Magnetic resonance imaging of extraocular rectus muscles abnormalities in acute acquired concomitant esotropia

AIM:To investigate the difference of medial rectus(MR)and lateral rectus(LR)between acute acquired concomitant esotropia(AACE)and the healthy controls(HCs)detected by magnetic resonance imaging(MRI).METHODS:A case-control study.Eighteen subjects with AACE and eighteen HCs were enrolled.MRI scanning data were conducted in target-controlled central gaze with a 3-Tesla magnetic resonance scanner.Extraocular muscles(EOMs)were scanned in contiguous image planes 2-mm thick spanning the EOM origins to the globe equator.To form posterior partial volumes(PPVs),the LR and MR cross-sections in the image planes 8,10,12,and 14 mm posterior to the globe were summed and multiplied by the 2-mm slice thickness.The data were classified according to the right eye,left eye,dominant eye,and non-dominant eye,and the differences in mean cross-sectional area,maximum cross-sectional area,and PPVs of the MR and LR muscle in the AACE group and HCs group were compared under the above classifications respectively.RESULTS:There were no significant differences between the two groups of demographic characteristics.The mean cross-sectional area of the LR muscle was significantly greater in the AACE group than that in the HCs group in the non-dominant eyes(P=0.028).The maximum cross-sectional area of the LR muscle both in the dominant and non-dominant eye of the AACE group was significantly greater than the HCs group(P=0.009,P=0.016).For the dominant eye,the PPVs of the LR muscle were significantly greater in the AACE than that in the HCs group(P=0.013),but not in the MR muscle(P=0.698).CONCLUSION:The size and volume of muscles dominant eyes of AACE subjects change significantly to overcome binocular diplopia.The LR muscle become larger to compensate for the enhanced convergence in the AACE.

Cochlear implant challenges encountered in tuberculous otitis media

Tuberculous otitis media(TOM) is rare in ENT department,and is frequently misdiagnosed as otitis media.Thus early systemic treatment is very important for TOM.We reported a case report with TOM to highlight development of the disease and difficulties in clinical treatment in late stage of TOM.Implantation of ossified and eroded cochlea poses many unique challenges to both the surgeon and programming learn.With thorough preparation and complete knowledge about characters of specific issues,implantation would be performed successfully,and patients with ossified cochlear could benefit from cochlear implantation.

Ozone oxidation of 4H-SiC and flat-band voltage stability of SiC MOS capacitors

We investigate the effect of ozone(O_(3))oxidation of silicon carbide(SiC)on the flat-band voltage(Vfb)stability of SiC metal–oxide–semiconductor(MOS)capacitors.The SiC MOS capacitors are produced by O_(3)oxidation,and their Vfbstability under frequency variation,temperature variation,and bias temperature stress are evaluated.Secondary ion mass spectroscopy(SIMS),atomic force microscopy(AFM),and x-ray photoelectron spectroscopy(XPS)indicate that O_(3)oxidation can adjust the element distribution near SiC/SiO_(2)interface,improve SiC/SiO_(2)interface morphology,and inhibit the formation of near-interface defects,respectively.In addition,we elaborate the underlying mechanism through which O_(3)oxidation improves the Vfbstability of SiC MOS capacitors by using the measurement results and O_(3)oxidation kinetics.

First branchial cleft cyst accompanied by external auditory canal atresia and middle ear malformation:A case report

BACKGROUND We report a rare case of first branchial cleft anomaly(FBCA)accompanied by bony atresia of the external auditory canal,middle ear malformation,and location malformation of the facial nerve according to the intraoperative findings.CASE SUMMARY A 19-year-old male patient presented to our department with a mass behind the right earlobe and recurrent postauricular swelling and pain since childhood,he also had severe hearing loss in the right ear since birth.The patient underwent surgery including mass removal,mastoidectomy,and simultaneous meatoplasty and ossiculoplasty under microscopy.No facial palsy or recurrence was noted during postoperative follow-up.CONCLUSION FBCAs are rare,and to our knowledge,this is the first report of FBCA accompanied by external auditory canal bony atresia,middle ear malformation,and location malformation of the facial nerve.An effective postauricular approach under microscopy facilitated complete lesion removal and simultaneous otologic reconstruction.

