Objective:To analyze the risk factors for complications of the retromandibular approach in patients with parotid gland posterior and lower pole tumors.Methods:A retrospective analysis was conducted on the clinical data of 140 patients with parotid posterior lower pole tumors admitted to the Xingtai Third Hospital from October 2019 to October 2021. They were divided into two groups based on whether complications occurred: the occurrence group and the non occurrence group. General data of the two groups of patients were collected, including age, gender, course of disease, previous surgical history, number of tumors, tumor length, resection range, facial nerve dissociation, tumor site resection frequency, and fascia preservation; Single factor and logistic multivariate analysis were conducted to determine the risk factors for complications of the posterior retromandibular approach in patients with parotid gland posterior and lower pole tumors.Results:A total of 140 patients with parotid gland posterior lower pole tumors underwent retromandibular approach treatment, with complications occurring in 38 cases (27.14%), including 7 cases of temporary facial paralysis, 10 cases of facial depression, 11 cases of Frey syndrome, 2 cases of fistula, and 8 cases of sensory abnormalities of the greater auricular nerve. Through logistic multivariate analysis, it was found that the number of tumors ≥ 2 ( OR=2.856), the resection range (total resection) ( OR=2.477), the number of surgeries ≥3 ( OR=5.637), facial nerve dissociation ( OR=3.526), and lack of fascia preservation ( OR=2.551) were all risk factors for postoperative complications in patients with parotid posterior pole tumors (all P<0.05). Conclusions:In clinical practice, relevant prevention and treatment measures should be formulated for these high-risk factors to reduce the incidence of postoperative complications.

Objective:To investigate the molecular features of hand, foot and mouth disease (HFMD) caused by coxsackievirus A10 (CVA10) in Qingdao and analyze the clinical features of mild and severe cases.Methods:A total of 6 677 cases of HFMD routinely monitored by Qingdao Women and Children Hospital from 2014 to 2021 were enrolled. Throat swab samples were collected. Clinical data of these cases were retrospectively analyzed. Virus nucleic acid was extracted from the samples and the serotypes of enteroviruses were identified. The VP1 genes of CVA10 strains were amplified and sequenced. A phylogenetic tree based on the VP1 gene sequences was constructed using MEGA7. 0 software. SPSS23.0 software was used for statistical analysis.Results:There were 285 cases positive for CVA10, including 183 males and 102 females, and children under five years old accounted for 89.8%. Most of CVA10 infection occurred between the months of April to September. The count of white blood cells, the percentage of neutrophils, the concentration of hemoglobin, and the levels of aspartate aminotransferase and alanine transaminase were significantly higher in severe patients than in mild patients. Besides, chest radiography and brain CT revealed more abnormalities in severe patients, and the duration of ECG monitoring was longer in them. Compared with mild cases, severe cases developed rash early than fever with rash mostly on buttocks ( P<0.05). Phylogenetic analysis showed that most of the CVA10 strains circulating in Qingdao between 2014 and 2021 belonged to clade Ⅰ, and there were two variations A23V and I283V in the amino acid sequence of clade Ⅰ. Conclusions:This study showed that children of all ages were susceptible to CVA10, especially those under five years old. CVA10 showed complex and diverse epidemic trends in different regions and years.

