Objective To compare the clinical efficacy and safety of ultrasound-guided microwave ablation(MWA)combined with percutaneous ethanol injection(PEI)and MWA alone for the treatment of cystic-solid thyroid nodules.Methods A computerized retrieval of academic papers concerning the randomized controlled trials(RCT)on the comparison of the effectiveness and safety between MWA combined with PEI(combination group)and MWA alone(simple MWA group)for cystic-solid thyroid nodules from the databases of PubMed,China National Knowledge Internet(CNKI),Wanfang Database,etc.was conducted.The quality of the enrolled articles was assessed according to the Newcastle-Ottawa scale(NOS)score.Results A total of six articles including 458 patients were finally included in this meta-analysis.Meta-analysis showed that the volume reduction rate of cystic-solid thyroid nodules in the combination group was higher than that of the simple MWA group(P＜0.05).No statistically significant differences in the complication incidences of hoarseness and fever existed between the two groups(both P＞0.05),but the complication incidences of bleeding and neck pain in the combination group were lower than those in the simple MWA group(both P＜0.05).Conclusion In treating cystic-solid thyroid nodules,MWA combined with PEI is superior to MWA alone in the curative effect and clinical safety.

Intracerebral hemorrhage (ICH) is a hemorrhagic cerebrovascular disease with high incidence and mortality. Oxidative stress response plays an important role in the pathological and physiological processes of ICH, and is also a potential effective target for clinical treatment. In this paper, the pathogenesis of oxidative stress after ICH, mechanism of nerve and vascular injury in oxidative stress, and detection and treatment of oxidative stress are reviewed in order to provide references for basic research and clinical practice in ICH.

Previous studies have proposed two cognitive mechanisms responsible for the Ebbinghaus illusion effect, i.e., contour interaction and size contrast. However, the neural underpinnings of these two mechanisms are largely unexplored. The present study introduced binocular depth to the Ebbinghaus illusion configuration and made the central target appear either in front of or behind the surrounding inducers in order to disturb size contrast instead of contour interaction. The results showed that the illusion effect, though persisted, was significantly reduced under the binocular depth conditions. Notably, the target with a larger perceived size reduced early alpha-band power (8-13 Hz, 0-100 ms after stimulus onset) at centroparietal sites irrespective of the relative depth of the target and the inducers, with the parietal alpha power negatively correlated with the illusion effect. Moreover, the target with a larger perceived size increased the occipito-parietal beta-band power (14-25 Hz, 200-300 ms after stimulus onset) under the no-depth condition, and the beta power was positively correlated with the illusion effect when the depth conditions were subtracted from the no-depth condition. The findings provided neurophysiological evidence in favor of the two cognitive mechanisms of the Ebbinghaus illusion by revealing that early alpha power is associated with low-level contour interaction and late beta power is linked to high-level size contrast, supporting the claim that neural oscillations at distinct frequency bands dynamically support different aspects of visual processing.
Humans ; Alpha Rhythm/physiology* ; Female ; Male ; Size Perception/physiology* ; Young Adult ; Adult ; Beta Rhythm/physiology* ; Photic Stimulation/methods* ; Illusions/physiology* ; Optical Illusions/physiology* ; Depth Perception/physiology*

Integrating multisensory inputs to generate accurate perception and guide behavior is among the most critical functions of the brain. Subcortical regions such as the amygdala are involved in sensory processing including vision and audition, yet their roles in multisensory integration remain unclear. In this study, we systematically investigated the function of neurons in the amygdala and adjacent regions in integrating audiovisual sensory inputs using a semi-chronic multi-electrode array and multiple combinations of audiovisual stimuli. From a sample of 332 neurons, we showed the diverse response patterns to audiovisual stimuli and the neural characteristics of bimodal over unimodal modulation, which could be classified into four types with differentiated regional origins. Using the hierarchical clustering method, neurons were further clustered into five groups and associated with different integrating functions and sub-regions. Finally, regions distinguishing congruent and incongruent bimodal sensory inputs were identified. Overall, visual processing dominates audiovisual integration in the amygdala and adjacent regions. Our findings shed new light on the neural mechanisms of multisensory integration in the primate brain.
Animals ; Macaca ; Acoustic Stimulation ; Auditory Perception/physiology* ; Visual Perception/physiology* ; Amygdala/physiology* ; Photic Stimulation

