Objective:This study aims to evaluate the nasal structural and electrophysiological features of patients with postoperative olfactory dysfunction following aesthetic rhinoplasty.Methods:We retrospectively analyzed the clinical features of 30 outpatients (females, aged 33±6 years) from Beijing Anzhen Hospital and China-Japan Friendship Hospital between 2014 and 2023, who complained of olfactory dysfunction following aesthetic rhinoplasty. The control group was 30 healthy females aged 32±9 years. Psychophysical olfactory test (Sniffin′ Sticks, SS), olfactory and trigeminal event-related potentials (oERPs and tERPs), and acoustic rhinometry were used for evaluating the olfactory function and nasal structure in patients and healthy controls. SPSS 17.0 software was used to compare the difference in olfactory function and nasal structure between the two groups and to analyze the factors related postoperative olfactory dysfunction.Results:There was a significant difference in the scores on psychophysical olfactory test between the patients and controls (10.78±3.90 vs. 33.66±2.42, t=-23.35, P<0.001). ERPs could be evoked in all patients and controls. Patients showed higher amplitudes of N 1 waves in both oERPs and tERPs than controls ( P<0.05 for all), but no differences in the latencies of N 1 and P 2 waves or in the amplitudes of P 2 waves were observed between the two groups ( P>0.05 for all). There was no difference in nasal structure between the two groups ( P>0.05). However, after nasal decongestant, mucosal congestion in the cross-sectional area (CSA) from the nostril to 6 cm level was found more significantly in patients than controls (nasal congestion index 40.00% vs. 1.00%, t=2.09, P=0.047). Better olfactory function was associated with increasing nasal volumes, increasing nasal threshold and anterior nasal turbinate plane CSA( P<0.05 for all). Conclusion:The important factor related to olfactory dysfunction following aesthetic rhinoplasty may be attributed to local mucosal congestion, rather than nasal structural alteration or neurophysiologic deficits in the olfactory pathway.

Objectives:The ORION-18 study has demonstrated that inclisiran can significantly reduce low-density lipoprotein cholesterol(LDL-C)and has good safety in Asian atherosclerotic cardiovascular disease(ASCVD)patients or ASCVD high-risk population.This subgroup analysis aims to further evaluate the efficacy and safety of inclisiran in Chinese mainland population.Methods:ORION-18 study is a multi-center,randomized,double-blind,placebo-controlled,phase Ⅲ clinical trial among Asian subjects,Chinese mainland subgroup included 232 ASCVD patients or ASCVD high-risk subjects who had already been treated with diet control and maximum tolerated doses of statins treatment(with or without other lipid-lowering treatments)but still had elevated LDL-C levels.Subjects were randomized in a 1:1 ratio to the inclisiran group and the placebo group(n=116 each),and received 300 mg of inclisiran or placebo respectively on day 0,90 and 270.The primary endpoint was the percentage change in LDL-C from baseline to day 330.The secondary endpoints included the time-adjusted percentage change and absolute change in LDL-C from baseline after day 90 and up to day 360,the absolute change in LDL-C from baseline to day 330,and the percentage changes from baseline to day 330 in proprotein convertase subtilisin/kexin type 9(PCSK9),total cholesterol,apolipoprotein B(ApoB),non-high-density lipoprotein cholesterol(non-HDL-C).Other secondary endpoints included the proportion of participants reaching LDL-C levels of<1.8 mmol/L at day 330,the proportion of participants with≥50%LDL-C reduction from baseline to day 330 and the proportion of participants who attained global lipid targets(the LDL-C target was<1.4 mmol/L for ASCVD patients and<1.8 mmol/L for ASCVD high-risk subjects)at day 330.Safety endpoints included adverse events during treatment,aboratory test abnormalities during treatment,serious adverse events,and assessed their severity and relation to treatment.Results:The inclisiran group showed a placebo-corrected percentage change in LDL-C from baseline to day 330 of-61.16%,and an absolute change of-1.73 mmol/L(both P<0.0001).Compared to the placebo group,the inclisiran group's time-adjusted percentage change in LDL-C from baseline between day 90 and day 360 was-58.51%,and an absolute change of was-1.64 mmol/L(both P<0.0001).At day 330,reductions from baseline were observed in the inclisiran group for PCSK9,total cholesterol,ApoB,non-HDL-C,with placebo-corrected percentage changes of-77.44%,-35.65%,-43.43%,-50.90%(all P<0.0001),respectively.At day 330,79.6%(74/93)of patients in the inclisiran group and 7.8%(6/77)in the placebo group achieved LDL-C levels<1.8 mmol/L,69.9%(65/93)of patients in the inclisiran group and 0%(0/77)in the placebo group achieved≥50%LDL-C reduction from baseline,66.7%(62/93)of patients in the inclisiran group and 2.6%(2/77)in the placebo group achieved their global LDL-C targets.The safety profile of inclisiran treatment over 12 months was comparable to that of the placebo,with no occurrence of treatment-related serious adverse events.Conclusions:In ASCVD patients or ASCVD high-risk subjects in Chinese mainland who have received diet control and maximum tolerable dose statins treatment(with or without other lipid-lowering treatments)and still have elevated LDL-C,inclisiran has a definite efficacy and good safety in reducing LDL-C.The efficacy and safety results of inclisiran assessed in Chinese mainland population are consistent with those of the general Asia population.

