Case report: regression of aspiration pneumonitis after nasal endoscopic repair of traumatic cerebrospinal fluid nasal leak.

Aspiration pneumonitis is an inflammatory lung disease caused by the inhalation of oropharyngeal secretions colonized by pathogenic bacteria. Accurate diagnosis of aspiration pneumonitis can be challenging, and cerebrospinal fluid (CSF) rhinorrhea is often overlooked as a rare cause of aspiration. In this case report, we present the case of a 48-year-old male patient who experienced right-sided nasal flow of clear watery secretions for 6 months, accompanied by a dry cough as the major symptom. Through comprehensive assessment of clinical symptoms, sinus imaging, nasal endoscopy, and relevant laboratory testing, a presumptive diagnosis of traumatic cribriform plate fracture with CSF rhinorrhea was made. Chest imaging revealed flocculent ground glass shadows in the bilateral lungs. After ruling out viral pneumonia, nasal endoscopic repair of the skull base defect was performed. The patient's dry cough and rhinorrhea symptoms resolved within 1 week after surgery, and the pneumonia showed significant improvement and complete resolution within 2 weeks postoperatively. Despite the absence of characteristic symptoms and evident inhalation factors, chronic CSF rhinorrhea caused by the cribriform plate fracture was ultimately identified as the primary etiology of the patient's aspiration pneumonitis. This rare case highlights the importance of considering traumatic CSF rhinorrhea as an uncommon cause of aspiration, which can enhance physicians' awareness and focus on the less-common etiologies of aspiration. Such awareness can contribute to more accurate diagnosis and early operative intervention, particularly in the context of the coronavirus disease 2019 pandemic.

Bell's palsy research hotspots and frontiers from 2002 to 2021: a bibliometric and visual analysis.

Bell's palsy is an idiopathic, acute, unilateral peripheral facial nerve paralysis, where incomplete or failed recovery causes substantial social and psychological stress to the patient, seriously influencing their quality of life and social activities. We conducted a bibliometric investigation of the knowledge structure and frontier hotspots in Bell's palsy research. Bell's palsy publications between 2002 and 2021 were retrieved from Web of Science. CiteSpace, VOSviewer, and an online bibliometric platform were used for visual, burst, citation, and co-occurrence analyses, respectively. A total of 1,378 publications were included. The annual Bell's palsy publication output followed an upward trend from 2002 to 2021. The USA and Harvard University published the most Bell's palsy research articles. Yeo SG and Otology & Neurotology were the most prolific author and journal, respectively, on Bell's palsy. The results suggested that Bell's palsy research hotspots focused on rehabilitating facial nerve function and improving prognosis, and combining specific therapies (acupuncture) would be of future interest. The cited references timeline revealed that Bell's palsy following COVID-19 vaccination was an emerging research hotspot. The bibliometric analysis demonstrated that the USA dominates Bell's palsy research and that rehabilitating facial nerve function and prognosis were research hotspots. Emerging mechanistic studies mainly focused on Bell's palsy following COVID-19 vaccination. Our findings could be a reliable source for global scholars to rapidly identify research hotspots and potential research directions and frontiers.

Function and molecular mechanism of a poplar placenta limited MIXTA gene in regulating differentiation of plant epidermal cells.

The placenta in fruits of most plants either desiccate and shrink as the fruits mature or develop further to form the fleshy tissues. In poplars, placental epidermal cells protrude collectively to produce catkin fibers. In this study, three carpel limited MIXTA genes, PdeMIXTA02, PdeMIXTA03, PdeMIXTA04, were find to specifically expressed in carpel immediately after pollination. Heterologous expression of the three genes in Arabidopsis demonstrated that PdeMIXTA04 significantly promoted trichomes density and could restore trichomes in the trichomeless mutant. By contrast, such functions were not observed with PdeMIXTA02, PdeMIXTA03. In situ hybridization revealed that PdeMIXTA04 was explicitly expressed in poplar placental epidermal cells. We also confirmed trichome-specific expression of the PdeMIXTA04 promoter. Multiple experimental proofs have confirmed the interaction between PdeMIXTA04, PdeMYC and PdeWD40, indicating PdeMIXTA04 functioned through the MYB-bHLH-WD40 ternary complex. Our work provided distinctive understanding of the molecular mechanism triggering differentiation of poplar catkins.

