Objective To study the correlation between the middle ear transfer function and the tympanoscle-rosis locations and severities,via idealized finite element simulations of the fixation effects of different parts of the middle ear.Methods A finite element model was developed based on human middle ear histological data,and the air-conduction sound transmission was simulated for verification.Mimicking tympanosclerosis with different loca-tions by increasing the Young's modulus of related tissues,the changes in the middle ear transfer function under tympanic membrane,ligaments,and joint fixations were calculated.Results Limited hardening of eardrum did not influence the sound transmission(＜5 dB).Ligaments hardening(including the superior mallear ligament,superior incudal ligament,and the posterior incudal ligament)induced fixations of the ossicular chain and caused low-to-mid velocity drop down of the tympanic membrane umbo and the stapes footplate.The results indicated low-to-mid fre-quency hearing loss,about 40 dB when the ligaments were fully fixed.The sound transmission was not affected by incudomalleolar joint,a slightly high frequency improvement(0～6 dB)occurred when the incudostapedial joint got hardened.Significant low-to-mid frequency drop was found for the stapes footplate velocity in the case of otosclero-sis,while the velocity of tympanic membrane umbo was not significantly affected.Conclusion Tympanosclerosis in-fluences middle ear sound transferring by increasing the stiffness of the system,the effects are sensitive to tympano-sclerosis locations and severity.Moreover,as the hardened location approaches the stapes,the variations of tympan-ic membrane and stapes footplate movement can be quite different.

Objective To explore the diagnosis,treatment and prognostic factors of urachal carcinoma(UrC),aiming to provide reference for the standardized diagnosis and treatment of this disease.Methods A retrospective analysis was conducted on the clinical data of 75 UrC patients confirmed with postoperative pathology treated in our hospital during Mar.2010 and Mar.2023.All patients underwent surgical treatment,and 35 received postoperative chemotherapy.Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors.Kaplan-Meier curves were adopted to calculate the cumulative survival rates and overall survival(OS).Results Among the 75 patients,the male to female ratio was 2.8∶1 and the mean age was(58.4±2.2)years.Median follow-up was 60 months and median OS was 48 months.The 3-year survival rate was 67.3％and the 5-year survival rate was 38.8％.There were 19 cases(25.3％)of CK7 positive,60 cases(80.0％)of Sheldon stage Ⅲ and above,and 26 cases(34.7％)of postoperative recurrence.CK7 positive(P=0.001),Sheldon staging Ⅲ+Ⅳ(P=0.005)and postoperative recurrence(P=0.003)were independent prognostic factors.Conclusion Urachal carcinoma is a rare malignant tumor in males with occult onset.CK7 positive,Sheldon staging and postoperative recurrence were independent prognostic factors of this disease.

Objective To explore the diagnosis,treatment and prognostic factors of urachal carcinoma(UrC),aiming to provide reference for the standardized diagnosis and treatment of this disease.Methods A retrospective analysis was conducted on the clinical data of 75 UrC patients confirmed with postoperative pathology treated in our hospital during Mar.2010 and Mar.2023.All patients underwent surgical treatment,and 35 received postoperative chemotherapy.Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors.Kaplan-Meier curves were adopted to calculate the cumulative survival rates and overall survival(OS).Results Among the 75 patients,the male to female ratio was 2.8∶1 and the mean age was(58.4±2.2)years.Median follow-up was 60 months and median OS was 48 months.The 3-year survival rate was 67.3％and the 5-year survival rate was 38.8％.There were 19 cases(25.3％)of CK7 positive,60 cases(80.0％)of Sheldon stage Ⅲ and above,and 26 cases(34.7％)of postoperative recurrence.CK7 positive(P=0.001),Sheldon staging Ⅲ+Ⅳ(P=0.005)and postoperative recurrence(P=0.003)were independent prognostic factors.Conclusion Urachal carcinoma is a rare malignant tumor in males with occult onset.CK7 positive,Sheldon staging and postoperative recurrence were independent prognostic factors of this disease.

