Aural vertigo frequently encountered in the otolaryngology department of traditional Chinese medicine （TCM） mainly involves peripheral vestibular diseases of Western medicine， such as Meniere's disease， benign paroxysmal positional vertigo， vestibular neuritis， and vestibular migraine， being a hot research topic in both TCM and Western medicine. Western medical therapies alone have unsatisfactory effects on recurrent aural vertigo， aural vertigo affecting the quality of life， aural vertigo not relieved after surgery， aural vertigo with complex causes， and children's aural vertigo. The literature records and clinical practice have proven that TCM demonstrates unique advantages in the treatment of aural vertigo. The China Association of Chinese medicine sponsored the "17th youth salon on the diseases responding specifically to TCM： Aural vertigo" and invited vertigo experts of TCM and Western medicine to discuss the difficulties and advantages of TCM diagnosis and treatment of aural vertigo. The experts deeply discussed the achievements and contributions of TCM and Western medicine in the diagnosis and treatment of aural vertigo， the control and mitigation of the symptoms， and the solutions to disease recurrence. The discussion clarified the positioning and advantages of TCM treatment and provided guidance for clinical and basic research on aural vertigo.

Objective To investigate the expression of zinc finger E-box-binding protein 2(ZEB2)and CC chemokine ligand 20(CCL20)in glioma tissue and their relationship with prognosis.Methods The tumor tissues of 156 patients with glioma were collected as tumor group and 52 normal brain tissues of the same period were collected as normal group.The expression of ZEB2 and CCL20 in tissues were detected by immunohistochemistry,and the relationship between the expression and survival was analyzed by Kaplan-Meier survival curve.Patients in the tumor group were followed up for three years and grouped into a poor prognosis group and a good prognosis group based on their survival status,and the prognostic factors were analyzed by COX regression.Results The positive expression rate of ZEB2 and CCL20 in the tumor group were higher than those in the normal group(P＜0.05).The 3-year survival rate of 156 glioma patients was 69.87%.The survival rate of patients with positive ZEB2 and CCL20 expression was lower than that of patients with negative expression(P＜0.001).Age,maximum tumor diameter,tumor pathological grade,and positive expression of ZEB2 and CCL20 were all risk factors for poor prog-nosis of patients with glioma(P＜0.05),and preoperative KPS,postoperative radiotherapy,and course of temo-zolomide treatment were all protective factors(P＜0.05).Conclusion The expression level of ZEB2 and CCL20 in tumor tissues of glioma patients is up-regulated,and related to the prognosis of patients.

In response to the Opinions of the CPC Central Committee and the State Council on Promoting the Inheritance， Innovation， and Development of traditional Chinese medicine（TCM） and the spirit of the National Conference on TCM， Chinese Association of Chinese Medicine organized experts in Otorhinolaryngology Head and Neck Surgery of traditional Chinese and western medicine to discuss the clinical advantages of TCM and integrated traditional Chinese and western medicine in the treatment of allergic rhinitis （AR） and they reached a basic consensus. In recent years， the prevalence of AR has been on the rise， threatening the quality of life of patients and giving rise to a heavy burden to both the patients and the society. AR is resulted from immune imbalance rather than reduced immunity or hyperimmunity， and the imbalance is similar to the Yin-yang disharmony in TCM. In the treatment of this disease， western medicine features rapid onset. However， it is cost-intensive and causes severe surgical trauma， and the recurrence is common. TCM boasts diverse methods for AR， which can be used in all stages of this disease. It has advantages in controlling symptoms such as nasal congestion， runny nose， or dysosmia in the attack stage， preventing recurrence in the remission stage， and treating refractory AR or steroid-resistant AR. In particular， acupuncture enjoys a reputation in treatment of AR， which has been supported by evidence-based medicine and recommended by guidelines. While treating local symptoms of AR， TCM regulates the psychosomatic conditions， which facilitates chronic disease management and long-term follow-up. We should integrate the advantages of TCM and western medicine， give full play to the unique nonnegligible and irreplaceable advantages of TCM， formulate a comprehensive diagnosis and treatment scheme for learning and promotion， and summarize the research outcomes to promote the theoretical innovation of TCM on AR from the perspective of integrated traditional Chinese and western medicine.

