Objective:To investigate the correlations between subjective nasal patency, nasal valve area size and aerodynamic parameters in normal nasal cavity by means of numerical simulation, and to explore the effect of nasal valve on nasal subjective sensation and nasal airflow regulation.Methods:A total of 52 healthy participants (31 males and 21 females) with the average age of 37.8 years, were recruited from the outpatient Department of Otorhinolaryngology Head and Neck Surgery, the Ninth People′s Hospital Affiliated to the Medical College of Shanghai Jiao Tong University between January and August 2023. Visual Analog Scale (VAS) scores for unilateral nasal subjective sensation were obtained from all participants. Additionally, the aerodynamic characteristics of inspiratory airflow were simulated. A correlation matrix analysis was conducted to identify the correlation strength between these subjective and objective parameters.Results:VAS scores showed negative correlations with unilateral nasal valve cross-sectional area ( r=-0.85, P<0.01) and unilateral intranasal airflow ( r=-0.57, P<0.01), and was a positive correlation with unilateral nasal resistance (NR) at the front-end of inferior turbinate ( r=0.61, P<0.01). The average cross-sectional area of unilateral nasal valve was (0.85±0.35) cm 2. The cross-sectional area of unilateral nasal valve was negatively correlated with unilateral NR ( r=-0.50, P<0.01), and positively correlated with unilateral nasal airflow ( r=0.61, P<0.01). The NR at the nasal valve area accounted for (40.41±23.54)% of the total unilateral NR. Nearly half of the unilateral NR [(46.74±21.38)%] and air warming [(49.96±10.02)%] occurring before the front end of inferior turbinate were achieved. Conclusions:The nasal valve area plays a crucial role in influencing nasal NR, unilateral nasal airflow, and changes in nasal airflow temperature. Moreover, it is associated with subjective perception of nasal patency.

Malignant tumors are major diseases that seriously threaten human health.Although the integration of traditional Chinese and Western medicine has become an expert consensus on treatment of malignant tumors in China,a mature treatment mode of integrat-ed traditional Chinese and Western medicine has not yet been formed.This paper explores the construction of integrated traditional Chi-nese and Western medicine treatment mode for malignant tumors,namely synergistic therapy,palliative therapy,and preventive thera-py,covering different stages of malignant tumors,in order to give full play to the advantages and characteristics of integrated traditional Chinese and Western medicine treatment in the treatment of malignant tumors.

Objective    To explore the safety and effectiveness of different interventional approaches for the treatment of patent ductus arteriosus (PDA) in children. Methods    The children (≤7 years) who underwent interventional treatment for PDA from 2019 to 2020 in our hospital were retrospectively included. The patients were divided into 3 groups according to the procedures: a conventional arteriovenous approach group, a simple venous approach group, and a retrograde femoral artery approach group. The clinical efficacy of the patients was compared. Results     A total of 220 patients were included. There were 78 males and 142 females, with an average age of 3.21±1.73 years, weight of 14.99±5.35 kg, and height of 96.19±15.77 cm. The average diameter of the PDA was 3.35±1.34 mm. A total of 85 patients received a conventional arteriovenous approach, 104 patients received a simple venous approach, and 31 patients received a retrograde femoral artery approach. The diameter of PDA in the retrograde femoral artery group was smaller than that in the other two groups (3.44±1.43 mm vs. 1.99±0.55 mm; 3.69±1.17 mm vs. 1.99±0.55 mm, P<0.001); the contrast medium usage [40 (30, 50) mL vs. 20 (20, 30) mL; 35 (25, 50) mL vs. 20 (20, 30) mL, P≤0.001] and operation time [32 (26, 44) min vs. 25 (23, 30) min; 29 (25, 38) min vs. 25 (23, 30) min, P<0.05] in the simple venous approach group were significantly less or shorter than those in the other two groups; the length of hospital stay of the conventional arteriovenous group was longer than that in the other two groups [3 (3, 5) d vs. 4 (3, 6) d; 4 (3, 5) d vs. 4 (3, 6) d, P<0.05]. There was no significant difference in postoperative complications. Conclusion    It is safe and effective to close PDA through simple venous approach. The retrograde femoral artery approach has the advantage of simplifying the surgical procedure for PDA with small diameters.

With the rapid development of the field of interventional therapy of cardiac valve, the innovative researches of interventional therapy of cardiac valve products have become the focus of global research. At present, there is a serious shortage of interventional valvular medical devices on the market in China, and large-scale interventional valve products are undergoing early human trials or confirmatory clinical trials. The effective quality control of clinical trials is of great significance to ensure that clinical trial data can be used to support the marketing of device products. By analyzing the problems in clinical trials quality control of interventional valvular medical devices in our hospital, and combining the characteristics of device products and diseases, we explore the key points of quality control and provide reference for the implementation and completion of high-quality clinical trials.

