Background Chronic non-communicable diseases, including hypertension, have become major threats to urban public health. The built environment has been linked to blood pressure. Objective To examine joint exposure patterns of built environment factors in relation to residents' blood pressure status and to identify environmental profiles of neighborhoods that may be favorable or unfavorable to hypertension prevention. Methods (1) A cross-sectional study was conducted among 1910 residents in Longzihu District, Bengbu City. Demographic characteristics, clinical indicators (including blood pressure), and lifestyle behavioral data were collected. Nine built environment indicators were derived within a 500-meter buffer zone surrounding each participant's residential address. (2) Using elevated blood pressure status as a binary outcome (all residents) and grade of elevated blood pressure as an ordinal multi-class outcome (residents with elevated blood pressure), the predictive performance of four binary classification models and nine multi-class classification models was compared, respectively. Feature importance was ranked based on the best-performing model. Multi-variable logistic regression with stepwise adjustment was then used to identify key environmental factors. (3) Using partial dependence plots, a joint exposure analysis was conducted in the target population of residents with elevated blood pressure (high-normal blood pressure and hypertension grades 1–3), with the 25th and 75th percentiles of key environmental factors as the low- and high-level thresholds, respectively. The 95% confidence intervals were estimated using the Bootstrap method. Results (1) Among the study participants, 863 had elevated blood pressure: 349 (40.4%) had high-normal blood pressure, and 398 (46.1%), 93 (10.8%), and 23 (2.7%) had hypertension grades 1, 2, and 3, respectively. (2) Logistic regression showed the best performance in analyzing the association between built environment factors and elevated blood pressure status (n=1910), whereas random forest showed the best performance in analyzing the association between built environment factors and grade of elevated blood pressure (n=863). Road density, bus stop density, and hospital/clinic density were key environmental factors. (3) Pairwise joint exposure patterns were observed among the three key environmental factors: When any two were both below the low-level thresholds (road ≤0.54 km·km⁻², bus stop ≤0.51 points·km⁻², hospital ≤5.99 points·km⁻²), the risk of a higher grade of elevated blood pressure was greater than the overall sample average (relative predicted odds 1.29–1.31, 95% confidence interval lower bound >1); when any two were both above the high-level thresholds (road ≥0.75 km·km⁻², bus stop ≥1.25 points·km⁻², hospital ≥15.00 points·km⁻²), the risk was lower than the overall sample average (relative predicted odds 0.54–0.61, 95% confidence interval upper bound <1); low-high and high-low combinations did not differ significantly from the overall sample average (P > 0.05). Conclusion Joint exposure profiles characterized by road density, bus stop density, and hospital/clinic density are associated with elevated blood pressure among residents: Simultaneously low levels of any two of these environmental indicators are associated with a higher predicted risk of a more severe grade, whereas simultaneously high levels are associated with a lower predicted risk. These findings suggest that coordinated configurations of road networks, public transit accessibility, and medical service facilities may represent important environmental feature of neighborhoods favorable to hypertension prevention and control.

Circular RNAs(CircRNAs)are a class of non-coding RNAs with a covalently closed-loop structure,high stability,and tissue specificity,with the production mechanisms different from linear RNAs.Recent studies have discovered that some CircRNAs can encode proteins via cap-independent translation mechanisms such as internal ribosome entry site,N6-methyladenosine,and rolling loop translation.The encoded proteins regulate homologous linear proteins or downstream signaling pathways via protein bait or other mecha-nisms,thereby exerting biological functions.Studies have shown that CircRNAs play a role in various diseases,especially in tumor progression,proliferation,invasion,and metastasis and immune regulation.Therefore,by elucidating the expression and roles of proteins encoded by CircRNAs in tumorigenesis and development,this pa-per is expected to provide new tumor markers and potential targets for tumor diagnosis and treatment.