Objectives:The ORION-18 study has demonstrated that inclisiran can significantly reduce low-density lipoprotein cholesterol(LDL-C)and has good safety in Asian atherosclerotic cardiovascular disease(ASCVD)patients or ASCVD high-risk population.This subgroup analysis aims to further evaluate the efficacy and safety of inclisiran in Chinese mainland population.Methods:ORION-18 study is a multi-center,randomized,double-blind,placebo-controlled,phase Ⅲ clinical trial among Asian subjects,Chinese mainland subgroup included 232 ASCVD patients or ASCVD high-risk subjects who had already been treated with diet control and maximum tolerated doses of statins treatment(with or without other lipid-lowering treatments)but still had elevated LDL-C levels.Subjects were randomized in a 1:1 ratio to the inclisiran group and the placebo group(n=116 each),and received 300 mg of inclisiran or placebo respectively on day 0,90 and 270.The primary endpoint was the percentage change in LDL-C from baseline to day 330.The secondary endpoints included the time-adjusted percentage change and absolute change in LDL-C from baseline after day 90 and up to day 360,the absolute change in LDL-C from baseline to day 330,and the percentage changes from baseline to day 330 in proprotein convertase subtilisin/kexin type 9(PCSK9),total cholesterol,apolipoprotein B(ApoB),non-high-density lipoprotein cholesterol(non-HDL-C).Other secondary endpoints included the proportion of participants reaching LDL-C levels of<1.8 mmol/L at day 330,the proportion of participants with≥50%LDL-C reduction from baseline to day 330 and the proportion of participants who attained global lipid targets(the LDL-C target was<1.4 mmol/L for ASCVD patients and<1.8 mmol/L for ASCVD high-risk subjects)at day 330.Safety endpoints included adverse events during treatment,aboratory test abnormalities during treatment,serious adverse events,and assessed their severity and relation to treatment.Results:The inclisiran group showed a placebo-corrected percentage change in LDL-C from baseline to day 330 of-61.16%,and an absolute change of-1.73 mmol/L(both P<0.0001).Compared to the placebo group,the inclisiran group's time-adjusted percentage change in LDL-C from baseline between day 90 and day 360 was-58.51%,and an absolute change of was-1.64 mmol/L(both P<0.0001).At day 330,reductions from baseline were observed in the inclisiran group for PCSK9,total cholesterol,ApoB,non-HDL-C,with placebo-corrected percentage changes of-77.44%,-35.65%,-43.43%,-50.90%(all P<0.0001),respectively.At day 330,79.6%(74/93)of patients in the inclisiran group and 7.8%(6/77)in the placebo group achieved LDL-C levels<1.8 mmol/L,69.9%(65/93)of patients in the inclisiran group and 0%(0/77)in the placebo group achieved≥50%LDL-C reduction from baseline,66.7%(62/93)of patients in the inclisiran group and 2.6%(2/77)in the placebo group achieved their global LDL-C targets.The safety profile of inclisiran treatment over 12 months was comparable to that of the placebo,with no occurrence of treatment-related serious adverse events.Conclusions:In ASCVD patients or ASCVD high-risk subjects in Chinese mainland who have received diet control and maximum tolerable dose statins treatment(with or without other lipid-lowering treatments)and still have elevated LDL-C,inclisiran has a definite efficacy and good safety in reducing LDL-C.The efficacy and safety results of inclisiran assessed in Chinese mainland population are consistent with those of the general Asia population.

