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Formal concept analysis is a data analysis method based on concept lattice, while decision implication and variable decision implication are two decision knowledge representations of formal concept analysis. Both decision implication and variable decision implication have complete inference rules for knowledge reasoning. In order to further clarify the differences between variable decision implication and decision implication, this paper first eliminates uncertainty from variable decision implication and introduces restricted variable decision impli-cation. Then, based on the related research on variable decision implication, this paper presents semantic and syntactic characteristics of restricted variable decision implication. On this basis, a complete set of inference rules is obtained for restricted variable decision implication, and decision implication and restricted variable decision implication are compared from the syntactic perspective. Besides, this paper further discusses the differences between the two decision types in knowledge representation and reasoning from the semantic perspective, and summarizes the characteristics of restricted variable decision implication relative to decision implication from the semantic and syntactic perspectives. These conclusions provide new ideas for comparative research of different decision types such as decision implication, variable decision implication, and fuzzy decision implication, as well as a new perspective for introducing more efficient and concise inference rules.

The ecological civilization construction in China currently demands high-quality development, and a standards system can guide and support the high-quality development of ecological civilization. In this study, we review the strategic demand for the high-quality development of ecological civilization, present the theoretical and practical progress of the standards system, and summarize the problems regarding the construction of the current standards system, such as lack of standards in key areas and a low implementation rate. Moreover, we propose several suggestions for optimizing the framework and content of the standard system and implementation paths for key areas. Specifically, a standards system for realizing ecological product values should be established to support the development of ecological economy; the standards system for ecological and environmental quality should be improved to guarantee national ecological and environmental safety; terrestrial and marine standards systems should be promoted to support territory spatial arrangement; and a green living standards system should be established to regulate the ecological culture construction.

To solve the problem of path planning in blood transportation by unmanned aerial vehicles (UAVs), a path planning model for blood transportation by UAVs is established with the goal of minimizing total transportation distance of UAVs. Considering the safe time interval of continuous take-off and landing of UAVs under the condition that the number of UAVs take-off and landing platforms is limited, a scheduling strategy of UAVs take-off sequence is designed to reduce the total time consumption for UAVs to complete transportation. And an imperialist competitive algorithm based on the imperialist reform is proposed. A sinusoidal disturbance strategy and an imperialist reform are introduced to improve the search accuracy of the algorithm. The acceptance criteria related to solution quality is designed to increase the diversity of the population. The benchmark example and the UAVs transporting blood example are used for verification. The results show that the proposed algorithm can provide transport tasks for the blood transportation by UAVs that meets various constraints and without UAVs take-off and landing conflicts. In addition, using the scheduling strategy of UAVs take-off sequence can reduce the total time spent by UAVs to actually complete the tasks effectively. [ABSTRACT FROM AUTHOR]

Objective To investigate the expression and clinical significance of phosphatidylinoinosidine-3-kinase (PI3K) and matrix metalloproteinase 9 (MMP-9) in bronchoscopic alveolar lavage fluid of children with severe pneumonia in pediatric intensive care unit (PICU). Methods A total of 103 children with severe pneumonia admitted to PICU of the hospital from January 2021 to June 2022 were enrolled. All patients underwent fiberbronchoscopic alveolar lavage. Real-time fluorescence quantitative polymerase chain reaction was used to determine the expression of PI3K, and enzyme-linked immunosorption was used to determine the expression of MMP-9 in alveolar lavage fluid. The patients were followed up for 21 days after admission to evaluate the prognosis. Logistic regression analysis was used to analyze the factors affecting the prognosis. Pearson correlation was used to analyze the correlation between the expression levels of PI3K and MMP-9 in the bubble lavage solution and the child Critical Case Score (PCIS) and child Organ Dysfunction 2 (PELOD-2) Scores. The values of PI3K and MMP-9 expression levels in alveolar lavage fluid to predict the prognosis were analyzed by receiver operating curve (ROC). Results Among the 103 children, 29 cases had poor prognosis vs 74 cases had good prognosis. Logistic multivariate regression analysis showed that combined shock (OR = 4.104, 95%CI: 1.689 ~ 9.974), PELOD-2 score (OR = 4.764, 95%CI: 1.960 ~ 11.577), PCIS score (OR = 5.068, 95%CI: 2.085 ~ 12.318), PI3K (OR = 3.924, 95%CI: 1.614 ~ 9.536) and MMP-9 (OR = 3.873, 95%CI: 1.594 ~ 9.412) were the prognostic factors of PICU children with severe pneumonia (P < 0.05). Pearson correlation analysis showed that the expression levels of PI3K and MMP-9 in alveolar lavage fluid were negatively correlated with PCIS scores (r = -0.598, P = 0.000; r = -0.537, P = 0.000), PI3K and MMP-9 expression levels in alveolar lavage fluid were positively correlated with PELOD-2 scores (r = 0.546, P = 0.000; r = 0.571, P = 0.000). ROC curve results showed that the sensitivity of PI3K, MMP-9 and their combination to predict the prognosis of PICU children with severe pneumonia was 75.86% (95%CI: 56.08% ~ 88.98%), 72.41% (95%CI: 52.51% ~ 86.55%) and 82.76% (95%CI: 63.51% ~ 93.47%), the specificity was 75.68% (95%CI: 64.07% ~ 84.58%), 79.73% (95%CI: 68.47% ~ 87.85%), 89.19% (95%CI: 79.28% ~ 94.88%), and the AUC was 0.762 (95%CI: 0.666 ~ 0.859), 0.767 (95%CI: 0.670 ~ 0.873), 0.909 (95%CI: 0.848 ~ 0.971). Conclusion The expression of PI3K and MMP-9 in bronchoscopic alveolar lavage fluid was related to the prognosis of children with severe pneumonia in PICU, and the combination in predicting the prognosis was effective, so it has certain clinical value to use them as a sensitive indicator to predict the prognosis of children with severe pneumonia in PICU. [ABSTRACT FROM AUTHOR]

