Duodenum-preserving pancreatic head resection， also known as Beger surgery， has a high incidence rate of bile duct injury after surgery， while the treatment modality for bile duct injury depends on the severity of the injury， and endoscopic therapy is often challenging in case of severe bile duct injury. Recently a patient with biliary fistula after Beger surgery was admitted to Affiliated Hangzhou First People’s Hospital， Westlake University， and successful diagnosis and treatment were achieved through oral choledochoscopy-assisted percutaneous-endoscopic rendezvous technique.

Objective:To identify the core symptoms of prostate cancer patients with endocrine therapy by constructed the symptom network, and provide a basis for precise intervention of symptoms management.Methods:In a cross-sectional study, we conveniently sampled patients receiving endocrine therapy for prostate cancer at Fudan University Shanghai Cancer Center between March and August 2018. The Expanded Prostate cancer Index Composite 26-item version (EPIC-26) and the Hospital Anxiety and Depression Scale (HADS) were used to assess symptoms.Symptom networks were constructed, and network indexes and the accuracy and stability of core symptoms were computed based on various packages of R4.3.1. Subgroup network comparison tests were conducted by Prostate-specific antigen (PSA) level, stratifying patients into PSA>0.2 ng/ml and PSA≤0.2 ng/ml groups.Results:A total of 270 questionnaires were distributed, and 261 valid questionnaires were returned, yielding a valid response rate of 96.7%. The included patients were aged 43 - 87(67.81 ± 8.14) years. Symptom network analysis revealed that the core symptom in patients undergoing endocrine therapy for prostate cancer was endocrine disorder ( rs = 1.86, rc = 0.048). However, in the population with PSA ≤ 0.2 ng/ml, depression ( rs = 1.80, rc = 0.028) occupied a more central position. There was no statistically significant difference in the network structure among patients with different PSA levels ( M = 0.294, P = 0.100). But the difference in network strength was statistically significant ( S = 1.15, P<0.05). The strongest associations were observed between depression and anxiety, as well as between endocrine disorder anddepression.The network demonstrated good stability and accuracy,indicating a reliable network model. Conclusions:Endocrine disorder is the core symptom in patients undergoing endocrine therapy for prostate cancer, serving as a critical target for intervention. Special attention should be given to the interconnected effects between endocrine disorder and depression. For the population with PSA ≤ 0.2 ng/ml, negative emotions such as depression still require ongoing focus. In the future, comprehensive interventions centered on psychological support and endocrine symptom management should be implemented for prostate cancer patients receiving endocrine therapy.

Objective:To evaluate the efficacy of combined cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) in the management of dysphagia secondary to glossopharyngeal and vagal nerve injury.Methods:This retrospective cohort study collected the clinical data of 18 patients with persistent dysphagia due to glossopharyngeal and vagus nerve injuries, who underwent concurrent cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) at the Department of Otolaryngology, Peking Union Medical College Hospital, from January 2017 to December 2024. Pre-and postoperative assessments included electronic flexible laryngoscope, the Chinese version of Swallow Quality-of-Life Questionnaire (CSWAL-QOL), videofluoroscopic swallowing study (VFSS), body weight changes, and nasogastric tube (NGT) removal status with routine follow-up. The comparison of swallowing function before and after surgery was conducted using paired samples t-test and χ2 test. Results:The study cohort comprised 10 male and 8 female patients, with ages ranging from 33 to 70 years (mean±SD: 53.8±10.5). All surgical procedures were completed successfully without complications. During the 6-to 24-month follow-up period, 10 of the 13 patients who were initially nasogastric tube-dependent achieved successful decannulation. Compared with preoperative values, postoperative measurements demonstrated statistically significant improvements across all parameters: mean body weight increased from (56.95±9.14) kg to (59.22±8.72) kg ( t=3.689 , P<0.01), CSWAL-QOL scores improved from 91.89±17.81 to 130.83±25.42 ( t=6.921 , P<0.01), while, both VFSS scales showed marked reductions (VFSS-SWAL: 6.78±1.40 to 3.39±1.61, t=-8.001, P<0.01; PAS: 6.56±1.15 to 2.94±1.26, t=-10.114, P<0.01). Conclusions:Combined CPM and AFIL represents an effective surgical approach for dysphagia following glossopharyngeal and vagal nerve injury, thereby demonstrating significant improvements in both swallowing function and quality of life.