An extremely rare pedunculated lipoma of the hypopharynx: A case report

BACKGROUND Hypopharyngeal lipoma is a rare disease that can lead to asphyxiation after aspiration.Sclerotic lipoma in the hypopharynx is an extremely rare histological type.Hypopharyngeal lipoma should be resected in time after diagnosis.CASE SUMMARY An 86-year-old female patient presented to our department with a long pedunculated mass protruding from her mouth.Until this time,the patient had no dyspnea,dysphagia,or throat discomfort.Physical examination showed stable vital signs and clear consciousness.The pedicel was derived from the posterior wall of the hypopharynx.The tumor was smooth,hyperemic and dark red,about 10 cm long,and 4 cm wide.In order to prevent airway obstruction,the hypopharyngeal tumor was excised in emergent operation.The pharyngeal cavity was exposed by a mouth gag during the operation.A disposable plasma knife was used to completely remove the tumor along the base of the new organism,and no active bleeding occurred.The postoperative pathological results were sclerotic lipoma.CONCLUSION Lipoma in the pharynx is relatively rare.Patients with this condition must be referred immediately to Ear-Nose-Throat specialists and complete surgical excision should be performed as soon as possible to prevent serious complications,such as airway obstruction and death.

Electron Momentum Spectroscopy of Valence Orbitals of Cyclopentene:Nuclear Dynamics and Distorted Wave Effect

We report a measurement of electron momentum distributions of valence orbitals of cyclopentene employing symmetric noncoplanar(e,2e)kinematics at impact energies of 1200 and 1600 eV plus the binding energy.Experimental momentum profiles for individual ionization bands are obtained and compared with theoretical calculations considering nuclear dynamics by harmonic analytical quantum mechanical and thermal sampling molecular dynamics approaches.The results demonstrate that molecular vibrational motions including ring-puckering of this flexible cyclic molecule have obvious influences on the electron momentum profiles for the outer valence orbitals,especially in the low momentum region.Forπ^(*)-like molecular orbitals 3a′′,2a′′,and 3a′,the impact-energy dependence of the experimental momentum profiles indicates a distorted wave effect.

Dumbbell-shaped solitary fibrous tumor in the parapharyngeal space:A case report

BACKGROUND Solitary fibrous tumors(SFTs)occurring in the parapharyngeal space are rare,and their final diagnosis depends on pathological and immunohistochemical analyses.Once the tumor is diagnosed,complete resection and regular postoperative follow-up are required.CASE SUMMARY A 40-year-old male patient with a right parotid gland mass discovered 8 years ago was admitted to hospital.The mass showed no tenderness or local skin redness.Imaging was carried out as the patient had stable vital signs and showed that the mass was a dumbbell-shaped tumor comprising a superficial tumor approximately 5 cm long and 3 cm wide in size that compressed the right parotid gland and a deep tumor located in the right parapharyngeal space approximately 4.5 cm long and 2.5 cm wide in size.Both tumors were connected in the middle.Prior to surgery,the tumors were considered to be parapharyngeal schwannomas.During surgical dissection,the tumors were found to be smooth and tough,without obvious adhesion to the surrounding tissues.The tumors were revealed to be a SFT following postoperative pathological analysis.CONCLUSION SFTs in the parapharyngeal space are rarely reported,and complete resection of such tumor is recommended.Adjuvant chemoradiotherapy is used in patients with extensive tumor invasion to lower the recurrence rate.Postoperative longterm follow-up is required.