The phosphorus-silicon synergistic flame-retardant epoxy resins were prepared separately by using two types of polyhedral oligomeric silsesquioxane (POSS) combined with 9, 10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide (DOPO)-based organophosphorus flame retardants (D-bp), and their flame retardant, thermal properties, mechanical, and dynamic mechanical properties were investigated. The results indicated that the phosphorus-silicon synergistic flame retardant epoxy resins obtained a UL 94 V-0 rating at a phosphorus content of only 0. 25 wt%. The epoxy resins exhibited a peak heat release rate of 31,3. 9 kW/m², total heat release of 118. 2 MJ/m², and average effective combustion heat of 23. 1 MJ/kg, which decreased by 66. 6 %, 41. 4 % and 26. 9 % respectively when the Phenyl-POSS was compounded with D-bp. The combination of Epoxy-POSS and D-bp could simultaneously improve the flame retardant, thermal, mechanical, and dynamic mechanical properties of phosphorus-silicon synergistic flame retardant epoxy resins, indicating excellent comprehensive performance. [ABSTRACT FROM AUTHOR]

The PE-LD/eucalyptus flour powders wood plastic composites were prepared by a twin-screw extruder and an open-type refine machine using PE-LD-g-MAH a compatibilizer, and the effects of molding temperature, molding time, PE-LD-g-MAH concentration and preparation methods on the tensile strength and notched impact strength of the composites were investigated. The morphology and chemical structure of the composites were characterized by SEM and FTIR. The results indicated that the optimum molding temperature and time is 160 °C and 10 min for the preparation of composites, and the use of the open-type refine machine and PE-LD-g-MAH led to the excellent mechanical properties for the composites due to a better dispersion and interface bonding strength of eucalyptus flour powders. The tensile strength of composites increased from 16.53 MPa to 24. 46 MPa, and their notched impact strength increased from 2.04 kJ/m² to 4. 58 kJ/m². The improvement in mechanical properties was due to the enhanced interface-bonding strength derived from the esterification reaction between PE-LD-g-MAH and the hydroxyl groups on the surface of eucalyptus flour powders. [ABSTRACT FROM AUTHOR]

