OBJECTIVE To explore the influencing factors for successful detoxification in patients undergoing methadone maintenance therapy. METHODS A retrospective selection of 161 methadone maintenance therapy patients from the South Branch of Zhongshan Second People’s Hospital （including methadone maintenance treatment sites in Shiqi District， Xiqu District， Development Zone of Zhongshan City） from January 1， 2012， to January 1， 2025， was conducted as the study object. Data collected included patients’ sociodemographic information， drug abuse history， laboratory test results， medication records， etc. Patients were divided into the unsuccessful detoxification group and the successful detoxification group based on whether methadone detoxification was achieved. Univariate， univariate Cox regression， and multivariate Cox proportional hazards regression were used for influencing factor analysis， and the Kaplan-Meier method was employed for survival analysis. RESULTS Among the 161 methadone maintenance therapy patients， 96 were in the successful detoxification group and 65 in the unsuccessful detoxification group， yielding a successful detoxification rate of 59.63%. Multivariate Cox proportional hazards regression analysis revealed that age， registered residence status， age at first drug use， and duration of drug abuse were key influencing factors for successful detoxification in methadone maintenance therapy patients （P＜0.05）. Specifically， the successful detoxification rate for patients with Zhongshan local registered residence was 8.364 times higher than that for patients with non-local registered residence； for every 1-year increase in patient age， the successful detoxification rate decreased by 22.7%； for every 1-year increase in age at first drug use， the successful detoxification rate rose by 33.4%； and for every 1-year increase in duration of drug abuse， the successful detoxification rate increased by 33.5%. Survival analysis showed that the successful detoxification rate in the methadone low-dose group （≤30.8 mg） was significantly higher than that in the methadone high-dose group （＞30.8 mg） （P＝0.015）， and the successful detoxification rate in the population with Zhongshan local registered residence was significantly higher than that in those with non-local registered residence （P＜0.001）. CONCLUSIONS Age， registered residence status， age at first drug use， and duration of drug abuse are key influencing factors for successful detoxification in patients undergoing methadone maintenance therapy， and the last methadone dose may be associated with successful detoxification.

Objective To explore the mechanism of apoptosis induced by diacetyl hexamethylene diamine(CAHB)in adult acute lymphoblastic leukemia Jurkat cells,and to provide theoretical basis for the clinical application of CAHB.Methods Annexin V+/PI-cell rate of Jurkat cells after CAHB induction was analyzed by flow cytometry.The Annexin V+/PI-cell rate was observed after treatment with caspase-9 inhibitor Z-LEHD-FMK.The expressions of apoptosis-related proteins caspase-8,caspase-9 and caspase-3 were observed by Western blotting.Results After CAHB induction,Jurkat cells were reduced in size,cell membrane crinkling,chromatin thickening,nuclear pyknosis or fragmentation,etc.Typical apoptotic bodies could be seen.CAHB induced Jurkat cell apoptosis by activating caspase-9 and caspase-3 in a dose-effect and time-dependent manner.Caspase-9 inhibitors could inhibit apoptosis induction of CAHB to a certain extent.Conclusion CAHB induced Jurkat cell apoptosis was related to caspase-9 and caspase-3 activation.

Objective: To explore the relationship between adolescent sports participation and aggression, so as to provide a reference basis for sports interventions aimed at reducing adolescent aggression. Methods: The search databases used in the study included China National Knowledge Infrastructure, Vipo, Wanfang, Web of Science, Ebsco, Pro Quest, and PubMed, and the search period was from the construction of the database to October 22, 2023. The search terms for sports participation were "sport" "exercise" "exercise" "physical activity" "physical activity"; the search terms for aggressive behavior were "assault" "aggressive behavior" "aggression"; the search terms for aggressive behavior were "assault" "aggressive behavior" "aggression" "bullying", and "violence", and the above keywords were jointly searched. Foreign language data were searched using Web of Science, Ebsco, Pro Quest, PubMed and supplemented by Google Scholar. The search terms for sports participation were sport, athletics, exercise, train, fitness, physical exercise, physical activity, physical education; and the search terms for aggressive behavior were aggression, bullying, violence, atrocity, fighting, aggressive behavior, physical assault; the above keywords were jointly searched. Statistical analysis was performed using CMA 3.0 software. Results: A total of 20 studies with 80 effect sizes and 9 308 subjects were included. The Metaanalysis showed that adolescent sports participation was moderately negatively correlated with indicators of aggression (r=-0.11), physical aggression (r=-0.14), verbal aggression (r=-0.14), and hostility (r=-0.16), and weakly negatively correlated with indicators of anger (r=-0.08) (P<0.05). Aggressive behavior was influenced by gender, school stage, mode of exercise, and the sports participants region (P<0.05). Conclusions Exercise participation has a positive impact on reducing aggressive behavior in adolescents, and mode of exercise, age, gender, and region are moderating variables in the relationship. Schools can reduce adolescent aggression by developing exercise and physical education interventions.

