Objective:To explore the surgical efficacy of conductive deafness caused by otosclerosis and ossicular malformation with 980 nm fiber laser stapedial floor fenestration.Methods:Data of 58 patients (ears) who were diagnosed with conductive deafness caused by otosclerosis (49 ears) and ossicular malformation (9 ears) treated by 980 nm Diode laser small-fenestra stapedotomy were retrospectively analyzed. Air conduction (AC) thresholds, bone conduction (BC) thresholds, and air-bone gap (ABG) at 0.5, 1, 2, 4 kHz pure tone frequencies were compared before and 3 months after surgery, and the advantages and precautions of 980 nm fiber laser were summarized. Paired t-test (SPSS 26.0 software) was use to analyze the listening data. Results:Fiber optic laser stapes fenestration and artificial stapes implantation were successfully completed in all 57 cases (ears), the hearing of another one patient (ear) with floating malformation of detachment of stapedial floor was lower than that before surgery. Preoperative at 0.5, 1, 2, 4 kHz frequencies of AC thresholds, BC thresholds, and ABG were (65.4±9.7) dB, (27.2±8.9) dB, and (38.2±9.8) dB respectively. Postoperative 3 months at the same frequency of AC thresholds, BC thresholds, and ABG were (42.1±11.3) dB, (26.9±6.6) dB, and (15.2±9.1) dB. Preoperative and postoperative of AC threshold and ABG were statistically significant at 0.5, 1, 2, 4 kHz ( t value was 13.270 and13.948, both P<0.01), and yet the BC threshold was not statistically significant before and after surgery at the same frequency ( t=0.418, P>0.05). Conclusions:980 nm fiber laser stapes floor fenestration is an effective treatment for conductive deafness caused by otosclerosis and ossicular malformation.

Studies have shown a large number of aberrant epigenetic changes in patients with psoriasis, including DNA methylation, histone modification, non-coding RNA regulation, etc., suggesting that epigenetic mechanisms may be involved in the occurrence of psoriasis. This review focuses on the recent progress in epigenetic regulation in psoriasis.

Objective:To analyze the clinical characteristics of children diagnosed with systemic lupus erythematosus(SLE)complicated with thrombotic microangiopathy(TMA)for early recognition.Methods:We retrospectively reviewed the clinical records of 14 SLE patients with TMA hospitalized at Shanghai Children′s Medical Center, Shanghai Jiaotong University School of Medicine from December 2005 to October 2020.Results:The incidence of TMA was 5.65%(14/248)of the hospitalized patients with SLE and 7.87%(14/178)of the hospitalized patients with lupus nephritis.Four patients were boys while ten patients were girls.One boy was six years old and other 13 patients were from 11 to 18 years old.Their SLEDAI scores ranged from 14 to 31, and all of them were severe activity.Renal biopsy of 11 patients during TMA course all revealed lupus nephritis(type Ⅳ, n=8; type Ⅳ+ Ⅴ, n=3). These 14 SLE children were diagnosed with TMA within 3 days to 2 months after admission.At the beginning of the hospitalization, only six patients had both anemia and thrombocytopenia, while eight patients only had moderate anemia.All of the patients had obvious hypocomplementemia.Especially in the patients with first onset of SLE without treatment, their serum levels of C3 were less than 0.17 g/L and C4 were less than 0.07 g/L.Moreover, glomerular filtration rates of these patients were lower than that in normal range.The follow-up time were 0.2-11.3 years(median time was 2.6 years). After treatment, six patients obtained complete remission, and five patients obtained partial remission.One patient had sudden death during the 4th plasmapheresis, and the other two patients deteriorated. Conclusion:Children with SLE and TMA are mostly in severe disease activity, and renal pathology is type Ⅳ lupus nephritis.The SLE children with anemia should be paid special attention to the level of serum complement whether they have thrombocytopenia or not.If the level of serum complements decrease obviously, glomerular filtration rates should be monitored closely and schistocytes should be searched repeatedly in the blood smears of the peripheral blood to facilitate the early recognition of TMA.

Objective:To investigate the therapeutic effects of antibiotic articular cement spacer on shoulder joint infection in the elderly patients during stage-one operation.Methods:The data of 3 patients were analyzed retrospectively who had been treated at Department of Orthopaedics, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University for shoulder infection from May 2018 to December 2019. They were one man and 2 women with an average age of 65.3 years (from 64 to 67 years). One case of infection followed shoulder puncture, another proximal humeral fracture and another shoulder prosthesis replacement. All the 3 patients underwent radical debridement and implantation of antibiotic shoulder cement spacer in stage-one operation but no stage-two operation. The therapeutic effects were evaluated by American Shoulder and Elbow Surgeons (ASES) scoring, Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) scoring, Visual Analog Scale (VAS), and range of shoulder motion.Results:The 3 patients were followed up for 18 to 28 months (mean, 22.7 months). There was no recurrence of infection and the spacers were in good position. The microorganisms detected were Bifidobacterium brevis in one case and methicillin-resistant Staphylococcus aureus in 2 cases. At the final follow-up, the ASES scores averaged 54.4 (from 46.3 to 60.0), Quick-DASH scores 45.1 (from 40.8 to 50.0), VAS scores 2.3 (from 2 to 3), ranges of elevation 65.7 °, ranges of abduction 43.8° and ranges of external rotation 21.7°.Conclusion:For the elderly patients with shoulder infection, implantation of antibiotic shoulder cement spacer after radical debridement can well control infection, relieve pain and improve shoulder functions, sparing them secondary operation.