Objective: To compare the expression levels of SCCAg in inverted papilloma of the nasal sinuses and other sinuses and sinus masses. To investigate the correlation between the expression of SCCAg in sinonasal inverted papilloma and outcome. Methods: Sixty-eight patients with unilateral nasal and sinus masses admitted to the Otorhinolaryngology Center of the Affiliated Hospital of Guangdong Medical University from September 2020 to February 2023 were randomly selected, including 31 patients with inverted papilloma （experimental group） and 37 patients with unilateral nasal and sinus masses excluding inverted papilloma （control group）. The application of automatic chemiluminescence immunoassay to test the serum SCCAg of the experimental group before surgery and 1 week after surgery, and the control group to measure the serum SCCAg before surgery. Clinical data were also collected. Results: There was no significant difference between the experimental group and the control group in gender and preoperative peripheral blood inflammatory indicators. However, there was significant difference in age and preoperative serum SCCAg level（ P <0.001）. The serum SCCAg levels of the experimental group before and 1 week after surgery were significantly different（ P <0.001）. The positive predictive value, negative predictive value, sensitivity and specificity of serum SCCAg in the diagnosis of varus papilloma were 92.6%, 85.4%, 77.4%, 94.6% and 0.72, respectively. The effect of serum SCCAg in the diagnosis of varus papilloma was analyzed by drawing the subject's working characteristic curve, and the area under the curve was 0.968（ P <0.001）. When serum SCCAg greater than 2.7 ng/mL, the sensitivity and specificity were 67.7% and 94.6%, respectively. There was statistical significance in serum SCCAg levels between patients with and without recurrence（ P <0.05）. Conclusion: The level of SCCAg in unilateral nasal and sinuses tumors, excluding squamous cell carcinoma, was significantly increased in inverted papilloma. The detection of serum SCCAg can be used as a simple and cost-effective auxiliary diagnostic tool for patients with nasal inverted papilloma before operation. Significant differences in preoperative and postoperative levels can be used for preliminary evaluation of surgical efficacy. Monitoring the serum SCCAg level in patients with inverted papilloma after surgery can predict recurrence and provide a simple and feasible method for postoperative follow-up., 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 effectiveness of nasal endoscopic anterior lacrimal recess approach combined with temporary fenestration of the nasal septum in resecting recurrent nasal inverted papilloma. Methods: Patients with recurrent nasal inverted papilloma who underwent reoperation in our hospital during the past 2 years were included . The nasal septum may hinder full access to and effective treatment of the lesions at the anterior and medial wall of the maxillary sinus by endoscope, aspirator and surgical instrument in the narrow aperture of the prelacrimal recess, although these lesions could be observed by 70° nasal endoscope. Results: The nasal septum is temporarily opened on the basis of the prelacrimal recess approach, and the nasal endoscope and instrument was introduced through trans-septal window, so as to provide a better view of the operative field and the angular range of the instrument's movement. Conclusion: The recurrent nasal inverted papilloma could be successfully managed by re-endoscopic anterior lacrimal recess approach combined with temporary fenestration of the nasal septum, and no recurrence was observed during the 2-year follow-up. This surgical approach is recommended for the inverted papilla which originates from the anterior medial wall of the maxillary sinus, as the tumor can be removed completely using this surgical approach., 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 assess the value of high-throughput sequencing for the detection of thalassemia-associated variants in ethnic Li minority areas of Hainan, China., Methods: In Baoting Li and Miao Autonomous County of Hainan Province, 1842 middle school students were randomly selected as the subjects, which included 1249 ethnic Lis, 454 ethnic Hans, and 139 individuals from other ethnic minorities. With DNA extracted from peripheral blood samples, gap-PCR combined with high-throughput sequencing were carried out to detect potential variants of the globin genes., Results: In total 22 α-thalassemia genotypes, 5β-thalassemia genotypes, and 21 α-composite β-thalassemia genotypes were detected. The carrier rates for ethnic Li, ethnic Han and other ethnic minorities were 78.14%, 24.01%, and 28.06%, respectively. In addition, 22 fusion genes, 8 variants leading to abnormal hemoglobin, and 10 rare mutations were identified., Conclusion: High-throughput sequencing can detect a wide range of genetic variants associated with thalassemia in the ethnic Li minority areas and has played an important role for the identification of fusion genes, variants underlying hemoglobin anomalies and rare mutations.

Objective: To observe the effect of nasal mucosa flap in the repair of nasopharyngeal skull base bone exposure after radiotherapy for nasopharyngeal carcinoma, and to provide a basis for the repair with nasal mucosa flap in skull base bone exposure after radiotherapy. Methods: The clinical data of 8 patients who underwent nasal endoscopic surgery were analyzed retrospectively. The survival of mucosal flap, the mucosal epithelialization of bone defect or exposed site, the improvement of main clinical symptoms and complications were followed up after operation. Results: Severe mucosal flap necrosis and bone exposure occurred in 1 case after operation, in the other 7 cases, the mucosal flap survived and the mucosal epithelium of nasopharynx recovered well. After operation, most of the patients' clinical symptoms such as headache and nasal odor were improved compared with those before operation. Conclusion: Nasal mucosal flap is a safe and minimally invasive autogenous material with good biocompatibility. It has a good application prospect in repairing bone defect or exposure of nasopharyngeal skull base after radiotherapy and is worth popularizing in clinic., 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 compare the early effectiveness of arthroscopic suture bridge technique and conventional double tunnel suture technique in the treatment of avulsion fracture of posterior cruciate ligament (PCL) insertion., Methods: Between June 2013 and December 2018, 62 patients with tibial avulsion fracture of PCL insertion that met the criteria were selected and randomly divided into trial group (using arthroscopic suture bridge technique) and control group (using conventional double tunnel suture technique), 31 cases in each group. There was no significant difference in gender, age, injured side, cause of injury, time from injury to operation, Meyers & McKeever classification, Kellgren-Lawrence classification, and preoperative knee range of motion, difference of posterior relaxation of bilateral knee joints, International Knee Documentation Committee (IKDC) score, and Lysholm score between the two groups ( P >0.05). The operation time and IKDC score, Lysholm score, knee range of motion, the difference of posterior relaxation of bilateral knee joints (measured by KT-2000 under knee flexion of 90° and 30 lbs) were recorded and compared between the two groups before operation and at 3 and 12 months after operation., Results: Both groups successfully completed the operation, and the operation time of the trial group and the control group were (61.81±6.83) minutes and (80.42±4.22) minutes respectively, showing significant difference between the two groups ( t =12.911, P =0.000). All the incisions healed by first intention, and there was no wound infection and other early postoperative related complications. All patients were followed up 13-18 months (mean, 14.6 months). The fractures in both groups healed at 3 months after operation. No knee pain, limited movement, or other complications occurred. At 3 and 12 months after operation, the IKDC score, Lysholm score, knee range of motion, and the difference of posterior relaxation of bilateral knee joints in both groups were significantly improved when compared with preoperative ones, and further improved at 12 months after operation when compared with at 3 months after operation ( P <0.05). At each time point after operation, the above indexes and the grade of the difference of posterior relaxation of bilateral knee joints in the trial group were significantly better than those in the control group ( P <0.05)., Conclusion: Arthroscopic suture bridge technique in the treatment avulsion fracture of PCL insertion is simple and reliable, which can significantly improve the function and stability of the knee joint and obtain satisfactory early effectiveness.

