Objective To explore the effect of exposure to noise of 3.0T magnetic resonance imaging(MRI)on children's cochlear function.Methods We prospectively recruited 72 children who underwent cranial MRI examination at our hospital from May to November 2018;3M earplugs and sponge mats were used for hearing protection during MRI scanning.Noise level(dBA)of each MRI sequence was detected with a nonmagnetic microphone and a sound level meter.Distortion product otoacoustic emissions(DPOAE)test at 2-7 kHz was performed 24 hours before and 30 minutes after the MRI examination.Paired t-test or Wilcoxon signed-rank test was used to analyze differences in DPOAE amplitude before and after the MRI examination.Results The average noise level of MRI measured in the study was(107.7±3.92)dBA.Compared with that before the MRI examination,the DPOAE amplitude(dB)changed little after the MRI examination;the range of amplitude differences in each age group was as follows:left ear(-0.24-1.10)and right ear(-0.24-0.74)in the 0-1 year-old group;left ear(-0.07-0.59)and right ear(-0.57-0.75)in the 2-5 year-old group;left ear(-0.36-0.44)and right ear(-0.30-0.57)in the 6-12 year-old group.No statistically significant difference was found(correction P＞0.05).Conclusion No potential impact of 3.0T MRI noise on children's cochlear function was observed under routine hearing protection.

Objective To explore the key nursing cooperation points in single-port laparoscopic cholecystectomy based on magnetic anchor technique. Methods The general information of 24 patients with transumbilical single-port laparoscopic cholecystectomy based on magnetic anchor technique was analyzed. Combined with the surgical procedure, the key nursing cooperation points of this innovative surgery were analyzed from the perspective of operating room nurses. Results By learning the principles of magnetic anchor technique before surgery, understanding the usage and precautions of the magnetic anchor device, accurately passing the magnetic anchor device during surgery, and avoiding mutual interference between the magnetic anchor device and conventional surgical instruments, the operating room nurses successfully assisted the surgeons in completing 24 cases of transumbilical single-port laparoscopic cholecystectomy based on magnetic anchor technique. Conclusion Real-time understanding of the surgeon's operation progress during surgery, accurate delivery of instruments, and avoidance of interference between the magnetic anchor device and conventional surgical instruments are important factors in the nursing cooperation of this surgical procedure.

Wound healing is a complex process of biological integration in which the adverse conditions such as excessive inflammatory reactions, cell proliferation and migration disorders, and cellular secretion impairment can lead to refractory wounds. Characterized by complex etiology, protracted condition, and high morbidity and recurrence rate, refractory wounds severely impair patients′ physical and mental health. In clinical practice, refractory wounds are primarily treated with surgical debridement and skin transplantation, but there still exist problems such as large surgical wounds, prolonged recovery time, and high recurrence rate. In recent years, owing to the multipotent differentiation, immunomodulatory, and paracrine functions of stem cells, cell-assisted lipotransfer (CAL) technique, which involves intra-body injection of a mixture of autologous adipose-derived stem cells (ADSCs) and granular fat for refractory wound repair, has demonstrated promising application prospects. It is of great significance in its clinical application to clarify the mechanism of effects of CAL technique in refractory wound repair. The authors reviewed the research progress in the mechanism of effects of CAL technique in repairing refractory wounds to provide references for the research and treatment of refractory wounds.

Objective To investigate the feasibility of the optimally designed"I"shaped structure mag-net based on the principle of magnetic compression technique for the preparation of rectovaginal fistula animal model.Methods Using 10 New Zealand female rabbits as the model animals,two self-designed magnets were inserted through the vagina and anus respectively after anesthesia,and the two magnets were adjusted to the appropriate position and made them attraction each other to form a magnet-rectovaginal partition-magnet structure.When the compression tissue between the magnets became ischemic necrosis and fell off,the two magnets formed the"1"shape structure and were located in the stoma of rectovaginal fistula to prevent the stoma from becoming smaller or even closing itself.The operation time and rectovaginal fistula formation time were recorded.The experimental rabbits were killed in postoperative 2 weeks,and the rectovaginal fistula specimens were obtained.The formation of fistula orifice was observed and the size of fistula orifice was meas-ured.Results The animal model of rectovaginal fistula was successfully prepared in all 10 experimental rab-bits.The procedure of intraoperative magnet placement was smooth and the operation time was(1.55±0.65)min.The experimental animals were generally in good condition after surgery,and the fistula orifice was formed on postoperative(4.80±0.75)d.After taking the gross specimen of rectovaginal septum in postopera-tive 2 weeks,the magnet was removed.The fistula orifice of rectovaginal fistula was visible with the diameter of(5.86±0.38)mm.Conclusion The"I"shaped structure magnet designed based on the principle of mag-netic compression technique could be used in the preparation of the rectovaginal fistula animal model.Its oper-ation is simple with high success rate of model preparation and good uniformity in fistula orifice.

