Botulinum toxin type A (BTX-A) is widely used in clinical practice due to its precise efficacy, high safety and low invasiveness. BTX-A injections may cause some common complications, such as unnatural expression, brow deformity, ptosis, diplopia, and, rarely, allergic reactions, dysphagia, and dyspnea. There are reports in the literature that visual loss can also occur after injection, and although there are very few relevant reports, this should also attract sufficient attention from clinicians. To this end, the authors reviewed the relevant literature in recent years and reviewed the clinical manifestations, pathogenesis and treatment method of vision loss caused by BTX-A injection.

Botulinum toxin type A (BTX-A) is widely used in clinical practice due to its precise efficacy, high safety and low invasiveness. BTX-A injections may cause some common complications, such as unnatural expression, brow deformity, ptosis, diplopia, and rare allergic reactions, dysphagia, and dyspnea. There are reports in the literature that visual loss can also occur after injection, and although there are very few relevant reports, clinicians should pay enough attention on it. To this end, the authors reviewed the relevant literature in recent years and reviewed the clinical manifestations, pathogenesis and treatment method of vision loss caused by BTX-A injection.

Objective:To analyze the audiology and occupational health data of applicants diagnosed of occupational noise deafness, and to explore the influencing factors in the diagnosis of suspected occupational noise deafness.Methods:In May 2022, the information of patients diagnosed with occupational noise deafness in Peking University Third Hospital from January 2018 to December 2021 was collected, and the occupational health data of their working environment, clinical audiological examination results and diagnosis basis of occupational noise deafness were collected and analyzed. Multi-factor unconditional logistic regression analysis was used to analyze independent risk factors for the diagnosis of occupational noise deafness.Results:A total of 129 subjects were included, all of which were suspected cases of occupational noise deafness found in various occupational health examination institutions. Eight cases (6.20%) were diagnosed as occupational noise deafness, and 121 cases (93.80%) were non-occupational noise deafness. After hearing examination, only 27.27% (24/88) of the patients' audiological changes were consistent with the starting point of occupational noise deafness diagnosis. Further analysis of the noise intensity in the workplace showed that 16 patients were identified as non-occupational noise deafness because the noise intensity of the working environment was less than 85 dB. Logistic regression analysis showed that the working hours were more than 8 hours ( OR=9.274, 95% CI: 1.388-61.950, P=0.022) and the noise intensity of the working environment ( OR=1.189, 95% CI: 1.059-1.334, P=0.003) were independent risk factors for the diagnosis of occupational noise deafness. Conclusion:The exclusion rate of suspected occupational noise deafness found in occupational health examination is higher after adequate rest. The test results of working environment noise intensity provided by the employer can help to determine occupational noise deafness.

Botulinum toxin type A (BTX-A) is widely used in clinical practice due to its precise efficacy, high safety and low invasiveness. BTX-A injections may cause some common complications, such as unnatural expression, brow deformity, ptosis, diplopia, and, rarely, allergic reactions, dysphagia, and dyspnea. There are reports in the literature that visual loss can also occur after injection, and although there are very few relevant reports, this should also attract sufficient attention from clinicians. To this end, the authors reviewed the relevant literature in recent years and reviewed the clinical manifestations, pathogenesis and treatment method of vision loss caused by BTX-A injection.

Botulinum toxin type A (BTX-A) is widely used in clinical practice due to its precise efficacy, high safety and low invasiveness. BTX-A injections may cause some common complications, such as unnatural expression, brow deformity, ptosis, diplopia, and rare allergic reactions, dysphagia, and dyspnea. There are reports in the literature that visual loss can also occur after injection, and although there are very few relevant reports, clinicians should pay enough attention on it. To this end, the authors reviewed the relevant literature in recent years and reviewed the clinical manifestations, pathogenesis and treatment method of vision loss caused by BTX-A injection.

