ObjectiveTo analyze the epidemiological characteristics of clustered vomiting and diarrhea outbreaks in Minhang District of Shanghai, to identify the influencing factors of outbreak scale and duration of epidemic, and to provide scientific evidence for further strengthening surveillance early-warning efforts in key settings and for optimizing prevention and control measures. MethodsThe data for describing epidemiological characteristics of clustered vomitting and diarrhea outbreaks in Minhang District from 2018 to 2023 were collected, multivariable logistic regression models were applied to analyze the influencing factors for epidemic scale,and Spearman rank correlation analyses were applied to analyze the factors duration. ResultsA total of 136 clustered vomiting and diarrhea outbreaks were reported in Minhang District from 2018 to 2023, all occurring in school settings, with an overall attack rate of 0.90%. The outbreaks exhibited distinct seasonality, predominantly occurring from October to December (43.38%) and March to May (32.35%). The primary settings were preschools (45.59%) and elementary schools (44.12%), with students accounted for the majority of cases (99.48%). The predominant clinical manifestation was vomiting (90.44%), with person-to-person contact being the primary transmission route (98.53%). Norovirus genogroup Ⅱ was identified as the main pathogen (71.32%). Standardized terminal disinfection of outbreak sites (OR=0.39, 95%CI=0.20‒0.74) and effective isolation of affected classes (OR=0.23, 95%CI=0.09‒0.57) were significant protective factors for reducing outbreak scale. Both response time (r=0.64, P<0.001) and the number of case generations (r=0.71, P<0.001) showed positive correlations with outbreak duration. ConclusionSchools are the key settings for the prevention and control of clustered vomiting and diarrhea outbreaks in Minhang District, with peak occurring in autumn and spring. Early detection, timely reporting, and prompt response to outbreaks are crucial. Strengthening school-based surveillance systems and standardizing outbreak management protocols are of particular importance.

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.

The regulatory role of long non-coding RNA (lncRNA) in cancer radiosensitivity has obtained increasing attention. Radiotherapy is one of the primary treatment methods for cancer, yet some patients experience disease progression or recurrence due to radioresistance. Exploring the regulatory mechanisms of radiosensitivity during cancer radiotherapy and identifying new molecular therapeutic targets are crucial for enhancing the efficacy of cancer radiotherapy. LncRNA can participate in the response of cancer to radiotherapy and regulate cancer radiosensitivity through various pathways, including modulation of the DNA damage response, apoptosis, cancer stem cells, and epithelial-mesenchymal transition (EMT). This study discussed the research progress on the mechanisms of lncRNA in the field of cancer radiotherapy, highlighting their important roles in enhancing tumor radiosensitivity.

Objective:To summarize the experience of assisted pregnancy through preimplantation genetic testing for monogenic diseases (PGT-M) in a Norrie disease family where the female has undifferentiated connective tissue disease and thrombosis.Methods:This article mainly reported the clinical process for a patient with a heterozygous deletion in exon 2 of the NDP gene combined with undifferentiated connective tissue disease and thrombosis, which was conducted through a multidisciplinary diagnostic and therapeutic process involving reproductive genetics, reproductive medicine, ophthalmology, rheumatology, and obstetrics. The stages of treatment included family pedigree construction, controlled ovarian hyperstimulation, embryo testing, frozen-thawed embryo transfer, amniocentesis, as well as antenatal and perinatal monitoring. Results:The patient successfully conceived and gave birth to a healthy baby girl at full term.Conclusion:Through multidisciplinary management, we successfully helped the couple achieve a healthy offspring with one PGT-M cycle, thus relieved their psychological and physiological burden.

OBJECTIVE To assess the efficacy of bioabsorbable steroid-releasing sinus stents for improving surgical outcomes and subjective symptoms when placed in the bilateral frontal sinus opening(FSO)following full functional endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).METHODS CRSwNP patients who had under full functional endoscopic sinus surgery with complete data of nasal endoscopy and sinus computed tomography data were identified and included in the study.The patients were divided into a control group consisting of patients receiving only full functional endoscopic sinus surgery(n=92)and a stent group consisting of patients receiving full functional endoscopic sinus surgery combined with placement of steroid implants in both FSO(n=38).The visual analogue scale(VAS)subjective symptom scores and surgical outcomes were compared preoperatively,and on postoperative day(PD30 and PD90)between the two groups.RESULTS Compared to baseline,the overall symptom VAS scores of patients after operation decreased significantly in both groups(P<0.05),and the degree of improvement of overall symptoms in the stent group was significantly better than in the control group(P<0.05).On PD30,the proportion of patients requiring postoperative interventions for bilateral FSO was reduced by 42.3%in the stent group,and was significantly lower than in the control group(P<0.05).Compared to the control group,the proportion of patients needing postoperative intervention in both ethmoid sinus on the stent group decreased by 17.7%(P>0.05).The results at PD90 were consistent with those at PD30.CONCLUSION Full functional endoscopic sinus surgery in combination with bilateral frontal sinus stent implantation is better than full functional endoscopic sinus surgery alone.