Approximation Algorithms for Multi-vehicle Stacker Crane Problems

We study a variety of multi-vehicle generalizations of the Stacker Crane Problem(SCP).The input consists of a mixed graph G=(V,E,A)with vertex set V,edge set E and arc set A,and a nonnegative integer cost function c on E∪A.We consider the following three problems:(1)k-depot SCP(k-DSCP).There is a depot set D⊆V containing k distinct depots.The goal is to determine a collection of k closed walks including all the arcs of A such that the total cost of the closed walks is minimized,where each closed walk corresponds to the route of one vehicle and has to start from a distinct depot and return to it.(2)k-SCP.There are no given depots,and each vehicle may start from any vertex and then go back to it.The objective is to find a collection of k closed walks including all the arcs of A such that the total cost of the closed walks is minimized.(3)k-depot Stacker Crane Path Problem(k-DSCPP).There is a depot set D⊆V containing k distinct depots.The aim is to find k(open)walks including all the arcs of A such that the total cost of the walks is minimized,where each(open)walk has to start from a distinct depot but may end at any vertex.We present the first constant-factor approximation algorithms for all the above three problems.To be specific,we give 3-approximation algorithms for the k-DSCP,the k-SCP and the k-DSCPP.If the costs of the arcs are symmetric,i.e.,for every arc there is a parallel edge of no greater cost,we develop better algorithms with approximation ratios max{9/5,2−1/2k+1},2,2,respectively.All the proposed algorithms have a time complexity of O(|V|3)except that the two 2-approximation algorithms run in O(|V|2log|V|)time.

Finite Element Analysis of Mobile-bearing Unicompartmental Knee Arthroplasty： The Influence of Tibial Component Coronal Alignment

Background： Controversies about the rational positioning of the tibial component in unicompartmental knee arthroplasty （UKA） still exist. Previous finite element （FE） studies were rare, and the results varied. This FE study aimed to analyze the influence of the tibial component coronal alignment on knee biomechanics in mobile-bearing UKA and find a ration range of inclination angles. Methods： A three-dimensional FE model of the intact knee was constructed from image data of one normal subject. A 1000 N compressive load was applied to the intact knee model for validating. Then a set of eleven UKA FE models was developed with the coronal inclination angles of the tibial tray ranging from 10° valgus to 10° varus. Tibial bone stresses and strains, contact pressures and load distribution in all UKA models were calculated and analyzed under the unified loading and boundary conditions. Results： Load distribution, contact pressures, and contact areas in intact knee model were validated. In UKA models, von Mises stress and compressive strain at proximal medial cortical bone increased significantly as the tibial tray was in valgus inclination 〉4°, which may increase the risk of residual pain. Compressive strains at tibial keel slot were above the high threshold with varus inclination 〉4°, which may result in greater risk of component migration. Tibial bone resection comer acted as a strain-raiser regardless of the inclination angles. Compressive strains at the resected surface slightly changed with the varying inclinations and were not supposed to induce bone resorption and component loosening. Contact pressures and load percentage in lateral compartment increased with the more varus inclination, which may lead to osteoarthritis progression. Conclusions： Static knee biomechanics after UKA can be greatly affected by tibial component coronal alignment. A rauge from 4° valgus to 4° varus inclination oftibial component can be recommended in mobile-bearing UKA.

Incidence of Vascular Anomalies and Variants Associated with Unilateral Venous Pulsatile Tinnitus in 242 Patients Based on Dual-phase Contrast-enhanced Computed Tomography

Background：A comprehensive assessment of various vascular anomalies and variants associated with venous pulsatile tinnitus （PT） by radiography is essential for therapeutic planning and improving the clinical outcome.This study evaluated the incidence of various vascular anomalies and variants on the PT side and determined whether these lesions occurred as multiple or single entities.Methods：The dual-phase contrast-enhanced computed tomography images of 242 patients with unilateral venous PT were retrospectively reviewed.The vascular anomalies and variants on the symptomatic and asymptomatic sides were analyzed,and the incidences of anomalies or variants on each side were compared.The number of anomalies and variants on the symptomatic side in each patient was calculated.Results：（1） A total 170 patients （170/242） had more than one anomaly or variant on the symptomatic side,and 58 patients （58/242） had a single lesion on tomography.（2） There was a statistically significant difference in the incidence of dehiscent sigmoid plate （P =0.000）,lateral sinus stenosis （P =0.014）,high jugular bulb （P =0.000）,sigmoid sinus diverticulum （P =0.000）,jugular bulb diverticulum （P =0.000）,dehiscent jugular bulb （P =0.000）,and a large emissary vein （P =0.006） between the symptomatic and asymptomatic sides.（3） Dehiscent sigmoid plate （86.4%） was the most frequent lesion on the symptomatic side,followed by lateral sinus stenosis （55.8%）,high jugular bulb （47.1%）,sigmoid sinus diverticulum （34.3%）,jugular bulb diverticulum （13.6%）,dehiscent jugular bulb （13.6%）,large emissary vein （4.1%）,sinus thrombosis （1.2%）,and petrosquamosal sinus （0.8%）.Conclusions：Various vascular anomalies and variants occur more frequently on the venous PT side.Preliminary findings suggest that venous PT patients may have multiple vascular anomalies or variants on the symptomatic side.