Objective:To analyze the audiology and occupational health data of applicants diagnosed of occupational noise deafness, and to explore the influencing factors in the diagnosis of suspected occupational noise deafness.Methods:In May 2022, the information of patients diagnosed with occupational noise deafness in Peking University Third Hospital from January 2018 to December 2021 was collected, and the occupational health data of their working environment, clinical audiological examination results and diagnosis basis of occupational noise deafness were collected and analyzed. Multi-factor unconditional logistic regression analysis was used to analyze independent risk factors for the diagnosis of occupational noise deafness.Results:A total of 129 subjects were included, all of which were suspected cases of occupational noise deafness found in various occupational health examination institutions. Eight cases (6.20%) were diagnosed as occupational noise deafness, and 121 cases (93.80%) were non-occupational noise deafness. After hearing examination, only 27.27% (24/88) of the patients' audiological changes were consistent with the starting point of occupational noise deafness diagnosis. Further analysis of the noise intensity in the workplace showed that 16 patients were identified as non-occupational noise deafness because the noise intensity of the working environment was less than 85 dB. Logistic regression analysis showed that the working hours were more than 8 hours ( OR=9.274, 95% CI: 1.388-61.950, P=0.022) and the noise intensity of the working environment ( OR=1.189, 95% CI: 1.059-1.334, P=0.003) were independent risk factors for the diagnosis of occupational noise deafness. Conclusion:The exclusion rate of suspected occupational noise deafness found in occupational health examination is higher after adequate rest. The test results of working environment noise intensity provided by the employer can help to determine occupational noise deafness.

Objective To investigate the application prospect of the most extensive genome engineering pig internationally in preclinical xenotransplantation. Methods Porcine endogenous retrovirus (PERV) knockout combined with 3 major heterologous antigen gene knockouts and 9 humanized genes for inhibition of complement activation, regulation of coagulation disorders, anti-inflammatory and anti-phagocytosis were transferred into a pig (PERV-KO/3-KO/9-TG) as a donor, and the heart, liver and kidney were obtained and transplanted to 3 Rhesus macaque recipients respectively to establish a preclinical research model of pig-to-Rhesus macaque xenotransplantation. The functional status of xenografts after blood flow reconstruction was observed and the survival of recipients was summarized. The hemodynamics of xenografts were monitored. The change of hematological indexes of each recipient was compared. The histopathological manifestation of xenografts was observed. Results After the blood flow was reconstructed, all xenografts showed ruddy color, soft texture and good perfusion. The transplant heart, liver and kidney showed full arterial and venous blood flow and good perfusion at 1 d after operation. The postoperative survival time of heart, liver, and kidney transplant recipients was 7, 26, and 1 d, respectively. The levels of creatine kinase, creatine kinase isoenzyme, and lactate dehydrogenase increased in heart transplant recipient at 1 d after operation, and gradually recovered to near normal levels at 6 d after operation. All indexes increased sharply at 7 d after operation. The level of aspartate aminotransferase increased in liver transplant recipients at 2 d after operation, and the alanine aminotransferase basically returned to normal at 10 d after operation, but the total bilirubin continued to increase. Both aspartate aminotransferase and alanine aminotransferase increased at 12 d after operation, and reached a peak at 15 d after operation. The kidney transplant recipient developed mild proteinuria at 1 d after operation, and died of sudden severe arrhythmia. Histopathology showed that the tissue structure of cardiac and renal xenografts was close to normal, and liver xenografts presented with patchy necrosis, the liver tissue structure was disordered, accompanied by inflammatory damage, interstitial hemorrhage and thrombotic microangiopathy. Conclusions PERV-KO/3-KO/9-TG pig shows advantages in overcoming hyperacute rejection, mitigating humoral rejection and coagulation dysregulation. However, whether it can be used as potential donor for clinical xenotransplantation needs further evaluation.

