OBJECTIVE: To summary and analyze the bleeding causes after uvulopalatopharyngoplasty(UPPP) with endotherm knife, and preventive measures will be given to effectively reduce postoperation hemorrhage. METHOD: Two hundred and twenty-six cases of obstructive sleep apnea hypopnea syndrome (OSAHS) adult patients, were carryed out UPPP under general anesthesia with endotherm knife to observe postoperation hemorrhage. RESULT: Eight cases out of 226 patients or 3.5% occurred postoperation hemorrhage, 2 cases after 1 or 2 days, 6 cases after 6 or 12 days. The postoperation hemorrhage stopped by local compression hemostasis or bi-polar coagulation hemostasis, and no more bleeding occurred. CONCLUSION The minimal trauma, quick operation and less-bleeding will be caused by UPPP with endotherm knife. Few patients 3.5% had a small amount of bleeding after operation, but no serious bleeding occured. Hemorrhage often happened during pseud mucosa falling off period. The bleeding was related with using skill of endotherm knife during operation, postoperation pse-ud mucosa falling off, local inflammation, improper eating and emotional stress of patients.
Adult ; Hemorrhage ; etiology ; Humans ; Otorhinolaryngologic Surgical Procedures ; adverse effects ; instrumentation ; Palate ; surgery ; Pharynx ; surgery ; Postoperative Period ; Pressure ; Sleep Apnea, Obstructive ; surgery ; Uvula ; surgery

Objective To analyze the direct and indirect effects of influencing factors on suicide ideation among college students based on the structural equation model. Methods 1505 college students were investigated with ASLEC, Simplified Coping Style Questionnaire, SSRS, QSA and BDI. Results Incidence rate of college students' suicidal ideations during the past year was 6.67%. The goodness of fit for the structural equation model was satisfactory and 3 major indices( x2/df = 2.23, GFI = 0. 982, RMSEA = 0. 029 ) had met corresponding requirements. The depression was directly influencing factor on suicide ideation, while four factors including passive coping style, social support, positive coping style and suicide attitude, had indirect impacts. Negative life event not only directly affected suicide ideation, but also had indirect effects. According to the percentages of their contribution, the risk factors were ranked as follows:depression (41.08%), negativity life event (35.35%) and passive coping style (6.05%). Similarly, the top protective factor was: social support ( 11.94% ), followed by positive coping style (4.94%) and suicide attitude (0.63%). Conclusion Depression is an important risk factor of suicide,and has a direct impact. So, not only strengthen the mental health of college students, but also train students to face up the difficulties with a positive style, and make the college students get social supports sufficiently.

BACKGROUND:Hip fracture has become one of the main reasons for morbidity, death and heavy medical costs in the elderly. With aging, the incidence of hip fractures in the elderly is increased day by day. OBJECTIVE:To investigate and analyze the incidence and distribution of hip fractures in middle-aged and old population from Changning District of Shanghai, China. METHODS:Medical records of patients with hip fracture ICD-9 CODE (femoral neck fracture and intertrochanteric fracture) admitted from July 2008 to June 2013 were col ected at the Changning District Public Health Information Center and Shanghai Shen Kang Medical Al iance Center. Population distributions of Changning District in 2010 and 2011 were provided by the Disease Control Center of Changning District. Then, the crude morbidity of hip fracture was calculated in terms of different ages and genders. For patients aged over 50 years, every 5 years served as an age group. RESULTS AND CONCLUSION:The incidence rate of hip fractures in the population aged over 50 years was 197.04/100 000, 88.51/100 000 in male and 304.73/100 000 in female. The annual standardized incidence rate of hip fracture was higher in female than male (P<0.05). The crude incidence rate of hip fracture was increased dramatical y in the population over 70 years, especial y in females. It indicates that the incidence rate of hip fractures is closed related to age, gender and osteoporosis.

