Objective: To evaluate the efficacy of the left spermatic vein transposition to the great saphenous vein in treating left varicocele (VC) secondary to nutcracker syndrome (NCS). Methods: Clinical data of 8 patients treated during Feb.2020 and Feb.2023 in our hospital were retrospectively analyzed.A meticulous preoperative evaluation of the vascular status of the spermatic vein and the great saphenous vein was performed using color Doppler ultrasound.A spermatic vein-great saphenous vein shunt surgery was performed in patients who were strictly selected.The clinical symptoms and hemodynamics of renal vein were compared before and after operation. Results: The median age of patients was 23.5(18-33) years.There was a notable reduction in post-exercise scrotal and lower back pain in all patients，and the score of scrotal pain decreased to 0 in 7 patients. The median quantification of urinary protein was 352.8(54.4-687.3) mg prior to surgical intervention，which significantly diminished to 125.5(25.9-255.1) mg 6 months after operation.Notably，3 cases of preoperative positive urine occult blood tests were undetectable in the subsequent postoperative assessments.The median peak blood flow velocity at the site of stenosis in the left renal vein measured at 74.4(48.7-117.6) cm/s preoperatively，subsequently reduced to 45.1(25.5-61.2) cm/s postoperatively.During the 6-month follow-up，no recurrence of varicocele，vascular anastomotic stenosis or thrombosis were observed. Conclusion: Our research indicates that spermatic vein to great saphenous vein bypass is safe and feasible in the treatment of left varicocele secondary to nutcracker syndrome for strictly selected patients，which can effectively alleviate renal vein congestion without significant complications.

ObjectiveTo analyze the prevalence and influencing factors of overweight and obesity among primary school students in a community of Fengxian District, Shanghai, and to provide references for formulating prevention and control strategies against overweight and obesity. MethodsData on height and weight of all primary school students in a community in Fengxian District, Shanghai, in 2023 were obtained by physical examination, and 1 759 primary school students were included according to the entry criteria. Overweight and obesity were determined using body mass index (BMI). Additionally, a questionnaire survey was performed to 1 045 students to collect their demographic characteristics, dietary behaviors, dietary habits, sleep and physical activity information. Chi-square test and logistic regression analysis were used to analyze the influencing factors of overweight and obesity. ResultsIn 2023, among the 1 759 primary school students in the community in Fengxian District, 923 (52.47%) were male and 836 (47.53%) were female, with an overweight/obesity detection rate of 28.08%. The detection rate of overweight and obesity was 33.37% in males and 22.25% in females, which was significantly higher in males than that in females (χ²=26.845, P<0.001). Students aged 10‒12 years had a higher overweight/obesity detection rate (32.55%) than those aged 6‒<10 years (26.53%), and the difference was statistically significant (χ²=10.925, P<0.001). Logistic regression analysis revealed that being female, with young age, parental education level of bachelor’s degree and above, a high global dietary recommendation healthy (GDR-healthy) score, preference for vegetables and sweeter home-cooked meals, and a slow eating speed were negatively correlated with overweight/obesity. Whereas, parental overweight and obesity, binge eating, and a faster eating pace than same-age, same-gender peers may be positively correlated with overweight/obesity. ConclusionThe detection rate of overweight and obesity among primary school students in the community in Fengxian District of Shanghai is higher than the national level. Gender, age, parental BMI, parental education level, dietary behaviors and habits are the main influencing factors of overweight/obesity among primary school students.

BACKGROUND: Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited. METHODS: This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed. RESULTS: Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P  = 0.021) and transitioning to plaque psoriasis ( P  = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP. CONCLUSIONS The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.
Humans ; Male ; Female ; Psoriasis/pathology* ; Adult ; Cross-Sectional Studies ; Adolescent ; Child ; Young Adult ; Quality of Life ; Middle Aged ; China/epidemiology* ; Recurrence ; Risk Factors ; Surveys and Questionnaires ; East Asian People

