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Objective: To conduct a systematic description and meta-analysis of the treatment of unilateral vocal cord paralysis（UVCP） with recurrent laryngeal nerve reinnervation through literature search, and to analyze the therapeutic effect of recurrent laryngeal nerve reinnervation on improving vocal function in UVCP. Methods: Electronic databases Pubmed, Web of Science, EMBASE, Cochrane Library, CNKI, and Wanfang databases were searched using relevant keywords and screened in strict accordance with the inclusion and exclusion criteria, and quality evaluations were conducted. Reported treatment outcomes were measured by relevant data extracted from literature, such as auditory perception assessment（GRBAS）, voice handicap index（VHI）, maximal phonation time（MPT）, jitter, shimmer, and noise harmonic ratio（NHR）, etc. Meta-analysis was performed by Revman5.3 and heterogeneity was analyzed using fixed effects or random effects models. Results: Eight articles were included in this study, all of which showed that the postoperative maximum phonation time of patients was significantly prolonged compared to preoperative, while the postoperative GRBAS score, Jitter, Shimmer, and NHR decreased compared to preoperative with statistical significance. Conclusion: The innervation of the internal laryngeal muscle was obtained through the reinnervation of the recurrent laryngeal nerve, which effectively improved the patient's vocal function and had a good long-term therapeutic effect. Although there was no difference in the efficacy of surgical methods for reconstructing the recurrent laryngeal nerve, the anastomosis between ansa cervicalis nerve and the recurrent laryngeal nerve is more ideal. Further randomized controlled studies with longer follow-up periods and larger samples will increase the credibility of their effectiveness., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

This study aims to explore the effect and mechanism of a mitochondrion-targeted derivative of ergosterol peroxide(Mito-EP) on breast cancer. The methyl thiazolyl tetrazolium(MTT) assay was employed to examine the proliferation of MDA-MB-231 cells treated with different concentrations(0, 0.075, 0.15, 0.3, 0.6, 1.2, and 2.4 μmol·L~(-1)) of Mito-EP. Cells were grouped for treatment with water(blank control), low, medium, and high concentrations(0.15, 0.3, and 0.6 μmol·L~(-1)) of Mito-EP, and ergosterol peroxide(EP)(0.6 μmol·L~(-1)). After the cells were treated for 48 h, flow cytometry was employed to examine the apoptosis rate, reactive oxygen species(ROS) level, mitochondrial membrane potential, and cell cycle distribution, and the apoptosis, ROS, and mitochondrial membrane potential were observed by laser confocal microscopy. A mouse model bearing subcutaneous xenograft tumor was established by injecting 4T1 cell suspension and used to study the inhibitory effect of Mito-EP on breast cancer. Western blot was employed to determine the protein levels of B-cell lymphoma 2(Bcl-2), Bcl-2-associated X protein(Bax), cytochrome C(Cyt C), cleaved caspase-7, and cleaved caspase-9 in cells and the tumor tissue. The results showed that Mito-EP reduced the proliferation rate of MDA-MB-231 cells in a concentration-dependent manner. Compared with the blank control group, EP(0.6 μmol·L~(-1)) caused slight changes in the apoptosis rate, ROS level, and mitochondrial membrane potential. However, Mito-EP increased the apoptosis rate, elevated the ROS level, decreased mitochondrial membrane potential, up-regulated the protein levels of Bax, Cyt C, cleaved caspase-7, and cleaved caspase-9, and down-regulated the protein level of Bcl-2(all P<0.05). Moreover, Mito-EP reduced the tumor volume and weight. In summary, Mito-EP may promote apoptosis in breast cancer cells by activating the mitochondrial apoptosis pathway.

This study investigated the effects of ergosterol peroxide(EP) on the proliferation and apoptosis of MCF-7 breast cancer cells, explored its possible mechanisms of action, and verified the effects and mechanisms by in vitro experiments. Network pharmaco-logy was used to screen the target proteins of EP and construct target networks and protein-protein interaction(PPI) networks to predict the potential target proteins and related pathways involved in EP anti-breast cancer effects. The MTT assay was performed to measure the inhibitory effect of EP on MCF-7 cell proliferation, and the colony formation assay was used to assess the cell cloning ability. Flow cytometry and laser confocal microscopy were employed to evaluate cell apoptosis, mitochondrial membrane potential and reactive oxygen species(ROS) levels. Western blot analysis was conducted to examine the expression levels of B-cell lymphoma 2(Bcl-2), Bcl-2-associated X protein(Bax), cytochrome C(Cyt C), caspase-7, cleaved caspase-7, phosphatidylinositol 3-kinase(PI3K), and se-rine/threonine kinase B(AKT) in MCF-7 cells treated with EP. The results of network pharmacology prediction yielded 173 common targets between EP and breast cancer; the results of Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analysis showed that EP treatment for breast cancer mainly affected the signaling pathways such as cancer pathway, PI3K-AKT signaling pathway, cellular senescence signaling pathway, and viral carcinogenesis pathway; and the MTT assay results showed that the viability of MCF-7 cells in the EP group was significantly lower than that in the control group, exhibiting a time-and concentration-dependent trend, and EP can inhibit colony formation of MCF-7 breast cancer cells. Treatment with 10, 20, and 40 μmol·L~(-1) EP for 24 h resulted in a significant increase in the total apoptosis rate of MCF-7 cells, a significant decrease in mitochondrial membrane potential, and a significant increase in ROS levels. In addition, treatment with EP led to an upregulation of Cyt C, Bax, and cleaved caspase-7 protein expression, and a downregulation of p-PI3K, p-AKT, and Bcl-2 protein expression in MCF-7 cells. Studies have shown that EP inhibits MCF-7 breast cancer cell proliferation and reduces colony formation by a mechanism that may be related to the PI3K-AKT pathway mediating the mitochondrial apoptotic pathway.

Peritoneal metastasis is one of the common site of colorectal cancer metastasis and associated with a poor prognosis. The core strategy for colorectal cancer peritoneal metastasis primarily revolves around a comprehensive treatment approach with cytoreductive surgery and systemic chemotherapy as the mainstay, supplemented by intraperitoneal chemotherapy. As an important supplement to treatment, intraperitoneal chemotherapy has broad application prospects. The main modalities are hyperthermic intraperitoneal chemotherapy (HIPEC), neoadjuvant intraperitoneal and systemic chemotherapy (NIPS), early postoperative intraperitoneal chemotherapy (EPIC), sequential postoperative intraperitoneal chemotherapy (SPIC), normothermic intraperitoneal chemotherapy (NIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC). To promote the standardized application of intraperitoneal chemotherapy, further research on the mechanisms underlying peritoneal metastasis of colorectal cancer, selection of effective intraperitoneal chemotherapy agents, determination of optimal timing and administration protocols, exploration of the feasibility of sequential intraperitoneal chemotherapy and conduction of valuable basic and clinical research are currently needed. This paper will review the development and origins of intraperitoneal chemotherapy, treatment modalities, as well as the current application status and prospects of various treatment approaches in the context of peritoneal metastasis of colorectal cancer.

This study aims to investigate the effect of ergosterol peroxide(EP) on the apoptosis of human hepatocellular carcinoma and its mechanism of action. The cell viability of HepG2 and SK-Hep-1 cells with 0(blank control), 2.5, 5, 10, 20, 40, and 80 μmol·L~(-1) of EP after 24, 48, and 72 h of action was detected by using CCK-8 assay, and the half inhibitory concentrations(IC_(50)) at 24, 48, and 72 h were calculated. Formal experiments were performed to detect the effect of EP on intracellular reactive oxygen species(ROS) using DCFH-DA staining, the effect of EP on intracellular mitochondrial membrane potential using JC-1 staining, the number of apoptotic cells using Annexin V-FITC/PI double-staining after HepG2 cells were co-cultured with 0(blank control), 10, 20, 40 μmol·L~(-1) EP for 48 h. The effects of EP at different concentrations on apoptotic morphology were detected using AO/EB staining. The effects of different concentrations of EP on the protein expression of mitochondrial apoptosis pathway-related proteins B cell lymphoma 2(Bcl-2), cytochrome C(Cyt-C), Bcl-2-related X protein(Bax), caspase-3, cleaved caspase-3, caspase-9, and cleaved caspase-9 were examined by using Western blot. The results showed that different concentrations of EP could inhibit the proliferation of hepatocellular carcinoma with concentration-and time-dependent trends. Compared with the blank control group, the ROS level in the EP-treated group increased significantly(P<0.05). The mitochondrial membrane potential decreased significantly(P<0.05). The total apoptosis rate increased significantly(P<0.05). The expression of Bcl-2 protein was significantly down-regulated, and the expression of Cyt-C, Bax, cleaved caspase-9, and cleaved caspase-3 were significantly up-regulated(P<0.05). In summary, EP may inhibit the proliferation of hepatocellular carcinoma by modulating the mitochondria-mediated apoptosis pathway and induce apoptosis.