Objective:To explore the clinical characteristics and genetic etiology of a child with Spondyloocular syndrome (SOS) in order to enhance the awareness and understanding of this disease.Methods:A 3.5-year-old boy with SOS who had presented at the Department of Medical Genetics of Hunan Children′s Hospital on August 10, 2023 due to the repeated fractures for over 2 years and after binocular cataract surgery was selected as the study subject. Clinical data of his pedigree were collected, and peripheral venous blood samples were collected for the extraction of genomic DNA and subjected to trio-whole exome sequencing. Candidate variants were verified by Sanger sequencing and analyzed with bioinformatic software. This study was approved by the Medical Ethics Committee of Hunan Children′s Hospital (No. KYSQ2022-263).Results:The child had manifested repeated fractures, bilateral bowed femur, osteoporosis, cataract, atrial septal defect, and developmental delay. Ultrasonography has revealed fetal edema, peritoneal effusion, pleural effusion and polyhydramnios. Trio-whole exome sequencing and Sanger sequencing revealed that he has harbored compound heterozygous variants of the XYLT2 gene, namely c. 1103_1104delAG (p.Gln368Argfs*8) and c. 1238_1253delinsA (p.Val413_Pro418delinsGlu), which were inherited from his phenotypically normal father and mother, respectively. Neither variant was reported previously. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG) and recommendations from the Clinical Genome Resource (ClinGen), the c. 1103_1104delAG was predicted as a pathogenic variant (PVS1+ PM2_Supporting+ PP4), whilst the c.1238_1253delinsA was predicted as a likely pathogenic variant (PM4+ PM3+ PM2_Supporting+ PP4). Conclusion:The c. 1103_1104delAG and c. 1238_1253delinsA compound heterozygous variants of the XYLT2 gene probably underlay the pathogenesis in this child. Above finding has enriched the phenotypic and mutational spectrum of SOS, and provided a basis for the clinical diagnosis, treatment, prognosis assessment and genetic counseling for this pedigree.

Objective To investigate the role and potential mechanisms of tumor necrosis factor alpha-inducible protein 8-like molecule 1(TNFAIP8L1)in acute liver injury in mice.Methods The second generation of C57BL/6J male wild-type(WT)mice and the C57BL/6J female TNFAIP8L1+/-mice and WT mice were selected to further self-breed the third generation of male TNFAIP8L1-/-mice and the third generation of WT male mice.Five normal third-generation male WT mice and five normal third-generation male TNFAIP8L1-/-mice were selected.The serum alanine aminotransferase(ALT)levels of the two types of normal mice were measured and compared.The infiltration of inflammatory cells and cell necrosis in the liver tissues of the two types of normal mice were observed after hematoxylin & eosin(HE)staining.Flow cytometry was used to detect the percentages of neutrophils(Neu),eosinophils(EOS),dendritic cells(DC),bone marrow-derived macrophages(BMDMs),and bone marrow-derived mononuclear cell(BMNCs)in the liver myeloid cell subsets of the two types of normal mice.Another 5 third-generation male WT mice and 4 third-generation male TNFAIP8L1-/-mice were selected to induce acute liver injury mouse models using lipopolysaccharide(LPS)/D-galactosamine(D-Gal).After 24 hours,the serum ALT levels of the two types of acute liver injury mice were detected and compared,the infiltration of inflammatory cells and cell necrosis in the liver tissues of the two types of acute liver injury mice were observed,and the percentages of Neu,EOS,DC,BMDMs and BMNCs in the liver myeloid cell subsets of the two types of acute liver injury mice were measured by using the above methods.Results There was no significant difference in the percentages of Neu,EOS,DC,BMDMs and BMNCs,and serum ALT levels in the livermyeloid cell subsets of normal WT mice and TNFAIP8L1-/-mice(P＞0.05).HE staining results of liver tissues in normal WT mice and TNFAIP8L1/mice showed that hepatic lobules were structurally complete and clear,hepatocytes were morphologically normal and arranged neatly,and there was no obvious inflammatory cell infiltration or cell necrosis.Twenty-four hours after acute liver injury,the percentages of Neu and BMNCs in the liver myeloid cell subsets and the serum ALT levels in the liver tissues of TNFAIP8L1-/-mice were significantly higher than those of WT mice(P＜0.05);there was no significant difference in the percentages of EOS,DC and BMDMs in the liver myeloid cell subsets of mice between the two groups(P＞0.05).In the liver tissues of WT mice with acute liver injury,hepatic lobules were structurally blurred,hepatocytes were swollen with scattered vacuolated steatosis,and a small amount of inflammatory cells were infiltrated.In the liver tissues of TNFAIP8L1/mice with acute liver injury,hepatic lobules were structurally non-existent,and hepatocytes were severely damaged and extensively necrotic,with a large amount of inflammatory cell infiltration.Conclusion The deficiency of the TNFAIP8L1 gene in mice does not affect the development of liver myeloid cells and the homeostasis of the liver.TNFAIP8L1 plays an inhibitory role in the occurrence and development of acute liver injury.TNFAIP8L1 gene deficiency aggravates LPS/D-Gal-induced acute liver injury,possibly by increasing Neu and BMNCs infiltration and recruiting other types of immune cells to infiltrate liver tissues,thereby exacerbating liver cell necrosis.

