey from March 1 to May 31, 2019. The Chi -square test was performed to compare differences in the prevalence of cyberbullying among groups with different sociodemographic characteristics, and the multivariate Logistic regression model was employed to analyze the risk factors. A risk predictive nomogram model was constructed and then verified. Results: Middle school students were found to be victims of cyberbullying at a rate of 12.3%. The Logistic regression results showed that alcohol use ( OR =1.93), lack of emotional management ( OR =1.30), feeling unsafe ( OR =1.70), not trusting people ( OR =1.66), increased daily online time ( OR =1.39), higher frequency of using social software or websites ( OR =2.24), poor relationships with family members ( OR =1.46), parental neglect ( OR =1.50), class leadership ( OR =1.30) and poor relationships with classmates ( OR =1.34) were risk factors for middle school students who were victims of cyberbullying ( P <0.05). Based on these 10 independent risk factors, the nomogram prediction model, had good discrimination ( AUC =0.73). Conclusion Cyberbullying is common among middle school students. Internet use, parental neglect and class leadership all have an impact on cyberbullying.

Alzheimer's disease (AD) is a central neurodegenerative disease with still unclear pathogenesis. Recent studies have shown that axonal transport dysfuction of mitochondria may contribute to AD progression. Normal mitochondrial axonal transport mainly involves microtubules, molecular motors and connexins, while AD early pathological changes can damage mitochondrial axonal transport by interfering with these proteins: accumulated β-amyloid (Aβ) impairs the function of molecular motors; abnormally modified Tau protein reduces microtubule stability; mutant presenilin-1 (PS1) can induce phosphorylation of some related proteins by activating glycogen synthase kinase-3β (GSK-3β); all these processes can damage mitochondrial axonal transport, leading to synaptic dysfunction. This review aims to clarify the possible mechanisms of axonal transport dysfuction of mitochondria in AD and provides new ideas for AD treatment.

Objective: To explore the mediating effect of anxiety, insomnia, and family cohesion between Internet addiction and non suicidal self injury (NSSI) behavior among junior and senior school students, so as to develop interventions to promote adolescent mental health. Methods: A total of 3 026 junior and senior school students from Yixing, Jiangsu Province, China, were selected by stratified cluster sampling from December 2022 to February 2023, and were administered the Ottawa Self injury Inventory (OSI), Depression, Anxiety and Stress Scale-21 (DASS-21), Family Environment Scale-Chinese Version (FES-CV), Insomnia Severity Index (ISI), and Chinese Internet Addiction Scale Revised (CIAS-R). A mediating effect model was constructed to analyze the mediating effect of anxiety, insomnia, and family cohesion on Internet addiction and NSSI. Results: Internet addiction ( r = 0.24), insomnia ( r =0.28), and anxiety ( r =0.27) were positively correlated with NSSI, while the latter was negatively correlated with family cohesion ( r =-0.23) ( P <0.01). The mediating effect model was well fitted ( CFI=0.999, TLI=0.978, RMSEA = 0.030 ). Anxiety (mediation effect value:0.12, 95% CI =0.08-0.18) and family cohesion (mediation effect value:0.08, 95% CI = 0.03 -0.13) had a separate mediating effect. A chain meditating effect was found in the case of anxiety and insomnia (mediation effect value:0.14, 95% CI =0.10-0.20), family cohesion and anxiety (mediation effect value:0.05, 95% CI =0.03-0.07), family cohesion and insomnia (mediation effect value:0.05, 95% CI =0.03-0.07), and family cohesion, anxiety, and insomnia (mediation effect value:0.06, 95% CI =0.04-0.08). The mediating effect accounted for 14.9%, 10.1%, 17.5%, 6.0%, 5.6%, and 7.1%, respectively. Conclusions Anxiety, insomnia, and family cohesion partially mediate Internet addiction and NSSI. Schools and families should pay attention to Internet addiction among junior and senior school students and develop appropriate interventions to promote adolescent mental health, so as to reduce the prevalence of NSSI.