Objective: To investigate the effects of galangin on angiogenic activity of oxidized low-density lipoprotein (ox-LDL)-induced human aortic endothelial cells (HAECs) and explore the underlying mechanisms., Methods: HAECs incubated with 10, 20, 40, and 80 μmol/L galangin for 24 h were assessed for cell viability changes using MTT assay to determine the cytotoxicity of galangin. HAECs treated with 5 mg/mL ox-LDL and incubated with 20 and 40 μmol/L galangin for 24 h, and the cells overexpressing lncRNA H19 and incubated with 40 μmol/L galangin for 24 h were examined for lncRNA H19 level with qRT-PCR. The migration and tube formation capacity of the cells were observed using scratch assay and angiogenesis assay, and ROS levels in the cells were detected with flow cytometry. The protein expression levels of VEGFA, MMP-2 and MMP-9 in the treated cells were detected with Western blotting., Results: Galangin at 10, 20, or 40 μmol/L produced no obvious toxicity ( P >0.05), whereas 80 μmol/L galangin significantly inhibited the viability of HAECs ( P <0.01). Treatment with ox-LDL significantly increased the expression of lncRNA H19 in HAECs. Galangin significantly lowered lncRNA H19 expression in ox-LDL-induced HAECs, suppressed cell migration, angiogenesis and ROS production level, and reduced the protein levels of VEGFA, MMP-2 and MMP-9 ( P <0.01). The effects of galangin were blocked by overexpression of lncRNA H19 in the cardiomyocytes., Conclusion: The therapeutic effect of galangin for atherosclerosis is mediated by inhibiting lncRNA H19 expression to reduce ox-LDL-induced migration, oxidative stress, and angiogenesis of HAECs.

CAPOS syndrome is an autosomal dominant neurological disorder caused by mutations in the ATP1A3 gene. Initial symptoms, often fever-induced, include recurrent acute ataxic encephalopathy in childhood, featuring cerebellar ataxia, optic atrophy, areflflexia, sensorineural hearing loss, and in some cases, pes cavus. This report details a case of CAPOS syndrome resulting from a maternal ATP1A3 gene mutation. Both the child and her mother exhibited symptoms post-febrile induction,including severe sensorineural hearing loss in both ears, ataxia, areflexia, and decreased vision. Additionally, the patient's mother presented with pes cavus. Genetic testing revealed a c. 2452G>A（Glu818Lys） heterozygous mutation in the ATP1A3 gene in the patient . This article aims to enhance clinicians' understanding of CAPOS syndrome, emphasizing the case's clinical characteristics, diagnostic process, treatment, and its correlation with genotypeic findings., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Cell-mediated immune response is an important part of machinery in maintaining the body's homeostasis. After the innate immune system selectively activates the adaptive immune system, the cell-mediated immunity exerts its killing and clearance functions. Therefore, evaluating the level of cell-mediated immune response is crucial in the diagnosis and treatment of cancer, monitoring the immune status after organ transplantation, diagnosing and preventing viral diseases, and evaluating the effectiveness of vaccines and other areas. From the initial overall assessment of the immune effects in vivo to the precise detection of the number and function of multiple immune cells, the evaluation methods of cell-mediated immune response have greatly advanced. However, cell-mediated immune response involves multiple levels in the body, and it's difficult to choose the numerous detection methods available. The article systematically compares the evaluation methods of cell-mediated immune response at four different levels: the organism, the tissue and organ, the immune cells and the immune molecules, with the aim to facilitate the applications of related technologies.

Objectives: To observe the effects of electroacupuncture (EA) at "Neiguan" (PC 6) and "Zusanli"(ST 36) on the gastric emptying rate, the level of serotonin (5-HT) and the protein expression of motilin (MTL), ghrelin, substance P (SP) and vasoactive intestinal peptide (VIP) in the antral tissue of the rats with functional dyspepsia (FD) and explore the effect mechanism of EA in treatment of FD., Methods: A total of 21 SPF male SD rat pups were randomly divided into a normal group, a model group and an EA group, with 7 rats in each group. In the model group and the EA group, FD model was prepared by the gavage with 0.1% sucrose iodoacetamide solution combined with the modified small platform method. After the successful modeling, EA was applied to "Neiguan" (PC 6) and "Zusanli"(ST 36) in the rats of the EA group, with disperse-dense wave, 20 Hz/100 Hz in frequency, stimulated for 30 min, once daily, for 7 days consecutively. Before and after intervention, the general condition of the rats was observed in each group. After the completion of intervention, the gastric emptying rate was measured, the morphological changes of gastric antral tissue were observed using HE staining, the level of 5-HT was detected with ELISA method, and the protein expression of MTL, ghrelin, SP, and VIP was determined with Western blot method in the antral tissue of rats., Results: In the normal group, the rats were in a good mental state, with lustrous fur, flexible movement and the increase of food intake and body mass. In the model group, the rats were poor in mental state, lack of lustre in fur, preference for the body curled up, reduced activity and response; and a part of rats had loose stool, obviously enlarged gastric body and gastric food retention. In the EA group, the general condition of rats, e.g. the mental state, food intake and activity, were improved, the gastric body got smaller obviously and the gastric food retention was reduced when compared with the model group. The antral structure was intact, the glands were rich and no injury of the gastric mucosa was found, e.g. inflammatory reaction and edema in the rats of each group. Compared with the normal group, the gastric emptying rate was decreased ( P <0.01), 5-HT level was increased ( P< 0.01), the protein expression of MTL and ghrelin was reduced ( P <0.01) and that of VIP was elevated ( P< 0.01) in the rats of the model group. The gastric emptying rate was increased ( P <0.01), 5-HT level was decreased ( P< 0.01), and the protein expression of MTL and ghrelin was elevated ( P <0.05, P< 0.01) in the rats of the EA group when compared with those in the model group., Conclusions: Electroacupuncture at "Neiguan" (PC 6) and "Zusanli"(ST 36) may effectively relieve gastric dysfunction, strengthen gastric motility and promote gastric emptying so as to alleviate the symptoms of dyspepsia in FD rats, and its mechanism may be related to the regulation of gastrointestinal hormones in the antral tissue.

Coding with high-frequency stimuli could alleviate the visual fatigue of users generated by the brain-computer interface (BCI) based on steady-state visual evoked potential (SSVEP). It would improve the comfort and safety of the system and has promising applications. However, most of the current advanced SSVEP decoding algorithms were compared and verified on low-frequency SSVEP datasets, and their recognition performance on high-frequency SSVEPs was still unknown. To address the aforementioned issue, electroencephalogram (EEG) data from 20 subjects were collected utilizing a high-frequency SSVEP paradigm. Then, the state-of-the-art SSVEP algorithms were compared, including 2 canonical correlation analysis algorithms, 3 task-related component analysis algorithms, and 1 task discriminant component analysis algorithm. The results indicated that they all could effectively decode high-frequency SSVEPs. Besides, there were differences in the classification performance and algorithms' speed under different conditions. This paper provides a basis for the selection of algorithms for high-frequency SSVEP-BCI, demonstrating its potential utility in developing user-friendly BCI.

Objective: To analyze the influential factors of loneliness in the elderly aged ≥60 years in China. Methods: Data used in this study were obtained from participants aged ≥60 years from the China Longitudinal Aging Social Survey, with a sample size of 7 593. Loneliness was measured with loneliness scale, and the influence of subjective and objective factors on loneliness and their interaction were analyzed with stepwise linear regression model and simple slope test. SPSS 25.0 was used for statistical analysis. PROCESS 3.3 macro program was used for simple slope test. Results: A total of 8 926 participants were included. Among the objective factors, the elderly with poor family network have a higher level of loneliness ( P <0.05), and community provision of elderly care services could reduce the loneliness of the elderly ( P <0.05). Elderly people with subjective aging age ≤60 years old and poor social adaptation and emotional perception have higher levels of loneliness (all P <0.05). Subjective aging age plays a negative regulatory role in the impact of community elderly care services on loneliness ( P <0.05), Social adaptation and emotional perception play a negative regulatory role in the impact of family network on loneliness ( P <0.05). Conclusions: Elderly people aged ≥60 years of feeling of loneliness was affected by both subjective and objective factors and subjective factors play an important regulatory role in the influence of objective factors on elderly people's feeling of loneliness in China. Therefore, while creating a good aging environment to provide strong external support for the elderly, the subjective initiative of the elderly should also be fully mobilized, to alleviate the loneliness of the elderly from these two aspects.

Objective: To summarize the efficacy and safety of minimally invasive esophagectomy through cervical and abdominal double single-port. Methods: A total of 28 patients who underwent cervical and abdominal double single-port minimally invasive radical resection of esophageal cancer from January 2021 to October 2022 in the First Affiliated Hospital of Fujian Medical University were retrospectively collected, including 18 males and 10 females, aged 58-80 (72±4) years. All patients were placed in the supine position, the single port was operated through the cervical mediastinum first, then the single port was operated through the abdominal cavity, and finally the neck was anastomosed. The operative time, intraoperative blood loss, postoperative ambulation time, postoperative drainage tube removal time, postoperative complications, postoperative pathological examination results, postoperative discharge time of patients were recorded and followed. Results: In the included 28 patients, there were twenty-six patients successfully completed the cervical and abdominal double single-port minimally invasive radical resection of esophageal cancer, and two patients were transferred to the right thoracoscopic surgery due to oozing of blood and unclear visual field, without conversion to laparotomy or enlargement of the incision occurred. The operation time was 125 to 215 (152±32) minutes, including 43 to 100 (56±15) minutes in the mediastinum and 35 to 63 (40±5) minutes in the abdominal cavity. Intra-operative blood loss was 55-100 (45±20) ml. There were 8 to 14 (11±3) lymph nodes dissected in the mediastinum and 7 to 15 (9±3) lymph nodes dissected in the abdominal cavity. Twenty-eight patients were active in bed 1 to 2 days after surgery. The left cervical drainage tube was removed 2 days after surgery. There was no anastomotic fistula, anastomotic stenosis, pulmonary infection, chylothorax and stomach emptying disorder in the whole group. Pleural effusion occurred in 4 cases, all of them had pleural damage during the operation, and were cured after postoperative puncture and drainage; two cases had hoarseness and one case had cough after eating, all patients were discharged from hospital after eating liquid. Postoperative hospital median stay was [ M ( Q 1 , Q 3 )] 7(6, 9) d. The postoperative pathological examination results of all patients were squamous cell carcinoma, and the postoperative pathological stage was pT1-3N0-1M0. The median postoperative follow-up was 25 (5, 35) months, and no patients had complications, recurrence, metastasis or death during the follow-up period. Conclusion: The cervical and abdominal double single-hole minimally invasive radical resection of esophageal cancer is safe and feasible, with good short-term efficacy, which provide an opportunity for radical surgery for patients with advanced age, poor cardiopulmonary function or insufficient thoracic conditions.