Objective To evaluate the effectiveness of filter membranes made from different materials in monitoring the health status of rodents in barrier environment facilities by investigating their microbial capture performance.Methods Pasteurella pneumotropica(Pp)and Staphylococcus aureus(Sa)were used as representative strains to simulate the process of microbial capture by filter membranes under laboratory conditions.The microbial capture effectiveness of five self-selected filter membranes(M1,M2,M3,M4,and M5)with adsorption and breathability properties and a commercial filter membrane(T1)were comprehensively evaluated based on captured dust mass,minimum detection limit,and differences in Ct values obtained through fluorescence quantitative PCR detection.The best-performing self-selected filter membrane was placed in the ventilation ducts of cage racks within the barrier facility,with sentinel mice in corresponding cage racks as the control group.Staphylococcus epidermidis and Escherichia coli were used as indicator bacteria to calculate the positive detection rate and coincidence rate,thereby exploring the feasibility of using microbial capture filter membranes to monitor the health status of experimental animals in barrier facilities.Results In terms of the captured dust mass,the self-selected filter membrane M3(non-woven filter membrane with a diameter of 0.1 μm);showed a capture effectiveness second only to T1,with a capture mass of 0.126 g.For Sa,all filter membranes except M4 had a minimum detection limit of 102 CFU/g.For Pp,the minimum detection limit for all filter membranes was 102 CFU/g.However,the Ct value of the quantitative fluorescence PCR amplification results for M3 was significantly lower than that of other materials,indicating that M3 had the best capture performance among the five self-selected materials.In the filter detection verification experiment,the positive detection rate of Staphylococcus epidermidis in sentinel mouse feces and M3 was 50.00％(6/12)and 58.33％(7/12),respectively,with a coincidence rate of 92％.The positive detection rate of Escherichia coli in both sentinel mouse feces and M3 was 50.00％(6/12),with a coincidence rate of 100％.Conclusion Among the 5 self-selected filter membranes,M3 exhibits the best capturing performance.Within the barrier environment facilities,M3 outperforms sentinel mice in monitoring Staphylococcus epidermidis.Therefore,non-woven filter membrane with a diameter of 0.1 μm;can be used as the material for microbial capture filter membranes,providing valuable insights for the selection and application of microbial capture filter membranes used in PCR monitoring of cage exhaust air dust.

Purpose To evaluate the function of swallowing by examining the relative motion of the hyoid bone and larynx(HL)via ultrasonography,and to explore the value of HL motion ratio in the evaluation of stroke with pharyngeal dysphagia.Materials and Methods A total of 43 stroke patients with dysphagia(dysphagia group)and 43 healthy adults(healthy control group)from June 2021 to April 2022 in the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine and the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were enrolled.The displacement and motion time of HL were measured by ultrasonography when the participants swallowed 5 ml water.The median flow tracking algorithm was implemented in Python language to measure the displacement of the hyoid bone,the movement time of the hyoid bone,the displacement of the larynx and the movement time of larynx,and then HL movement ratio was calculated,respectively.The differences in ultrasonography measurements between the two groups were compared,and the influencing factors of stroke with dysphagia were screened out via Logistic regression analysis.Then the receiver operating characteristic curve was drawn,the area under curve and the cut-off value,sensitivity and specificity were calculated subsequently.Results The larynx motion time(static phase),the larynx displacement(elevation phase)and the HL motion ratio were significantly related to swallowing in healthy participants,with significant differences between the two groups(t=4.97,6.38,6.17,P<0.05).The results of Logistic regression analysis showed that the HL motion ratio was the influencing factor of stroke with dysphagia(OR>1,P<0.05).The optimal cut-off value of the HL motion ratio for the diagnosis of dysphagia was 0.58,leading to a sensitivity of 86.0%,a specificity of 93.0%and the area under curve of 0.967,respectively.Conclusion Ultrasonography can quantitatively evaluate the motion of the HL during swallowing,and the HL motion ratio can be considered as a parameter for the evaluation of stroke with dysphagia,providing new insights for clinical diagnosis of dysphagia.