Genome-Wide Analysis of the Expansin Gene Family in Populus and Characterization of Expression Changes in Response to Phytohormone (Abscisic Acid) and Abiotic (Low-Temperature) Stresses.

Expansins are a group of cell wall enzyme proteins that help to loosen cell walls by breaking hydrogen bonds between cellulose microfibrils and hemicellulose. Expansins are essential plant proteins that are involved in several key processes, including seed germination, the growth of pollen tubes and root hairs, fruit ripening and abscission processes. Currently, there is a lack of knowledge concerning the role of expansins in woody plants. In this study, we analyzed expansin genes using Populus genome as the study target. Thirty-six members of the expansin gene family were identified in Populus that were divided into four subfamilies (EXPA, EXPB, EXLA and EXLB). We analyzed the molecular structure, chromosome localization, evolutionary relationships and tissue specificity of these genes and investigated expression changes in responses to phytohormone and abiotic stresses of the expansin genes of Populus tremula L. (PtEXs). Molecular structure analysis revealed that each PtEX protein had several conserved motifs and all of the PtEXs genes had multiple exons. Chromosome structure analysis showed that the expansin gene family is distributed on 14 chromosomes. The PtEXs gene family expansion patterns showed segmental duplication. Transcriptome data of Populus revealed that 36 PtEXs genes were differently expressed in different tissues. Cis-element analysis showed that the PtEXs were closely associated with plant development and responses to phytohormone and abiotic stress. Quantitative real-time PCR showed that abscisic acid (ABA) and low-temperature treatment affected the expression of some PtEXs genes, suggesting that these genes are involved in responses to phytohormone and abiotic stress. This study provides a further understanding of the expansin gene family in Populus and forms a basis for future functional research studies.

A bibliometric and visualization analysis of global research on vestibular schwannoma.

BACKGROUND: Vestibular schwannoma is the most common benign tumor in the pontocerebellar horn region. As the tumor grows, it often causes severe hearing loss due to compression of nearby nerves, resulting in a lower quality of life. This study examined vestibular schwannoma-related research through a bibliometric and visualization analysis, and it explored current trends and research hot spots. METHODS: Research related to vestibular schwannoma published from 2002 to 2021 was searched using the Web of Science Core Collection. The processing and visualization analysis of the data were conducted using R software, VOSviewer, and CiteSpace. RESULTS: A total of 3,909 publications were included in this study, and an overall increasing trend in the annual output of publications was found. The United States, Germany, and the United Kingdom were the most prolific countries, publishing the most articles. Germany had the most frequent international cooperation and the highest centrality score. The Mayo Clinic, University of California, and Harvard University were the three most productive institutions. Otology & Neurotology was the most prolific journal, and MJ Link was the most productive and highest scoring author for centrality. Current frontier topics mainly focused on "hearing preservation" and "radiosurgery". A map of trends in topics and a thematic graph revealed that "hearing loss", "vertigo", "magnetic resonance imaging", "radiosurgery", "stereotactic radiosurgery", and "gamma knife" were the topics of focus of current discussions. CONCLUSION: Hearing preservation is a current frontier topic in this area. Radiosurgery has a promising future in the field of vestibular schwannoma, and stereotactic radiosurgery is a focus of global attention. Bibliometric and visualization analysis offer a unique and objective perspective of the field of vestibular schwannoma and may assist scholars in the identification of new research directions.

Genome-Wide Comparative Analysis of the Fasciclin-like Arabinogalactan Proteins (FLAs) in Salicacea and Identification of Secondary Tissue Development-Related Genes.