Objective:To investigate the effect of mini-retromandibular and transparotid approach in open reduction and internal fixation of middle or low condylar fractures.Methods:A total of 28 condylar fracture cases which were treated with mini-retromandibular approach from January 2016 to January 2019 in Nanjing Stomatological Hospital were included in this study. These cases included 18 males and 10 females with ameanage of 42.5 years. There were 11 cases of left condyle fractures, 13 cases of right condyle fractures and 4 of bilateral condyle fractures. During the operations, incisions of 2-3 cm long were made on the skin and subcutaneous tissue along the posterior margin of the mandible. Then we performed blunt dissections parallel to the facial nerves, directly passing through the parotid gland and masseter muscles, without the facial nerve injuried. After exposing the fracture line, the fracture ends were fixed and restored with two 4-hole titanium miniplates under direct vision.The medical reviews were performed on the third day and 3-6 months after operation by imaging examination and clinical examination. The contents included: postoperative hematoma, postoperative infection, nerve injury, salivary fistula, maximum mouth opening degree, mouth opening type, occlusal relationship, scar condition, etc.Results:All of the 28 patients had good restoration of fracture ends without nerve injury, salivary fistula or other complications. Only one patient suffered with postoperative infection. After 3 months, titanium miniplate was removed by second operation. The mouth opening of patients ranged 1.5-3.8 cm, with an average of 3.1 cm, which was significantly improved compared to the pre-operation (0.5-2.0 cm, average 1.2 cm). One patient’s chin was slightly deviated to the affected side at the time of opening, and the occlusal relationship was recovered well with intermaxillary elastic traction for 3-5 days.The mouth opening type of other patients was nearly normal. Followed up for 6-36 months, all of the patients had no obvious scars after operation.The patients were satisfied with the operation effect. All patients took postoperative CT and 3D reconstruction 3 to 6 months after operation, which showed that the fracture reduction was good.Conclusions:Mini-retromandibular and transparotid approach is effective, simple, efficient and fast in the treatment of condylar middle or low fracture, without facial nerve dissection. It can not only reduce the operation time and the possibility of facial nerve injury, but also make postoperative scar relatively inconspicuous.

Objective:To investigate the effect of mini-retromandibular and transparotid approach in open reduction and internal fixation of middle or low condylar fractures.Methods:A total of 28 condylar fracture cases which were treated with mini-retromandibular approach from January 2016 to January 2019 in Nanjing Stomatological Hospital were included in this study. These cases included 18 males and 10 females with ameanage of 42.5 years. There were 11 cases of left condyle fractures, 13 cases of right condyle fractures and 4 of bilateral condyle fractures. During the operations, incisions of 2-3 cm long were made on the skin and subcutaneous tissue along the posterior margin of the mandible. Then we performed blunt dissections parallel to the facial nerves, directly passing through the parotid gland and masseter muscles, without the facial nerve injuried. After exposing the fracture line, the fracture ends were fixed and restored with two 4-hole titanium miniplates under direct vision.The medical reviews were performed on the third day and 3-6 months after operation by imaging examination and clinical examination. The contents included: postoperative hematoma, postoperative infection, nerve injury, salivary fistula, maximum mouth opening degree, mouth opening type, occlusal relationship, scar condition, etc.Results:All of the 28 patients had good restoration of fracture ends without nerve injury, salivary fistula or other complications. Only one patient suffered with postoperative infection. After 3 months, titanium miniplate was removed by second operation. The mouth opening of patients ranged 1.5-3.8 cm, with an average of 3.1 cm, which was significantly improved compared to the pre-operation (0.5-2.0 cm, average 1.2 cm). One patient’s chin was slightly deviated to the affected side at the time of opening, and the occlusal relationship was recovered well with intermaxillary elastic traction for 3-5 days.The mouth opening type of other patients was nearly normal. Followed up for 6-36 months, all of the patients had no obvious scars after operation.The patients were satisfied with the operation effect. All patients took postoperative CT and 3D reconstruction 3 to 6 months after operation, which showed that the fracture reduction was good.Conclusions:Mini-retromandibular and transparotid approach is effective, simple, efficient and fast in the treatment of condylar middle or low fracture, without facial nerve dissection. It can not only reduce the operation time and the possibility of facial nerve injury, but also make postoperative scar relatively inconspicuous.

