Objective:To investigate the effect of single-port laparoscopy and conventional laparoscopic surgery in ovarian cystectomy.Methods:The clinical data of 139 patients with laparoscopic surgery for ovarian cyst admitted to the same department of gynecology from December 2016 to December 2019 in Suzhou Hospital Affiliated of Anhui Medical University were retrospectively analyzed, and they were divided into single-port laparoscopic surgery group (62 cases) and conventional laparoscopic surgery group (77 cases) according to different surgical methods. The clinical indictors, the levels of estrogen, T lymphocyte subgroups, the complications rate and incision satisfaction rate between two groups were compared.Results:The operation in both groups was smooth and there was no conversion to open surgery. Compared with the conventional laparoscopic surgery group, the surgery time, intraoperative blood loss in single-port laparoscopic surgery group were higher, the hospital stays in single-port laparoscopic surgery group was shorter, but there were no significant differences ( P>0.05). The levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E 2) in two groups before operation had no significant differences ( P>0.05). At 30 d after operation, the levels of FSH, LH and E 2 in single-port laparoscopic surgery group were higher than those in conventional laparoscopic surgery group, but the differences were no statistically significant ( P>0.05). Before operation, the levels of CD 4+, CD 8+ and CD 4+/CD 8+ in two groups has no significant differences ( P>0.05). At 3 d after operation, the levels of CD 4+, CD 8+ and CD 4+/CD 8+ in single-port laparoscopic surgery group were higher than those in conventional laparoscopic surgery group: 0.51 ± 0.03 vs. 0.47 ± 0.02, 0.41 ± 0.23 vs. 0.39 ± 0.05, 1.36 ± 0.02 vs. 1.24 ± 0.02, and the differences were statistically significant ( P<0.05). The rate of complication in two groups had no significant difference ( P>0.05). At 3 d after operation, the scores of visual analogue scale (VAS) of pain in single-port laparoscopic surgery group were lower than that in conventional laparoscopic surgery group: (1.12 ± 0.21) scores vs. (3.56 ± 0.65) scores, and the difference was statistically significant ( P<0.05). The incision satisfaction rate in single-port laparoscopic surgery group was significantly higher than that in conventional laparoscopic surgery group: 90.32%(56/62) vs. 72.73%(56/77), and the difference was statistically significant ( P<0.05). Conclusions:Single-port laparoscopy can be safely and smoothly implemented in ovarian cystectomy, and can reduce postoperative pain, improve cell immunity, and have better cosmetic result.

Objective: To investigate the clustering of risk factors among populations at high risk of cardiovascular diseases in Shaoxing City, Zhejiang Province, so as to provide the evidence for formulating the cardiovascular disease control measures among populations at high risk of cardiovascular diseases. Methods: The populations with hypertension, diabetes, dyslipidemia and a history of cardio-cerebrovascular disease at ages of 35 to 70 years were sampled from 6 districts (counties) of Shaoxing City using a multi-stage cluster random sampling method from May to July 2021. Participants' demographics, history of disease, smoking, alcohol consumption and drug use were collected through questionnaires, and height, body weight and blood lipid were measured. The participants at high risk of cardiovascular diseases were enrolled, and the prevalence and clustering of five risk factors were investigated, including current smoking, current alcohol consumption, overweight/obesity, never exercise and daily sedentary duration of 3 hours and longer. Factors affecting the clustering of risk factors were identified with an ordinal logistic regression model. Results: Totally 1 695 participants were enrolled, including 940 men (55.46%) and 755 women (44.54%), with a mean age of (62.56±6.08) years old. There were 213 participants with a history of cardio-cerebrovascular disease (12.57%), and the prevalence of hypertension, diabetes and dyslipidemia was 78.53%, 61.95% and 46.78%, respectively, and there were 32.63% of participants with current smoking, 35.99% with current alcohol consumption, 49.38% with overweight/obesity, 62.12% with never exercise and 61.24% with daily sedentary duration of 3 hours and longer, respectively. There were 28.85% of participants with two risk factors, and 46.90% with three to five risk factors. Ordinal logistic regression analysis showed that male (OR=5.430, 95%CI: 4.389-6.726), and development of hypertension (OR=1.655, 95%CI: 1.313-2.090) led to present more numbers of clustering of risk factors, and annual household income of 20 000 to 50 000 Yuan (OR=0.620, 95%CI: 0.473-0.812), a history of cardio-cerebrovascular diseases (OR=0.430, 95%CI: 0.324-0.572), presence of diabetes (OR=0.592, 95%CI: 0.476-0.736) led to less numbers of clustering of risk factors among populations at high risk of cardiovascular diseases. Conclusions There is clustering of risk factors among populations at high risk of cardiovascular diseases in Shaoxing City. Men, income, history of cardio-cerebrovascular diseases, hypertension and diabetes are factors affecting the clustering of risk factors.