Objective: To explore the association between negative emotion (depression, anxiety and stress), family intimacy and Internet addiction, so as to provide a basis for the intervention of Internet addiction among junior and senior high school students. Methods: Students were selected by stratified random cluster sampling method from junior high schools and senior high schools from December 2022 to February 2023 in Yixing City, Jiangsu Provicne. A total of 3 026 students completed the questionnaire survey, including the demographic characteristics, Depression, Anxiety and Stress Scale-21 (DASS-21), Family Environment Scale-Chinese Version (FES-CV), and Chinese Internet Addiction Scale Revised (CIAS-R). Bivariate correlation was used to analyzed the association of family intimacy, depression, anxiety, stress, and Internet addiction. Mediating effect model was used to analyzed the mediating effect of negative emotion between family intimacy and Internet addiction. Results: The average score of Internet addiction among junior and senior high school students was (46.26±15.58), and there were statistical differences in the average scores of Internet addiction across different grades ( F=87.15, P <0.01). Depression ( r =0.57), anxiety ( r =0.56), stress ( r = 0.57) were positively correlated with Internet addiction, and family intimacy ( r =-0.34) was negatively correlated with Internet diction ( P <0.01). In the mediating effect model, family intimacy negatively predicted negative emotion ( β =-0.48) and Internet addiction ( β =-0.10), and negative emotion positively predicted Internet addiction ( β =0.45) ( P <0.01). Negative emotion played a partial mediating role between family intimacy and Internet addiction (the mediation value:-1.71, 95% CI =-1.96--1.49, mediation ratio:67.9%, P <0.05). Conclusions There are associations between negative emotion, family intimacy and Internet addiction among junior and senior school students. Family intimacy indirectly affects Internet addiction mainly through negative emotion. It suggests that family education is in need of attention to reduce the prevalence rate of Internet addiction among junior and senior high school students, especially family intimacy.

Objective: To understand different types of depression and anxiety among primary and secondary school students, as well as their influencing factors, so as to provide a basis for the development of future intervention programs for adolescent mental health. Methods: From December 2022 to February 2023, a self administered questionnaire survey was administered among grades 4 to 6 students and junior school, senior school students in Yixing City using Depression Anxiety and Stress Scale-21 (DASS-21), Insomnia Severity Index (ISI), Family Environment Scale (FES), and modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), Ottawa Self injury Inventory (OSI). A total of 4 180 students were included in the analysis. Different types of depression and anxiety in students and their influencing factors were analyzed by the Chi squaretest and multivariate Logistic regression. Results: The overall prevalence of depression and anxiety among primary and secondary school students were 16.6% and 22.4%, respectively, with 14.0% of depression and anxiety comorbidities. The Logistic regression results showed that, compared to students with low depression-low anxiety, students of depression and anxiety who had parents in conflicts ( OR =3.06), smoked ( OR =3.16), exhibited moderate food addiction ( OR =3.56), and had non suicidal self injury (NSSI) ( OR =2.26) were more likely to be classified as a depression predominant-depression anxiety type. Students of depression and anxiety who consumed alcohol ( OR =2.00), had serious food addiction ( OR =5.44), moderate to severe insomnia ( OR =3.25), and mild insomnia ( OR =1.88) were more likely to be classified as anxiety predominant-depression anxiety type. Students of depression and anxiety with low mood ( OR =10.87), mild food addiction ( OR =2.00), moderate food addiction ( OR =4.32), and severe food addiction ( OR =7.35), mild ( OR =2.96) or moderate to severe ( OR =16.52) insomnia, and NSSI ( OR =4.24) were more likely to be classified as the severe depression anxiety type( P < 0.05 ). Conclusions There are significant differences between different depression-anxiety types among primary and secondary school students with respect to food addiction, insomnia, NSSI, smoking, and alcohol use. Relevant departments should engage with schools and families to adopt targeted interventions for students to reduce the occurrence of mental health problems.