Objective To evaluate the effect of enteral nutrition by a polymeric formula in patients with severe acute pancreatitis (SAP).Methods Fifty-eight patients with SAP were randomly divided into polymeric group (29 cases) and semi-elemental group (29 cases),and the two groups of patients were treated in accordance with the conventional SAP management protocol,nasojejunal tube was endoscopically inserted for enteral nutrition.The polymeric group received enteral nutritional suspension (TPF),and the semi-elemental group received the same quantity of VIVONEX TEN.The gastrointestinal tolerance (VAS score),incidence of diarrhea,infection,28-day mortality rate,and length of hospital stay was evaluated.Nutritional parameters were evaluated by pre-albumin,albumin,alanine aminotransferase,C reactive protein at the time of admission and one week later.Results The two groups of patients were comparable in terms of VAS score,incidence of diarrhea,infection,28-day mortality rate,and length of hospital stay (P ＞0.05).And the levels of prealbumin,albumin,alanine aminotransferase,C reactive protein after admission were not statistically significant (P ＞ 0.05).Conclusions Compared with the semi-dement formula,the price of polymeric formula is cheap,configuration is convenint,enteral nutrition is well tolerated,and it is suitable for early enteral nutrition in SAP.

Objective To investigate the feasibility of using low Kv,low iodine contrast Agent concentration (dual low)CT scan techniques in Coronary CTA (CCTA).Methods Seventy-six patients undergoing CCTA were divided into Group A and Group B , randomly.Group A (38 patients)was the dual-low group,which was scanned with tube voltage of 100 kVp,and injected with iso-osmolarity contrast agent visipaque 270 (270 mg I/mL),with iterative reconstruction technique (ASIR 40%).Group B (38 pa-tients)was scanned with 120 kVp,and low osmolarity contrast agent omnipaque 350 (350 mg I/mL)and FBP reconstruction,The images are assessed double-blindly by two experienced radiologists.Five ROIs were placed onto the ascending root of aorta (AO), left main artery(LM),left anterior descending (LAD),left circumflex artery(LCX),right coronary artery (RCA),and the image qualities are evaluated objectively using CT values,noise,signal noise ratio (SNR),contrast noise ratio (CNR),and compared sta-tistically using Paired t-test.The radiation dosages,such as CTDIvol,DLP and ED were also recorded and compared with Paired t-test.Results CTDIvol,DLP and ED of Group A (dual low)decreased 35.7%,38.6% and 38.6% respectively compared with Group B,the iodine intake decreased 22.9%.While the image qualities of the two groups were not significantly different,all images are good enough for diagnosis,with Group A slightly better than Group B in radiologists’scores.Conclusion Voltage 100 kVp, combined with low contrast agent concentration of 270 mg I/mL can fully satisfy the diagnostics need in CCTA,and significantly lower both the radiation dosage and iodine intake.

The present study examined von Willebrand factor (vWF) levels and ADAMTS13 activity in pregnant and severe preeclamptic women in order to shed light on the prothrombotic state in severe preeclampsia. Thirty healthy women of childbearing age, 22 second trimester pregnant women, 30 third trimester pregnant women and 10 severe preeclamptic patients were recruited in this study. ADAMTS13 activity was determined by the FRETS-vWF73 assay and vWF antigen (vWF:Ag) levels by an enzyme-linked immunosorbent assay. The results showed that there were statistically significant differences in plasma vWF antigen levels between the severe preeclamptic and third trimester pregnant women, between third and second trimester pregnant women (P<0.05). The third trimester pregnant women had significantly lower plasma ADAMTS13 activity than second trimester pregnant women (P<0.05). Nevertheless, no significant differences in plasma ADAMTS13 activity were found between severe preeclamptic patients and the third trimester pregnant women (P>0.05). In conclusion, plasma ADAMTS13 activity is normal in severe preeclampsia despite the increased vWF:Ag levels. Prothrombotic state is involved in the pathogenesis of severe preeclampsia, as a result of endothelial injury.
ADAM Proteins ; blood ; metabolism ; ADAMTS13 Protein ; Adult ; Blood Coagulation ; physiology ; Case-Control Studies ; Female ; Humans ; Pre-Eclampsia ; blood ; enzymology ; physiopathology ; Pregnancy ; Pregnancy Trimester, Third ; Young Adult ; von Willebrand Factor ; metabolism