Objective: To investigate sleep quality among patients with hypertension and diabetes, so as to provide the basis for improving the health of patients with chronic diseases. Methods: From May to August 2022, patients with hypertension and diabetes under the community management in 4 counties and cities (districts) of Shaoxing City, Zhejiang Province were recruited using a multi-stage stratified cluster random sampling method. Demographic information, disease history, smoking, alcohol consumption, physical activity and sleep quality were collected by questionnaire surveys, and blood pressure, fasting blood glucose and glycosylated hemoglobin were collected through physical examination and laboratory testing. The incidence of poor sleep quality symptoms (snoring/asphyxia/suffocation, difficulty falling asleep, night awakening, taking sleeping pills and early morning awakening) in patients with diabetes and hypertension was descriptively analyzed, and sleep quality was evaluated. Results: A total of 1 539 patients with hypertension and diabetes were surveyed, including 715 males (46.46%) and 824 females (53.54%). The patients had a mean age of (68.68±7.62) years. The proportions of night awakening, early morning awakening, snoring/asphyxia/suffocation, difficulty falling asleep and taking sleeping pills were 29.82%, 28.53%, 20.73%, 15.79% and 4.29%, respectively. The proportion of poor sleep quality was 66.54%. Employment status, smoking status, moderate/high intensity physical activity and blood pressure control were related to poor sleep quality (all P<0.05). Conclusion Poor sleep quality is common in patients with hypertension and diabetes, with the main symptoms being night awakening, early morning awakening, difficulty falling asleep and snoring/asphyxia/suffocation.

Objective: To investigate the situation of road traffic injuries (RTIs) among middle school students in Shaoxing City, Zhejiang Province, so as to provide the basis for implementation of interventions against RTIs among students. Methods: From 2021 to 2023, a multi-stage stratified cluster sampling method was used to select 82 junior high school classes and 89 senior high school classes in Shaoxing City as the survey population. Data on basic information, commuting travel, road safety behaviors and road safety knowledge awareness were collected through questionnaires, and the prevalence of RTIs in the past year was analyzed. Results: A total of 6 287 middle school students were surveyed, and 971 cases of RTIs were reported, with a reporting rate of 15.44%. The reporting rate of RTIs was higher in males than in females (17.68% vs. 13.34%, P<0.05). The reporting rate of RTIs was higher in high school students than in junior high school students (17.70% vs. 12.66%, P<0.05). The students who mainly walked to school (18.00%), walked 5 days a week (17.82%) and traveled with classmates (17.58%) had higher reporting rates of RTIs. Among those who walked for ≥20 minutes, the reporting rate of RTIs was higher in males than in females (P<0.05). Among different road safety behaviors, the reporting rate of RTIs was higher in males than in females who used electronic devices (P<0.05). The reporting rates of RTIs were relatively high among students who played for ≥10 minutes on the way (32.92%), crossed traffic lights directly when being late for school (41.54%) and crossed traffic barriers directly (30.67%). The reporting rate of RTIs among middle school students decreased with the increase of road safety knowledge scores (P<0.05). Conclusions Male students, high school students, students with road risky behaviors and with low awareness of road safety knowledge have higher reporting rates of RTIs. It is necessary to strengthen road safety knowledge education for students.

Objective To observe the serum γ-glutamyltransferase (γ-GGT) levels in patients with chronic hepatitis B virus (HBV) infection in different immune status and investigate their relationship with HBV DNA loads and ALT levels. Methods Blood samples were collected from 191 patients with chronic HBV infection in different immune status, including inactive HBV carrier state (group B,n = 55), immune tolerance phase (group C, n=47), HBeAg-negative CHB (group D, n =17), immune-reactive phase (group E, n=72) and 61 healthy individuals ( group A) for the detection of the serum γ-GGT, ALT level and HBV DNA loads. Results γ-GGT level were obviously higher in groups D and E than those in groups of A, B and C (P<0.01). Correlation analysis showed that the γ-GGT levels were positively correlated with serum ALT , AST levels in HBeAg-negative CHB and immune-reactive phase , but not correlated with HBV DNA loads. Conclusions The levels of γ-GGT are different during different immune status in patients with chronic HBV infection. The increased serum γ-GGT level may be an indicator for patients with chronic HBV infection entering immune active phase. The liver inflammation is the major impact factor to the γ-GGT levels.

