Spin Manipulation of Co sites in Co9S8/Nb2CTx Mott-Schottky Heterojunction for Boosting the Electrocatalytic Nitrogen Reduction Reaction.

Regulating the adsorption of an intermediate on an electrocatalyst by manipulating the electron spin state of the transition metal is of great significance for promoting the activation of inert nitrogen molecules (N2) during the electrocatalytic nitrogen reduction reaction (eNRR). However, achieving this remains challenging. Herein, a novel 2D/2D Mott-Schottky heterojunction, Co9S8/Nb2CTx-P, is developed as an eNRR catalyst. This is achieved through the in situ growth of cobalt sulfide (Co9S8) nanosheets over a Nb2CTx MXene using a solution plasma modification method. Transformation of the Co spin state from low (t2g 6eg 1) to high (t2g 5eg 2) is achieved by adjusting the interface electronic structure and sulfur vacancy of Co9S8/Nb2CTx-P. The adsorption ability of N2 is optimized through high spin Co(II) with more unpaired electrons, significantly accelerating the *N2→*NNH kinetic process. The Co9S8/Nb2CTx-P exhibits a high NH3 yield of 62.62 µg h-1 mgcat. -1 and a Faradaic efficiency (FE) of 30.33% at -0.40 V versus the reversible hydrogen electrode (RHE) in 0.1 m HCl. Additionally, it achieves an NH3 yield of 41.47 µg h-1 mgcat. -1 and FE of 23.19% at -0.60 V versus RHE in 0.1 m Na2SO4. This work demonstrates a promising strategy for constructing heterojunction electrocatalysts for efficient eNRR.

Understanding electron structure of covalent triazine framework embraced with gold nanoparticles for nitrogen reduction to ammonia.

Regulating the electron structure and precise loading sites of metal-active sites within the highly conjugated and porous covalent-triazine frameworks (CTFs) is essential to promoting the nitrogen reduction reaction (NRR) performance for electrocatalytic ammonia (NH3) synthesis under ambient conditions. Herein, experimental method and density functional theory (DFT) calculations were conducted to deeply probe the effect on NRR of the modulation of modulating the electron structure and the loading site of gold nanoparticles (Au NPs) in a two-dimensional (2D) CTF. 2D CTF synthesized using melem and hexaketocyclohexane octahydrate as building blocks (denoted as M-HCO-CTF) served as a robust scaffold for loading Au NPs to form an M-HCO-CTF@AuNP hybrid. DFT results uncovered that well-defined Au sites with tunable local structure were the active site for driving the NRR, which can significantly suppress the conversion of H+ into *H adsorption and enhance the nitrogen (N2) adsorption/activation. The overlapped Au (3d) and *N2 (2p) orbitals lowered the free energy of the rate-determining step to form *NNH, thereby accelerating the NRR. The M-HCO-CTF@AuNPs electrocatalyst exhibited a large NH3 yield rate of 66.3 µg h-1 mg-1cat. and a high Faraday efficiency of 31.4 % at - 0.2 V versus reversible hydrogen electrode in 0.1 M HCl, superior to most reported CTF-based ones. This work can provide deep insights into the modulation of the electron structure of metal atoms within a porous organic framework for artificial NH3 synthesis through NRR.

Sea Urchin-Like NiCo-LDH Hollow Spheres Anchored on 3D Graphene Aerogel for High-Performance Supercapacitors.

