Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective:To evaluate the quality of life in patients with psoriasis across varying levels of psychological resilience.Methods:A cross-sectional study was conducted, employing a convenient sampling method to recruit 390 psoriasis patients from Beijing University of Chinese Medicine Dongzhimen Hospital from February to August 2023. The sample included 57 male and 333 female patients, with a mean age of (24.9±5.4) years. Participants were guided through questionnaire completion using a standardized protocol by trained investigators. Patients were stratified into three groups based on the Connor-Davidson Resilience Scale (CD-RISC-10): low ( n=53), moderate ( n=251), and high ( n=86) psychological resilience. The dermatology life quality index (DLQI) was utilized to assess quality of life across six domains: symptom perception, daily activities, leisure and recreation, work and study, interpersonal relationships, and treatment. Results:The total scores for the DLQI among psoriasis patients with low, moderate, and high psychological resilience were 10.05 (6.75, 15.00), 7.00 (4.00, 11.00), and 5.00 (2.00, 10.00), respectively. Symptom perception scores were 3.00 (2.00, 4.00), 2.00 (2.00, 4.00), and 2.00 (1.00, 3.00), respectively. Scores for daily activities were 2.00 (2.00, 4.00), 1.00 (1.00, 2.00), and 1.00 (0.00, 2.00), respectively. Leisure and recreation scores were 2.00 (1.00, 3.00), 1.00 (0.00, 3.00), and 1.00 (0.00, 2.00), respectively. Work and study scores were 1.00 (0.00, 3.00), 0.00 (0.00, 1.00), and 0.00 (0.00, 1.00), respectively. Interpersonal relationship scores were 1.00 (0.00, 2.00), 0.00 (0.00, 1.00), and 0.00 (0.00, 1.00), respectively. Treatment scores were 1.00 (0.00, 1.25), 0.00 (0.00, 1.00), and 0.00 (0.00, 1.00), respectively. Statistically significant differences were observed in the total DLQI scores and individual item scores among the three groups (all P<0.05), with patients exhibiting high psychological resilience demonstrating superior quality of life. Conclusion:This study demonstrates statistically significant differences in the quality of life among psoriasis patients with varying psychological resilience levels, and those exhibiting higher resilience demonstrate superior quality of life.

Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective:To evaluate the quality of life in patients with psoriasis across varying levels of psychological resilience.Methods:A cross-sectional study was conducted, employing a convenient sampling method to recruit 390 psoriasis patients from Beijing University of Chinese Medicine Dongzhimen Hospital from February to August 2023. The sample included 57 male and 333 female patients, with a mean age of (24.9±5.4) years. Participants were guided through questionnaire completion using a standardized protocol by trained investigators. Patients were stratified into three groups based on the Connor-Davidson Resilience Scale (CD-RISC-10): low ( n=53), moderate ( n=251), and high ( n=86) psychological resilience. The dermatology life quality index (DLQI) was utilized to assess quality of life across six domains: symptom perception, daily activities, leisure and recreation, work and study, interpersonal relationships, and treatment. Results:The total scores for the DLQI among psoriasis patients with low, moderate, and high psychological resilience were 10.05 (6.75, 15.00), 7.00 (4.00, 11.00), and 5.00 (2.00, 10.00), respectively. Symptom perception scores were 3.00 (2.00, 4.00), 2.00 (2.00, 4.00), and 2.00 (1.00, 3.00), respectively. Scores for daily activities were 2.00 (2.00, 4.00), 1.00 (1.00, 2.00), and 1.00 (0.00, 2.00), respectively. Leisure and recreation scores were 2.00 (1.00, 3.00), 1.00 (0.00, 3.00), and 1.00 (0.00, 2.00), respectively. Work and study scores were 1.00 (0.00, 3.00), 0.00 (0.00, 1.00), and 0.00 (0.00, 1.00), respectively. Interpersonal relationship scores were 1.00 (0.00, 2.00), 0.00 (0.00, 1.00), and 0.00 (0.00, 1.00), respectively. Treatment scores were 1.00 (0.00, 1.25), 0.00 (0.00, 1.00), and 0.00 (0.00, 1.00), respectively. Statistically significant differences were observed in the total DLQI scores and individual item scores among the three groups (all P<0.05), with patients exhibiting high psychological resilience demonstrating superior quality of life. Conclusion:This study demonstrates statistically significant differences in the quality of life among psoriasis patients with varying psychological resilience levels, and those exhibiting higher resilience demonstrate superior quality of life.

