Objective:To investigate the value of electronic nasolaryngoscope combined with nasopharyngeal three dimensional computed tomography(3D-CT)in postoperative assessment for the surgery of pediatric tonsil adenoid.Methods:A total of 106 pediatric patients with tonsil adenoid admitted to the Affiliated Hospital of Weifang Medical College from January 2021 to January 2024 were selected,and all of them underwent electronic nasal laryngoscopy combined with nasopharyngeal 3D-CT before and after surgery.According to different assessment methods,pediatric patients who underwent the assessment of electronic nasolaryngoscope combined with nasopharyngeal 3D-CT were included in the combined assessment group(42 patients),and pediatric patients who underwent the assessment of electronic nasolaryngoscope were included in the electronic nasolaryngoscope assessment group(30 patients),and pediatric patients who underwent the assessment of nasopharyngeal 3D-CT were included in the nasopharyngeal 3D-CT assessment group(34 patients).Descriptive statistics was conducted on the basic characteristics of the three groups.The accuracies of nasopharyngeal 3D-CT combined with electronic nasolaryngoscope,the single electronic nasolaryngoscope,and the single nasopharyngeal 3D-CT in the postoperative assessment were calculated and compared.Results:In assessment effect of 42 pediatric patients of the combined assessment group,20 cases were effective,and 22 cases were ineffective,and the effective rate of assessment was 47.62%(20/42).In assessment effect of 30 pediatric patients of the electronic nasolaryngoscope assessment group,5 cases were effective,and 25 cases were ineffective,and effective rate of assessment was 16.67%(5/30).In assessment effect of 34 pediatric patients of the nasopharyngeal 3D-CT assessment group,13 cases were effective and 21 cases were ineffective,and the effective rate of assessment was 38.24%(13/34).The effective rate of the assessment of the combined assessment group was significantly higher than that of each single assessment group,and the difference was statistically significant(x2=7.414,P<0.05).The sensitivity,specificity,accuracy,positively predictive value and negatively predictive value of the combined assessment were respectively 47.60%,83.30%,55.60%,80.00%and 53.60%.These indicators of single electronic nasolaryngoscope assessment were respectively 16.70%,47.60%,35.70%,18.20%and 44.40%.These indicators of single nasopharyngeal 3D-CT assessment were respectively 38.20%,83.30%,50.00%,72.20%and 54.30%.Conclusion:The combined application of nasopharyngeal 3D-CT and electronic nasolaryngoscope can improve the accuracy of postoperative assessment for the surgery of pediatric tonsil adenoid,and it is helpful to timely find and deal with postoperative problems,and improve the treatment effect.

Objective:To investigate the application and effectiveness of slit-lamp microscope demonstration combined with supervisory clinical teaching in ophthalmology training for general practice residents.Methods:Sixty general practice residents who underwent ophthalmology training in Fifth Affiliated Hospital of Sun Yat-sen University from March 2021 to March 2023 were randomly assigned to 2 groups. In the traditional teaching group ( n=29), the teaching was primarily led by the instructors, and trainees observed and recorded the clinical findings under their guidance; while in the combined teaching group ( n=31), the trainees received integrated slit-lamp microscope demonstration and supervisory outpatient teaching. Both groups underwent a unified exit examination after the training, with the scores based on knowledge, diagnostic skills, comprehensive evaluation and overall performance. Additionally, satisfaction with the teaching process was assessed through questionnaires completed by both trainees and instructors. Results:There were no significant differences in gender composition, age and initial exam scores between the two groups (all P>0.05). Upon completion of the training, the combined teaching group scored higher in ophthalmology knowledge, outpatient diagnostic skills, and overall performance compared to the traditional teaching group (all P<0.05). Satisfaction scores from both trainees and instructors were also higher in the combined teaching group compared to the traditional teaching group (all P<0.05). Conclusion:The use of slit-lamp microscope demonstration combined with supervisory outpatient teaching can significantly enhance the effectiveness of ophthalmology training for general practice residents.