To enhance the inherent poor conductivity and low cycling stability of dimetallic layered double hydroxides (LDHs) materials, designing a synergistic effect between EDLC capacitors and pseudocapacitors is an efficient strategy. In this paper, we utilized a solvothermal technique employing Co-glycerate as a precursor to prepare sea urchin-like NiCo-LDH hollow spheres anchored on a 3D graphene aerogel. The unique morphology of these hollow microspheres significantly expand the specific surface area and exposes more active sites, while reducing the volume changes of materials during long-term charging and discharging processes. The 3D graphene aerogel serves as a conductive skeleton, improving the material's electrical conductivity and buffering high current. The sea urchin-like NiCo-LDH hollow spheres anchored on 3D graphene aerogel (H-NiCo-LDH@GA) has a specific surface area of 51 m2 g-1 and the ID/IG value is 1.02. The H-NiCo-LDH@GA demonstrate a significant specific capacitance of 236.8 mAh g-1 at 1 A g-1, with a remarkable capacity retention rate of 63.1 % even at 20 A g-1. Even after 8000 cycles at 10 A g-1, the capacity retention still remains at 96.3 %, presenting excellent cycling stability.

Single-Atom Co─O4 Sites Embedded in a Defective-Rich Porous Carbon Layer for Efficient H2O2 Electrosynthesis.

The production of hydrogen peroxide (H2O2) via the two-electron electrochemical oxygen reduction reaction (2e- ORR) is an essential alteration in the current anthraquinone-based method. Herein, a single-atom Co─O4 electrocatalyst is embedded in a defective and porous graphene-like carbon layer (Co─O4@PC). The Co─O4@PC electrocatalyst shows promising potential in H2O2 electrosynthesis via 2e- ORR, providing a high H2O2 selectivity of 98.8% at 0.6 V and a low onset potential of 0.73 V for generating H2O2. In situ surface-sensitive attenuated total reflection Fourier transform infrared spectra and density functional theory calculations reveal that the electronic and geometric modification of Co─O4 induced by defective carbon sites result in decreased d-band center of Co atoms, providing the optimum adsorption energies of OOH* intermediate. The H-cell and flow cell assembled using Co─O4@PC as the cathode present long-term stability and high efficiency for H2O2 production. Particularly, a high H2O2 production rate of 0.25 mol g-1 cat h-1 at 0.6 V can be obtained by the flow cell. The in situ-generated H2O2 can promote the degradation of rhodamine B and sterilize Staphylococcus aureus via the Fenton process. This work can pave the way for the efficient production of H2O2 by using Co─O4 single atom electrocatalyst and unveil the electrocatalytic mechanism.

Ferric Oxide Nanocrystals-Embedded Co/Fe-MOF with Self-Tuned d-Band Centers for Boosting Urea-Assisted Overall Water Splitting.

A novel semiconductive Co/Fe-MOF embedded with Fe2 O3 nanocrystals (Fe2 O3 @CoFe-MOF) is developed as a trifunctional electrocatalyst for the urea oxidation reaction (UOR), oxygen evolution reaction (OER), and hydrogen evolution reaction for enhancing the efficiency of the hydrogen production via the urea-assisted overall water splitting. Fe2 O3 @CoFe-TPyP-MOF comprises unsaturated metal-nitrogen coordination sites, affording enriched defects, self-tuned d-band centers, and efficient π-π interaction between different layers. Density functional theory calculation confirms that the adsorption of urea can be optimized at Fe2 O3 @CoFe-TPyP-MOF, realizing the efficient adsorption of intermediates and desorption of the final product of CO2 and N2 characterized by the in situ Fourier transform infrared spectroscopy. The two-electrode urea-assisted water splitting device-assembled with Fe2 O3 @CoFe-TPyP-MOF illustrates a low cell voltage of 1.41 V versus the reversible hydrogen electrode at the current density of 10 mA cm-2 , attaining the hydrogen production rate of 13.13 µmol min-1 in 1 m KOH with 0.33 m urea. The in situ electrochemical Raman spectra and other basic characterizations of the used electrocatalyst uncover that Fe2 O3 @CoFe-TPyP-MOF undergoes the reversible structural reconstruction after the UOR test, while it demonstrates the irreversible reconstruction after the OER measurement. This work redounds the progress of urea-assisted water spitting for hydrogen production.