Humans ; Gastrointestinal Microbiome ; Constipation/therapy* ; Probiotics/therapeutic use* ; Patients

Objective To investigate the effect of final vowel types on the voice onset time(VOT)of differ-ent stops in children with hearing impairment,and to provide a basis for the acquisition and correction of stop sounds.Methods A total of 22 hearing-impaired children aged 3～6 and 22 children with normal hearing were ran-domly selected-18 consonant-vowel(CV)syllables composed of 6 stops and 3 single finals were recorded,using first tone.Using Praat 6.1.29 software to analyze and extract the stops VOT.Two-way ANOVA was used for each stop,the dependent variable was VOT,and the independent variables were hearing status and final type.Results Children in the hearing-impaired group had articulation errors in/t/,/g/,and/k/.Hearing status had significant effect on the main effect of plosives/g/,/p/,/t/,/k/(P＜0.05),and the VOT of slurs/g/,/p/,/t/,/k/in the normal hearing group significantly greater than the hearing-impaired group(P＜0.05).The main effect of finals on the VOT of the stops/b/,/p/and/t/was significant(P＜0.05).Hearing status and final type had an interac-tive effect on the stop/t/,and the simple main effect showed that the difference in VOT of/ti/between the hear-ing-impaired group and the normal hearing group was greater than that of/ta/and/tu/.Conclusion The stops/g/,/p//t/,/k/VOT of hearing-impaired children are smaller than those of with normal hearing.The difference in VOT of/ti/sound between the hearing impaired group and the normal hearing group is greater than that of/ta/sound and/tu/sound.In the teaching of the initial/t/sound for hearing-impaired children,we can start with/ta/and/tu/with less difference,and the/ti/sound is consolidated later.Pay attention to breathing and oral exercise training,to lay a good foundation for clear pronunciation.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Objective:To simulate the neuroendoscopy assisted contralateral cervical 7 (C 7) nerve transfer via prespinal route and measure its relevant anatomical landmarks to explore the clinical feasibility and efficacy of this surgical approach for central upper limb spastic paralysis. Methods:(1) Six fresh cadaver specimens of the head and neck were obtained. Linear incisions of approximately 5 cm were made above the midpoint of the bilateral clavicles to simulate neuroendoscopy assisted contralateral C 7 nerve transfer via prespinal route. With the superior margin of midpoint of the clavicle as central point, distance to the distal bifurcation of the C 7 nerve, distances to the superior or inferior trunks of the proximal brachial plexus nerves, and distances to the exit of the intervertebral foramina of the C 6, C 7, and C 8 nerves were measured. (2) One patient with upper limb spastic paralysis after intracerebral hemorrhage accepted neuroendoscopy assisted contralateral C 7 nerve transfer via prespinal route; the clinical data and efficacy of the patient were retrospectively analyzed. Results:(1) The C 7 nerve, the upper trunk of brachial plexus formed by the C 5 and C 6 nerves and the lower trunk of brachial plexus formed by the C 8 and T 1 nerves could be exposed after neuroendoscopy assisted contralateral C 7 nerve transfer via prespinal route. The distance between the superior margin of midpoint of the clavicle and the distal bifurcation of the C 7 nerve is (2.20±0.11) cm, and its distance to the superior trunk of the proximal brachial plexus is (2.62±0.10) cm, and its distance to the inforior trunk of the proximal brachial plexus nerve is (2.72±0.11) cm. The distance between the superior margin of midpoint of the clavicle and the proximal C 7 nerve (at the exit of the intervertebral foramen) is (7.22±0.15) cm, its distance to the proximal C 6 nerve (at the exit of the intervertebral foramen) is (7.84±0.12) cm, and its distance to the proximal C 8 nerve (at the exit of the intervertebral foramen) is (6.96±0.12) cm. (2) The patient with central upper limb spastic paralysis accepted neuroendoscopy assisted contralateral C 7 nerve transfer via prespinal route successfully, with surgical time lasting for 2 h and bleeding amount of 20 mL. After surgery, the incision healed well, and the patient experienced pain and numbness in the healthy side of the upper limb with subsided symptoms one month after surgery. The spasticity symptoms of the affected upper limb obviously improved after surgery with decreased muscle tone. Follow-up after discharge was performed for 14 months, and the muscle strength of the affected upper limb recovered to level 1 +. Conclusion:Neuroendoscopy assisted contralateral C 7 nerve transfer via prespinal route can expose the proximal and distal C 7 nerves, with minimal invasion; this clinical study has preliminarily confirmed the safety and effectiveness of this transfer via prespinal route in central upper limb spastic paralysis.

