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.

Objective To explore the difference in left ventricular reverse remodeling(LVRR)between coarctation of aorta(CoA)complicated by bicuspid aortic valve(BAV)and that by tricuspid aortic valve(TAV)after percutaneous intervention.Methods The clinical data on 47 patients undergoing percutaneous balloon dila-tion and stent implantation due to CoA in Fuwai Hospital of Chinese Academy of Medical Sciences from January 2014 to December 2021 were retrospectively analyzed.According to the preoperative imaging data,there were 18 patients with BAVA and 29 with TAV.The results of echocardiography before and one year after the procedure were compared.Results CoA Vmax,CoA PG,LVEDd,LVEDdi,LVM and LVMI were significantly improved in CoA patients one year after percutaneous intervention,and 23.4%of the patients developed left ventricular reverse remodeling.AV Vmax,AV PG and LVEDdi in the patients with BAV were higher than those in the TAV group(P = 0.005 and P = 0.007;P = 0.03),and the rate of left ventricular reverse remodeling in BAV patients was lower than that in TAV patients,but there was no statistical significance.Multivariate analysis did not find any influence factors affecting left ventricular reverse remodeling one year after the procedure.Conclusions Part of the CoA patients develops left ventricular remodeling reversal one year after percutaneous intervention.LVRR in patients with BAV is lower than that in those with TAV,which still needs further clinical research.

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.

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 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.

Prosthetic loosening and periprosthetic inflammation, as serious complications after joint replacement surgery, often require the secondary surgery for repair, which is easy to adversely affect the physical/mental health and economic status of patients.Studies have shown that the functional phenotype expressed by macrophages by different stimuli, namely macrophage polarization state, prolonged M1 polarization can lead to the continuation of long-term inflammation, while timely and effective M2 macrophage phenotype will lead to enhanced osteogenesis and tissue remodeling cytokine secretion and subsequent osseointegration, which play a crucial role in the development and outcome of prosthetic loosening and periprosthetic inflammation.The local micro-environment of extracellular matrix (ECM) is an important factor in the activation, migration, proliferation and fusion of macrophages. Researchers have deeply understood it mainly through the crosstalk between surface properties of biomaterials and macrophages. As an effector cell, macro-phages can perform complex spatiotemporal cellular functional responses by sensing the physical and chemical environment (surface topography, wettability, chemical composition, biological proteins) represented by surface properties of biomaterials.This paper summarizes the recent findings on macrophage polarization and material surface properties.

OBJECTIVE： To analyze the application of antibiotics in 18 community health service centers in Shanghai Chongming district， and to further strengthen rational use of antibiotics. METHODS： By retrospective analysis， statistical analysis was made on the monitoring data of antibiotic use and 21 600 prescriptions reported by 18 community health service centers in Chongming district of Shanghai from Jan. 2016 to Dec. 2018 in respect of antibiotics use， top 5 antibiotics in the list of DDDs， prescription analysis， etc. RESULTS： From 2016 to 2018， the average annual total income of medical treatment， drugs and antibiotics of 18 community health service centers in Chongming district of Shanghai were 490 499 000 yuan， 427 231 500 yuan and 41 602 900 yuan respectively. Annual average incomes of outpatient and inpatient antibiotics were 35 435 700 and 6 262 100 yuan. Annual consumption amount of antibiotics were 2 129 627.71 and 70 829.51 DDD. The proportion of antibiotics was 9.76％. Annual antibiotics use density （AUD） was 29.41 DDD. Compound annual growth rate （CAGR） was negative for antibiotics ratio （－3.27％）， outpatient antibiotics consumption amount （－18.40％）， antibiotics consumption amount for outpatient per time      （－17.83％）， inpatient antibiotics consumption amourt （－1.25％） and AUD （－0.98％）. The dosage form of top 5 antibiotics in the list of DDDs within 3 years were oral preparation， among which cefuroxime， cefaclor， levofloxacin and cefpropene were all ranked in the top five in three years. In 21 600 prescriptions， average number of drug per prescriptions was 1.99， the average amount of prescription was 120 yuan， and the number of antibiotics types used accounted for 8.24％ of total drug types； 15.43％ of the prescriptions used antibiotics， the average amount of the prescriptions containing antibiotics was 114.46 yuan， and the total amount of antibiotics accounted for 8.24％ of the total amount of the prescriptions. CONCLUSIONS： The rational use of antibiotics in Chongming community health service center has been continuously improved， and can provide reference for drug management of primary hospitals.