Objective:This study aims to evaluate the nasal structural and electrophysiological features of patients with postoperative olfactory dysfunction following aesthetic rhinoplasty.Methods:We retrospectively analyzed the clinical features of 30 outpatients (females, aged 33±6 years) from Beijing Anzhen Hospital and China-Japan Friendship Hospital between 2014 and 2023, who complained of olfactory dysfunction following aesthetic rhinoplasty. The control group was 30 healthy females aged 32±9 years. Psychophysical olfactory test (Sniffin′ Sticks, SS), olfactory and trigeminal event-related potentials (oERPs and tERPs), and acoustic rhinometry were used for evaluating the olfactory function and nasal structure in patients and healthy controls. SPSS 17.0 software was used to compare the difference in olfactory function and nasal structure between the two groups and to analyze the factors related postoperative olfactory dysfunction.Results:There was a significant difference in the scores on psychophysical olfactory test between the patients and controls (10.78±3.90 vs. 33.66±2.42, t=-23.35, P<0.001). ERPs could be evoked in all patients and controls. Patients showed higher amplitudes of N 1 waves in both oERPs and tERPs than controls ( P<0.05 for all), but no differences in the latencies of N 1 and P 2 waves or in the amplitudes of P 2 waves were observed between the two groups ( P>0.05 for all). There was no difference in nasal structure between the two groups ( P>0.05). However, after nasal decongestant, mucosal congestion in the cross-sectional area (CSA) from the nostril to 6 cm level was found more significantly in patients than controls (nasal congestion index 40.00% vs. 1.00%, t=2.09, P=0.047). Better olfactory function was associated with increasing nasal volumes, increasing nasal threshold and anterior nasal turbinate plane CSA( P<0.05 for all). Conclusion:The important factor related to olfactory dysfunction following aesthetic rhinoplasty may be attributed to local mucosal congestion, rather than nasal structural alteration or neurophysiologic deficits in the olfactory pathway.

Objective:To establish and validate reference intervals of serum vitamin K for healthy children in China.Methods:A cross-sectional study was conducted from January 2020 to May 2023, involving 807 healthy children aged 0 to 14 years, selected by stratified random sampling based on the population distribution of children in eastern, central, western, and northeastern China. Sample collection was carried out in 16 hospitals across 12 provinces, autonomous regions, and municipalities. Basic information of the children was collected using a standardized self-design questionnaire. Serum levels of vitamin K 1 and vitamin K 2 (menaquinone-4 (MK-4), menaquinone-7 (MK-7)) were measured using liquid chromatography-tandem mass spectrometry. The reference intervals was established by direct approach. The children were divided into different groups by age. Inter-group comparisons were conducted using the Kruskal-Wallis non-parametric test, and the reference intervals ( P2.5- P97.5) were determined using non-parametric methods. Screening 40 healthy children for small sample validation based on age groups within the reference range(25 from eastern, 10 from central, and 5 from western regions). Results:The age of the 807 children was 5.00 (2.00, 9.81) years, and 495 (61.3%) were males and 312 (38.7%) females. Reference intervals were established for 795 children, of whom 303 children were aged 1 month to 3 years and 492 were aged 4 to 14 years. The reference intervals for serum vitamin K 1 were 0.09-4.54 μg/L for children aged 1 month to 3 years, and 0.10-1.73 μg/L for 4-14 years. For MK-7, the intervals were 0.07-1.42 μg/L for 1 month to 3 years and 0.19-2.03 μg/L for 4-14 years. The reference intervals for MK-4 in children aged 1 month to 14 years were 0-0.42 μg/L. The measured values of serum vitamin K 1, MK-4, and MK-7 in the validation samples did not exceed the reference limit in more than 2 samples. Conclusion:Reference intervals for vitamin K 1, MK-4, and MK-7 in healthy children aged 1 month to 14 years have been established and validated, and can be used to assess vitamin K nutritional status in children.