Objective: To investigate the effectiveness of the reconstruction of posterior cruciate ligament (PCL) with platelet rich plasma (PRP) and 3-strand peroneal longus tendons under arthroscope., Methods: Between June 2014 and December 2017, 58 patients with PCL rupture were randomly divided into two groups: the trial group (PRP assisted reconstruction of 3-strand peroneal longus tendons) and the control group (4-strand hamstring tendon reconstruction alone), 29 cases in each group. There was no significant difference in gender, age, injury side, Kellgren-Lawrence grade, time from injury to operation, and preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, International Knee Documentation Committee (IKDC) score, Lysholm score between the two groups ( P >0.05). Before operation, at 3 months and 12 months after operation, the IKDC score and Lysholm score of the two groups were recorded to evaluate the knee joint function, AOFAS ankle-hindfoot score was used to evaluate ankle function; KT-2000 examination (knee flexion of 90°, 30 lbs) was used to evaluate the difference of bilateral knee joint posterior relaxation at 12 months after operation, and MRI was used to evaluate ligament reconstruction; CT was used to evaluate the bone tunnel expansion of femur and tibia at 3 months and 12 months after operation., Results: The operation was completed successfully in both groups, there was no complication in the donor tendon area. All the incisions healed by first intention. All the patients were followed up for more than 1 year. The follow-up time of the trial group was 13-17 months, with an average of 15.0 months; that of the control group was 15-20 months, with an average of 15.4 months. At 3 and 12 months after operation, there was no significant difference in AOFAS ankle-hindfoot score when compared with preoperative score and between the two groups ( P >0.05). At 3 and 12 months after operation, the IKDC score and Lysholm score of the two groups were significantly improved, and further improvement was found at 12 months when compared with at 3 months ( P <0.05); the scores in the trial group were significantly better than those of the control group ( P <0.05). At 12 months after operation, the difference of the posterior relaxation of the bilateral knees in the trial group was less than 5 mm in 27 cases, 6-10 mm in 2 cases; in the control group was less than 5 mm in 20 cases, 6-10 mm in 6 cases, and >10 mm in 3 cases; the difference between the two groups was not significant ( Z =0.606, P =0.544). At 12 months after operation, MRI of knee joint showed that all patients had good PCL graft. The MRI score of the trial group was better than that of the control group ( t =2.425, P =0.019). CT examination at 3 and 12 months after operation showed that the bone tunnel expansion of femur and tibia in the trial group were significantly better than those in the control group ( P <0.05)., Conclusion: PRP combined with 3-stand peroneal longus tendons can significantly improve the function and stability of knee joint, effectively promote graft remodeling, and promote tendon bone healing, reduce the expansion of bone tunnel. The effectiveness is satisfactory.