Objective To discuss with micro-tympanoplastic operation with osteo retention on treating cholesteatomatous otitismedis. Methods Choose 33 cases cholesteatomatous otitis medis patients who toke the tympanoplastic with osteo retention operation,then analyze the postulate and method of the operation, curative effect and complication after operation. Results Follow up with those patients by 12-72 months, and when 3-4 months after operation we endoscopiced the ears, could see that 43 cases of patients ear mastoid process and tympanic sinus were covered with epithelium, those mastoid cavity were well epithelial metaplasia;and the middle ear was separate from mastoid cavity; 39 cases patient of transplant eardrums are heal up (39/43, 90.7%). 2 cases have perforation of the tympanic membrane toke place after 4 months and 6 months with the operation, and it will heal up by anti-inflammatory drug and laser burning, 1 case had tympanic sinus hyperplasia with granulation tissue, and also had grassery juice; after taken anti-inflammatory drug and change bandage for 15 weeks, the symptom disappear. 1 case had grassery juice of operation cavity, after taking anti-inflammatory drug and physiotherapy, the symptom disappear in 24 weeks. After operation the pure tone audiometry shows that air conduction raise (16.8±6.8) dB HL, hearing raise up to:79.1%(34/43). Conclusion Base on right indication of operation choose, taken combined therapy of ambi-operation period, focus of infection are thoroughly cleaning up. Tympanoplastic with osteo retention are treating well with patients of cholesteatomatous otitismedis.

The present study examined von Willebrand factor (vWF) levels and ADAMTS13 activity in pregnant and severe preeclamptic women in order to shed light on the prothrombotic state in severe preeclampsia. Thirty healthy women of childbearing age, 22 second trimester pregnant women, 30 third trimester pregnant women and 10 severe preeclamptic patients were recruited in this study. ADAMTS13 activity was determined by the FRETS-vWF73 assay and vWF antigen (vWF:Ag) levels by an enzyme-linked immunosorbent assay. The results showed that there were statistically significant differences in plasma vWF antigen levels between the severe preeclamptic and third trimester pregnant women, between third and second trimester pregnant women (P<0.05). The third trimester pregnant women had significantly lower plasma ADAMTS13 activity than second trimester pregnant women (P<0.05). Nevertheless, no significant differences in plasma ADAMTS13 activity were found between severe preeclamptic patients and the third trimester pregnant women (P>0.05). In conclusion, plasma ADAMTS13 activity is normal in severe preeclampsia despite the increased vWF:Ag levels. Prothrombotic state is involved in the pathogenesis of severe preeclampsia, as a result of endothelial injury.

Objective To explore clinical value of transvagiTIa ultrasound in diagnosis of cctopie oviductpregnancy.Methods EUB-2000 ultrasound diagnosis meter was used,the vagina probe head frequency is 5～10MHz,after the vagina to the womb,the double-side ovary,the double side oviduct and its periphery organizes to carry on omni-direetionally sweeps looks up.Results Transvagina ultrasound diagnosis ectopic pregnancy center oviduct pot abdomen pregnancy 158 cases,the oviduct canyon department 4 cases,between the oviduct the nature department pregnancy 2 cases,all pass through the cefioseope of our hospital.Coincidence rate was 100%.Conclusion Transvagina ultrasound diagnosis ectopie pregnancy is one of most accurate ultrasound diagnosis methods presendy,suggested various basic units hospital widely develops.