Lactobacillus crispatus Modulates Vaginal Epithelial Cell Innate Response to Candida albicans

Background： Vulvovaginal candidiasis is caused by Candida albicans. The vaginal epithelium, as the first site of the initial stage of infection by pathogens, plays an important role in resisting genital tract infections. Moreover, lactobacilli are predominant members of the vaginal microbiota that help to maintain a normal vaginal microenvironment. Therefore, Lactobacillus crispatus was explored for its capacity to intervene in the immune response of vaginal epithelial cells VK2/E6E7 to C. albicans. Methods： We examined the interleukin-2 （IL-2）, 4, 6, 8, and 17 produced by VK2/E6E7 cells infected with C. albicans and treated with L. crispatus in vitro. The capacity ofL. crispatus to adhere to VK2/E6E7 and inhibit C. albicans growth was also tested by scanning electron microscopy （SEM） and adhesion experiments. Results： Compared with group VK2/E6E7 with C. albicans, when treated with L. crispatus, the adhesion of C. albicans to VK2/E6E7 cells decreased significantly by 52.87 ± 1.22%, 47.03 ± 1.35%, and 42.20 ± 1.55% under competition, exclusion, and displacement conditions, respectively. SEM revealed that the invasion of C. albicans into VK2/E6E7 cells was caused by induced endocytosis and active penetration. L. crispatus could effectively protect the cells from the virulence ofhyphae and spores of C. albicans and enhance the local immune function of the VK2/E6E7 cells. The concentrations of IL-2, 6, and 17 were upregulated significantly （P 〈 0.0 1） and that of IL-8 were downregulated significantly （P 〈 0.0 1） in infected VK2/E6E7 cells treated with L. crispatus. The concentration of IL-4 was similar to that of the group VK2/ E6E7 with C. albicans （24.10 ± 0.97 vs. 23.12 ±0.76 pg/ml, P= 0.221）. Conclusions： L. crispatus can attenuate the virulence of C. albicans, modulate the secretion of cytokines and chemokines, and enhance the immune response of VK2/E6E7 cells in vitro. The vaginal mucosa has a potential function in the local immune responses against pathogens that can be promoted by L. crispatus.

Species Distribution and In Vitro Antifungal Susceptibility of Vulvovaginal Candida Isolates in China

Background： Vulvovaginal candidiasis （WC） was a common infection associated with lifelong harassment of woman＇s social and sexual life. The purpose of this study was to describe the species distribution and in vitro antifungal susceptibility of Candida species （Candida spp.） isolated from patients with VVC over 8 years. Methods： Species which isolated from patients with VVC in Peking University First Hospital were identified using chromogenic culture media. Susceptibility to common antifungal agents was determined using agar diffusion method based on CLSI M44-A2 document. SPSS software （version 14.0, Inc., Chicago, IL, USA） was used for statistical analysis, involving statistical description and Chi-square test. Results： The most common strains were Candida （C.） albicans, 80.5% （n = 1775） followed by C. glabrata, 18.1% （n = 400）. Nystatin exhibited excellent activity against all species （〈4% resistant JR]）. Resistance to azole drugs varied among different species. C. albicans： clotrimazole （3.1% R） 〈 fluconazole （ 16.6% R） 〈 itraconazole （51.5% R） 〈 mieonazole （54.0% R）, C. glabrata： miconazole （25.6% R） 〈 clotrimazole （50.5% R） 〈 itraconazole （61.9% R） 〈 fluconazole （73.3% R）; Candida krusei： clotrimazole （0 R） 〈 fluconazole （57.7% R） 〈 miconazole （73.1% R） 〈 itraconazole （83.3% R）. The susceptibility of fluconazole was noticeably decreasing among all species in the study period. Conclusions： Nystatin was the optimal choice for the treatment of VVC at present. The species distribution and in ~＇itro antifungal susceptibility of Candida spp. isolated from patients with VVC had changed over time.

