OBJECTIVE To analyze the clinicopathological features of laryngeal squamous carcinoma tumors and their correlation with prognosis in order to improve the understanding and diagnosis of laryngeal squamous cell carcinoma.METHODS The clinical and pathological data(including gender,age,stage,differentiation,immunohistochemistry,etc.)of 179 patients with laryngeal squamous cell carcinoma[171 males,8 females,aged 30-84(61.53±8.02)years]who were treated in Department of Otolaryngology Head and Neck Surgery,The First and Second Clinical Medical Schools of Ningxia Medical University from January 2015 to December 2022 were retrospectively studied,and the effects of various factors on prognosis were analyzed.RESULTS Among the 179 patients with laryngeal squamous cell carcinoma,the male-to-female ratio was 21.4:1,and the incidence was high in the age group of 60-79 years old(58.7%),and the youngest age of onset was 30 years old.The main clinical manifestations were hoarseness 138 cases(77.1%),sore throat 16 cases(8.9%)and pharyngeal foreign body sensation 13 cases(7.3%).Glottic type was more common in the primary site 135 cases(75.4%),and 31 cases were accompanied by cervical lymph node metastasis(17.3%).The degree of differentiation was more common in the moderately differentiated type 80 cases(44.7%).The positive rates of immunohistochemistry markers p16,EGFR(epidermal growth factor receptor),PD-1/PD-L1 and VEGF(vascular endothelial growth factor)were 20.3%,96.4%,36.4%and 77.3%,respectively.Univariate Kaplan-Meier survival analysis showed that the site of disease,lymph node metastasis,and tumor stage were significantly correlated with disease recurrence.Multivariate Cox regression analysis showed that the clinical stage of the tumor was an independent risk factor for the prognosis of the disease(HR=3.715,95%CI:1.519-9.088,P=0.04).CONCLUSION The stage of laryngeal squamous cell carcinoma,the site of the disease,and the metastasis of the lymph nodes are the main factors affecting the prognosis.The high positive expression rate of immunohistochemistry markers EGFR and VEGF is worth paying attention to Targeted therapy for patients with positive PD-1/PD-L1 testing is a promising research direction.

Antipsychotic medications are commonly used to treat schizophrenia,but they can have negative effects on lipid metabolism,leading to an increased risk of cardiovascular diseases,reduced life expectancy,and difficulties with treatment adherence.The specific mechanisms by which antipsychotics disrupt lipid metabolism are not well understood.Sterol regulatory element-binding proteins(SREBPs)are important transcriptional factors that regulate lipid metabolism.Proprotein convertase subtilisin/kexin type 9(PCSK9),a gene regulated by SREBPs,plays a critical role in controlling levels of low-density lipoprotein cholesterol(LDL-C)and has become a focus of research on lipid-lowering drugs.Recent studies have shown that antipsychotic drugs can affect lipid metabolism through the SREBP/PCSK9 pathway.A deep understanding of the mechanism for this pathway in antipsychotic drug-related metabolic abnormalities will promote the prevention of lipid metabolism disorders in patients with schizophrenia and the development and application of new drugs.

Objective:To investigate the distribution of allergens in patients with allergic rhinitis （AR） in Ningxia, and provide theoretical data for the prevention and treatment of AR in this region. Methods:A total of 1664 patients diagnosed with AR in the Otorhinolaryngology Head and Neck Surgery Department of Yinchuan First People's Hospital Outpatient Clinic from January 2018 to December 2021 were retrospectively collected. Use the allergen sIgE antibody detection kit （immunoblotting method） to detect inhalation and ingestion allergens in patients.Results: ①Among all AR patients, 1 158 cases were detected positive, resulting in the detection rate was 69.59%; ②The detection rate of inhalation allergen was 65.87%, and the detection rate of ingestion allergen was 19.83%; ③Mugwort was the most sensitive allergen, and 76.32% of the patients having a positive grade ≥3; ④Out of the patients, 294 cases （25.39%） were allergic to only one allergen, 244 cases （21.07%） were allergic to two allergens, and 620 cases （53.54%） were allergic to three or more allergens; ⑤During different seasons, the highest number of positive allergens detected was in the summer, with 968 cases （83.59%）. Mugwort was the main allergen during this season （69.01%）. After the COVID-19 epidemic, the total positive rate of sIgE tests in AR patients decreased compared to before, and the difference was statistically significant （P<0.001）; ⑥Mugwort, dog epithelium, mold combination, egg, peanut, soybean, Marine fish combination and fruit combination all showed statistically significant differences between different gender groups （P<0.05）; ⑦Common ragweed, mugwort, dust mite combination, cockroach, egg, milk, Marine fish combination, shrimp, fruit combination and nut combination all showed statistically significant differences among different age groups （P<0.05）; ⑧There were statistically significant differences in hay dust among different ethnic groups （P<0.05）. Conclusion:Artemisia argyi is the main allergen in Ningxia, and the distribution characteristics of different allergens are influenced by treatment season, the COVID-19 epidemic, gender, age, ethnicity, and other factors, showing certain distribution patterns and rules.
Allergens ; Artemisia ; COVID-19 ; Retrospective Studies ; Rhinitis, Allergic ; Skin Tests ; Humans ; Male ; Female