Relationship among maternal gut,vaginal microbiota and microbiota in meconium and vernix caseosa in newborns / 上海交通大学学报（医学版）

Objective·To analyze the diversity and composition of the maternal gut microbiota and vaginal microbiota in late pregnancy,neonatal meconium microbiota and vernix caseosa microbiota,and analyze the similarities,differences and correlations.Methods·This is a prospective study.Maternal stool samples and vaginal swabs in late-pregnancy,and neonatal meconium samples were collected from 11 mother-infant pairs at Xinhua Hospital,Shanghai Jiao Tong University School of Medicine from August to November 2018;the vernix caseosa from three sites(forehead,axilla,and inguinal crease)and meconium samples were collected from 14 healthy newborns at International Peace Maternity and Child Health Hospital,Shanghai Jiao Tong University School of Medicine in December 2018.All births were vaginal deliveries.The 16S rRNA gene V3?V4 region sequencing was used.The diversity,composition and similarities/differences of the maternal gut microbiota,the vaginal microbiota,and the neonatal meconium microbiota from the 11 mother-infant pairs,as well as the neonatal vernix caseosa microbiota and the meconium microbiota from the 14 newborns were analyzed.Results·The number of operational taxonomic units(OTUs),ACE index,Chao1 index,and Shannon index of maternal gut microbiota were all higher than those of vaginal microbiota;the ACE indices and the Chao1 indices of the vernix caseosa microbiota at three sites were all higher than those of meconium microbiota(P<0.01).The β diversity varied among the maternal gut microbiota,vaginal microbiota,and neonatal meconium microbiota(P<0.01).The β diversity of neonatal vernix caseosa microbiota from three sites(forehead,axilla,and inguinal crease)was similar,but different from meconium microbiota(P<0.01).At the phylum level,the dominant bacteria were Firmicutes(52.76%)and Bacteroidetes(41.67%)in the maternal gut microbiota,Firmicutes(74.36%)and Actinobacteria(21.25%)in the maternal vaginal microbiota,and Firmicutes(84.22%)and Proteobacteria(8.80%)in the neonatal vernix caseosa microbiota.The dominant bacterium in the neonatal meconium was Proteobacteria in the two batches of samples(81.11%and 88.72%,respectively).At the genus level,the dominant bacteria were Bacteroides(35.42%)and Faecalibacterium(10.12%)in the maternal gut microbiota,Lactobacillus(69.10%)and Bifidobacterium(11.30%)in the vaginal microbiota,and Lactobacillus(79.81%)and Pseudomonas(3.23%)in the vernix caseosa microbiota.The dominant bacterium in the neonatal meconium was Escherichia in the two batches of samples(55.21%and 31.18%,respectively).Conclusion·The α diversity of maternal gut microbiota is higher than that of vaginal microbiota and neonatal meconium microbiota,and it is higher in neonatal vernix caseosa than that in meconium microbiota.The Firmicutes is the predominant phylum in the maternal late-pregnancy gut microbiota,vaginal microbiota,and neonatal vernix microbiota.Lactobacillus is the predominant genus in both maternal vaginal and neonatal vernix caseosa microbiota.Proteobacteria in phylum and Escherichia in genus are predominant in meconium microbiota.The microbiota composition is similar in vernix caseosa at different body sites,but there are differences between the vernix caseosa microbiota and meconium microbiota.

The penile vibrating perception threshold assay can help diagnose the severity of erectile dysfunction / 现代泌尿外科杂志

