简介：AbstractMany factors can cause inner ear injury, such as noise exposure, chemicals, viral infection, and radiation. The main pathological manifestations of inner ear injury are local hypoxia-ischemia, micro-trauma, and an increased level of reactive oxygen species and inflammatory mediators. The contribution of the inflammatory response to the mediation of cochlear and vestibular pathologies has received increasing attention in recent years. Aseptic inflammation can devastate audition and balance, which can lead to many typical clinical inner ear diseases. In this review, we will discuss the most pertinent and recent research on inflammatory mechanisms in inner ear injury. We will also discuss the pathophysiology of some common and significant ear diseases, such as sudden sensorineural hearing loss, age-related hearing loss, noise-induced hearing loss, and Meniere’s disease.

简介：AbstractObjective:To evaluate the necessity and effectiveness of a preplanned technique for drilling during transcanal endoscopic ear surgery.Methods:Study design: Retrospective case series study from June 2011 to June 2015. Setting: Private tertiary care hospital. Patients: Eighty-five ears of 78 patients, age ranging from 9 to 57 years underwent transcanal endoscopic drilling for various types of pathology in their middle and external ear. Interventions: Application of a preplanned technique for transcanal drilling in endoscopic ear surgery that involved short timed drilling with use of intermittent irrigation and suction. Every events of the procedure were done one after another with the single hand of the surgeon. An attachment providing protecting sheath around rotating burr was used during each time of drilling. Main outcomes measure: Efficacy of such drilling technique in single handed endoscopic ear surgery. Presence of any postoperative thermal injury of facial nerve and any lacerated injury of skin of external ear.Results:This preplanned technique was found suitable for transcanal endoscopic drilling with the single hand of the surgeon. Postoperative facial nerve palsy or laceration of skin of external ear was not noted in any patient.Conclusion:After using the present technique, transcanal endoscopic drilling could be done easily and safely with single hand of the surgeon.

简介：AbstractThe development of applications for the CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/CRISPR-associated nuclease 9) system has increased greatly in recent years, especially in the area of gene therapy by efficient in vivo genome editing. Although great success has been achieved in repairing and rewriting genomes through homology-directed repair coupled with Cas9 nuclease cleavage, its in vivo efficiency is insufficient for gene therapy. Base editing is a next-generation genome-editing tool that does not involve double-stranded DNA breaks and uses components of the CRISPR system together with other enzymes to make point mutations directly in cellular DNA or RNA. Base editors, composed of an engineered deaminase and a catalytically impaired CRISPR/Cas9 variant, are powerful tools for targeted base editing in cells and organisms. In non-dividing cells, base editors can directly transform one base or base pair into another, efficiently installing a point mutation. Undesired by-products of editing are seldom generated during this procedure. Herein we review the different base-editing platforms, including their deaminase recruitment strategies and editing outcomes, and the in vivo delivery of base editors. Additionally, we summarize therapeutic applications of base editing in disorders of the inner ear.

简介：摘要ObjectiveTo establish the local data on the growth of ear in Hong Kong children and provide a reference for the timing of reconstruction in unilateral microtia.MethodsWe reviewed case notes of paediatric patients up to 18 years of age who had attended our Ear, Nose and Throat Out-patient Clinic from March to November 2017. We recorded the pinna length of these patients and that of their parents, compared the patients’ ear length against that of their parents, and investigated any discrepancy of pinna.ResultsWe recruited 226 local individuals (139 males and 87 females). The patients were divided into different age groups. The means of ear length of patients were compared with the mean length of pinna of their parents. Data of boys and girls are analyzed separately. Boys at 7－8 years old achieved 87.33% and 93.54% of their fathers’ and mothers’ ear length respectively. Girls at 7－8 years old achieved 83.00% and 90.80% of their fathers’ and mothers’ ear length respectively. Moreover, the average ratio of the length of left and right ear ratio is 97.3% in all groups of children.ConclusionsIn Hong Kong children, at the age of 7－8 the ear approaches the size of normal adult ear and is the feasible age with less asymmetry after reconstruction of the microtia.

简介：AbstractObjective:To determine anatomic relationships and variation of the round window membrane to bony surgical landmarks on computed tomography.Study design:Retrospective imaging review.Methods:100 temporal bone images were evaluated. Direct measurements were obtained for membrane position. Vector distances and angulation from umbo and bony annulus were calculated from image viewer software coordinates.Results:The angle of round window membrane at junction with cochlear basal turn was (42.1 ± 8.6)°. The membrane’s position relative to plane of the facial nerve through facial recess was (14.7 ± 5.2)° posterior from a reference line drawn through facial recess to carotid canal. Regarding transtympanic drug delivery, the round window membrane was directed 4.1 mm superiorly from the inferior annulus and 5.4 mm anteriorly from the posterior annulus. The round window membrane on average was angled superiorly from the inferior annulus (77.1 ± 27.9)° and slightly anteriorly from the posterior annulus (19.1 ± 11.1°). The mean distance of round window membrane from umbo was 4 mm and posteriorly rotated 30° clockwise from a perpendicular drawn from umbo to inferior annulus towards posterior annulus. Together, these measurements approximate the round window membrane in the tympanic membrane’s posteroinferior quadrant.Conclusions:These radiologic measurements demonstrate normal variations seen in round window anatomy relative to facial recess approach and bony tympanic annulus, providing a baseline to assess round window insertion for cochlear implantation and outlines anatomic factors affecting transtympanic drug delivery.

