Objective To investigate the expression of pepsin in vocal cord polyps and vocal cord cancer,and to compare the difference of pepsin expression.Methods From May 2020 to December 2021,27 patients with vocal cord polyp,27 patients with vocal cord cancer and 23 healthy volunteers were selected.RSI and RFS scoring scales were used for scoring,pepsin detection kit was used for saliva pepsin detection,and immunohistochemical methods were used to detect the expression of pepsin in vocal cord tissues of patients with vocal cord polyps and vocal cord cancer.Results The RSI score,RFS score and pepsin test kit results of vocal cord polyp group and vocal cord canc-er group were higher than those of non-vocal cord disease group,and the differences of the three indexes were statis-tically significant(P＜0.05).RSI score,pepsin detection kit results and pepsin immunohistochemistry results of vocal cord polyp group showed no significant difference compared with vocal cord cancer group(P＞0.05).The RFS score of vocal cord polyp group was significantly different from that of vocal cord cancer group(P＜0.05).Conclusion Pepsin may be an important pathogenic factor of vocal cord polyp and vocal cord cancer,and play an im-portant role in the occurrence of these two diseases.The difference of pepsin expression in vocal cord polyp and vo-cal cord cancer suggests that pepsin may have different pathogenesis.

Objective To form the expert consensus on the limb management of patients with transvenous temporary cardiac pacing,standardize the limb management of patients with transvenous temporary cardiac pacing,and reduce complications related to the limb.Methods Using evidence-based methods,the evidence in this field was searched,evaluated and summarized,and relevant recommendations and research conclusions were extracted and classified by the level of evidence quality,and then the first draft of the consensus was formed.From December 2023 to January 2024,through 2 rounds of expert consultation and 4 rounds of expert meetings,the content was adjusted and the consensus was reached.Results Totally 16 experts participated in the consultation.The positive coefficient is 100%;the authoritative coefficient is 0.847 and 0.836;the average value of each index is more than＞3.8;the coefficient of variation is less than 0.21.The Kendall's harmony coefficient of the 2 rounds of expert consultation is 0.372 and 0.314,respectively,which were statistically significant.The consensus covers the preoperative,intraoperative and postoperative on limb management of patients with transvenous temporary cardiac pacing.Totally 11 themes were involved,including the preoperative preparation,position and catheter fixation in operation,position and catheter fixation in postoperative,activity,turn and transfer,duty shift on limb,nursing care after withdrawal of the catheter,prevention of deep vein thrombosis of the operative limb and prevent infection.Conclusion The consensus is highly scientific,and it is helpful to standardize the limb management of patients with transvenous temporary cardiac pacing.

Objective:To explore the genetic basis for a child with pachygyria.Methods:A proband who had visited Qinzhou Maternal and Child Health Care Hospital for pachygyria and mental retardation in June 2020 was selected as the study subject. Clinical data was collected. The child was subjected to whole exome sequencing (WES), and candidate variant was verified by Sanger sequencing. This study was approved by the Qinzhou Maternal and Child Health Care Hospital (Ethics No. 20220710).Results:The proband, a 4-year-old and 6-month-old female, was clinically diagnosed with megagyrus deformity. WES revealed that she has harbored compound heterozygous variants of the ADGRG1 gene, namely c. 781G>T (p.E261*) in exon 6 and c. 1369A>C (p.S457R) in exon 11, which were verified by Sanger sequencing to be derived from her mother and father, respectively. Her younger sister was also heterozygous for the c. 1369A>C (p.S457R) variant. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), both variants were rated as likely pathogenic (PVS1+ PM2_ Supporting; PM1+ PM2_Supporting+ PM3+ PP3). Conclusion:The c. 781G>T (p.E261*) and c. 1369A>C (p.S457R) compound heterozygous variants of the ADGRG1 gene probably underlay the pachygyria malformation in this child.