Fasciclin-like arabinogalactan proteins (FLAs) are a subclass of arabinogalactan proteins (AGPs) containing both AGP-like glycated domains and fasciclin (FAS) domains, which are involved in plant growth and development and synthesis of the cell wall. However, these proteins have not been identified or analyzed in willow, Salix, the sister genus of Populus. In this study, we performed a whole genome study of the FLA gene family of Salix suchowensis and compared it with the FLA gene family of Populus deltoides. The results showed the presence of 40 and 46 FLA genes in P. deltoides and S. suchowensis, distributed on 17 and 16 chromosomes, respectively. Four pairs of tandem repeat genes were found in willow, while poplar had no tandem repeat genes. Twelve and thirteen pairs of duplicated gene fragments were identified in poplar and willow, respectively. The multispecies phylogenetic tree showed that the FLA gene family could be divided into four groups (I-IV), with Group 1 showing significant expansion in woody plants. A gene expression analysis showed that PdeFLA19/27 in Group I of poplar was highly expressed, specifically during the secondary growth period of the stem and the rapid elongation of seed hairs. In the Group I genes of S. suchowensis, SsuFLA25/26/28 was also highly expressed during the secondary growth period, whereas increased expression of SsuFLA35 was associated with seed hair tissue. These results provide important clues about the differences in the FLA gene family during the evolution of herbs and woody plants, and suggest that the FLA gene family may play an essential role in regulating the secondary growth of woody plants. It also provides a reference for further studies on the regulation of secondary growth and seed hair development by FLA genes in poplar and willow.

Effects of immune inflammation in head and neck squamous cell carcinoma: Tumor microenvironment, drug resistance, and clinical outcomes.

Background: Head and neck squamous cell carcinoma (HNSCC) is a malignant tumor with a very high mortality rate, and a large number of studies have confirmed the correlation between inflammation and malignant tumors and the involvement of inflammation-related regulators in the progression of HNSCC. However, a prognostic model for HNSCC based on genes involved in inflammatory factors has not been established. Methods: First, we downloaded transcriptome data and clinical information from patients with head and neck squamous cell carcinoma from TCGA and GEO (GSE41613) for data analysis, model construction, and differential gene expression analysis, respectively. Genes associated with inflammatory factors were screened from published papers and intersected with differentially expressed genes to identify differentially expressed inflammatory factor-related genes. Subgroups were then typed according to differentially expressed inflammatory factor-related genes. Univariate, LASSO and multivariate Cox regression algorithms were subsequently applied to identify prognostic genes associated with inflammatory factors and to construct prognostic prediction models. The predictive performance of the model was evaluated by Kaplan-Meier survival analysis and receiver operating characteristic curve (ROC). Subsequently, we analyzed differences in immune composition between patients in the high and low risk groups by immune infiltration. The correlation between model genes and drug sensitivity (GSDC and CTRP) was also analyzed based on the GSCALite database. Finally, we examined the expression of prognostic genes in pathological tissues, verifying that these genes can be used to predict prognosis. Results: Using univariate, LASSO, and multivariate cox regression analyses, we developed a prognostic risk model for HNSCC based on 13 genes associated with inflammatory factors (ITGA5, OLR1, CCL5, CXCL8, IL1A, SLC7A2, SCN1B, RGS16, TNFRSF9, PDE4B, NPFFR2, OSM, ROS1). Overall survival (OS) of HNSCC patients in the low-risk group was significantly better than that in the high-risk group in both the training and validation sets. By clustering, we identified three molecular subtypes of HNSCC carcinoma (C1, C2, and C3), with C1 subtype having significantly better OS than C2 and C3 subtypes. ROC analysis suggests that our model has precise predictive power for patients with HNSCC. Enrichment analysis showed that the high-risk and low-risk groups showed strong immune function differences. CIBERSORT immune infiltration score showed that 25 related and differentially expressed inflammatory factor genes were all associated with immune function. As the risk score increases, specific immune function activation decreases in tumor tissue, which is associated with poor prognosis. We also screened for susceptibility between the high-risk and low-risk groups and showed that patients in the high-risk group were more sensitive to talazoparib-1259, camptothecin-1003, vincristine-1818, Azd5991-1720, Teniposide-1809, and Nutlin-3a (-) -1047.Finally, we examined the expression of OLR1, SCN1B, and PDE4B genes in HNSCC pathological tissues and validated that these genes could be used to predict the prognosis of HNSCC. Conclusion: In this experiment, we propose a prognostic model for HNSCC based on inflammation-related factors. It is a non-invasive genomic characterization prediction method that has shown satisfactory and effective performance in predicting patient survival outcomes and treatment response. More interdisciplinary areas combining medicine and electronics will be explored in the future.