【Objective】 To analyze the application value of penile vibrating perception threshold measurement in the diagnosis of erectile dysfunction (ED) and provide reference for the seversity of ED patients. 【Methods】 The clinical data, Erectile Hardness Scale (EHS) score, International Index of Erectile Function Questionnaire-5 (IIEF-5) score, and the vibrating perception threshold (VPT) of the penis of 257 patients with decreased erectile function as the main complaint or accompanying symptoms treated during Jan. and Dec.2021 were retrospectively collected and analyzed.Patients with EHS=4 and IIEF-5≥22 were classified into the normal group, and the rest into the ED group.The differences in VPT in patients with different EHS scores were compared, and the correlation between IIEF-5 and VPT was analyzed.The diagnostic value of VPT for ED was evaluated with receiver operating characteristic (ROC) curve. 【Results】 The difference in penile VPT among patients with different EHS scores was statistically significant (P<0.05).With the decrease of EHS score, VPT showed an increasing trend.Glans VPT was negatively correlated with IIEF-5 score (ρ=-0.22, P<0.001), and penile shaft VPT was also negatively correlated with IIEF-5 score (ρ=-0.26, P<0.001).The VPT of glans penis [(4.17±1.37) V vs.(3.47±1.24) V, P=0.009] and the VPT of penis body [(3.73±1.41) V vs.(2.99±1.14)V, P=0.003] in the ED group were both higher than those in the normal group.The area under the ROC curve (AUC) of the glans VPT was 0.642.When the cut-off value was 3.537 V, the sensitivity was 63.4%, and the specificity was 63.6%.The AUC of the penile shaft VPT was 0.659.When the cut-off value was 2.775 V, the sensitivity was 72.3%, with a specificity of 54.5%. 【Conclusion】 The penile VPT of ED patients is higher than that of normal ones, and there is a correlation between VPT and the severity of ED.Severe ED is associated with higher VPT.The measurement of penile VPT is helpful for the clinical diagnosis of ED patients.

Analysis of drug treatment of a suspected CKD 5 patient with acute hyperkalemia caused by traditional Chinese medicine / 中国药师

To explore the thinking and working mode of clinical pharmacists of traditional Chinese medicine participating in clinical,the drug treatment was analyzed by an acute hyperkalemia patient suspected of CKD 5 caused by traditional Chinese medicine.This case is a CKD 5 patient.Since proteinuria was found for 8 years,bilateral lower limb edema was intermittent for 4 years,and the recurrence was aggravated for 1 week,the patient was admitted to the hospital.In the Department of Traditional Chinese Medicine,the patient received standard and reasonable antiplatelet,lipid regulation,kidney protection,anemia improvement,blood pressure reduction,and heart load reduction,Traditional Chinese medicine decoction,traditional Chinese patent medicines.The patient's condition improved,but the newly emerging hyperkalemia prolonged the patient's hospital stay.After the treatment of blood potassium lowering drugs,the blood potassium still increased repeatedly.For this reason,clinical Chinese pharmacists assisted clinicians to find out the factors that caused the repeated increase of blood potassium in combination with existing domestic and foreign literature.Finally,considering the high possibility of traditional Chinese medicine,they stopped using traditional Chinese medicine and continued to use blood potassium lowering drugs,and the blood potassium returned to normal.Hyperkalemia caused by traditional Chinese medicine is not common in clinical practice and often is ignored.It can be seen that clinical pharmacists can participate in pharmaceutical care to find adverse drug reactions as soon as possible and ensure the safety of drug use.

Concurrent chemoradiotherapy plus anlotinib vs. concurrent chemoradiotherapy alone in locally advanced nasopharyngeal carcinoma: An interim analysis of a multicenter randomized controlled trial.

