ObjectiveTo investigate the association between serum fasting triglyceride glucose-body mass index （TyG-BMI） and new-onset metabolic dysfunction-associated fatty liver disease （MAFLD） within 10 years. MethodsA retrospective analysis was performed for the data of individuals who underwent physical examination in The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University in 2013， 2018， and 2023 and were not diagnosed with MAFLD in 2013， and a total of 1 340 valid subjects were enrolled according to the inclusion and exclusion criteria. The gbmt package in R 4.3.0 was used to construct the dynamic change trajectory model of TyG-BMI， and four different TyG-BMI trajectory groups were determined， i.e.， the low-level group （n=352）， the medium-level group （n=517）， the high-level group （n=314）， and the extremely high-level group （n=157）. The data on general information and blood biochemical parameters were collected from all subjects and were then compared between groups. The chi-square test was used for comparison of categorical data between groups， and the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data with heterogeneity of variance between multiple groups. The Cox regression analysis was used to investigate the association between different TyG-BMI trajectories and the risk of MAFLD， and the receiver operating characteristic （ROC） curve was used to assess the value of TyG-BMI in the diagnosis of MAFLD. ResultsThe cumulative incidence rate of MAFLD increased with the increase in the level of TyG-BMI trajectory， with a cumulative incidence rate of 4.83% in the low-level group， 29.98% in the medium-level group， 61.15% in the high-level group， and 83.44% in the extremely high-level group （P<0.001）， and the cumulative incidence rate of MAFLD in men was significantly higher than that in women （51.34% vs 20.67%， P<0.001）. The multivariate Cox regression analysis showed that increases in the levels of TyG-BMI trajectory， uric acid， diastolic blood pressure， hemoglobin， and alanine aminotransferase were independent risk factors for the onset of MAFLD （all P<0.05）， while the increase in high-density lipoprotein cholesterol was an independent protective factor against MAFLD （P<0.001）. After adjustment for confounding factors， the medium-， high-， and extremely high-level groups had a hazard ratio of 4.430 （95% confidence interval ［CI］： 2.660 — 7.377， P<0.001）， 6.937 （95%CI： 4.110 — 11.708， P<0.001）， and 7.989 （95%CI： 4.616 — 13.827， P<0.001）， respectively. The ROC curve analysis showed that TyG-BMI had the highest diagnostic value， with an area under the ROC curve of 0.859 （95%CI： 0.840 — 0.879）， a sensitivity of 79.8%， and a specificity of 76.3%. ConclusionThe risk of MAFLD increases with the increase in the level of TyG-BMI trajectory， and TyG-BMI can be used as a predictive indicator for MAFLD.

Objective:To explore the impact of the interaction between alcohol consumption and overweight/obesity on the risk of hypertension.Methods:It was a cross-sectional study, and convenient sampling was used to enroll physical examination participants aged 18-60 years from the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, the Affiliated Hospital of Southwest Medical University and Luzhou People′s Hospital from June to November in 2020. All the participants were given questionnaire survey, physical examination and biochemical tests. A total of 5 000 questionnaires were distributed in the study, and 4 878 questionnaires were collected, of which 4 397 (90.14%) were valid. According to the diagnostic criteria for hypertension, the study participants were divided into hypertension group (1 128 cases) and non-hypertension group (3 269 cases), and t-test and chi-square test were used to compare the differences in gender, age, and other data between the two groups; and multivariate logistic regression analysis was used to analyze the association of alcohol consumption, overweight/obesity with the risk of hypertension and the interaction between alcohol consumption and overweight/obesity on the risk of hypertension, and relative excess risk of interaction, attributable proportion of interaction and the synergy index were used to evaluate the impact of the interaction between alcohol consumption and overweight/obesity on the risk of hypertension. Results:Among the 4 397 individuals included in the analysis, 3 116 were male and 1 281 were female, with a mean age of (42.42±8.83) years. The detection rate of hypertension was 25.7% (1 128/4 397). The risk of hypertension in overweight/obese individuals was 2.566 times ( OR=2.566, 95% CI: 2.167-3.038) higher than that of non-overweight/obese individuals, and the risk of hypertension in alcohol consumption individuals was 1.486 times ( OR=1.486, 95% CI: 1.250-1.766) higher than that of non-drinkers. The risk of hypertension in drinking+non-overweight/obesity group, non-drinking+overweight/obesity group, and drinking+overweight/obesity group was 1.468 times ( OR=1.468, 95% CI: 1.112-1.936), 2.538 times ( OR=2.538, 95% CI: 1.968-3.272), and 3.796 times ( OR=3.796, 95% CI: 2.963-4.863) higher than that of non-drinking+non-overweight/obesity group, respectively (all P<0.05). Alcohol consumption and overweight/obesity had an additive interaction effect on the risk of hypertension, and the relative excess risk of interaction, attributable proportion of interaction and the synergy index was 0.791 (95% CI: 0.158-1.424), 0.208 (95% CI: 0.049-0.368), 1.394 (95% CI: 1.030-1.888), respectively. There was no significant multiplicative interaction between alcohol consumption and overweight/obesity on the risk of hypertension ( P>0.05). Conclusions:Alcohol consumption and overweight/obesity are both associated higher risk of hypertension. In addition, there is an additive interaction between alcohol consumption and overweight/obesity on the risk of hypertension.

