Background Per- and polyfluoroalkyl substances (PFAS), a group of persistent organic pollutants associated with adverse health effects including hepatotoxicity, immunosuppression, and carcinogenicity, have undergone risk assessments by multiple international organizations, with dietary exposure being the primary pathway. Objective To characterize the exposure to PFAS from food and drinking water sources of elderly residents in Songjiang District of Shanghai and to evaluate associated health risk and health effects. Methods A cross-sectional study was conducted from May to July 2024 in Songjiang District based on the Shanghai Suburban Adult Cohort and Biobank (SSACB) cohort. Dietary surveys were administered via face-to-face interviews among older adults aged 65 years and above, yielding 4 583 valid questionnaires. The estimated daily intake (EDI) of PFAS was calculated by integrating data from the Sixth National Dietary Survey and recent literature on PFAS concentrations in food and drinking water in Shanghai. Health risk assessment was performed using health-based guideline values (HBGV) proposed by various institutions and studies. Additionally, correlation analysis and linear regression modeling of EDI and biochemical indicators in the elderly were conducted to evaluate potential adverse health effects. Results The elderly population in Songjiang District exhibited dietary characteristics consistent with the Eastern Healthy Diet Pattern. Among PFAS compounds, PFOA showed the highest level of oral exposure [mean: 1.495 ng·(kg·d⁻¹)], followed by PFOS [mean: 0.637 ng·(kg·d⁻¹)], PFHxS [mean: 0.636 ng·(kg·d⁻¹)], and PFBS [mean: 0.273 ng·(kg·d⁻¹)]. Specifically, drinking water was the primary source of PFOA [1.415 ng·(kg·d⁻¹), accounting for 94.60%], while aquatic products were the major source of PFOS [0.278 ng·(kg·d⁻¹), accounting for 43.66%]. Using the HBGV derived by China's epidemiological studies, the mean hazard index (HI) for PFAS exposure was 1.39, indicating 54.35% of the population had potential health risks (HI>1). Following the 2024 standard established by the Food Safety Commission of Japan (FSCJ), the HI value dropped to 0.11, suggesting negligible risk. PFAS exposure was negatively associated with triglyceride levels and the indicators of liver and kidney function, but positively associated with low-density lipoprotein cholesterol (LDL-C) and lung cancer markers in the elderly residents. Conclusion PFAS exposure among the elderly residents in Songjiang District is predominantly attributed to PFOA, PFOS, PFHxS, and PFBS, with drinking water and aquatic products identified as primary exposure sources. Current exposure levels demonstrate significant associations with biomarkers of lipid metabolism and lung cancer markers, suggesting potential population health risks. These findings underscore the urgent need to establish HBGV for PFAS compounds based on Chinese population-specific metabolic characteristics.

Purpose/Significance The establishment of a specialized database for children with attention deficit hyperactivity disorder(ADHD)aims to address the issues of low data usage efficiency caused by scattered and low-quality diagnostic data.Method/Process Based on clinical diagnostic data of children with ADHD from March 2020 to April 2024,natural language processing(NLP)techniques are utilized to realize the post-structuring of the data.Furthermore,standardization of the database is performed according to industry standards and treatment guidelines.Result/Conclusion The specialized database for children with ADHD is established,comprising data from 75 835 ADHD children and 280 000 clinical visits.This database supports various applications such as the analysis of basic character-istics of the ADHD population,prediction model construction,resource allocation optimization,and clinical pathway optimization.

Urbanization has increased the population density and exposure to environmental risk factors, accelerated changes of people's lifestyles and aggravated population health disparities. A general population cohort in eastern China, Shanghai Suburban Adult Cohort and Biobank (SSACB), was established to understand the incidence and prevalence of chronic and non-communicable diseases, and identify environmental, lifestyle, and genetic risk factors in adults (aged 20-74 years old) living in the suburban of Shanghai, where urbanization process is rapid, and provide evidence for the precise prevention and control of chronic diseases. The cohort study was launched by School of Public Health,Fudan University depended on "Discipline Construction Project Shanghai Peak for Public Health and Preventive Medicine". Four districts in Shanghai, i.e. Songjiang, Jiading, Minhang and Xuhui, were selected. A total of 69 116 permanent residents aged 20-74 years were recruited. Epidemiological investigation, physical examination and laboratory tests were conducted to collect the basic information of the study subjects. Blood and urine samples were collected from them to establish a biobank. An information platform was established, from which the baseline data of the study subjects in electronic medical record system, chronic disease management system, cancer registry, infectious disease reporting system, and death registry can be shared. This paper introduces the design concept, process and future plan of SSACB.