Despite the use of intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy (CCRT), the treatment of locoregionally advanced nasopharyngeal carcinoma (LA-NPC) is not satisfactory. EGFR and VEGFR are highly expressed in 60-80% of patients with LA-NPC and this is associated with a poor prognosis, which suggests the potential effectiveness of an inhibitor targeting tumor angiogenesis for treating LA-NPC. The present study aimed to assess the safety and effectiveness of CCRT combined with anlotinib in patients with LA-NPC. The study involved patients with LA-NPC (stage III-IVA) from four institutions in Guangxi, China. Patients were randomized to receive CCRT + anlotinib (n=36) or CCRT alone (n=37). Acute toxicity and short-term efficacy were evaluated. The most common grade 3 or 4 adverse events were leucopenia [10 (27.7%) vs. 8 (21.6%)], neutropenia [6 (16.7%) vs. 5 (13.5%)] and mucositis [13 (36.1%) vs. 11 (29.7%)] in the CCRT + anlotinib vs. CCRT cohort but there were no significant differences between the two cohorts (P=0.54, P=0.70 and P=0.56, respectively). Two patients (5.6%) displayed grade 1/2 hemorrhage in the CCRT + anlotinib cohort. No patient displayed grade 3/4 hemorrhages or adverse event-associated deaths in any cohort. Complete response rates in the CCRT + anlotinib arm at 1 week and 3 and 6 months post-radiotherapy were 60.0, 91.4, and 97.1%, respectively, compared with 40.5, 81.1 and 91.9% in the CCRT arm but there was no significant difference (P=0.10, P=0.35 and P=0.65, respectively). This interim analysis of the ongoing trial showed that administration of CCRT + anlotinib has acceptable toxicity profiles, good compliance and promising results in patients with LA-NPC. A larger study cohort and a longer follow-up period are needed to confirm therapeutic effectiveness and late toxicity.

Photo-assisted Zn-air battery-driven self-powered aptasensor based on the 2D/2D Schottky heterojunction of cadmium-doped molybdenum disulfide and Ti3C2Tx nanosheets for the sensitive detection of penicillin G.

A novel photocatalyzed Zn-air battery-driven (ZAB)-based aptasensor has been manufactured using the two dimensional (2D)/2D Schottky heterojunction as photocathode and Zn plate as photoanode. It was then employed to sensitively and selectively detect penicillin G (PG) in the complex environment. The 2D/2D Schottky heterojunction was established by the in situ growth of cadmium-doped molybdenum disulfide nanosheets (Cd-MoS2 NSs) around Ti3C2Tx NSs (denoted as Cd-MoS2@Ti3C2Tx) by using phosphomolybdic acid (PMo12) as precursor, thioacetamide as sulfur source, and Cd(NO3)2 as a doping agent through the hydrothermal method. The gained Cd-MoS2@Ti3C2Tx heterojunction possessed contact interface, hierarchical structure, and plenty of sulfur and oxygen vacancies, thus showing the enhanced separation ability of photocarriers and electron transfer. Due to the enhanced UV-vis light adsorption ability, high photoelectric conversion efficiency, and exposed catalytic active sites, the constructed photocatalyzed ZAB displayed a boosted output voltage of 1.43 V under UV-vis light irradiation. The developed ZAB-driven self-powered aptasensor demonstrated an ultralow detection limit of 0.06 fg mL-1 within a PG concentration ranged from 1.0 fg mL-1 to 0.1 ng mL-1, as deduced from the power density-current curves, along with high specificity, good stability and promising reproducibility, as well as excellent regeneration ability and wide applicability. The present work provided an alternative analysis method for the sensitive analysis of antibiotics based on the portable photocatalyzed ZAB-driven self-powered aptasensor.

[Identification and expression of uridine diphosphate glycosyltransferase(UGT) gene family from Dendrobium officinale].

Uridine diphosphate glycosyltransferase(UGT) is a highly conserved protein in plants, which usually functions in secondary metabolic pathways. This study used the Hidden Markov Model(HMM) to screen out members of UGT gene family in the whole genome of Dendrobium officinale, and 44 UGT genes were identified. Bioinformatics was used to analyze the structure, phylogeny, and promoter region components of D. officinale genes. The results showed that UGT gene family could be divided into four subfamilies, and UGT gene structure was relatively conserved in each subfamily, with nine conserved domains. The upstream promoter region of UGT gene contained a variety of cis-acting elements related to plant hormones and environmental factors, indicating that UGT gene expression may be induced by plant hormones and external environmental factors. UGT gene expression in different tissues of D. officinale was compared, and UGT gene expression was found in all parts of D. officinale. It was speculated that UGT gene played an important role in many tissues of D. officinale. Through transcriptome analysis of D. officinale mycorrhizal symbiosis environment, low temperature stress, and phosphorus deficiency stress, this study found that only one gene was up-regulated in all three conditions. The results of this study can help understand the functions of UGT gene family in Orchidaceae plants and provide a basis for further study on the molecular regulation mechanism of polysaccharide metabolism pathway in D. officinale.