Objective:To explore the impact of the interaction between alcohol consumption and overweight/obesity on the risk of hypertension.Methods:It was a cross-sectional study, and convenient sampling was used to enroll physical examination participants aged 18-60 years from the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, the Affiliated Hospital of Southwest Medical University and Luzhou People′s Hospital from June to November in 2020. All the participants were given questionnaire survey, physical examination and biochemical tests. A total of 5 000 questionnaires were distributed in the study, and 4 878 questionnaires were collected, of which 4 397 (90.14%) were valid. According to the diagnostic criteria for hypertension, the study participants were divided into hypertension group (1 128 cases) and non-hypertension group (3 269 cases), and t-test and chi-square test were used to compare the differences in gender, age, and other data between the two groups; and multivariate logistic regression analysis was used to analyze the association of alcohol consumption, overweight/obesity with the risk of hypertension and the interaction between alcohol consumption and overweight/obesity on the risk of hypertension, and relative excess risk of interaction, attributable proportion of interaction and the synergy index were used to evaluate the impact of the interaction between alcohol consumption and overweight/obesity on the risk of hypertension. Results:Among the 4 397 individuals included in the analysis, 3 116 were male and 1 281 were female, with a mean age of (42.42±8.83) years. The detection rate of hypertension was 25.7% (1 128/4 397). The risk of hypertension in overweight/obese individuals was 2.566 times ( OR=2.566, 95% CI: 2.167-3.038) higher than that of non-overweight/obese individuals, and the risk of hypertension in alcohol consumption individuals was 1.486 times ( OR=1.486, 95% CI: 1.250-1.766) higher than that of non-drinkers. The risk of hypertension in drinking+non-overweight/obesity group, non-drinking+overweight/obesity group, and drinking+overweight/obesity group was 1.468 times ( OR=1.468, 95% CI: 1.112-1.936), 2.538 times ( OR=2.538, 95% CI: 1.968-3.272), and 3.796 times ( OR=3.796, 95% CI: 2.963-4.863) higher than that of non-drinking+non-overweight/obesity group, respectively (all P<0.05). Alcohol consumption and overweight/obesity had an additive interaction effect on the risk of hypertension, and the relative excess risk of interaction, attributable proportion of interaction and the synergy index was 0.791 (95% CI: 0.158-1.424), 0.208 (95% CI: 0.049-0.368), 1.394 (95% CI: 1.030-1.888), respectively. There was no significant multiplicative interaction between alcohol consumption and overweight/obesity on the risk of hypertension ( P>0.05). Conclusions:Alcohol consumption and overweight/obesity are both associated higher risk of hypertension. In addition, there is an additive interaction between alcohol consumption and overweight/obesity on the risk of hypertension.

Objective To investigate the efficacy and short-term prognosis of the treatment of complex preauricular fistulas by double-incision tunneling combined with total resection of preauricular tissue and cartilage.Methods The data on 134 children with complicated preauricular fistula admitted to the hospital from January 2018 to July 2022 were retrospectively analyzed.According to the treatment method,they were divided into a study group(68 undergoing double-incision tunnel combined with preauricular tissue and cartilage resection)and a control group(66 receiving preauricular tissue and cartilage resection).Both groups were followed up for one year.The conditions of surgery,pain,postoperative incision healing,aesthetics of incision healing,complications and short-term prognosis were compared between the two groups.Results There was no significant difference in the amount of blood loss between the two groups(P>0.05).The surgical duration was longer in the study group than in the control group(P<0.05).There was no significant difference in Pain Behavior Scale(FLACC)scores between the two groups at hours 4 and 24 after surgery(P>0.05).There was no significant difference in wound healing between the two groups(P>0.05).The SBSES score of the study group was higher than that of the control group(P<0.05).There was no significant difference in the total complication rate between the two groups(P>0.05).No recurrence occurred in both groups during postoperative follow-up.Conclusion Double-incision tunnel combined with resection of preauricular tissue and cartilage for preauricular fistula can completely remove fistula tissue.Incision healing is satisfactory,safe and reliable.As compared with the total excision of preauricular tissue and cartilage,double-incision tunnel com-bined with total excision of preauricular tissue and cartilage has more advantages in aesthetics of incision healing.

