Objective:To observe the efficacy and safety of combined lienal polypeptide injection therapy in the treatment of Mycoplasma pneumoniae pneumonia（MPP）in children aged 3 to 14 years old in multiple clinical centers.Methods:A randomized，controlled，multi-center clinical study design was adopted.A total of 240 hospitalized children aged 3 to 14 years old with MPP from 7 hospitals from September 1，2023 to January 31，2024 were included.According to the severity of pneumonia，they were divided into the mild MPP group with 80 cases and the severe MPP/refractory MPP（SMPP/RMPP）group with 160 cases，and then randomly divided into the control group and the experimental group at a ratio of 1 ∶1，using the random number table method.After screening，subjects entered a treatment period of 5 to 7 days.The control group was treated with azithromycin，while the experimental group was treated with azithromycin plus lienal polypeptide injection .The recovery of lung CT，length of hospital stay，duration of fever，cough score，whether mild cases developed into severe or refractory cases，duration of hormone use，use of intravenous immunoglobulin（IVIG），bronchoscopy treatment，and immune function were observed between the two groups to evaluate the efficacy of lienal polypeptide injection.Adverse events after medication，vital signs，blood routine，urine routine，liver function，myocardial enzymes，renal function，and electrocardiogram were observed to evaluate the safety. Results:A total of 231 subjects have completed the trial in the 7 hospitals，including 118 cases in the experimental group and 113 cases in the control group.Main observation index：the rate of lung CT aggravation in the experimental group was lower than that in the control group（2.6% vs 15.3%， P<0.01），and the difference was statistically significant.Secondary indexes：there were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and immunoglobulin between the two groups（all P>0.05）.However，the rate of cases of plastic bronchitis（PB）found under bronchoscopy in the experimental group was lower than that in the control group（0 vs 18.8%， P=0.03），and the difference was statistically significant.Among the mild MPP（72 cases），there were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and the improvement rate of lung CT between the two groups（all P>0.05）.However，compared with the control group，the rate of cases developing into SMPP/RMPP in the experimental group was less（24.3% vs 48.6%， P=0.03），and the difference in IgG before and after treatment was small［0.53（-0.04，1.18）g/L vs 1.33（0.48，2.25）g/L， P=0.01］.Among the SMPP/RMPP cases（159 cases），the rate of cases of PB found under bronchoscopy in the experimental group was less than that in the control group（0 vs 20%， P=0.04），and the rate of cases with aggravated lung CT in the experimental group was less than that in the control group（1.3% vs 19.5%， P<0.01），and the improvement rate of lung CT in the experimental group was higher than that in the control group（88.8% vs 75.3%， P=0.03），with statistically significant differences.There were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and immunoglobulin between the two groups（all P>0.05）.Two cases in the experimental group developed rashes，which improved after the drug was discontinued.There were no serious adverse reactions such as abnormal vital signs like dyspnea and cyanosis due to the use of lienal polypeptide injection.There were no obvious changes in blood routine，liver function，myocardial enzymes，renal function，electrocardiogram，and urine routine values before and after medication compared with the baseline. Conclusion:The combined use of lienal polypeptide injection in the treatment of MPP in children can reduce the probability of the transformation from mild cases to SMPP/RMPP，reduce the rate of aggravation of the image findings，promote the absorption of lung inflammation，reduce the rate of PB found under bronchoscopy，and has good safety.

BACKGROUND: Weather conditions are a possible contributing factor to age-related macular degeneration (AMD), a leading cause of irreversible loss of vision. The present study evaluated the joint effects of meteorological factors and fine particulate matter (PM_2.5) on AMD. METHODS: Data was extracted from a national cross-sectional survey conducted across 10 provinces in rural China. A total of 36,081 participants aged 40 and older were recruited. AMD was diagnosed clinically by slit-lamp ophthalmoscopy, fundus photography, and spectral domain optical coherence tomography (OCT). Meteorological data were calculated by European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis and were matched to participants' home addresses by latitude and longitude. Participants' individual PM_2.5 exposure concentrations were calculated by a satellite-based model at a 1-km resolution level. Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the joint effects of meteorological factors and PM_2.5 on AMD. RESULTS: The prevalence of AMD in the study population was 2.6% (95% CI 2.42-2.76%). The average annual PM_2.5 level during the study period was 63.1 ± 15.3 µg/m³. A significant positive association was detected between AMD and PM_2.5 level, temperature (T), and relative humidity (RH), in both the independent and the combined effect models. For PM_2.5, compared with the lowest quartile, the odds ratios (ORs) with 95% confidence intervals (CIs) across increasing quartiles were 0.828 (0.674,1.018), 1.105 (0.799,1.528), and 2.602 (1.516,4.468). Positive associations were observed between AMD and temperature, with ORs (95% CI) of 1.625 (1.059,2.494), 1.619 (1.026,2.553), and 3.276 (1.841,5.830), across increasing quartiles. In the interaction analysis, the estimated relative excess risk due to interaction (RERI) and the attributable proportion (AP) for combined atmospheric pressure and PM_2.5 was 0.864 (0.586,1.141) and 1.180 (0.768,1.592), respectively, indicating a synergistic effect between PM_2.5 and atmospheric pressure. CONCLUSIONS This study is among the first to characterize the coordinated effects of meteorological factors and PM_2.5 on AMD. The findings warrant further investigation to elucidate the relationship between ambient environment and AMD.
Humans ; Adult ; Middle Aged ; Cross-Sectional Studies ; Air Pollutants/analysis* ; Particulate Matter/analysis* ; China/epidemiology* ; Macular Degeneration/etiology* ; Meteorological Concepts