Ocular trauma is a leading cause of permanent visual impairment and loss of working a-bility.Among them,orbital foreign body injuries are often accompanied by multiple injuries to the eye-ball and surrounding tissues,adversely affecting the quality of life.This paper reported a 33-year-old male patient with right orbital foreign body resulting in eyeball contusion,extraocular muscle injury,and restricted ocular movement.After surgical removal of the foreign body combined with integrated traditional Chinese and western medicine treatment,the patient's visual acuity improved from 0.4 to 0.8,and ocular motility function significantly improved.This suggests that comprehensive treatment contributes to promoting functional recovery and enhancing clinical efficacy.

Iodine is an essential micronutrient for the synthesis of thyroid hormones and for growth and development in the human body. Recent studies have revealed that iodine can exert biological functions beyond the thyroid. By modulating oxidative stress and gut microbiota abundance, it influences systemic metabolic homeostasis. Imbalance in iodine nutrition during pregnancy is closely associated with the onset and progression of gestational metabolic diseases. Based on studies pertaining to the relationship between iodine nutrition during pregnancy and gestational metabolic diseases from 1980 to 2025, this review summarized the relationship of iodine nutrition during pregnancy with gestational metabolic diseases, including gestational diabetes mellitus, gestational hypertension and preeclampsia, gestational overweight or obesity, and gestational dyslipidemia, and described the underlying biological mechanisms, so as to provide the evidence for formulating prevention and control strategies for gestational metabolic diseases.

Objective:To analyze the characteristics of CD4 + T cell subsets and cytokines in patients with mixed connective tissue disease (MCTD) and the correlation of MCTD disease activity, laboratory data, and clinical symptoms with cytokines. Methods:A total of 48 MCTD patients (including 24 newly diagnosed patients and 24 treated patients) were enrolled from the Department of Rheumatology and Immunology, the Second Hospital of Shanxi Medical University from 2018 to 2021. Meanwhile, 49 healthy subjects who underwent physical examination were recruited (healthy control group). The absolute counts of CD4 + T cell subsets in peripheral blood samples were analyzed by flow cytometry. The levels of serum cytokines were detected by flow bead array. Analysis of variance and Mann-Whitney U test were used to compare the differences between groups. Pearson or Spearman correlation analysis was used for correlation analysis. Logistic regression analysis was used to analyze related factors. The receiver operating characteristic curve was used to detect the best cut-off value and effectiveness. Results:The absolute counts of Th1 ( P<0.01), Th2 ( P<0.01) and Treg cells ( P<0.01) in the newly diagnosed MCTD patients and the treated MCTD patients were lower than those in the healthy subjects. The levels of cytokines (IL-2, IL-4, IL-6, IL-10, IL-17, IFN-γ, and TNF-α) in the two MCTD groups were higher than those in the healthy control group ( P<0.01). Further analysis revealed that the cardiac enzymes in MCTD patients included creatine kinase, creatine kinase-MB, aspartate aminotransferase, α-hydroxybutyrate dehydrogenase, and lactate dehydrogenase were positively correlated with cytokines ( P<0.05). In addition, it was found that IL-2 was positively correlated with erythrocyte sedimentation rate ( r=0.477, P<0.001), but it was negatively correlated with complement C3 ( r=-0.546, P=0.002) and complement C4 ( r=-0.422, P=0.02). IL-10 was correlated with the myositis symptoms in MCTD patients and the area under the receiver operator characteristic curve was 0.745 (95% CI: 0.576-0.915, P<0.05). Conclusions:This study provides insights into the unique immunological characteristics of CD4 + T lymphocyte subsets and cytokines in patients with MCTD, and also reveals a close correlation between cytokines and cardiac enzymes in MCTD patients. IL-2 has been shown to be associated with disease activity in MCTD patients. The level of IL-10 may be related to the occurrence of myositis symptoms in MCTD.