This study aims to prepare altrenogest extended-release tablets,evaluate their quality and establish a content determination method.The hydrophilic gel skeleton type,dosage and core thick-ness of altrenogest extended-release tablets were used as the investigating factors,and the release degree of the tablets was used as the investigating index,the prescription process of altrenogest ex-tended-release tablets was optimized by one-factor screening and central combinatorial design re-sponse surface method,and quality evaluation was carried out,the in vitro release model was es-tablished,and a high-performance liquid chromatography(HPLC)assay method was set up for the determination of altrenogest extended-release tablets.The results showed that the optimal pre-scription of altrenogest extended-release tablets was 2％as the main drug,70％as the solubilizer,0.5％as the lubricant,19.1％as the filler,8.4％as the hydrophilic gel skeleton material,and the thickness of the tablets was 3.8 mm.The in vitro drug release conformed to the Higuchi model,and the altrenogest showed a good linear relationship with the R2=0.999 98 in the range of 10-80 mg/L.The optimized process for the extended-release tablets was stable and had a good quality.The extended-release tablets were stable and had significant slow-release effect.The HPLC method is accurate and reliable and can be used for the determination of altrenogest in extended-release tablets.

Objective To investigate the relationship between peripheral blood immunoglobulin,erythrocyte sedimentation rate(ESR),homocysteine(Hey)and the severity of central nervous system vasculitis(CNSV)in children,as well as its impact on prognosis.Methods A total of 103 children with CNSV from February 2018 to February 2023 were selected as the study group,and 103 healthy children as the control group.The peripheral blood levels of immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),ESR and Hcy were compared between the 2 groups to evaluate the relationship between each index and the degree of CNSV disease[Birmingham vasculitis disease activity score(BVAS)]and its predictive value for prognosis.Results The levels of peripheral blood IgA,IgG,IgM,ESR and Hcy in the study group were higher than those in the control group of healthy children(P＜0.05);the BVAS scores and the levels of peripheral blood IgA,IgG,IgM,ESR and Hcy in children with active disease were higher than those in children with inactive disease(P＜0.05);the levels of peripheral blood IgA,IgG,IgM,ESR and Hcy were positively correlated with the BVAS scores in children with CNSV(P＜0.05);two cases were lost to follow-up after 6 months.Among the children with CNSV,76 had good prognosis and 25 poor prognosis.The levels of peripheral blood IgA,IgG,IgM,ESR and Hcy in children with poor prognosis were higher than those in children with good prognosis(P＜0.05);before and after correcting for other factors,peripheral blood IgA,IgG,IgM,ESR and Hcy were all independent factors affecting the prognosis of children with CNSV(P＜0.05);the area under curve(AUC)of peripheral blood IgA,IgG,IgM,ESR and Hey for predicting the prognosis of children with CNSV was 0.747,0.808,0.841,0.839,and 0.746,respectively,with optimal cutoff values of 350.58 mg/dL,1513.06 mg/dL,124.84 mg/dL,51.22 mm/h,and 13.66 pmol/L,respectively;the AUC of peripheral blood IgA,IgG,IgM,ESR and Hey for jointly predicting the prognosis of children with CNSV was 0.943(95％CI 0.878-0.979),with a sensitivity of 92.00％and a specificity of 93.42％,which was superior to individual prediction of each indicator.Conclusion Peripheral blood IgA,IgG,IgM,ESR and Hey are positively correlated with the severity of CNSV.Abnormally high expression increases the risk of poor prognosis,and the combined predictive value is reliable.

To analyze the methodological and reporting quality of systematic reviews of prediction models published in Chinese journals, with the aim of providing reference for enhancing the overall quality of Chinese systematic reviews of prediction models.