Objective To study the correlation between the middle ear transfer function and the tympanoscle-rosis locations and severities,via idealized finite element simulations of the fixation effects of different parts of the middle ear.Methods A finite element model was developed based on human middle ear histological data,and the air-conduction sound transmission was simulated for verification.Mimicking tympanosclerosis with different loca-tions by increasing the Young's modulus of related tissues,the changes in the middle ear transfer function under tympanic membrane,ligaments,and joint fixations were calculated.Results Limited hardening of eardrum did not influence the sound transmission(＜5 dB).Ligaments hardening(including the superior mallear ligament,superior incudal ligament,and the posterior incudal ligament)induced fixations of the ossicular chain and caused low-to-mid velocity drop down of the tympanic membrane umbo and the stapes footplate.The results indicated low-to-mid fre-quency hearing loss,about 40 dB when the ligaments were fully fixed.The sound transmission was not affected by incudomalleolar joint,a slightly high frequency improvement(0～6 dB)occurred when the incudostapedial joint got hardened.Significant low-to-mid frequency drop was found for the stapes footplate velocity in the case of otosclero-sis,while the velocity of tympanic membrane umbo was not significantly affected.Conclusion Tympanosclerosis in-fluences middle ear sound transferring by increasing the stiffness of the system,the effects are sensitive to tympano-sclerosis locations and severity.Moreover,as the hardened location approaches the stapes,the variations of tympan-ic membrane and stapes footplate movement can be quite different.

Objective:To investigate the association of exposure to PM 2.5 and its constituents during pregnancy and fetal growth and to further identify critical windows of exposure for fetal growth. Methods:We included 4 089 mother-child pairs from the Jiangsu Birth Cohort Study between January 2016 and October 2019. Data of general characteristics, clinical information, daily average PM 2.5 exposure, and its constituents during pregnancy were collected. Fetal growth parameters, including head circumference (HC), abdominal circumference (AC), and femur length (FL), were measured by ultrasound after 20 weeks of gestation, and then estimated fetal weight (EFW) was calculated. Generalized linear mixed models were adopted to examine the associations of prenatal exposure to PM 2.5 and its constituents with fetal growth. Distributed lag nonlinear models were used to identify critical exposure windows for each outcome. Results:A 10 μg/m 3 increase in PM 2.5 exposure during pregnancy was associated with a decrease of 0.025 ( β=-0.025, 95% CI: -0.048- -0.001) in HC Z-score, 0.026 ( β=-0.026, 95% CI: -0.049- -0.003) in AC Z-score, and 0.028 ( β=-0.028, 95% CI:-0.052--0.004) in EFW Z-score, along with an increased risk of 8.5% ( RR=1.085, 95% CI: 1.010-1.165) and 13.5% ( RR=1.135, 95% CI: 1.016-1.268) for undergrowth of HC and EFW, respectively. Regarding PM 2.5 constituents, prenatal exposure to black carbon, organic matter, nitrate, sulfate (SO 42-) and ammonium consistently correlated with decreased HC Z-score. SO 42- exposure was also associated with decreased FL Z-scores. In addition, we found that gestational weeks 2-5 were critical windows for HC, weeks 4-13 and 19-40 for AC, weeks 4-13 and 23-37 for FL, and weeks 4-12 and 20-40 for EFW. Conclusions:Our findings demonstrated that exposure to PM 2.5 and its constituents during pregnancy could adversely affect fetal growth and the critical windows for different fetal growth parameters are not completely consistent.

