Objective:To investigate the distribution and primary drainage sites of the venous drainage system in the pedicled nasal septal mucosal flap, as well as to examine protective measures for the venous system of the nasal septal mucosal flap and its application in repairing the nasal skull base through the anatomical study of the nasal septum mucosal venous system in cadavers.Methods:Gross anatomy dissections were performed on 13 sides perfused fresh frozen cadaveric head specimens. The nasal septum mucosal flap was separated along the perichondrium and subperiosteum, then passed across the vomer, anterior wall of sphenoid sinus, clivus, and towards the anterior edge of vertical plate of palatine bone. Detailed documentation, including photographs, was made to record the morphology, distribution and drainage location of veins of the nasal septum mucosal flap and its pedicle, along with number of sphenopalatine veins. Furthermore, venous injuries resulting from obtaining a pedicled nasal septal mucosa flap were observed. From March 2023 to March 2024, a retrospective analysis was conducted on patients with nasopharyngeal lesions who underwent surgical repair using a modified pedicled nasal septum mucosal flap for venous system protection in the ENT institute and Department of Otorhinolaryngology at the Eye & ENT Hospital of Fudan University. The postoperative endoscopy was employed to assess the viability of the mucosal flap.Results:The veins of the nasal septum mucosa were primarily located in the posterior region, including the vomerine region, anterior wall of the sphenoid sinus, clivus region, and posterolateral wall of the nasal cavity, in a reticular pattern. Perforating veins draining into these bony structures could be observed, although their quantity and morphology varied. Notably, no prominent sphenopalatine veins were identified in 10 specimens examined, while 3 specimens exhibited sphenopalatine veins: one with a small single branch and two with venous bundles. Preservation of the nasal septal vein was possible when dissection was limited to the anterior edge of the wing of vomer. A wider range of dissection increased the risk of veinous injury. In cases where only vascular pedicles at the sphenopalatine foramen were preserved, three cadaveric head specimens retained intact sphenopalatine veins, while drainage veins were completely destroyed in ten other specimens. Fifteen patients with unilateral lesions (8 with recurrent nasopharyngeal carcinoma and 7 with nasopharyngeal radionecrosis) were included in this study. The postoperative reconstructions were carried out using contralateral pedicled nasal septal mucosal flaps. The average follow-up time was 7 months (ranging from 3 to 12 months), and all the nasal septal mucosal flaps survived.Conclusions:The primary location of the drainage vein within the nasal septum mucosa is situated in its posterior region, where it penetrates into adjacent bone structures. Very few sphenopalatine veins pass through the sphenopalatine foramen. Extensive dissection of the pedicled nasal septal mucosal flap may potentially impair the venous system and adversely affect flap survival rates, necessitating further clinical exploration.

Objective　To investigate the effects of narrow-band ultraviolet B (NB-UVB) irradiation, a psoriasis treatment, on the mRNA and proteinexpression of C-C motif chemokine ligand 20 (CCL20) in human immortalized keratinocytes (HaCaT cells) and to explore the underlying mechanisms. Methods　HaCaT cells were divided into two groups after routine culture. The first group was exposed to NB-UVB at doses of 0, 100, 200, and 400 mJ/cm2, and treated after 3, 12, and 24 hours of culture. The second group was pre-treated with different concentrations of pyrrolidine dithiocarbamate ammonium (PDTC) (1.0, 12.5, 25.0 μmol/L), followed by NB-UVB (400 mJ/cm2) exposure. The expression of CCL20 mRNA in the cell culture lysate was detected using the reverse transcription polymerase chain reaction (RT-PCR) method, the expression of CCL20, nuclear factor κB(NF-κB) p65, and phosphorylated NF-κB p65 proteins in HaCaT cells was detected by Western blot, and the expression of CCL20 protein in the cell culture supernatant was measured by enzyme-linked immunosorbent assay (ELISA). Results　After NB-UVB irradiation, the CCL20 mRNA expression level in HaCaT cells and the CCL20 protein expression level in cell culture supernatant increased with the increase of NB-UVB irradiation dose, showing a statistically significant difference (P<0.05). The phosphorylation level of NF-κB p65 in HaCaT cells also increased with the increase of NB-UVB irradiation dose, demonstrating a statistically significant difference (P<0.05). Compared with the group treated solely with NB-UVB, the mRNA and protein expression levels of CCL20, as well as the phosphorylation level of NF-κB p65 in HaCaT cells pre-treated with PDTC, were all reduced to varying degrees (P<0.05), and exhibited a dose-dependent manner, with a more pronounced reduction as the concentration of PDTC increased. Conclusions　NB-UVB can regulate the expression and secretion of the chemokine CCL20 in human HaCaT keratinocytes through the activation of the NF-κB signaling pathway.

