[Objective]To explore the role of estrogen and estrogen receptor (ER) in the pathogenesis and regulation of non-invasive fungal rhinosinusitis (NIFR).[Methods]Totally 60 patients with NIFS who met the inclusion criteria in Fuzhou Second General Hospital from November 2020 to November 2023 were selected as the NIFS group,while 30 healthy volunteers were recruited as the blank control group. Samples of each group were collected. The number of eosinophils and mast cells in each group were detected by HE staining;ER expression was detected by immunohistochemistry and immunofluorescence;mRNA expression levels of NF-κB,IKK and MASPIN were detected by qPCR;and protein expression levels of NF-κB,IKK and MASPIN were detected by immunohistochemistry and Western blot.[Results]In the NIFS group,the counts of eosinophils and mast cells were significantly increased respectively,compared with those in the control group,and the inter-group differences are statistically significant (P<0.01 and P<0.05,respectively). The Estrogen Receptor (ER) score in the NIFS group was significantly increased compared with that in the control group,and the inter-group differences are statistically significant (P<0.05). Additionally,the average high-density value in the NIFS group was significantly increased compared with that in the control group,and the inter-group differences are statistically significant (P<0.01). The expression levels of NF-κB,IKK,and MASPIN in the NIFS group were significantly increased respectively,compared with those in the control group,and the inter-group differences are statistically significant (P<0.01,P<0.05,and P<0.01,respectively). The mRNA expression levels of NF-κB,IKK,and MASPIN in the NIFS group were significantly increased,respectively,compared with those in the control group (P<0.01). Furthermore,the protein expression levels of NF-κB,IKK,and MASPIN in the NIFS group were increased,respectively,and the inter-group differences are statistically significant (P<0.01,P<0.01,and P<0.05,respectively).[Conclusion]Our results show that the significant increase in the number of eosinophils and mast cells,and in the expression levels of ER,NF-κB,IKK and MASPIN may indicate a significant increase in eosinophil and mast cell infiltration in ER positive patients,and suggest the involvement of estrogen and its receptors in the pathogenesis of NIFS.

Objective:To observe any effect of functional magnetic stimulation (FMS) of the sacral 3 nerve root on relieving urine retention after a spinal cord injury.Methods:Forty-four patients with neurogenic bladder disorders after a spinal cord injury were divided at random into a 5Hz group ( n=14), a 20Hz group ( n=15), and a sham stimulation group ( n=15). In addition to conventional bladder control training, the 5Hz and 20Hz groups were given 20 minutes of FMS of the sacral 3 nerve root at the appropriate frequency five days a week for 4 weeks. The sham stimulation group was not given any stimulation. A detailed urination diary was kept during the treatment, and before and after the 4 weeks, everyone′s bladder pressure volume was assessed and an electromyogram was recorded. Results:After the treatment those in the 5Hz and 20Hz groups had improved significantly in terms of average bladder capacity, bladder pressure, residual urine volume, daily number of urethral catheterizations, daily micturition frequency, single urine output, H-reflex latency, and the amplitude and incubation period of the F wave. Those in the sham stimulation group showed no consistent improvement in any of these indicators. Moreover, the average residual urine volume, daily urination frequency and H-reflex latency and amplitude of the 20Hz group were significantly better than those of the 5Hz group.Conclusions:Magnetic stimulation of the S3 nerve roots can effectively improve the urination of persons with neurogenic bladder disorders after a spinal cord injury. The preferred frequency is 20Hz.

Objective:To observe the effect of repeated, bilateral administration of high-frequency transcranial magnetic stimulation (rTMS) in treating post-stroke dysphagia.Methods:Forty-five persons with post-stroke dysphagia were randomly divided into a bilateral group ( n=14 after one dropout), an affected group ( n=15) and a healthy group ( n=15). All received 30 minutes of conventional swallowing rehabilitation training 5 times a week for 2 weeks from a speech therapist. Those in the affected group also received 5Hz rTMS applied to the motor cortex controlling the suprachyoid muscle group. The bilateral group received the same stimulation bilaterally with the same duration and treatment course. Videofluoroscopy was used to assess their swallowing before and after the 2 weeks of treatment. It was rated using the penetration-aspiration scale (PAS) and the functional swallowing disorder scale (FDS). Surface electromyography was employed to evaluate suprachyoid muscle function. Cortical excitability was assessed by measuring the resting motor threshold (RMT) of the unaffected hemisphere. Results:After the treatment, the average PAS, FDS and muscle function values had improved significantly for all three groups, but significant RMT differences were observed only between the bilateral and the unaffected group. Significant differences in the average FDS and PAS scores were observed after the treatment, as well as significant changes in FDS and muscle function between the affected group and the other two groups. The average FDS scores before and after treatment were significantly different between the unaffected and bilateral group, with the former scoring significantly better than the latter. But no significant differences in the average PAS scores were observed after the treatment.Conclusions:5Hz rTMS of either the unaffected or affected cerebral cortex (or bilateral) can effectively improve the swallowing function of persons with post-stroke dysphagia. Bilateral stimulation has the greatest therapeutic effect, followed by stimulation of the unaffected cerebral cortex.