Objective:To explore the expression levels and significance of programmed death factor 1 (PD-1)/programmed death factor ligand 1 (PDL-1) in T cells, regulatory T cells (Tregs), and regulatory B cells (Bregs) in patients with unexplained recurrent spontaneous abortion (URSA).Methods:Forty-two URSA patients (as patient group), 34 healthy pregnant women (as normal pregnancy group) and 30 unpregnant healthy examination patients (as control group) were collected for retrospective analysis,all study subjects were from patients who were treated in Taizhou Hospital affiliated to Wenzhou Medical University from February 2020 to February 2022. Flow cytometry was used to detect the expression level of PD-1/PDL-1 in Treg cells, Breg cells and [T cells, B cells and natural killer cells (TBNK)] lymphocyte subsets, as well as the expression level of serum Th1 (IFN-γ, TNF-α)/Th2 (IL-4, IL-6, IL-10)/Th17 (IL-17) cytokine expression. The patients were treated with lymphocyte immunotherapy, the changes of PD-1/PDL-1 levels were detected at the end of treatment, and the pregnancy outcome was recorded during follow-up. Comparisons between multiple groups were performed by ANOVA, comparisons before and after treatment in URSA patients were performed by paired T-test, and correlation of each test index by bivariate correlation analysis.Results:The expression levels of PD-1/PDL-1 in Treg, Breg cells and T lymphocyte subsets in peripheral blood of patients with URSA was significantly lower than that of healthy pregnant women(all P<0.01). The expression level of PD-1/PDL-1 in CD4+T cells was negatively correlated with the expression of serum Th1 cytokines Interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) (The r values were -0.44, -0.85, -0.33, and -0.94, respectively, all P<0.01). The expression level of PD-1/PDL-1 in CD4+T cells was positively correlated with the expression of serum Th2 cytokines interleukin 4(IL-4), interleukin 6(IL-6) and interleukin 10(IL-10)(The r values were 0.55, 0.47, 0.41, 0.33, 0.46, and 0.69, respectively,all P<0.01). The proportion of Breg cells and Treg cells were positively correlated with the level of serum IL-10 expression(The r values were 0.97, and 0.95 respectively, all P<0.01). The proportion of Treg cells was negatively correlated with the expression of IL-17( r=?0.95, P<0.01). The expression of PD-1/PDL-1 in Breg cells and Treg cells was positively correlated with the expression of serum IL-10(The r values were 0.95, 0.36, 0.96, and 0.95, respectively, all P<0.01). There was a negative correlation between serum IL-10 expression level and IL-17 expression level( r=?0.58, P<0.01). After URSA treatment, pregnancy was successful in 23 cases and failed in 19 cases. The expression of PD-1/PD-L1 on CD4, CD8, Tregs cells and Bregs cells in USRA treatment group was significantly higher than that before treatment( P<0.01), but there was no significant change in treatment failure group( P>0.05). Conclusion:The low expression of PD-1/PD-L1 in Treg cells, Breg cells and T cell subsets in peripheral blood of patients with URSA results in the immune imbalance of Th1/Th2 and Tregs/Th17, and the damage of maternal-fetal immune tolerance leads to pregnancy failure, which may be a potential therapeutic target.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Objective:To investigate the clinical effect and safety of mid-face lifting combined with compound fat transplantation in facial rejuvenation.Methods:From October 2016 to May 2020, 26 patients with mid-facial aging were enrolled, including 10 males and 16 females, with an average age of (47±6) years (38-65 years). The facial superficial musculoaponeurotic system was stripped, folded and suspended through the temporal hairline incision to lift the middle of the face. Liposuction was performed and compound fat was prepared, in which structural fat was injected into the area marked with loss of facial volume before operation, and extravascular matrix component gel was injected into the static wrinkle dermis. Six and 12 months after operation, the global aesthetic improvement scale of the observer and the global aesthetic improvement scale of the patient were scored, and the postoperative complications and patients＇ satisfaction were counted.Results:At the end of 6 months, improvements in mid face were reported in all patients by blinded reviewers. 12 months after operation, 53.8% (14 cases) of patients had significant improvement in facial aging, 30.8% (8 cases) had moderate improvement, and 15.4% (4 cases) had slight improvement; 25 patients (96%) were satisfied with the postoperative results. Postoperative hemorrhage occurred in one patient, scar hyperplasia occurred in one patient, and no obvious complications occurred in the other patients.Conclusions:The method of midface lifting combined with compound fat transplantation can improve the facial soft tissue and supplement the facial missing capacity, improve the static wrinkles of the face, and comprehensively solve the aging problem of midface. It has a definite clinical effect, fewer complications, and is safe and reliable. It has definite clinical effect with less complications.