Global trends in the research on benign paroxysmal positional vertigo: A 20-year bibliometric and visualization analysis.

Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vestibular vertigo. Although BPPV is benign, its underlying mechanisms are complicated, and patients diagnosed with BPPV are significantly affected by it in their daily lives. Hence, this study's purpose was to investigate global trends and frontiers in the field of BPPV. Methods: We searched the research literature published from 2002 to 2021 on BPPV using two databases from the Web of Science Core Collection, and we conducted a bibliometric and visualization analysis. Bibliometric tools were used to perform co-authorship, co-citation, and co-occurrence analyses of countries or regions, institutions, authors, journals, keywords, and references. Results: In all, 1,419 publications from 4,594 authors, 1,542 institutions, and 65 countries or regions with 71 subject categories were included in the study. The number of articles increased gradually from 2002 to 2021. Seoul National University, the University of Munich, and Osaka University were among the leading institutions with the most publications, while United States of America, South Korea, and China were the leading countries. JS Kim was the most prolific author, Otology & Neurotology was the most prolific journal, and Otorhinolaryngology was the most published subject category. The five most frequently occurring keywords were BPPV, vertigo, dizziness, nystagmus, and management and the top research hot spots were osteoporosis and vitamin D. Conclusion: This study systematically analyzed trends in global scientific research on BPPV. The academic understanding of BPPV has improved significantly over the last two decades, with osteoporosis and vitamin D the two main research hot spots in the field of BPPV in recent years. These findings provide direction for current research to grasp the trends and research frontiers of current research.

Unveiling the knowledge domain and emerging trends of olfactory dysfunction with depression or anxiety: A bibliometrics study.

Olfactory dysfunction (OD) accompanied by depression or anxiety is a very common clinical problem, and there has been a growing number of studies on OD with depression or anxiety in recent decades. This study performed bibliometric and visual analyses of the literature on OD with depression or anxiety to derive research trends and identify emerging research foci. Relevant publications were obtained from the Science Citation Index-Expanded and Social Sciences Citation Index in the Web of Science Core Collection databases (2002-2021). CiteSpace and VOSviewer were applied to identify and evaluate research foci and emerging trends in this research domain. The analyses found that the number of publications related to OD with depression or anxiety has increased significantly over the past 20 years, up from 15 in 2002 to 114 in 2022. The country that ranked highest in the number of articles and international cooperation was the United States. The top 10 most frequent keywords were "depression," "olfaction," "anxiety," "dysfunction," "olfactory bulbectomy," "olfactory dysfunction," "Parkinson's disease," "odor identification," "brain," and "disorders." Analysis of keywords with the strongest citation bursts revealed that "oxidative stress" is an emerging research hotspot. A timeline chart of the cluster of co-cited references demonstrated that Parkinson's disease was always a topic of interest in this area of research. This study conducted an objective, comprehensive, and systematic analysis of these publications, and identified the development of trends and hotspots in this research domain. It is hoped that this work will provide scholars, worldwide, with information to assist them in further research and the development of new therapies.

Emerging trends and research foci in allergic rhinitis immunotherapy from 2002 to 2021: a bibliometric and visualized study.

BACKGROUND AND OBJECTIVE: Research on allergic rhinitis (AR) immunotherapy has increased in recent decades. This study conducted a bibliometric and visualization analysis of studies related to AR immunotherapy to identify research trends and highlight current research foci. METHODS: Relevant original publications were obtained from the Science Citation Index-Expanded and Social Sciences Citation Index in the Web of Science Core Collection databases between 2002 and 2021. CiteSpace and VOSviewer software were used to identify and analyze the research foci and emerging trends in the field of AR immunotherapy. RESULTS: Over the last two decades, the number of publications related to AR immunotherapy has increased markedly. With regard to publications and access to collaborative networks, the leading country was the USA. Inspection of keyword bursts suggested that "subcutaneous immunotherapy", "quality of life", "prevalence", "rhino-conjunctivitis", and "mechanism" are emerging research hotspots. The timeline of the co-cited references cluster diagram revealed that the mechanism of allergen immunotherapy has emerged as a main topic in AR immunotherapy. CONCLUSION: Over the past 20 years, scholars have significantly improved their understanding of AR immunotherapy. The current research hotspots of AR immunotherapy in the health promotion domain lie in "subcutaneous immunotherapy", "quality of life", and "rhino-conjunctivitis". In addition, the mechanism of allergen immunotherapy has emerged as a frontier and focus of this field.