Objective:To evaluate the efficacy of combined cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) in the management of dysphagia secondary to glossopharyngeal and vagal nerve injury.Methods:This retrospective cohort study collected the clinical data of 18 patients with persistent dysphagia due to glossopharyngeal and vagus nerve injuries, who underwent concurrent cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) at the Department of Otolaryngology, Peking Union Medical College Hospital, from January 2017 to December 2024. Pre-and postoperative assessments included electronic flexible laryngoscope, the Chinese version of Swallow Quality-of-Life Questionnaire (CSWAL-QOL), videofluoroscopic swallowing study (VFSS), body weight changes, and nasogastric tube (NGT) removal status with routine follow-up. The comparison of swallowing function before and after surgery was conducted using paired samples t-test and χ2 test. Results:The study cohort comprised 10 male and 8 female patients, with ages ranging from 33 to 70 years (mean±SD: 53.8±10.5). All surgical procedures were completed successfully without complications. During the 6-to 24-month follow-up period, 10 of the 13 patients who were initially nasogastric tube-dependent achieved successful decannulation. Compared with preoperative values, postoperative measurements demonstrated statistically significant improvements across all parameters: mean body weight increased from (56.95±9.14) kg to (59.22±8.72) kg ( t=3.689 , P<0.01), CSWAL-QOL scores improved from 91.89±17.81 to 130.83±25.42 ( t=6.921 , P<0.01), while, both VFSS scales showed marked reductions (VFSS-SWAL: 6.78±1.40 to 3.39±1.61, t=-8.001, P<0.01; PAS: 6.56±1.15 to 2.94±1.26, t=-10.114, P<0.01). Conclusions:Combined CPM and AFIL represents an effective surgical approach for dysphagia following glossopharyngeal and vagal nerve injury, thereby demonstrating significant improvements in both swallowing function and quality of life.

Objective To assess the global,regional,and national burdens of eye cancer between 1990 and 2021,examine its change trends with the age,sex,geographic location,and socio-demographic index(SDI)level,and provide scientific evidence for the development of eye cancer prevention and control strategies.Methods Based on the data from the Global Burden of Disease(GBD)study,the global burden of eye cancer was evaluated using the indicator system inclu-ding incidence,prevalence,mortality,and disability-adjusted life years(DALYs).The change trend of the burden of eye cancer with time was quantified with Join-point regression.Frontier analysis methods were used to evaluate the relationship between the burdens of eye cancer with SDI.Results From 1990 to 2021,the global incidence,age-standardized inci-dence rate(ASIR),prevalence and age-standardized prevalence rate(ASPR)of eye cancer showed an upward trend over time.Conversely,the mortality,age-standardized mortality rate(ASMR),DALYs,and age-standardized DALY rate(ASDR)declined during the same period.All the above indicators in males were higher than those in females.Regionally,Eastern Sub-Saharan Africa bore the highest disease burden,while Oceania had the lowest.It should be noted that East Asia experienced the most significant increase in ASIR,and Southern Sub-Saharan Africa showed the greatest rise in ASPR.Meanwhile,Southern Latin America demonstrated the most pronounced decrease in both ASIR and ASPR.East Asia also re-corded the largest reductions in ASMR and ASDR.At the national level,Malawi had the highest disease burden in 2021.To-kelau exhibited the most substantial increase while Norway showed the greatest decrease in disease burden.Age-specific analysis revealed a bimodal distribution,with children under 5 years and adults over 80 being the most affected groups.Furthermore,SDI-based analysis indicated a wave-like relationship between SDI and ASIR/ASPR,and both ASMR and AS-DR declined with the increasing SDI.Conclusion The global burden of eye cancer shows a decline trend generally.The difference in the burden of eye cancer between regional and national levels may be related to medical resource allocation and public health policies.The results of this study provide scientific evidence for the development of tailored eye cancer prevention and control strategies.It is recommended that more attention should be paid to high-burden regions,resource distribution should be optimized,early screening should be enhanced,and targeted interventions for different age and gen-der groups should be implemented.

