ObjectiveTo observe the changes in the levels of different subtypes of epidermal growth factor receptor （ErbB）， namely ErbB1， ErbB2， ErbB3， and ErbB4， in the spinal dorsal horn of inflammatory pain model rats， and to explore their mechanism of mediating hyperalgesia as well as the intervention mechanism of electroacupuncture at "Zusanli （ST 36）" and "Kunlun （BL 60）". MethodsThe study was divided into five parts. In experiment 1， 14 Sprague Dawley （SD） rats were randomly divided into control and inflammatory pain group （7 rats each group） to observe the pain behavior and the protein expression of different ErbB receptor subtypes in the spinal dorsal horn. In experiment 2， 30 rats were randomly divided into control group 1， inflammatory pain group 1， and low-， medium-， and high-concentration TX1-85-1 groups， with 6 rats in each group， to observe the effect of inhibiting spinal ErbB3 on inflammatory pain. In experiment 3， 12 rats were randomly divided into control virus group and ErbB3 knockdown virus group， with 6 rats in each group， to observe the effect of knocking down ErbB3 in the spinal dorsal horn on inflammatory pain. In experiment 4， 44 rats were randomly divided into control group 2， inflammatory pain group 2， electroacupuncture group， and sham electroacupuncture group， with 11 rats in each group， to observe the effect of electroacupuncture. In experiment 5， 40 rats were randomly divided into control group 3， inflammatory pain group 3， electroacupuncture group 1， and electroacupuncture + NRG1 group， with 10 rats in each group， to observe the effect of activating ErbB3 on electroacupuncture. A rat model of inflammatory pain was established by subcutaneous injection of 100 μl of complete Freund's adjuvant into the sole of the unilateral hind foot of SD rats. Rats in the low-， medium-， and high-concentration TX1-85-1 groups were intrathecally injected with ErbB3 inhibitor TX1-85-1 on day 5 to day 7 after modeling. Rats in the ErbB3 knockdown virus group were injected with ErbB3 knockdown virus packaged with adenovirus vector-based short hairpin RNA （shRNA） into the spinal dorsal horn in situ 3 weeks before modeling. Rats in each electroacupuncture group received electroacupuncture at bilateral "Zusanli （ST 36）" and "Kunlun （BL 60）" from day 1 to day 7 after modeling， with dense-sparse waves at a frequency of 2 Hz/100 Hz and a current of 0.5-1.5 mA for 30 minutes once a day. Rats in the electroacupuncture + NRG1 group were intrathecally injected with ErbB3 ligand recombinant human neuregulin-1 （NRG1） after electroacupuncture intervention from day 5 to day 7 after modeling. The mechanical withdrawal threshold and thermal withdrawal latency of rats were measured on day 1， 3， 5， and 7 after modeling to evaluate behavior， and Western Blot was used to detect the protein and phosphorylation levels of each ErbB subtype in the spinal dorsal horn. ResultsCompared with the control group， rats in the inflammatory pain group showed decreased mechanical withdrawal threshold and thermal withdrawal latency of rats， and increased expression of phosphorylated ErbB3 （p-ErbB3） protein in the spinal dorsal horn on days 1， 3， 5， and 7 after modeling （P＜0.01）. On day 5 and day 7 after modeling， compared with the inflammatory pain group 1， the mecha-nical withdrawal threshold and thermal withdrawal latency of rats in the medium- and high-concentration TX1-85-1 groups increased， and the expression of p-ErbB3 protein decreased （P＜0.05）. On day 1， 3， 5， and 7 after modeling， compared with the control virus group， the mechanical withdrawal threshold and thermal withdrawal latency of rats in the ErbB3 knockdown virus group increased （P＜0.05）. On day 5 and day 7 after modeling， compared with the inflammatory pain group 2 and the sham electroacupuncture group， the mechanical withdrawal threshold and thermal withdrawal latency of rats in the electroacupuncture group increased， and the expression of p-ErbB3 protein decreased （P＜0.05）. On day 5 and day 7 after modeling， compared with the electroacupuncture + NRG1 group， the mechanical withdrawal threshold and thermal withdrawal latency of rats in the electroacupuncture group 1 increased （P＜0.05）. ConclusionThe p-ErbB3 in the spinal dorsal horn involved in hyperalgesia in rats with inflammatory pain， and electroacupuncture at "Zusanli （ST 36）" and "Kunlun （BL 60）" can alleviate inflammatory pain by inhibiting the expression of p-ErbB3 protein in the spinal dorsal horn of rats.