5-aminovalanoic acid (5AVA) can be used as the precursor of new plastics nylon 5 and nylon 56, and is a promising platform compound for the synthesis of polyimides. At present, the biosynthesis of 5-aminovalanoic acid generally is of low yield, complex synthesis process and high cost, which hampers large-scale industrial production. In order to achieve efficient biosynthesis of 5AVA, we developed a new pathway mediated by 2-keto-6-aminohexanoate. By combinatory expression of L-lysine α-oxidase from Scomber japonicus , α-ketoacid decarcarboxylase from Lactococcus lactis and aldehyde dehydrogenase from Escherichia coli , the synthesis of 5AVA from L-lysine in Escherichia coli was achieved. Under the initial conditions of glucose concentration of 55 g/L and lysine hydrochloride of 40 g/L, the final consumption of 158 g/L glucose and 144 g/L lysine hydrochloride, feeding batch fermentation to produce 57.52 g/L of 5AVA, and the molar yield is 0.62 mol/mol. The new 5AVA biosynthetic pathway does not require ethanol and H 2 O 2 , and achieved a higher production efficiency as compared to the previously reported Bio-Chem hybrid pathway mediated by 2-keto-6-aminohexanoate.

Objective: To analyze the risk factors of recurrence and canceration for premalignant vocal fold lesions after surgery, and to provide a reasonable basis for preoperative evaluation and postoperative follow-up. Methods: This study retrospective analyzed the relationship between clinicopathological factors and clinical outcome（recurrence, canceration, recurrence-free survival, and canceration-free survival） in 148 patients undergoing surgical treatment in Chongqing General Hospital from 2014 to 2017. Results: The five-year overall recurrence rate was 14.86% and the overall recurrence rate was 8.78%. Univariate analysis showed that smoking index, laryngopharyngeal reflux and lesion range were significantly associated with recurrence（ P <0.05）, and smoking index and lesion range were significantly associated with canceration （P <0.05）. Multivariate logistic regression analysis showed that smoking index ≥600 and laryngopharyngeal reflux were independent risk factors for recurrence（ P <0.05）, and smoking index ≥600 and lesion range ≥1/2 vocal cord were independent risk factors for canceration（ P <0.05）. The mean carcinogenesis interval for the postoperative smoking cessation group was significantly longer（ P <0.05）. Conclusion: Excessive smoking, laryngopharyngeal reflux and a wide range of lesions may be related to postoperative recurrence or malignant progression of precancerous lesions in the vocal cord, and further large-scale multi-center prospective randomized controlled studies are needed to clarify the effects of the above factors on recurrence and malignant changes in the future., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Difficulty in swallowing is a common symptom in stroke patients, and nasogastric tubes are routinely used to solve the nutritional support problem of these patients. The existing nasogastric tube have the disadvantages of causing aspiration pneumonia and patient discomfort. The traditional transoral gastric tube has no one-way valve switch and gastric content storage device, and cannot be fixed in the stomach, resulting in reflux of gastric contents, inability to fully understand the digestion and absorption of gastric contents, and accidental dislocation of the gastric tube, affecting further feeding and gastric content detection. For these reasons, the medical staff of the department of gastroenterology and colorectal surgery of Jilin University China-Japan Union Hospital designed a new transoral gastric tube that can extract and store gastric contents, and was granted a national utility model patent of China (ZL 2020 2 1704393.1). The device consists of collection, cannula and fixation modules. The collection module includes three parts. Gastric contents storage capsule, which can clearly visualize the gastric contents; three-way switch, which can be controlled by rotating the pathway, makes the pathway exist in different states, which is convenient for medical personnel to extract gastric juice, as well as perform intermittent oral tube feeding on the patient or close the pipeline, and reduce contamination and prolong the service life of the gastric tube; one-way valve, which can effectively avoid the contents of the reflux back into the stomach. The tube insertion module includes three parts. A graduated tube, which can enable the medical staff to effectively identify the insertion depth; a solid guide head, which makes the insertion of the tube through the mouth more smoothly; the gourd-shaped passageway, which effectively avoids the blockage of the tube. The fixation module is a water-filled balloon, which is properly filled with water and air. After the pipe is inserted through the mouth, it can be injected with water and gas properly to avoid accidental withdrawal of the gastric tube. Intermittent oroesophageal tube feeding of patients with dysphagia after stroke through a transoral gastric tube that can extract and store gastric contents can not only accelerate the recovery process of patients and shorten the hospitalization time, but also transoral enteral nutrition can effectively promote the recovery of patients' systemic systems, which has certain clinical use value.

Objective: To analyze the consistency of pepsin assay kit, pepsin IHC, reflux symptom index（RSI） and reflux finding score（RFS） in the diagnosis of laryngopharyngeal reflux disease（LPRD）. Methods: The clinical data of 61 inpatients with laryngeal diseases who were admitted to the Department of Otolaryngology, the First Affiliated Hospital of Kunming Medical University from May 2020 to December 2021 were retrospectively analyzed. The RSI and RFS scores, the Formwitz score of pepsin immunohistochemistry, and the results of pepsin detection kit were recorded. ICC group correlation coefficient and Kappa consistency analysis was used for three detection methods. Results: Among 61 patients, 30 cases were positive and 31 cases were negative for the pepsin test kit, with a positive rate of 49.18%. The positive rate of pepsin immunohistochemistry was 45.90%（28/61）, and the diagnostic agreement rate between the two was 70.49%. The consistency between them was high（ κ =0.409）. The positive rate of RSI and RFS in diagnosing LPRD was 62.30%（38/61）, and the consistency rate was 73.77% with pepsin detection kit. The consistency between them was high（ κ =0.486）. Taking pepsin IHC as the reference standard, the sensitivity, specificity, positive predictive value and negative predictive value of pepsin detection kit were 71.43%（20/28）, 69.70%（23/33）, 66.67%（20/30） and 74.19%（23/31）, respectively. Using RSI and RFS scales as reference criteria, the sensitivity, specificity, positive predictive value and negative predictive value of pepsin detection kit were 89.29%（25/28）, 60.61%（20/33）, 65.79%（25/38） and 86.96%（20/23）, respectively. Analysis of correlation coefficient within ICC group: ICC value was 0.628, 95% confidence interval（0.497-0.741）, the three methods have good consistency. Conclusion: The RSI and RFS scale scores were in good agreement with the pepsin test kit, and the pepsin test kit was also in good agreement with pepsin immunohistochemistry. As a non-invasive diagnostic technique, the pepsin test kit can be widely used in the diagnosis of pharyngeal reflux in combination with pepsin immunohistochemistry and RSI and RFS scale., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Special attention must be paid to children and infants because health issues stemming from a poor immunologic system and low weight make them a vulnerable risk group. Complementary foods for infants and young children, which are a class of special dietary foods, are essential transitional foods for infants from lactation to adaptation to ordinary food. Some complementary foods for infants and young children are of animal origin such as fish, meat, and the liver, which may contain veterinary drug residues. Veterinary drugs are usually small-molecular-weight chemicals that are essential for treating infections, increasing production, and improving animal husbandry. However, abuse of these substances can provoke transfer to the food chain, leading to negative consequences for humans, especially infants and young children. For a more comprehensive safety supervision of infant supplementary foods, a method based on ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was developed and used for the determination of 50 antibiotics and antivirals (grouped into six categories: fluoroquinolones, sulfonamides, macrolides, nitroimidazoles, chloramphenicols, and antivirals) in complementary foods for infants and young children. The matrix of complementary foods for infants and young children is complex and contains a large number of proteins and lipids, which poses a serious challenge for sample pretreatment. The Captiva EMR-Lipid solid-phase extraction (SPE) column is a new type of product that allows for selective and efficient lipid/matrix removal without negatively affecting the recovery of the analyte. In this study, samples were extracted with acidified acetonitrile and then purified using a Captiva EMR-Lipid SPE column. The target analytes were separated on a BEH C18 column by gradient elution using acetonitrile and water containing 0.1% (v/v) formic acid as the mobile phases. MS detection was performed with an electrospray source in the positive and negative modes in the multireaction monitoring (MRM) mode. The ion spray voltages were set at 5500 V and -4500 V in the positive and negative modes, respectively. The source temperature for both the ionization modes was set to 500 ℃. Instrumental parameters such as collision energy and declustering potential were optimized. The samples were quantified using the external standard method with matrix calibration curves to reduce the influence of the matrix effect on the quantitative results.The results showed that the 50 veterinary drug residues had good linear relationships in the range of 0.5 to 50 μg/L, with correlation coefficients higher than 0.995. The limits of detection (LODs) and quantification (LOQs) were in the range of 0.03-0.70 μg/kg and 0.09-2.33 μg/kg, respectively. The average recoveries for all the compounds under different matrices ranged from 64.37% to 119.3% at spiked levels of 5 μg/kg and 50 μg/kg, with relative standard deviations of less than 15%. Compared to QuEChERS, this method has a better purification effect. The recoveries of the 50 veterinary drugs extracted by this method were also much higher than those in the case of QuEChERS. This method was applied to the detection of 14 domestic and six imported infant supplementary foods. Sulfaquinoxaline, sulfamethazine, and tilmicosin were detected in one imported meat-based baby food. With its simple operation, high sensitivity and accuracy, and low sample quantity consumption, this method is suitable for the determination of multiveterinary drug residues in complementary foods for infants and young children. This study provides an effective analysis method for risk monitoring and troubleshooting of complementary foods for infants and young children, which is of great significance in ensuring the healthy growth of the next generation.

