Objective To investigate the incidence and risk factors of postcholecystectomy syndrome (PCS), and provide theoretical basis for the prevention of PCS. Methods A total of 338 patients with PCS were randomly selected in our hospital from May 1st 2013 to April 30th 2014, in which 316 cases were successful followed up including 101 males and 215 females. The data were collected from the 7 aspects including blood type, drinking history, smoking history, diabetes history, mental anxiety, dietary tendence and preoperative symptoms, and which were analyzed by binary-logistic regression analysis. Results According to the PCS diagnostic criteria, 115 patients were diagnosed with PCS (36.39%). The anxiety status and preoperative discomfort were closely related to the occurrence of PCS, with statistically significant difference (P<0.05). Conclusion The diagnosis and treatment of PCS are more complicated. We should focus on the prevention of PCS according to its risk factors, and pay attention to preoperative communication and individualized analysis of patients in order to reduce the occurrence of PCS.

BACKGROUND: Most of studies focus on the biomechanical characteristics of thoracic spine neoplasm, but there is little report on the fracture risk in the patients with vertebral hemangioma through finite element analysis.OBJECTIVE: To establish a finite element model of vertebral hemangioma, and to analyze its biomechanical characteristics, and assess the risk of vertebral fracture.METHODS: Three-dimensional finite element models of T12-L2 vertebrae from normal individuals, the patients with vertebral hemangioma (hemangioma accounting for 20%, 40%, 60%, 80% of the vertebral cancellous bone) and bone cement filling were established, respectively, and then the mechanical characteristics were analyzed. The stress distribution and characters of each model were determined under a vertical static pressure of 600 N.RESULTS AND CONCLUSION: (1) Three-dimensional finite element models of T12-L2 vertebrae were established successfully. Under static pressure, the stress distribution of L1 cortical bone showed no significant difference among models, and the maximum stress all occurred at the base of pedicle, zygapophysial joint and isthmus. (2) The stress distribution did not differ significantly between vertebral hemangioma accounting for 20%-40% of vertebral cancellous bone with complete cortical bone and normal ones, but which differed significantly in hemangioma accounting for 60%-80%. (3) To conclude, the established thoracolumbar three-dimensional model is available. Additionally,biomechanical tests manifest that the completeness of cortical bone and destruction ratio of cancellous bone destruction are key factors for the fracture risk of vertebral hemangioma.

Objective To investigate the correlation of trace elements in maternal blood,breast milk and infant blood.Methods Atomic absorption spectrographic method was used to measure blood and milk trace elements [calcium (Ca),ferrum (Fe),zinc (Zn),magnesium (Mg),copper(Cu)] of maternal of natural delivery and infant in 250 cases,then to analyze the correlation of trace elements in maternal blood,breast milk and infant blood in postpartum 42 days.Results There were statistically significant differences in trace elements between the maternal blood,breast milk and infant blood (P ＜ 0.05).There was a positive correlation of Ca,and Fe between maternal blood and infant blood [Ca (r =0.221,P =0.047),Fe (r =0.107,P =0.043)];Fe had a positive correlation between breast milk and infant blood (r =0.139 P =0.035);There was a positive correlation of the trace elements between maternal blood and milk,but no correlation in Mg.Conclusions There was the gradient of trace elements in maternal blood and breast milk in postpartum 42 days.It can keep breast milk in a certain percentage of trace element and contribute to absorption of trace elements and growth and development in infant.The regular determination of trace elements during pregnancy and postpartum in women and their infant can direct a balanced diet and advocate breastfeeding.It can also prevent the lack of calcium,iron,zinc and other trace elements in infant.

Objective:To determine drug dose and usage of timolol maleate eye drops in the treatment of superficial infantile hemangioma.Methods:A total of 250 superficial hemangioma infants were recruited and assigned into 5 groups (n=50 for each group):an external application group and 4 exterior coating groups (2,4,6,8 times per day).We evaluated the therapeutic effect of different methods for drug application (external application or exterior coating) and the frequency for drug administration on superficial infantile hemangioma.Results:The external application group (twice a day and 0.5 hour per time) showed better effect than that in the exterior coating group with twice a day (P＜0.001).The difference in therapeutic effect between the exterior coating group with 6 times a day and exterior coating group with twice a day or with 3 times a day was significant (P＜0.001).The differences in drug efficacy were not found among the exterior coating group with 6 times a day,the exterior coating group with 8 times a day,or the external application group with twice a day (All P＞0.05).Conclusion:Drug dose may affect the therapeutic effect oftimolol maleate eye drops in superficial hemangioma infants,and exterior coating with 6 times a day may achieve the best curative effect.