Objective: To investigate the protective effect of the antioxidant glutathione (GSH) on the steroid-induced imbalance between osteogenesis and adipogenesis in human bone marrow mesenchymal stem cells (BMSCs)., Methods: The BMSCs were isolated from the proximal femur bone marrow from 3 patients of femoral neck fracture and were separated, cultured, and purificated by density gradient centrifugation and adherent wall method in vitro . The third generation BMSCs were divided into 5 groups: group A, BMSCs (1×10 5 cells/mL); group B, BMSCs (1×10 5 cells/mL)+10 μmol/L dexamethasone; group C, BMSCs (1×10 5 cells/mL)+10 μmol/L dexamethasone+5 μmol/L GSH; group D, BMSCs (1×10 5 cells/mL)+10 μmol/L dexamethasone+10 μmol/L GSH; group E, BMSCs (1×10 5 cells/mL)+10 μmol/L dexamethasone+50 μmol/L GSH. After cultured for 7 days, the reactive oxygen species expression was detected by flow cytometry; the superoxide dismutase (SOD) and Catalase mRNA expressions were determined by RT-PCR; the peroxisome proliferator-activated receptors γ (PPAR-γ), CCAAT/enhancer-binding family of proteins (C/EBP), Runx2, and alkaline phosphatase (ALP) mRNA expressions were evaluated by real-time fluorescence quantitative PCR. After cultured for 21 days, Oil red O staining was used to observe the adipogenesis differentiation of cells, and the expressions of related proteins were detected by Western blot., Results: The reactive oxygen species expression in group B was obviously higher than in the other groups, in group C than in groups A, D, and E, and in groups D, E than in group A, all showing significant differences between groups ( P <0.05); but there was no significant difference between groups D and E ( P >0.05). The oil red O staining positive cells in group B were obviously more than the other groups, and groups C, D, E, and A decreased sequentially, the absorbance ( A ) values had significant differences between groups ( P <0.05). RT-PCR detection showed that the relative expressions of SOD and Catalase mRNA in group B were significantly lower than those in the other groups, while in group C than in groups A, D, and E ( P <0.05), but there was no significant difference among groups A, D, and E ( P >0.05). Real-time fluorescence quantitative PCR detection showed that the relative expressions of PPAR-γ and C/EBP mRNA in group B were significantly higher than those in the other groups, while in group C than in groups A, D, and E, and in groups D, E than in group A ( P <0.05); but there was no significant difference between groups D and E ( P >0.05). The relative expressions of Runx2 and ALP mRNA in group B were significantly lower than those in the other groups, while in group C than in groups A, D, and E, and in groups D, E than in group A ( P <0.05); but there was no significant difference between groups D and E ( P >0.05). Western blot detection showed that the relative expression of PPAR-γ and C/EBP protein in group B was significantly higher than those in the other groups, and groups C, D, E, and A decreased sequentially, all showing significant differences between groups ( P <0.05). The relative expression of Runx2 and ALP protein in group B was significantly lower than those in the other groups, and groups C, D, E, and A increased sequentially, all showing significant differences between groups ( P <0.05)., Conclusions: GSH can inhibit the adipogenesis differentiation and enhance the osteogenic differentiation of human BMSCs by reducing the intracellular reactive oxygen species level; and in a certain range, the higher the concentration of GSH, the more obvious the effect is.

Objective: To compare the effectiveness of anterior cruciate ligament (ACL) reconstruction between by long fibular muscle tendon and by hamstring tendon under arthroscopy after ACL rupture., Methods: Between February 2010 and December 2012, 56 cases of ACL rupture underwent ACL reconstruction under arthroscopy. The long fibular muscle tendon was used in 26 cases (group A) and the hamstring tendon was used in 30 cases (group B). There was no significant difference in gender, age, side, disease duration, and preoperative Lachman test, Lysholm score, and the International Knee Documentation Committee (IKDC) score between 2 groups (P > 0.05). The treatment after operation was identical in 2 groups., Results: Primary healing of incision was obtained after operation in 2 groups. There was no major neurovascular injury and knee synovitis. There was no significant difference in operation time, hospitalization time, and postoperative 24-hour drainage volume between 2 groups (P > 0.05). The patients were followed up 25-32 months (mean, 28 months) in group A, and 27-37 months (mean, 31 months) in group B. There was no related complication at donor site in 2 groups. MRI examination showed good ACL reconstruction. The Lysholm score and the IKDC score of group A at 6 months after operation were significantly better than those of group B (P < 0.05), but no significant difference was found between 2 groups at 2 years after operation (P > 0.05). There was no significant difference in Lachman score between 2 groups at 6 months and 2 years after operation (P > 0.05)., Conclusion: The long fibular muscle tendon for arthroscopic reconstruction of ACL has much simpler operation, earlier knee function recovery, and better subjective satisfaction than the hamstring tendon.