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.

Objective:To explore the application effects of the Doctor-nurse-therapist integrated Model on the patients with brain injury in the rehabilitation period.Methods:A total of 60 patients with brain injury from January 2016 to October 2017 were selected as the control group underwent interventions based on traditional treatment model involving medical treatment, nursing and rehabilitation, and then 56 patients with brain injury from January 2018 to October 2019 were aselected as the experimental group followed Doctor-Nurse-Therapist integrated model for rehabilitation treatment. All subjects were recruited from inpatients hospitalized in the Forth Department of Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center). The differences of motor function, activities of daily life (ADLs), anxiety and depression scores between the two groups were compared.Results:After 6 weeks of interventions, the scores of motor function were 80.27±18.20 and 67.32±19.71, and ADLs scores were 73.14±19.18 and 64.59±20.33 for the experimental group and the control group, respectively. The differences of the motor function and ADLs scores showed statistical significance between the experimental group and the control group ( t values were 3.491, 2.105, P<0.05). The anxiety and depression scores were 44.68±12.29 and 42.61±17.95 in the experimental group, while 52.25±12.95 and 50.84±18.14 in the control group, respectively. Statistical significance was found according to differences of anxiety and depression scores between the experimental group and the control group ( t values were 2.965,-2.236, P<0.05). Conclusions:Under the integrated model, doctors, nurses and therapists can evaluate, discuss, formulate and implement the flow scheme of the model, which can significantly improve the motor function and daily life ability of patients with brain injury in the rehabilitation period as well as anxiety, depression and the quality of medical services, and reduce the burden of family and society.

OBJECTIVE: To compare the accuracy of five warfarin-dosing algorithms and warfarin stable dose model (2.5 mg/day) for Shandong population. METHODS: One hundred and twenty five patients who achieved stable warfarin dose were enrolled. Clinical and genetic data were used to evaluate the value of each algorithm by calculating the percentage of patients whose predicted warfarin dose was within 20% of the actual stable therapeutic dose and mean absolute error (MAE). RESULTS: The frequency of patients with CYP2C9*1/*1, CYP2C9*1/*3 and CYP2C9*1/*2 genotype was 92.00%, 7.20%, 0.80%, respectively. That of VKORC1-1639 AA, AG and GG genotype was 82.40%, 15.20%, 2.40%, respectively. CYP4F2*1/*1, *1/*3, *3/*3 genotype was 50.40%, 39.20%, 10.40%, respectively. With the same genotypes for other loci, patients who carried at least one VKORC1-16398G mutant allele had increased warfarin stable daily dose compared with VKORC1-1639AA. Compared with CYP4F2*1/*1, those carrying at least one CYP4F2*3 mutant allele had warfarin stable daily dose increased by 5.9%-13.00%. The percentage of ideal prediction calculated from IWPC model (59.20%), Huang model (57.60%) and Ohno model (52.80%) were higher than others. The MAE were 0.35 (95%CI: 0.11-0.49), 0.15 (95%CI: 0.10-0.32), 0.39 (95%CI: 0.12-0.51), respectively. CONCLUSION The polymorphisms of CYP2C9, VKORC1 and CYP4F2 genes can influence the stable dose of warfarin in Shandong population. IWPC algorithm is suitable for guiding the use of warfarin in this population.
Anticoagulants ; administration & dosage ; Aryl Hydrocarbon Hydroxylases ; Cytochrome P-450 CYP2C9 ; genetics ; Cytochrome P450 Family 4 ; genetics ; Dose-Response Relationship, Drug ; Genotype ; Humans ; Models, Theoretical ; Polymorphism, Genetic ; Vitamin K Epoxide Reductases ; genetics ; Warfarin ; administration & dosage