Objective:To investigate the clinical efficacy of carbomer hemorrhoid gel in the treatment of second-degree internal hemorrhoid bleeding.Methods:A total of 160 anorectal outpatients with second-degree internal hemorrhoid bleeding who received treatment in Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to January 2021 were included in this study. They were randomly divided into an observation group and a control group ( n = 80/group). In the observation group, carbomer hemorrhoid gel was used to plug the anus, while in the control group, a hemorrhoid suppository was used to plug the anus. All patients were treated for 7 days. Clinical efficacy was compared between the two groups. Results:After 4 days of treatment, the bleeding score in the observation group was lower than that in the control group [1(0) point vs. 2(1) points, Z = -6.70, P < 0.05). After 7 days of treatment, the bleeding score in the observation group was significantly lower than that in the control group [0(1) point vs. 1(1) point, Z = -4.73, P < 0.05]. After 4 days of treatment, there was no significant difference in the size score of the hemorrhoids between the two groups ( P > 0.05). After 4 days of treatment, the size score of hemorrhoids in the control group did not differ significantly compared with before treatment ( P > 0.05). After 4 days of treatment, the size score of hemorrhoids in the observation group differed significantly compared with before treatment ( Z = -3.16, P < 0.05). After 7 days of treatment, the size score of the hemorrhoids in the observation group was lower than that in the control group [1(1) point vs. 1(0) point, Z = -4.48, P < 0.05]. The total response rate in the observation group was significantly higher than that in the control group [97.5% (78/80) vs. 75% (60/80), Z = -4.50, P < 0.05]. Conclusion:Carbomer hemorrhoid gel is a new drug used to treat hemorrhoids. It has a new dosage form, has no stimulation to the rectum, and is safe to use. Carbomer hemorrhoid gel is highly effective on second-degree internal hemorrhoid bleeding and deserves clinical popularization.

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.

Objective To investigate the predictors of early neurological deterioration (END) after intravenous thrombolysis in patients with acute ischemic stroke and its impact on short-term outcomes. Methods From January 2017 to April 2019, patients with acute ischemic stroke treated with intravenous thrombolysis in the Second Affiliated Hospital of Xuzhou Medical University were enrolled retrospectively. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score within 7 days after admission increased by ≥2 compared with the baseline. The short-term outcomes were evaluated by the modified Rankin Scale at discharge. 0-2 was defined as good outcomes and 3-6 was defined as poor outcomes. Multivariate logistic regression analysis was used to determine the independent predictors of END and their correlation with short-term outcomes. Results A total of 199 patients with acute ischemic stroke received intravenous thrombolysis were enrolled. The median age was 68 years (interquartile range: 62- 76 years), 69 were women (34. 7％), and the baseline median NIHSS score was 6 (interquartile range: 3- 12). END occurred in 35 patients (17. 6％). Symptom progression occurred mainly 2 days after admission (31 patients, 88. 6％). Most of the causes of END were ischemic progression or recurrence (28 patients, 80. 0％). The univariate analysis showed that fasting blood glucose and symptomatic intracranial hemorrhage were associated with END (all P < 0. 05). However, multivariate logistic regression analysis did not find independent predictors of END. Excluding 12 patients with missing short-term outcome data, a total of 187 patients were included in the short-term outcome analysis. Among them, 110 patients had good outcomes and 77 had poor outcomes. Univariate analysis showed that ischemic heart disease, atrial fibrillation, mild stroke, etiological classification, baseline NIHSS score, absolute lymphocyte count, fasting blood sugar, neutrophil/lymphocyte ratio, whether to receive interventional therapy, and END were correlated with short-term outcomes (all P < 0. 05 ). Multivariate logistic regression analysis indicated that high baseline NIHSS score (odds ratio 1. 350, 95％ confidence interval 1. 182-1. 541; P < 0. 001) and END (odds ratio 32. 540, 95％ confidence interval 6. 149- 172. 21; P < 0. 001 ) were the independent risk factors for short-term poor outcomes. Conclusions END still occurs in some patients after intravenous thrombolysis for acute ischemic stroke, and END is an independent risk factor for short-term poor outcomes.