【Objective】 To explore the correlation between the severity of jaundice in ABO hemolytic disease of fetus and newborn (HDFN) and multiple indicators, in order to achieve accurate diagnosis, timely treatment, and prevent complications in ABO HDFN. 【Methods】 From March 2020 to February 2023, a total of 283 ABO HDFN in our hospital were classified into mild, moderate and severe groups based on total bilirubin levels. The differences in basic data, relevant laboratory indicators and the agglutination intensity of the three hemolysis tests were analyzed and compared. 【Results】 In the severe group, 75% (12/16) were male infants, which was significantly higher compared to 37.5% (57/152) in the moderate group (P<0.05). The values (mg/dL) of transcutaneous jaundice in the mild, moderate and severe groups were:forehead 9.88±1.93 vs 12.34±2.01 vs 15.56±2.69, face 10.25±2.27 vs 13.28±2.32 vs 15.99±2.86, chest 9.67±2.16 vs 12.51±2.11 vs 15.33±2.36, respectively. The values(µmol/L) of direct bilirubin (DBIL) and indirect bilirubin (IBIL) were 9.87±2.06 vs 11.90±2.59 vs 16.12±4.73, and 159.36±37.55 vs 252.98±30.52 vs 353.76±55.68, respectively, and the differences between the mild, moderate and severe groups were statistically significant (all P<0.05) . The creatine kinase (CK) values(unit/L) of mild, moderate and severe groups were 664.15±498.26 vs 500.51 ±451.63 vs 402.63±224.27, and the difference between the mild group and the other two groups was statistically significant (P<0.05) . There was no statistically significant difference in the agglutination intensity of the three hemolysis tests among HDFN with different severity of jaundice. 【Conclusion】 Clinicians can predict the severity of jaundice in light of gender, transcutaneous jaundice, DBIL, IBIL and CK of ABO HDFN, for further and graded treatment, so as to avoid the sequelae or even life-threatening consequences caused by ABO HDFN.

Objective:To explore the transition from hospital discharge to home care in heart transplant recipients based on the Meleis' transition theory, so as to provide a basis for improving the quality of life of recipients.Methods:In July 2021, purposeful sampling was used to select heart transplant recipients from the First Affiliated Hospital of Zhejiang University School of Medicine as the research subject. A total of 12 recipients of one year after heart transplantation were selected for semi-structured interviews by snowballing. The interview data were analyzed using the Colaizzi 7-step method.Results:Through reading, analysis, sorting and summarizing, 4 themes and 11 sub-themes were extracted, namely, relatively stable recovery of physical condition, lack of medication and emotional management (unmet needs for medication cognition and management, good physical condition, early emotional experience of vulnerability) , the support of family and social resources affected the transition (the communication and support of patients promoted the transition, the support of the family promoted the transition, the lack of community resources hindered the transition, and the reimbursement policy affected the transition) , a positive experience in the transition (confidence to deal with future life, return to society and self-realization) , and expecting to obtain comprehensive and continuous management of body and mind (the needs of nursing care centered on mental health, the needs of professional management teams and the communication platform among doctors, nurses and patients) .Conclusions:The experience of home self-care after discharge has many physical and psychological impacts on heart transplant recipients. It is necessary to pay attention to the recipients in the transition period, and to build a whole-of-society support system to give help to heart transplant recipients.

Objective::To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas (aUCBG).Methods::A prospective cohort study was conducted in obstetrics and gynecology department between October 2017 and August 2018 at Tongji Hospital in Wuhan, China, and 360 aUCBG samples were collected. The average age of pregnant women was (29.50±4.42) years, range from 19 to 48 years old. The gestational age range from 28 +4 weeks to 41 +3 weeks at admission. Logistic regression and area under the curve (AUC) from Receiver operating characteristic curves were used to identify risk factors, such as, premature rupture of membranes (PROM), high blood pressure, premature delivery (PD), low 1-minute Apgar scores (Apgar 1), low 5-minute Apgar scores (Apgar 5), pH, base excess, bicarbonate, neonatal blood sugar (NBS), and so on, to predict neonatal condition and evaluate the predictive ability of traditional and aUCBG parameters. Results::In all cases, PROM, PD, Apgar 1, Apgar 5, pH, base excess, bicarbonate, total carbon dioxide, and neonatal blood sugar were risk factors and were associated with poor condition of neonate. Apgar 1 were an independent risk factor. Combined traditional and aUCBG parameters had higher AUC of 0.895 (95% confidence interval ( CI): 0.830-0.960, P<0.001). In cesarean section subgroup, high blood pressure, PD, and Apgar 1 were risk factors and were associated with poor condition of neonate. Apgar 1 and low pH were the independent risk factors. Combined traditional and aUCBG parameters had highest AUC of 0.940 (95% CI: 0.886-0.993, P<0.001). In vaginal delivery subgroup, maternal age above 35 years, PROM, PD, Apgar 1, Apgar 5, and male newborn were risk factors and were associated with poor condition of neonate. Maternal age above 35 years was an independent risk factor. Combined traditional and aUCBG parameters had highest AUC of 0.897 (95% CI: 0.828-0.965, P<0.001). For pregnant women without comorbidities and complications of pregnancy, aUCBG may not be necessary. Conclusion::In high-risk pregnancies, especially lower Apgar scores, PD, and maternal age above 35-year old, aUCBG is recommended. Traditional parameters combined with aUCBG might increase the predicting ability of neonate condition.