Objective:To evaluate the effect of surgical revision of nasofacial deformity secondary to maxillary frontal process fracture.Methods:The clinical data of patients with nasofacial deformities secondary to maxillary frontal process fractures who underwent surgery in the Department of Otolaryngology, Head and Neck Surgery of Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2009 to December 2020 were retrospectively analyzed. The nasofacial deformity was surgically treated by open reduction with internal fixation, nasal septum correction, and reconstruction of orbital wall fracture. Three months after surgery, the surgical results were evaluated from the following three aspects. (1) Nasofacial morphology, which was evaluated by two doctors and the patient, and was classified into 3 levels: very satisfied, satisfied, and unsatisfied. (2) Objective assessment of nasal ventilation function, which was measured by nasal acoustic rhinometry and nasal resistance detection, including measurements of nasal minimum cross-sectional area (MCA), nasal volume 7 cm from the anterior nostril (NV), total nasal inspiratory resistance (TRi) and total nasal expiratory resistance (TRe). To eliminate the differences caused by swelling of the nasal mucosa, the patients were divided into 3 groups of <7 d, 7-14 d, and >14 d according to the time from trauma to preoperative examination for pre- and post-operative comparisons, respectively. (3) Subjective assessment of nasal ventilation function was performed using the nasal obstructive symptom evaluation (NOSE) scale, with a total score of 0 to 20, with a higher score indicating more severe nasal obstruction symptoms. The SPSS 17.0 software was used for statistical analysis, and the measurement data were expressed as Mean±SD. A paired t-test was used to compare the preoperative and 3-month postoperative data, with P<0.05 indicating a statistically significant difference. Results:A total of 83 patients were included, 53 males and 30 females, aged 7 to 78 years, with a median of 35 years. All patients underwent successful surgery, and all soft tissue incisions healed well after surgery with improved nasofacial morphology. Three months after surgery, the physicians were very satisfied and satisfied with the nasofacial morphology in 49 (59%) and 34 (41%) patients, respectively, and patients were very satisfied, satisfied, and unsatisfied in 51 (61%), 29 (35%), and 3(4%) cases, respectively. Before surgery, the <7 d group (14 cases), 7-14 d group (28 cases), and >14 d group (41 cases) had MCA values of (0.43±0.10) cm 2, (0.51±0.15) cm 2, and (0.50±0.14) cm 2; NV values of (9.76±2.20) cm 3, (12.40±4.15) cm 3, and (12.40±3.87) cm 3; TRi values of (1.93±0.28) kPa·L -1·s -1, (1.96±0.24) kPa·L -1·s -1, and (1.96±0.23) kPa·L -1·s -1; TRe values of (2.02±0.35) kPa·L -1·s -1, (2.08±0.38) kPa·L -1·s -1, and (2.08±0.34) kPa·L -1·s -1, respectively. Three months after surgery, in the three groups, the MCA values were (0.48±0.08) cm 2, (0.56±0.15) cm 2, and (0.56±0.14) cm 2; the NV values were (11.56±2.49) cm 3, (14.40±4.50) cm 3, and (14.41±4.24) cm 3; the TRi values were (1.74±0.19) kPa·L -1·s -1, (1.78±0.15) kPa·L -1·s -1, (1.78±0.14) kPa·L -1·s -1; the TRe values were (1.73±0.24) kPa·L -1·s -1, (1.79±0.24) kPa·L -1·s -1, and (1.79±0.22) kPa·L -1·s -1, respectively. In all three groups, the MCA and NV values at 3 months postoperatively were greater than the preoperative values of MCA and NV (all P < 0.01), and the TRe and TRi values at 3 months postoperatively were less than those preoperative values (all P < 0.01). At 3 months postoperatively, the NOSE scale score was (4.1±1.2)points, which was significantly lower than the preoperative score of NOSE scale score[(10.5±1.8)points] ( P<0.01). Conclusion:The combination of objective and subjective assessment method can help the surgeon to accurately determine the nasofacial morphological and functional defects caused by the fracture of the maxillary frontal process area before surgery and to formulate a perfect surgical plan. The patients’ nasofacial appearance and nasal ventilation functions were significantly improved after the fracture revision surgery.

Objective:To adapt and build Guideline for Management of Antipsychotic Medication Adherence in Schizophrenics which is suitable for China's national conditions. Methods:Guided by the ADAPTE guideline adaptation method, and combined with the current status of antipsychotic medication adherence of schizophrenics in China, we systematically searched the existing antipsychotic medication adherence management guidelines and systematic evaluation, and evaluated, selected, and integrated the best evidence. We conducted usability research on the adapted guidelines, conducted discussions among experts and external evaluations to form the final version of the guideline.Results:A total of 9 guidelines and 14 systematic evaluations were included. The adapted guideline contained 30 pieces of evidence, including 4 themes of policy and decision support, medication adherence assessment, medication adherence management plan, and medication adherence management measures.Conclusions:The adapted guideline for nursing management of antipsychotic medication adherence in schizophrenics can provide evidence support for clinical nursing practice.

