Objective To investigate the clinical value of transumbilical endoscopic thoracic sympathectomy on women patients with palmar hyperhidrosis.Methods A total of 25 consecutive women patients with palmar hyperhidrosis underwent transumblical thoracic sympathectomy with ultra-thin endoscope.The operative data,including duration of operation,intra-operative and postoperative complications were recorded.Results The procedure was performed successfully in all 25 patients with a mean operative time of 64 min(58-113 min).No umbilical hernia,diaphragmatic hernia,Horner's syndrome or hemothorax were observed.Minor pneumothorax was found in postoperative chest X-ray in 3 patients,all of which were completely resolved with conservative treatment.All patients recovered to their normal life at 1 week after discharge.The scar was small and hidden in umbilical with no visible incisions.After a follow-up of 4 to 12 months,all patients' hands sweating symptoms completely disappeared,axillary sweat symptoms completely resolved in 6 patients,significantly improved in 4 and mildly improved in 1.Conclusion Transumbilical thoracic sympathectomy with ultrathin flexible endoscope is a safe and effective option for women patients with severe palmar hyperhidrosis,which provides excellent cosmetic outcomes.

Administration, Oral ; Calcium Compounds ; poisoning ; Humans ; Sulfides ; poisoning

Objective To survey on the intention of seeking pediatric service in primary care institutions among parents in Shanghai rural area .Methods A survey on the intention of pediatric care-seeking was conducted during June to December in 2016 using simple random sampling method in Fengxian District of Shanghai.Subjects were choosen from the parents visiting pediatric department in Xidu Community Health Center ( CHC) (289 ), parents having kids in the local kindergarten ( 121), and medical staff working in this district with children under age 14 (205).Results Total 615 individuals were surveyed and 572 responded with a response rate of 93.0%.The age of participants was (32.1 ±6.4) years, and they were 191 males and 381 females.Among all responders, 88.4%(505/571) wanted to have pediatric service in CHC, 9.5%(54/571) did not care and 2.1%(12/571) did not want.If the CHC had service provided by pediatric specialists , 81.5%( 466/572) intended to seek pediatric care in CHC , 10.8%(62/572) did not care and 7.7%(44/572) did not want.If the general practitioner provided pediatric service, the rates were 51.9%(297/572), 12.1%(69/572) and 36.0%(206/572), respectively.In comparison, the intention to seek care provided by pediatric specialists was stronger (Z ＝-12.553, P ＜0.001). Parents who were not medical professionals preferred to set pediatric clinic in CHC ( OR ＝6.849, P ＝0.026); parents who were not Shanghai residents preferred to see pediatric specialists (OR＝2.732, P＝0.033).Parents who were older than 30 years (OR＝1.770, P＝0.013), who were medical professionals (OR＝2.093, P＝0.003) or having children aged 0-3 years (OR＝2.154, P＝0.001) preferred to visit general practice clinics .Only 11.7%(66/562) would choose CHC when their children were ill . Parents who were older than 30 years (OR＝2.083, P＝0.038) or whose family income was less than 8 000 yuan/m (OR＝1.967, P＝0.030) preferred to choose CHC.The reason for choosing CHC was close to home for 93.8%(61/65) and good treatment effect for only 18.5%(12/65).The expectations of pediatrics in CHC included more comprehensive medical equipment (82.2%, 466/567), higher service level (77.8%,441/567), more complete medicine stock (74.8%, 424/567)and regular expert outpatient service (70.0%, 397/567).Conclusion Parents have strong demands of providing pediatric care in CHC, but the pediatric skills of general practitioners are not trusted .The CHC should upgrade related facilities and medicine stock for further improving the quality of pediatric service .

Objective:To explore the multidisciplinary management that centred on gastroenterology department, and follow-up study of children with Alagille syndrome(ALGS).Methods:The clinical data of 19 children diagnosed with ALGS in Pediatric Gastroenterology Department, Shengjing Hospital of China Medical University since June 2013 to December 2022 was retrospectively analyzed, and the clinical manifestations of various systems of the body were followed up and evaluated, and then developed the personalised management strategies.Results:Among the 19 confirmed patients, 18 cases were confirmed by genetic testing.Eighteen cases(94.7%) had characteristic facial features.To follow-up node, 8 cases(42.1%) had cholestasis, with alanine aminotransferase(210.20±110.50)U/L, aspartate aminotransferase(187.86±96.70)U/L, and direct bilirubin(110.93±108.15)μmol/L.Eighteen cases(94.7%) had pruritus.Eighteen cases(94.7%) of the patients had a high risk of malnutrition, and the level of total bilirubin[(76.17±107.34)μmol/L] and total bile acid[(100.18±83.78)μmol/L] were significantly increased in the children with obvious growth retardation.Thirteen cases(68.42%) had diffuse liver injury.The clinical opinions on genetic counseling, application of new drugs, liver transplantation, cardiac medicine and surgery follow-up, spine and oral surgery orthodontics were given by multiple disciplines.Conclusion:ALGS children have a high risk of long-term malnutrition and are associated with the severity of liver injury, and pruritus and jaundice are the main clinical manifestations.The management of ALGS patients should be centered around liver disease doctors, combined with multiple disciplines, paying attention to changes in various related organs of ALGS patients, and improving their quality of life.