BACKGROUND:Mechanical factors can affect the angiogenic ability of vascular endothelial cells.How the vessel number affects the hydrodynamic properties of microvessels remains to be clarified. OBJECTIVE:To investigate the influence of vessel number on the hydrodynamics of vascular networks based on computational fluid dynamics. METHODS:Three three-dimensional models of vascular network with different vessel numbers were constructed using the Geometry module of ANSYS 19.0 software,and then the vascular network was meshed to tetrahedral elements in Mesh module.The vascular network was assumed to rigid wall without slip,and the blood was assumed to laminar,viscous,and incompressible Newtonian fluid.Blood density,velocity,and a series of blood viscosity coefficients were also established.The Navier-Stokes equation was used for calculation.Hydrodynamic properties of different parts of vascular network with different vessel numbers were analyzed and compared. RESULTS AND CONCLUSION:The streamline,velocity,and mass flow all had the same trend in the vascular network,that is,the outlet and inlet were higher and the middle junction of vascular network was lower.The more the number of vessels,the thinner the blood flow lines in each part of the vascular network.Also,the velocity,mass flow,and wall shear decreased with the increase of the number of blood vessels.Therefore,the changes in vessel number could influence the hydrodynamic environment in the vascular network.Computational fluid dynamics indicates that the changes in vessel numbers can influence the hydrodynamic properties of blood,and provides a new idea for treating bone hypoperfusion-induced diseases(fracture nonunion,bone defect,osteoporosis,etc.)through tonifying kidney and activating blood circulation based on the coupling between angiogenesis and osteogenesis.

OBJECTIVE To identify the key genes associated with lymph node metastasis in head and neck squamous carcinoma(HNSCC)and construct a prognostic model based on The Cancer Genome Atlas(TCGA)database.METHODS Differentially expressed genes(DEGs)between tumor tissues and normal tissues in the HNSCC dataset in the TCGA database were screened by R software,and gene modules related to lymph node metastasis were screened by weighted gene co-expression network(weighted gene co-expression network analysis,WGCNA).Prognostic risk models were constructed by univariate cox regression and Lasso regression analyses.Survival analyses and ROC curves were performed to verify the Reliability of prognostic models.CIBERSORT,TIMER and ESTIMATE algorithms analysed the differences in the tumor micro environment(TME)of different risk groups.RESULTS There were 2 565 DEGs screened,and a set of gene modules highly correlated with disease prognosis and lymph node metastasis were obtained by WGCNA analysis,and correlation analysis verified that the expression of genes in this gene module was highly correlated with lymph node metastasis.Univariate cox regression and Lasso regression were used to identify 6 key prognostic genes:CDKN2A,CCNE2,KNSTRN,AURKA,KPNA2,and ORC1.A prognostic model was constructed based on the 6 genes,and survival analysis showed that the prognosis of the high-risk group was significantly worse than that of the low-risk group(P<0.0001).The ROC curves demonstrated the good predictive performance of this prognostic model.CIBERSORT analyses revealed differences in the immune microenvironment of tumors in different risk groups.CONCLUSION The 6 key prognostic genes screened were helpful in predicting the prognosis of HNSCC patients and were closely associated with the immune microenvironment of HNSCC,suggesting that they may serve as potential therapeutic targets.

Objective:To explore the efficacy of ansa cervicalis anterior root-recurrent laryngeal nerve (RLN) anastomosis in the treatment of unilateral vocal fold paralysis (UVFP) and to analyze the effect of different pathogenic factors on efficacy.Methods:From January 2010 to January 2022, 428 patients (187 males and 241 females) at Changhai Hospital with UVFP who underwent ansa cervicalis anterior root-RLN anastomosis due to thyroid surgery, thoracic surgery, idiopathic vocal ford paralysis or high cranial base injury were analyzed. The course of nerve injury ranged from 6 to 24 months. Videostroboscopy, auditory perceptual evaluation parameters (GRBAS including Grade, Roughness, Breathiness, Asthenia, Strain), Voice Handicap Index (VHI-10), acoustic analysis including Jitter, Shimmer and noise to harmonic ratio (NHR), maximum phonation time (MPT) and laryngeal electromyography were used to evaluate the surgery efficacy, and the therapeutic difference of the above 4 different etiology patients receiving the operation was compared. Data processing was performed using SPSS 26.0 statistical software, and Wilcoxon signed rank test was used. Kruskal Wallis one-way ANOVA was used for those with equal variance.Results:At 12 months after operation, the affected vocal ford position, vocal ford edge, glottal closure, symmetry and regularity of vocal ford vibration were significantly improved in all four groups ( P<0.01). G, R, B, A, S, VHI-10, Jitter, Shimmer and NHR were significantly lower than those before operation, while, MPT was significantly longer ( P<0.01). Also, the maximum voluntary motor unit recruitment (VMUR) in the affected thyroarytenoid muscles and posterior cricoarytenoid muscles was significantly improved after surgery ( P<0.01). However, the results of thyroid surgery group, thoracic surgery group and idiopathic vocal ford paralysis group were better than those of high cranial base injury group respectively, and the differences were statistically significant ( P<0.05). Conclusion:Ansa cervicalis anterior root-RLN anastomosis has an obvious efficacy on the recovery of phonatory function in UVFP patients with different causes, but the high cranial base injury is significantly worse than that of vocal ford paralysis caused by other causes.

Objective:To summarize the experience of assisted pregnancy through preimplantation genetic testing for monogenic diseases (PGT-M) in a Norrie disease family where the female has undifferentiated connective tissue disease and thrombosis.Methods:This article mainly reported the clinical process for a patient with a heterozygous deletion in exon 2 of the NDP gene combined with undifferentiated connective tissue disease and thrombosis, which was conducted through a multidisciplinary diagnostic and therapeutic process involving reproductive genetics, reproductive medicine, ophthalmology, rheumatology, and obstetrics. The stages of treatment included family pedigree construction, controlled ovarian hyperstimulation, embryo testing, frozen-thawed embryo transfer, amniocentesis, as well as antenatal and perinatal monitoring. Results:The patient successfully conceived and gave birth to a healthy baby girl at full term.Conclusion:Through multidisciplinary management, we successfully helped the couple achieve a healthy offspring with one PGT-M cycle, thus relieved their psychological and physiological burden.