Objective:To explore the efficacy and safety of camrelizumab combined with apatinib as the second-line treatment for patients with advanced gastric cancer.Methods:The clinical data of 19 patients with advanced gastric cancer in Hebei General Hospital from August 2019 to March 2022 were retrospectively analyzed. All patients received camrelizumab combined with apatinib as the second-line treatment. The treatment efficacy and adverse reactions were evaluated; the survival analysis was performed using Kaplan-Meier method; Cox proportional hazards model was used to analyze the influencing factors for overall survival (OS) of patients.Results:Among 19 patients, no one achieved complete remission, 4 patients (21.1%) achieved partial remission, 9 patients (47.4%) had stable disease. The objective response rate (ORR) and disease control rate (DCR) were 21.1% (4/19) and 68.4% (13/19), respectively. The ORR of patients with deficient mismatch repair (dMMR) was higher than that of patients with proficient mismatch repair (pMMR) [100.0% (2/2) vs. 11.8% (2/17), P < 0.05], and patients with programmed death receptor ligand 1 (PD-L1) combined positive score (CPS) ≥1 had a higher DCR than patients with PD-L1 CPS < 1 [100.0% (5/5) vs. 25.0% (1/4), P < 0.05]. The median follow-up time of 19 patients was 14.7 months (12.0-17.4 months), the median progression-free survival time and OS time were 2.8 months and 5.7 months (95% CI 2.4-8.9 months). Increased lactate dehydrogenase (LDH) was negatively correlated with OS ( χ2 = 10.262, P = 0.001). Multivariate Cox regression analysis showed that LDH was an independent influencing factor for the OS of patients (<250 U/L vs. ≥250 U/L: HR = 0.149, 95% CI 0.039-0.657, P = 0.005). The most common treatment-related adverse reactions were fatigue (52.6%, 10 cases), anemia (47.4%, 9 cases), thrombocytopenia (36.8%, 7 cases), rash (36.8%, 7 cases), and reactive capillary hemangioma (36.8%, 7 cases). Conclusions:Camrelizumab combined with apatinib as the second-line treatment for advanced gastric cancer have good efficacy and safety.

Objective: To investigate the role of nucleotidebinding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome in hyperalgesia induced by temporomandibular joint osteoarthritis (TMJOA) in rats. Methods : Twenty 6-week-old male SD rats were randomly divided into NS group and MIA group．The rat model of TMJOA was established by injection monosodium iodoacetate ( MIA) into the upper cavity of temporomandibular joint (TMJ) ．The changes of pain threshold in the TMJ region of rats after MIA injection were detected by Von Frey．The changes of condyle structure were observed by Hematoxylin-eosin ( HE ) and Safranin O-fast green stains．Histopathological changes of trigeminal ganglion (TG) were observed by HE stains．The expression and distribution of TG NLRP3 protein were detected by immunohistochemistry．Western blot was used to detect the protein levels of NLRP3 and interleukin (IL) -1 β in TG．The mRNA levels of NLRP3，apoptosis-associated speck-like protein (ASC) ，cysteinyl aspartate specific proteinase ( Caspase-1) ，IL-1β and IL-18 in TG were detected by quantitative real-time polymerase chain reaction ( qRT-PCR) . Results : Compared to saline group，the pain threshold of experimental TMJ osteoarthritis rats decreased (P＜0. 05) ．TMJ and TG showed obvious pathological changes．The protein and mRNA levels of NLRP3 expressed in the tissues of rats in the TMJOA group increased (P ＜0. 05 ) . Conclusion NLRP3 inflammasome may be involved in the regulation of hyperalgesia in TMJOA rats.