With the development of vaccine research and development technologies, novel vaccines have been widely used in the prevention of various infectious diseases. Due to the excellent safety, novel vaccines have unique advantages in the application of vaccines against virulent pathogens. The major premise of developing novel vaccines is to screen protective antigens. With the development of various omics research, cutting-edge bioinformatics tools for eukaryotes have been well developed, while the much simpler structure of viruses compared with eukaryotic cells corresponds to relatively simple research methods. Strategies for screening protective antigens need to combine the advantages of both bioinformatics methods and traditional molecular biology methods. In this review, the strategies for screening virus protective antigens were discussed from the perspective of host and virus, and a series of bioinformatics tools developed based on eukaryotic cells that may be used for screening protective antigens were listed. This review also summarized the cases of using protective antigens to design novel vaccines, in order to better understand the strategies for screening virus protective antigens and facilitate the research and development of novel vaccines.

Objective: To investigate the efficacy and safety of the combination therapy with chemotherapy, programmed death-1 (PD-1) inhibitor and anlotinib in the treatment of advanced dedifferentiated liposarcoma (DDLPS). Methods: The clinical data of patients with dedifferentiated liposarcoma who received chemotherapy combined with PD-1 inhibitor and anlotinib in the Department of Medical Oncology, Zhongshan Hospital Affiliated to Fudan University from January 1, 2020 to November 30, 2021 were retrospectively analyzed. A total of 24 patients were included in this study, including 12 males and 12 females, with a median age of onset of 56 years (range, 31-69 years). Efficacy and safety in those patients were assessed. Results: All patients had unresectable or metastatic dedifferentiated liposarcoma with G2 (moderate differentiation) or G3 (differential differentiation) in a concise three-grade grading scheme of tumor pathology. Twelve patients received the regimen as the first-line treatment, while the other 7 taken the regimen as second-line treatment and 5 as third-line or above. The median follow-up time for overall survival (OS) was 7.7 months. The overall response rate (ORR) was 20.8% (5/24) and disease control rate (DCR) was 83.3% (20/24) with 5 partial response (PR), 15 stable disease (SD) and 4 progressive disease (PD). Overall, the median progression-free survival (PFS) was 4.9 months (95% CI : 3.4-16.2 months). The ORR of anthracycline-based, eribulin-based or gemcitabine-based regimens was 1/12, 2/6 and 2/6, respectively; and the median PFS was 7.7, 7.3 and 4.4 months, respectively. Waterfall plots showed notable tumor shrinkage of any degree in eribulin and gemcitabine-based regimens(3/6 and 2/6, respectively), while there were more patients presented with SD in anthracycline-based group(9/12). Common adverse reactions included myelosuppression, fatigue, anorexia, rash, pruritus, palpitate, hypothyroidism and hypertension. Conclusions: The combination regimen with chemotherapy, PD-1 inhibitor and anlotinib in the treatment of advanced DDLPS is effective and well tolerable. There are more responders in eribulin or gemcitabine-based regimens.

Objective: To summarize the clinical experience in treating children with variant preauricular fistula who present with posterior auricular abscess, and to improve the diagnostic accuracy and therapeutic outcome. Methods: The clinical data of 11 children with preauricular fistula with retroauricular abscess as the main clinical manifestation were analyzed retrospectively. Among them, 10 patients underwent surgical treatment after infection control, and 1 patient underwent preauricular fistula resection during infection period. During the operation, methylene blue was used to trace the fistula, and the fistula and the infected tissue behind the ear were removed as a whole. Follow up regularly after operation. Results: The fistulas of the 11 patients were all located at the helix crus. After the auricular fistula resection with double-incision, the patients were followed up for more than 1 year without recurrence. Conclusion: Children with variant anterior auricular fistula who manifested with postauricular abscess could be successfully managed by Preauricular fistula resection with Double-incision. Careful physical examination before operation and the complete removal of the fistula and the attached cartilage during the operation can avoid misdiagnosis and postoperative recurrence., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To analyzed perioperative safety of cytoreductive surgery (CRS) for patients with colorectal cancer peritoneal metastasis (CRPM) and to construct a predictive model for serious advese events (SAE). Methods: A descriptive case-series study was conducted to retrospectively collect the clinicopathological data and treatment status (operation time, number of organ resection, number of peritoneal resection, and blood loss, etc.) of 100 patients with peritoneal metastases from colorectal cancer or appendix mucinous adenocarcinoma who underwent CRS at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to August 2021. There were 53 males and 47 females. The median age was 52.0 (39.0-61.8) years old. Fifty-two patients had synchronous peritoneal metastasis and 48 had metachronous peritoneal metastasis. Fifty-two patients received preoperative neoadjuvant therapy. Primary tumor was located in the left colon, the right colon and the rectum in 43, 28 and 14 cases, respectively. Fifteen patients had appendix mucinous adenocarcinoma. Measures of skewed distribution are expressed as M (range). Perioperative safety was analyzed, perioperative grade III or higher was defined as SAE. Risk factors associated with the occurrence of SAEs were analyzed using multivariate logistic regression. A nomogram was plotted by R software to predict SAE, the efficacy of which was evaluated using the area under the ROC curve (AUC) and correction curves. Results: The median peritoneal cancer index (PCI) score was 16 (1-39). Sixty-eight (68.0%) patients achieved complete tumor reduction (tumor reduction score: 0-1). Sixty-two patients were treated with intraperitoneal hyperthermic perfusion chemotherapy (HIPEC). Twenty-one (21.0%) patients developed 37 SAEs of grade III-IV, including 2 cases of ureteral injury, 6 cases of perioperative massive hemorrhage or anemia, 7 cases of digestive system, 15 cases of respiratory system, 4 cases of cardiovascular system, 1 case of skin incision dehiscence, and 2 cases of abdominal infection. No grade V SAE was found. Multivariate logistic regression analysis showed that CEA (OR: 8.980, 95%CI: 1.428-56.457, P =0.019), PCI score (OR: 7.924, 95%CI: 1.486-42.259, P =0.015), intraoperative albumin infusion (OR: 48.959, 95%CI: 2.115-1133.289, P =0.015) and total volume of infusion (OR: 24.729, 95%CI: 3.956-154.562, P =0.001) were independent risk factors for perioperative SAE in CRS (all P <0.05). Based on the result of multivariate regression models, a predictive nomogram was constructed. Internal verification showed that the AUC of the nomogram was 0.926 (95%CI: 0.872-0.980), indicating good prediction accuracy and consistency. Conclusions: CRS is a safe and effective method to treat CRPM. Strict screening of patients and perioperative fluid management are important guarantees for reducing the morbidity of SAE.

Objective: To review the osteoimmunomodulatory effects and related mechanisms of inorganic biomaterials in the process of bone repair., Methods: A wide range of relevant domestic and foreign literature was reviewed, the characteristics of various inorganic biomaterials in the process of bone repair were summarized, and the osteoimmunomodulatory mechanism in the process of bone repair was discussed., Results: Immune cells play a very important role in the dynamic balance of bone tissue. Inorganic biomaterials can directly regulate the immune cells in the body by changing their surface roughness, surface wettability, and other physical and chemical properties, constructing a suitable immune microenvironment, and then realizing dynamic regulation of bone repair., Conclusion: Inorganic biomaterials are a class of biomaterials that are widely used in bone repair. Fully understanding the role of inorganic biomaterials in immunomodulation during bone repair will help to design novel bone immunomodulatory scaffolds for bone repair.

Objective: To examine the prevalence and frequencies of human papillomavirus (HPV) genotypes in cervical adenocarcinoma in situ (AIS). Methods: The cases of cervical AIS with concurrent tests of cytology and HPV typing from January 2007 to February 2020 in the Obstetrics and Gynecology Hospital of Fudan University were collected and analyzed. Results: A total of 478 cases of cervical AIS were obtained. The average age of the patients was 39.4 years (range, 19-81 years). The largest age group was 30-39 years (44.8%), followed by 40-49 years (34.7%). Among the 478 patients, 355 underwent high-risk HPV (hrHPV) testing and had a hrHPV-positive rate of 93.8%. Of the 355 patients, 277 also underwent HPV typing and were mostly positive for either or both HPV16 and HPV18 (93.1%), with 55.6% positive for HPV18 and 48.7% positive for HPV16. Among the 478 cases, 266 cases (55.6%) were diagnosed with both AIS and squamous intraepithelial lesion (SIL), while 212 cases (44.4%) were diagnosed with only AIS. Patients infected with HPV16 in the AIS and SIL group significantly outnumbered those in the AIS alone group ( P <0.05). Moreover, the rate of positive cytology was 55.9% (167/299 cases), while that of negative cytology was 44.1% (132/299). Among the 109 patients with negative cytology results and co-tested hrHPV, there were 101 HPV-positive cases (92.7%), of which 88 cases were subject to HPV typing and showed an HPV16/18 positive rate of 94.3% (83/88 cases). Conclusions: The combination of HPV typing and cytological screening can maximize the detection rate of cervical AIS, and should continue to be utilized, ideally on a larger scale, in the future.