Objective:To investigate the results of the superficial circumflex iliac artery(SCIA)-based conjoined flap for covering extremely large lower limb defects.Methods:From February 2017 to June 2019, 15 patients were admitted, who suffered from severe degloved injury for the lower limb, including 9 males and 6 females with a median year of 45 (ranged, 36-67 ) years old. All were taken thorough and radical debridement and covered by the VSD device during the emergency operation. The dimension of defects was ranged from 25.0 cm ×8.0 cm to 50.0 cm ×15.0 cm. Using the lower abdominal wall or side chest wall as the donor site, the conjoined flap was dissected when the wound surface became granulating. The perforator match fashions included bilateral SCIA, and ipsilateral SCIA and thoracodorsal artery(TA). The donor sites were primary closure. The follow-up was accomplished by the same surgeon.Results:Fourteen flaps survived completely without significant complications, and distal necrosis was observed in one longitudinal flap, which was healed with the skin graft in the second stage. All flaps were available for a mean follow-up of 18 (ranged 16-24) months. The aesthetic outcomes were achieved on the recipient site without hairy appearance and hyper-pigmentation. A concealed line scare was left on the donor site, without the hernia and limited function. At the last follow-up, 7 cases were excellent and 1 case was good, evaluated with the LEFS criteria. And 6 cases were excellent and 1 case was good, assessed by the AOFAS criteria.Conclusion:The simultaneous reconstruction of extreme lower limb defects and better salvage treatment could be achieved by the SCIA-based conjoined flap. And as a versatile flap, it was blessed with concealed donor site, various design fashions, and larger dissection size in selected cases.

OBJECTIVE To investigate the mechanism of Fuke duanhongyin capsule in improving dysfunctional uterine bleeding （DUB） in rats. METHODS Pregnant SD rats were randomly divided into blank control group （distilled water）， model control group （distilled water） and Fuke duanghongyin capsule group （1.296 g/kg）， with 6 rats in each group. Except for blank control group， DUB model was established in other groups. After modeling， they were given relevant medicine/distilled water 10 mL/kg intragastrically， once a day， for consecutive 14 d. After medication， uterine index， ovary index and hemorheology indexes （whole blood high shear relative index， whole blood low shear relative index， erythrocyte aggregation index， Carson viscosity） of rats were all determined. The pathological changes of uterus and ovary tissues were observed； mRNA relative expression levels of epidermal growth factor （EGF）， hypoxia-inducible factor 1α （HIF-1α）， epidermal growth factor receptor （EGFR） and serine/ threonine-protein kinase 1（AKT1）， and protein relative expression levels of EGF and EGFR in uterine tissue were all measured. RESULTS Compared with model control group， the uterine index， ovary index， erythrocyte aggregation index were all decreased significantly in Fuke duanghongyin capsule group （P＜0.05 or P＜0.01）； whole blood high shear relative indexes， mRNA relative expression levels of EGF， HIF-1α and EGFR and protein relative expression levels of EGF and EGFR in uterine tissue were all increased significantly （P＜0.05 or P＜0.01）. The pathological changes of ovary and uterus were improved. CONCLUSIONS Fuke duanhongyin capsule can improve DUB in rat， the mechanism of which may be related to the activation of EGF-EGFR signaling pathway.

This study aimed to isolate and identify novel toxin peptides targeting voltage-gated sodium channels (VGSGs) from the venom of the Buthus martensii Karsch (BmK) scorpion. Using G50-gel filtration, HPLC, peptide fingerprinting and amino acid sequencing, a novel sodium channel modulator, BmK M2, was identified from BMK scorpion. BmK M2 is a relatively abundant long chain polypeptide toxin in BmK scorpion venom with a molecular weight of 7 235.59, consisting of 64 amino acids and 4 pairs of disulfide bonds.Sequence alignment showed that the amino acid sequence of BmK M2 had high sequence and structural similarity to that of the discovered sodium channel toxins of BmK M1, BmK M3 and BmK M9, etc.BmK M2 is a potential new sodium channel modulator.Electrophysiological results revealed that BmK M2 can significantly enhance the activation, delay the steady-state inactivation and closed-state inactivation of Nav1.7, but has no activity on Nav1.8.BmK M2 can be used as a novel peptide probe for the study of the structure and function of Nav1.7 and the development of drugs targeting Nav1.7.

