Altitude sickness is a disease caused by series of physiological and pathological changes and compensatory adaptation changes caused by acute or chronic exposure to high altitude hypoxia.High altitude pulmonary edema(HAPE)and high altitude cerebral edema are life-threatening diseases that are likely to develop;chronic high-altitude sickness,if not taken seriously,can affect various systems of the patient.This article reviews the drug prevention and treatment of three types of altitude sickness,HAPE,high altitude polycythemia(HAPC),and high altitude pulmonary hypertension(HAPH),to provide a reference for the rapid adaptation of people entering high altitudes and the health care of high-altitude residents.

Objective : To investigate and analyze the root and root canal morphology of mandibular first molars (MFMs) in the Tibetan population using cone-beam computed tomography (CBCT) and to provide references for clinical root canal treatment in the Tibetan population. Methods: This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. CBCT imaging data of 300 mandibular first molars from 300 Tibetan patients were included. Patient age, the number of roots in mandibular first molars were recorded. The morphology and incidence of mesial root and mesial root canals and the morphology and incidence of distal root and distal root canals were statistically analyzed by Vertucci classification. Results : There were 198 double-root teeth and 102 three-root teeth in the 300 mandibular first permanent molars. Among the three-rooted molars, 1 case had mesiolingual roots, and the rest had distolingual roots. The incidence rate of the distolingual root was 33.7%(101/300). The most common root canal configuration was Vertucci Ⅳ 65.7% (197/300), followed by Vertucci Ⅱ 20.3% (61/300) in the mesial roots. The overall incidence of middle mesial canals (MMCs) was 6% (18/300), with the highest incidence of MMCs in the 20-40 year-old group at 9% (9/100). The distal roots canals of single-distal-rooted mandibular first molars were mainly Vertucci Ⅰ 66.8% (133/199), followed by Vertucci Ⅱ 14.6% (29/199) and Vertucci Ⅳ 11.6% (23/199). For the mandibular first permanent molars with two distal roots, 96% (97/101) of the distal buccal roots and 100% (101/101) of the distal lingual roots were Vertucci Ⅰ root canals. Conclusion The root and root canal morphology of mandibular first permanent molars in a Tibetan population is complex and variable. Approximately one-third of patients have distolingual roots, and clinicians should carefully explore the root canals under the guidance of CBCT.

Objective: To summarize the clinical features, management and outcome of superior vena cava syndrome (SVCS) associated with mediastinal malignancy in children. Methods: Clinical data of 42 children of SVSC associated with mediastinal malignancy in Shanghai Children's Medical Center from January 2015 to December 2021 were collected and analyzed retrospectively. The clinical manifestations, pathological diagnosis, disease diagnosis process, and prognosis were summarized. Results: Among 42 children of SVCS associated with mediastinal malignancy, there were 31 males and 11 females. The age at diagnosis was 8.5 (1.9, 14.9) years. Cough and wheezing (33 cases, 79%), orthopnea (19 cases, 45%) and facial edema (18 cases, 43%) occurred most commonly. T-cell lymphoblastic lymphoma (T-LBL) was the most frequent pathological diagnosis (25 cases, 60%), followed by T-cell acute lymphoblastic leukemia (T-ALL) (7 cases, 17%), anaplastic large cell lymphoma (4 cases, 10%) and diffuse large B-cell lymphoma (2 cases, 5%), peripheral T-lymphoma, Hodgkin lymphoma, Ewing's sarcoma and germ cell tumor (1 case each). Pathological diagnosis was confirmed by bone marrow aspiration or thoracentesis in 14 cases, peripheral lymph node biopsy in 6 cases, and mediastinal biopsy in 22 cases. Twenty-seven cases (64%) had local anesthesia. Respiratory complications due to mediastinal mass developed in 3 of 15 cases who received general anesthesia. Of the 42 cases, 27 cases had sustained remission, 1 case survived with second-line therapy after recurrence, and 14 cases died (2 cases died of perioperative complications and 12 cases died of recurrence or progression of primary disease). The follow-up time was 36.7 (1.2, 76.1) months for 27 cases in continuous complete remission. The 3-year overall survival (OS) and events free survival (EFS) rates of 42 children were 59% (95%CI 44%-79%) and 58% (95%CI 44%-77%) respectively. Conclusions: SVCS associated with mediastinal malignancy in children is a life-threatening tumor emergency with high mortality. The most common primary disease is T-LBL. The most common clinical symptoms and signs are cough, wheezing, orthopnea and facial edema. Clinical management should be based on the premise of stable critical condition and confirm the pathological diagnosis through minimal invasive operation.
Child ; China ; Cough ; Edema ; Female ; Humans ; Male ; Mediastinal Neoplasms/diagnosis* ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; Respiratory Sounds ; Retrospective Studies ; Superior Vena Cava Syndrome/therapy*