Objective: To study the clinical application of nonsurgical correction of cryptotia in children older than 6 months. Methods: The children with cryptotia deformity treated in Guangzhou Women and Children's Medical Center from January 2017 to January 2021 were divided into two groups according to their ages. The study group was over 6 months old and the control group was under 6 months old. They were treated with a Earwell auricle correction system, the follow-up was continued for 3-6 months, and the correction effects, complications and recurrence after the treatment were calculated in the two groups. Results: The average time of the treatment start stage and consolidation stage in the study group was（20.29±7.14） days and（31.82±9.65） days, and respectively the control group was（7.5±3.21） days and（16.64±6.53） days, the difference in treatment time between the two groups was statistically significant（ P =0.001）. The effective rate in the study group was 90.91%（20/22）, and the effective rate in the control group was 96.43%（27/28）, there was no statistically significant difference between the two groups（ P =0.576）. The recovery rate in the study group was 31.82%（7/22）, and the recovery rate in the control group was 85.71%（24/28）, the cure rate of the control group was higher than that of the study group（ P =0.002）. Complications occurred in both groups. The most common complications in the study group were skin redness and swelling 18 cases（81.82%） and stent shedding 16 cases（72.73%）, pressure ulcers followed by 12 cases（54.55%）. The most common complication in the control group was skin eczema 9 cases（32.14%）, pressure ulcers 6 cases（21.43%）, stent shedding 5 cases（17.86%）. There was a statistical difference in the incidence of complications between the two groups（ P <0.05）. Conclusion: For older children with cryptotia, Earwell correction systems can still be actively tried to correct hidden ears, but only the hidden auricle can be pulled out. Other combined malformations such as helix adhesion, dysplasia of the upper helix, etc. cannot be improved. Before treatment, it is necessary to fully communicate with the parents about possible complications during the treatment process. Encouraging children and parents to insist on wearing the correction system is the key to successful treatment., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To observe the effect of electroacupuncture (EA) of "Tianshu"(ST25) and "Dachangshu"(BL25) on the intestinal transit function， expression level of glial cell-derived neurotrophic factor (GDNF) and methylation level of GDNF gene promoter region in colon tissue of rats with slow transit constipation (STC)， so as to explore its mechanisms underlying improvement of STC., Methods: Male Sprague-Dawley (SD) rats were randomized into control， saline， model and EA groups ( n =16 in each group). The STC model was replicated by gavage of compound diphenoxylate suspension (10 mL· kg -1 · d -1 ) for 28 days. Rats of the saline group received the same dose of normal saline via gavage. EA (2 Hz/15 Hz， 0.1-1 mA) was applied to bila-teral ST25 and BL25 for 15 min， once daily for 14 days. The intestinal transmission function (the intestinal propulsion rate) was assessed by recording the first black grain stool discharge time and the number and weight of the discharged stool grains in 30 min after gavage of the activated carbon suspension (1 mL/100 g， 150 g/L). The score of fecal trait and the weight of stool within 24 h were recorded. The ultrastructural changes of Cajal interstitial cells in the colon tissue were observed by transmission electron microscope. The expression levels of GDNF protein and mRNA in the colon tissue were detected by using Western blot and real-time fluorescent quantitative PCR， separately， and changes of methylation level in the promoter region of GDNF gene detected by using Bisulfite sequencing method., Results: Compared with the control group， the time of the 1 st black stool grain discharging was obviously prolonged， and the number and weight of the discharged black stool grains were significantly decreased in the mo-del group ( P <0.05)， suggesting a success of STC. The weight and trait score of stool in 24 h， intestinal propulsive rate， and the expression levels of GDNF protein and mRNA were significantly lower in the model group than in the control group ( P <0.01， P <0.05). After EA， the weight and trait score of stool within 24 h， intestinal propulsive rate，and the expression levels of GDNF protein and mRNA were significantly increased in the EA group in contrast to the model group ( P <0.01， P <0.05). The total CpGs methylation level of GDNF gene in colon tissue was considerably higher in the model group than in the control group ( P <0.05)， and markedly lower in the EA group than in the model group ( P <0.05). No significant differences were found between the control and saline groups in all the above-mentioned indexes ( P >0.05)., Conclusion: EA of back-shu and front-mu acupoints can effectively improve symptoms of constipation and intestinal transport function in STC rats， which may be related to its function in up-regulating the expression of GDNF and down-regulating the methylation level in the promoter region of GDNF gene in colon tissue.

Objective: To explore the clinical characteristics, treatment methods and outcomes of extramedullary plasmacytoma of the head and neck. Methods: A retrospective analysis was conducted on 10 cases with extramedullary plasmacytoma of the head and neck who were admitted to Henan Tumor Hospital from January 2005 to January 2020. Among the 10 patients, 6 were male and 4 were female. The average age at diagnosis was 56.3 years old (34-74 years old). Among them, 3 cases were located in the nasal cavity, 2 cases in the nasopharynx, 1 case in the sinuses, 2 cases in the larynx, 1 case in the oropharynx, and 1 case in the cervical lymph nodes. Treatments were administered according to tumor size and resection extent. Complete surgical excision (negative margins) was preferred, followed by adjuvant radiotherapy or radiotherapy alone. The clinical characteristics, diagnosis, treatment and prognosis of EMP were analyzed. Results: The patients' symptoms were not specific, frequently with local obstruction symptom and localized masses. All patients were confirmed pathologically as suffering from monoclonal plasmacytoma, with negative bone marrow biopsy and negative skeletal survey. Five patients received surgery, 3 received radiotherapy, and 2 received surgery with additional radiation. The follow-up time was 16-125 months, with a median of 92 months. Two patients developed into multiple myeloma. One patient who received radiotherapy after surgery relapsed after 7 years of follow-up and again received surgical treatment, with no evidence of second recurrence. The remaining patients had no recurrence or progression. Conclusion: Extramedullary plasmacytoma of the head and neck has a good prognosis. Surgical treatment can be considered for completely resectable lesions.

The effects of Jingui Shenqi Pills(Jingui) and Liuwei Dihuang Pills(Liuwei) which respectively tonify kidney Yang and kidney Yin on brain function have attracted great attention, while the differences of protein expression regulated by Jingui and Liuwei remain to be studied. This study explored the difference of protein expression profiles in the hippocampi of mice orally administrated with the two drugs for 7 days. The protein expression was quantified using LC-MS/MS. The results showed that among the 5 860 proteins tested, 151, 282 and 75 proteins responded to Jingui alone, Liuwei alone, and both drugs, respectively. The ratio of up-regulated proteins to down-regulated proteins was 1.627 in Jingui group while only 0.56 in Liuwei group. The proteins up-regulated by Jingui were mainly involved in membrane transport, synaptic vesicle cycle, serotonergic synapse, dopaminergic synapse and so on, suggesting that Jingui may play a role in promoting the transport of neurotransmitter in the nervous system. The proteins down-regulated by Liuwei were mainly involved in membrane transport, synapse, ion transport(potassium and sodium transport), neurotransmitter transport, innate and acquired immune responses, complement activation, inflammatory response, etc. In particular, Liuwei showed obvious down-regulation effect on the members of solute carrier(SLC) superfamily, which suggested that Liuwei had potential inhibitory effect on membrane excitation and transport. Finally, consistent results were obtained in the normal mouse and the mouse model with corticosterone-induced depressive-like behavior. This study provides an experimental basis for understanding the effect of Jingui and Liuwei on brain function from protein network.

Objective To investigate the effect of chiral self-assembled peptides SciobioII and Sciobio IV on the repair of anterior cruciate ligament injury. Methods The structure of the self-assembled peptides SciobioII and Sciobio IV was analyzed by circular dichroism, transmission electron microscopy, and aniline blue staining; the activity and morphology of human ligament fibroblasts (HLF) in 3D cell culture matrix were detected by acridine orange/ethidium bromide (AO/EB) staining and FITC-phalloidin staining. The rabbit model of anterior cruciate ligament injuries was established and the effects of self-assembled peptides on the ligament repair were analyzed by HE staining and immunohistochemistry. Results The self-assembled peptides SciobioII and Sciobio IV formed a stable β-sheet after self-assembling in PBS for 24 hours, and futher constructed a nanofiber network structure, which was suitable for 3D cell culture. Human ligament fibroblasts maintained a round shape and grew vigorously in the 3D cell culture media constructed by self-assembled peptides. Animal experiments showed that the self-assembled peptide SciobioII promoted the repair rate of anterior cruciate ligament injury in rabbit. Conclusion Chiral self-assembled peptides Sciobio II and Sciobio IV can be used for 3D cell culture and repair of anterior cruciate ligament injury in rabbit.