Objective To explore the differentially expressed micro RNAs (miRNAs) in serum-derived extracellular vesicles (EVs) of patients with Parkinson's disease (PD) and healthy individuals.Methods Thirty-six patients with late-onset Parkinson's disease (LOPD,age of onset being more than 50 years),20 patients with early-onset Parkinson's disease (EOPD,age of onset being no more than 50 years),and 10 healthy individuals were collected in our hospital from January 2015 to December 2017.Serum of all subjects was collected and EVs were extracted.The miRNA chip and real-time quantitative (qRT)-PCR were used to analyze and verify the differentially expressed exosomal miRNAs between PD patients and healthy individuals;Cytoscape software was used to analyze the common target genes regulated by differentially expressed miRNAs,and String database was used to analyze the interaction and function of target genes.And qRT-PCR was further used to analyze the expression level and correlation of differentially expressed miRNAs and their target genes in patients with EOPD and LOPD,respectively.Results As compared with healthy individuals,LOPD patients had significantly up-regulated expression levels ofmiR-143-3p and miR-1180 in the serum derived EVs,and statistically down-regulated miR-451 and miR-500 levels (P＜0.05).The miR-143-3p expression level in EOPD patients was significantly higher than that in LOPD patients (t=3.888,P=0.018).The target genes B-cell lymphoma-2 (BCL2) and AKT1 were involved in regulating the cholinergic synapses and neurotrophin signaling pathways,and the BCL2 relative expression level in EOPD patients was significantly higher than that in LOPD patients and healthy controls (P＜0.05);and the relative expression levels of BCL2 and miR-143-3p were negatively correlated in the serum derived EVs of EOPD patients (r=-0.556,P=0.025).Conclusion The miR-143-3p and BCL2 expression levels are negatively correlated in the serum derived EVs of EOPD patients;changes of expression level may be related to plasticity of synaptic structure and apoptosis of nerve cells.

Objective: To illuminate the gene characteristics and clinical characterization of Coxsackievirus B5 (CV-B5) strains isolated from patients with sevre hand, foot and mouth disease (HFMD) in Qingdao city. Methods: A total of 1 844 patients of HFMD were consecutively admitted to Qingdao Women and Children's Hospital from 2013 to 2014. Information of the study population described above was collected retrospectively. The samples were collected from at least 1 site (throat swab, cerebrospinal fluid), which viral nucleic acid extracted and the entire VP1 gene sequences of CV-B5 isolates were amplified and sequenced, then the homology and phylogeny analysis were conducted by MEGA7.0. The prototype Faulkner strain and other VP1 amino acid sequences were derived from the GenBank database. Results: A total of 8 CV-B5 positive cases were obtained, including 4 males and 4 females; 6 severe hospitalized cases and 2 outpatients. The age of 6 hospitalized patients ranged from 3 to 48 months, with a median of 26 months. For the six inpatients, fever, convulsions vomiting, diarrhea and rash were the main clinical manifestation, and all combined with viral encephalitis. Compared with the prototype strain Faulkner, in the VP1 region,the nucleotide and the amino acid homologies was 77.3%-78.8% and 95.5%-97.0% respectively. Five out of the six severe cases with substitution of serine (S) to asparagine (N) at amino acid site 95 in the VP1 region. The sequences of 8 CV-B5 strains were classified into genogroup D. Conclusion Hand, foot and mouth disease associated with CV-B5 virus infection can result in nervous system involvement and the main complication was viral encephalitis. The CV-B5 strains associated with severe hand, foot and mouth disease had high nucleotide homology and present a certain regional aggregation.

Objective To investigate the effect of preoperative percutaneous dilatational trache-otomy (PDT)in oral and maxillofacial surgery anesthesia versus traditional surgical tracheotomy (ST).Methods General data,vital signs,operation time,anesthetics,the amount of bleeding and complications during the procedure were analyzed after reviewing the clinical data of 124 cases under-going radical correction of oral and maxillofacial tumor plus flap transferring and repairing and trache-otomy during May 2013 to May 201 5.Results A total of 124 cases were divided into two groups:PDT group (group P,n =41)and ST group (group S,n =83).There was no significant difference of general data between the two groups.The incision length and operation time were significantly shorter and the amount of bleeding was remarkably lower in group P than those in group S (P <0.05),while the incidence of complications was not significantly different between the two groups.Conclusion PDT has more advantages over traditional ST and is a better airway approach in oral and maxillofacial surgery.