Objective? To investigate the effect of Team collaboration management program on the metabolic syndrome in schizophrenic patients. Methods? From March 2017 to March 2018, the schizophrenic patients with metabolic syndrome who were admitted in Shanghai Mental Health Center Affiliated to Shanghai Jiao Tong University School of Medicine were selected as the participants of this study and divided into observation group (n=45) and control group (n=47) according to the time of admission. The two groups were both given routine treatment and nursing care in psychiatric department. Besides of that, the team collaboration management program was implemented in the observation group. Assessments were done before intervention and 16 weeks after intervention using related metabolic parameters, the Brief Scale of World Health Organization Quality of Life (WHOQOL-BREF) and the Positive and Negative Symptoms Scale (PANSS). Results? There was no significant difference in metabolic parameters, WHOQOL-BREF and PANSS scores between the two groups before intervention (P＞0.05). After 16 weeks of intervention, patients' fasting blood sugar level, body weight, waist circumference, triglyceride, high density lipoprotein and systolic pressure in the observation group were lower than those in the control group, and the difference was statistically significant (P＜0.05). The scores of"physical health" and "psychological function" in WHOQOL-BREF in the observation group were higher than those in the control group, meanwhile, the scores of "positive and general pathological symptoms" in PANSS in the observation group were lower than those in the control group, both with statistical significance (P＜0.05). Conclusions? Team collaboration management program can help controlling the related metabolic parameters of the schizophrenic patients with metabolic syndrome effectively, improve their quality of life and promote recovery from their mental symptoms.

Objective To describe the status of prevalence,awareness,treatment,and control of hypertension among the residents in severe historical endemic areas of Keshan Disease in Heilongjiang Province,and to provide scientific evidence for prevention and control of hypertension.Methods In December 2015,Yongjin,Yongli groups of Yongjin Village,and Fengnian,Fengtian,Fengfu groups of Fengnian Village in Fanrong Township,Fuyu County,Qiqihaer City,Heilongjiang Province were selected via the cross-sectional method.The residents aged 18 years or older were surveyed as respondents by cluster sampling.Demography,risk factors,hypertension related information were collected through questionnaire survey.Blood pressure,height and weight were measured through physical examination.Blood pressure measurement was conducted with Omron HEM-1020 electronic sphygmomanometer,the diagnostic criteria was Chinese Guidelines for Prevention and Treatment of Hypertension (revised in 2010).Results Totally 683 residents were surveyed,the valid participants were 669,the prevalence of hypertension was 49.2％ (329/669),the standardized prevalence was 37.9％,the prevalence of men [58.0％ (164/283)] was higher than that of women [42.7％ (165/386),x2 =15.103,P ＜ 0.01],the prevalence increased with increasing age (total,men,women:x2tendency =9.044,4.560,7.789,all P ＜ 0.01).The awareness of hypertensive patients was 60.8％ (200/329),the standardized awareness was 41.2％,the awareness of men [54.3％ (89/164)] was lower than that of women [67.3％ (111/165),x2 =5.836,P ＜ 0.05],the awareness of hypertensive patients increased with increasing age (total,men,women:x2tendency =3.638,2.686,2.419,all P ＜ 0.05).The treatment of hypertensive patients was 51.1％ (168/329),the treatment of men [43.9％ (72/164)] was lower than that of women [58.2％ (96/165),x2=6.711,P ＜ 0.05],the treatment of hypertensive patients increased with increasing age (total,men,women:x2tendency =4.422,2.704,3.633,all P ＜ 0.01).The control rate of hypertensive patients was 5.5％ (18/329),the control rate among the treatment was 10.7％ (18/168).Conclusions The standardized prevalence of hypertension among the residents of the severe historical endemic areas of Keshan disease in Heilongjiang Province is higher than the national average (25.2％),the standardized awareness is lower than the national average (46.5％),the treatment and the control are low.We should pay more attention to the hypertension in the severe historical endemic areas of Keshan disease.