Objectives: . Branchio-oto syndrome (BOS) primarily manifests as hearing loss, preauricular pits, and branchial defects. EYA1 is the most common pathogenic gene, and splicing mutations account for a substantial proportion of cases. However, few studies have addressed the structural changes in the protein caused by splicing mutations and potential pathogenic factors, and several studies have shown that middle-ear surgery has limited effectiveness in improving hearing in these patients. BOS has also been relatively infrequently reported in the Chinese population. This study explored the genetic etiology in the family of a proband with BOS and provided clinical treatment to improve the patient’s hearing. Methods: . We collected detailed clinical features and peripheral blood samples from the patients and unaffected individuals within the family. Pathogenic mutations were identified by whole-exome sequencing and cosegregation analysis and classified according to the American College of Medical Genetics and Genomics guidelines. Alternative splicing was verified through a minigene assay. The predicted three-dimensional protein structure and biochemical experiments were used to investigate the pathogenicity of the mutation. The proband underwent middle-ear surgery and was followed up at 1 month and 6 months postoperatively to monitor auditory improvement. Results: . A novel heterozygous EYA1 splicing variant (c.1050+4 A>C) was identified and classified as pathogenic (PVS1(RNA), PM2, PP1). Skipping of exon 11 of the EYA1 pre-mRNA was confirmed using a minigene assay. This mutation may impair EYA1-SIX1 interactions, as shown by an immunoprecipitation assay. The EYA1-Mut protein exhibited cellular mislocalization and decreased protein expression in cytological experiments. Middle-ear surgery significantly improved hearing loss caused by bone-conduction abnormalities in the proband. Conclusion . We reported a novel splicing variant of EYA1 in a Chinese family with BOS and revealed the potential molecular pathogenic mechanism. The significant hearing improvement observed in the proband after middle-ear surgery provides a reference for auditory rehabilitation in similar patients.

Objective:To analyze the MRI features of medulloblastoma (MB) in children, and screen out the key signs that can predict the risk of MB before surgery.Methods:Clinical and radiological data of 62 children with MB confirmed by pathology in Shenzhen Children′s Hospital from December 2012 to December 2021 were retrospectively analyzed. According to the diagnosis and treatment guidelines for children with MB (2021 edition), the patients were divided into standard risk group (43 cases) and high risk group (19 cases). MRI features of MB were observed and recorded, including tumor site, location of tumor center, tumor morphology, signal intensity of T 1WI, T 2WI and diffusion weighted imaging (DWI), enhancement pattern, cystic lesion size, location and number, peritumoral edema and hydrocephalus, and the maximum diameter of tumor was measured. The χ 2 test or Fisher exact probability method was used to compare the differences in age, gender and MRI signs between the two groups. The t test of two independent samples was used to compare the differences in the maximum diameter of tumors between the two groups. The indicators with statistically significant differences were included in binary logistic regression analysis to obtain independent influencing factors associated with the risk groups. The receiver operation characteristic curve was used to evaluate the diagnostic efficacy. Results:There were significant differences in age ( P=0.026), enhancement pattern ( P=0.018), cystic lesion size ( P=0.005), location ( P=0.011) and number ( P=0.003) between standard risk group and high risk group. There were no significant differences in gender, tumor site, location of tumor center, tumor morphology, signal intensity of T 1WI, T 2WI and DWI, peritumoral edema, hydrocephalus and maximum diameter of tumor between the two groups ( P>0.05). Binary logistic regression results showed the age (OR=0.207, 95%CI 0.040-0.983, P=0.042) and the number of cystic lesions (OR=0.215, 95%CI 0.073-0.630, P=0.005) were the protective factors for MB in high risk group, the enhancement pattern Ⅲ (OR=5.226, 95%CI 1.516-52.920, P=0.048) was the dangerous factor for MB in high risk group. The area under the curve of the combined diagnosis of high risk MB was 0.845 (95%CI 0.741-0.949). Conclusions:The age and MRI signs the pattern of tumor enhancement Ⅲ and the number of cystic lesion can be used to predict the risk grouping of MB preoperatively. When the child is younger and MB enhancement pattern is mainly peripheral enhancement without obvious cystic change, it may indicate high risk MB.