Significance of Lateral Pillar in Osteonecrosis of Femoral Head:A Finite Element Analysis

Background： The lateral pillar of the femoral head is an important site for disease development such as osteonecrosis of the femoral head. The femoral head consists of medial, central, and lateral pillars. This study aimed to determine the biomechanical effects of early osteonecrosis in pillars of the femoral head via a finite element （FE） analysis. Methods： A three-dimensional FE model of the intact hip joint was constructed from the image data of a healthy control. Further, a set of six early osteonecrosis models was developed based on the three-pillar classification. The von Mises stress and surface displacements were calculated for all models. Results： The peak values of von Mises stress in the cortical and cancellous bones of normal model were 6.41 MPa and 0.49 MPa, respectively. In models with necrotic lesions in the cortical and cancellous bones, the von Mises stress and displacement of lateral pillar showed significant variability： the stress of cortical bone decreased from 6.41 MPa to 1.51 MPa （76.0% reduction）, while cancellous bone showed an increase from 0.49 MPa to 1.28 MPa （159.0% increase）; surface displacements of cortical and cancellous bones increased from 52.4 μm and 52.1 μm to 67.9 μm （29.5%） and 61.9 μm （18.8%）, respectively. In addition, osteonecrosis affected not only pillars but also adjacent structures in terms of the von Mises stress and surface displacement levels. Conclusions： This study suggested that the early-stage necrosis in the femoral head could increase the risk of collapse, especially in lateral pillar. On the other hand, the cortical part of lateral pillar was found to be the main biomechanical support of femoral head.

Evaluation of the vaginal microbiome in clinical diagnosis and management of vaginal infectious diseases

When patients attend with medical complaints such as abnormal leucorrhea,the clinician should consider the possibility of an infection in the lower genital tract,such as vulvovaginal candidiasis (WC).At that point,it is appropriate to then further assess the typical clinical manifestation,diagnosis,and routine management of the infection.However,sometimes,it is not possible to detect any pathogen at all through standard diagnostic techniques.In such a scenario,what happens to these patients?

A modified technique for tibial bone sparing in unicompartmental knee arthroplasty

Background:Previously,the authors modified the surgical technique to preserve tibial bone mass for Oxford unicompartmental knee arthroplasty(UKA).The purpose of this study was to determine the clinical outcomes and values of this modified technique.Methods:Clinical data of 34 consecutive patients who underwent the unilateral modified UKA technique(modified group,34 knees)were retrospectively analyzed.To compare the outcome,a match-paired control group(conventional group,34 knees)of an equal number of patients using the conventional technique system in the same period were selected and matched with respect to diagnosis,age,pre-operative range of motion(ROM),and radiological grade of knee arthrosis.Clinical outcomes including knee Hospital for Special Surgery(HSS)score,ROM,and complications were compared between the two groups.Post-operative radiographic assessments included hip-knee-ankle angle(HKA),joint line change,implant position,and alignment.Results:The mean follow-up time was 38.2±6.3 months.There was no difference in baseline between the two groups.The amount of proximal tibial bone cut in the modified group was significantly less than that of the conventional group(4.7±1.1 mm vs.6.7±1.3 mm,t=6.45,P<0.001).Joint line was elevated by 2.1±1.0 mm in the modified group compared with-0.5±1.7 mm in the conventional group(t=-7.46,P<0.001).No significant differences were observed between the two groups after UKA with respect to HSS score,VAS score,ROM,and HKA.Additionally,the accuracy of the post-operative implant position and alignment was similar in both groups.As for implant size,the tibial implant size in the modified group was larger than that in the conventional group(x^2=4.95,P=0.035).Conclusions:The modified technique for tibial bone sparing was comparable with the conventional technique in terms of clinical outcomes and radiographic assessments.It can preserve tibial bone mass and achieve a larger cement surface on the tibial side.

