A comparative analysis of laryngeal nerve damage in patients with idiopathic vocal cord paralysis exhibiting different paralytic sides.

Objective: To assess the extent of recurrent laryngeal nerve (RLN) and superior laryngeal nerve (SLN) damage in patients with idiopathic vocal cord paralysis (IVCP) exhibiting different paralytic sides. Methods: A total of 84 IVCP cases were evaluated using stroboscopic laryngoscopy, voice analysis, and laryngeal electromyography (LEMG). The results were compared between patients with left-sided paralysis and right-sided paralysis based on different disease courses (less than or more than 3 months). Results: Initially, the average age and disease progression of IVCP patients were found to be similar regardless of the side of paralysis (p > .05). Additionally, there were no significant variations in voice indicators, such as MPT, DSI, and VHI, between IVCP patients with left and right vocal cord paralysis (p > .05). Furthermore, no disparities were detected in the latencies and amplitudes of the paralyzed RLN and SLN, as well as the durations and amplitudes of the action potentials in the paralyzed TM and PCM, among IVCP patients with left and right vocal cord paralysis (p > .05). Notably, the amplitudes of the left paralytic CM were significantly lower than those of the right paralytic CM (0.45 vs. 0.53, Z = -2.013, p = .044). In addition, no disparities were observed in APDs and amplitudes between the ipsilateral PCM and TM, either for patients with left or right vocal fold paralysis (p > .05). Finally, all the IVCP patients were subdivided into two subgroups according to different disease course (less than or more than 3 months), and in each subgroup, the comparison of voice indicators and LEMG results in IVCP patients with left or right vocal fold paralysis were similar with the above findings (p > .05). Conclusion: Overall, the degree of RLN and SLN damage appeared to be similar in IVCP patients with left and right vocal cord paralysis, provided that the disease course was comparable. Level of Evidence: 4.

A retrospective analysis of mortality in a Beijing hospital Emergency Department.

OBJECTIVE: The aim of this study was to analyze the epidemiological characteristics of mortality in the emergency department of Beijing Tongren Hospital from 2014 to 2019. METHODS: A total of 781 cases in the hospital's emergency department that resulted in mortality were retrospectively screened, and epidemiological and analytical methods were used to analyze the epidemiological characteristics and the trend of adult mortality in the emergency department of our hospital. RESULTS: Of the 781 selected cases, 448 were male, and 333 were female. Mortality rates were highest in patients aged 80-89 years, and most of the patients were retired (71.57%). Infection disease was associated with the highest mortality rate (44%), followed by cardiovascular disease and malignant tumors. CONCLUSION: Infectious diseases, cardiovascular diseases, and malignant tumors are the major threats to the lives of patients in the hospital's emergency department. The cause of death differs depending on the patient's age. KEY WORDS: Death, Emergency department, Epidemiological characteristics, Etiology, Retrospective analysis.

Identification and Characterization of Gonatobotryum apiculatum Causing Leaf Spot and Blight on Sinowilsonia henryi.

Sinowilsonia henryi is a rare and endangered plant, as well as an endemic species in China. In July 2018, leaf spot and blight disease was observed on S. henryi in Yichang, Hubei, China. A fungus isolated from disease tissues was identified as Gonatobotryum apiculatum based on morphology and sequence analyses of ITS and LSU regions. Phylogenetic analyses indicated that the species belongs to Dothioraceae (Dothideales). Morphologically, the species produced two distinct types of conidia from authentic media, both conidia were described here. Pathogenicity tests showed that the fungus is a pathogen causing leaf spots on S. henryi. This is the first report of leaf spot and blight disease on S. henryi caused by G. apiculatum in China.

Association between the sonographer's experience and diagnostic performance of IOTA simple rules.