ObjectiveTo analyze drug resistance status and risk factors in elderly tuberculosis patients in Ninghai County of Zhejiang Province， and to provide basis for prevention and control of drug-resistant tuberculosis. MethodsClinical data were collected from 142 elderly tuberculosis patients （with positive sputum culture） who were diagnosed and treated in medical institutions in Ninghai from 2016 to 2020. The risk factors of drug resistance were analyzed by Chi-square test and logistic regression model. ResultsThe overall drug resistance rate was 33.80%， and the drug resistance rate in patients with recurrent pulmonary tuberculosis was significantly higher than that in patients with initial pulmonary tuberculosis， and the difference was statistically significant. Multivariate unconditional logisitic regression analysis showed that irregular medication and disease recurrence were independent risk factors for multidrug resistance in the elderly patients. ConclusionThe drug resistance rate in elderly tuberculosis patients in Ninghai is high. It is necessary to strengthen the management and supervision of tuberculosis in the community， and to carry out effective health education and visit for elderly patients， especially for newly treated patients， and to avoid treatment failure caused by irregular medication and interruption of treatment.

Objective:To investigate the clinical value of referral colposcopy in cervical high-risk human papillomavirus (HR-HPV) positive women in cervical cancer screening.Methods:Totally 2 445 cases, which were referred for colposcopic cervical biopsy for cervical HR-HPV positive in Karamay Central Hospital from January 2018 to November 2021 were collected. The status of cervical HR-HPV positive transferred colposcopy in different situations to identify high-grade squamous intraepithelial lesions (HSIL) and above (HISL+ ) was analyzed. The value of referral colposcopy in cervical HR-HPV positive women under different conditions was evaluated.Results:2 445 HR-HPV positive women were referred for colposcopic cervical biopsy, which confirmed 1 447 cases of negative for intraepithelial lesion or malignancy (NILM), 362 cases of low grade squamous intraepithelia lesion (LSIL), 510 cases of HSIL and 126 cases of squamous cell carcinoma (SCC); The complete coincidence rate between colposcopy diagnosis and pathological diagnosis was 67.08%(1 640/2 445), and the Kappa value of consistency test was 0.489. The sensitivity and specificity of colposcopy in the diagnosis of LSIL+ were 91.28% and 69.38%, and HSIL+ were 74.52% and 93.15%. The detection rates of HSIL+ in HPV16/18 positive and other 12 HPV positive patients with abnormal cervical liquid based cytology (TCT) were 64.78%(103/159) and 78.79%(364/462), respectively. The positive rates of HPV16/18 and 12 other HPV positive HSIL+ with normal TCT were 16.46%(82/498) and 6.56%(87/1 326), respectively. The rate of detecting HSIL+ in abnormal areas under colposcopy was 44.69%(534/1 195), and that in routine biopsy was 8.16%(102/1 250).Conclusions:Among the referred for colposcopic cases, the detection rate of HSIL+ was higher in cases with cervical HR-HPV positive and TCT abnormalities. Colposcopy has obvious value in identifying cervical lesions. The accurate diagnosis of cervical lesions is based on cervical biopsy under colposcopy.