Objective:To investigate the effects of atorvastatin combined with alendronate in the treatment of type 2 diabetes mellitus (T2DM) with osteoporosis (OP) on bone metabolism, tumor necrosis factor alpha (TNF-α) , interleukin 6 (IL-6) , and 25-hydroxyvitamin D[25- (OH) D] level.Methods:A total of 152 patients with T2DM and OP who were diagnosed and treated in our hospital from Jul. 2017 to Jul. 2020 were selected. According to the different treatment methods, they were divided into control group (73 cases with alendronate treatment) and study group (79 cases receiving atova Statins combined with alendronate sodium treatment) . The two groups were compared in terms of bone metabolism indexes, bone mineral density, changes in serum TNF-α, IL-6, 25- (OH) D levels, and adverse reactions before and after treatment.Results:After treatment, osteocalcin (BGP) , bone-specific alkaline phosphatase (BAP) , lumbar spine L1-4 bone mineral density, femoral neck bone mineral density, and 25- (OH) D of the two groups increased ( P< 0.001) , and the study group was significantly higher than the control group (BGP: 7.68±0.89 vs 6.88±0.93; BAP: 18.62±3.97 vs 16.82±3.24; lumbar spine L1-4: 0.95±0.08 vs 0.92±0.05; femoral neck: 0.79±0.07 vs 0.75±0.06; 25- (OH) D: 31.35±10.1 vs 26.54±7.14; all P<0.05) . After treatment, the serum type I collagen C-terminal peptide (s-CTX) , human tartrate acid phosphatase (TRAP-5b) , TNF-α, IL-6 were decreased for both groups ( P<0.001) , and they were significantly lower in the study group than those in the control group (s-CTX:0.37±0.12 vs 0.55±0.12; TRAP-5b: 2.43±0.66 vs 2.99±0.75; TNF-α: 9.93±1.91 vs 11.77±2.69; IL-6: 10.65±1.26 vs 12.91±1.21; all P<0.001) . The incidence of adverse reactions in the study group was significantly lower than that in the control group (16.46% vs 39.73%, P=0.001) . Conclusion:Atorvastatin combined with alendronate in the treatment of T2DM patients with OP can effectively increase 25- (OH) D levels, reduce inflammation, and promote bone metabolism and bone density.

Lower extremity deep vein thrombosis (DVT) is one of the main complications in patients with traumatic fractures, and for severe patients, the DVT can even affect arterial blood supply, resulting in insufficient limb blood supply. If the thrombus breaks off, pulmonary embolism may occur, with a high mortality. The treatment and rehabilitation strategies of thrombosis in patients with lower extremity fractures have its particularity. DVT in traumatic fractures patients has attracted extensive attention and been largely studied, and the measures for prevention and treatment of DVT are constantly developing. In recent years, a series of thrombosis prevention and treatment guidelines have been updated at home and abroad, but there are still many doubts about the prevention and treatment of DVT in patients with different traumatic fractures. Accordingly, on the basis of summarizing the latest evidence-based medical evidence at home and abroad and the clinical experience of the majority of experts, the authors summarize the clinical treatment and prevention protocols for DVT in patients with traumatic fractures, and make this consensus on the examination and assessment, treatment, prevention and preventive measures for DVT in patients with different fractures so as to provide a practicable approach suitable for China ′s national conditions and improve the prognosis and the life quality of patients.