Objective:To study the transdermal characteristics of myrrh essential oil and its percutaneous penetration enhancement for ibuprofen. Methods:The content of ibuprofen was determined by HPLC. Ibuprofen was used as the model drug and mouse skin was used as the permeation barrier in vitro. The transdermal properties of myrrh essential oil and its effect on percutaneous absorption of ibuprofen were investigated using Franz diffusion cells. Results:Without myrrh essential oil or with 1%, 2% and 3% myrrh essential oil, the cumulative transdermal penetration amount in 12h of ibuprofen in vitro was (0. 427 05 ± 0. 069 82), (0. 315 04 ± 0. 032 24), (0.230 50 ±0.031 14) and (0.181 34 ±0.053 70) mg·cm-2, with Jss of(0.031 4 ±0.005 7), (0.020 8 ±0.002 8), (0.017 2 ±0.001 6) and (0.013 9 ±0.003 4) mg·(cm2·h) -1, respectively. Conclusion: Myrrh essential oil shows no transdermal en-hancement for ibuprofen in vitro, to the contrary, it shows inhibitory effect with positive correlation to the concentration.

OBJECTIVE:To study the chemical constituents in ethanol extract from the stem of Miao medicine Rubus multibracteatus. METHODS:The ethanol extract from the stem of Miao medicine R. multibracteatus was isolated and purified by silica gel column,preparative liquid chromatography and Sephadex LH-20 gel column,etc. The structure of compounds were analyzed and identified according to physicochemical properties and spectrum data(MS,hydrogen spectrum and carbon spectrum). RESULTS:Ten compounds were isolated from the ethanol extract of R. multibracteatus stem,i.e. 5,4′-dihydroxy-8-(3,3-dimethylally)-2″, 2″-dimethylpyrano [5,6∶6,7] isoflavone(1),3-hydroxy-1-(4′-hydroxy-3′-methoxyphenyl)propan-1-one(2),3β-hydroxysitost-5-en-7-one (3),Lupeol(4),Coniferaldehyde(5),E-p-hydroxy-coumaric acid(6),Genistein(7),1-O-p-coumaroylglycerol(8),Scopoletin(9), and Kaempferol(10). CONCLUSIONS:Compound 1-9 are isolated from the plants of R. multibracteatus for the first time,and Compound 2,5,8 are isolated from the plants of Rubus L. for the first time. The study lays the foundation for further development and utilization of R. multibracteatus.

Objective :To assess the clinical efficacy of proximal femoral locking plate for the treatment of subcapital femoral neck fracture .Methods :A total of 15 patients with the subcapital femoral neck fracture who were admitted and treated with proximal femoral locking plate in Tong Ren Hospital ,Shanghai Jiao Tong University School of Medicine during Jun .2013 and Jun .2014 were enrolled .Regular postoperative follow-up was done .Fracture healing was assessed by X-ray and function of hip joint was evaluated with Harris score .Results :All the 15 patients were followed up for 12-24 months (mean 16 .7 months) . All the cases were well healed and there was no wound infection .Partial necrosis of the femoral head was found in 1 case , however there was no joint function limitation .The delayed union of fracture or bone nonunion was not found ,and there was no internal fixation loosening ,nail off ,broken nail ,neck rotation ,or neck shortening .The Harris score indicated that the excellent and good rate was 86 .67% (13/15) .Conclusions :Proximal femoral locking plate provides good fracture reduction , stable fixation ,good postoperative recovery ,high healing rate for the treatment of subcapital femoral neck fracture .

Objective:To prepare anti-human IgE nanobody by phage display technology,and to establish a method for hyper-sensitivity detection of cat dander specific IgE antibody.Methods:Allergen bio-information of cat was searched in WHO/IUIS Allergen Database.After synthesizing sequence,recombinant cat dander allergenic protein Fel d 1 was expressed and purified in prokaryotic ex-pression system.Human IgE was used to immunize Bactrian camel and RNA were extracted from lymphocyte to construct phage dis-play library.Library capacity,diversity and insertion rate were analyzed,anti-human IgE nanobody were obtained by screening and identification.A magnetic particle chemical method for cat dander specific IgE antibody detection was established using recombinant allergen-coupled magnetic particles and acridine ester-labeled nanobodies.Results:Capacity of phage display library was 1.88×108 cfu/ml,insertion rate was 93.6%,and purity of nanobody was>95%.Linear range of the method based on nanobody was 0.1～100 U/ml,who was consistent with ImmunoCAP detection system by clinical data.Conclusion:Nanobody-based cat dander specific IgE antibody hypersensitivity assay is successfully prepared,providing a technical basis for auxiliary diagnosis of cat allergic diseases.