Objective:To investigate the awareness of diabetes knowledge among the health examination population and its influencing factors.Methods:A cross-sectional study. From september to november 2022, the subjects of six health examination centers located in six different cities (Beijing, Shanghai, Tianjin, Chongqing, Xiamen, Hangzhou) in China were investigated in the form of questionnaires to investigate the awareness of diabetes core information and the level of trust to different information sources of diabetes knowledge. According to the questionnaire results, the subjects were divided into a high awareness group of diabetes core information and a low awareness group. Logistic regression was used to analyze the influencing factors of diabetes core information awareness; the t-test was used to compare the trust degree of the two groups to different information sources. Results:A total of 9 315 people were included in the six centers, including 4 932 men (52.90%) with an average age of (39.36±12.64) years and 4 383 women (47.10%) with a mean age of (37.47±11.85) years. Only 36% of the people had high awareness of diabetes core information; variables such as gender, age, education level, physical examination frequency in the past three years, package price of this physical examination, self-evaluation of diabetes knowledge, diabetes status, and city of residence were variables that affect the level of awareness of core information related to diabetes (all P<0.05). Compared with the low awareness group of diabetes core information, the high awareness group trusted professional medical staff ( t=-9.597, P<0.05) and community health promotion more ( t=-5.014, P<0.05), but did not trust the emerging popular science propaganda means, such as WeChat official accounts/WeChat groups/QQ groups, Internet web page, Tiktok/Kwai and other short video APPs. Conclusion:The awareness rate of diabetes knowledge among the health examination population is low, and it is affected by many factors; Health education on diabetes knowledge should be carried out for people undergoing physical examination.

Radiotherapy, as a common modality for the treatment of head and neck cancer (HNC), frequently induces oral and maxillofacial complications. However, the complex tissues and diverse pathogeneses of these regions lead to limited treatment protocols and research progress currently. This paper systematically summarizes radiation-induced oral mucositis, salivary gland injury, and dental caries in radiotherapy for HNC and reviews existing pathogenetic hypotheses, treatment, and research progress. The purpose is to provide some reference for further research on relevant pathological mechanisms and the development of new preventive and treatment methods.

Objective:To explore the clinical effects of combined medial and lateral approaches in treating of calcaneal fractures combined with sustentaculum tali fractures and/or dislocations of sustentaculum tali-talus joint.Methods:Four adult cadaver specimens (8 feet) were selected, of which two (4 feet) were dissected on the medial side of the calcaneus to observe the adjacency and exposure range of sustentaculum tali. The other two specimens were simulated as medial and lateral approaches to reduce and fix calcaneal fractures. Retrospective analysis of 9 cases (9 feet) of Sanders II-IV type calcaneal fractures with combined medial and lateral approaches in the treatment of fractures and/or dislocations of sustentaculum tali-talus joint was performed. The average age was 49.9±11.3 (25-58) years. During the operation, the medial incision was made first, and the sustentaculum tali fracture was temporarily reduced and fixed to the talus. Then the lateral incision was made to expose the lateral side of the calcaneus, and the fracture fragments were reduced and fixed; the sustentaculum tali was fixed laterally with screws, and 2 cases were additionally fixed medially with absorbable rods. At the same time, six cases (8 feet) of calcaneal fractures with sustentaculum tali fractures and/or dislocations of sustentaculum tali-talus were treated with lateral approach as a control group. The lateral sides of both groups were fixed with calcaneal locking plate and implanted with demineralized bone matrix into the cavity after articular surface reduction. The B?hler and Gissane angles of the two groups of patients were measured at 1 year after operation. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system was used to evaluate the clinical efficacy.Results:The sustentaculum tali-talus joint had a shape of an inverted "V" with two divided parts. The tip of the sustentaculum tali was exposed through the front window of the posterior tibial tendon. The sustentaculum tali and the medial side of the calcaneal body was completely exposed and fixed through the window between the posterior tibial tendon and the flexor digitorum longus tendon. The postoperative incision blood loss in the combined medial and lateral approach group was 73.6±4.3 ml, which was greater than that in the lateral approach group (70.6±7.1 ml) ( t=2.18, P=0.045). The lateral incision healed in both groups. The medial incision healed delayed in 1 patient in the combined medial and lateral approach group. The fractures in the combined medial-lateral approach group and the lateral approach group were both healed. The healing duration was 12.2±2.1 weeks and 12.8±2.8 weeks, respectively, without significant difference ( t=0.50, P=0.622). The B?hler angles of the combined medial-lateral approach group and the lateral approach group were 37.0°±5.7° and 27.9°±4.0° at 1 year after operation, respectively. These values were greater than the preoperative values of 4.7°±3.4° and 3.9°±2.9° ( P<0.05), with significant difference between groups ( t=3.76, P=0.002). The Gissane angles were 133.2°±9.8° and 139.1°±9.4° respectively, which were lower than those of 172°±7.3° and 175.6°±5.6° before operation ( P<0.05). There was no significant difference between the groups ( t=1.26, P=0.226). The AOFAS score of the combined medial and lateral approach group was 93.6±4.0 points, which was higher than that of the lateral approach group (84.3±8.2 points) ( t=3.03, P=0.008). Conclusion:Intra-articular calcaneal fractures combined with a high probability of sustentaculum tali fractures and/or dislocations of sustentaculum tali-talus joint. Compared with the simple lateral approach, the use of the combined medial-lateral approach and the medial-lateral surgical sequence is beneficial to restore the calcaneal alignment and anatomic shape, especially the alignment relationship of the medial calcaneus and talus, so as to obstain better early clinical outcomes.