Objective:To assess the potentials for lung donation among 128 donors (deceased citizens) in 2017 from Beijing.Methods:Gender, age, blood type, duration of ventilation, oxygenation index (PaO 2/FiO 2), chest film and bronchoscopy were analyzed. Results:A total of 5135 deceased Chinese citizens were available for donation in 2017. The rate of donation per million population (PMP) was 3.71. And 463 donors from Beijing were recorded in 2017 and the rate of PMP was 21.05. In 2017, 299 lung transplantations were performed with an average rate of donor lung utility at 5.82%. Among 128 cases assessed for potential lung donors in Beijing, 72 were successfully procured with a percentage of lung utilization of 15.55%. There were 110 males (85.94%) and 18 females (14.06%) with an average age of (39.61±10.67) years. Mechanical ventilation duration was (7.59±2.93) days. The oxygenation rate (PaO 2/FiO 2) was (397.38±105.01) mmHg, (450±67.79) mmHg in procurement group and (338.89±116.15) mmHg in non-procurement group ( P=0.020). The median level of procalcitonin (PCT) was 0.195 ng/ml in procurement group versus 0.349 ng/ml in giving-up group ( P=0.042). Conclusions:Oxygenation rate and PCT level are the independent risk factors for reaching a procurement decision of donor lung. The actual PMP and lung procurement rate in Beijing were both higher than average domestic level (15.55% vs. 5.82%, P=0.000) because of excellent cooperation between Organ Procurement Organization (OPO) and lung transplantation centers. The evaluation of donor lungs and lung maintenance protocols from Beijing should be popularized nationwide.

Objective To discuss the value of CT and MRI in diagnosis of laryngeal non-Hodgkin's lymphoma(NHL).Methods The clinical data,CT and MRI findings and pathology of 26 patients with laryngeal NHL were analyzed retrospectively.Results Of 26 patients with laryngeal NHL,14 were diffuse large B-cell lymphoma,6 were NK/T-cell lymphoma,2 were follicular lymphoma,2 were small lymphocytic lymphoma(SLL),1 was angioimmunoblastic lymphoma and 1 was peripheral T-cell lymphoma.CT and MRI findings of laryngeal NHL:(1)laryngeal NHL showed homogeneous density on CT,slightly high signal intensity on T2WI,intermediate signal intensity on T1WI and moderate homogeneous enhancement;(2)laryngeal NHL was symmetrical and diffuse in appearance;(3)laryngeal NHL tended to spread through the submucosal and fat space,while muscle or cartilage invasion was quite rare but existed;(4)multisite lesions in Waldeyer's ring were obseverd occasionally.For those young male presenting diffuse multisite laryngeal lesion without a history of tuberculosis,a diagnosis of NHL should be raised.Conclusion CT and MRI can show the characteristics of the laryngeal NHL exactly,thus have applied value in detecting laryngeal NHL.

Objective:To study the clinical significance of daytime and nighttime blood pressure changes in patients diagnosed with renal parenchymal hypertension (RPH ) .Methods :Subgrouping 50 patients of diagnosed RPH into renal insufficiency compensatory period (RICP) of 20 cases ,with an average age of 55 ± 7 .88 years old ,renal insufficiency decompensated period (RIDP) of 17 cases ,with an average age of 56 ± 12 .9 years old ,renal failure (RF) of 13 cases ,with an average age of 53 ± 10 . 34 years old .Normal group was composed with 30 individuals selected from the healthy people with normal ambulatory blood pressure (ABPM ) .The Spacelab 90207 , a non‐invading ambulatory blood pressure monitor , was used to obtain indexes including 24‐hour mean systolic blood pressure (24 h SBP) ,24‐hour mean diastolic blood pressure (24 h DBP) ,daytime mean systolic blood pressure (dSBP ) , daytime mean diastolic blood pressure (dDBP ) , nighttime mean systolic blood pressure (nSBP) ,nighttime mean diastolic blood pressure (nDBP) ,nSBP/dSBP ,nDBP/dDBP ,mean arterial pressure (MAP) ,systolic blood pressure load ,and diastolic blood pressure load .Results :1 .In comparison to the normal group ,three subgroups with RPH projected higher values in all indexes .2 .Standard Deviations among these 3 RPH subgroups were obviously different .It was particularly different in systolic and diastolic loads ,where the RIDP higher ,and RF of 60% higher .3 .The statistical analysis resulted from one‐on‐one comparison between RPH subgroups showed that SBP ,DBP and MAP were significantly different ,while other indexes had no statistical differences .Conclusions :The rhythms of day and night changes of blood pressure in RPH sufferings disappeared .The values of blood pressure load and MAP in renal decompensated rise along with the deterioration of renal function .Effective control of blood pressure load and MAP may slow down this deterioration .