Objective To study interleukin-23 (IL-23) levels in serum and dendritic cells of acute-on-chronic liver failure (ACLF) patients with chronic hepatitis B (CHB) and to explore its relationship with the prognosis.Methods Peripheral blood mononuclear cells and serum were collected from 40 ACLF patients with CHB (including survival group 27 cases and non-survival group 13 cases) and 26 healthy controls.Monocytes were induced to immature dendritic cell in vitro and TNF-α was added to induce dendritic cell maturation.IL-23 mRNA of dendritic cells was detected by real time polymerase chain reaction (PCR), and serum IL-23 level was measured by enzyme-linked immuno sorbent assay (ELISA).Differences among the parameters with normal distribution were compared using t test, those with non-normal distribution were compared using non-parametric Mann-Whitney U-test, and the relationship between two variables was assessed by Spearman′s rank correlation.Results International normalized rate (INR) and model for end-stage liver disense (MELD) scores in non-survival group of ACLF were higher than those in survival group (INR: 2.32 vs 1.64, U=69.00, P=0.002 2;MELD:36 vs 30, U=64.50, P=0.001 4).However, there were no significant differences between two groups at gender, age, alanin aminotransferase (ALT), aspartate aminotrans ferase (AST), bilirubin, creatinine, hepatitis B virus (HBV) DNA, hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and serum IL-23.IL-23 mRNA level in dendritic cells at baseline in non-survival group of ACLF was significantly higher than that in survival group (76 vs 43, U=71.50, P=0.002 8).After treatment, serum IL-23 was significantly declined in survival group ([160±75] ng/L vs [91±49] ng/L, t=4.012, P=0.000 2), but not in non-survival group.Significant positive correlation was observed between IL-23 mRNA level in dendritic cells and MELD score at baseline (r=0.7198,P<0.01).Conclusions Persistent high serum IL-23 level suggests poor prognosis in ACLF patients with CHB.IL-23 mRNA expression in dendritic cells has good consistency with MELD score and the patients with high IL-23 mRNA expression has poor outcome.

Objective To explore the diagnostic values of combined detection of serum procalcitonin (PCT) and β2 microglobulin (β2MG) in tsutsugamushi disease.Methods Serum PCT and β2MG were compared in cases of tsutsugamushi disease and fever patients at the same time,who were hospitalized at Fourth Affiliated Hospital of Guangxi Medical University from June 2014 to May 2017.The best diagnosis cut-off value of tsutsugamushi disease was calculated by receiver operating characteristic (ROC) curve.Results A total of 57 cases of tsutsugamushi disease,40 cases of sepsis,17 cases of acquired immunodeficiency syndrome (AIDS),17 cases of severe community-acquired pneumonia (SCAP),63 cases of common community-acquired pneumonia (CCAP),14 cases of pulmonary tuberculosis (PTB),20 cases of upper respiratory tract infection,13 cases of other infectious fever and 28 cases of non-infectious fever patients were selected.The level of serum PCT in tsutsugamushi disease [0.87 (0.68-1.34) μg/L] was higher than those in AIDS [0.47 (0.20-1.12) μg/L],CCAP [0.17 (0.09-0.51) μg/L],PTB [0.13 (0.05-0.18) μg/L],upper respiratory tract infection [0.23 (0.05-0.48) μg/L] and non-infectious fever [0.09 (0.06-0.13) μg/L],but was lower than those in sepsis [5.00 (1.04-18.78) μg/L] and SCAP [3.35 (0.76-14.41) p,g/L,P ＜ 0.05],while the difference was not significant compared with other infectious fever [0.76 (0.13-1.99) μg/L,P ＞ 0.05].The level of serum β2MG in tsutsugamushi disease [(5.67 (4.47-7.90) mg/L] was higher than those in sepsis [2.83 (2.10-4.54) mg/L],AIDS [3.85 (3.19-5.22) mg/L],SCAP [3.83 (2.98-5.58) mg/L],CCAP [1.99 (1.51-2.75) mg/L],PTB [1.92 (1.37-3.00) mg/L],upper respiratory tract infection [2.02 (1.25-2.74) mg/L],other infectious fever [2.45 (1.51-4.12) mg/L] and non-infectious fever [2.99 (2.06-4.30) mg/L,P ＜ 0.05].ROC curve showed that the most suitable diagnosis cut-off value of serum PCT in tsutsugamushi disease was 0.53 μg/L,the sensitivity was 94.7％,and the specificity was 60.4％.The critical value of serum β2MG was 3.74 mg/L in diagnosis of tsutsugamushi disease,its corresponding sensitivity and specificity were 91.2％ and 75.9％,respectively.The sensitivity and specificity of combined serum PCT and β2MG in diagnosis of tsutsugamushi disease was 87.7％ and 86.3％,respectively.Conclusion Combined detection with serum PCT and β2MG can improve early diagnosis of tsutsugamushi disease.