Liver cancer is one of the malignant tumors with the highest fatality rate in China and the 5-years survival rate is only 12.5%. Early detection to undertake early treatment can improve the survival rate of patients with liver cancer. Nowadays, the unsatisfactory performance of serum Alpha-fetoprotein (AFP) test, and the problems of insensitive to small lesions for ultrasound and exposure to nuclear radiation for CT, necessitate the urgency to explore novel diagnostic biomarkers of liver cancer. It has been demonstrated the presence of autoantibodies targeting tumor-associated antigens prior to clinic symptoms implied underlying early diagnostic value of malignancies. High specificity but low sensitivity of single autoantibodies such as the most reported anti-p53, anti-insulin like growth factor-Ⅱ mRNA binding protein, and anti-glucose regulated protein can be solved by combining different autoantibodies. However, the autoantibodies of different combinations vary in studies. Simultaneously, autoantibodies in combination with AFP facilitate further improving the detection rate of liver cancer. Nevertheless, the autoantibodies related to prognosis of liver cancer needs to be more studied in the near future.

Objective: To analyze the microbiological characteristics of patients with severe burns caused by blast in different periods and explore the application value of metagenomics next-generation sequencing (mNGS) in detecting pathogenic microorganisms. Methods: The retrospective observational study was applied. From June 13 to September 13, 2020, twenty-three patients (21 males and 2 females) with severe burns caused by blast who met the inclusion criteria were admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine, with age of (64±5) years and total burn area of (86±14) % total body surface area. Abbreviated burn severity index (ABSI) score, revised Baux score, acute physiology and chronic health status evaluation (APACHE) Ⅱscore, and sequential organ failure assessment (SOFA) score were counted on admission. Within 7, 8-20 and 21-30 d after admission, the complications, infection source and distribution of pathogenic microorganisms in patients were recorded. The detection of pathogenic microorganisms was analyzed, and the difference in detection efficiency between microbial culture method and mNGS was compared. After admission, the infection of overall source distribution of pathogenic microorganisms in patients was analyzed, and the difference in detection efficiency between microbial culture method and mNGS was compared. Data were statistically analyzed with McNemar and Fisher exact probability test. Results: On admission, ABSI score, revised Baux score, APACHE Ⅱ score and SOFA score were (12.6±2.4), (91±22), (26±4), and (10.3±2.3) respectively. Within 7 d after admission, the main complications of patients were inhalation injury, septic shock, and hypoproteinemia. Patients were mainly infected with pathogenic microorganism on wound, blood stream, and lung. Within 8-20 d after admission, the incidence of septic shock was the highest. The incidence of inhalation injury was significantly lower than that of ≤7 d after admission ( P <0.01), the main source of infection were wound, lung, and blood stream, and the incidence of wound and blood stream infection were significantly lower than that of ≤7 d after admission ( P <0.01). Within 21-30 d after admission, the incidences of multiple organ failure and acute respiratory distress syndrome were low, the incidence of inhalation injury was significantly lower than that of ≤7 d after admission ( P <0.01), and the incidence of septic shock was significantly lower than that of ≤7 d after admission ( P <0.01) and 8-20 d after admission ( P <0.01). There were only low bloodstream infections, and the incidence of wound infection was significantly lower than that of ≤7 d after admission ( P <0.01) and 8-20 d after admission ( P <0.05), and the incidences of lung and blood stream infection were significantly lower than those of ≤7 d after admission ( P <0.01). Within ≤7 d after admission, gram-positive bacteria were mainly Staphylococcus aureus . Gram-negative bacteria were mainly Klebsiella pneumoniae and Stenotrophomonas maltophilia . The fungi contained only Candida . Within 8-20 d after admission, Staphylococcus aureus was mainly the gram-positive bacteria, and the detection rate of Enterococcus was significantly lower than that of ≤7 d after admission ( P <0.01). Pseudomonas aeruginosa and Acinetobacter baumannii were the main gram-negative bacteria, and their detection rates were significantly lower than those of ≤7 d after admission ( P <0.01).There was a new detection of Fusarium . Within 21-30 d after admission, Staphylococcus aureus was the mainly gram-positive bacteria, and the detection rates of Enterococcus and Bacillus were significantly lower than those of ≤7 d after admission ( P <0.01). Pseudomonas aeruginosa and Acinetobacter baumannii were still the main gram-negative bacteria, and increased with the extension of time after admission. The detection rate of Pseudomonas aeruginosa was significantly higher than that of ≤7 d after admission ( P <0.01) and 8-20 d after admission ( P <0.01), and the detection rate of Acinetobacter baumannii was significantly higher than that of ≤7 d after admission ( P <0.01). The detection rate of Klebsiella pneumoniae was significantly lower than those of ≤7 d after admission ( P <0.01) and 8-20 d after admission ( P <0.01). All Candida, Mould, Fusarium were detected. Within ≤7 d and 8-20 d, the consistency between mNGS and bacterial culture was high ( κ =0.659, 0.596). Within 21-30 d after admission, the consistency between mNGS and bacterial culture was moderate ( κ =0.407). In different time periods, the positive test rate of mNGS was basically constant, while that of microbial culture showed a decline with the extension time after admission. Five hundred and six strains of pathogenic microorganisms were isolated from wound, blood, sputum, and indwelling catheter, and Staphylococcus aureus , Pseudomonas aeruginosa , Acinetobacter baumannii , Klebsiella pneumoniae were the main pathogenic microorganisms. Pseudomonas aeruginosa and Acinetobacter baumannii were the most common in the wound samples, Klebsiella pneumoniae was more often seen in blood samples while Pseudomonas aeruginosa and Acinetobacter baumannii in sputum samples, and Acinetobacter baumannii in indwelling catheter samples were the most common. The detection rates of Pseudomonas aeruginosa in wound and sputum were significantly higher than those of blood ( P <0.05 or P <0.01) and indwelling catheter ( P <0.01), respectively. The consistency between the overall results of mNGS and microbial culture were moderate ( κ =0.556). The consistency between mNGS and microbial culture was high in samples of blood and indwelling catheter ( κ =0.631, 0.619), but those were moderate in sputum and wound ( κ =0.558, 0.528). Conclusions: The most common infections of patients with severe burn caused by blast injury were wound infection and blood stream infection. With the extension of time after admission, the main pathogenic bacterial strains of patients changed from Staphylococcus aureus , Klebsiella pneumoniae , and Stenotrophomonas maltophilia to Acinetobacter baumannii and Pseudomonas aeruginosa . mNGS showed a higher positive rate of detecting pathogenic microorganisms than conventional microbial culture.

Objective: To explore the clinical phenotype and genetic characteristics of two children with developmental epileptic encephalopathy type 66., Methods: Genomic DNA was extracted from peripheral blood samples of the two children and their parents. Whole exome sequencing (WES) was carried out and suspected variant was verified by Sanger sequencing., Results: The main manifestations of the two children were neonatal onset seizures, hypotonia, global developmental delay, and facial dysmorphisms. Cranial MRI showed delayed myelination in case 1 and cerebellar dysgenesis in case 2. WES has identified a de novo pathogenic variant in the PACS2 gene in both patients, namely c.625G>A (p.Glu209Lys)(NM&#95;001100913.3), which was reported as a pathogenic variant before. This variant was predicted to be pathogenic according to the American College of Medical Genetics and Genomics guideline (PS2+PM2+PP3). The seizures were controlled after combination treatment of sodium valproate and levetiracetam in both cases. At last follow-up, the motor and intellectual development of the 2 cases were improved. Compared with the cases reported, the clinical symptoms and signs of our cases were relatively mild, and the treatment effects were fairly good., Conclusion: The variant of c.625G>A (p.Glu209Lys) in PACS2 gene is a hotspot variant of developmental epileptic encephalopathy 66. Gene testing can facilitate the clinical diagnosis and treatment.

Objective: To investigate the MRI features of hepatic nodular regenerative hyperplasia (NRH) induced by chemotherapy. Methods: The clinical data and MRI of 20 cases with hepatic NRH induced by chemotherapy and confirmed by pathology in Zhongshan Hospital Fudan University from August 2014 to May 2019 were retrospectively analyzed. There were 13 males and 7 females, with an average age of 49.8 ± 9.7 years. Contrast-enhanced MR scan with Gd-DTPA was performed eighteen patients, and two patients underwent contrast-enhanced MR scan with hepatobiliary specific contrast (Gd-EOB-DTPA). The image analysis includes the number, location, size, shape, signal intensity in plain scan and enhancement pattern of lesions. The apparent diffusion coefficient (ADC) values of the lesions and adjacent hepatic parenchyma were measured on the ADC map, and the difference was compared with paired sample t test. Results: A total of 36 lesions in 20 patients were rounded or oval, including 23 (63.9%) lesions in the right lobe, 12 (33.3%) in the left lobe and 1 (2.8%) in the caudate lobe. The average diameter of all lesions was 15.4 ± 6.4 (7.0-37.0) mm. The boundary was clear in 9 (25.0%) lesions and blurred in 27 (75%) lesions. In T1WI, 35 (97.2%) lesions showed slightly hypointensity, and in 1 (2.8%) lesion was iosintensity. All 36 lesions showed slightly hyperintensity in T2WI. 33 (91.7%) lesions showed slightly hyperintensity in DWI, and 3 (8.3%) lesions showed iosintensity. 31 lesions with Gd-DTPA enhanced MR scan were significantly enhanced in the arterial phase and showed slightly high signal intensity in early portal vein phase, late portal vein phase and equilibrium phase. 5 lesions with Gd-EOB-DTPA enhanced MR scan were also significantly enhanced in the arterial phase and showed slightly high signal intensity in early portal vein phase, late portal vein phase and equilibrium phase, then all lesions showed circular high signal intensity in hepatobiliary specific phase. The average ADC value of 29 lesions was (1.471 ± 0.253) × 10(-3) mm(2)/s, and that of adjacent liver parenchyma was (1.460 ± 0.235) ×10(-3) mm(2)/s. There was no significant difference between the two groups ( P > 0.05). Conclusion: MR findings of NRH induced by chemotherapy have certain characteristics, and the morphological manifestations, diffusion-weighted imaging, enhanced imaging and hepatobiliary specific phase features of the lesions can help to diagnose the disease.

