Objective:To compare the clinical results of modified posterolateral approach combined medial approach versus traditional posterolateral approach combined with medial approach in open reduction and internal fixation of trimalleolar ankle fracture.Methods:A retrospective cohort study was used to analyze the clinical data of 46 patients with trimalleolar ankle fracture admitted to the First Affiliated Hospital of Naval Military Medical University from June 2013 to June 2019, including 14 males and 32 females, at age of 19-71 years [(49.2±14.9)years]. There were 33 patients with supination-external rotation type IV ankle fracture and 13 with pronation-external rotation type IV ankle fracture according to Lauge-Hansen classification. Open reduction and internal fixation was performed through the modified posterolateral approach combined with medial approach in 25 patients (modified approach group), and through the traditional posterolateral approach combined with medial approach in 21 patients (traditional approach group). The visual analogue score (VAS) at 3 days and 1 week after surgery, fracture healing time, range of ankle flexion and extension and Baird-Jackson score at the final follow-up and postoperative complications (numbness of the affect limb, wound necrosis, etc.) were compared between the two groups.Results:All patients were followed up for 11-21 months [(14.8±2.2)months]. There was no statistical difference in VAS or fracture healing time at 3 days after surgery between the two groups (all P>0.05). The VAS was 3.0 (3.0, 4.0)points in modified approach group at 1 week after surgery, significantly lower than 4.0 (3.0, 5.0)points in traditional approach group ( P<0.05). At the final follow-up, there was no statistical difference in range of ankle plantarflexion between the two groups ( P>0.05), but range of ankle dorsiflexion was significantly greater in modified approach group [(11.8±2.8)°] than that in traditional approach group [(8.1±3.5)°] ( P<0.01). At the final follow-up, Baird-Jackson score was not statistically different between the two groups ( P>0.05). There were 4 patients with numbness and 2 with wound necrosis in traditional approach group, but no numbness or wound necrosis occurred in modified approach group ( P<0.01). Conclusion:Both the modified posterolateral approach combined with medial approach and traditional posterolateral approach combined with medial approach can achieve good clinical results in open reduction and internal fixation of trimalleolar ankle fractures, but the former has advantages of better pain relief, better recovery of ankle dorsiflexion and less complications.

The acoustic detection method based on machine learning and signal processing is an important method of pathological voice detection and the extraction of voice features is one of the most important. Currently, the features widely used have disadvantage of dependence on the fundamental frequency extraction, being easily affected by noise and high computational complexity. In view of these shortcomings, a new method of pathological voice detection based on multi-band analysis and chaotic analysis is proposed. The gammatone filter bank was used to simulate the human ear auditory characteristics to analyze different frequency bands and obtain the signals in different frequency bands. According to the characteristics that turbulence noise caused by chaos in voice will worsen the spectrum convergence, we applied short time Fourier transform to each frequency band of the voice signal, then the feature gammatone short time spectral self-similarity (GSTS) was extracted, and the chaos degree of each band signal was analyzed to distinguish normal and pathological voice. The experimental results showed that combined with traditional machine learning methods, GSTS reached the accuracy of 99.50% in the pathological voice database of Massachusetts Eye and Ear Infirmary (MEEI) and had an improvement of 3.46% compared with the best existing features. Also, the time of the extraction of GSTS was far less than that of traditional nonlinear features. These results show that GSTS has higher extraction efficiency and better recognition effect than the existing features.
Acoustics ; Databases, Factual ; Fourier Analysis ; Humans ; Noise ; Signal Processing, Computer-Assisted

The WHO Classification of Thoracic Tumors (5 th edition) mainly has the following changes in the chapter of pleural malignant mesothelioma. (1) The concept of mesothelioma in situ and its diagnostic method have been established for the first time; (2) The tumour grading of pleural malignant mesothelioma was added, it was divided into low grade and high grade according to the cellular atypia, mitotic activity and presence of necrosis. (3) The morphological features of pleural malignant mesothelioma was classified into architectural pattern, cellular and stromal features, the correlation between histological features and prognosis was refined, and some of the controversial cellular types have been reclassified. In this review, we introduced the changes of related pathologic diagnosis, in the WHO Classification of Thoracic Tumors (5 th edition) and discussed its clinical significance.