Objective To analyze the energy supply nutrients (protein,fat and lactose) and mineral elements (calcium,copper,iron,zinc,magnesium,sodium,potassium) supplied in breast milk from the resident of Lanzhou,and investigate the problems of those energy supply nutrients and mineral elements in breast milk of this population so that to provide basis for breast feeding.Methods Breast milk from 1 215 mothers whose babies were fed totally by the breast milk and grew well was collected and assayed for the contents of protein,fat,lactose,calcium,copper,iron,zinc,magnesium,sodium and potassium in Lanzhou region.The optimal range for breast feeding was set by normal distribution method.The results were compared with the breast milk from other internal region in order to clarify the contents difference.Results The prevalence of mother-milk-fed in this region was 48.5％.The normal ranges (unit:g/100 g) of fat,lactose and protein were 1.57-5.11,6.58-7.16 and 0.79-1.35,and the normal ranges of calcium,copper,iron,zinc,magnesium,sodium and potassium were 5.25-7.83 mmol/L,5.66-8.28 mmol/L,0.14-0.3 mmol/L,15-64.48 μmol/L,0.98-1.62 mmol/L,1.92-18.82 mmol/L,7.95～ 17.31 mmol/L in the high quality breast milk.Compared with the other internal region,the normal ranges of the protein,fat and lactose in Lanzhou were lower.The contents of protein,fat,lactose,calories,calcium,copper,zinc and sodium in the breast milk from the whole investigated population were significantly lower compared with breast milk of high quality (P＜0.01).Conclusion The quality of breast milk in Lanzhou is not so good.The contents of various nutrients in breast milk should be improved to a proper level by appropriate ways so that to improve the growth and development of the baby.

Objective To be good for the different working age midwives to carry out the same evaluation of the pregnant woman,we build and use the Episiotomy Evaluation Form for reducing the rate of episiotomy with ensuring the safety of mother and baby.Methods Consult relevant literature,combine clinical practice,discuss,report to the hospital ethics committee many times and at last it was made after approval.The details included:perineal lesions,perineum elasticity,perineal length,maternal coordination,gestational age,age,fetal distress degree,amniotic fluid situation,the weight of fetus estimated,the second time of labor and so on,to score by 0,1,3,5,20.A total of 600 patients with low risk of natural childbirth were randomly divided into observation group and control group according to method of random number table with 300 cases each.The observation group was graded according to the perineal incision evaluation and we operated according to its use method.The control group was judged according to the experience of midwife and subjective cognition.At last compared the effects on the mother and baby.Results The rates of lateral episiotomy and Ⅰ degree laceration were 15.00％ (45/300) and 63.00％ (189/300) in the observation group and 48.33％ (145/300) and 21.67％ (65/300) in the control group,respectively.The difference between the two groups was statistically significant (x2=16.238,21.507,P ＜ 0.05).There was no statistical difference in the perineal intact rate,median perineal incision rate,perineal Ⅱ degree laceration rate,severe perineal laceration,second stage of labor,postpartum hemorrhage 2 hours,neonatal asphyxia rate,incidence of neonatal birth injury (brachial plexus injury,clavicle fracture,etc.) and pelvic floor muscle strength of 42 days after delivery between the two groups (P ＞ 0.05).Conclusions By using the episiotomy evaluation form,we can improve the accuracy and homogeneity of the midwife's assessment about the episiotomy which is benefit to reduce rate of episiotomy.It is worth promoting in clinical practice but we should ensure the safety of maternal and child.