Adams-Oliver syndrome is a rare genetic disease. We retrospectively analyzed the clinical data of two neonates with Adams-Oliver syndrome and large congenital scalp defects admitted to Tangshan Maternal and Child Health Hospital, and summarized their clinical manifestations and treatment methods in combination with literature. The two patients were full-term infants, both with lower limbs and heart congenital malformations, combined with leukodystrophy. One patient with Adams-Oliver syndrome underwent karyotype analysis, and the chromosomes were polymorphic (46, XX, 15pstk+). Both cases of congenital scalp defects were treated conservatively. For neonates with large congenital scalp defects, accompanied by congenital malformation at the extremities and heart as well as abnormal development of the central nervous system. Adams-Oliver syndrome should be considered and relevant pathogenic gene testing should be completed to provide a basis for precise diagnosis and treatment.

Adams-Oliver syndrome is a rare genetic disease. We retrospectively analyzed the clinical data of two neonates with Adams-Oliver syndrome and large congenital scalp defects admitted to Tangshan Maternal and Child Health Hospital, and summarized their clinical manifestations and treatment methods in combination with literature. The two patients were full-term infants, both with lower limbs and heart congenital malformations, combined with leukodystrophy. One patient with Adams-Oliver syndrome underwent karyotype analysis, and the chromosomes were polymorphic (46, XX, 15pstk+). Both cases of congenital scalp defects were treated conservatively. For neonates with large congenital scalp defects, accompanied by congenital malformation at the extremities and heart as well as abnormal development of the central nervous system. Adams-Oliver syndrome should be considered and relevant pathogenic gene testing should be completed to provide a basis for precise diagnosis and treatment.

Objective:To evaluate the reliability and validity of the Chinese version of HEMO-FISS-QoL(HF-QoL) questionnaire (HF-QoL-C) in the Chinese population with hemorrhoids.Methods:From November 2021 to November 2022, a self-constructed general information questionnaire, HF-QoL-C, and the 36-item short form health survey (SF-36), Goligher classification, and Giordano severity of hemorrhoid symptom questionnaire (GSQ) were used to conduct a questionnaire survey on 760 hemorrhoid patients in the anorectal department of six hospitals. The data was analyzed for reliability and validity using SPSS 21.0 and AMOS 26.0 software.Results:The Cronbach's α coefficient of HF-QoL-C and its dimension ranged from 0.831 to 0.960, and the split coefficient was 0.832-0.915. Four common factors were extracted through principal component exploratory factor analysis. Confirmatory factor analysis indicated acceptable structural validity( χ2/ df=8.152, RSMEA=0.097, CFI=0.881, IFI=0.881, NFI=0.867). HF-QoL-C was correlated with SF36 and GSQ( r=-0.694, 0.501, both P<0.01). There were differences in the total score and dimensional scores of HF-QoL-C between surgical and drug treated patients, different grades of Goligher classification for hemorrhoidal disease, and different ranges of hemorrhoid prolapse (all P<0.001). No ceiling effect was found in the total score and the scores of each dimension(0.3%-2.0%). There was a floor effect in both psychological function and sexual activity dimensions (16.7%, 35.1%). Conclusion:HF-QoL-C has good reliability and validity, which can be used to measure the quality of life of Chinese hemorrhoid patients.

With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.