BACKGROUND: To validate the clinical value of simple rules in distinguishing malignant adnexal masses from benign ones and to explore the effect of simple rules for experienced and less-experienced sonographers. METHODS: Patients with persistent adnexal masses were enrolled between November 2013 and December 2015. All masses were proven through histological examinations. Five sets of diagnoses were made and compared with one another. Diagnosis 1 was made, according to the simple rules, by a trainee with little clinical diagnostic experience. Diagnoses 2 and 3 were made by experienced and less-experienced sonographers, respectively, according to their clinical experiences. With diagnosis 1 as a reference, the two sonographers were asked to provide a second diagnosis, which were diagnoses 4 and 5. The efficiency of the five sets of diagnoses was compared using ROC curves. RESULTS: In total, 75 malignant (37.7%) and 124 benign lesions (62.3%) were enrolled in this study. The mean diameter of the benign masses was obviously smaller than that of the malignant ones (6.8 ± 3.4 cm vs. 9.3 ± 4.9 cm, p < 0.01). The malignant ratio in postmenopausal women was much higher (66.1%) than that in the premenopausal population (25.7%) (p < 0.0001). Totally, 156 of the 199 cases (79.4%) resulted in conclusive diagnoses. Sensitivity and specificity were 98.4% and 73.9%, respectively, among the conclusive cases. The area under the ROC curve (Az) for the simple rule diagnosis was significantly lower than that for the experienced sonographer diagnosis (0.85 vs. 0.96, p < 0.0001); compared with the less-experienced sonographer, this difference was not significant (0.85 vs. 0.86, p = 0.9776). No significant difference was found in the comparison between the diagnoses made by the experienced sonographer before and after referencing the simple rule diagnosis (Az, 0.96 vs. 0.97, p = 0.2055). Using diagnosis 1 as a reference, the diagnostic performance of the less-experienced sonographer increased (from 0.86 to 0.92, p = 0.012); however, it was still lower than that of the experienced sonographer (Az, 96% vs. 92%, p = 0.0241). CONCLUSIONS: The simple rules was an appealing method for discriminating malignant masses from benign ones, particularly for a less-experienced sonographer.

[Vestibular Dysfunction in Patients with Sudden Sensorineural Hearing Loss without Vertigo].

OBJECTIVE: To observe the vestibular dysfunction in sudden sensorineural hearing loss (SSHL) patients without vertigo. METHODS: Forty-two cases of unilateral SSHL without vertigo were enrolled in the study from May 2012 to May 2014. All patients underwent air conducted sound elicited oVEMP and cVEMP respectively. Some of them also received caloric test. Sixty-two SSHL patients with vertigo and twenty-five age-and gender-matched normal subjects were recruited as controls to analyze the vestibular dysfunction in SSHL patients without. vertigo. RESULTS: Abnormal oVEMP was observed in 54. 8% affected ears without vertigo (23/42), 64. 5% ears with vertigo (40/62), and 26. 0% normal ears (13/50). Abnormal cVEMP was observed in 52. 4% affected ears without vertigo (22/42), 48. 4% ears with vertigo (30/62), and 14. 0% normal ears (7/50). Caloric test was operated in 21 SSHL patients without vertigo and 29 patients with vertigo. Abnormal caloric test was observed in 52.4% (11/21) SSHL patients without vertigo and 75. 9% (22/29) SSHL patients with vertigo respectively. Statistical significance was found in oVEMP and cVEMP rates between SSHL without vertigo and normal group (P<0. 01). However, no significant statistical difference was found in oVEMP, cVEMP rates and caloric test between SSHL without vertigo and SSHL with vertigo group (P>0. 05). CONCLUSION: Vestibular function could be damaged in SSHL patients without vertigo. The abnormal rates of oVEMP, cVEMP and caloric test in SSHL patients without vertigo were similar to that of SSHL patients with vertigo. The appearance of vertigo might be irrelevant to the range and extent of vestibular dysfunction.

Quality control measures for lowering the seroconversion rate of hemodialysis patients with hepatitis B or C virus.