The WHO Classification of Thoracic Tumors (5 th edition) mainly has the following changes in the chapter of pleural malignant mesothelioma. (1) The concept of mesothelioma in situ and its diagnostic method have been established for the first time; (2) The tumour grading of pleural malignant mesothelioma was added, it was divided into low grade and high grade according to the cellular atypia, mitotic activity and presence of necrosis. (3) The morphological features of pleural malignant mesothelioma was classified into architectural pattern, cellular and stromal features, the correlation between histological features and prognosis was refined, and some of the controversial cellular types have been reclassified. In this review, we introduced the changes of related pathologic diagnosis, in the WHO Classification of Thoracic Tumors (5 th edition) and discussed its clinical significance.

Background and Objectives: Psoriasis is a chronic inflammatory skin disease, which the mechanisms behind its initiation and development are related to many factors. DMSCs (dermal mesenchymal stem cells) represent an important member of the skin microenvironment and play an important role in the surrounding environment and in neighbouring cells, but they are also affected by the microenvironment. We studied the glucose metabolism of DMSCs in psoriasis patients and a control group to reveal the relationship among glucose metabolism, cell proliferation activity，and VEC (vascular endothelial cell) differentiation in vitro, we demonstrated the biological activity and molecular mechanisms of DMSCs in psoriasis. Methods: and Results: We found that the OCR of DMSCs in psoriatic lesions was higher than that in the control group, and mRNA of GLUT1 and HK2 were up-regulated compared with the control group. The proliferative activity of DMSCs in psoriasis was reduced at an early stage, and mRNA involved in proliferation, JUNB and FOS were expressed at lower levels than those in the control group. The number of blood vessels in psoriatic lesions was significantly higher than that in the control group (p＜0.05), which the mRNA of VEC differentiation, CXCL12, CXCR7, HEYL and RGS5 tended to be increased in psoriatic lesions compared to the control group, in addition to Notch3. Conclusions We speculated that DMSCs affected local psoriatic blood vessels through glucose metabolism, and the differentiation of VECs, which resulted in the pathophysiological process of psoriasis.

Objective:To investigate the association between systemic inflammation response index (SIRI) and early neurological deterioration (END) in patients with basal ganglia hemorrhage (BGH), and then set up a prediction Nomogram model for END.Methods:The retrospective cohort study was conducted. A total of 146 patients with BGH from January 2016 to December 2018 were chosen in the Affiliated Jiangyin Hospital of Southeast University Medical College. The patients were divided into the END group ( n=34) and non-END group ( n=112), according to whether END occurred or not. The normally distributed data were presented as the mean±standard deviation ( Mean± SD), and the groups were compared using the t test. The non-normally distributed data were expressed as M ( P25, P75), and this data was analysed via the Kruskal-Wallis test. Categorical variables were described as numbers of patients (%) and compared using chi-square analysis or Fisher exact test, as appropriate. Univariate analysis and multivariate logistic regression analysis were used to identify the risk factors of END occurrence, and the relationship with SIRI. Then, each factor was scored by Nomogram method to construct the prediction model. Receiver operating characteristic curve (ROC) was drawn to assess the predictive value of SIRI and Nomogram model in the occurrence of END. Results:Univariate analysis showed that the occurrence of END was associated with hematoma volume, presence of intraventricular hemorrhage, blood glucose, lymphocyte count and SIRI ( P<0.05). Multivariate logistic regression analysis showed that hematoma volume ( P<0.001), presence of intraventricular hemorrhage ( P=0.012) and SIRI ( P=0.023) are independent risk factors for END occurrence. ROC curve analysis showed that SIRI has certain predictive value for END occurrence, and the optimal cut-off value was SIRI=5.40×10 9/L. Then these risk factors were incorporated into the Nomogram. Statistically analysis showed the model had a good predictive value, and the model combining the SIRI and other prognostic factors (AUC=0.869, 95% CI: 0.804-0.935, P<0.001) showed more favorable discriminative ability than the model without the SIRI (AUC=0.811, 95% CI: 0.734-0.889, P<0.001) and the model using the SIRI only (AUC=0.716, 95% CI: 0.622-0.810, P<0.001). Conclusion:SIRI is closely correlated with the occurrence of END in patients with BGH, and the nomogram model combining the SIRI has a more accurately predictive value, which improved the early identification and screening of END, and patient outcomes.