A 63-year-old female patient received Ⅳ infusions of salvianolate,cattle encephalon glycoside,and pantoprazole and an intramuscular injection of diphenhydramine (only once) in Emergency Department for dizziness,nausea,vomiting,and weakness of lower limbs.Laboratory tests showed no abnormalities in liver function.Craniocerebral CT showed multiple lacunar ischemic demyelination and bilateral internal carotid atherosclerosis.The patient was diagnosed with lacunar cerebral infarction and admitted to hospital.On the night of admission,oral rosuvastatin calcium 10 mg/d and clopidogrel75 mg/d were given.Eleven hours later,laboratory tests showed aspartate aminotransferase (AST) 254 U/L and alanine aminotransferase (ALT) 157 U/L.Salvianolate and pantoprazole were discontinued and reduced glutathione was given.On day 3 of reduced glutathione treatment,laboratory tests showed AST 587 U/L and ALT 660 U/L.Rosuvastatin calcium-induced liver transaminase elevation was considered.Then rosuvastatin calcium was discontinued and compound glycyrrhizin was given.On day 9 of rosuvastatin calcium withdrawal,laboratory tests showed AST 112 U/L and ALT 201 U/L,and then reduced glutathione was discontinued.On day 15 of rosuvastatin calcium withdrawal,laboratory tests showed AST 42 U/L and ALT 63 U/L,and then compound glycyrrhizin was discontinued.The patient was discharged 4 days later.At 2 weeks of follow-up,no abnormalities in liver function were found in the patient.

A 63-year-old female patient received Ⅳ infusions of salvianolate,cattle encephalon glycoside,and pantoprazole and an intramuscular injection of diphenhydramine (only once) in Emergency Department for dizziness,nausea,vomiting,and weakness of lower limbs.Laboratory tests showed no abnormalities in liver function.Craniocerebral CT showed multiple lacunar ischemic demyelination and bilateral internal carotid atherosclerosis.The patient was diagnosed with lacunar cerebral infarction and admitted to hospital.On the night of admission,oral rosuvastatin calcium 10 mg/d and clopidogrel75 mg/d were given.Eleven hours later,laboratory tests showed aspartate aminotransferase (AST) 254 U/L and alanine aminotransferase (ALT) 157 U/L.Salvianolate and pantoprazole were discontinued and reduced glutathione was given.On day 3 of reduced glutathione treatment,laboratory tests showed AST 587 U/L and ALT 660 U/L.Rosuvastatin calcium-induced liver transaminase elevation was considered.Then rosuvastatin calcium was discontinued and compound glycyrrhizin was given.On day 9 of rosuvastatin calcium withdrawal,laboratory tests showed AST 112 U/L and ALT 201 U/L,and then reduced glutathione was discontinued.On day 15 of rosuvastatin calcium withdrawal,laboratory tests showed AST 42 U/L and ALT 63 U/L,and then compound glycyrrhizin was discontinued.The patient was discharged 4 days later.At 2 weeks of follow-up,no abnormalities in liver function were found in the patient.

Objective: To compare the pharmacokinetics and bioavailability of pirfenidone in the fasted and fed states in healthy volunteers. Methods: An open-label, randomized crossover study was conducted in 12 healthy subjects. Food effects were examined by comparing pharmacokinetic data of pirfenidone after administration of a single oral 400 mg dose under fasted or fed conditions. Plas-ma pirfenidone concentration was determined by an HPLC method and its pharmacokinetic parameters were calculated with DAS v2. 0 software. Results: Under fasted and fed conditions, the concentration-time profiles of pirfenidone were fitted a one-compartment model and the pharmacokinetic parameters were as follows: t1/2were (2. 16 ± 0. 47) and (2. 05 ± 0. 42) h;tmaxwere(0. 69 ± 0. 16)and (1. 46 ± 0. 40)h;Cmaxwere (12. 95 ± 1. 79) and (9. 16 ± 2. 87) mg·L-1;AUC0-12were (44. 97 ± 15. 06) and (36. 19 ± 14. 44) mg·h·L-1;AUC0-∞were (46. 55 ± 16. 79) and (37. 41 ± 15. 43) mg·h·L-1, respectively. When compared with that of the fasted group, tmaxwas significantly increased (P<0. 001) while Cmaxand AUC were remarkedly decreased in the fed group (P<0. 001 and P<0. 01, respectively). Conclusion: Concomitant food intake significantly influences the pharmacokinetics and bioavail-ability of pirfenidone as indicated by reducing its extent and rate of absorption, which is associated with better tolerability.