Objective: To study the relationship between the radiotherapy resistance and autophagy. To provide a theoretiacal basis for drugs that regulate autophagy to improve radiotherapy sensitivity., Method: Flow cytometry (FCM) was performed to analyze the distribution of the cell cycle of CNE2 and CNE2/DDP cells under the action of X radiation. The expression of autopagy-specific gene Beclin1 and microtubule-associated protein light chain 3β (MAPLC3β) in CNE2 and CNE2/DDP cells was determined by real time PCR and Immumofluorescence staining., Result: CNE2/DDP and their parental CNE2 cells produced the G2-M phase arrest under the action of X radiation. With the radiation dose increasing,The cells which in the G2-M phase were more and more (P<0. 05). The G2-M phase arrest in CNE2/DDP cells was more obvious than in CNE2 cells (P<0. 05). The expression of Beclin1 and MAPLC3β in CNE2 and CNE2/DDP cells increased under the action of X radiation. What's more, the raise was more and more obvious with the increase of the irradiation dose(P<0. 05). The expression levels of Beclin1 and MAPLC3β in CNE2/DDP was lower than that in CNE2 cells (P<0. 05)., Conclusion: Autophagic cell death may be the one manner of death in nasopharyngeal carcinoma CNE2 and CNE2/DDP cells under the action of X radiation. The radiation resistance of CNE2/DDP cells may be related to the low expression of autophagy-related genes.

Objective: To investigate the effect of Fuzhenghuayu compound (FZHc) on expression of nuclear factor E2-related factor 2 (Nrf2) in hepatocytes under conditions of hepatic fibrosis using a mouse model., Methods: Mice were randomly assigned to a control group and a hepatic fibrosis model group. The control group was further divided into three subgroups for use as normal controls (A1), mineral oil-treated controls (A2), and FZHc-treated controls (A3); the hepatic fibrosis model group was administered carbon tetrachloride (CC14 dissolved in mineral oil and injected intraperitoneally) and further divided into four subgroups for use as 6-weeks models (B1), 10-weeks models (B2), low-dose (L)-FZHc models (C1), and high-dose (H)-FZHc models (C2). The FZHc (capsule powder diluted with double-distilled water to 0.1 g/mL) was administered via gastric perfusion to groups A3, C1, and C2 starting at week 7 of the experiment. At the end of week 6 and 10, hepatic specimens were collected and evaluated for degree of hepatic fibrosis and inflammation using routine haematoxylin-eosin staining and Masson staining. Immunohistochemical analysis was performed to measure the hepatocyte expression of Nrf2, NAD(P)H quinine oxidoreductase 1 (Nqol), a-smooth muscle actin (a-SMA) and fibronectin (FN). Real-time fluorescence quantitative PCR was used to measure Nrf2 mRNA expression. Western blotting was used to detect Nrf2 and Nqol total protein expression and Nrf2 nuclear translocation. F test, LSD test and ridit test were used for statistical analyses., Results: Compared with the B2 group (ridit value: 0.09), the model groups treated with FZHc showed significantly lower degrees of hepatic inflammation and fibrosis for both the low (C1 group, ridit value: 0.32) and high doses (C2 group, ridit value: 0.40) (F =82.927, P less than 0.05). In addition, compared with the B2 group, the model groups treated with FZHc showed significantly decreased expression of a-SMA and FN proteins, with a dose-dependent trend (by immunohistochemistry: C 1 group at the end of 10 weeks, F =77.421, 118.262, P less than 0.05; C2 group, P =0.002, 0.013) and significantly increased expression of Nrf2 and Nqol proteins (by immunohistochemistry:C1 and C2 groups at the end of 10 weeks, F =182.537, 75.615, P less than 0.05 and by westen blotting: F =45.664, 127.673, P less than 0.05), which also showed a dose-dependent trend (C2 group, P =0.000, 0.014; 0.005, 0.014). Western blotting also indicated that the amount of nuclear transported Nrf2 was higher in the C1 and C2 groups at the end of 10 weeks (vs. B2 group, F =94.787, P less than 0.05), and the amount of nuclear transported Nrf2 was significantly higher in the C2 group (vs. C1 group, P =0.044). Nrf2 mRNA expression was significantly higher in the C1 group than in the B2 group (F =3230.105, P less than 0.05), and the C2 group had more substantially increased expression (P =0.001); there was no statistical difference found between groups B1 and B2 (P =0.094)., Conclusion: Fuzhenghuayu compound increased the expression of Nrf2 mRNA and protein under conditions of hepatic fibrosis in mice and stimulated Nrf2 nuclear transport, as well as increased expression of the Nrf2 target gene Nqol that is known to suppress activation of hepatic stellate cells and decrease the deposition of FN. Therefore, Fuzhenghuayu compound may ameliorate hepatocyte injury in hepatic fibrosis in mice by exerting an antihepatic fibrosis effect.