Objective To evaluate the different arteriographic manifestations of acute renal arterial hemorrhage,and the treatment effects of emergency interventional embolization.Methods 87 patients with renal arterial hemorrhage who were failed to conservative treatment underwent the renal arteriography to confirm the position and degree of lesion.According to the arteriographic manifesta-tions,appropriate embolic agents such as spring coil,acrylic acid microspheres and the like were used to embolize the targeted vessel. The arteriographic manifestations and embolization efficacy were retrospectively analyzed.Results Contrast medium leakage was showed by renal angiography in 43 patients,13 of whom had arterio-venous fistula (AVF)and 1 5 of whom had renal pseudoaneu-rysms (RAP).Among this 1 5 patients,there were 5 patients with arteriovenous fistula and one patiernt with artery-calyces fistula. Hemorrhage of tumor vessel was shown in 1 5 patients and renal arteriovenous malformation (RAVM)in 1.47 patients underwent renal artery CT arteriography before emergency interventional embolization.The hematuresis was completely stopped or significantly relieved in 82 of all patients.Only 3 patients with renal trauma and 2 patients with percutaneous nephroscope were still had haematu-ria.All patients were followed up for 2 years.The total effective rate of emergency interventional embolization treatment was 94.25%(82/87),and no serious complications were observed.Conclusion As a safe,effective and micro-invasive treatment,emergency in-terventional embolization therapy can be used to treat the acute renal hemorrhage effectively.It can keep the maximum renal func-tion.Though acute renal hemorrhage angiography may have different manifestations,the choice of embolic agents is the key to stop the symptom.Renal artery CTA before embolotherapy is important for the diagnosis and therapy of acute renal hemorrhage.

Objective To evaluate the clinical effect of endovascular embolization for traumatic carotid cavernous fistula (TCCF).Methods In 20 patients with TCCF,10 were treated with the detachable balloon embolization,4 were treated with the detachable balloon embolization and coils,2 were treated with coils alone,3 were treated with coils and Onyx,and 1 was treated with covered stenting.Two of them were embolized again because of leaking balloon.Results Eighteen of the 20 patients were embolizeded successfully once,2 were embolizeded successfully twice.The patency rate of internal carotid artery was 100％.No operation-related complications occurred.Conclusions Endovascular embolization is a simply,safe and reliable method of curative effect for the treatment of TCCF.

Objective:To investigate the clinical effect of bridging fixation with locking plate for the Seinsheimer type V subtrochanteric femoral fracture. Methods:From March 2009 to September 2014,18 cases of Seinsheimer type V sub-trochanteric femoral fracture were treated by open reduction and bridging fixation with locking plate through proximal and distal approach including 16 males and 2 females with an average age of 41 years old ranging from 22 to 67 years old. Among them , 12 cases caused by traffic accident,5 cases by falling,1 case by heavy aboving. All cases were fresh and closed fractures. Time between injury and operation was from 4 to 9 days with an average of 6.2 days. Of them ,11 cases were fixed with reverse LISS and the other 7 cases were fixed with anatomical locking plates of proximal femur. Results:The mean time of operation was 110 min (ranged from 90 to 155 min). The mean blood loss during operation was 425 ml (ranged from 350 to 650 ml) and 16 cases got blood transfusion which was meanly 300 ml. The mean hospital time was 14 days (ranged from 12 to 18 days). The mean duration of followed up was 11.8 months (ranged from 8 to 22 months). The mean time of bone union was 6.6 months (ranged from 5 to 8 months). There was not any complication such as infection,implant failure,hip varus,external rotation deformity of low limb or fat embolism. The Sanders hip scores were 53.22±6.48,the result was excellent in 12 cases and good in 6 cases at the last follow up. Conclusion:Under the principle of biological osteosynthesis ,treatment of Seinsheimer type V sub-trochanteric femoral fracture with bridging locking plate fixation has such advantages as high mechanism ,less interference of blood supply,stable fixation and little complication. It is a safe and idea way for the treatment of the Seinsheimer type V sub-trochanteric femoral fracture.