Objective To explore the biological behavior of renal cell carcinoma cases after treatment with siRNA silencing epidermal growth factor receptor (EGFR) gene.Methods Renal cell carcinoma cell line ACHN were divided into three groups,the control group without any intervention,negative control transfection group by adding the nonspecific transfection reagent and siRNA interference,and the observation group adding transfection reagent and siRNA interference.Cells with EGFR expression and proliferation activity,growth curve,migration and invasion activity were detected in three groups.Results After 72 h of siRNA treatment,the observation group had significantly lower EGFR expression levels,and cell growth activity ability,and cell number of RNAi group after 48 h than negative control transfection group and control group (P ＜ 0.05).Compared with the blank control group and negative control transfection group,the observation group was significantly inhibited (P ＜0.05),and cell scratch distance after 12 h and 24 h was significantly higher than that of the control group and negative control transfection group (P ＜ 0.05).The control group and negative control transfection group showed no significant difference in the cell membrane at 12 h (P ＞0.05).The observation group had significantly lower transmembrane cell number than the control group and negative control transfection group (P ＜ 0.05).Conclusion The proliferation,growth,migration and invasion of renal carcinoma cells can be effectively improved by using siRNA EGFR protein.

Dental pulp stem cells(DPSCs)are a type of mesenchymal stem cells with broad application potential.Due to their multipotent differentiation capabilities and ease of access,DPSCs have become a focus of research in the field of ophthalmology.In recent years,DPSCs have shown the potential clinical applications in the treatment of corneal epithelial injuries and retinal degenerative diseases.DPSCs can promote the corneal epithelial regeneration and reconstruction by differentiating into the corneal epithelial cells and inhibiting the M1 macrophages.Additionally,DPSCs can differentiate into the retinal photoreceptor-like cells and retinal ganglion-like cells,replace original retinal neurons,secrete neurotrophic factors to mediate injury repair,promote retinal regeneration,and improve the original function of the retina.This article systematically reviews the relevant domestic and international literatures in recent years,discussing the biological characteristics of DPSCs and the research progress in their applieation in the treatment of corneal and retinal diseases,with the aim of providing insights and strategies for the study of DPSCs in translational medicine and ophthalmic-related diseases.

Objective: To understand the occurrence and predictive factors of depressive symptoms among multi ethnic middle school students in Yunnan Province, so as to provide a referential framework for schools to carry out targeted mental health education. Methods: From October to December 2022, 8 500 first grade students from 23 middle schools were selected from 11 minority areas in Yunnan Province by cluster random sampling method. Demographic information and data relating to the students lifestyles were collected by questionnaire, and the Children s Depression Inventory (CDI) was used to evaluate depressive symptoms. Chi square test was performed to compare differences in the detection rate of depressive symptoms among first grade middle school students for univariate analysis. A decision tree model of depressive symptoms in middle school students was established by using the Chi squared automatic interaction detector (CHAID). Results: The detection rate of depressive symptoms among first grade students from multi ethnic middle schools in Yunnan Province was 28.26%. The decision tree model of depressive symptoms was academic stress ( χ 2=469.08) at the first level, breakfast behaviors (low/moderate academic stress: χ 2=155.49; severe academic stress: χ 2=105.24) at the second level, and the number of close friends (low/moderate academic stress and consuming breakfast 0- 2 days weekly: χ 2=23.15; low/moderate academic stress and consuming breakfast 3-4 days weekly: χ 2=14.99; severe academic stress and consuming breakfast 0-2 days weekly: χ 2=29.26; severe academic stress and consuming breakfast 3-4 days weekly: χ 2=20.15), ethnicity ( χ 2=78.22) and drinking ( χ 2=50.36) at the third level ( P <0.01). Conclusions The study identifies academic stress, breakfast behaviors, number of close friends, drinking and ethnicity as predictive factors of depressive symptoms among multi ethnic middle school students in Yunnan Province. Schools should develop targeted strategies for preventing and managing depressive symptoms in middle school students, so as to reduce their occurrence.