Low-temperature plasma modification, structural characterization and anti-diabetic activity of an apricot pectic polysaccharide.

To fully research the anti-diabetic activity of apricot polysaccharide, low temperature plasma (LTP) was used to modify apricot polysaccharide. The modified polysaccharide was isolated and purified using column chromatography. It was found that LTP modification can significantly improve the α-glucosidase glucosidase inhibition rate of apricot polysaccharides. The isolated fraction FAPP-2D with HG domain showed excellent anti-diabetic activity in insulin resistance model in L6 cell. We found that FAPP-2D increased the ADP/ATP ratio and inhibited PKA phosphorylation, activating the LKB1-AMPK pathway. Moreover, FAPP-2D activated AMPK-PGC1α pathway, which could stimulated mitochondrial production and regulate energy metabolism, promoting GLUT4 protein transport to achieve an anti-diabetic effect. The Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy data showed that the LTP modification could increase the CH bond content while decreasing the C-O-C/C-O bond content, indicating that LTP destroyed the C-O-C/C-O bond, which enhanced the anti-diabetes activity of the modified apricot pectin polysaccharide. Our findings could pave the way for the molecular exploitation of apricot polysaccharides and the application of low-temperature plasma.

Defective porphyrin-based metal-organic framework nanosheets derived from V2CTx MXene as a robust bioplatform for impedimetric aptasensing 17ß-estradiol.

An electrochemical aptasensor was prepared for the efficient, sensitive, and selective detection of 17ß-estradiol. The sensor was based on a defective two-dimensional porphyrin-based metal-organic framework derived from V2CTx MXene. The resulting metal-organic framework nanosheets benefited from the advantages of V2CTx MXene nanosheets and porphyrin-based metal-organic framework, two-dimensional porphyrin-based metal-organic framework nanosheets demonstrated amplified electrochemical response and enhanced aptamer-immobilization ability compared with V2CTx MXene nanosheets. The sensor's detection limit was ultralow at 0.81 fg mL-1 (2.97 fM), and the 17ß-estradiol concentration range was wide, thereby outperforming most reported aptasensors. The high selectivity, superior stability and reproducibility, and excellent regeneration performance of the constructed aptasensor indicated its remarkable potential application for 17ß-estradiol determination in diverse real samples. This aptasensing strategy can be used to analyze other targets by replacing the corresponding aptamer.

A Study on the Effectiveness of 650-nm Red-Light Feeding Instruments in the Control of Myopia.

INTRODUCTION: This study analyzed the effectiveness of 650-nm red-light feeding instruments in the control of myopia. METHODS: In this study, 164 school-aged participants diagnosed with myopia in the city of Shenzhen were enrolled in a red-light feeding instrument study. Of these, 41 were enrolled in the mild-to-moderate myopia group that received red-light feeding (RLMM group), 65 were enrolled in the mild-to-moderate myopia group that received single-vision spectacle treatment (SVSMM group), and 58 were included in the severe myopia group that received red-light feeding (RLS group). RESULTS: After the baseline values of the three groups were matched, the right eye data were used for statistical analysis. The average return visit time of each group was 60.42 days, and changes in the observation indexes before treatment and after follow-up treatment were compared. As the primary outcome, the axial length changes in the right eye of the SVSMM group (0.08 ± 0.40 mm), the RLMM group (-0.03 ± 0.11 mm), and the RLS group (-0.07 ± 0.11 mm) were compared and showed a statistical result of p < 0.001. CONCLUSION: The study results verified that red light had a noticeable effect on the control of myopia and that low-level red-light therapy played a vital role in the treatment of severe myopia.