Systematic analysis of protein expression in Candida albicans exposed to farnesol

Background:The phenotypic switching of Candida spp.plays an important role in the development of vulvovaginal candidiasis(VVC).Farnesol,as a quorum-sensing molecule in Candida albicans,has the ability to prevent yeast-to-hyphal conversion in vitro.However,the mechanism underlying this ability is unclear.This study aimed to investigate changes in protein levels to better understand how farnesol impacts processes contributing to VVC.Methods:The isobaric tag for relative and absolute quantitation technique was used to detect protein expression in C.albicans strain SC5314(ATCC MYA-2876)with or without farnesol exposure.Proteins with a threshold fold change greater than 1.5 were screened and considered differentially expressed proteins.All the altered proteins were analyzed using Gene Ontology annotation,Kyoto Encyclopedia of Genes and Genomes(KEGG)annotation,and metabolic pathway annotation.Results:Between the farnesol-exposed group and the farnesol-unexposd group,we detected 297 altered proteins among all 2047 tested proteins based on a threshold fold change of more than 1.5(P<0.05).Eighty-seven of the 297 altered proteins exhibited metabolic enzyme activity and participated in 85 metabolic pathways according to KEGG pathway analysis.Most of these metabolic pathways were associated with central carbon metabolism processes.In the sterol synthesis pathway,which involves the synthesis of farnesol,ERG25(methylsterol monooxygenase)and ERG4(delta 24(24(1))-sterol reductase)were both down-regulated in the farnesol-exposed group.All six altered proteases associated with the oxidative phosphorylation process were down-regulated in the farnesol-exposed group relative to the farnesol-unexposed group.Conclusions:The mechanisms underlying farnesol-induced phenotype switching involves the adjustment of metabolic activities and epigenetic modification.Exogenous farnesol had an evident,but non-deterministic effect on the synthesis of ergosterol.The potential drug activity of farnesol warrants further investigation.

Phytosphinganine Affects Plasmodesmata Permeability via Facilitating PDLP5-Stimulated Callose Accumulation in Arabidopsis

Plant plasmodesmata (PDs) are specialized channels that enable communication between neighboring cells. The intercellular permeability of PDs, which affects plant development, defense, and responses to stimuli, must be tightly regulated. However, the lipid compositions of PD membrane and their impact on PD permeability remain elusive. Here, we report that the Arabidopsis sld1 sld2 double mutant, lacking sphingolipid long-chain base 8 desaturases 1 and 2, displayed decreased PD permeability due to a significant increase in callose accumulation. PD-located protein 5 (PDLP5) was significantly enriched in the leaf epidermal cells of sld1 sld2 and showed specific binding affinity to phytosphinganine (t18:0), suggesting that the enrichment of t18:0-based sphingolipids in sld1 sld2 PDs might facilitate the recruitment of PDLP5 proteins to PDs. The sld1 sld2 double mutant seedlings showed enhanced resistance to the fungal-wilt pathogen Verticillium dahlia and the bacterium Pseudomonas syringae pv. tomato DC3000, which could be fully rescued in sld1 sld2 pdlp5 triple mutant . Taken together, these results indicate that phytosphinganine might regulate PD functions and cell-to-cell communication by modifying the level of PDLP5 in PD membranes.

Effect of High-fat Diet-induced Disorders on Rat with Endometrial Hyperplasia and Adiponectin System in Circulation and Uterus