Esophageal cancer is a malignant tumor of the digestive system that has a high incidence in China. The traditional treatment methods include surgery, radiotherapy, and chemotherapy, but the long-term efficacy is not good and the side effects are obvious. As a traditional physical therapy, hyperthermia has no significant toxic and side effects. Studies have shown that hyperthermia can increase the sensitivity of esophageal cancer to radiotherapy and chemotherapy, and its combined use in the treatment of esophageal cancer can prolong the survival and improve the quality of life. In addition, the innovation of materials and technologies brings new breakthroughs to tumor hyperthermia.

OBJECTIVETo evaluate the feasibility of endoscopic lobectomy for pulmonary sequestration in children.

METHODSClinical data of 47 children with pulmonary sequestration treated with endoscopic lobectomy from April 2015 to November 2017 were reviewed. According to the operation date, 19 children received operation from April 2015 to December 2016 were early group, and 23 children received operation from January 2017 to November 2017 were late group (5 children with lesions inside diaphragm were excluded). The operation time, intraoperative blood loss, retention time of drainage tube, length of hospital stay and incidence of complications were compared between two groups.

RESULTSAmong 47 children, endoscopic lobectomy was successfully completed in 45 children, and the rest 2 children were converted to thoracotomy. No death was observed. The operation time in late group was shorter than that in the early group (<0.05), and the intraoperative blood loss of the late group was less than that of early group (<0.05); while there were no significant differences in retention time of drainage tube and length of hospital stay between two groups (both >0.05). Postoperative complications occurred in 14 children, including 4 cases of pneumothorax, 8 cases of pleural effusion, 1 case of pulmonary infection, and 1 case of diaphragmatic hernia. The incidence rates of postoperative complications in late group and early group were 17.4% (4/23) and 42.1% (8/19), and the difference was not statistically significant(>0.05). During the follow-up (2-26 months), no relapse and thoracic collapes were observed, and CT examination found that the remaining lungs were well compensated in all children.

CONCLUSIONSThe endoscopic lobectomy is effective and safe with less trauma and bleeding, which is recommended for treatment of pulmonary sequestration in children.

Objective To understand the psychological state , labor and childbirth knowledge awareness in hospitalized pregnant women with 37 to 41 weeks gestation and effect on rate of cesarean section , and to put forward the corresponding countermeasures .Methods Two hundred hospitalized pregnant women were chosen and divided into the labor group in which the pregnant women felt contractions regularly and the cervical dilatation was more than 1 cm and the no labor group in which the pregnant women were threatened labor or without, each with 100 cases.The self-rating anxiety scale (SAS), the self-rating depression scale (SDS), and the questionnaire on the knowledge of labor and delivery were used in two groups , and the delivery outcome was investigated.Results The scores of SAS and SDS were respectively (49.21 ±6.09), (58.97 ±6.43) in the no labor group, and were higher than (42.96 ±5.61), (49.95 ±6.02) in the labor group, and the differences were statistically significant (t=3.074, 4.146, respectively;P<0.01).The incidence rates of anxiety and depression in the no labor group were higher than those in the labor group , and the differences were statistically significant (χ2 =7.14, 5.64, respectively;P<0.05).The qualification rate of mastering the knowledge of labor and delivery was 63.0%in the labor group, and was 27.0%in the no labor group, and the difference was statistically significant (χ2 =26.18, P<0.01).The cases of cesarean section were 65 in the no labor group including 44 cases cesarean section induced by social factors , and were 19 in the labor group including 8 cases cesarean section induced by social factors , and the difference was found in the rate of cesarean section in two groups (χ2 =43.44, P <0.01 ).Two groups of pregnant women in labor oxytocin utilization comparative difference was statistically significant (P<0.01).Conclusions The main causes of early admission in the without labor pregnant women are respectively the psychological state before labor and the awareness of the knowledge of labor and delivery .The situation of the psychological state before labor and the awareness of the knowledge of labor and delivery in the no labor group are worse than that in the labor group , and the psychological health during pregnancy should be strengthened , and the propaganda and education of the knowledge of labor and delivery should be increased .