Objective To evaluate the clinical effect and efficacy of endoscopy treatment for isolated gastric varices 1 with tissue glue and metal clips. Metheds The clinical date of 21 patients who treated tissue glue and metal clips were retrospectively analyzed from Jan 2015 to Dec 2016. Results The treatments were completed successfully and reviewed by endoscopy after 1 week, 1 month, 3 months, 6 months. The gastric varices were reduced, and the serious complications of bleeding, embolism were little. Conclusion The endoscopy treatment for isolated gastric varices 1 with tissue glue and metal clips is contributed to clinical effect, and the treatment provides a reference for clinical treatment.

Objective:To study the significance of H19 gene in the progress from normal mucosa through oral submucous fibrosis (OSF) to carcinogenesis.Methods:Real-time fluorescent quantitative PCR technique was used to detect LncRNA H19 expression level in 12 cases of normal buccal mucosa tissue,33 cases of OSF buccal mucosa tissue and 31 cases of buccal carcinoma with OSF.Results:The relative expression levels of LncRNA H19 in normal buccal mucosa tissues,OSF buccal mucosa tissue and buccal carcinoma with OSF tissue were 1.17 ±0.37,3.44 ± 1.08 and 8.88 ± 1.78 respectively(between each 2 groups,P ＜ 0.01).Conclusion:H19 may involve the occurrence and canceration of OSF.

OBJECTIVE: To analyze the characteristics soft tissue profile in Hunan Han adults with normal occlusion and to explore the differences of the soft tissue profile in gender, region and race. METHODS: Lateral cephalometric radiographs were performed for 323 volunteers (164 females and 159 males) from Hunan Province. The digital cephalometric radiographs were imported into the WinCeph8.0 measurement and analysis system in a same computer. According to the Holdaway analysis method, the mean and standard deviation were calculated. Then the results were compared to the data from Liaoning, Nepalese, Japanese, North American Caucasians. RESULTS: The normal value of cephalometric facial soft tissue profile in Han population adults with normal occlusion in Hunan Province were obtained. There were significant differences in subnasale to H line (Sn-H), upper lip tension, lower lip sulcus depth (Si-PgsLs), and soft tissue chin thickness (Pg-Pgs) between males and females (all P<0.05). Compared with Liaoning Province, significant regional differences in soft tissue facial angle (FH-NsPgs), upper lip sulcus depth (Ss-Ls), Sn-H, lower lip thickness, upper lip thickness, H angle, lower lip to H line (Li-PgsLs), Si-PgsLs, and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the Japan, significant regional differences in FH-NsPgs, nose prominence (Sn-Pn), lower lip thickness, upper lip tensity, H angle, Li-PgsLs, Si-PgsLs, and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the Nepalese, significant regional differences in Sn-Pn, Ss-Ls, Sn-H, skeletal profile convexity (A-NPs), basic upper lip thickness, upper lip tensity, H angle, Li-PgsLs and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the North America, significant regional differences in Sn-Pn, Ss-Ls, Sn-H, A-NPs, basic upper lip thickness, upper lip tensity, H angle, Li-PgsLs, Si-PgsLs and Pg-Pgs were found in Hunan Province (all P<0.05). CONCLUSION There are both similarities and differences in facial soft tissue profile between males and females with normal occlusion in Hunan Province. The characteristics of facial soft tissue profile in Hunan Province are different from that in Liaoning area, Nepal, Japan and North America.
Adult ; Asian Continental Ancestry Group ; Cephalometry ; European Continental Ancestry Group ; Face ; anatomy & histology ; Female ; Humans ; Lip ; anatomy & histology ; Male ; Reference Values

Adenomatous Polyposis Coli Protein ; chemistry ; metabolism ; Amino Acid Sequence ; Chromatography, High Pressure Liquid ; HeLa Cells ; Humans ; Kinesin ; chemistry ; metabolism ; Microtubule-Associated Proteins ; chemistry ; metabolism ; Microtubules ; metabolism ; Molecular Sequence Data ; Phosphopeptides ; analysis ; Phosphorylation ; Protein Multimerization ; Tandem Mass Spectrometry