Developments and Emerging Trends in the Global Treatment of Chronic Rhinosinusitis From 2001 to 2020: A Systematic Bibliometric Analysis.

Background: Research on the treatment of chronic rhinosinusitis (CRS) has increased in recent decades. We undertook a bibliometric and visualization analysis of studies on CRS treatment to track research trends and highlight current research "hotspots". Methods: Original publications related to CRS treatment were obtained from the Science Citation Index-Expanded (SCI-E) and Social Sciences Citation Index (SSCI) databases in the Web of Science Core Collection (WoSCC) of Clarivate Analytics between 2001 and 2020. The country/region, institution, author, journal, references, and keywords involved in this topic were extracted using CiteSpace and VOSviewer to identify and analyze the research focus and trends in this field. Results: In the previous two decades (especially after 2015), the number of publications on CRS treatment has grown markedly. With regard to publications and access to collaborative networks, the leading country was the USA. High-frequency keywords were "CRS," "endoscopic sinus surgery," "sinusitis," "nasal polyps," "asthma," "rhinosinusitis," "management," "diagnosis," "outcomes," and "quality of life." Inspection of keyword bursts suggested that "clinical practice guideline," "adult CRS," "innate lymphoid cell," "recurrence," and "mepolizumab" are the emerging research hotspots. The timeline view of the cluster map revealed that biologic agents have become an up-and-coming "hot topic" in CRS treatment in recent years. Conclusion: Academic understanding of CRS treatment has improved markedly over the past 20 years. We study analyzed the papers objectively, methodically, and comprehensively, and identified hotspots and prospective trends in the field of CRS treatment. These results will aid rhinologists in gaining greater insight into CRS treatment strategies and identifying the changing dynamics of CRS research.

A Selection of Reliable Reference Genes for Gene Expression Analysis in the Female and Male Flowers of Salix suchowensis.

Salix is a dioecious plant. Research on the molecular regulation mechanism of male and female inflorescence differentiation and development is necessary to analyze sex differentiation in the willow and the underlying mechanisms of unisexual flower development. However, at present, there are no reference genes suitable for stable expression in the process of willow inflorescence development. In this study, Salix suchowensis was used as the research material, nine candidate reference genes (α-TUB1, α-TUB2, ACT, H2A, DnaJ, CDC2, GAPDH, TIP41, ß-TUB) were selected, and qRT-PCR technology was used to detect the expression of each candidate reference gene in female and male flowers at different developmental stages and using five algorithms (geNorm, Normfinder, Delta Ct, BestKeeper, and RefFinder) to comprehensively evaluate the stability of candidate reference genes. The results showed that ACT and DnaJ were stably expressed in all samples and could be used as reference genes. In addition, the reliability of the screening results was further verified via an expression pattern analysis of the CFS gene that encodes flower specific transcription factor in different samples. The stable reference genes selected in this study provide the basis for future research on the expression analysis of functional genes related to the development of male and female flowers of S. suchowensis.

Worldwide Tinnitus Research: A Bibliometric Analysis of the Published Literature Between 2001 and 2020.