Objective:To analyze the iodine nutrition status and its related factors among adults aged 18 years and above in Zhejiang Province in 2022.Methods:A multistage stratified sampling method was used to select 4 320 adults aged 18 years and above from 16 on-site survey sites in Zhejiang Province for the study. A questionnaire was used to investigate the general demographic information and personal dietary characteristics of the study participants. Household edible salt and urine samples were collected to detect salt iodine content and urinary iodine level by using direct titration and cerium arsenate-catalyzed spectrophotometry, respectively, to evaluate the iodine nutritional status according to the standard. The multiple-ordered logistic regression model was used to analyze the factors influencing the urinary iodine concentration.Results:The age of the 4 320 study participants was (51.19±15.33) years, with males accounting for 44.44% (1 920). About 40.16% of adults (1 735) were from coastal areas and 56.37% (2 435) from urban areas. The salt iodine content, M ( Q1, Q3), of the 4 320 household edible salt samples was 21.10 (0.00, 24.16) mg/kg, including 1 662 non-iodized salt samples, 182 unqualified iodized salt samples and 2 476 qualified iodized salt samples. The rate of iodized salt coverage was 61.53%, and the rate of qualified iodized salt consumption was 57.31%. There was a statistically significant difference in the proportion of qualified iodized salt in adult households among different regions ( P<0.001), with the proportion of non-iodized salt gradually decreasing from coastal to inland areas ( χ 2trend=618.458, P<0.001). The urinary iodine concentration M ( Q1, Q3) was 137.60 (86.85, 210.60) μg/L in 4 320 adult urine samples, with the urinary iodine levels of<100, 100-199, 200-299, and≥300 μg/L accounting for 31.64% (1 367), 40.56% (1 752), 17.66% (763), and 10.14% (438), respectively. There was a nonlinear positive correlation between household salt iodine content and urinary iodine level in adults aged 18 years and above by using the χ 2 test for trend ( χ 2regression=231.10, P<0.001 and χ 2skew=28.81, P<0.001). Urinary iodine concentrations were higher in men than in women ( P=0.029) and higher in adults in rural areas than in urban areas ( P<0.001). There were statistically significant differences in the distribution of iodine nutritional status among adults of different ages, regions, and urban and rural areas (all P<0.001). The proportion of those with urinary iodine levels<100 μg/L gradually increased with age ( χ 2trend=37.493, P<0.001), and gradually decreased from coastal areas to inland areas ( χ 2trend=71.381, P<0.001). The results of the multiple-ordered logistic regression model analysis showed that compared with adults aged 18 to 44 years and male adults, those aged 45 to 59 years and female adults had lower urinary iodine levels, with OR (95% CI) of 0.75 (0.68-0.83) and 0.85 (0.76-0.95), respectively. Compared with adults in coastal and urban adults, those in sub-coastal, inland and rural adults had higher levels of urinary iodine, with OR (95% CI) of 1.89 (1.63-2.19), 2.02 (1.72-2.37) and 1.46 (1.28-1.66), respectively. Conclusion:The overall iodine nutrition level of adults aged 18 years and above in Zhejiang Province in 2022 is generally appropriate. However, there is a potential risk of iodine deficiency among adults in coastal areas.

Objective To assess the global,regional,and national burdens of eye cancer between 1990 and 2021,examine its change trends with the age,sex,geographic location,and socio-demographic index(SDI)level,and provide scientific evidence for the development of eye cancer prevention and control strategies.Methods Based on the data from the Global Burden of Disease(GBD)study,the global burden of eye cancer was evaluated using the indicator system inclu-ding incidence,prevalence,mortality,and disability-adjusted life years(DALYs).The change trend of the burden of eye cancer with time was quantified with Join-point regression.Frontier analysis methods were used to evaluate the relationship between the burdens of eye cancer with SDI.Results From 1990 to 2021,the global incidence,age-standardized inci-dence rate(ASIR),prevalence and age-standardized prevalence rate(ASPR)of eye cancer showed an upward trend over time.Conversely,the mortality,age-standardized mortality rate(ASMR),DALYs,and age-standardized DALY rate(ASDR)declined during the same period.All the above indicators in males were higher than those in females.Regionally,Eastern Sub-Saharan Africa bore the highest disease burden,while Oceania had the lowest.It should be noted that East Asia experienced the most significant increase in ASIR,and Southern Sub-Saharan Africa showed the greatest rise in ASPR.Meanwhile,Southern Latin America demonstrated the most pronounced decrease in both ASIR and ASPR.East Asia also re-corded the largest reductions in ASMR and ASDR.At the national level,Malawi had the highest disease burden in 2021.To-kelau exhibited the most substantial increase while Norway showed the greatest decrease in disease burden.Age-specific analysis revealed a bimodal distribution,with children under 5 years and adults over 80 being the most affected groups.Furthermore,SDI-based analysis indicated a wave-like relationship between SDI and ASIR/ASPR,and both ASMR and AS-DR declined with the increasing SDI.Conclusion The global burden of eye cancer shows a decline trend generally.The difference in the burden of eye cancer between regional and national levels may be related to medical resource allocation and public health policies.The results of this study provide scientific evidence for the development of tailored eye cancer prevention and control strategies.It is recommended that more attention should be paid to high-burden regions,resource distribution should be optimized,early screening should be enhanced,and targeted interventions for different age and gen-der groups should be implemented.