Objective:To explore the clinical application effect of the integrated health education model of medical care and treatment in the rehabilitation of hospitalized patients with brain injury.Methods:A total of 90 patients with brain injury who were admitted to Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) from May 2018 to October 2019 were selected as the research objects by the convenient sampling method. The patients were divided into the observation group ( n=46) and the control group ( n=44) by random number table method. The control group adopted traditional methods for health education, while the observation group adopted integrated health education model of medical care and treatment. Standardized assessments were performed before the intervention and the first, third and sixth weeks of the intervention. The responsible nurses used Fugl-Meyer Assessment Scale (FMA) , Self-care Ability Assessment Scale (Barthel index) and Exercise of Self-Care Agency scale (ESCA) to evaluate the motor function, daily life self-care ability and self-care ability of the observation group and the control group. And self-made questionnaire was used to assist patients to complete the nursing quality satisfaction score. Results:After 6 weeks, the score of limb motor function score of the observation group was (89.57±11.28) and score of the daily self-care ability was (89.46±11.75) . Those of the control group were respectively (69.82±10.04) and (56.70±10.67) . The differences were all statistically significant ( P<0.05) . After intervention, the scores of self-care ability of patients in the observation group were (23.26±2.87) , (34.17±4.23) , (17.57±2.52) and (48.40±6.03) , and the satisfaction rate of nursing quality was 87.0% (40/46) . The scores of self-care ability of patients in the control group were (16.50±1.86) , (24.21±3.01) , (12.66±1.78) and (34.18±3.96) and 63.6% (28/44) . The differences were all statistically significant ( P<0.01) . Conclusions:The integrated health education model of medical care and treatment can improve the limb motor function of patients with brain injury and the self-care ability of daily life, improve the self-care ability of patients in rehabilitation treatment, improve the satisfaction of nursing quality and improve the quality of medical service.

Objective To explore the effects of swallow-feeding management in patients with dysphagia after traumatic brain injury (TBI). Methods By convenient sampling, 53 TBI patients from the Forth Department of Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) from January 2016 to December received a conventional rehabilitation program as the control group. 52 TBI patients from January 2017 to December were recruited into the observation group, while they received the swallow-feeding training and rehabilitation nursing intervention in comparison with the conventional rehabilitation program received in the above control group. The therapeutic effects were evaluated in the two groups through comparing swallowing function pre and post the 30-days interventions, respectively. Results Before intervention the swallowing function of the observation group was graded as grade I (0 example), grade Ⅱ (16 examples), grade Ⅲ (14 examples), grade Ⅳ (14 examples) and grade Ⅴ (8 examples) respectively, while the swallowing function of the control group was graded as gradeⅠ(0 example), gradeⅡ(11 examples), grade Ⅲ(13 examples), gradeⅣ (18 examples) and grade Ⅴ (11 examples) respectively before intervention. The difference in the degrees of the swallowing function had no statistical significance between the control group and the observation group before interventions (Z=-1.268, P=0.205). After intervention the swallowing function of the observation group was graded as grade Ⅰ (20 example), grade Ⅱ (19 examples), grade Ⅲ (10 examples), grade Ⅳ (2 examples) and grade Ⅴ (8 examples) respectively. Meanwhile the swallowing function of the control group was graded as grade Ⅰ (8 example), grade Ⅱ (19 examples), grade Ⅲ (13 examples), grade Ⅳ(10 examples) and grade Ⅴ(3 examples) respectively after intervention. Hence, The difference in the degrees of the swallowing function had statistical significance between the observation group (Z=-6.222, P＜0.01) and control group (Z=-5.892, P＜0.01) pre and post interventions. Moreover, the improvement of swallowing function in the observation group was larger than that of the control group and the difference in the degree of the swallowing function have statistics significance between the two groups (Z=-3.265, P＜0.01). The food intake of the two groups were observed for 30 days, and the results revealed that there were 1 502 cases and 808 cases in respiratory aspiration in the control group and observation group respectively. It can be seen that the incident rate of respiratory aspiration was significantly lower in the observation group than that of the control group (χ2=52.567, P=0.047). Conclusion The Swallow-feeding management can improve the swallowing function, effectively reduce the incidence of respiratory aspiration and also enhance the quality of life in TBI patients.