Ablation Techniques ; adverse effects ; methods ; Humans ; Lung Neoplasms ; diagnostic imaging ; radiotherapy ; surgery ; Postoperative Complications ; prevention & control ; therapy ; Radio Waves ; therapeutic use ; Radiotherapy, Image-Guided ; adverse effects ; methods ; Treatment Outcome

Objective To provide objective parameters for differentiating pancreatic cystic tumors via using computed tomography texture analysis (CTTA) to quantify the special imaging features of pancreatic cystadenomas.Methods Enhanced CT images of pancreas from patients who were admitted in Department of Radiology in First Hospital affiliated with Zhejiang University and First People's Hospital of Hangzhou City and pathologically diagnosed as pancreatic serous cystadenomas (n =48) and mucinous cystadenomas (n =34) from January 2009 to December 2016 were retrospectively analyzed.Regions of interest were drawn on the parenchymal phase CT images in 5 slices according to the border of the tumors.Mean grey level intensity (M),variance (V),entropy (E),skewness (Ske) and kurtosis (Kur) were obtained from fine texture (σ =1.0) to coarse texture (σ =2.5).Receiver operating characteristic (ROC) curve for texture parameters with statistically difference was drawn,and the area under curve (AUC),diagnostic sensitivity and specificity were calculated.The diagnostic accuracy of senior and junior doctors was compared with the traditional CT analysis method.Results Reliability coefficient of the two radiologists was 0.809 ～ 0.997 with high consistency.Compared with mucinous cystic tumors,serous cystadenomas had a significantly different V (5.93 ± 9.02 vs 1.29±0.62),E (2.39±0.61 vs2.02±0.39) and Kur(30.18 ±42.55 vs 8.80-±4.34) in Ske0 of 2.5 (P ＜0.05),and there were no statistically significant differences on other parameters.The AUC of differential parameters for diagnosing two kinds of cystic tumors ranged from 0.56 to 0.84.The diagnostic accuracy of the traditional CT analysis method by junior doctor and senior radiologist was 60％ and 71％,respectively.Conclusions CTTA can not only effectively quantify the heterogeneity of pancreatic cystadenomas,but also is effective in the differentiation.

Objective To investigate TCM resources in Changshou District of Chongqing based on the fourth national census of TCM resources; To provide theoretical references for the protection and exploitation of TCM resources. Methods Sample-plot survey, line survey and interview survey were used in this study. Results Totally 142 families, 482 genera and 639 species (including subspecies and varieties) were collected from the general survey of TCM resources in this region. There were a total of 575 species of medicinal plants, including 456 kinds of ordinary medicinal plants and 119 species of national key medicinal plant which were recorded in the Chinese Pharmacopoeia (2015 Edition). But there was no department leader of the Chinese medicine industry and TCM cultivation was almost blank. Nowadays there was no TCM processing enterprise, and the quality could not be controlled. The continual increase of production cost restricted the development of TCM industry. Conclusion TCM resources in Changshou District of Chongqing are abundant, while the TCM industry is almost blank. The support and guidance from government are needed to develop TCM industry in this area.

Anesthesia, Intravenous ; Bronchoscopes ; Bronchoscopy ; Humans ; Pneumoconiosis ; diagnosis

Objective To estimate the influence of ADAR1 gene,which is considered to be responsible for the pathogenesis of dyschromatosis symmetrica hereditaria,on Wnt1 1 expression and tyrosinase activity.Methods Some cultured HaCaT cells were equally divided into four groups:control group remaining untreated,three experimental groups transfected with three different ADAR1-specific shRNAs respectively.Then,Western blot was performed to quantify the expression of Wnt11 protein in HaCaT cells so as to select the most potent shRNA.Some human A375 melanoma cells were cocultured with untransfected HaCaT cells (normally expressing ADAR1 and Wnt1 1 proteins) or HaCaT cells transfected with the selected specific shRNA (lowly expressing ADAR1 and Wnt11 proteins).Thereafter,cell appearance was observed using inverted microscopy at 24,48 and 72 hours,and tyrosinase activity was estimated at 48 hours.Results As Western blot showed,the expression of Wnt 11 protein was significantly lower in the three ADAR1-silenced experimental groups than in the control group.The number of dendritic protrusions at the junction sites between HaCaT cells and A375 cells was significantly decreased,together with a significant reduction in tyrosinase activity (absorbance value:0.0168 ± 0.0069 vs.0.0490 ± 0.0132,P ＜0.01),in A375 cells cocultured with transfected HaCaT cells compared with those cocultured with normal control HaCaT cells.Conclusion ADAR1 gene silencing in HaCaT cells can attenuate the expression of Wnt11 protein,and affect tyrosinase activity in A375 cells.

Objective To evaluate the clinical efficacy of factional multiplex laser (AffirmTM) with combined apex pulse (CAP) technology in treating depressive acne scars,post inflammatory erythema and enlarged pores and other lesions.By following up,the correlative factors were analyzed to guide the further use of the factional laser (AffirmTM) with CAP technology.Methods Patients who received the AffirmTM laser therapy from Sept.2007 to July 2008 were enrolled in this retrospective follow-up study.Pictures were taken before and after each treatment during the therapy.Then the pictures were evaluated by dermatologists to attain object variables.Other subject variables from patients were recorded during survey.The relation between the efficacy and age,sex and treatment frequencies were analyzed statistically.Results The effective rate was 25.34 ％ for post-acne scars,36.84 ％ for post-acne erythema.28.57 ％ for enlarged pores,and 14.29 ％ for rythids.Nonparametric test showed no statistical difference with gender or age.There was correlation between efficacy and treatment frequencies.No severe adverse effect was observed.Conclusions AffirmTM laser with CAP technology has a good effect on treating post-acne depressed scars and erythema,enlarged pores and fine rythids.