BACKGROUND: In recent years, tinnitus has attracted increasing research interest. However, bibliometric analysis of global research on tinnitus is rare. The objective of this study was to identify and describe the foci and developing trends of tinnitus research using a bibliometric approach. METHODS: Publications related to tinnitus published from 2001 to 2020 were searched for in the Science Citation Index-Expanded (SCI-E) and Social Sciences Citation Index (SSCI) databases in the Web of Science Core Collection of Clarivate Analytics. The bibliometric approach was used to estimate the searched data, and VOSviewer and CiteSpace software were used to identify and analyze research foci and trends in the field of tinnitus. RESULTS: A total of 5,748 articles were included. The number of publications on tinnitus has increased dramatically in the last 20 years, especially since 2010. The leading country in terms of publications and access to collaborative networks was the United States. High-frequency keywords included tinnitus, hearing loss, prevalence, management, depression, mechanism, vertigo, hearing, inferior colliculus, and noise. The analyses of keyword burst detection indicated that prevalence, anxiety, and neural network are emerging research hotspots. CONCLUSION: In the past 20 years, academic understanding of tinnitus has improved considerably. This study provides an objective, systematic, and comprehensive analysis of tinnitus-related literature. Furthermore, current hot spots and prospective trends in the field of tinnitus were identified. These results will assist otolaryngologists and audiologists in identifying the evolving dynamics of tinnitus research and highlight areas for prospective research.

Computed Tomography Image Analysis and Clinical Correlations of Retromaxillary Cells.

OBJECTIVE: This study aimed to investigate and analyze the anatomic characteristics of the retromaxillary cell (RMC) by using computed tomography (CT) images of paranasal sinuses and to improve its identification with ethmomaxillary sinus (EMS). METHODS: The paranasal sinus CT scans of 441 outpatients or inpatients in our hospital from January 2018 to October 2018 were analyzed. The incidence of RMC, EMS, Haller cell, imaging anatomical characteristics, and morphological manifestations were observed via sinus CTs. The relationship of RMC and ipsilateral maxillary sinusitis was analyzed. RESULTS: The incidence of RMC is 83.90% (740/882). The incidence of males and females was 83.81% (414/494) and 84.02% (326/388), respectively. The incidence of bilateral (72.79%, 321/441) was much higher than that of unilateral (22.22%, 98/441). The lateral extension of the RMC ranged from 1.18 to 13.31 mm, with an average of 6.10 ± 2.03 mm. The incidence of ipsilateral maxillary sinus opacification on the RMC sides and non-RMC sides has no significance difference (χ2 = .054, P = .459). The incidence of Haller cell and EMS decreased significantly in the presence of RMC (P < .01). CONCLUSION: The RMC is an anatomical variation originating from posterior ethmoid cells, which is commonly encountered in the clinic. The pneumatization of RMC is highly variable, and a bilateral is common. During endoscopic sinus surgery, it is necessary to carefully identify such an air cell to ensure the complete opening of the paranasal sinus during surgery.

Activation of Dopamine D2 Receptor Alleviates Neuroinflammation in a Mouse Model of Allergic Rhinitis With Olfactory Dysfunction.

PURPOSE: Allergic rhinitis (AR) is a common otolaryngology disease and one of the clinical causes of olfactory dysfunction (OD). The olfactory bulb serves as a transfer station for olfactory information transmission, and alleviating its neuroinflammation may be expected to improve AR-induced OD. Recent studies have suggested that the dopamine D2 receptor acts as a key target in regulating immune functions and neuroinflammatory reaction. However, the effect of dopamine D2 receptor on AR-induced neuroinflammation is still unknown. METHODS: An AR mouse model with OD induced by ovalbumin were constructed. The buried food pellet test was to evaluate the olfactory function of the mice. Immunofluorescence staining, hematoxylin and eosin staining, enzyme-linked immunosorbent assay and western blotting were also used to investigate the molecular mechanisms underlying the anti-inflammatory effects of the dopamine D2 receptor in AR-induced OD. RESULTS: We found that AR-induced OD has a relationship with inflammatory responses in the olfactory bulb. Nasal administration of quinpirole (Quin, a dopamine D2 receptor agonist, 3 mg/kg) improved olfactory function in mice, inhibited the expression of toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signalings and the levels of tumor necrosis factor-α, interleukin (IL)-1ß and IL-6 in the olfactory bulb. In vitro, Quin (20 µmol/L) inhibited the release of TLR4/NF-κB signalings-dependent inflammatory cytokines in cultured microglia. CONCLUSIONS: Activation of the dopamine D2 receptor inhibits the release of inflammatory cytokines through TLR4/NF-κB signaling in the olfactory bulb microglia, and protects olfactory function.

Genome-Wide Comparative Analysis of R2R3 MYB Gene Family in Populus and Salix and Identification of Male Flower Bud Development-Related Genes.