简介：摘要本文围绕地铁安防系统集成方案的议题进行了研究和探讨，分析了地铁安防系统区别于其他安防系统的特征，论述了地铁安防系统当下及未来的发展趋势，论述了地铁安防管理系统的架构以及安防管理系统的解决方案，旨在不断提升我国地铁安防系统的安全性、稳定性，更好地为社会民众服务。

简介：摘要测量技术是实现铁路安全、舒适运营的重要技术支撑。随着测绘信息化、测绘新装备的发展和铁路建设需求,铁路测量规范不断发展。另外，随着现代高速铁路行业的进一步发展，我们国家对于社会的铁路工程建设也投入了很大的成本和精力，对于铁路工程测量精度和测量模式的要求也在随着我们的社会科学进步的发展而越来越提高，铁路的工程测量与许多因素有关，其中比较重要的方面就是对于铁路的测量准确度的把握和提升，本文就是从铁路设计、施工、运营角度论证铁路工程测量的精度要求，提出新的铁路工程测量模式，阐述改变目前铁路工程测量流程和方式的优越性和可行性。

简介：摘要测量技术是实现铁路安全、舒适运营的重要技术支撑。随着测绘信息化、测绘新装备的发展和铁路建设需求,铁路测量规范不断发展。另外，随着现代高速铁路行业的进一步发展，我们国家对于社会的铁路工程建设也投入了很大的成本和精力，对于铁路工程测量精度和测量模式的要求也在随着我们的社会科学进步的发展而越来越提高，铁路的工程测量与许多因素有关，其中比较重要的方面就是对于铁路的测量准确度的把握和提升，本文就是从铁路设计、施工、运营角度论证铁路工程测量的精度要求，提出新的铁路工程测量模式，阐述改变目前铁路工程测量流程和方式的优越性和可行性。

简介：

简介：摘要大树是指胸径在10cm以上的乔木树种，由于大树移植成活率低，极易发生枝条干枯、死亡等现象，因此，掌握正确的移栽管理技术非常重要。每年的早春1月下旬至2月上旬树木处于休眠或半休眠状态，生长势弱，代谢活动缓慢，为大树最佳移植时间。本文着重分析大树春季移植的技术方案。

简介：摘要接触网支柱折断故障是一种较严重的接触网故障，一般破坏性比较严重，抢修难度大，中断行车，严重影响列车运输秩序，抢修时间较长。本文通过对接触网支柱折断后果及原因进行分析，阐述了接触网支柱折断故障时所遵循的抢修原则，准备工作、抢修方案以及注意事项，重点介绍了锚柱折断抢修方案，并针对性的提出了一些建议和预防措施。

简介：本文分析了目前主流的储热技术，提出了适合开展大规模集中供暖的几种储热技术。并针对这几种技术进行分析，从技术方案、设备、关键技术以及经济性等几个角度进行了分析，给相关项目的方案比选和设计提供一定的参考。关键词储热技术供暖前言

简介：摘要目的构建基于SSKIN集束化方案的俯卧位通气（PPV）患者面部压力性损伤护理方案，为临床护理实践提供指导。方法以SSKIN集束化方案为指导，总结现有研究证据，初步构建PPV患者面部压力性损伤护理方案。于2021年8—9月选取19名护理专家进行2轮德尔菲专家函询，根据专家意见对方案条目进行修改。结果2轮专家函询均发放问卷19份，回收有效问卷19份，有效回收率均为100.00%；专家权威系数均为0.85；第2轮专家函询各条目重要性和可操作性肯德尔和谐系数分别为0.48、0.41（P均<0.01）。最终形成PPV患者面部压力性损伤护理方案包括5个框架，即皮肤评估、支撑面、体位变换、潮湿处理、营养支持，共27个条目。结论本研究构建的基于SSKIN集束化方案的PPV患者面部压力性损伤护理方案具有科学性、可行性和较强的临床实用价值，能够为临床护理实践提供指导。