Objective:To evaluate the effect of surgical revision of nasofacial deformity secondary to maxillary frontal process fracture.Methods:The clinical data of patients with nasofacial deformities secondary to maxillary frontal process fractures who underwent surgery in the Department of Otolaryngology, Head and Neck Surgery of Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2009 to December 2020 were retrospectively analyzed. The nasofacial deformity was surgically treated by open reduction with internal fixation, nasal septum correction, and reconstruction of orbital wall fracture. Three months after surgery, the surgical results were evaluated from the following three aspects. (1) Nasofacial morphology, which was evaluated by two doctors and the patient, and was classified into 3 levels: very satisfied, satisfied, and unsatisfied. (2) Objective assessment of nasal ventilation function, which was measured by nasal acoustic rhinometry and nasal resistance detection, including measurements of nasal minimum cross-sectional area (MCA), nasal volume 7 cm from the anterior nostril (NV), total nasal inspiratory resistance (TRi) and total nasal expiratory resistance (TRe). To eliminate the differences caused by swelling of the nasal mucosa, the patients were divided into 3 groups of <7 d, 7-14 d, and >14 d according to the time from trauma to preoperative examination for pre- and post-operative comparisons, respectively. (3) Subjective assessment of nasal ventilation function was performed using the nasal obstructive symptom evaluation (NOSE) scale, with a total score of 0 to 20, with a higher score indicating more severe nasal obstruction symptoms. The SPSS 17.0 software was used for statistical analysis, and the measurement data were expressed as Mean±SD. A paired t-test was used to compare the preoperative and 3-month postoperative data, with P<0.05 indicating a statistically significant difference. Results:A total of 83 patients were included, 53 males and 30 females, aged 7 to 78 years, with a median of 35 years. All patients underwent successful surgery, and all soft tissue incisions healed well after surgery with improved nasofacial morphology. Three months after surgery, the physicians were very satisfied and satisfied with the nasofacial morphology in 49 (59%) and 34 (41%) patients, respectively, and patients were very satisfied, satisfied, and unsatisfied in 51 (61%), 29 (35%), and 3(4%) cases, respectively. Before surgery, the <7 d group (14 cases), 7-14 d group (28 cases), and >14 d group (41 cases) had MCA values of (0.43±0.10) cm 2, (0.51±0.15) cm 2, and (0.50±0.14) cm 2; NV values of (9.76±2.20) cm 3, (12.40±4.15) cm 3, and (12.40±3.87) cm 3; TRi values of (1.93±0.28) kPa·L -1·s -1, (1.96±0.24) kPa·L -1·s -1, and (1.96±0.23) kPa·L -1·s -1; TRe values of (2.02±0.35) kPa·L -1·s -1, (2.08±0.38) kPa·L -1·s -1, and (2.08±0.34) kPa·L -1·s -1, respectively. Three months after surgery, in the three groups, the MCA values were (0.48±0.08) cm 2, (0.56±0.15) cm 2, and (0.56±0.14) cm 2; the NV values were (11.56±2.49) cm 3, (14.40±4.50) cm 3, and (14.41±4.24) cm 3; the TRi values were (1.74±0.19) kPa·L -1·s -1, (1.78±0.15) kPa·L -1·s -1, (1.78±0.14) kPa·L -1·s -1; the TRe values were (1.73±0.24) kPa·L -1·s -1, (1.79±0.24) kPa·L -1·s -1, and (1.79±0.22) kPa·L -1·s -1, respectively. In all three groups, the MCA and NV values at 3 months postoperatively were greater than the preoperative values of MCA and NV (all P < 0.01), and the TRe and TRi values at 3 months postoperatively were less than those preoperative values (all P < 0.01). At 3 months postoperatively, the NOSE scale score was (4.1±1.2)points, which was significantly lower than the preoperative score of NOSE scale score[(10.5±1.8)points] ( P<0.01). Conclusion:The combination of objective and subjective assessment method can help the surgeon to accurately determine the nasofacial morphological and functional defects caused by the fracture of the maxillary frontal process area before surgery and to formulate a perfect surgical plan. The patients’ nasofacial appearance and nasal ventilation functions were significantly improved after the fracture revision surgery.