The MYB transcription factor (TF) family is one of the largest plant transcription factor gene family playing vital roles in plant growth and development, including defense, cell differentiation, secondary metabolism, and responses to biotic and abiotic stresses. As a model tree species of woody plants, in recent years, the identification and functional prediction of certain MYB family members in the poplar genome have been reported. However, to date, the characterization of the gene family in the genome of the poplar's sister species willow has not been done, nor are the differences and similarities between the poplar and willow genomes understood. In this study, we conducted the first genome-wide investigation of the R2R3 MYB subfamily in the willow, identifying 216 R2R3 MYB gene members, and combined with the poplar R2R3 MYB genes, performed the first comparative analysis of R2R3 MYB genes between the poplar and willow. We identified 81 and 86 pairs of R2R3 MYB paralogs in the poplar and willow, respectively. There were 17 pairs of tandem repeat genes in the willow, indicating active duplication of willow R2R3 MYB genes. A further 166 pairs of poplar and willow orthologs were identified by collinear and synonymous analysis. The findings support the duplication of R2R3 MYB genes in the ancestral species, with most of the R2R3 MYB genes being retained during the evolutionary process. The phylogenetic trees of the R2R3 MYB genes of 10 different species were drawn. The functions of the poplar and willow R2R3 MYB genes were predicted using reported functional groupings and clustering by OrthoFinder. Identified 5 subgroups in general expanded in woody species, three subgroups were predicted to be related to lignin synthesis, and we further speculate that the other two subgroups also play a role in wood formation. We analyzed the expression patterns of the GAMYB gene of subgroup 18 (S18) related to pollen development in the male flower buds of poplar and willow at different developmental stages by qRT-PCR. The results showed that the GAMYB gene was specifically expressed in the male flower bud from pollen formation to maturity, and that the expression first increased and then decreased. Both the specificity of tissue expression specificity and conservation indicated that GAMYB played an important role in pollen development in both poplar and willow and was an ideal candidate gene for the analysis of male flower development-related functions of the two species.

Influencing Factors of Outpatients' Satisfaction in China a Cross-Sectional Study of 16 Public Tertiary Hospitals.

PURPOSE: This study aimed to analyze the status of patient satisfaction in outpatients of tertiary hospitals and the factors affecting patient satisfaction, in order to provide a scientific basis for improving patient satisfaction. METHODS: A total of 6480 surveys of outpatients were conducted by a cross-sectional study in 16 tertiary hospitals in the Zhejiang province of China. The main contents of the survey were the basic characteristics of patients. Statistical description, single-factor analysis and binary logistic regression analysis were used to screen influencing factors. RESULTS: Results of this study showed that the total satisfaction score of outpatients was 87.13±13.47, and higher scored factors in the survey factors were nursing level, the convenience of registration and convenience of appointment diagnosis and treatment. The factors with lower scores were treatment effect, environmental sanitation and comfort and other staffs' attitudes. Hospital managers should pay attention to the improvement of treatment level, environmental sanitation and comfort and other staffs' attitudes. CONCLUSION: In the process of serving outpatients, doctors should pay more attention to patients who are male, 31-45 years old or over 60 years old, permanent residents, from public institutions, possessed postgraduate education, without medical insurance, and who visiting paediatrics and Chinese medicine hospitals.

TAK-242 ameliorates olfactory dysfunction in a mouse model of allergic rhinitis by inhibiting neuroinflammation in the olfactory bulb.