BACKGROUND: Hemodialysis (HD) patients are at high risk of infection by hepatitis B virus (HBV) or hepatitis C virus (HCV). The present study was designed to determine the impact of quality control measures on the prevention of transmission of blood-borne viruses. METHODS: A total of 6182 adult maintenance HD patients from all HD units in Zhejiang Province were recruited on January 1, 2007. The baseline demographic and clinical characteristics were recorded and all patients were followed up until death or survival at 4 years later. The Quality Control Standards of Hemodialysis were gradually implemented in HD units. The HBV or HCV seroconversion rates of the recruited patients were calculated and compared every year during the observation period. RESULTS: The prevalence of HBV was 8.3% at the beginning of the study, and 6.6% for HCV. With the implementation of the HD quality control measures, the HBV seroconversion rate tended to decrease year by year (X2=6.620, P=0.085), and the HCV seroconversion rate decreased significantly (X2=10.41, P=0.015). Compared with the data in 2007, the HBV seroconversion rate (X2=4.204, P=0.040, relative risk ratio 0.393, 95% CI 0.156-0.991) and the HCV seroconversion rate (X2=7.373, P=0.007, relative risk ratio 0.386, 95% CI 0.189-0.787) decreased significantly in 2010. CONCLUSION: Quality control measures for HD decreased the seroconversion rates of HBV or HCV in HD patients, showing that updated quality control measures reduce the risk for transmission of blood-borne viruses in the HD population.

[Characteristics of the air-conducted ocular evoked myogenic potential in the young normal Chinese subjects].

OBJECTIVE: To identify the characteristics of the air-conducted ocular vestibular-evoked myogenic potential (oVEMP) in the young normal Chinese subjects. METHODS: Twenty five normal subjects were recruited for conventional examinations of oVEMP. The subjects were 19 - 45 years of age [(24.3 ± 5.6) years], 12 males and 13 females. 500 Hz air-conducted tone burst was employed for examination. The threshold of oVEMP in each ear was examined; patterns of these waves were observed and the normal ranges of the oVEMP waves responded to 100 dBnHL were calculated. RESULTS: All subjects were elicited with normal oVEMP N1-P1 waves in both ears. The response rate in these subjects was 100%. The threshold of oVEMP examination was (86.6 ± 3.6) dBnHL (x(-) ± s), latency N1 (10.1 ± 0.4) ms, latency P1 (14.7 ± 1.2) ms, interval N1-P1 (4.5 ± 1.0) ms, amplitude (7.9 ± 4.4) µV. CONCLUSIONS: Air-conducted oVEMP is a kind of vestibular-ocular reflex respond to intensive sound generated by otolithic vestibular end organs. It is stable in the young normal subjects with minor variabilities.

[Genetic analysis and molecular mapping of stripe rust resistance gene in a restore line of Thermo-Photo sensitive hybrid wheat MR168].

Stripe rust, caused by Puccinia striiformis f. sp. tritici, is an important limiting factor to popularize hybrid wheat. The objectives of this study were to map a stripe rust resistance gene in a Chinese thermo-photo-sensitive hybrid wheat restore line MR168 using gene postulation and SSR markers. MR168 was highly resistant to 23 Pst races including CYR29, CYR31, CYR32, and CYR33. The populations F1, BC1, F2, and F3 from the cross between MR168 and SY95-71 (a wheat cultivar susceptible to Pst races) were inoculated with the race of Pst CYR32 of China in greenhouse. MR168 carried a single dominant gene for resistance to CYR32, tentatively designated YrMR168. It originated from Liaochun 10, a spring wheat variety. A total of 183 F2 plants, the resistant and susceptible parents and resistant and susceptible bulks were used for resistance gene mapping with 329 pairs of wheat SSR markers.Five SSR markers on chromosome 1BS including Xgwm18, Xbarc187, Xwmc269, Xgwm273, and Xwmc406 were linked with YrMR168. The resistance gene was closely linked to Xgwm18 and Xbarc187 with the genetic distances of 1.9 and 2.4 cM, respectively. Xgwm18 and Xbarc187 could be used for molecular marker assisted selection of YrMR168 in hybrid wheat breeding program.

Anthriscifolcine A, a C18-diterpenoid alkaloid.

The title compound, C(26)H(39)NO(7), which was isolated from Delphinium anthriscifolium var. majus, has a lycoctonine carbon skeleton containing four six-membered rings (A, B, D and E) and three five-membered rings (C, F and G). Rings A, B and E adopt chair conformation, while ring D adopts a boat conformation. Rings C and F adopt envelope conformations.