Objective To investigate the mechanism of Sini San Formula in the treatment of ulcerative colitis and depression through"homotherapy for heteropathy"based on network pharmacology and molecular docking.Methods The TCMSP database was used to obtain the potential active components and their related targets;GeneCards,CTD,and TTD databases were used to screen the disease-related targets of ulcerative colitis and depression;the intersection of the predicted targets of the active components and the disease-related targets was used to obtain the potential targets(shared targets)for the treatment of ulcerative colitis and depression by Sini San Formula,and Cytoscape 3.7.2 software to construct a"Chinese medicinals-active components-diseases-common targets"network to analyze the core components;importing the common targets into the STRING database,constructing a common protein-protein interaction(PPI)network.The GO function and KEGG pathway enrichment of the shared targets were analyzed by DAVID database,and molecular docking between the core components and the key targets was verified.Results A total of 136 active components of Sini San Formula were obtained,and 220 potential targets of action(shared targets)for the treatment of ulcerative colitis and depression by Sini San Formula,involving 657 biological processes,70 cellular components,147 molecular functions and 133 signaling pathways.The screening yielded core active compounds such as quercetin,kaempferol,lignans,naringenin,7-methoxy-2-methylisoflavone,key target proteins such as JUN,MAPK3,STAT3,AKT1,and MAPK1,as well as signaling pathways such as TNF,IL-17,Th17 cellular differentiation,HIF-1,and Toll-like receptor.Five potential key targets have strong binding activity to quercetin,kaempferol,lignans and naringenin.Conclusion Sini San Formula may act on key targets such as JUN,MAPK3,STAT3,AKT1,MAPK1,etc.through active components such as quercetin,kaempferol,lignocerotonin,naringenin,etc.,and play the role of"homotherapy for heteropathy"for ulcerative colitis and depression through the signaling pathways such as TNF,IL-17,HIF-1,Toll-like receptor and Th17 cell differentiation.

Diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus. 4％～10％ of DM patients have DFU,of which 10％～20％ of ulcers fail to heal. Traditional treatment or surgical treatment is difficult to cure DFU fundamentally. The amputation rate of DFU patients is as high as 25％,and the 5-year mortality rate after surgery is as high as 39％～68％. Mesenchymal stem cells (MSCs) have high self-renewal ability and multi-directional differentiation potential,which can promote vascular regeneration,wound healing,and improve blood supply. This article reviews the research progress of MSCs in the treatment of DFU.

Diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus. 4％～10％ of DM patients have DFU,of which 10％～20％ of ulcers fail to heal. Traditional treatment or surgical treatment is difficult to cure DFU fundamentally. The amputation rate of DFU patients is as high as 25％,and the 5-year mortality rate after surgery is as high as 39％～68％. Mesenchymal stem cells (MSCs) have high self-renewal ability and multi-directional differentiation potential,which can promote vascular regeneration,wound healing,and improve blood supply. This article reviews the research progress of MSCs in the treatment of DFU.

This article was aimed to study medication rules of traditional Chinese medicine (TCM) in the treatment of gastric cancer. The history information of 111 hospitalized cases from 2008 to 2011 was collected from the Department of Oncology of Guang'anmen Hospital with the clinical collection system. The medication rules in the treatment of gastric cancer by TCM were explored by the scale-free network analysis from several aspects, such as effects, classifications and compatibility relations of Chinese medicine. The analysis result of 111 gastric cancer cases showed that strengthening the body resistance was the main treatment principle. Liujunzi decoction was the most frequently used prescription. In TCM compatibility, deficiency-nourishing herbs were the main ingredients, especiallyqi-supplementing herbs which take the first place in the prescription. And the heat-reducing herbs, dampness-eliminating herbs, blood-activating and stasis-eliminating herbs, food stagnation resolving herbs and qi regulation herbs were also used in the combination. Core herbs in the prescription for the treatment of gastric cancer were Tuckahoe, Codonopsis pilosula, Astragalus root, Pericarpium Citri Reticulatae, Fructus Aurantii, Nidus Vespae and etc. TCM treatment, syndrome differentiation and medication are varied according to different therapeutic stages and disease stages. The result showed that scale-free network analysis had certain significance in the understanding of medication rules of TCM treatment of gastric cancer.