Objective:To investigate the value of rate-pressure product (RPP) in predicating the prognosis of postural tachycardia syndrome (POTS) in children.Methods:Fifty-three children (26 males and 27 females) aged 5 to 15 who had syncope of unknown reasons or presyncope and were diagnosed with POTS by head-up tilt test (HUTT) at the Children′s Syncope Specialist Clinic, the Second Xiangya Hospital, Central South University from April 2012 to May 2019 were selected as the POTS group.Thirty-eight children aged 5 to 16 (19 males and 19 females) who underwent medical examinations at the Children′s Health Specialist Clinic of the Second Xiangya Hospital, Central South University over the same period were enrolled as controls (control group). POTS children were followed up after intervention and they were divided into the response group ( n=40) and the non-response group ( n=13) according to the follow-up results.The products (RPP0, RPP5, RPP10) of the heart rate (HR0, HR5, HR10) and systolic blood pressure (SBP0, SBP5, SBP10) at baseline (HUTT 0 min), HUTT 5 min and HUTT 10 min were calculated.Statistical analysis was performed using SPSS 22.0 software and EmpowerStats software. Results:(1) There was no statistical difference in age and gender between the POTS group and the control group (all P> 0.05). (2) HR5 [(115.45±14.50) times/min vs.(95.79±13.89) times/min], HR10 [(120.57±16.13) times/min vs.(96.05±12.43) times/min], RPP5 (12 814.55±2 304.56 vs.10 371.42±1 910.20), and RPP10 (13 449.17±2 360.40 vs.10 523.18±1 771.48) in the POTS group were significantly higher than those in the control group( t=0.799, 7.842, 5.747, 6.446, all P<0.01). No statistical difference of HR0 and RPP0 was observed between the 2 groups (all P>0.05). (3) In the POTS group: HR5 [(98.73±12.43) times/min vs.(113.77±17.65) times/min], HR10 [(96.90±13.96) times/min vs.(119.08±13.52) times/min], RPP5 (11 125.45±1 952.35 vs.12 914.69±3 192.12) and RPP10 (10 819.58± 2 144.26 vs.13 375.46±2 807.01) in the response group were significantly lower than those in the non-response group( t=3.406, 5.012, 2.432, 3.455, all P<0.01). HR0 and RPP0 were no significantly different between the 2 groups(all P>0.05). (4) When SBP10<114 mmHg(1 mmHg= 0.133 kPa), the probability of response after POTS intervention increased by 10% with every 1 mmHg increase in SBP10, and there was a non-linear relationship between the 2 group ( P<0.05). (5) The receiver operating characteristic curve suggested that when RPP5 was 11 548.50, the sensitivity and specificity to predict the response after POTS intervention were 81.82% and 61.70%, respectively.When RPP10 was 10 988.00, the sensitivity and specificity were 77.78% and 86.21%, respectively. Conclusions:RPP is closely related to the intervention effect of POTS in children.RPP5 and RPP10 can predict the prognosis of POTS in children.There is a non-linear relationship between SBP10 and the intervention effect of POTS in children.