Objective: To explore the better operational methods by the laser surgery to treat diseases involving the laryngeal anterior commissure. It can excise the diseases as well as avoid anterior commissure adhesion, laryngostenosis and dyspnea after operations., Method: Twelve dogs were divided into 4 groups at random. There were three dogs in one group. A: excising experimental dog's anterior commissure by twice operations, the interval time was two weeks; B: excising experimental dog's anterior commissure in one time, at the same time suturing the silica gel sheet on the anterior commissure; C: excising experimental dog's anterior commissure in one time and then applying MMC on the wound of the anterior commissure; D: excising experimental dog's anterior commissure in one time, without any treatment., Result: All of the dog's surgery were completed successfully by laser. Four weeks later, we observed the raw surfaces. A: the neonatal membrane covered the wound, inflammatory reaction slight, we could not see obvious adhesion in the anterior commissure. B: the membrane covered the wound, appearing the dark chronic inflammation, we could see the adhesion in the anterior commissure slight. C: the membrane covered the wound, edematization, we could see the moderate adhesion in the anterior commissure. D: edematization, we could see the adhesion in the anterior commissure obviously. Four groups were all appeared hoarsenesses, the most slightly in group A, secondly in B and C, the worst in D. The analysis of vocal cord length of 4 groups, we used matched-pairs t-test, A, B, C groups' P>0.05, the vocal cord length didn't become shorter than before obviously. Group D's P<0.01, that meant the vocal cord length became shorter obviously. Between each group,we used reiterature-measurement analysis of variance (P<0.05), the change of vocal cord length had disparity in different groups. The comparison in two groups suggested that group A is the best. B and C are inferior ,but no disparity between them. The analysis of glottis area of 4 groups, as the same method above, A,B groups' P>0.05, the glottis area didn't shrink than before obviously. C and D groups' P<0.05, that meant having statistical significance and glottis area shrinked obviously. Between each group, we used reiterature-measurement analysis of variance (P>0.05), we could not think that the changes of four groups have disparity., Conclusion: Excising the experimental dog's anterior commissure by laser, compared the 4 different operation methods, group A is the best method. B and C are inferior. The results are valuable in clinic when we perform operations by laser to treat the disease involving the anterior commissure.

Objective: To evaluate the short-term clinical outcomes of metal-on-metal total hip resurfacing arthroplasty in treating osteonecrosis of the femoral head (ONFH) in young and middle-aged patients and to compare with patients of hip osteoarthritis at the same period., Methods: From July 2006 to October 2008, 33 patients (45 hips) with ONFH (ONFH group) and 39 patients (45 hips) with osteoarthritis (osteoarthritis group) were treated with metal-on-metal total hip resurfacing arthroplasty. In ONFH group, there were 18 males (27 hips) and 15 females (18 hips) with an average age of 42.7 years (range 19-58 years), including 22 left hips and 23 right hips. The causes were trauma (4 cases), glucocorticoid (25 cases), drugs (2 cases), alcohol (1 case), and psoriasis (1 case). According to Steinberg classification, there were 10 hips at stage III, 18 hips at stage IV a, 13 hips at stage IV b, and 4 hips at stage IV c. The Harris score was 52.0 +/- 4.6. The disease course was 1-12 years. In osteoarthritis group, there were 26 males (30 hips) and 13 females (15 hips) with an average age of 47.1 years (range 42-65 years), including 17 left hips and 28 right hips. The causes were degenerative arthritis (23 cases), trauma (11 cases), and ankylosing spondylitis (5 cases). The Harris score was 57.0 +/- 3.8. The disease course was 3-17 years. There were no significant differences in general data between two groups (P > 0.05)., Results: All incisions achieved healing by first intention without complications of infection and thrombosis of deep vein of lower extremities. The patients were followed up for 26 months in ONFH group and 28 months in osteoarthritis group. Femoral neck fracture occurred in 1 case of osteoarthritis group after 4 months, who received total hip arthroplasty; no complication of prosthesis loosening, dislocation, incision infection, osteonecrosis, and bone absorption occurred in other patients. At last follow-up, the Harris scores were 93.0 +/- 5.5 in ONFH group and 94.0 +/- 2.4 in osteoarthritis group, showing no significant difference between two groups (P > 0.05); but there were significant differences between pre- and post-operation (P < 0.01)., Conclusion: The clinical short-term outcomes of metal-on-metal total hip resurfacing arthroplasty to treat ONFH are satisfactory. It can achieve similar outcomes to that of osteoarthritis group. More cases and long-term follow-up are needed to investigate long-term clinical outcomes.

Objective: To study the effect of OSAHS on adult nasal-cycle., Method: The nasal cycle of 20 healthy adults, 18 patients of snoring and 22 patients of OSAHS were examined with acoustic rhinometry, which was performed every 30 minutes in 7 hours., Result: The ratio of nasal cycle in healthy adults was (19/20, 95.0%), in snoring patients was (15/18, 83.0%), in patients of OSAHS was (15/22, 68.2%). The mean alteration amplitude of nasal cycle in healthy adults was significantly larger than that in patients with OSAHS (P < 0.05). The distribution of the healthy adults and patients with OSAHS between the typical cycle categories was significantly different (P < 0.05)., Conclusion: The characteristics of nasal-cycle in of OSAHS patients were different with healthy adults, which maybe owing to change of physical function of basal cavity.