Objective: To explore the factors associated with the distance from the anal verge to rectal cancer (DAVtRC) ． Methods: 102 patients with rectal cancer provided the clinicopathological data．Two groups of patients were created : low rectal cancer group ( LRC) for those with DAVtRCs less than 7cm and mid / high rectal cancer group ( M / HRC) for those with DAVtRCs greater than 7 cm． The two groups' clinical and pathological differences were compared．Quantile regression was used to analyze the associations between DAVtRC and the clinicopathological factors. Results : LRC had a lower median DAVtRC (5. 00 cm ［IQR : 4. 00，6. 00 cm］) than that in M / HRC ［10. 00 cm(IQR : 10. 00，11. 00 cm) ］(P＜0. 01) ，but had higher mean monocytes［(0. 41 ± 0. 16) vs (0. 34 ± 0. 11) ，P＜0. 05］．In the model with continuous and categorical variables at 95% quantile，DAVtRC was negatively associated with age ( β = －0. 204 ，P ＜0. 01 ) ，TNM stage ( Ⅲ + Ⅳ vs Ⅰ : β = －6. 623 ，P < 0. 01) ，platelet (PLT，β = －0. 024，P＜0. 01) ，vessel invasion(β = －1. 544，P＜0. 01) ，but positively associat- ed with BMI(β = 0. 278，P＜0. 01) ，tumor diameters(β = 0. 548，P＜0. 01) ，male(β = 1. 421，P＜0. 01) ，low and middle differentiations(β = 4. 727，P＜0. 01) ，T stage(T2 vs T1 : β = 4. 422，P＜0. 01) ，N stage(N1 vs N0 : β = 6. 670，P＜0. 01) ，nerve invasion(β = 1. 825，P ＜0. 01) ，carcinoembryonic antigen( CEA，β = 0. 068，P < 0. 01) ，lymphocyte(L，β = 3. 068，P＜0. 01) ，platelet lymphocyte ratio(PLR , β = 0. 045，P＜0. 01) ，lymphocyte monocyte ratio(LMR , β = 1. 088，P ＜0. 01) ．Quantile regression curves showed that the coefficients of age，body mass index(BMI) ，tumor diameter，PLT，PLR and LMR were different in different quantiles of DAVtRC． Conclusion DAVtRC is significantly associated with multiple clinicopathological factors in rectal cancer，but in different quantiles，the coefficients are different.

Objective To investigate the effect of enteral nutritional support beginning at different time on aspiration events and immune function in the early post-traumatic (within 14 days) period in patients with severe traumatic brain injury.Methods From June, 2018, to February, 2021, 75 patients with acute traumatic brain injury admitted in the Department of Neurosurgery of the Second People's Hospital of Lianyungang were randomly divided into early feeding group (24 to 48 hours, n=35) and delayed feeding group (48 to 120 hours, n=40). The 14-day reflux rate, aspiration rate, incidence of aspiration pneumonia, immune indexes and complications were compared between two groups.Results There was no significant difference in the reflux rate, aspiration rate and the incidence of aspiration pneumonia between the two groups (P > 0.05). The levels of IgG, IgA, and complements C3 and C4 were significantly higher in the early feeding group than in the delayed feeding group (|t| > 1.720, P<0.001). The incidence of non-aspiratory lung infections was significantly lower in the early feeding group than in the delayed feeding group (χ2=4.728, P<0.05).Conclusion Initiating enteral nutrition within 24 to 48 hours after injury may preserve immune function and reduce the incidence of non-aspiratory lung infections in patients with severe traumatic brain injury.