Objective To study the relationship between the cognitive function and speech recognition ability in young patients with OSAHS.Methods We selected 60 young male patients,according to the apnea-hypopnea index(AHI)and the severity of hypoxemia.They were divided into three subgroups on the basis of their syndrome severities:mild group (n= 19;AHI 5~15/h,85%≤minimum SaO2≤90%),moderate group (n= 20;AHI>15~30/h,80%≤minimum SaO2<85%),and severe group (n= 21;AHI>30/h,minimum SaO2<80%).First,we used the MoCA scale for cognitive function tests and recorded the scores.Then 15 lists of sentence Mandarin Speech Test Materials(MSTMs)were utilized to test each group.A data analysis was performed using SPSS 17.0 software. Results The total MoCA scores(mild group:27.32±1.16;moderate group:25.85±1.23;severe group:24.52± 1.69;control group:28.52 ±1.16)decreased progressively as the disease severity increased,showing significant differences between the control group and the mild,moderate and severe groups of OSAHS patients (allP<0.05). When sound stimuli were presented at 22,24,and 26 dB SPL,the speech recognition rates in the patients with se-vere(35.4±22.6,56.3±23.9,75.2±16.5)lower than the other groups (mild group:38.4±23.5,58.3±25.5,79.2 ±18.5;moderate group:38.8±21.6,58.7±22.7,78.5±16.7;control group:39.4±23.5,60.3±24.3,80.2±16.4, respectively,allP<0.05).The differences in intensity of 50% recognition rate between the severe group(4.15± 0.80)and the control(3.62±0.41),mild (3.66±0.50)and moderate groups(3.72±0.55)of OSAHS patients were statistically significant(allP<0.05).Conclusion With hypoxia and disease severity increased,speech recogni-tion abilities in OSAHS patients decreased.This may be an important factor associated with cognitive assessment scale score.

BACKGROUND:Angiotensin II receptor antagonists have been found to exerct a stronger protective effect on bone than angiotensin converting enzyme inhibitors. OBJECTIVE:To investigate the effect of different concentrations of irbesartan (angiotensin II receptor antagonist) on the differentiation and mineralization of mouse preosteoblasts. METHODS:Mouse preosteoblast cel lines MC3T3-E1 in logarithmic phase were selected and cultured in the osteogenic induction medium containing 0 (control group), 0.001, 0.01, 0.1 mmol/L irbesartan, respectively. Ten days later, the cel differentiation was observed by alkaline phosphatase staining. The mineralization was observed by alizarin red staining after 21 days of culture. mRNA expressions of osteocalcin, alkaline phosphatase and Runt-associated transcription factor 2 in osteoblasts were detected by real-time PCR at 1, 4, 7, 14 and 21 days of culture. RESULTS AND CONCLUSION:The activity of alkaline phosphatase in al the irbesartan groups (0, 0.001, 0.01, 0.1) was higher than that in the control group (P<0.05), which was the most obvious in 0.01 mmol/L. The number and area of calcium nodules in each irbesartan group were significantly higher than those in the control group (P<0.05), especial y in 0.01 mmol/L. Compared with the control group, 0.01 mmol/L irbesartan significantly upregulated the mRNA expressions of osteocalcin, alkaline phosphatase and Runt-associated transcription factor 2 (P<0.05). These results suggest that 0.01 mmol/L irbesartan significantly promotes the differentiation and mineralization of osteoblasts.