Twenty batches of Aurantii Fructus Immaturus(AFI) were collected, with their peel and pulp taken as research objects. Ultra-high performance liquid chromatography(UPLC) fingerprints of peel and pulp of AFI were established with 17 common peaks in peel and 10 in pulp. Six kinds of flavonoids were identified, i.e., narirutin, naringin, rhoifolin, hesperidin, neohesperidin and nobiletin. The Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine was employed for similarity analysis, which showed that the chromatographic peaks of peel and pulp were basically similar to their respective reference fingerprints, with all similarities greater than 0.90. The similarity between peel and pulp of the same batch of AFI ranged from 0.850 to 0.983. Cluster analysis(CA), principal component analysis(PCA), and orthogonal partial least squares discriminant analysis(OPLS-DA) were conducted on the common peaks of peel and pulp of AFI with SPSS 17.0 and SIMCA 14.1. Combined with the reference fingerprints, these analyses revealed 12 differential components regarding peel and pulp. Further, the content of the 6 flavonoids and synephrine was determined. The proposed method integrating UPLC fingerprint and multicomponent quantitative analysis is applicable to the quality evaluation of AFI. The results provide a certain basis for the scientific connotation about the appearance characteristic of AFI.

Objective: To evaluate the short-term efficacy of nasal nitric oxide（nNO） on specific allergen subcutaneous immunotherapy in children with allergic rhinitis. Methods: The data of 87 children with allergic rhinitis treated in the otolaryngology clinic of Guangzhou Women and Children's Medical Center from January 2018 to January 2019（case group） and 80 healthy children who received physical examination in the hospital during the same time period（control group） were retrospectively analyzed. The case group was treated with specific allergen subcutaneous immunotherapy. Compare the nNO and symptom score changes of the control group and the case group at different time points. Describe the treatment effect of children in the case group after 1 years of treatment. Analyze the changes of nNO and TNSS（nNO, TNSS） in the case group of patients with different treatment effects during treatment, and calculate the evaluation value of nNOand TNSSon the treatment effect of children. Results: The nNO and TNSS in the case group decreased significantly with the prolonged treatment time（both P <0.05）. The nNO and TNSS of the case group at different treatment time points were higher than those of the control group（all P <0.05）. There was a positive correlation between nNO and TNSS in the control group and case group at all information collection time points（ r =0.870, P <0.05）. After 1 year of treatment, the effective rate of treatment in the case group was 78.16%（68/87）. There was a statistically significant difference in nNO and TNSS of children with different treatment effects in the case group（ P <0.05）. Using the nNO and TNSS to infer the therapeutic effect of children, the best cut-off values were 457.78μg/L and 3.95（points）. The Youden Index was 0.821, 0.639. Conclusion: Specific allergen subcutaneous immunotherapy has a good therapeutic effect on children with allergic rhinitis, and it is of good value to evaluate the therapeutic effect by using the changes of nNO values before and after treatment in children., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Abstract: In recent years, as the third-generation of drugs, new psychoactive substances （NPS） have expanded rapidly and become a serious concern for China's anti-drug prevention and control system. As a new drug monitoring technology in the current anti-drug field, wastewater analysis is an objective, real-time, accurate, convenient and effective drug monitoring method. In recent years, it has gradually been applied to the monitoring of NPS. This study summarizes wastewater sample collection, target stability research, wastewater sample pretreatment, wastewater sample analysis methods, target NPS consumption calculations and actual monitoring applications, with a view to the construction of a monitoring system for NPS in wastewater, real-time and accurate grasp of information on the use of NPS in cities, the reflection of the actual consumption of different types of NPS and consumption trends in a short period of time, and prediction of the development trend of abused use, which is of great significance for combating NPS crimes, serving and guaranteeing the personal safety of the people, and maintaining social stability., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Forensic Medicine.)

Objective: To investigate the middle ear function of the patients with cleft palate pre and post palatoplasty. Methods: 76 patients with cleft palate were investigated by clinical history and audiology examinations including electric otoscopy,tympanometry and click-ABR threshold. Results: The risk for middle ear function decreased with advancing age in the first 5 years. It was noticed that the otologic outcomes was related to the CP type. During long time follow-up, the frequency with the middle ear function disorder was always high within the CP patients but the proportion of the patients received tympanostomy tubes was low relatively. The prevalence of middle ear dysfunction did not differ with the time of cleft palate repair. Conclusion: The patients with cleft palate have middle ear function dysfunction in a long period of time,therefore a standard long-time follow-up system is necessary.

Objective: To compare the clinicopathological characteristics and the prognosis of gastric adenocarcinoma patients with and without neuroendocrine differentiation (NED) after radical gastrectomy plus D2 lymph node dissection. Methods: A retrospective cohort study was performed. The inclusion criteria were as follows: (1) patients who underwent radical resection of gastric cancer plus D2 lymph node dissection and were confirmed as gastric adenocarcinoma by postoperative pathology and received immunohistochemical examination of neuroendocrine markers Syn and/or CgA; (2) patients aged 20 to 75 years with normal organ function; (3) patients who did not receive neoadjuvant chemotherapy or radiotherapy before operation; (4) patients with postoperative pathological stage I to III according to the 8th edition of tumor staging system of American Joint Committee on Cancer (AJCC); and (5) patients who completed adjuvant chemotherapy according to the postoperative pathological stage. Those who had other malignant tumors in the past 5 years and who could not be followed up according to the required rules were excluded. According to the above criteria, the clinicopathological characteristics of gastric cancer patients who underwent radical resection plus D2 lymph node dissection in Zhongshan Hospital of Fudan University from January 2010 to June 2017 were collected and compared. All patients were followed up till June 2020. The disease-free survival (DFS) and overall survival (OS) between the patients with and without NED were compared, and the effect of NED on the prognosis was corrected by Cox proportional hazards model. The propensity score matching method was used for sensitivity analysis. Results: A total of 539 patients were enrolled in this study, including 35 with NED and 504 without NED. Compared with the patients without NED, the patients with NED were older [(65.0±7.5) years vs. (54.5±11.3) years, t =-7.681, P <0.001], had higher proportion of undergoing proximal gastrectomy [22.9% (8/35) vs. 7.6% (36/504), χ(2)=10.335, P =0.006], higher proportion of intestinal-type based on Lauren classification [77.1% (27/35) vs. 42.5% (214/504), χ(2)=14.553, P <0.001], and higher proportion of pathologic stage III [65.7% (23/35) vs. 27.6% (139/504), χ(2)=25.653, P <0.001]. The 3-year DFS of patients with NED and those without NED was 48.9% (95% CI: 33.8%-70.8%) and 37.4% (95% CI: 32.9%-42.5%) respectively, and no significant difference was found ( P =0.44). The 3-year OS was 56.1% (95% CI: 39.9%-79.1%) and 64.3% (95% CI: 59.3%-69.7%) respectively, and no significant difference was found as well ( P =0.32). Univariate and multivariate analyses showed that NED was not an independent risk factor for DFS and OS (all P >0.05). Sensitivity analysis showed that there was no significant difference in DFS and OS between the two groups after propensity score matching. Conclusion: Compared with patients without NED, patients with NED were older at onset, had a higher proportion of proximal gastrectomy, intestinal-type, and later diagnostic stage, but the survival prognosis had no significant difference with that of patients without NED.

Objective: To explore the effect of estradiol (E2) binding to its receptor ERβ on the proliferation and apoptosis of C28I2 cells., Objective: We cloned the sequence of ESR2 into a recombinant adenovirus plasmid (pAd-ESR2) and packaged the plasmid in HEK293 cells. Normal human chondrocyte C28I2 cells were transfected with Ad-ESR2 or small interfering RNA targeting ESR2-siRNA (ESR2-siRNA), and the effects of treatment with DMSO or E2 on the expression of the proteins associated with endoplasmic reticulum (ER) stress and cell apoptosis were determined using Western blotting. qRT-PCR was used to detect the expressions of proliferation-related marker genes, and an EdU kit and flow cytometry were used to assess cell proliferation and apoptosis. We also tested the effects of U0126 (an ERK pathway inhibitor) and E2, alone or in combination, on ER stress, apoptosis and the ERK signaling pathway in C28I2 cells infected with Ad-ESR2 using Western blotting., Objective: Overexpression of Ad-ESR2 in C28I2 cells significantly promoted the expressions of IRE1 α , PERK, XBP1s, and cleaved caspase-12, inhibited proliferation related marker genes PCNA, cyclin B1, cyclin D1, and decreased the level of ERK phosphorylation following E2 treatment (all P < 0.05). Interference of ESR2 caused significant reduction in the expressions of ER stress-related proteins and apoptosis-related proteins, up-regulated the genes related to cell proliferation, and increased intracellular pERK/ERK ratio in C28I2 cells. The effect of E2 binding to ERβ, which promoted the expressions of ER stress associated proteins and apoptosis related proteins, was obviously antagonized by treatment of the cells with U0126., Objective: The binding of E2 to ERβ promotes ER stress and apoptosis in human chondrocytes by activating ERK pathway phosphorylation inhibit cell proliferation.