Objective To explore the association between family function and self-esteem in college students.Methods Totally 2560 college students were sampled.They were assessed with the self-compiled questionnaire on family information,Rosenberg' s self-esteem scale (SES) and family assessment device (FAD).Results The students from only-child family (30.32±4.19) scored higher on SES than students with siblings (29.54±3.97).The students with experience of grandparents raising (29.84±4.19) scored lower on SES than students raised by parents (30.29±4.13).Students from harmonious family and with monthly incoming above 10000 Yuan scored higher on SES than other groups.All the differences were statistically significant (P＜0.01,P＜0.05).There was significant correlation between SES and all of the dimensions of FAD (r=-0.260-0.379,P=0.000).Multiple regression showed that such dimensions of FAD as role,communication,behavior control,problem solving and general functioning,as well as social economic status of the family played important role on self-esteem of the students(β=0.039-0.169,P＜0.01 orP＜0.05).Conclusion Family factors have significant impact on self-esteem of the college students,especially family role and communication which are important positive predictors on self-esteem of college students.

Objective:To explore the postoperative electrocardiogram characteristics and its clinical significance in patients who had undergone orthotopic heart transplantation with double vena cava anastomosis .Methods :The electrocardiogram results of 70 patients during postoperative follow‐up ,who underwent orthotopic heart transplantation with double vena cava anastomosis in Zhongshan Hospital ,Fudan University from 2009 to 2012 ,were retrospectively analyzed .Results:The patients’ average ventricular rate was a bit faster than normal after operation ,and the common phenomena of electrocardiogram were non‐ischemic ST‐T changes ,increasing P terminal force in lead V1(Ptfv1) and incomplete right bundle branch block(IRBBB) .The rare phenomena such as slow ventricular rate ,ischemic ST‐T changes and arrhythmia ,however ,indicated poor prognosis . Conclusions : The postoperative electrocardiogram characteristics in patients who have undergone orthotopic heart transplantation with double vena cava anastomosis are conducive to predicting the patients ’ prognosis .

Objective:To explore the application and effect of ambulatory electrocardiography in the detecting the long RR interval .Methods:The patients who took ambulatory electrocardiography with effective records of 20 to 24 hours in Zhongshan Hospital ,Fudan University from Jan 2012 to Mar 2013 were enrolled .The number of cases with RR interval ≥ 2 s were counted .The degree distribution of the longest RR interval and the types of arrhythmia that cause the longest RR interval were analyzed .Results:Among the 15 492 patients who underwent ambulatory electrocardiography with effective records of 20‐24 h , there were 1745 cases with long RR interval ≥2 s .The incidence rate of the long RR interval was 11 .26% .The average age of patients with long RR interval was older than that of general population .The incidence rate of long RR interval in male was higher than that in female .The degree distribution of the longest RR interval was from 2 s to 16 .85 s ,of which the most common ranged from 2 s to 3 s and contributed 83 .27% .There was 0 .23% cases over 10 s .The arrhythmia that caused the longest RR interval were , in order , persistent atrial fibrillation or atrial flutter , sinus arrest , ectopic P’ wave without conduction to ventricle and degree II type I atrioventricular block .Conclusions:Ambulatory electrocardiography is an simple , convenient and effective method for detecting long RR interval .It is conductive to detect the presence of bradyarrhythmia in time and take corresponding treatment .