Objective Based on intra-set correlation analysis, this paper deconstructs the clinical medical records of traditional Chinese medicine (TCM) Master ZHOU Zhongying in treating thyroid cancer, and analyzes the experience in “mechanism-syndrome-medicine-prescription” for thyroid cancer. Methods Through Medcase data processing platform, based on Frequent Pattern (FP)-Growth enhanced correlation analysis algorithm, the medical records of Professor ZHOU Zhongying for the treatment of thyroid cancer from June 1, 2001 to February 28, 2015 were analyzed within the set. Results This study involved 43 medical records, 43 patients, and 167 visits. After processing intra-set correlations, 28 groups of highly correlated symptoms, 21 groups of highly correlated tongue images, 10 groups of highly correlated pulse conditions, 28 groups of highly correlated pathogenesis, 34 groups of highly correlated herbs, and 26 groups of highly correlated western medicine diagnosis were selected. Professor ZHOU Zhongying treats thyroid cancer according to syndrome differentiation. Symptoms with more association rules included neck swelling, neck pain, cough, and dry mouth; tongue images with more association rules included dark purple tongue, dark red tongue, and fissured tongue; pulse conditions with more association rules were wiry pulse, thready pulse, small pulse, and slippery pulse; the pathogenesis with more association rules was phlegm and blood stasis, damp-heat accumulation, and impairment of both Qi and Yin; herbs with more association rules were Chaihu (Bupleuri Radix), Zeqi (Sun Euphoribiae Herb), and Tiandong (Asparagi Radix); western medicine diagnosis with more association rules included thyroid cancer, insomnia, and chronic gastritis. Conclusion Thyroid cancer mostly presents as deficiency in origin and excess in manifestations. The basic pathogenesis is phlegm and blood stasis, damp-heat accumulation, and impairment of both Qi and Yin, which are closely related to liver, kidney, and spleen. Professor ZHOU Zhongying adopts both attack and supplement approaches as the general treatment principle, with a strong emphasis on regulating Qi and relieving depression, eliminating phlegm and resolving stagnation, eliminating dampness and turbidity, clearing fire and destroying poison, moistening dryness and softening hard mass, invigorating Qi and nourishing Yin, and paying attention to nourishing liver and kidney, invigorating spleen and stomach, while protecting the heart and lungs.

The incidence of papillary thyroid cancer after liver transplantation is relatively low. This article introduces the treatment and prognosis of a case of papillary thyroid cancer after liver transplantation, and discusses the occurrence and development of thyroid cancer after liver transplantation and perioperative management and the prognosis, in order to further enhance the comprehensive management of such patients, extend the survival period and improve the quality of life.

Objective:To explore the clinical characteristics of pediatric glucose transporter type 1 deficiency syndrome (GLUT1 DS), evaluate the efficacy and safety of ketogenic diet therapy (KDT).Methods:Clinical data of 19 children with GLUT1 DS admitted to Children′s Hospital of Fudan University, Tianjin Children′s Hospital, Shenzhen Children′s Hospital, Children′s Hospital of Nanjing Medical University and Jiangxi Provincial Children′s Hospital between 2015 and 2019 were collected retrospectively. The first onset symptom, main clinical manifestations, cerebrospinal fluid features and genetic testing results of patients were summarized, the efficacy and safety of ketogenic diet treatment were analyzed. Results:Among the 19 cases, 13 were males and 6 females. The age of onset was 11.0 (1.5-45.0) months,the age of diagnosis was 54.0 (2.8-132.0) months. Epilepsy was the first onset symptom of 13 cases. Different forms of tonic-clonic seizures were the most common types of epilepsy (7 cases with generalized tonic-clonic seizures, 5 cases with focal tonic or clonic seizures, 4 cases with generalized tonic seizures). Antiepileptic drugs were effective in 4 cases. Paroxysmal motor dysfunction was present in 12 cases and ataxia was the most common one. All patients had different degrees of psychomotor retardation. Among 17 patients received cerebrospinal fluid examination, cerebrospinal fluid (CSF) glucose level was lower than 2.2 mmol/L and CSF glucose/glycemic index was<0.45 in 16 cases, only 1 case presented normal CSF glucose level (2.3 mmol/L) and normal CSF glucose/glycemic index(0.47). SLC2A1 gene mutations were found in 16 patients, missense, frameshift and nonsense mutations were the common types with 5 cases, 5 cases and 3 cases respectively. All 19 patients were treated with ketogenic diet, which was effective in 18 cases in seizure control, 11 cases in dyskinesia improvement and 18 cases in cognitive function improvement. No serious side effects were reported in any stage of KDT.Conclusions:The diagnosis of GLUT1 DS is often late. It is necessary to improve the early recognition of the disease and perform CSF glucose detection and genetic testing as early as possible. The KDT is an effective and safe treatment for GLUT1 DS, but a small number of patients have not response to diet therapy.