Objective: To explore the application of microscope combined with radiofrequency coblation in the treatment of infantile epiglottic cyst. Method: 17 cases of infantile epiglottic cysts were treated with radiofrequency coblation under supporting laryngoscope and microscope. Result: All 17 patients were successfully resected the epiglottic cysts, without complications during and after surgery. The dyspnea symptoms disappeared at the time of discharge. The wounds healed well after reexamination at 1 month after operation. There was no recurrence in the 6-23 months follow-up. Conclusion: The treatment of infantile epiglottic cysts with radiofrequency coblation under microscope has many advantages, such as clear vision, strong three-dimensional sensation, stable operation of both hands, less bleeding, and light postoperative tissue reaction., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the status of monotherapy for newly diagnosed tic disorders and its comorbidity in children, so as to provide a reference for clinical medication. Methods: A questionnaire survey was conducted to collect the application experience of monotherapy for newly diagnosed tic disorders and comorbidities in 110 pediatric neurologists and psychiatrists from Chinese Tic Disorders Study Consortium from February to August in 2019. Doctors were asked to rate treatment options based on a rank 5-point scale with "1" least appropriate and "5" most appropriate. The drug evaluation index was based on the comparison of the median score of a single drug with the overall scores of all drugs in this disease ( M ( Q 1 , Q 3 )), single drug M ≥ overall Q 3 was recommended as preferred drugs; overall Q 1 ≤ single drug M < overall Q 3 was considered as secondary drugs; single drug M < overall Q 1 was considered as unsuitable drugs. Results: Among 110 electronic questionnaires, 94 (86%) were availably responded, responding doctors included 37 (39%) males and 57 (61%) females, the age of responding doctors was (48±10) years, and their working year was (17±10) years. In the investigation of the first and second monotherapy for newly diagnosed tic disorders in children without comorbidities, there were no preferred drugs for mild transient tic disorders. The scores of clonidine, aripiprazole and tiapride were 4 (3, 4), 4 (3, 4), 4 (4, 5) scores respectively, and were greater than overall scores (3 (2, 4) scores), so they could be recommended as the preferred drugs for moderate chronic tic disorders, the recommendation for initial mild Tourette syndrome (TS) treatment was the same as preferred drugs for moderate chronic tic disorders. Similarly, clonidine, aripiprazole, tiapride and haloperidol could be recommended as the preferred drugs for other kinds of tic disorders. As for the second monotherapy, the preferred drugs for moderate transient tic disorders, mild chronic tic disorders and severe TS were all aripiprazole, tiapride, haloperidol, sulpiride, clonidine and topiramate. While clonidine, aripiprazole, tiapride could be considered as preferred drugs for severe transient tic disorders, moderate to severe chronic tic disorders and mild to moderate tic disorders. In the investigation of monotherapy for newly diagnosed tic disorders in children with comorbidities, for moderate chronic tic disorders and TS comorbid with obsessive-compulsive disorder, aripiprazole (4 (3, 5) scores) and sertraline (4 (3, 4) scores) were preferred drugs,the median scores of which were all greater than overall scores (3 (3, 4) scores), they were also the preferred treatment for severe transient tic disorders and mild chronic tic disorders. For mild and moderate transient tic disorders, severe chronic tic disorders and TS comorbid with obsessive-compulsive disorder, aripiprazole, fluvoxamine, fluoxetine, haloperidol and sertraline were preferred drugs. When comorbid with attention deficit hyperactivity disorder (ADHD), severe transient tic disorders, moderate chronic tic disorders and TS, tomoxetine and clonidine were recommended as preferred drugs (both 4 (4, 5) scores), and tomoxetine and clonidine were also the preferred treatment for severe TS. For severe chronic tic disorders comorbid with ADHD, clonidine (5(4, 5) scores) was preferred drug, greater than overall scores (4 (3, 5) scores), while for mild and moderate transient tic disorders clonidine, tomoxetine, guanidine and methylphenidate were recommended as preferred drugs. For mild chronic tic disorders and TS comorbid with ADHD tomoxetine was preferred drug. When comorbid with sleep disorders, there were no preferred drugs for mild transient tic disorders; estazolam (3 (2, 3) scores) was the preferred drug for mild chronic tic disorders and TS comorbid with sleep disorders. For othe kind of tic disorders comorbid with sleep disorders, estazolam, melatonin and clonazepam were preferred drugs. When comorbid with anxiety and depressive disorders, for all kinds of tic disorders sertraline was recommended as preferred drugs, the median scores of sertraline were all (4 (3, 5) scores) in severe transient tic disorders, moderate to severe chronic tic disorders and moderate TS, and greater than overall scores (3 (3, 4) scores). While severe chronic tic disorders comorbid with anxiety and depressive disorders, fluvoxamine could also be chosen as preferred drugs. Conclusions: Drug therapy is not recommended for mild transient tic disorders, while tiapride, aripiprazole, clonidine, and haloperidol are mainly preferred drugs for the other kinds of tic disorders. Corresponding drugs should be selected when tic disorders are combined with obsessive-compulsive disorder, ADHD, sleep disorders, anxiety, depression, etc.

Multiple sclerosis (MS) is a demyelinating disease of central nervous system, which often affects ocular region and causes structural and functional changes of eyes. Therefore, there have been plenty of researches on the alteration of motor and structures of eyes by MS. This paper reviews and summarizes the progress of MS-related changes of ocular motor, cornea, structure and blood flow of retina, and optic nerve, and may provide a new insight for related clinical researches. (Chin J Ophthalmol, 2020, 56: 711-715) .

Objective: To report the nonsurgical correction of congenital auricular deformities in children older than 3 months, analysis the effect and the recurrence and the influencing factors. Method: Patients with auricular deformities who came to our department from July 2017 to August 2019 were collected. EarWell correction was performed for non-invasive correction. Follow-up was performed for at least 3 months after treatment. Data was collected to analysis the effect and the recurrence and the influencing factors. Result: At the end of follow-up, 76 cases of 88 ears were collected, at the end of treatment in this group, the efficiency was 87.5%, and the recurrence rate was 19.48%, 3 months after the end of treatment. There was a statistically significant difference in the distribution of auricle deformities（ P =0.018） and the age of first treatment（ P =0.028） between children in the effective group and those in the ineffective group. Of all the auricle deformities, the treatment of cryptotia was the most effective, and the effectiveness of prominent ears was the lowest. The family history（ P =0.314）, gender（ P =0.421）, and feeding method（ P =0.557） of the effective and ineffective groups. There was no significant difference in the gestational weeks at birth（ P =0.641）, the mode of production（ P =0.849）, and birth weight（ P =0.08）. There was no significant difference in age between the relapsed group and the non-relapsed group at the age of first treatment（ P =0.833）.There was significant difference in the distribution of auricle deformities between the relapsed group and the non-relapsed group（ P =0.013）. There was no statistically significant difference between the effective group and the ineffective group at the age of first diagnosis and treatment time if we exclude cryptotia. Conclusion: For children who are treated beyond the treatment time window, the main factor affecting the treatment effect is the type of deformity. Nonsurgical correction can still be tried for older than 3 months with auricular deformities, especially for cryptotia, ear wheel deformities, and auricular cavity deformities. We do not recommend to try nonsurgical correction for children older than 3 months with prominent ears and cup ears., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

A survey was conducted on the application status of "Internet plus" technology in maternal and child health management in 31 provincial maternal and child health care institutions through the national comprehensive information platform for maternal and child health. 19 provincial institutions had realized one or more maternal and child health management and service functions under their jurisdiction through the regional health information platform, accounting for 61%. Among thirteen functions of management and service achieved in the regional health information platform, the top four were maternal system management (39%), high-risk maternal management (29%), high-risk newborn management (26%) and children system management (26%). Most functions were better in the eastern regions than those in the central and western regions. 15 provinces had established maternal and child health information platforms. 52% of provincial maternal and child health institutions provided telemedicine services, which were mainly for remote consultation. The main cooperative institutions of telemedicine services were subordinate health care institutions (39%).

Objective: The study aimed to observe the difference in postoperative complications and recurrence rates of adenoidectomy plus myringotomy or adenoidectomy plus tympanostomy with tube insertion for children with adenoid hypertrophy combined with otitis media with effusion. Method: Children 4 to 12 years old with otitis media with effusion combined with adenoid hypertrophy were assigned to receive either adenoidectomy plus myringotomy（group A） or adenoidectomy plus tympanostomy tube insertion（group B）. Pre-and post-operative data was recorded. Result: There is no ear complication in group A. In group B, some children suffered otorrhea, perforation, blocked tympanic membrane vent and calcification. The recurrence rate of the group A was significantly higher than that of the group B at 3 month after operation. There was no significant difference in recurrence rate between the two groups at 6th month and 12th month after operation. Conclusion: For children aged 4-12 years with adenoid hypertrophy combined with otitis media with effusion, adenoidectomy plus myringotomy can avoid complications after tympanic tube insertion without increasing the risk of long-term recurrence, we recommend this procedure as the first choice., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)