Objective:To evaluate the effect of N-acetylcysteine (NAC) in relieving discomfort symptoms after esophageal Lugol′s iodine staining.Methods:From April 1 to September 30, 2023, a total of 204 subjects who received endoscopy at the First Affiliated Hospital of Shihezi University were enrolled. All the subjects were stained with 10 mL 1.5% compound iodine solution after endoscopy. According to random number table method, the 204 subjects were randomly divided into two groups which received 20 mL 0.9% sodium chloride solution (sodium chloride group, 103 cases) and 10% NAC (NAC group, 101 cases) to neutralize the iodine, respectively. The primary outcome indicators of the subjects of the two groups were analyzed, including the incidence of retrosternal burning sensation and pharyngeal discomfort 15 and 30 min after spraying the neutralization solution, and the degree of discomfort was evaluated by visual analogue scale (VAS). Fisher′s exact probability method and non-parametric test were used for statistical analysis.Results:The incidence of retrosternal burning sensation and pharyngeal discomfort 15 and 30 min after spraying the neutralization solution in the sodium chloride group were higher than those in the NAC group (15 min: 17.5% (18/103) vs. 2.0% (2/101), 10.7% (11/103) vs. 1.0% (1/101); 30 min: 11.7%(12/103) vs. 1.0% (1/101), and 5.8% (6/103) vs. 0 (0/101)), and the differences were statistically significant (Fisher′s exact probability method, P<0.001, =0.005, =0.003, and =0.029). There was no significant difference in the VAS score 15 min after spraying neutralization solution between the sodium chloride group and the NAC group (3.00 (3.00, 4.25) vs. 4.00 (3.00, 5.25), P>0.05). At 30 min after spraying the neutralization solution, the VAS score of the sodium chloride group was higher than that of the NAC group (4.00(3.75, 5.00) vs. 1.50(1.00, 1.50)), and the difference was statistically significant ( Z=-2.37, P=0.007). Conclusion:NAC can effectively relieve the discomfort caused by esophageal iodine staining.

Objective:To evaluate the effect of N-acetylcysteine (NAC) in relieving discomfort symptoms after esophageal Lugol′s iodine staining.Methods:From April 1 to September 30, 2023, a total of 204 subjects who received endoscopy at the First Affiliated Hospital of Shihezi University were enrolled. All the subjects were stained with 10 mL 1.5% compound iodine solution after endoscopy. According to random number table method, the 204 subjects were randomly divided into two groups which received 20 mL 0.9% sodium chloride solution (sodium chloride group, 103 cases) and 10% NAC (NAC group, 101 cases) to neutralize the iodine, respectively. The primary outcome indicators of the subjects of the two groups were analyzed, including the incidence of retrosternal burning sensation and pharyngeal discomfort 15 and 30 min after spraying the neutralization solution, and the degree of discomfort was evaluated by visual analogue scale (VAS). Fisher′s exact probability method and non-parametric test were used for statistical analysis.Results:The incidence of retrosternal burning sensation and pharyngeal discomfort 15 and 30 min after spraying the neutralization solution in the sodium chloride group were higher than those in the NAC group (15 min: 17.5% (18/103) vs. 2.0% (2/101), 10.7% (11/103) vs. 1.0% (1/101); 30 min: 11.7%(12/103) vs. 1.0% (1/101), and 5.8% (6/103) vs. 0 (0/101)), and the differences were statistically significant (Fisher′s exact probability method, P<0.001, =0.005, =0.003, and =0.029). There was no significant difference in the VAS score 15 min after spraying neutralization solution between the sodium chloride group and the NAC group (3.00 (3.00, 4.25) vs. 4.00 (3.00, 5.25), P>0.05). At 30 min after spraying the neutralization solution, the VAS score of the sodium chloride group was higher than that of the NAC group (4.00(3.75, 5.00) vs. 1.50(1.00, 1.50)), and the difference was statistically significant ( Z=-2.37, P=0.007). Conclusion:NAC can effectively relieve the discomfort caused by esophageal iodine staining.

