Objective:To conduct the clinical effect achieved by the combination of axillary flap trimming and scraping through small axillary incisions in treating bromhidrosis.Methods:From June 2021 to December 2022, a study was conducted on patients with bilateral bromhidrosis in the Department of Plastic Surgery, Jining First People’s Hospital. The study used a self-control method, with one side undergoing axillary flap trimming combined with scraping through small axillary incisions (designated as Group A), while the other side underwent direct axillary flap trimming through central axillary incisions (designated as Group B). Randomization was achieved using a number table method for both sides. In Group A, two short incision lines of 0.5-1.0 cm were designed on both sides of the armpit. These incisions separated all layers of the skin, and excised the sweat glands and fat tissue. Additionally, two drainage openings were left in the surgical area to maintain two drainage tubes through the surgical incision. In Group B, the incision lines of 2-3 cm were designed in the central axillary area. After incision and dissection, four drainage tubes were retained in the operation area. The efficacy evaluation consisted of three aspects: the surgical outcome one month post-operation, categorized as cure, effective, or ineffective; the recurrence of bromhidrosis six months post-operation; and the occurrence of surgical complications. SPSS 25.0 software was used for data analysis, and chi-square test was applied for the comparisons between the two groups in terms of response rate, recurrence rate, and complication rate. A statistically significant difference was determined at the P<0.05 level. Results:A study was conducted on 62 patients, aged between 16 and 35 years, with bilateral bromhidrosis, including 38 males and 24 females. In Group A, 55 patients achieved complete cure, while 7 patients experienced significant improvement, resulting in an overall effectiveness rate of 100%. However, 5 cases of recurrence were observed, with a recurrence rate of 8.1%. Additionally, there were 1 case of subflap hematoma, 2 cases of flap erosion, and 1 case of scar hypertrophy, resulting in a complication rate of 6.5%. In Group B, 58 patients achieved complete cure, while 4 patients experienced improvement, resulting in an overall effectiveness rate of 100%. Three cases of recurrence were reported within 6 months, with a recurrence rate of 4.8%. Furthermore, there were 4 cases of subflap hematoma, 4 cases of flap erosion, 2 cases of flap necrosis, and 4 cases of scar hypertrophy, resulting in a complication rate of 22.6%. Statistical analysis showed no significant difference in treatment response rate ( χ2=0.34, P=0.559) or postoperative recurrence rate ( χ2=0.53, P=1.000) between the two groups. However, the complication rate in Group A was significantly lower than that in Group B ( χ2=6.50, P=0.011). Conclusion:The clinical outcome is satisfactory, achieving a high rate of effectiveness by the combination of axillary flap trimming and scraping through small axillary incisions in treating bromhidrosis. And the complications are fewer compared to the direct axillary flap trimming through central axillary incisions.

Objective:To conduct the clinical effect achieved by the combination of axillary flap trimming and scraping through small axillary incisions in treating bromhidrosis.Methods:From June 2021 to December 2022, a study was conducted on patients with bilateral bromhidrosis in the Department of Plastic Surgery, Jining First People’s Hospital. The study used a self-control method, with one side undergoing axillary flap trimming combined with scraping through small axillary incisions (designated as Group A), while the other side underwent direct axillary flap trimming through central axillary incisions (designated as Group B). Randomization was achieved using a number table method for both sides. In Group A, two short incision lines of 0.5-1.0 cm were designed on both sides of the armpit. These incisions separated all layers of the skin, and excised the sweat glands and fat tissue. Additionally, two drainage openings were left in the surgical area to maintain two drainage tubes through the surgical incision. In Group B, the incision lines of 2-3 cm were designed in the central axillary area. After incision and dissection, four drainage tubes were retained in the operation area. The efficacy evaluation consisted of three aspects: the surgical outcome one month post-operation, categorized as cure, effective, or ineffective; the recurrence of bromhidrosis six months post-operation; and the occurrence of surgical complications. SPSS 25.0 software was used for data analysis, and chi-square test was applied for the comparisons between the two groups in terms of response rate, recurrence rate, and complication rate. A statistically significant difference was determined at the P<0.05 level. Results:A study was conducted on 62 patients, aged between 16 and 35 years, with bilateral bromhidrosis, including 38 males and 24 females. In Group A, 55 patients achieved complete cure, while 7 patients experienced significant improvement, resulting in an overall effectiveness rate of 100%. However, 5 cases of recurrence were observed, with a recurrence rate of 8.1%. Additionally, there were 1 case of subflap hematoma, 2 cases of flap erosion, and 1 case of scar hypertrophy, resulting in a complication rate of 6.5%. In Group B, 58 patients achieved complete cure, while 4 patients experienced improvement, resulting in an overall effectiveness rate of 100%. Three cases of recurrence were reported within 6 months, with a recurrence rate of 4.8%. Furthermore, there were 4 cases of subflap hematoma, 4 cases of flap erosion, 2 cases of flap necrosis, and 4 cases of scar hypertrophy, resulting in a complication rate of 22.6%. Statistical analysis showed no significant difference in treatment response rate ( χ2=0.34, P=0.559) or postoperative recurrence rate ( χ2=0.53, P=1.000) between the two groups. However, the complication rate in Group A was significantly lower than that in Group B ( χ2=6.50, P=0.011). Conclusion:The clinical outcome is satisfactory, achieving a high rate of effectiveness by the combination of axillary flap trimming and scraping through small axillary incisions in treating bromhidrosis. And the complications are fewer compared to the direct axillary flap trimming through central axillary incisions.