Objective:To explore the correlation between blastomere count variations “skip value” which extracted from by time-lapse technology (TLT) combined with artificial intelligence (AI) and morphological features of in vitro fertilization (IVF) embryo, and to test its feasibility in clinical applications.Methods:This study was a diagnostic experiment (AI reassessment of embryo transferred patients), a total of 6 545 embryos from 1 226 patients who underwent IVF at the Women and Children′s Hospital of Chongqing Medical University from December 2020 to December 2021 were retrospectively analyzed, of which 2 869 embryos were attempted to cultured to blastocyst stage by TLT. The embryo dynamic map (EDM) was drawn by Embryo Viewer, a TLT recording software, based on embryo developmental kinetics. The self-developed AI embryo evaluation software identified and recorded the number of cleavages in real time during embryonic development, and compared with the EDM, the correlation between the skip value formed by the change of cleavage sphere counts and the outcomes of the embryos was analyzed. The correlation among skip value, morphological score of embryo, implantation rate and live birth rate were performed by Spearman and step-up logistic regression. The receiver operating characteristic (ROC) curve was selected for reporting there relationship of skip value and morphology. Finally, predicting power of skip value for implantation and live birth rate were performed by ROC analysis.Results:The total skip values extracted from the blastomere count of embryos (72 hours post-fertilization) were negatively correlated with abnormal cleavage, blastocyst formation rate, day 3 (D3)-cell score, uneven size and fragmentation (the β values were -0.268, -0.116, -0.213, -0.159 and -0.222, respectively; all P<0.001); positively correlated with D3-cell number ( β=0.034; P<0.001); negatively correlated with blastocyst formation rate and implantation rate ( OR=0.97, 95% CI: 0.93-0.99, P=0.034; OR=0.96, 95% CI: 0.93-0.98, P=0.044). The power of predicting implantation were similar between the order selection of skip values and traditional morphology criteria [area under curve (AUC): 0.679 vs 0.620]. Live birth rate were negatively correlated with female age ( OR=0.91, 95% CI: 0.88-0.93; P<0.001), D3 general score ( OR=0.77, 95% CI: 0.59-0.99; P=0.045) and order selection of skip values ( OR=0.98, 95% CI: 0.96-0.99; P=0.038), while positively correlated with retrieved oocyte number and endometrial thickness in embryo transferred ( OR=1.08, 95% CI:1.05-1.11, P<0.001; OR=1.09, 95% CI:1.06-0.12, P<0.001, respectively) from multivariate regression analysis, and the power of predicting live birth was 0.666 for AUC. Conclusions:The skip value and its order form is a systematic quantification of embryo development, correlated with embryo developmental quality and clinical outcome. It could be an addition parameter for embryo culture and selection.

BACKGROUND:Superovulation is a common therapy in assisted reproductive technology.In clinical practice,some patients experience repeated superovulation to get pregnant. OBJECTIVE:To explore the effect of repeated superovulation on the developmental potential of oocytes in mice and humans. METHODS:Both animal experiments and retrospective clinical research were conducted.The animal study involved 90 SPF grade ICR 8-week-old female mice,who were randomly divided into three groups for 1,3,and 5 superovulations,respectively.The clinical study involved 306 patients who had undergone three consecutive in vitro fertilization cycles.The number of ovules obtained and embryonic development in different cycles were compared. RESULTS AND CONCLUSION:(1)The animal study indicated that repeated superovulation did not affect the embryonic development or developmental speed of mouse embryos.Similarly,there was no significant difference in the mouse blastocyst apoptosis,DNA damage,or the formation of inner cell mass and trophectoderm(P>0.05).(2)The clinical study also revealed no significant differences in the number of retrieved oocytes(8.60±5.04,8.58±4.87,and 8.38±4.63,P=0.81)and transferable embryos(2.42±1.99,2.40±1.92,and 2.64±2.00,P=0.26)over the three cycles.(3)In both the young group(<35 years)and the old group(≥35 years),the embryo quality was not affected by repeated superovulation(P>0.05).(4)These findings show that repeated superovulation does not affect the developmental potential of oocytes in mice and humans.