BACKGROUND:Recently, the effects of human umbilical cord mesenchymal stem cel s (hUCMSCs) and placenta-derived mesenchymal stem cel s (PDMSCs) on treatment of acute graft versus host disease (aGVHD) have been confirmed in some in vitro studies or animal models. But there are stil no reports comparing the therapeutic effects of these two cel types. OBJECTIVE:To compare the immunosuppressive function of hUCMSCs and PDMSCs in vitro or in a mouse aGVHD model. METHODS:(1) In vitro experiment. Human peripheral blood mononuclear cel s (PBMCs) were isolated and divided into four groups:PBMCs cultured alone, PBMCs stimulated with phytohaemagglutinin (PHA), PHA stimulated-PBMCs cocultured with hUCMSCs, PHA stimulated-PBMCs cocultured with PDMSCs. After 5 days, PBMCs proliferation and interferon-γlevel in cel supernatant were measured. (2) In vivo experiment. Fifty-seven BABL/C(H-2d) mice exposed to 8.5 Gy irradiation were randomly divided into five groups:only saline injection group, syngeneic bone marrow transplantation group, al ogeneic bone marrow transplantation group, aGVHD group, hUCMSCs treatment group, PDMSCs treatment group. The clinical aGVHD score, histopathology of skin, liver, and smal intestine, and survival time were analyzed at days 11, 14, 21 after transplantation. RESULTS AND CONCLUSION:(1) In vitro test:compared with the hUCMSCs, PDMSCs had stronger anti-inflammatory function. (2) In vivo test:The clinical scores on acute graft versus host disease were significantly lower in the hUCMSCs and PDMSCs treatment groups than that in the aGVHD group (P<0.05). The survival rates of mice were significantly increased in the hUCMSCs and PDMSCs treatment groups compared to the aGVHD group (P<0.05). Evident skin lesions were not found in al groups. Although smal intestine mucosal lesions were found in al groups, the damage level seemed similar. Notably, significant difference was found in the liver that multifocal necrosis and a large number of inflammatory cel s were seen in the aGVHD group, but less necrosis and inflammatory cel s in the hUCMSC and PDMSC treatment groups. In conclusion, hUCMSC and PDMSC are comparably effective in the treatment of aGVHD in mice.

Objective To develop a method for the determination of five furostanol saponins(timosaponin N,timosaponin L, timosaponin BⅡ,25R-timosaponin BⅡ,and 25S-officinalisnin-Ⅰ)in rhizome and fibrous root of Anemarrhena asphodeloides Bge. by HPLC with the charged aerosol detector(CAD). Methods The analysis was performed on TechMate C18-ST-II(250 mm×4.6 mm,5μm)with acetonitrile:water(22:78,V/V),the flow rate of 1.0 ml/min and column temperature at 30℃. The Corona parameters were as follows:sampling rate 10 Hz,filter 5 s,and the nebulizer temperature 55℃. Results The approach showed good linearity for five saponins. The correlation coefficients(r2)for calibration curves varied from 0.9992 to 0.9998. The limits of detection(LOD)were 0.28,0.92,0.92,0.92 and 0.92 ng for five steroidal saponins,respectively. The limits of quantitation(LOQ)were found to be 0.92, 2.77,2.77,2.77 and 2.76 ng,respectively. RSD calculated from peak area of precision,repeatability and stability in 48 h were all less than 3.0%. The average recoveries of timosaponin N,timosaponin L,timosaponin BⅡ,25R-timosaponinBⅡ,and 25S-officinalis-nin-Ⅰwere 98.17%,101.37%,98.53%,97.63%,and 98.17%,respectively. Conclusion The developed method is accurate,reli-able,which could be applied to the quality control of multiple components in A. asphodeloides Bge.