Objective:To explore the clinical effects of pre-expanded anterior perforator flap of transverse cervical artery in extensive facial and cervical scar reconstruction and contralateral pre-expanded thoracic random flap in relay in donor site repair.Methods:A retrospective cohort study was conducted. From May 2008 to December 2018, 10 patients with extensive facial and cervical scar after burns were treated in the Fourth Medical Center of PLA General Hospital, including 8 males and 2 females, aged 10-55 years. In the first stage of operation, two skin and soft tissue expanders of the same volume (with rated capacity of 250-600 mL) were respectively placed in the right side and left side of the chest according to the size of scar, and then the skin was expanded. The total amount of normal saline injected was 2 to 4 times of the rated capacity of the expander. In the second stage, the defect with area of 12 cm×8 cm-23 cm×15 cm caused by scar resection and release was repaired with unilateral pre-expanded anterior perforator flap of transverse cervical artery with area of 12 cm×9 cm-24 cm×16 cm. The contralateral pre-expanded thoracic random flap with the same area as that of the above-mentioned perforator flap was extended to repair the secondary defect with area of 8 cm×6 cm-17 cm×14 cm formed after transfer of the above-mentioned perforator flap. The exploration of perforating branch of transverse cervical artery, flap transfer and survival, injury repair, and complications were observed. The appearance and related function of donor and recipient sites and satisfaction of patients were followed up.Results:The perforating branches of transverse cervical artery appeared stably in the 10 patients. All the flaps were transferred to the recipient area without tension and survived. Both facial and cervical injuries were repaired successfully with no common complications. During the follow-up of 6 months-8 years, the color and texture of the pre-expanded anterior perforator flap of transverse cervical artery matched with the surrounding tissue, the functions of head raising and neck rotation of patients were significantly improved compared with those before operation, the color and texture of the flap transplanted in the first donor site matched with the original skin, linear scar left at the surgical incision, and 9 patients were satisfied with the restoration of the appearance and function of donor and recipient sites.Conclusions:The color and texture of the pre-expanded anterior perforator flap of transverse cervical artery match well with the face and neck, and the repairable area is large. After the perforator flap is removed, the secondary wound can be repaired with the pre-expanded thoracic random flap at the same time, and the injury of the chest donor site is alleviated. This relay repair method is a good choice for reconstructing extensive facial and cervical scar.

ObjectiveTo explore the mental health status and relevant factors among community residents during the normalization stage of prevention and control of COVID-19. MethodsFrom August 28 to September 7， 2020， an online cross-sectional survey using snowball sampling was conducted among community residents via Wenjuanxing platform， and their mental health status were assessed using Patients' Health Questionnaire Depression Scale-9 item（PHQ-9）， Generalized Anxiety Disorder-7 item（GAD-7）， Insomnia Severity Index（ISI） and Chinese Perceived Stress Scale（CPSS）. ResultsAmong the 476 community residents， the detection rates of depression， anxiety， insomnia and high perceived stress were 32.35%， 21.22%， 24.58% and 48.74%， respectively. In terms of gender， the detection rate of high perceived stress was higher in male than in female（χ²=5.269）； in terms of marital status， the detection rates of depression and anxiety among the unmarried， divorced or widowed residents was higher than those of the married residents（χ²=5.251， 8.851）； in terms of mental health service status， the detection rates of depression， anxiety， insomnia and high perceived stress among residents with mental health service needs was higher than those among residents without the needs（χ²=46.316， 66.934， 20.153， 21.576）， with statistical significance（P<0.05 or 0.01）. Correlation analysis showed that the age of community residents was negatively correlated with CPSS score（r=-0.171， P<0.01）， sleep duration was negatively correlated with PHQ-9， GAD-7 and ISI scores（r=-0.210， -0.247， -0.297， P<0.01）， and time spent following news on COVID-19 per day was negatively correlated with ISI score（r=-0.097， P<0.05）. ConclusionDuring the normalization stage of prevention and control of COVID-19， the majority of community residents experience the symptoms of depression， anxiety， insomnia and high perceived stress. Male and younger residents are more likely to experience high levels of perceived stress. Those with shorter sleep duration and needs for mental health services are more likely to experience symptoms of depression， anxiety and insomnia， and those with short time spent following news on COVID-19 are more likely to experience insomnia symptom.