Objective: To investigate clinical therapeutic effect on early stage femoral head necrosis managed with allogeneic cortical bone cage support combining with autologous cancellous bone grafting through core decompression tunnel, and to discuss its effect on preventing femoral head collapse and influence factors., Methods: From January 2002 to December 2005, 40 patients (42 hips) with femoral head necrosis underwent core decompression and an allogeneic threaded cortical bone supporting cage which was loaded with autologous cancellous bone inside. There were 26 males and 14 females, aging 27-45 years (mean 35.6 years). The disease course was 6-28 months (mean 18.3 months). All the cases underwent X-ray, CT and MRI examination to confirm the diagnosis and necrosis area. Twelve hips were at Ficat stage I, 29 hip at stage II, and 1 hips at stage III. Harris hip score system was used to evaluate the hip function pre- and post-operatively. X-ray films were taken regularly after operation., Results: All the wound healed by first intention without any complications such as infection, fracture, nerve and vascular injury, and deep vein thrombosis. Thirty-six patients (38 hips) were followed up for 24-58 months with an average of 38 months. All the patients had different degrees of improvement in clinical symptoms. According to Harris hip score system, the Harris score was 63.1 +/- 6.4 before operation and 82.3 +/- 16.5 at the last follow-up, showing significant difference (P < 0.001). The results were excellent in 24 hips, good in 11 hips, fair in 2 hips and poor in 1 hips. The X-ray films showed femoral head repairing and no advancement of osteonecrosis and collapsing in 23 patients (24 hips) 24 months after operation., Conclusion: Allogeneic cortical bone cage support combining with autologous cancellous bone grafting is suitable for managing early stage femoral head necrosis and its short- and middle-term effect is satisfactory.

Objective: To investigate the anatomical structures of cranial nerves in the cerebellopontine angle region to offer anatomical data for clinical operation., Method: A total of 52 adult cadaveric heads fixed in 10% formalin were used for this study. After cutting cerebellum and meningeal between transverse and sigmoid sinus, simulate operating method of retrosigmoid approach to observe the cranial nerves., Result: External diameter and length of left V, VII, VIII, IX cranial nerves are (2.54 +/- 0.84) mm and (6.79 +/- 2.51) mm, (1.18 +/- 0.31) mm and (9.89 +/- 2.66) mm, (2.17 +/- 0.52) mm and (9.92 +/- 2.61) mm, (0.77 +/- 0.24) mm and (10.34 +/- 3.12) mm respectively. External diameter and length of right V , VII, VIII, IX cranial nerves are (2.52 +/- 0.86) mm and (6.91 +/- 2.66) mm, (1.14 +/- 0.31) mm and (10 +/- 2.96) mm, (2.13 +/- 0.63) m and (10.09 +/- 2.93) mm, (0.790.29) mm and (10.17 +/- 3.06) mm. intermedius nerve locate between facial nerve and acoustic nerve, external diameter of intermedius nerve is (0.47 +/- 0.91) mm (left) and (0.37 +/- 0.07) mm (right). Length of vagal nerve is (10.44 +/- 2.57) mm (left), (9.91 +/- 2.91) mm (right), rootlets of f vagal nerve is 6.37 +/- 2.26 (left) and 6.33 +/- 2.38 (right). external diameter of accessory nerve is (0.76 +/- 0.16) mm (left) and (0.81 +/- 0.19) mm (right)., Conclusion: This study provide anatomical data for retrosigmoid approach in the cerebellopontine angle region.

Objectives: To investigate intestinal permeability in patients with portal hypertension and to search for a relationship with portal pressure., Methods: Twenty patients with portal hypertension were divided two groups (A, B), 10 patients per group. In group A patients were treated with combined TIPS and modified Sugiura. In group B, patients were treated with modified Sugiura only. Intestinal permeability was assessed before operation, two weeks after TIPS, and two weeks after modified Sugiura, and 20 healthy control subjects were also assessed., Results: Intestinal permeability was significantly higher in patients with portal hypertension than in healthy controls (0.132 +/- 0.110 vs. 0.032 +/- 0.018, P < 0.01). In group A, portal pressure and intestinal permeability decreased two weeks after TIPS (P < 0.05) and no obvious change was noted two weeks after modified Sugiura; but they were significantly lower than those before TIPS (P < 0.05). In group B intestinal permeability was not different before and after operation. Intestinal permeability in group A was not different from that in group B before treatment, but significantly lower after modified Sugiura (P < 0.05). Portal pressure was significantly correlated with intestinal permeability (r = 0.627, P < 0.01)., Conclusions: This study shows that combined TIPS and modified Sugiura can lower portal pressure and intestinal permeability, and enhance the therapeutic efficacy on portal hypertension.