Background：Epidemiologic and genetic studies suggest a link between insulin resistance （IR） and endometrial cancer,and endometrial hyperplasia （EH） is a precancerous stage of endometrial cancer.Adiponectin is an adipokine which previously shown to be a risk factor for endometrial cancer.The aim of the study was to develop a rat model of IR and EH and evaluate adiponectin system in circulation and uterus.Methods：This study was a 46-week animal trial from February 2014 to January 2015.Female Sprague-Dawley rats were fed with high-fat diet （HFD） for 40 weeks to induce IR.Followed by ovariectomization,rats were orally administrated to 173-estradiol （E2） for 4 weeks to induce EH and then sacrificed.A total of 36 rats were divided into four groups：E2,HFD,HFD ＋ E2,and control groups.Data were analyzed with Student＇s t-test,one-way analysis of variance （ANOVA）,and Mann-Whitney U-tests.Chi-square was used to evaluate the score of immunohistochemistry.Results：The thickness ofendometrial,glandular epithelium,and myometrium in the HFD-E2 group were higher than the E2 group （F=59.02,F=23.51 and F =12.53,respectively,all P 〈 0.00 1）.Plasma adiponectin levels in the E2 group were lower than those in the control group,and the levels in the HFD-E2 group were lower than those in the HFD group （F =13.15,P 〈 0.05）.However,after normalized to visceral adipose tissue,compared to the control group,plasma adiponectin levels were decreased in rat with HFD in the absence or presence of E2,respectively （F =6.72,P 〈 0.05）.Adiponectin gene （F =10.48,P 〈 0.05） and protein （P 〈 0.05） levels in uterus in the HFD-E2 group were higher than those in the HFD group.Conclusions：This study manifests that IR can effectively modulate EH,which suggests the involvement of energetic metabolism in uterine alternation.The combination effects of IR and EH modulate circulating adiponectin levels.However,adiponectin gene and protein levels in uterus are mainly response to estradiol.

Transcutaneous auricular vagus nerve stimulation for impaired glucose tolerance:a randomized controlled trial Protocol

Background:impaired glucose tolerance(IGT)is the early stage of diabetes and it would be deteriorated to type 2 diabetes mellitus(T2 DM)easily if no intervention provided.In western medicine,drug therapy assisted with the intervention of lifestyle is predominated.However,drug therapy brings serious side effect and high prices,while lifestyle intervention is difficult to be insisted on by patients.Therefore,a green and effective intervention mode is urgently needed.Transcutaneous auricular vagus nerve stimulation(taVNS)is a noninvasive and green therapeutic method based on the theory of traditional Chinese medicine(TCM),which can regulate glucose metabolism and reduce blood glucose,but the clinical effect of it has not been clarified yet at present.Hence,this randomized controlled trial(RCT)aims at exploring the effectiveness and safety of taVNS in the treatment of IGT.Methods:a total of 158 patients with IGT will be randomized into a taVNS group and a transcutaneous non-auricular vagus nerve stimulation(tnVNS)group,79 cases in each one.In the taVNS group and the tnVNS group,electric stimulation would be applied to Yidan(胰胆pancreas and gallbladder,CO11)and Pi(脾spleen,CO13)on auricular concha and Jian(肩shoulder SF4,5)on auricular rim respectively.The electric stimulation parameters would be the same in the patients of two groups,for 30 min in each treatment,twice a day,6 weeks as one course and 2 courses of treatment required totally.In week 0,6 and 12 of intervention,the effectiveness indicators would be determined,i.e.fasting plasma glucose(FPG),2 h plasma glucose(2 hPG)and glycosylated hemoglobin(HbA1c)successively.On week 0 and 12,body mass index(BMI)would be calculated,respiration,pulse and blood pressure would be recorded separately.Discussion:through observing the regulatory effect of taVNS on FPG,2 hPG,HbAlc and BMI as well as the adverse reactions,the effectiveness and safety of taVNS in treatment of IGT would be evaluated.This study will provide a safe,effective,convenient and nontoxic side effect intervention for clinical treatment of IGT and prevention from the occurrence and development of T2DM.

Magnetic Resonance Imaging Features of Extraocular Muscle Lymphoma in Five Cases

Lymphoma is the most common primary orbital malignant neoplasm in adults,accounting for 8-15% of extranodal non-Hodgkin＇s lymphomas and 2% of all lymphomas.Most of these tumors involve the conjunctiva,orbit,lacrimal gland,or eyelid.It is uncommon for lymphoma to originate from the extraocular muscles.The prevalence of intramuscular lymphoma is between 0.1% and 8.7% of all extranodal lymphomas.Fewer than 60 cases have been reported in the last 30 years, mostly as case reports with scant or no radiology information.