Objective:To explore the effect of high-frequency and low-frequency transcranial magnetic stimulation (rTMS) on the unaffected pharyngeal motor cortex of dysphagic stroke survivors.Methods:Forty-two stroke survivors with dysphagia were enrolled and randomly divided into a high-frequency stimulation group ( n=14), a low-frequency stimulation group ( n=13), and a sham group ( n=15). All received conventional swallowing training. The high- and low-frequency stimulation groups additionally received 250 pulses of 5Hz or 1Hz rTMS over the cortical representation of the mylohyoid muscle on the unaffected side daily for 2 consecutive weeks. In the sham group, sham rTMS was applied with identical protocols. Before and after the intervention, all subjects were subjected to a videofluoroscopic swallowing study and surface electromyography (sEMG). They were also evaluated using the fuctional dysphagia scale (FDS) and the penetration aspiration scale (PAS). Results:After the intervention, a significant improvement was observed in the average PAS, FDS and sEMG results in both rTMS groups compared with the sham control group. The average FDS score of the high-frequency stimulation group had improved significantly more than that of the low-frequency group.Conclusions:rTMS of the contra-lesional cortical representation of the mylohyoid muscle at either 5Hz or 1Hz can effectively improve dysphagia post-stroke. The higher frequency gives superior results.

Objective To discuss the relationship between body mass index(BMI)and flag_raising syncope ( PS)and micturition syncope(MS)in children and adolescents. Methods One hundred and six children and adoles_cents with PS or MS diagnosed at the Department of Dediatric Cardiovasology,Childrenˊs Medical Center,the Second Xiangya Hospital,Central South University from January 2003 to September 2017 were studied,including 51 males and 55 females,and their ages ranged from 5 to 18 years. There were 63 cases in the PS group(21 males and 42 females) and 43 cases in the MS group(30 males and 13 females). One hundred healthy children and adolescents including 50 males and 50 females who had routine healthy examinations at the hospital in the same period were selected as control subjects(healthy control group). Body length and body mass were measured,and BMI was calculated. Statistical inves_tigations were conducted with SDSS 22. 0 software. Results (1)The body mass and BMI in the PS group were lower than those in the MS group[(36. 33 ± 9. 85)kg vs.(42. 85 ± 12. 44)kg;(16. 56 ± 2. 41)kg∕m2 vs.(18. 48 ± 3. 04) kg∕m2],and the differences were statistically significant(F﹦7. 529,12. 411,all P〈0. 05). There was no difference in body length among the PS group,the MS group and the healthy control group[(146. 62 ± 12. 89)cm vs.(150. 79 ± 12. 78)cm vs.( 149. 75 ± 16. 02 )cm,F ﹦1. 314,P 〉0. 05 ]. No differences were found in age,frequency,body length,body mass and BMI between the PS syncope group and the MS group with different genders(all P〉0. 05).(2) The number of BMI_underweight children increased in the PS group(82. 53%,52∕63 cases)compared with that of the MS group(58. 14%,25∕43 cases)and that of the healthy control group( 52. 00%,52∕100 cases),and the difference was statistically significant(χ2 ﹦14. 556,P〈0. 01).(3)The positive rate by head_up tilt test(HUTT)was 72. 64%(77∕104 cases),and HUTT of the PS group was higher than that of the MS group[82. 53%(52∕63 cases)vs. 58. 14%(25∕43 cases)],and there was a significant difference statistically(χ2 ﹦7. 656,P〈0. 01). Conclusions Low BMI is prone to PS in children and adolescents.

Objective To investigate the genetic evolution of VP1 gene of pathogenic coxsackievirus A16 (CV-A16) strain isolated from clinical hand,foot,and mouth disease (HFMD) patients.Methods A total of 160 HFMD cases with CV-A16-positive results were collected from hospitals in Kunming during January 2015 to June 2017.Fecal samples were collected.Real-time polymerase chain reaction (PCR) was used to detect the CV-A16 virus nucleic acid.The VP1 genes of CV-A16-positive samples were amplified by reverse transcription-PCR.The amplified positive products were sequenced and aligned.The homologies were identified and their subgenotypes were determined.The phylogenetic tree was constructed and homology modeling was conducted.Results All the 160 CV-A16 isolates were B2 subtypes.The genetic distance between detected strains of CV-A16 and the strains in Fujian,Beijing,Nanjing was 0.76.The genetic distance to the strains in Malaysia was 0.78,and to the strains in Australia was 1.86.Homologous modeling revealed that the amino acid sequence of the VP1 gene of the strain had a G227R mutation.Conclusions There is no major genetic variation in the CV-A16 strains during 3 years.CV-A16 isolates are close to those of epidemic strains in Beijing,Fujian and Malaysia,but are far fram the strains from Australia.