OBJECTIVE: Olfactory dysfunction (OD) is a common symptom of allergic rhinitis (AR) that can seriously affect patient quality of life; however, the associated pathogenesis remains unclear. This study aimed to explore the relationship between OD and damage of the olfactory bulb (OB) in allergic rhinitis (AR). The therapeutic potential of TAK-242, a selective TLR4 inhibitor, was evaluated for OD. METHOD: An AR mouse model was established with ovalbumin (OVA) to test the olfactory function of AR mice using the buried food pellet test (BFPT). Mice with OD were intraperitoneally injected with TAK-242 or 1% DMSO (vehicle). Immunohistochemistry was used to detect microglia and astrocyte activation in the OB. TUNNEL staining was performed to detect apoptosis in the OB. Proteins in the TLR4 signaling pathway were detected by Western blot. The level of proinflammatory factor mRNA in the OB was determined by RT-PCR. RESULT: Neuroinflammation was observed in the OB of the OD group, as evidenced by glial cell activation and increased proinflammatory factor expression. The number of apoptotic cells was significantly increased in the OB of the OD group. The expression of TLR4, MyD88, and p-NF-κBp65 was significantly up-regulated in the OB of the OD group. TAK-242 treatment significantly reduced the level of IL-1ß, IL-6, and TNF-α mRNA expression, as well as activation of microglia and astrocytes in the OB tissues. CONCLUSION: TAK-242 improve olfactory function in AR mice mainly by reducing neuroinflammation and apoptosis in the OB, which may be related to blocking the TLR4/MyD88/NF-κB signaling pathway.

The imaging anatomy of ethmomaxillary sinus and its impact on chronic rhinosinusitis.

PURPOSE: The aim of this study was to investigate the pneumatization degree of ethmomaxillary sinus (EMS) and adjacent structures, and its impact on chronic rhinosinusitis (CRS). METHODS: A retrospective analysis of paranasal sinus CT scans of 996 patients was conducted. The maximum vertical diameter of EMS in the coronal plane was measured, allowing EMS to be classified, and its impact on ipsilateral CRS were examined. RESULTS: The prevalence of EMS was 11.9%. The maximum vertical diameter of EMS in the coronal plane ranged from 3.68 to 28.76 mm with a mean (± SD) of 11.32 ± 5.12 mm. The prevalence rates of EMS in CRS sides and non-CRS sides were 12.5% and 9.3%, respectively, which was significantly different (χ2 = 4.495; p < 0.05). The difference in prevalence between the three types of EMS in ipsilateral CRS was statistically significant (χ2 = 6.733; p < 0.05). The difference in Lund-Mackay (LM) score of ipsilateral CRS between the three types showed no statistically significant difference (H = 4.033; p > 0.05). CONCLUSION: EMS is a common anatomical variation with marked individual differences in shape and pneumatization degree. A higher degree of EMS pneumatization may contribute to the occurrence of CRS; this should be investigated before surgery.

miR-31 attenuates murine allergic rhinitis by suppressing interleukin-13-induced nasal epithelial inflammatory responses.

The present study aimed to investigate whether microRNA (miR)­31 exerted therapeutic potential in allergic rhinitis (AR) and to explore its underlying mechanism. Firstly, the expression levels of miR­31 were detected by reverse transcription­quantitative PCR in the nasal mucosa of patients and mice. Subsequently, an ovalbumin (OVA)­induced animal model of AR was constructed. Allergic symptom score, histopathological characteristics, OVA­specific immunoglobulin E (IgE) titers, and T­helper (Th)1 and Th2 cell­related cytokine levels were analyzed in OVA­sensitized mice, miR­31­overexpressing mice, miR­negative control mice and control mice. Furthermore, interleukin (IL)­13­stimulated nasal epithelial cells (NECs) were used to assess the effects of miR­31 on the production of IL­13­induced inflammatory cytokines and mucin 5AC by performing western blotting and ELISA. The expression levels of miR­31 were significantly decreased in the nasal mucosa of the AR group compared with those in the control group. Moreover, upregulation of miR­31 markedly attenuated sneezing and nasal rubbing events, reduced nasal eosinophil infiltration and goblet cell hyperplasia, and decreased the levels of OVA­specific IgE and Th2­related cytokines. In addition, subsequent in vitro experiments showed that upregulation of miR­31 inhibited IL­13 receptor α1 chain expression and signal transducer and activator of transcription 6 phosphorylation in NECs. Furthermore, miR­31 suppressed IL­13­induced expression of thymic stromal lymphopoietin, granulocyte­macrophage colony­stimulating factor, eotaxin and mucin 5AC in NECs. In conclusion, these data revealed that miR­31 could ameliorate AR by suppressing IL­13­induced nasal epithelial inflammatory responses, and thus may serve as a novel therapeutic target for AR.