Objective:To investigate the correlation and predictive value of serum miR-149-5p and matrix metalloproteinase-9 (MMP-9) and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received intravenous thrombolytic therapy in Shangqiu First People's Hospital from September 2019 to February 2022 were enrolled prospectively. They were divided into HT group and non-HT group according to whether HT occurred after intravenous thrombolysis. Serum miR-149-5p and MMP-9 were measured by real-time fluorescence quantitative polymerase chain reaction and enzyme-linked immunosorbent assay respectively. Multivariate logistic regression analysis was used to determine the independent risk factors for HT after thrombolysis. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum miR-149-5p, MMP-9 and their combination for HT after intravenous thrombolysis. Results:A total of 358 patients with AIS received intravenous thrombolytic therapy were enrolled, 71 of them (19.83%) developed HT. The serum MMP-9 in the HT group was significantly higher than that in the non-HT group (273.95±35.23 μg/L vs. 202.71±30.52 μg/L; t=17.062, P<0.001), while the serum miR-149-5p was significantly lower than that in the non-HT group (0.26±0.06 vs. 1.03±0.15; t=42.387, P<0.001). Multivariate logistic regression analysis showed that atrial fibrillation (odds ratio [ OR] 2.282, 95% confidence interval [ CI] 1.731-3.008; P<0.001), time from onset to intravenous thrombolysis ( OR 2.334, 95% CI 1.458-3.735; P<0.001), miR-149-5p ( OR 1.758, 95% CI 1.142-2.705; P=0.010) and MMP-9 ( OR 1.535, 95% CI 1.106-2.129; P=0.010) were the independent risk factors for HT after intravenous thrombolysis. Serum miR-149-5p (area under the curve 0.856, 95% CI 0.803-0.909; when the optimal cut-off value was 0.741, the sensitivity was 80.3% and the specificity was 89.9%), MMP-9 (area under the curve 0.875, 95% CI 0.821-0.929; when the optimal cut-off value was 240.051 μg/L, the sensitivity was 83.1% and the specificity was 90.2%) and their combination (area under the curve 0.897, 95% CI 0.854-0.941; sensitivity 84.5% and specificity 90.6%) had better predictive value for HT after thrombolysis, and there were no significant differences in the predictive value among the three. Conclusions:After intravenous thrombolysis, the serum miR-149-5p is lower and MMP-9 is higher at admission in patients with HT in patients with AIS. Both of them and their combination have better predictive value for HT after intravenous thrombolysis.

Objective To assess the level and trend of community acquired respiratory distress syndrome (CARDS) toxin after the infection of Mycoplasma pneumonia(MP),and evaluate the clinical characteristics,the level of immunoglobulin E (IgE) and interleukin-4 (IL-4) so as to find the association among these factors.Methods According to whether the child had wheezing symptoms,all the 63 children were divided into wheezing group (26 ca-ses) and non-wheezing group (3 cases).The levels of CARDS toxin were respectively detected in the acute stage of MP infection,3 and 6 months later after MP infection in different groups,moreover,IgE and IL-4 levels were monitored at the same time.Results (1) The mean level of IgE were (384.96 ± 316.62) × 103 IU/L and (87.32 ± 66.32) × 103 IU/L in wheezing group and non-wheezing group,respectively,and there was statistically significant difference (P ＜ 0.05).(2) The load of CARDS toxin in wheezing group and non-wheezing group were (1.87 ± 0.62) Delta Rn and (1.15 ± 0.48) Delta Rn in the stage of acute infection,respectively,and there was statistically significant difference (P ＜ 0.05).Nevertheless,differences between 2 groups after 3 months and 6 months were not significant.(3) In the acute stage,the level of CARDS toxin in the severe cases were higher than the mild cases [(2.37 ± 0.37) Delta Rn vs (1.21 ± 0.45) Delta Rn],and there was statistically significant difference (P ＜ 0.05).(4) IL-4 showed significant difference in the acute stage and 3 months later after acute infection between 2 groups,however,there were no difference between 2 groups after 6 months later.(5)The load of CARDS toxin showed no significant difference between 2 groups at 3 months [(0.96 ± 0.35) vs.(0.99 ± 0.40) Delta Rn,P =0.757] and 6 months [(0.67 ± 0.20) vs.(0.69 ±0.32) Delta Rn,P =0.641] later after MP infection.(6)The children in wheezing group coughed for (24.89 ±7.04) days after acute infection and the last time for non-wheezing group was (16.46 ± 4.79) days,and there was statistically significant difference(P =0.000).Conclusions The load of CARDS toxin decreased after acute MP infection and it was still detectable six months after onset in the blood.The level of CARDS toxin was associated with the cough and wheezing symptom and the severity of disease.