Objective:To investigate the changes of intestinal flora and its clinical significance in children with Helicobacter pylori (Hp)-positive duodenal ulcer before and after Hp eradication treatment. Methods:A total of 98 children with duodenal ulcer admitted to Ji′nan Second Maternal and Child Health Hospital from January 2018 to December 2020 were selected and divided into Hp infection group and Hp uninfected group according to whether they had Hp infection.Stools of Hp infection group were collected before treatment, treatment for 7 days, treatment for 14 days, and 30 days after treatment withdrawal for 16S rDNA sequencing.The independent samples t test was used to compare the detection of intestinal flora in the Hp infection group and the Hp uninfected group.Paired t test was used to compare the detection of intestinal flora in the Hp infection group before and after treatment.Nonparametric test was used to compare the bacterial diversity [diversity (Shannon, Simpson) index and richness (Chao 1) index] of Hp infection group and Hp uninfected group and the flora diversity of Hp infection group before and after treatment. Results:There was no significant difference in the detected numbers of Bifidobacterium [(5.92±1.85) lg copies/g feces vs.(6.58±2.01) lg copies/g feces], Lactobacillus [(4.89±1.35) lg copies/g feces vs.(4.47±1.59) lg copies/g feces], Bacteroides [(8.42±2.12) lg copies/g feces vs.(8.01±2.20) lg copies/g feces], Clostridium perfringens[(5.90±1.90) lg copies/g feces vs.(5.88±2.01) lg copies/g feces], Enterococcus[(5.41±1.27) lg copies/g feces vs.(5.02±1.48) lg copies/g feces], Enterobacter[(5.01±1.80) lg copies/g feces vs.(5.37±1.47) lg copies/g feces], and yeast [(5.90±1.85) lg copies/g feces vs.(5.88±2.01) lg copies /g feces] in the Hp infection group and the Hp uninfected group (all P>0.05). There was no statistically significant difference between the Shannon index (3.84±0.52 vs.3.90±0.45), Simpson index (0.16±0.04 vs.0.15±0.05), and Chao 1 index (178.52±40.22 vs.185.32±42.47) of the intestinal flora diversity between the Hp infection group and the Hp uninfected group (all P>0.05). Compared with before treatment, the number of Bifidobacterium, Lactobacillus and Bacteroides detected in the Hp infection group decreased at different times after treatment (all P<0.05). Compared with treatment for 7 days and treatment for 14 days, the number of Bifidobacterium [(4.54±1.78) lg copies/g feces vs.(4.20±1.22) lg copies/g feces vs.(5.21±1.55) lg copies/g feces], Lactobacillus [(4.01±1.20) lg copies/g feces vs.(3.89±1.32) lg copies/g feces vs.(4.43±1.10) lg copies/g feces], and Bacteroides [(6.78±1.88) lg copies/g feces vs.(6.55±1.90) lg copies/g feces vs.(7.68±2.00) lg copies/g feces] detected increased after 30 days of treatment (all P<0.05). There was no statistically significant difference in the number of Clostridium perfringens, Enterococcus, Enterobacter and yeast detected in Hp infection group at different times before and after treatment (all P>0.05). Compared with before treatment, the Shannon index and Chao 1 index at different time after treatment decreased, and the Simpson index increased (all P<0.05). Compared with treatment for 7 days and treatment for 14 days, the Shannon index (2.85±0.45 vs.2.57±0.48 vs.3.20±0.50) and Chao 1 index (148.45±32.33 vs.140.32±30.47 vs.160.42±38.42) increased, and Simpson index (0.25±0.06 vs.0.27±0.08 vs.0.19±0.05) decreased 30 days after treatment (all P<0.05). Conclusions:Hp infection has no significant effect on the intestinal flora of children with duodenal ulcer.Anti-Hp treatment can lead to imbalance of intestinal flora and decrease of intestinal flora diversity.The effect of a large number of antibiotics on intestinal flora should be considered in anti Hp treatment.

Perception ; Pupil ; Social Interaction