Objective·To develop a machine learning approach for early identification of metabolic syndromes associated with inflammatory metabolic state changes in breast cancer patients after neoadjuvant therapy,using common laboratory and transthoracic echocardiography indices.Methods·Female patients with primary invasive breast cancer diagnosed at the Department of Breast Surgery,Renji Hospital,Shanghai Jiao Tong University School of Medicine,between September 2020 and September 2022,were included.General patient information,laboratory test results,and transthoracic echocardiography data were collected.After feature extraction,five machine learning algorithms,including random forest(RF),gradient boosting(GB),support vector machine(SVM),K-nearest neighbor(KNN),and decision tree(DT),were applied to construct a prediction model for the changes of the patients' metabolic state after neoadjuvant therapy,and the prediction performances of the five models were compared.Results·A total of 232 cases with valid clinical data were included,comprising 135 cases before neoadjuvant therapy and 97 cases after completing 4 cycles of neoadjuvant therapy.Feature extraction identified five key features:white blood cell count,hemoglobin,high-density lipoprotein(HDL),interleukin-2 receptor,and interleukin-8.In the multi-feature analysis,the area under the receiver operating characferistic curve(AUC)was higher in the combination of white blood cell count,hemoglobin and HDL compared to the combination of interleukin-2 receptor and interleukin-8(RF:0.928 vs 0.772,GB:0.900 vs 0.792,SVM:0.941 vs 0.764,KNN:0.907 vs 0.762,DT:0.799 vs 0.714).The RF,SVM,and GB models showed higher AUC(0.928,0.941,0.900)and accuracy(0.914,0.897,0.776).The SVM model exhibited superior accuracy in the training data compared to the RF and GB models(P=0.394,0.122 and 0.097,respectively).Conclusion·The SVM model can be used to establish a prediction model for identifying breast cancer patients at high risk of developing inflammatory metabolic state-related metabolic syndrome after neoadjuvant therapy by incorporating five common clinical indicators,namely,white blood cell count,hemoglobin,high-density lipoprotein,interleukin-2 receptor,and interleukin-8.SVM modeling may be useful for clinicians to establish individualized screening protocols based on a patient's inflammatory metabolic state.

To explore the proportion for facial aesthetics that may be recognized by the potential group who will do plastic surgery in the future. 
 Methods: We measured the celebrity photos, who were born before 1980 recognizable by the people over 40 years old or by high school students. The proportions for facial aesthetics recognizable by these two generations were obtained and compared. 
 Results: Compared the new generation of male celebrities with the older generation of male celebrities, the difference was statistically significant by the independent samples t test (t=-2.502, P<0.05), while other ratios were not statistically significant (P>0.05). Compared the new generation of female celebrities with the older generation of female celebrities, the difference was statistically significant by the independent samples t test. The ratios between inter-canthic diameter and eyeslit breadth, mouth breadth and eyeslit breadth, stirnhohe and 1/3 of the physiognomic facial height, nasal height and 1/3 of the physiognomic facial height were significantly different (P<0.05), while other ratios were not significantly different (P>0.05).
 Conclusion: The young new generation loves more larger eyeslit breadth for men, while a larger eyeslit breadth, smaller bizygomatic breadth and sharper chin for women.
Adolescent ; Adult ; Cephalometry ; trends ; Esthetics ; psychology ; Eye ; Face ; Famous Persons ; Female ; Humans ; Male ; Middle Aged ; Mouth ; Nose ; Students ; psychology ; Surgery, Plastic ; trends

OBJECTIVE: To explore the safe method with anhydrous ethanol injection in the treatment of venous malformation.
 METHODS: A total of 96 patients with venous malformation were conducted anhydrous ethanol injection for 245 times through percutaneous puncture by three-point method. The complications were observed. In animal experiment, according to the different concentrations of anhydrous ethanol injection, rats were divided into an anhydrous ethanol group, a 75% ethanol group, a 50% ethanol group and a 25% ethanol group (n=5 in each group), and the damage of vessels after ethanol injection was observed.
 RESULTS: The successful rate for three-point ethanol injection was 88%. The incidence for both skin ulcer and numbness was 0.9% without severe complications in lung and heart. In the animal experiments, the entire vessel wall including outer membrane was damaged in the anhydrous ethanol group. Part of vessel walls, including the inner membrane and muscle layer, were damaged in both the 75% ethanol group and the 50% ethanol group. However, there was no damage in the vessels in the 25% ethanol group.
 CONCLUSION With the decrease in ethanol concentration, the vascular damage is decreased and eventually disappeared. Three-point anhydrous ethanol injection is safe and effective.
Animals ; Ethanol ; administration & dosage ; therapeutic use ; Humans ; Injections ; methods ; Rats ; Sclerosing Solutions ; therapeutic use ; Sclerotherapy ; Vascular Malformations ; therapy

Epigenetic mechanisms play a crucial role in the development and progression of nonalcoholic fatty liver disease （NAFLD）， especially among lean individuals. The research on related epigenetic mechanisms has provided new clues and directions for revealing the underlying causes and treatment strategies of NAFLD. This article introduces the role of epigenetics in the development and progression of NAFLD among lean individuals in recent years， analyzes the latest research advances in the epigenetics of NAFLD in this population， and briefly describes the basic concepts of epigenetics， including DNA methylation， histone modifications， and non-coding RNA regulation. This article also discusses how epigenetic alterations impact the pathogenesis， disease progression， and treatment strategies of NAFLD in lean individuals.