Single-center experience with vascularized adrenal displacement for the treatment of primary bilateral macronodular adrenal hyperplasia / 现代泌尿外科杂志

【Objective】 To explore a new treatment of primary bilateral macronodular adrenal hyperplasia (PBMAH) and its efficacy. 【Methods】 Clinical data of 20 PBMAH patients treated in our hospital during Mar.2010 and Apr.2021 were retrospectively analyzed. All patients underwent laparoscopic subcutaneous displacement of vascularized adrenal. The clinical symptoms, plasma free cortisol, adrenocorticotrophic hormone (ACTH), and 24 h urinary free cortisol were regularly monitored after surgery. 【Results】 Of all 20 patients, 19 were followed up for 18 to 120 months (median 60 months). Three months after surgery, reexamination showed 1 patient had decreased plasma free cortisol and increased ACTH, but had no symptoms of low corticosteroids. After another 3 months, the plasma free cortisol and ACTH returned to normal. After 4 to 48 months, the parameters recovered in all patients and the clinical symptoms disappeared. 【Conclusion】 Laparoscopic vascularized adrenal displacement is a new and effective method for the treatment of PBMAH. It can alleviate the Cushing syndrome with no obvious adverse reactions.

Outcomes of a modified microdot two-layer microsurgical vasovasostomy in the treatment of vas deferens obstruction caused by inguinal herniorrhaphy / 现代泌尿外科杂志

【Objective】 To introduce a modified microdot two-layer microsurgical vasovasostomy (MVV) and to analyze its effectiveness in patients with vas deferens obstruction caused by inguinal herniorrhaphy. 【Methods】 Clinical data of patients treated during Mar.2015 and Oct.2020 were retrospectively analyzed. According to different surgical methods, the patients were divided into the modified group and traditional group. The general data, intraoperative conditions, efficacies and complications of the two groups were compared. 【Results】 There were 59 cases in the modified group, 54(91.5%) of whom were successfully followed up, and 41 cases in the traditional group, 38(92.7%) of whom were successfully followed up. There were no significant differences in age, inguinal herniorrhaphy history, and unilateral/bilateral ratio between the two groups (P>0.05). The average operation time for unilateral lesions in the modified group was shorter than that in the traditional group [(89.44±24.86) vs. (112.04±43.40) min, P=0.032]. The postoperative patency rate (83.3% vs.73.7%, P>0.05) and natural pregnancy rate (33.3% vs.28.9%, P>0.05) of the modified group and traditional group were comparable. Incision fat liquefaction occurred in 2 cases (3.70%) in the modified group and in 1 case (2.63%) in the traditional group (P>0.05). 【Conclusion】 The modified microdot two-layer MVV is a safe surgical method with comparable effectiveness as the traditional approach. By adjusting the position of the marking points and the order of suturing, it helps the management of sutures, reduces the difficulty of vasovasostomy, shortens operation time, and can be applied to repair vas deferens obstruction caused by inguinal herniorrhaphy.

Application of nasal aesthetic polygon theory in reconstruction of new domes by costal cartilage on nasal tip / 中华医学美学美容杂志

Objective:To explore the application of nasal aesthetic polygon theory in the reconstruction of new domes on nasal tip with autogenous costal cartilage.Methods:From June 2019 to June 2021, 116 patients (26 males and 90 females) received rhinoplasty, CT-assisted examination of the costal cartilage, nasal bone and nasal cartilage was performed, and the autogenous costal cartilaginous cortex was used to make dome reconstruction grafts that were transplanted to the original alar cartilage and partially fixed to the original nasal septum cartilage to form a satisfactory and natural nasal shape.Results:All the patients were followed up for 6-24 months. No cartilaginous, overrotated or underrotated appearance was found in nasal tip. The shape of nasal tip was clear and good, with an obvious performance point and full lower lobule. The nose was tall and straight, and looked natural and beautiful in three dimensions.Conclusions:The nasal aesthetic polygon theory is used to guide the reconstruction of new domes with autogenous costal cartilage in nasal tip surgery. Compared to the cap and shield grafts, the nasal tip is more close to the normal anatomical structure, the shape and texture are more similiar to the natural state and the nasal tip is softer by using autogenous costal cartilage, and so it is an ideal surgical procedure for nasal tip reconstruction.