Objective To analyze pathogenic bacteria distribution and antimicrobial susceptibility in children with acute otitis media(AOM ) .Methods Otorrhea samples from 146 episodes of AOM were cultured .The antimi‐crobial susceptibility of the main pathogenic bacteria was determined .The results were analyzed by SPSS19 .0 .Re‐sults 1) The strains of bacteria were isolated from 109 children with the positive rate of 74 .66% .Streptococcus pneumoniae (SP ) was the major bacteria(64 episodes ,58 .72% ) ,followed by staphlococcus aureus(SA) (19 epi‐sodes ,17 .43% ) .2) Sp was all sensitive to vancomycin ,levofloxacin ,moderate to penicillin ,amoxicillin ,cefo‐taxime ,and highly resistent to erythromycin and clindamycin .Staphlococcus aureus were all sensitive to vancomy‐cin ,tetracycline ,and Amy card ,and moderate to amoxicillin clavulanic acid potassium ,cefoxitin ,and oxacillin ,all resistent to penicillin and ampicillin .3) The strains of SP in age≤1year ,>1 -3years ,and >3 years respectively were 31(50 .82% ) ,25(56 .82% ) ,8 (19 .51% ) .There were significant differences between them(χ2 =14 .073 ,P=0 .001) .4)The strains of SP in 2012 ,2013 ,2014 respectively were 16(30 .19% ) ,22(48 .89% ) ,26(54 .17% ) ,There were significant differences between them(χ2 =6 .557 ,P=0 .038) .The antimicrobial susceptibility of SP had no sig‐nificant differences among 2012 ,2013 ,2014 ,but a yearly resistance decreasing trend was seen .Conclusion SP was the main bacterial contributor for AOM in Wuhan children .SP detection rate increases every year ,mainly in chil‐dren less than 3 years old .T he antimicrobial susceptibility is stable .

Objective To investigate the value of laparoscopy in the treatment of liver cancer.Methods The clinical data of 128 liver cancer patients who received laparoscopic surgery at Southwest Hospital from March 2007 to October 2009 were retrospectively analyzed.Of all patients,116 were with primary liver cancer,and 12 with metastatic liver cancer.There were 107 patients who received laparoscopie bepatectomy,15 received laparoscopic radiofrequency ablation(RFA)and 6 received laparoscopic ligation of the right branch of portal vein.Results Of the 107 patients who received laparoscopic bepatectomy,7 were converted to open surgery,and 5 were converted to hand-assisted laparoscopic hepatectomy.Anatomical hepatectomy was performed on 88 patients,including left lateral lobectomy on 21,left hemihepatectomy on 15,extended left hemihepatectomy on 2,medial lobectomy on 1,right hemihepatectomy on 11,right posterior lobeetomy on 9 and hepatic segmentectomy on 29.Combined hepatic resection was performed on 4 patients,and nonanatomical hepatectomy on 15.The mean oporatire time and blood loss were(228±92)minutes and(393±213)ml,with no operative mortality.The mean postoperative hospital stay was(8±4)days,and the incidence of complications was 15%(16/107).A total of 126 patients were followed up for 1-42 months,12 patients with laparoscopic hepatectomy died within 16 months,with the mean survival time of(118±7)weeks and the mean tumor free survival time of(105±7)weeks;2 patients with laparoscopic RFA died within 11 months:2 patients with laparoseopie ligation of the right branch of portal vein received two-stage radical resection.Conclusion Laparoscopic surgery is safe and feasible with the advantages of minimal operative trauma and quick recovery of patients when it is applied to the treatment of liver cancer.

To determine the pharmacokinetics and bioequivalence of epinastine (EPN) hydrochloride, a promising histamine H1 receptor antagonist, in healthy Chinese volunteers under fasting conditions. METHODS: EPN hydrochloride test and reference tablets were administered as a single dose on two treatment days separated by a 1-week washout period. After dosing, serial blood samples were collected for a period of 36 h, and plasma EPN hydrochloride concentrations were determined by a validated reversed-phase HPLC method and pharmacokinetic parameters were calculated with DAS software. RESULTS: Plasma concentration-time profiles were adequately described by a two-compartment open model. The compound was rapidly absorbed and cleared slowly from plasma with a half-life of approximately 10 h. The main pharmacokinetic parameters of EPN hydrochloride test and reference tablets were as follow: tmax were (2.2±0.5) and (2.0±0.4)h, Cmax were (66±16)and (68±13)μg/L, t1/2 were(10.1±1.3) and (10.4±2.4)h, AUC0-36 were (592±88) and (601±94)μg·h·L-1, respectively. The relative bioavailability of test tablets was (99±13)%. CONCLUSION: The results indicate that the two formulations of EPN hydrochloride tablets are bioequivalent in the rate and extent of absorption.