Objective To explore the feasibility of rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models using magnetic compression anastomosis (MCA) technique. Methods Twelve healthy adult crossbred dogs were evenly divided into the MCA and hand suturing (HS) groups according to the anastomosis method between abdominal aorta and artificial blood vessels. The intraoperative duration of abdominal aorta occlusion, intraoperative condition of anastomotic stoma and postoperative imaging examination of anastomotic stoma were compared between two groups. Results The intraoperative duration of abdominal aorta occlusion in the MCA group was significantly shorter than that in the HS group [(5.2±2.3) min vs. (24.4±4.3) min, P < 0.001]. No anastomotic leakage of blood or anastomotic stenosis occurred in the MCA group during the operation. Intraoperative anastomotic leakage of blood occurred in all of the 6 dogs in the HS group. Among them, 1 dog died of excessive blood loss, and 2 dogs experienced mild anastomotic stenosis due to repeated repair. Postoperative color Doppler ultrasound and angiography showed smooth blood flow at the anastomotic stoma without stenosis or thrombosis in the MCA group. In the HS group, 4 dogs presented with anastomotic stenosis on angiography at postoperative 4 weeks. Conclusions MCA technique may achieve rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models, which reduces the incidence of anastomotic complications and accelerates postoperative recovery.

【Objective】 To evaluate the performance of the magnetic artificial blood vessel device for fast non-suture anastomosis of caval reconstruction with artificial blood vessel transplantation after resection in canines. 【Methods】 Sixteen adult mongrel dogs of either gender were randomly divided into two groups for vena cava reconstruction with artificial blood vessel transplantation after inferior vena cava (IVC) resection. Group MCA (n=8): magnetic artificial blood vessel device for IVC reconstruction; Group manual sewing (MS) (n=8): hand suturing for IVC reconstruction. Operation time and stoma errhysis were recorded during operation. Patency and stoma stenosis were confirmed via color Doppler ultrasound scanning and X-ray cholangiography at different time points as late as 4 weeks after surgery. 【Results】 The time required to perform the vascular anastomosis was significantly shorter for the magnetic artificial blood vessel device (6.25±2.25)min than for MS (27.32±5.12)min (P<0.001). There were four cases of stoma errhysis in MS group which had to be repaired (P=0.077). Vascular X-ray angiography and color Doppler ultrasound found normal blood flow and no stoma stenosis in MCA group, but three cases of stoma stenosis in MS groups (P=0.200). Compared with MS group, the magnetic ring device stoma was associated with smooth re-endothelialization and depressed infiltration of inflammatory cells at the anastomotic site. 【Conclusion】 The magnetic artificial blood vessel device offers a simple, fast, reliable, and efficacious technique for vena cava reconstruction with artificial blood vessel transplantation.

Objective:To determine the epidemiological characteristics and incidence trends of sexually transmitted diseases （STD） in Mengla County of Yunnan Province， and provide evidence for future prevention and control of STD. Methods:STD case information from 2005 to 2017 was extracted from the National Notifiable Infectious Disease Report Information System. Data were collected by year and disease type，and the incidence rate， epidemic characteristics and suspicious contact history of STD were statistically analyzed. Results:A total of 1 251 STD cases were reported in Mengla county from 2005 to 2017， including 490 gonorrhea， 483 syphilis， 216 condyloma acuminatum， 16 genital chlamydial infection and 46 genital herpes. The average annual incidence of STD was 35.57/100 000. The majority of STD cases were 20-29 years old （n=541，43.25%）， married （n=603，48.20%）， Han people （n=638，50.10%）， with education of middle school （n=536，42.85%）， and occupation of farmers （n=702， 56.12%）. The 42.61% of STD cases had non-marital sexual contact history， in which the proportion was significantly higher among male （55.05%） than female （28.98%）. In addition， the proportion of non-marital sex among STD cases increased gradually by year and significantly differed. Conclusion:The epidemic status of STD in Mengla county is relatively low. However， STD incidence increased gradually by year， which warrants more and specific measures on the STD control and prevention.