Objective:To introduce a surgical technique of implant-based immediate breast reconstruction using the "latent orifice" procedure after skin-sparing mastectomy and to investigate the clinical value of this procedure.Methods:Clinical data of 72 patients who underwent immediate breast reconstruction using the "latent orifice" procedure (we placed the silicone prosthesis in a "latent orifice" consisting of fascia and underlying muscles) from Jan. 2016 to Dec. 2019 were collected. Characteristics of surgical technique and the effect of the reconstruction surgery were analyzed.Results:70 patients underwent nipple-areola complex sparing mastectomy (NSM) . Two patients’ nipples were resected due to intraoperative frozen pathology suggesting carcinoma existing in the nipples. The nipple epidermal necrosis occurred in 3 patients. No seroma, incision infection or capsular contracture occurred. According to the evaluation scale, the overall aesthetic score was 9.39 points. The average score of each subscale was: 9.57 points for breast volume, 9.43 for breast contour, 9.84 for placement of implant, 9.38 for scars, 9.27 for lower pole projection and 9.21 for inframammary fold definition. BREAST-Q questionnaires were filled by patients. Scores of psychosocial well-being ranged from 62 to 93 points, with the median score of 77 points. Satisfaction with breasts scores ranged from 58 to 100 points, with the median score of 71 points.Conclusion:The "latent orifice" procedure is a simple, safe, practicable, aesthetic and satisfying type of immediate implant-based breast reconstruction, which is worth practicing and promoting.

Objective:To systematically review the incidence and risk of psychological disorders in pregnant women with gestational diabetes mellitus (GDM) .Methods:The studies on psychological disorders in pregnant women with GDM published up to January 19, 2022 were retrieved from PubMed, Web of Science, Embase, CINAHL, Cochrane Library, APA PsyINFO, WanFang, CNKI, VIP and other databases. Two researchers independently evaluated the literature quality and extracted relevant data, and Stata 15.0 was used for Meta-analysis.Results:Finally, 48 studies were included, and the incidence rates of stress, anxiety, depression, and postpartum depression in pregnant women with GDM were 25% (95% CI: 2%-48%), 49% (95% CI: 12%-85%), 23% (95% CI: 18%-28%), and 15% (95% CI: 11%-21%). GDM was the risk factor of anxiety ( OR=1.14; 95% CI: 1.04-1.25), depression ( OR=1.63; 95% CI: 1.21-2.20), and postpartum depression ( OR=1.52; 95% CI: 1.18-1.96) during pregnancy. Conclusions:GDM will affect the mental health of pregnant women. Medical and nursing staff should screen pregnant women for early psychological disorders and provide targeted interventions to help maintain the health of mothers and babies.

Objective To identify flavonoid glycosides with quorum sensing inhibitory activity from Epimedium brevicornum and evaluate their bioactivity. Methods The minimum inhibitory concentrations （MICs） of five major flavonoid glycosides （baohuoside, icariin, epimedin A/B/C） and the extract of E. brevicornum were firstly determined. Subsequently, the inhibitory effects on the production of purple pigments in Chromobacterium violaceum CV026 were measured. Additionally, the biofilm formation and chitin quantification of Pseudomonas aeruginosa PAO1 were assessed. Results The extract of E. brevicornum and its primary components exhibited significant quorum sensing inhibitory activity. Particularly, icariin and epimedin C demonstrated superior inhibitory activity. Conclusion E. brevicornum demonstrates the ability to inhibit the quorum sensing system of Chromobacterium violaceum CV026 and Pseudomonas aeruginosa PAO1. Furthermore, icariin and epimedin C （100 μg/ml） show promise for development into novel drugs for quorum sensing inhibitor.

Objective:To observe the changes of serum C-terminal peptide of type Ⅰ collagen (CTX-1) and N-terminal lengthening peptide of type Ⅰ collagen (P1NP) in adult patients with skeletal fluorosis in the tea-drinking-borne endemic fluorosis area in Qinghai Province, and to find sensitive indicators for diagnosis of skeletal fluorosis.Methods:From April to August 2019, a case-control study was carried out in tea-drinking-borne endemic fluorosis area in Zhiduo County, Yushu Tibetan Autonomous Prefecture, and Gangcha County, Haibei Tibetan Autonomous Prefecture of Qinghai Province. According to the Diagnostic Standard for Endemic Skeletal Fluorosis (WS/T 192-2008), the clinical diagnosis and X-ray examination of skeletal fluorosis were carried out for permanent residents ≥25 years old and living for more than 10 years in the area, combined with face-to-face inquiry and investigation of past disease history, lifestyle and clinical manifestations. The patients with skeletal fluorosis and healthy people were selected as skeletal fluorosis group and control group, respectively. Randomized urine samples and fasting venous blood from the two groups were collected. The content of fluoride in urine was determined by ion selective electrode method, and the contents of CTX-1 and P1NP in serum were determined by enzyme-linked immunosorbent assay (ELISA).Results:A total of 127 people in the disease area were investigated, including 63 cases in skeletal fluorosis group and 64 cases in control group. There was no statistically significant difference in age and sex ratio between the two groups ( t = 0.42, χ 2 = 0.07, P > 0.05). The X-ray examination results showed that the patients with skeletal fluorosis were mainly mild, accounting for 71.43% (45/63); X-ray changes were mainly ossification of interosseous membrane and tendon. The urinary fluoride in control group and skeletal fluorosis group was 1.62 (1.12, 1.95) and 3.22 (2.38, 4.89) mg/L, respectively, with statistically significant difference between the two groups ( Z = 7.07, P < 0.001). The difference of serum CTX-1 and P1NP contents between the two groups was statistically significant ( Z = 2.00, 4.89, P < 0.05). Conclusions:The levels of serum CTX-1 and P1NP in patients with skeletal fluorosis are higher than those in healthy people. Serum CTX-1 and P1NP may be used as sensitive indicators for diagnosis of skeletal fluorosis.

ABSTRACT:Objective To report the data of 4 cases of Trocar-assisted ureteroscopy in the treatment of transplanted renal ureteral stones,to analyze the effectiveness of this therapy,and provide a reference for the treatment of such patients.Methods Clinical data of 4 patients with ureteral stones of transplanted kidney treated at the Affiliated Hospital of Guizhou Medical University during Jan.2016 and Jul.2023 were retrospectively analyzed.All patients received auxiliary ureteral soft/rigid endoscopic combined with holmium laser lithotripsy after Trocar-assisted bladder fistula.Renal function was rechecked after surgery and all patients were followed up regularly.Results All 4 cases had upper ureteral stones.During the follow-up of 24-68(average 38)months,no residual or recurrent stones were observed.Renal function and creatinine level returned to normal(79.0 μmol,95.0 μmol,60.6 μmol,82.0 μmol,respectively).Conclusion The treatment of ureteral stones of transplanted kidney should be individualized.Bladder fistula with Trocar-assisted ureteroscopy can effectively protect the function of transplanted kidney,which is worthy of promotion and application.