Objective: To explore the relevant factors of behavioral development among 30-month-old infants in rural area, Shaanxi Province. Methods: The behavioral development among 977 infants aged 30-month-old was evaluated in Changwu and Binxian of Shaanxi province from July 2006 to August 2008. The inclusion criteria included single live birth between January 2004 and February 2006, mother had participated in a community-based intervention study named "Impact of multi-micronutrient supplementation during pregnancy on low birth weight and premature delivery" . Infants who had obvious deformity or other birth defects, infants who could not complete the questionnaire survey, physical examination were excluded from the study. The self-designed questionnaire was used to investigate the information of feeding patterns, disease status, physical development, and immunization status of the infants, and their behavioral development were assessed by Bayley scales of infant development (BSID). General Linear Model was used to adjust the possible confounding factors, and the analysis of variance was performed to explore the effects on the behavioral development among infants aged 30-month-old. Results: Among the infants in the study, the average age was (30.6±0.6) months old, the mean birth weight was (3 199.1±405.9)g. After adjusted the mothers' age of delivery, educational level and occupation of the parents, family ecnomic conditions and the number of children, infants whose mother exposed to toxic chemicals during pregnancy had lower score in activity (-0.179±0.961) and lower score in concentration (-0.177±1.099) compared with infants with unexposed mother (0.058±1.006, P=0.001; 0.057±0.960, P=0.003). Similarly, infants whose mother took drugs during pregnancy had lower score in persistent behaviors (-0.070±1.000) compared with infants whose mother did not(0.085±1.006, P=0.017). Compared with normal birth infants(0.043±0.981, P=0.007; 0.021±0.984, P=0.034), infants less than gestational age and low birth weight had lower score in concentration(-0.198±1.063 and-0.389±1.285, respectively). After adjusted the delivery gestational age of mothers, the months of infants, the mothers' age of delivery, educational level and occupation of the parents, family ecnomic conditions, the number of children, and the main orderlies of infants, the score of activity of infants suffered from diseases in early month age was-0.049±0.992, which was lower than those who did not(0.207±1.011, P=0.001). The infants with Rickets signs had lower score in motor coordination (-0.218±0.896) than normal infants (0.031±1.011, P=0.013). Infants whose mother with adequate micronutrient supplementation in pregnancy had higher score in concentration (0.066±0.966) than those whose mother with insufficient supplementation (-0.062±1.027, P=0.043). Furthermore, infants with fine protein added and minerals and vitamins added had higher score in activity and concentration compared with those insufficient, who scored 0.078±1.013 and 0.496±0.872 (-0.254±0.924, P<0.001; 0.001±0.997, P=0.033), respectively. Conclusion Micronutrient supplementation during pregnancy and reasonable nutrition added during childhood could affect behavioral development among infants.

Objective:To investigate the effect of 2-deoxy-D-glucose (2-DG) on hunmanγδT cells on the expression of CCR5 and killing function in vitro.Methods:UsingγδT medium to cultivate peripheral blood mononuclear cell( PBMCs) in vitro.After co-cultured with various concentrations of 2-DG for 48 h,the expression of CCR5 and killing activities of γδT cells for each group were detected by flow cytometry and CCK-8 methods.Results: 2-DG could not promote the growth of γδT cells with the increase in concentration from 0 μmol/L to 1.0 μmol/L and decreased thereafter.The certain concentration ( 0-2.0 μmol/L ) of 2-DG could upregulate the expression of CCR5 in dose dependent manner.Besides,at 0.5μmol/L and 1.0μmol/L of 2-DG could increase the ex-pression of CD107a and perforin and have no effect on the granzyme B.Conclusion: Human γδT cells isolated from peripheral blood treated with 2-DG could promote the expression of CCR5 and increase the killing activities at certain concentration in vitro.