Objective:To explore the impact of anterior cruciate ligament(ACL) augmented repair versus autologous hamstring tendon single-bundle reconstruction on long-term joint function and radiological outcomes in patients with ACL tear.Methods:A prospective study was conducted, including medical records of 100 patients with anterior cruciate ligament (ACL) tears admitted to the 983rd Hospital of the Joint Logistic Support Force of the Chinese People′s Liberation Army from January 2020 to January 2023. There were 68 males and 32 females, who were aged from 35 to 63 years old, with a mean age of (44.73±6.31) years. The lesion was on the left side in 41 cases and on the right side in 59 cases. According to the Sherman classification, 43 cases were type Ⅰ and 57 cases were type Ⅱ. Patients were sequentially numbered according to admission order, and a random integer generator was used to assign random numbers (1 or 2). Patients assigned "1" were included in the Group 1, while those assigned "2" were allocated to the Group 2, with 50 cases in each group.The Group 1 received ACL augmented repair, while the Group 2 was treated with autologous hamstring tendon single-bundle reconstruction. After treatment, the two groups were compared in terms of knee joint function[International Knee Documentation Committee (IKDC) score], motor function(Tegner score), knee joint stability(pivot shift test) at 12 and 24 months after surgery; the incidence of active pain[visual analog scale (VAS) score] at 1-3 months, 4-6 months, 7-12 months, and 13~24 months after surgery; radiological outcomes; and the rate of secondary revision. Measurement data with normal distribution were expressed as mean ± standard deviation( ± s), and comparisons between the two groups were performed using t-test. Comparisons among multiple time points within the group were conducted using repeated measures analysis of variance. Count data were presented as cases and percentages [ n(%)], and comparisons between groups were made using the chi-square test. Ranked data were analyzed using the Wilcoxon signed-rank test. Results:As of the last follow-up, a total of 45 patients were included in Group 1 (the repair group), and 48 patients were included in Group 2 (the reconstruction group). At 12 and 24 months postoperatively, the IKDC scores in the repair group showed significant improvements compared to preoperative values ( t =11.29, P<0.05; t=14.86, P<0.05), as did the Tegner scores ( t=36.13, P<0.05; t=52.21, P<0.05). Additionally, pivot-shift test results demonstrated significant improvement ( χ2=79.33, P<0.05; χ2=90.00, P<0.05). Similarly, in the reconstruction group, both IKDC scores ( t=10.02, P<0.05; t=13.73, P<0.05) and Tegner scores ( t=44.87, P<0.05; t=60.65, P<0.05) significantly increased at 12 and 24 months postoperatively, with pivot-shift test results also showing marked improvement ( χ2=89.33, P<0.05; χ2=96.00, P<0.05). However, no statistically significant differences were observed between the repair and reconstruction groups in Tegner scores or pivot-shift test results at either time point. However, no statistically significant differences were observed between the two groups for any outcome at either time point (IKDC: t=0.93, P>0.05 at 12 months; t=0.75, P>0.05 at 24 months; Tegner: t=1.52, P>0.05; t=0.77, P>0.05; pivot-shift: χ2=1.16, P>0.05; χ2=1.34, P>0.05). The duration of postoperative activity-related pain was significantly shorter in the repair group (3.24±0.61 months) compared to the reconstruction group (4.48±0.59 months) ( t=9.95, P<0.05). During postoperative months 1-3 and 4-6, pain levels were also significantly lower in the repair group ( t=5.32, P<0.05; t=8.71, P<0.05). However, no statistically significant differences in pain levels were observed between groups at postoperative 7th to 12th months ( t=0.40, P>0.05) and 13th to 24th months ( t=0.37, P>0.05). At 24th months postoperatively, the majority of patients in both groups exhibited ligament thicknesses approaching normal levels, with fibro-osseous bridging between the ligament and bone tunnel walls. The revision rates were 2.2% (1/45) in the repair group and 2.1% (1/48) in the reconstruction group, with no statistically significant difference between groups ( χ2=0.00, P>0.05). Conclusions:The effects of ACL augmented repair for treating ACL tears on patients′ knee joint function, knee joint stability, motor function, and ligament healing are comparable to those of autologous hamstring tendon single-bundle reconstruction. However, ACL augmented repair can reduce the incidence of early active pain in patients.

Pulmonary vascular remodeling is the core pathological feature in the onset and pro-gression of pulmonary arterial hypertension(PAH).Currently,there is no well-defined therapeutic strategy that can effectively delay or reverse this process.Despite the widespread clinical application of targeted vasodilator drugs,patients still face a high risk of mortality and adverse cardiovascular e-vents,suggesting an urgent need to explore new pathological mechanisms and therapeutic targets.In recent years,the relationship between dyslipidemia and PAH has garnered increasing attention.This article aimed to review the role of lipid metabolism disorders in pulmonary vascular remodeling in pul-monary arterial hypertension and its underlying mechanism,with the hope of providing new interven-tion targets for the treatment of PAH,thereby improving patient survival rates and quality of life.