Objective:To investigate the clinical efficacy of neoadjuvant chemotherapy with XELOX (oxaliplatin+capecitabine) regimen combined with postoperative adjuvant concurrent radiotherapy and chemotherapy for stage III advanced gastric cancer. Methods:A total of 55 patients with stage III advanced gastric cancer from Shouguang People's Hospital, Zibo Central Hospital, and Shandong Qian-foshan Hospital of Shandong University were enrolled in this study. The patients were randomly divided into the treatment group and the control group. In the treatment group, 28 patients were treated with neoadjuvant chemotherapy with XELOX regimen, underwent surgery, and then received postoperative adjuvant three-dimensional conformal radiotherapy synchronous XELOX regimen. In the con-trol group, 27 cases underwent surgery in advance, and received radiotherapy synchronous XELOX regimen. Results:The objective re-sponse rate of the treatment group was 75%. The tumor resection rate was 92.9%, which was significantly higher than that of the con-trol group at 81.5%(P=0.049). The tumor radical resection rates in the treatment and control groups were 71.4%and 44.4%, respec-tively, which are significantly different (P=0.043). The lymph node metastasis in the treatment group was 48.2%, which was significant-ly lower than that of the control group at 60.2%(P=0.006). In the treatment group, one case achieved pathologic complete tumor re-gression, 9 cases were of good tumor regression, and 7 cases were of moderate tumor regression. The 1-year, 2-year, and 3-year surviv-al rates of the treatment and control groups were 88.9%vs. 69.2%, 66.7%vs. 46.2%, and 59.3%vs. 38.5%, respectively, which are sig-nificantly different (P=0.037, P=0.045, and P=0.049). The results showed no significant difference of incidence of toxicity in the two groups (P>0.05). Conclusion: Neoadjuvant chemotherapy with XELOX regimen combined with postoperative adjuvant concurrent chemoradiotherapy for stage III advanced gastric cancer can improve the radical resection rate and long-term postoperative survival rate of patients, as well as reduce the rate of lymph node metastasis.

Objective To investigate the relationship between metabolites of sodium arsenite and sodium dihydrogen arsenate with related metabolic enzymes in kidney of male rats.Methods According to body mass,thirty-five male Wistar rats(body mass 150-190 g) were divided into 7 groups by random number table.Control group drank deionized water; the contents of iAsⅢ in low,medium and high arsenite groups and the contents of iAsv in low,medium and high of sodium dihydrogen arsenate groups were 2.2,6.7 and 20.0 mg/kg,respectively.After 3 months,kidneys were collected and stored at-80 C; high performance liquid chromatography and hydride genesis atomic fluorescence spectroscopy (HPLC-HGAFS) was used to determine the level of arsenic metabolites in kidney,and enzyme-linked immunosorbent assay was used to detect and analyze the content or the activity of metabolic enzymes,meanwhile correlation studies between the level of metabolites and the activity of metabolic enzymes were carried out.Results The differences of total arsenic (TAs),dimethyl arsenic acid (DMA),monomethyl arsenic acid (MMA) and methyl transferase enzyme activity in kidneys of rats between groups were statistically significant (F =1874.672,H =33.513,31.002,F =79.607,all P ＜ 0.01).The TAs[(526.52 ± 25.56),(1 654.00 ± 101.55),(1 904.24 ± 104.76)μg,/kg] and DMA[(323.20 + 16.13),(1 444.40 ± 113.81),(1 765.40 ± 104.39)μg/kg] of sodium arsenite in low,medium and high dose groups were higher than those of the corresponding sodium dihydrogen arsenate groups [(235.70 ± 6.23),(471.05 ± 18.32),(1 677.40 ± 83.29)μg/kg,and(0.00 ± 0.00),(1.75 ± 0.16),(410.50 ± 19.76)μg/kg,P ＜ 0.0024 or ＜ 0.05] ; the MMA[(4.02 + 0.86),(4.20 ± 0.65),(4.04 ± 0.80)μg/kg] of sodium arsenite in low,medium and high dose groups were lower than those of the corresponding sodium dihydrogen arsenate groups[(98.90 ± 9.59),(376.50 ± 15.41),(1 131.90 ± 74.26) μg/kg,all P＜ 0.05]; the methyl transferase enzyme activities[(7.80 ± 0.93),(5.55 ± 0.49),(3.56 ± 0.26)U/g] of sodium arsenite in low,medium and high dose groups were lower than those of the corresponding sodium dihydrogen arsenate group[(11.59 ± 0.93),(8.93 ± 0.88),(6.52 ± 1.04)U/g,all P ＜ 0.0024].The DMA of sodium arsenite in low,medium and high dose groups,the MMA of sodium dihydrogen arsenate in medium and high dose groups were positively correlated with those of TAs in each group(r =0.970,0.984,0.997,0.947,0.961,all P ＜ 0.05).Conclusions Effects of sodium arsenite and sodium dihydrogen arsenate on arsenic metobdites and related metabolic enzymes in kidney of rats are different.The function of sodium dihydrogen arsenate in promoting methyl transferase activity is stronger than that of sodium arsenite,which affects the amount and distribution of arsenic methylation metabolites in kidney.

