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To explore the efficacy and value of personalized surgical schemes in the repair of maxillary sinus perforation and maxillary sinus fistula based on the size of the maxillary sinus perforation and maxillary sinus fistula. A total of 28 patients with maxillary sinus perforation and maxillary sinus fistula who were admitted to the Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Kunming Medical University from July 2017 to May 2020 were included to conduct a prospective case clinical study. After the inflammation in the maxillary sinus was controlled, a proper surgical repair method was selected according to the size of the perforation and fistula based on the double-layer closure technique. The diameter of the perforation and fistula was measured with the assistance of cone-beam CT. After that, the platelet rich fibrin (PRF) repair was performed on the perforation and fistula with 3 mm≤diameter7 mm in size in 14 patients. The PRF repair and buccal flap repair were performed on the perforation and fistula with 7 mm ≤diameter15 mm in size in 7 patients. The adjacent buccal pad repair, palatine flap repair, and buccal flap repair were performed on the perforation and fistula with 15 mm≤ diameter25 mm in size in 4 patients. The nasolabial axial flap repair and nasolabial free flap repair were performed on the perforation and fistula with a diameter ≥25 mm in size in 3 patients. The medical follow-up was conducted in all patients in the 1st, 2nd, and 4th week after surgery, with an overall success rate reaching 96.4% (27/28) after the initial intervention. The relapse of disease occurred in one patient (4.6%) with diabetes and a smoking history in the 2nd week after surgery. Identifying a proper surgical repair method according to the size of the oral and maxillary sinus perforation and maxillary sinus fistula based on the double-layer closure technique can improve the one-time cure rate in these patients under the premise that the inflammation in the maxillary sinus can be controlled.根据患者上颌窦穿孔及上颌窦瘘孔大小，选择个性化手术方案，探索在口腔上颌窦穿孔及上颌窦瘘修复中的应用疗效和意义。纳入2017年7月至2020年5月就诊于昆明医科大学附属口腔医院口腔颌面外科的口腔上颌窦穿孔及上颌窦瘘患者28例，进行前瞻性病例临床研究。在保证上颌窦内炎症得以控制的情况下，以双层封闭技术为核心，根据穿孔及瘘孔的大小选择相应的手术修复方法。通过锥形束CT测量穿孔和瘘孔直径大小，对直径≥3 mm且7 mm的14例患者，采用富血小板纤维蛋白（platelet rich fibrin，PRF）填充修复法；对直径≥7 mm且15 mm 的7例患者，采用PRF+颊侧组织瓣修复方法；对直径≥15 mm且25 mm的4例患者，采用邻位颊脂垫组织瓣+腭侧组织瓣+颊侧组织瓣重叠修复法；对直径≥25 mm的3例患者，采用鼻唇沟轴型皮瓣或鼻唇沟任意皮瓣修复法。所有患者在术后第1、2、4周随访检查，初次干预后总成功率为96.4%（27/28）；1例（4.6%）患者术后第2周复发。在保证上颌窦内炎症得以控制的情况下，以双层封闭技术为核心，根据穿孔及瘘孔的大小程度选择相应的手术修复方法，可提高口腔与上颌窦穿孔及上颌窦瘘的一次性治愈率。.

Instrumental records indicate a close relationship between the El Nino-Southern Oscillation and the East Asian winter monsoon (EAWM) on interannual to decadal time scales. However, few studies have examined possible links between them on centennial/millennial time scales. In Northeast China, modern observations show that the immigration of temperate forest trees such as Pinus (pine) and Quercus (oak) into cold temperate boreal forest is sensitive to changes in winter temperature. Here we present a continuous high-resolution pollen record from Lake Moon in the central part of the Great Khingan Mountain Range, Northeast China. The record reveals increasing contents of Pinus and Quercus pollen after similar to 6.0 ka cal. BP, which may indicate a gradual weakening of the EAWM. It is broadly coupled with an increasing El Nino frequency since the middle Holocene, and we observe a statistically significant correlation between the percentages of Pinus and Quercus and a time series of El Nino events. On the centennial to millennial time scale, the results of wavelet analysis and band-pass filtering show that the occurrence and development of El Nino have also promoted a weaker EAWM after similar to 6.0 ka cal. BP, which is inversely correlated with the variation of the ca. 500-year cycle originated from changes in solar output. These results imply that the climate transition in the mid-Holocene is caused by the change of variations in solar activity and amplified by ocean circulation El Nino-Southern Oscillation to influence the East Asian Monsoon system, especially the EAWM, and finally change the vegetation in Great Khingan Mountain Range.

目的 探讨应用抗血小板膜糖蛋白GPⅠbα抗体AN51、R300建立原发免疫性血小板减少症（ITP）动物模型。 方法 将20只6~8周豚鼠和裸鼠分别分为对照组和3个实验组，每组5只。豚鼠对照组和实验组分别静脉注射0.2 µg/g IgG和0.05、0.1、0.2 µg/g AN51，裸鼠对照组和实验组分别腹腔注射0.2 µg/g IgG和0.05、0.1、0.2 µg/g R300。在注射后不同时间点对豚鼠和裸鼠行眼眶后静脉丛采血，应用血细胞分析仪检测血小板水平。 结果 ①静脉注射AN51后5 min，0.05、0.1、0.2 µg/g AN51组豚鼠血小板计数分别减低0~5%、50%~60%、70%~80%，0.2 µg/g组下降最为明显，与对照组比较差异有统计学意义（P