Effects of costal cartilage cortex on nasal tip contour improvement / 中华医学美学美容杂志

Objective:To investigate the effect of autologous costal cartilage cortex as nasal tip support and modified graft for nasal tip contour improvement.Methods:From June 2020 to June 2021, 116 patients (male 26, female 90, aged 20-45 years) who received rhinoplasty in the cosmetic surgery department of Myoung Beaucare Clinic of Beijing, were examined the costal cartilage by CT, and the costal cartilage was cut. The costal cartilage cortex was made into " strip" and " cap" grafts to shape the nasal tip, and the nasal dorsum was raised by polytetrafluoroethylene or silicone prosthesis for comprehensive rhinoplasty.Results:A total of 116 patients were followed up for an average of 11.7 months. After the operation, there was no space occupying in the nasal cavity, no graft protrusion, no obvious foreign body feeling in the nasal valve, and the nasal tip could swing left and right. At the same time, the nasal tip showed obvious signs, the lower lobule was full, and there were no complications such as cartilage appearance, exposure, infection, etc. Due to the untreated deviation of nasal septum, 3 cases had deviation of nasal columella and asymmetric nostrils. The shape of nasal tip was stable in the remaining 113 cases, and satisfactory results were obtained.Conclusions:By using autologous costal cartilage cortex as nasal tip support and modification graft for nasal tip contour improvement, the shaped nasal tip is soft and movable, and does not affect the airway. It is a good surgical technique in nasal tip plastic surgery, which is worthy of clinical application.

Pulmonary intimal artery sarcoma:a clinicopathological study of ten cases / 临床与实验病理学杂志

Purpose To investigate the clinicopathologic features,molecular changes,treatment and prognosis of pulmo-nary artery intimal sarcoma.Methods Ten cases of pulmonary artery intimal sarcoma were collected and the clinical features analyzed,by using HE,immunohistochemistry EnVision meth-od,FISH,and review of relevant literature.Results There were 4 males and 6 females,with a male to female ratio of 1∶1.5.The patients were 33-75 years old with an average age of 55.7 years.The main clinical symptoms were chest tightness,shortness of breath(6/10),chest pain(5/10)and cough(3/10),hemoptysis(2/10),syncope(1/10),heart murmur(1/10).1 patient had a history of bilateral breast cancer,bilateral papillary thyroid carcinoma and invasive lung adenocarcinoma,1 patient had bilateral breast cancer and 1 patient had pulmonary embolism and cardiac myxoma.Preoperative imaging showed pulmonary embolism or lung tumor.Histological morphology showed that the tumor cells were fusiform or epithelioid,with ob-vious atypia.Some tumors differentiated into rhabdomyosarco-ma,angiosarcoma and leiomyosarcoma,and giant cells were seen in 2 cases.The tumor lacked specific immune markers,and the tumor cells expressed vimentin,Fli-1,SMA,MyogD1,Myoglobin,BCL-2,ERG,etc.Ki-67 proliferation index was a-bout 30％-70％.Fluorescence in situ hybridization was used to detect MDM2(4/5)and CDK4(1/1).All cases received surgical treatment,7 cases were followed up from 1 month to 17 months,and 4 cases of them had recurrence or distant metasta-sis.Conclusion Pulmonary artery intimal sarcoma is rare,without specific immune markers and with complicated gene changes.There is no standard treatment,and the prognosis is poor.