Objective To assess the feasibility,safety and efficacy of endoscopic papillectomy (EP) for tumors at the ampulla of Vater (AV).Methods A total of 15 patients with tumor at AV that were indicated for EP were included in this prospective study.Their clinical profiles,procedural parameters and outcome were evaluated.Results All patients underwent EP procedure successfully.Four patients who were diagnosed as having chronic inflammation in the reference endoscopy were confirmed as having adenoma after EP.Out of the 11 patients who were previously diagnosed as andenoma on biopsy,2 of low differentiated adenocarcinoma,1 of well differentiated adenocarcinoma and 1 malignant transformation were pathologically confirmed after EP.Stents were implanted in 8 patients with dilated pancreatic and/or common bile duct.Except for 2 cases of melena and 2 transient elevated level of blood amylase after EP,no other major complications occurred.Three patients,including 1 case of low-differentiated adenocarcinoma,1 case of malignant transformation and 1 case of lesion residual,were referred to surgery,another patient with low-differentiated adenocarcinoma declined any additional intervention because of old age.In the remaining 11 cases ( 11/15,73.3％ ) including one well differentiated adenocarcinoma,no recurrence was observed during a follow-up period of 23.4 (5 to 47) months.Conclusion EP is a minimal invasive,safe and effective treatment for tumors at AV,which also can provide an accurate staging of the lesion.

OBJECTIVETo establish a method for the content determination of paprazine in Polygonum orientale, and provide a new evaluation index for the quality control for P. orientale.

METHODHPLC was carried out on Agilent C18 (4.6 mm x 150 mm, 5 microm) with methanol-water (40:60) as mobile phase. The flow rate was 1.0 mL x min(-1) and the wavelength of UV detector was set at 290 nm.

RESULTThe calibration curve was linear in the range of 0. 038-0.190 microg (r = 0.9999). The average recovery was 98.7% with the RSD of 2.36%.

CONCLUSIONThe method appears to be simple, accurate and reproducible, it can be used to determine the content of paprazine in P. orientale.

OBJECTIVETo establish the method for determining simultaneously eight kinds of ginsenoside Rg1, Re, Rf, Rg2, Rb1, Rc, Rb3 and Rd and their contents in Shizhu ginseng.

METHODHPLC was carried out on Agilent TC-C18 (4.6 mm x 150 mm, 5 microm) with acetonitrile -0.05% phosphoric acid, gradient elution, the volume of flow 1 mL x min(-1), column temperature 30 degrees C and detection wavelength 203 nm.

RESULTThe contents of eight kinds of ginsenosides in Shizhu ginseng were 1.32, 2.08, 0.72, 0. 24, 2.12, 1.06, 0.35, 0.55 mg x g(-1), respectively.

CONCLUSIONThe contents of ginsenoside ingredients in Shizhu ginseng were determined in the first time. The established method can be used in determining the contents of multiple gensenosides in herb ginseng simultaneously.