Objective To investigate the clinical value of homemade uniform drainage system and application results in continuous lumbar drainage of cerebrospinal fluid. Methods A total of 75 patients underwent continuous lumbar cistern drainage of cerebrospinal fluid in patients with mechanical sampling were randomly divided into two groups, the control group (35 cases) using the traditional methods of continuous lumbar cistern drainage, the test group (40 cases) with self-designed uniform drainage device, compared with two groups of 24 hours from fluid volume flow control and the incidence of adverse reactions and the workload of nurses. Results The drainage rate equilibrium, the frequency of inspections and time respectively and the incidence of adverse reaction were (1.07 ± 0.35)/h, (23.67 ± 7.23) min/d and 5.00%(2/40) in the test group, less than that in the control group (2.14 ± 0.83)/h, (48.54 ± 11.69) min/d and 25.71%(9/35), there were significant differences (t=8.547, 7.641, χ2=16.347, all P <0.05). Conclusions In order to control the workload of nurses and reduce the incidence rate of adverse reactions, it is worth to promote the application of the continuous lumbar cistern drainage.

Objective To determine the efficiency and safety of Phloroglucinol and Misoprostol for cervix pretreat-ment before diagnostic hysteroscopy. Methods Trials were located through electronic searches of the PubMed, MED-LINE, Springer, CNKI, VIP, CBM, WanFang Data (from the date of establishment of the databases to June 2015). Bibliographies of the retrieved articles were also checked. Result A total of 18 trials involving 2 341 patients were included. The Meta-analysis showed: application of Phloroglucinol lenovo better open and dilate the cervix [O? =2.95, 95 % CI (1.96, 4.45), = 0.000]; To better clarity of the operative field [ O? = 9.50, 95 % CI (6.46, 13.98), = 0.000]; To better shorten the operation time [O? =-4.12, 95 % CI (-5.75,-2.49), =0.000];To bet-ter able to reduce the amount of intraoperative leakage [ O? =0.22, 95%CI (0.10, 0.49), = 0.0002]; and postop-erative adverse reactions should be significantly lower than Misoprostol [ O? = 0.01, 95 % CI (0.00, 0.04), =0.000]. The difference was statistically significant. Conclusions Phloroglucinol is more effective and safer than Miso-prostol in inducing proper cervical priming and may be the optimal choice for cervical pretreatment before diagnostic hysteroscopy.

Objective:To investigate the expression of hypoxia-inducible factor-2α (HIF-2α)in non-small cell lung cancer (NSCLC)tissue,and to analyze its relationships with angiogenesis,cell proliferation and chemotherapy resistance. Methods: Total 112 cases of NSCLC and 20 cases of normal lung tissues were selected, immunohistochemical method was used to detect the expressions of HIF-2α,CD31,Ki67 and GST-π in 112 cases of cancer tissue and 20 cases of normal lung tissue,and the correlations of HIF-2α expression with microvessel density (MVD),Ki67, and GST-π were analyzed.Results:The positive expression rate of HIF-2α in NSCLC tissue was significantly higher than that in normal lung tissue (P < 0.05 ), the expression rate of HIF-2α in 112 cases of NSCLC was 47.3% (53/112).The MVD in HIF-2α protein high expression NSCLC group (31.1 ± 14.7)was higher than that in HIF-2αprotein low expression NSCLC group (24.3±15.8)(P <0.05).The cases of high expression of Ki67 in HIF-2αhigh expression group occupied 54.7% (29/53),and it was higher than that in HIF-2αlow expression group (16/59,27.1%);there was significant difference (r = 0.281,P = 0.003).The high expression of HIF-2α had no obvious correlation with the expression of GST-π (r = 0.122,P = 0.202). Conclusion:HIF-2αmay play an important role in the carcinogenesis and development of NSCLC by promoting the angiogenesis and enhancing the cell proliferation of NSCLC,but it may have no correlation with chemotherapy resistance.