Objective To observe the effects of pregnancy induced hypertension on lipid metabolism and bilirubin metabolism in term neonates.Methods 200 term neonates were selected and divided into the two groups,100 cases whose mother were healthy were control group and another 100 cases whose mother had gestational hypertension were observation group.Birth weight,measured in cord blood triglyceride (TG),total cholesterol (TC) levels,high density lipoprotein (HDL-C),low density lipoprotein (LDL-C),adiponectin (APN) level were recorded.Results Birth weight of the observation group had significantly lower birth weight (2 927 ± 492) g,than the weight of the control group (3 452 ± 348) g.The incidence of lower birth weight was higher than in the observation group.TG,LDL-C levels of the observation group were (0.6 ± 0.24) mmol/L,(1.95 ± 0.25) mmol/L,were higher than those of the control group[(0.39 ± 0.17) mmol/L,(1.95 ± 0.25) mmol/L].There was a statistically significant difference between the groups (t =12.35,2.35,P ＜ 0.01 or P ＜ 0.05).HL-C and APN of the observation group were lower than those of the control group (t =1.79,7.00,all P ＜ 0.05).Bilirubin after bomed 24 hours,48 hours,72 hours and bilirubin peak of the observation group were (8.64 ± 2.17) mg/L,(11.06 ± 3.12) mg/L,(10.32 ± 2.47) mg/L,(12.04 ± 2.13) mg/L and were higher than those of the control group [(3.06 ± 0.94) mg/L,(6.98 ± 1.56) mg/L,(7.26±1.89)mg/L,(9.64±1.98)mg/L](t=23.48,11.65,9.84,8.27,allP＜0.01).Conclusion Maternal PIH may affect birth weight,lipid metabolism and bilirubin metabolism.

Objective To evaluate the changes in the activity of extracellular signal-regulated kinase 5 (ERK5) in the distal cerebrospinal fluid contacting neurons (CSF-CNs) in the mid-brain of morphine dependent rats.Methods Forty-eight male adult Sprague-Dawley rats weighing 230-270 g,were randomly divided into 2 groups (n =24 each) using a random number table:control group (group A) and morphine dependence group (group B).Morphine dependence was induced by increasing doses of subautaneous morphine for 5 consecutive days.The initial dose of morphine was 10 mg/kg twice a day and was increased by 10 mg/kg everyday until 50 mg/kg on 5th dav.The equal volume of normal saline was injected subcutaneously instead of morphine in group A.On 3rd day after morphine dependence was induced,the distal CSF-CNs in the mid-brain was labeled with 30％ cholera toxin subunit B and horseradish peroxidase compound (CB-HRP) 3 μl injected in the lateral cerebral ventricle in the morning.At 4 h after the last injection of morphine,the segments in which CSF-CNs were located were removed,and CB-HRP positive neurons,phosphor-ERK5 (p-ERK5) positive neurons and CB-HRP/p-ERK5 positive neurons were counted.Results Compared with group A,the number of p-ERK5 and CB-HRP/p-ERK5 positive neurons in the mid-brain was significantly increased (P ＜ 0.05),and no significant change was found in CB-HRP positive neurons in group B (P ＞ 0.05).Conclusion The enhanced activity of ERK5 in the distal CSFCNs in the mid-brain may contribute to the development of morphine dependence in rats.

Objective To evaluate the role of spinal neuronal extracellular signal-regulated protein kinases 5/cAMP response element binding protein (ERK5/CREB) signaling pathway in withdrawal responses in morphinedependent rats.Methods Ninety-six adult male Sprague-Dawley rats in which intrathecal catheters were successfully placed,weighing 200-250 g,were randomly divided into 4 groups (n =24 each):normal control group (group A),morphine withdrawal group (group B),dimethyl sulfoxide (DMSO) + morphine withdrawal group (group C) and ERK5 inhibitor BIX02188 + morphine withdrawal group (group D).Morphine dependence (MD) was induced by increasing doses of subcutaneous morphine for 6 days.The initial dose of morphine was 10 mg/kg once a day and was increased by 10 mg/kg once a day from 2nd to 5th days until 50 mg/kg on 6th day in B,C and D groups.Morphine withdrawal response (MW) was induced by intraperitoneal naloxone 4 mg/kg at 4 h after last morphine administration in B,C and D groups.In addition,BIX02188 10 μg and 1％ DMSO 10 μl were injected intrathecally at 1 h before naloxone injection in D and C groups,respectively.MW and morphine withdrawal-induced hyperalgesia were scored.The rats were then sacrificed after hyperalgesia was scored and the spinal cord was removed for determination of CREB and phosphorylated CREB (p-CREB) expression.Results Compared with group A,MW and hyperalgesia scores were significantly increased and the expression of p-CREB was up-regulated in B,C and D groups.Compared with group B,MW and hyperalgesia scores were significantly decreased and the expression of p-CREB was down-regulated in D group,and no significant change was found in group C.Conclusion The spinal neuronal ERK5/CREB signaling pathway is involved in withdrawal responses in morphine-dependent rats.