Objective To investigate the effect of cognitive behavioral therapy (CBT) on the white matter microstructural changes in first?episode untreated major depressive disorder (MDD) adult patients. Methods Fourteen first?episode, medication?na?ve MDD patients and 15 healthy subjects as controls underwent diffusion tensor imaging (DTI) scan and assessment at baseline. Then, the patients received 28?week CBT treatment, and were given the second scan when finished. Fractional anisotropy (FA) was compared to indirectly explore abnormality of white matter in depressed patients and healthy subjects, and before?after treatments, using whole brain tract?based spatial statistic (TBSS) analysis. The clinical symptoms were assessed by psychiatrists using HAMD24. The relationship between the FA values of regions changed before and after CBT and the duration, scores of HAMD24 were analyzed by using Pearson correlation analysis. Results Post?treatment, MDD patients showed a significant reduction in HAMD24 (t=23.773,P<0.01). Compared with controls, the MDD patients showed a trend for lower value of FA in the right frontal lobe (MNI: x=20, y=14, z=58, P=0.001), the left temporal lobe (MNI: x=-50, y=-7, z=-24, P=0.006), the right hippocampus (MNI: x=21, y=-32, z=-5, P=0.004) and the left angular region (MNI: x=-45, y=-56, z=34, P=0.007) before CBT. After CBT, MDD patients still showed lower value of FA in the right frontal lobe (MNI: x=18, y=14, z=55, P=0.001), the right hippocampus (MNI: x=21, y=-33, z=-5, P=0.003) and the left angular region (MNI: x=-44, y=-57, z=34, P=0.006), and only the FA value of left temporal lobe came back to normal after 28 weeks treatment. MDD patients also showed increased FA value in the left cerebellum (MNI: x=-16, y=-55, z=-44, P=0.025) from pro?to post?treatment. Duration were not correlated with left temporal lobe (r=-0.188, P=0.520) and left cerebellum (r=-0.090, P=0.760) in patients. Scores of HAMD24 were also not correlated with left temporal lobe (before CBT: r=-0.105, P=0.722; after CBT: r=-0.152, P=0.603) and left cerebellum (before CBT: r=-0.224, P=0.441; after CBT: r=-0.167, P=0.568) in patients. Conclusion CBT may induce white matter changes in temporal lobe and cerebellum in MDD patients, and may play a role in improving depressive symptom.