Objective To observe the effect of injecting botulinum toxin type A ( BTX-A) into the tibialis anterior muscle on spasm and the walking function of stroke survivors with spastic foot drop and strephenopodia. Methods Fifty-six stroke survivors with spastic foot drop and strephenopodia were randomly divided into a tibialis anterior injection group ( Group TA) and a conventional injection group ( Group CG) , each of 28. Both groups had 50 U of BTX-A injected into the medial-lateral heads of the affected gastrocnemius and soleus muscles, and 35 U in-jected into each of two sites in the tibialis posterior. Group TA was additionally injected with 30 U in the tibialis ante-rior. Before the injection, as well as 2, 4 and 12 weeks afterward, both groups were evaluated using the modified Ashworth scale (MAS) for the plantar flexors and varus muscle groups, a 10-minute walking test (10 m-WT), a simple Fugl-Meyer assessment ( FMA) of the lower limb and a timed up and go test ( TUG) . Results Before the injection, there were no statistically significant differences in the average MAS, 10 m-WT, FMA or TUG results be-tween the two groups. After 2 weeks, however, the average MAS score of both groups had decreased significantly, and that improvement was maintained at 4 and 12 weeks after the injection. Moreover, 2, 4 and 12 weeks after the injec-tion, significant differences in the average MAS score were observed between the two groups. The average 10m-WT re-sults, FMA scores and TUG times of both groups also improved significantly, but there were significant differences between the two groups′10m-WT times and FMA scores after 2 and 4 weeks. Conclusions Injecting a small dose of BTX-A into the tibialis anterior can further relieve spasm in the tibialis anterior muscle and improve the walking a-bility of stroke survivors with spastic foot drop and strephenopodia.

Objective To explore the dilution regression method of coagulation detection(PT ,APTT) in fat blood samples . Methods We collected 40 normal blood coagulation specimens (no fat blood ,no jaundice ,no hemolysis) in Yan′an hospital of Kun-ming ,then we detected the PT and APTT of the original plasma and 3-fold diluted plasma and 5-fold diluted plasma ,the we used the data both of before dilution and diluted to do the linear regression analysis ,and finally we got the regression equations of each index .we also collected 33 fat blood samples in Yanan hospital of Kunming ,which be divide into three groups through the severity of triglycerides :mild fat blood group(1 .7 mmol/L≤TG<11 .0 mmol/L) and moderate fat blood group(11 .0 mmol/L≤TG<20 .0 mmol/L)and severe fat blood group(TG≥20 .0 mmol/L) ,then we detected the PT and APTT after 3-fold diluted plasma and high-speed centrifugation plasma ,and then we brought diluted results into the normal regression equations and the results were compared with the high-speed centrifugation results .Results Because most of the 5-fold diluted plasma can not get the effective results ,so we use 3-fold diluted plasma to get the regression equations .The results of 3-fold diluted plasma was calculated by the regression equa-tions ,which then compared with high-speed centrifugation results ,after the analysis of statistical software ,two results had not sta-tistically significant (P>0 .05) .Conclusion Dilution regression method can be used to detect the fat blood samples in the clinical coagulation detection .

Objective To explore the suitable delayed time of MSCT mesenteric venography and to probe the value of different post-processing methods.Methods 49 patients with abdominal pain (group A)underwent MSCT mesenteric venography with a delayed time of 15-20 s after the arterial phase,and the CT showed the mesenteric vein(MV)was normal.Meanwhile,other 49 ones with abdominal pain (group B)underwent conventional biphasic CT with a delay-time of 35 s after arterial phase.The CT value and diameter of superior mesenteric vein between two groups were compared,and the grading,scoring and display of mesenteric vein with different post-processingmethods were assessed.Results The diameters of SMV were (10.52±2.19)mm in group A and (9.88±2.60)mm in group B,exhibiting no statistically significant difference (P >0.05);Meanwhile the average attenuations of SMV were (1 96.55±40.59)HU in group A and (1 64.32± 28.35)HU in group B,exhibiting a statistically significant difference (P<0.05).In addition,the display ability and scoring of mesenteric vein and its branches on volume rendering (VR)in group A were better than those in group B (P <0.05).VR was better in display of the vascular space distribution than maximum intensity projection (MIP)and sliding thin slab maximum intensity projection (STS-MIP),the STS-MIP was better in display of tiny blood vessels than VR and MIP,and the curved planner reformation (CPR)was superior in display of vascular lumen and the relationship with adjacent structures.Conclusion The image quality of mesenteric vein with the delayed time of 1 5-20 s after arterial phase is superior to that with delayed time of 35 s,and different advantages of the post-processing methods are showed in display of MV.