Objective:To investigate the knowledge of Sixth Chinese national consensus report on the management of Helicobacter pylori infection ( treatment excluded) (hereinafter referred to as sixth national consensus) and 2022 Chinese national clinical practice guideline on Helicobacter pylori eradication treatment (hereinafter referred to as the guideline)among medical staff from general hospitals in Hainan. Methods:From February 20 to May 7, 2023, a questionnaire survey on the diagnosis and treatment of Helicobacter pylori ( H. pylori) infection was conducted among 1 463 medical staff from 15 general hospitals in Hainan Province. The questionnaire was drawn up according to the sixth national consensus and the guideline, covering knowledge of 6 sections, induding H. pylori related diseases, detection of H. pylori, eradication, prevention and influence factors of eradication of H. pylori, etc. Chi-square test was used for statistical analysis. Results:A total of 1 463 valid questionnaires were collected with the effective responsive rate of 100.00%.The 1 463 subjects included 225 gastroenterologists and 1 238 other medical staff(including 503 physicians from other departments, 264 surgeons and 471 medical technologists and pharmacists). About 78.67%(177/225)of gastroenterologists agreed that the overall infection rate of H. pylori in China was more than 20%, the awareness rate was higher than that of other medical staff (physicians from other departments 65.41%(329/503), surgeons 61.74%(163/264), medical technologists and pharmacists 60.30%(284/471); the following datas were sorted by this position), and the difference was statistically significant ( χ2=30.97, P<0.001). About 51.11%(115/225) of gastroenterologists considered that H. pylori serological antibody test could not be used as a diagnostic method for current infection, the awareness rate was higher than that of other medical staff(22.07%(111/503), 14.02%(37/264), 12.31%(58/471)), and the difference was statistically significant( χ2 =152.66, P<0.001). Proton pump inhibitor and potassium-competitive acid blocker should be discontinued for 2 weeks, and antibiotics and bismuth should be discontinued for 4 weeks before urea breath test, and the awareness rates of gastroenterologists were higher than those of other medical staff (38.67%(87/225) vs. 23.26%(117/503), 19.70%(52/264), 18.47%(87/471); 60.89%(137/225) vs. 26.64%(134/503), 25.76%(68/264), 23.78%(112/471)), and the differences were statistically significant ( χ2 =133.70 and 165.51, both P<0.001). For refractory H. pylori infection, 98.67%(222/225)of gastroenterologists agreed with the individualized diagnosis and treatment of H. pylori infection should be guided by bacterial culture, antibiotic susceptibility test or drug resistance gene test, and the awareness rate was higher than that of other medical staff (91.85%(462/503), 93.56%(247/264), 93.21%(439/471)), and the difference was statistically significant( χ2=20.55, P=0.002). About 70.67% (159/225) of gastroenterologists recommended a bismuth containing quadruple regimen, 80.44% (181/225) supported a 10 to 14 day H. pylori eradication course, and the awareness rates were higher than other medical staff (46.92%(236/503), 33.33%(88/264), 32.91%(155/471); 67.20%(338/503), 59.09%(156/264), 53.93%(254/471)), and the differences were statistically significant ( χ2=111.25 and 59.99, both P<0.001). The understanding rates of the sixth national consensus and the guideline in gastroenterologists was 85.33% (192/225), which was higher than that of other medical staff (64.21%(323/503), 66.67%(176/264), 57.96%(273/471)), and the difference was statistically significant ( χ2=85.47, P<0.001). Conclusions:Gastroenterologists from general hospitals in Hainan Province have a better understanding of the sixth national consensus and the guideline than other medical staff. However, there is still a lack of deep understanding of the sixth national consensus and the guideline, and it is necessary to further strengthen the learning and application of the sixth national consensus and the guideline.