Objective:To establish right middle cerebral artery occlusion(MCAO)model in rats and to investigate the mechanism underlying motor function regulation by transcranial alternating current stimulation(tACS)intervention.Furthermore,to dynamically observe the effects of electroacupuncture combined with tACS on neurological defi-cit scores(NDS),cerebral blood flow,inflammatory-cell apoptosis gene of MCAO model rats and to explore the mechanism of cerebral and neural regulation on motor function rehabilitation after cerebral ischemia reperfusion. Method:Forty SD rats were randomly divided into sham-operation group(S group),model group(M group),electroacupuncture group(EA group),transcranial alternating current stimulation group(T group)and electroacupuncture combined with transcranial alternating current stimulation group(EA+T group).After 2 h ischemia-reperfusion,EA group was given bilateral Qu chi(LI 11)and Zu san li(ST 36)electroacupuncture under anesthesia.Right Ml was selected for tACS in T group.EA+T group was treated with EA and tACS to-gether.S and M group were treated with anesthesia for 30min per time,for 7 days.The data from before modling(B)to after modling(D7)were recorded,including neurological deficit score and blood flow of the right middle cerebral artery by laser doppler flowmetry.RT-PCR was used to analyze inflammation-cell apopto-sis gene expression at D7. Result:Neurological deficit score:at 2h,D1,M group,EA group,T group and EA+T group increased signifi-cantly compared with other time(P＜0.05).At D3,D5,D7,S group decreased significantly compared with oth-er time(P＜0.05),while M group increased significantly compared with other group(P＜0.05).EA group,T group and EA+T group were significantly different in all times(P＜0.05).At 2h,D1,D3,D5,D7,M group increased significantly compared with B.At D1,D3,D5,D7,NDS decreased significantly compared with that at 2h(P＜0.05).Blood flow:EA+T group and S group decreased at 2h,increased at D1 and decreased at D3.EA group increased at D3.However,M group decreased significantly compared with other group at D1,D3 and D5(P＜0.05).RT-PCR:motor cortex △Ct analysis:Caspase 12 in EA+T group decreased significantly compared with T group(P＜0.05),IL-1β and NLRPla in EA group and T group decreased significantly com-pared with those in S group(P＜0.05).2-△△Ct analysis in ischemic region:ATF4 in M group increased significant-ly compared with that in other groups(P＜0.05);Bcl 2 in M group increased significantly compared with that in S group,EA group and EA+T group(P＜0.05);Bax,Caspase 12,C-fos in M group increased significantly compared with those in S Group(P＜0.05). Conclusion:Electroacupuncture combined with tACS can modulate the inflammatory response and inhibit cell apoptosis through regulating ATF4、Bcl-2、Bax、Caspase 12、C-fos and can be a new strategy for the treatment of ischemic stroke.

【Objective】 To explore the risk factors of severe postoperative hemorrhage in patients with staghorn renal calculi treated with mini-percutaneous nephrolithotomy (M-PCNL), and to construct a Bayesian network model to predict postoperative hemorrhage. 【Methods】 A retrospective analysis was conducted on 160 patients with staghorn renal calculi who were treated with M-PCNL by surgeons with equivalent qualifications at the First Affiliated Hospital of Xinxiang Medical College during Jan. 2020 and Jan. 2022.A computer-generated random number method was used to divide them into a modeling group (120 cases) and a validation group (40 cases).Patients in the modeling group were divided into severe bleeding group (38 cases) and non-severe bleeding group (82 cases).The general information of the two groups was compared, and the independent risk factors of severe postoperative hemorrhage were analyzed.A Bayesian network model was constructed using R software, the inference prediction was conducted using Netica software, and the performance of the model was evaluated with receiver operating characteristic (ROC) curve. 【Results】 Multivariate logistic regression analysis showed that renal insufficiency (OR: 2.845, 95%CI: 1.563-6.515), mixmum diameter of stones ≥2 cm (OR: 2.063, 95%CI: 1.824-4.555), operation time ≥90 minutes (OR: 3.632, 95%CI: 2.365-7.11), one-stage operation (OR: 2.321, 95%CI: 1.874-6.332), and multi-channel stone removal (OR: 1.842, 95%CI: 1.366-3.687) were independent risk factors of postoperative severe hemorrhage (P<0.05).Based on the above parameters, a Bayesian network model was established, which was then evaluated with the modeling and validation groups internally and externally.The AUC of the modeling group was 0.879 (95%CI: 0.804-0.931, P<0.001), with sensitivity and specificity being 87.68% and 89.63%, respectively.The AUC of the validation group was 0.875(95%CI: 0.818-0.908, P<0.001), with sensitivity and specificity being 87.55% and 89.40%, respectively.The model showed good discrimination. 【Conclusion】 Renal dysfunction, mixmum diameter of stones ≥2 cm, operation time ≥90 minutes, one-stage operation, and multi-channel stone removal are risk factors of severe hemorrhage in patients after M-PCNL.The prediction model has good predictive ability and can effectively describe the complex mechanism between diseases and risk factors.

Objective To investigate the expression of allograft inflammatory factor-1(AIF-1)in the testicular model of diabetes mellitus(DM)rats as well as its significance.Methods The rat model of DM testis(DMT)was established,which were randomly divided into the DM testis 4-week group(DMT4W),DM testis s 8-week group(DMT8W)and the DM testis 12-week group(DMT12W).The normal control group(NC group)was randomly divided into three subgroups:NC 4-week(NC4W),NC 8-week(NC8W)and NC 12-week(NC12W).The morphologic changes of testis in the different groups was detected by histopathology.The expression of AIF-1 protein was detected by immunohistochemistry.The expression of AIF-1 and NF-κB p65 protein was observed by immunofluorescence.Results The histopathological results suggested that the numbers of spermatogenic cells,sertoli cells,interstitial cells and sperms in the DMT group were significantly decreased,as compared with the NC group.The immunohistochemistry results showed that the expression of AIF-1 protein was significantly increased in the DMT group,as compared with the NC group(P<0.05).The intensity of AIF-1 and NF-κB p65 in the DMT group was significantly increased by immunofluorescence,as compared with the NC group.Conclusion The over expression of AIF-1 protein in DMT tissue suggests that it may play an important role in the pathological process of DMT and may become a new therapeutic target and diagnostic marker in the future.