Objective::To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas (aUCBG).Methods::A prospective cohort study was conducted in obstetrics and gynecology department between October 2017 and August 2018 at Tongji Hospital in Wuhan, China, and 360 aUCBG samples were collected. The average age of pregnant women was (29.50±4.42) years, range from 19 to 48 years old. The gestational age range from 28 +4 weeks to 41 +3 weeks at admission. Logistic regression and area under the curve (AUC) from Receiver operating characteristic curves were used to identify risk factors, such as, premature rupture of membranes (PROM), high blood pressure, premature delivery (PD), low 1-minute Apgar scores (Apgar 1), low 5-minute Apgar scores (Apgar 5), pH, base excess, bicarbonate, neonatal blood sugar (NBS), and so on, to predict neonatal condition and evaluate the predictive ability of traditional and aUCBG parameters. Results::In all cases, PROM, PD, Apgar 1, Apgar 5, pH, base excess, bicarbonate, total carbon dioxide, and neonatal blood sugar were risk factors and were associated with poor condition of neonate. Apgar 1 were an independent risk factor. Combined traditional and aUCBG parameters had higher AUC of 0.895 (95% confidence interval ( CI): 0.830-0.960, P<0.001). In cesarean section subgroup, high blood pressure, PD, and Apgar 1 were risk factors and were associated with poor condition of neonate. Apgar 1 and low pH were the independent risk factors. Combined traditional and aUCBG parameters had highest AUC of 0.940 (95% CI: 0.886-0.993, P<0.001). In vaginal delivery subgroup, maternal age above 35 years, PROM, PD, Apgar 1, Apgar 5, and male newborn were risk factors and were associated with poor condition of neonate. Maternal age above 35 years was an independent risk factor. Combined traditional and aUCBG parameters had highest AUC of 0.897 (95% CI: 0.828-0.965, P<0.001). For pregnant women without comorbidities and complications of pregnancy, aUCBG may not be necessary. Conclusion::In high-risk pregnancies, especially lower Apgar scores, PD, and maternal age above 35-year old, aUCBG is recommended. Traditional parameters combined with aUCBG might increase the predicting ability of neonate condition.

Objective For the second children diagnosed as ABO hemolytic disease of the newborn(ABO-HDN),we made a comprehensive analysis of the related indicators of prenatal and postpartum,so as to achieve early prevention,early diagnosis and early treatment.Methods Prenatal microcolumn gel assay was used to detect the father and mother's blood type and mother's irregular antibody,mother serum IgG anti A(B)anti-body titer.Microcolumn gel assay was used to detect hemolysis three tests after the production of pregnant women.The results were divided into five groups according to the results of hemolysis three tests:group A[di-rect antiglobulin test(+),free antibodies test(+)and antibody releasing test(+)],group B[direct antiglobu-lin test(-),free antibodies test(+)and antibody releasing test(+)],group C[direct antiglobulin test(+), free antibodies test(-)and antibody releasing test(+)],group D[direct antiglobulin test(-),free antibod-ies test(-)and antibody releasing test(+)]and group E[direct antiglobulin test(+),free antibodies test (-)and antibody releasing test(-)].Total bilirubin,unbound bilirubin,hemoglobin,reticulocyte percentage and lactate dehydrogenase were detected by automatic analyzer.Results ABO-HDN children hemolysis three tests,in the 5 groups,the higher the titer of the mother's IgG anti A(B)antibody,the more serious the child' s condition was,the difference was statistically significant(P<0.05).Reticulocyte percentage and lactate de-hydrogenase in the five groups,the difference was statistically significant(P<0.05).Conclusion A combina-tion of antenatal and postnatal multiple laboratory test parameters is more accurate in predicting the second child ABO-HDN.At the same time,it helps to master the state of the disease and reduce the occurrence of complications and sequelae.