Objective To compare the short-term mortality of acute-on-chronic liver failure (ACLF) in patients with chronic hepatitis B following lamivudine versus entecavir antiviral treatment. Methods All chronic hepatitis B patients associated with ACLF were included in this analysis if they were treated with lamivudine or entecavirat the Department of Infectious Diseases, Huashan Hospital, Fudan University, from August 2010 to August 2016. Results A total of 56 patients were included (36 in lamivudine group and 20 in entecavir group). The 7-day, 14-day and 28-day survival rate was 94％, 72％ and 64％ in lamivudine group, and 70％, 65％ and 65％ in entecavir group. Lamivudine group showed significantly lower 7-day mortality than entecavir group, but no significant difference in 14-day and 28-day mortality. Subgroup analysis did not show significant difference in 28-day mortality between the two groups either in model for end-stage liver disease (MELD)≤30 patients or in ACLF grade 0-1 patients. Lamivudine treatment was associated with significantly lower 7-day mortality than entecavir in cirrhosis patients, but no significant difference in 14-day and 28-day mortality. Conclusions Lamivudine treatment is associated with significantly higher 7-day survival rate than entecavir. However, the short-term (within 28 days) mortality of acute on chronic liver failure in chronic hepatitis B patients is similar between lamivudine and entecavir treatment. Lamivudine is also appropriate for the patients with cirrhosis or waiting for liver transplantation.

Objective To explore the relationship between urinary iodine level and breast cancer,we compare urinary iodine excretion levels in patients with breast cancer,benign breast disease,other female malignant tumors and control subjects in Xiangya Hospital of Central South University.Methods From December 2018 to January 2019,64 patients with newly diagnosed breast cancer in Xiangya Hospital of Central South University were selected as case group,benign breast disease group (n =49),other female malignant tumor group (n =39) and health examination group (n =50) as control group.Urinary iodine was determined by colorimetry.According to the urinary iodine level the patients divided into three groups:iodine excess (＞300 μg/L),medium iodine (100-300 μg/L) and iodine deficiency (＜ 100 μg/L).The relationship between urinary iodine and clinicopathology of breast cancer was analyzed.Results The level of urinary iodine in benign breast nodule group 319.13 (163.98) μg/L ＞ breast cancer group 273.96 (151.30) μg/L ＞ female other malignant tumor group 212.95 (161.71) μg/L ＞ normal control group 199.15 (194.45) μg/L,with significantly differance (H =9.936,P =0.019).Urinary iodine level in the normal control group was significantly lower than that in the benign breast disease group (P =0.013).The patients were further divided into three groups according to the urinary iodine level:iodine excess,iodine medium and iodine deficiency,the number of urine iodine ＜ 100 μg/L in the normal control group was significantly higher than that in the breast cancer group (P =0.021).The level of urinary iodine was negatively correlated with the size of the primary focus of breast cancer (Z =-2.307,P =0.021).The effect of urinary iodine was analyzed by multiple linear regression method.The size of primary focus was included in the regression equation (R2 =0.136,P=0.007),but had nothing to do with lymph node metastasis and the expression status of estrogen receptor (ER),androgen receptor (AR),progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2).Conclusions There is a negative linear correlation between urinary iodine level and the size of primary focus of breast cancer,but it has nothing to do with lymph node metastasis and the expression of ER,AR,PR and HER-2.

Objective To determine if preventive antibiotics is effective in stroke associated pneumonia in patients with acute stroke.Methods Medline (January 1950 to January 2017),EMBASE (January 1974 to January 2017),Cochrane Library (January 2009 to January 2017),CNKI (January 1979 to January 2017)and Wanfang data (January 1998 to January 2017) were searched for randomized controlled trial comparing preventive antibiotics with placebo/blank controls for stroke associated pneumonia in patients with acute stroke.The included studies were screened out strictly based on the criterion of inclusion and exclusion.The quality of included studies was evaluated and the data were extracted by two researchers independently.RevMan 5.1 was used for Meta analysis.Results A total of 4 studies involving 3894 patients were included.The results of Meta-analysis indicated that there was no significant difference in the incidence of stroke associated pneumonia between preventive antibiotics and control groups (OR=0.96,95％CI:0.72-1.29,P=0.810);and there were no statistically significant differences in mortality (OR=1.05,95％CI:0.88-1.25,P=0.570) and good outcome (modified Rankin scale ≤ 2,OR=1.02,95％CI:0.89-1.17,P=0.780).There were no serious adverse reactions related to the studied drugs in 4 studies.Conclusion Preventive antibiotics could neither reduce the incidence of stroke associated pneumonia nor decrease the mortality or improve the proportion of good outcome.