简介：摘要目的比较YEARS方案和简化Wells联合年龄调整D-二聚体（sWells-Age）方案在可疑急性肺栓塞患者评估中的价值。方法纳入2016至2017年浙江省人民医院行CT肺动脉造影（CTPA）检查的可疑急性肺栓塞患者285例，其中男155例，女130例，年龄18~89岁，中位年龄66岁。以CTPA为诊断标准，比较两种方案在总体以及按照院内/院外起病进行亚组分层后的患者中评估的差异。结果285例中80例患者经CTPA确诊急性肺栓塞（80/285，28.1%），两种方案的诊断一致性好（κ值为 0.855，P<0.05）。YEARS方案有效性为21.8%，sWells-Age方案有效性为17.2%，失败率分别为1.6%和0.0%，特异度分别为29.8%和23.9%（P<0.05），敏感度分别为98.8%和100.0%。在不同起病地点（院内、院外）的亚组分析中发现：院外起病患者YEARS方案和sWells-Age方案的有效性分别为33.0%和26.9%，特异度分别为44.7%和37.1%（P<0.05）；院内起病患者YEARS方案和sWells-Age方案的有效性分别为1.9%和0.0%，特异度分别为2.7%和0.0%。结论两种方案的诊断一致性好，失败率低，均可安全地排除可疑急性肺栓塞患者。YEARS方案较sWells-Age方案可安全地排除更多的可疑急性肺栓塞患者，尤其是院外起病的患者。但两种方案对院内起病的患者均不适用。

简介：摘要矿用刮板输送机是一种用来将煤输送至皮带机的输送设备，它中间部分由过渡槽和多节中部槽连接而成，机槽由钢板隔成上、下槽，槽内装刮板链。刮板链可以将煤刮至输送带，由于传动和联接是机械式的，阻力较大，再加上是机头、机尾双驱动，所以两台电机的启动时机就成为一个较为核心的问题。

简介：摘要企业的数字环境是基于设计研发，生产，销售一体化，研发驱动+销售拉动的闭环生态数据链。整个闭环的商品数据源头和终点都是在研发环节。而不是在销售产品的下市。所以，我们要打造一个闭环生态数据链，一定要解决研发数字化的问题。PLM产品生命周期管理，起到一个很核心的作用。情报采集，商品企划，设计企划，设计样衣开发，大货样衣数据调整，模板库我们将从这几个方面进行探讨。

简介：摘要当前，随着社会经济的快速发展以及人们对河流的过度开发，给地方的河流造成了诸多压力，河流生态系统的平衡受到极大破坏，河流所面临的淤积以及水环境的恶化现象也越发严重，这些在很大程度上影响到居民的生活质量以及身体健康。近年来，全国各地开始高度重视河道修防整治工作。本文主要根据河道修防整治工作现状，指出了修防整治中存在的问题，并提出了可行性治理方案，以期望改善河流生态环境，营造和谐优美的人居环境。

简介：摘要本文分析配煤方案对两种煤进行相配，根据配煤的目标值和原料煤的煤质数据计算配煤比。确定配煤比时，配煤产品的主要指标发热量和硫分的理论值与其目标值要有适量的余地，即发热量应高于目标值，而硫分应低于目标值。通过采用多项参数建立起数学模型，使配煤炼焦设计方案得到优化。

简介：摘要矿用刮板输送机是一种用来将煤输送至皮带机的输送设备，它中间部分由过渡槽和多节中部槽连接而成，机槽由钢板隔成上、下槽，槽内装刮板链。刮板链可以将煤刮至输送带，由于传动和联接是机械式的，阻力较大，再加上是机头、机尾双驱动，所以两台电机的启动时机就成为一个较为核心的问题。

简介：摘要目的探讨影响甲状腺髓样癌（medullary thyroid carcinoma，MTC）治疗方案制订与转归的关键要素。方法回顾性分析2007年4月至2020年3月湖南省人民医院乳甲外科收治的23例MTC患者病例资料、典型病例的临床特点及生存随访结果，结合ATA等指南对MTC治疗方案和转归进行分析。结果23例MTC中，有22例（95.65%）术前血清降钙素（calcitonin，Ctn）不同程度的升高；15例（65.22%）术前癌胚抗原（carcinoembryonic antigen，CEA）不同程度的升高；3例（13.04%）术前超声及增强CT提示颈部有可疑异常淋巴结；2例（8.70%）术中探查可见包膜侵犯。23例中行患侧甲状腺腺叶切除术1例、患侧甲状腺腺叶切除术+患侧中央区淋巴结清扫术2例、甲状腺全切术3例、甲状腺全切术+患侧中央区淋巴结清扫术1例、甲状腺全切术+双侧中央区淋巴结清扫术13例、甲状腺全切术+双侧中央区淋巴结清扫术+单侧侧颈区淋巴结清扫术3例。8例（34.78%）术后出现复发，其中有7例为第一次手术不规范导致。2例术前Ctn明显升高，仅行甲状腺全切+双侧中央区淋巴结清扫术，术后未见复发。结论规范化的手术治疗是MTC生物治愈的关键，但也不能简单参照如Ctn等单一因素来决定手术方式，MTC现代治疗方案需同时遵循规范化原则及个体化原则来制定。