Objective: To determine the latent class of dietary patterns and their association with depressive symptoms among first grade students from multi ethnic middle schools in Yunnan Province, so as to provide a reference basis for promoting mental health among border middle school students. Methods: A cluster random sampling involving 8 500 first grade middle school students from 11 counties in Yunnan Province was conducted by a questionnaire survey between October to December 2022. The Children s Depression Inventory (CDI) was used to assess the depressive symptoms and the Food Frequency Questionnaire was used to collect eating behavior data. The latent profile analysis model was used to fit the latent class of dietary patterns among students. The association between the dietary pattern latent class and depressive symptoms was analyzed by Logistic regression. Results: The depressive symptom detection rate among firstgrade middle school students was 28.3%. Prevalence of depressive symptom in girls (30.9%) was higher than boys (25.5%) with a statistically significant difference ( χ 2=29.83, P <0.01). The dietary patterns among first grade middle school students were classified into four latent classes, as follows:class 1 (low consumption of all dietary components), class 2 (high consumption of fruit, milk and dairy products), class 3 (high consumption of vegetables and meat, and low consumption of processed foods) and class 4 (low consumption of milk, dairy products and eggs, and high consumption of processed foods). After adjusting for confounding variables, the class 3 dietary pattern was negatively correlated with depressive symptoms ( OR=0.62, 95%CI =0.52-0.74) and the class 4 dietary pattern was positively correlated with depressive symptoms ( OR= 1.28 , 95%CI =1.05-1.57) ( P <0.05), compared with the class 1 dietary pattern. Conclusions Multi ethnic first grade middle school students in Yunnan Province follow various dietary patterns. Unhealthy dietary patterns increase the risk of depressive symptoms. The dietary patterns of multi ethnic middle school students in Yunnan Province should be adjusted to promote the establishment of healthy dietary patterns and reduce the risk of depression symptoms in middle school students.

Objective To explore the biological behavior of renal cell carcinoma cases after treatment with siRNA silencing epidermal growth factor receptor (EGFR) gene.Methods Renal cell carcinoma cell line ACHN were divided into three groups,the control group without any intervention,negative control transfection group by adding the nonspecific transfection reagent and siRNA interference,and the observation group adding transfection reagent and siRNA interference.Cells with EGFR expression and proliferation activity,growth curve,migration and invasion activity were detected in three groups.Results After 72 h of siRNA treatment,the observation group had significantly lower EGFR expression levels,and cell growth activity ability,and cell number of RNAi group after 48 h than negative control transfection group and control group (P ＜ 0.05).Compared with the blank control group and negative control transfection group,the observation group was significantly inhibited (P ＜0.05),and cell scratch distance after 12 h and 24 h was significantly higher than that of the control group and negative control transfection group (P ＜ 0.05).The control group and negative control transfection group showed no significant difference in the cell membrane at 12 h (P ＞0.05).The observation group had significantly lower transmembrane cell number than the control group and negative control transfection group (P ＜ 0.05).Conclusion The proliferation,growth,migration and invasion of renal carcinoma cells can be effectively improved by using siRNA EGFR protein.

Objective To observe the value of MR lymphangiography(MRL)radiomics for evaluating central conducting lymphatic anomaly(CCLA).Methods Sixty-one patients with complex lymphatic anomaly,including 41 CCLA(group A),20 non-CCLA(generalized lymphatic anomaly and Gorham-Stout disease)and 20 subjects with normal thoracic duct(group B,n=38)were retrospectively enrolled.Cervical and thoracic(combined with abdominal if necessary)MRL was acquired using three-dimensional heavily T2W fast spin echo sequence.ROI was delineated along overall thoracic duct,and radiomics features were extracted.Data sets of group A and B were divided into K subsets using 5-fold cross-validation.The union of(K-1)subset was always used as training set,while the other subsets were used as validation set.Radiomics model was constructed based on support vector machine(SVM)algorithm.Receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the efficacy of SVM model for assessing CCLA.Results The proportions of bifurcation,cystoid change and extension of main thoracic duct,and extension of terminal thoracic duct in group A were all higher,while of normal main and terminal thoracic duct in group A were both lower than those in group B(all P＜0.05).No significant difference of proportions of multiple thoracic ducts,dextral thoracic duct,part of thoracic duct invisible,multiple terminal thoracic ducts,cystoid change of terminal thoracic duct nor terminal thoracic duct pampiniform was found between groups(all P＞0.05).The sensitivity,specificity,accuracy,positive predictive,negative predictive and AUC of SVM model for evaluating CCLA in training set was 78.95％,97.56％,88.61％,96.77％,83.33％and 0.920,respectively,which in validation set was 78.95％,83.57％,82.28％,83.33％,81.40％and 0.833,respectively.Conclusion MRL radiomics could be used to effectively evaluate CCLA.