Objective:To investigate the effect of using the free medial planar artery flap(MPAF) pedicled by the superficial branch of the medial plantar artery in repair of pulp defect of thumb and finger.Methods:Ten patients with pulp defect of thumb and finger were repaired with MPAF of foot in the Department of Hand Surgery of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University from November 2020 to January 2022. There were 3 cases of cutting injury, 2 cases of chainsaw injury, 2 cases of extrusion injury and 3 cases of avulsion injury. Digits injuried: 4 index fingers, 3 thumbs, 2 middle fingers, and 1 ring finger. After admission, Doppler ultrasound was performed to understand the running course of medial plantar artery. Emergency surgeries were performed to repair the pulp defects of thumb and finger with free MPAF, and donor sites were repaired by skin grafting. The area of soft tissue defects was 2.0 cm×2.5 cm-3.0 cm×4.5 cm, and the size of flap was 2.5 cm×3.0 cm-3.5 cm×5.0 cm after debridement. Postoperative effect was assessed over the follow-up at outpatient clinics by same group of surgeons. Functional recovery was evaluated according to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association.Results:All 10 free MPAFs pedicled by the superficial branch of medial plantar artery survived. After the transfer, the colour, texture and thickness of the flaps were matched with the digit with pulps realistic appearance. Secondary flap thinning surgery was not required. Two cases had blisters at the distal end of the flap, and healed after fluid extraction and dressing change. All patients had 3 to 18 months of follow-up. The TPD of the flap was 4-7 mm. The skin grafts in the donor sites survived well. At the last follow-up, the upper limb function was evaluated according to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, with the results of 8 cases in excellent and 2 in good.Conclusion:Free MPAF pedicled by the superficial branch of medial plantar artery can repair the pulp defect of thumb and finger with reliable blood supply, excellent texture and good appearance. And there is no damage to the main vessels in the donor site.

Objective: To evaluate the clinical application of single-arm external stent combined with free flap in the treatment of forearm fractures of Gustilo type Ⅲ. Methods: A retrospective study was conducted of the 16 patients who had been treated at Repair and Reconstruction Center, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University from September 2015 to January 2018 for open forearm fractures combined with soft tissue defects with single-arm external stent combined with free flap. They were 11 men and 5 women, aged from 18 to 64 years (average, 41.6 years). By the Gustilo classification, 9 cases were type ⅢB and 7 type ⅢC. The area of soft tissue defects at the upper arm and hand ranged from 7.5 cm×5.5 cm to 16.5 cm × 11.0 cm. Emergency debridement was performed at the primary stage. After repair of major blood vessels, nerves and tendons, the reduced fractures were fixated with a single-arm external stent. The soft tissue defects were repaired with free flaps at the secondary stage. Nine cases were repaired with a free anterolateral perforating branch flap and 7 with a free ilioinguinal flap. The single-arm external stent became the ultimate fixation mode in 5 cases but was changed into plate fixation after survival of the flaps in the other 11 cases. Complications were recorded postoperatively. At the last follow-up, the upper limb function was evaluated according to the tentative criteria for evaluation of the upper limb function proposed by the Hand Surgery Society of Chinese Medical Association. Results: Of all the free flaps, 14 survived smoothly but 2 anterolateral ones survived only after the venous crisis appearing at 24 h after operation was relieved by exploration. The 16 patients were followed up for 9 to 18 months (average, 13.5 months). The fractures united well with fine alignment of the fracture ends and recovered force line. According to the Anderson criteria for forearm fractures, 10 cases were excellent, 4 good and 2 fair after operation. According to the tentative criteria for evaluation of the upper limb function proposed by the Hand Surgery Society of Chinese Medical Association, 11 cases were excellent and 5 good. No nail infection or nonunion occurred. Conclusion In the treatment of forearm fractures of Gustilo type Ⅲ, single-arm external stent plus free flap can effectively restore the force line of upper extremity, promote bone healing, allow reasonable timing for wound repair, reduce postoperative complications like infection and osteomyelitis and facilitate functional recovery of the affected extremity.

On the basis of the existing appointment process, artificial intelligence and Internet of things technologies were introduced to optimize such process. Thanks to the all appointment process management empowered by AI and IoT, patient waiting time is cut short and patient satisfaction enhanced as a result.

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is the gold standard for degenerative cervical disease,which would be replaced by cervical disc arthroplasty (CDA) with the wide application of CDA. But, the mid- and long-term outcomes of ACDF versus CDA remain controversial.OBJECTIVE: To compare the mid- and long-term outcomes of ACDF and CDA in the treatment of single-level cervical spondylosis.METHODS: PubMed, Medline, EMbase, Cochrane, CBM, CNKI, VIP and WanFang databases were searched for randomized controlled trials addressing CDA versus ACDF for single-level cervical spondylosis published before August 2016. The quality of trails was strictly evaluated, the data were extracted and a meta-analysis was performed on ReviewManager5.3 software.RESULTS AND CONCLUSION: (1) Totally 15 randomized controlled trials involving 2781 patients were included, with 4-10 years of follow-up. (2) Meta-analysis results showed that compared with ACDF, CDA had better SF-36 scores,larger range of motion at operation level, lower the Neck Disability Index, and Visual Analogue Scale scores for arm pain,lower reoperation rate at operation level and adjacent level at mid- and long-term follow-up. (3) The Visual Analogue Scale scores for neck pain, neurologic success and all-complication rate did not differ significantly between two groups.(4) These results manifest that CDA is superior to ACDF in the mid- and long-term outcomes for single-level cervical spondylosis; however, further large-scale, multi-center and high-quality randomized controlled trials will be necessary.