Objective To investigate the effect of cognitive behavioral therapy (CBT) on the white matter microstructural changes in first?episode untreated major depressive disorder (MDD) adult patients. Methods Fourteen first?episode, medication?na?ve MDD patients and 15 healthy subjects as controls underwent diffusion tensor imaging (DTI) scan and assessment at baseline. Then, the patients received 28?week CBT treatment, and were given the second scan when finished. Fractional anisotropy (FA) was compared to indirectly explore abnormality of white matter in depressed patients and healthy subjects, and before?after treatments, using whole brain tract?based spatial statistic (TBSS) analysis. The clinical symptoms were assessed by psychiatrists using HAMD24. The relationship between the FA values of regions changed before and after CBT and the duration, scores of HAMD24 were analyzed by using Pearson correlation analysis. Results Post?treatment, MDD patients showed a significant reduction in HAMD24 (t=23.773,P<0.01). Compared with controls, the MDD patients showed a trend for lower value of FA in the right frontal lobe (MNI: x=20, y=14, z=58, P=0.001), the left temporal lobe (MNI: x=-50, y=-7, z=-24, P=0.006), the right hippocampus (MNI: x=21, y=-32, z=-5, P=0.004) and the left angular region (MNI: x=-45, y=-56, z=34, P=0.007) before CBT. After CBT, MDD patients still showed lower value of FA in the right frontal lobe (MNI: x=18, y=14, z=55, P=0.001), the right hippocampus (MNI: x=21, y=-33, z=-5, P=0.003) and the left angular region (MNI: x=-44, y=-57, z=34, P=0.006), and only the FA value of left temporal lobe came back to normal after 28 weeks treatment. MDD patients also showed increased FA value in the left cerebellum (MNI: x=-16, y=-55, z=-44, P=0.025) from pro?to post?treatment. Duration were not correlated with left temporal lobe (r=-0.188, P=0.520) and left cerebellum (r=-0.090, P=0.760) in patients. Scores of HAMD24 were also not correlated with left temporal lobe (before CBT: r=-0.105, P=0.722; after CBT: r=-0.152, P=0.603) and left cerebellum (before CBT: r=-0.224, P=0.441; after CBT: r=-0.167, P=0.568) in patients. Conclusion CBT may induce white matter changes in temporal lobe and cerebellum in MDD patients, and may play a role in improving depressive symptom.

Objective To evaluate the effect of comprehensive control for schistosomiasis with emphasis on environmental modification in the Bianmin River water system of Nanjing City.so as to provide scientific evidence for making up further control measures in this water system.Methods Schistosome infections of Oncomelania snails in the waterway.sentinel mice in water and neighbouring human were investigated longitudinally from 1998 to 2007,and the changes of huaman infection rates in differentyears,the infection rates of sentinel mice and snails in different settings were analyzed and compared.Results A total of 77 395 snails collected from the Bianmin River water system were dissected from 1998 to 2007,and among them,27 snails were infected with Schistosoma japonicum,with a total snail infection rate of 0.03%.A total of 61 039 snails collected from the neighbouring marshland which connected to the Yangtze River wore dissected,and among them,257 were infected with S.japonicum,with a total snail infection rate of 0.42%,and there was a significant difference compared with that in the water system(χ~2=248.55,P<0.01).After the protection works in the waterway,the infection rates of sentinel mice in the water system decreased from 69.68% in 1998 to 17.50% in 2001.with a reduction rate of 74.89%.Two years afterthe clearance ofmarshlandinthewaterway,no infected sentinel mouse was found.The infection rates of residents from 1998 to 2007 were 1.96%,1.37%,1.34%,1.60%,0.30%, 0.26%,0.16%,0.10%,0.04% and 0,respectively,andthe rates declined year by year afterthecomprehensive control.Conclusions The control measures based on the elimination of snail habitats in the waterway that is connected to the Yangtze River have achieved obvious effect.However,the clearance of the re-emerging snail habitats should be carried out termly to consolidate the control effect.

Three endemic villages were selected as the national surveillance sites and Schistosoma japonicum infec-tion in residents and livestock was investigated in 2006. The positive rate of serological (IHA) and stool examinations was 10.06%(307/3 053) and 0.13%(4/3 053) for local residents, 10.8%(7/65) and 0(0/7) for moving people respectively. No infected livestock was found.

Objective To investigate the diagnostic value of MRI on Creutzfeldt-Jakob disease(CJD).Methods The imaging data of 15 patients with CJD were analyzed retrospectively.Results In the 15 cases,the diagnosis was clinical probable CJD 10 cases,maybe CJD 5 cases.There was no abnormal signal found by routine T 1WI and T 2WI scanning in the 15 cases.DWI showed that 10 cases had hyperintense abnormalities in both the cerebral cortex and the striatum,5 cases had hyperintense abnormalities only in the cerebral cortex.The hyperintense abnormalities were symmetric in 8 cases,but were asymmetric in the other 7 cases.1H-MRS were applied in the 4 cases and showed that N-acetylas partate(NAA),NAA/creatine(Cr) were decreased to some extent.Choline(Cho),Cho/Cr were decreased in 2 cases and increased in 2 cases.mI peak did not appear in all 4 cases.Conclusion MRI,especially DWI and 1H-MRS give can valuable information in detecting and diagnosing CJD early.