Objective:To explore the clinical effect of the composite reduction labiaplasty by divisional design.Methods:From January 2020 to February 2022, the clinical data of patients with complex labia minora and clitoris prepuce hypertrophy who were treated in the Medical Cosmetic Center of Beijing Friendship Hospital Affiliated to Capital Medical University were collected and analysed. The inner side of their labia minora showed no chalasis in the vertical direction, but the outer side were slack with folds, accompanied by clitoris prepuce hyperplasia. We adopted the composite reduction labiaplasty by divisional design. The outer side of the labia minora and the clitoral prepuce were considered as a whole, and a wedge-shaped incision line was designed to remove the excess tissue in the vertical direction. On this basis, an arc was projected on the inner side of the labia minora to form an arcuate incision line on the inner side. The composite reduction labiaplasty was performed with the combination of wedge resection and edge resection. The postoperative follow-up observations included: postoperative complications, the symmetry of the labia minora and clitoris prepuce, the improvement of frictional discomfort, the cleanliness of the labia minora and the clitoris prepuce, and the patient's satisfaction with the shape of the labia minora and clitoris prepuce. For patients with sexual experience, follow-up content also includes changes in sexual satisfaction.Results:A total of 17 female patients aged 20 to 35 years, with an average age of 27 years, were included in this study. Follow-up was conducted 2 months after the operation. All incisions healed by first intention with no sawtooth-like deformity at the incision margin, and had natural appearance. Patients felt that the bilateral labia minora and clitoral foreskin were completely symmetrical in 3 cases, basically symmetrical in 12 cases, and partially asymmetric in 2 cases. These 2 cases of partial asymmetry did not require further surgical repair. In all 17 patients, the frictional discomfort was completely resolved, and the labia minora and clitoral foreskin were easier to clean. The patients were very satisfied with the appearance in 5 cases, satisfied in 10 cases, and dissatisfied in 2 case. There were 15 patients with previous sexual life experience, of which 10 patients had improved sexual satisfaction, and 5 patients had no change in sexual satisfaction after the operation.Conclusions:Through the divisional design, wedge resection and edge resection are performed in the composite reduction labiaplasty, which can solve the friction and discomfort caused by the hyperplasia of labia minora and clitoris prepuce in a single operation, and achieve better aesthetic results at the same time.

Objective:To explore the clinical effect of the composite reduction labiaplasty by divisional design.Methods:From January 2020 to February 2022, the clinical data of patients with complex labia minora and clitoris prepuce hypertrophy who were treated in the Medical Cosmetic Center of Beijing Friendship Hospital Affiliated to Capital Medical University were collected and analysed. The inner side of their labia minora showed no chalasis in the vertical direction, but the outer side were slack with folds, accompanied by clitoris prepuce hyperplasia. We adopted the composite reduction labiaplasty by divisional design. The outer side of the labia minora and the clitoral prepuce were considered as a whole, and a wedge-shaped incision line was designed to remove the excess tissue in the vertical direction. On this basis, an arc was projected on the inner side of the labia minora to form an arcuate incision line on the inner side. The composite reduction labiaplasty was performed with the combination of wedge resection and edge resection. The postoperative follow-up observations included: postoperative complications, the symmetry of the labia minora and clitoris prepuce, the improvement of frictional discomfort, the cleanliness of the labia minora and the clitoris prepuce, and the patient's satisfaction with the shape of the labia minora and clitoris prepuce. For patients with sexual experience, follow-up content also includes changes in sexual satisfaction.Results:A total of 17 female patients aged 20 to 35 years, with an average age of 27 years, were included in this study. Follow-up was conducted 2 months after the operation. All incisions healed by first intention with no sawtooth-like deformity at the incision margin, and had natural appearance. Patients felt that the bilateral labia minora and clitoral foreskin were completely symmetrical in 3 cases, basically symmetrical in 12 cases, and partially asymmetric in 2 cases. These 2 cases of partial asymmetry did not require further surgical repair. In all 17 patients, the frictional discomfort was completely resolved, and the labia minora and clitoral foreskin were easier to clean. The patients were very satisfied with the appearance in 5 cases, satisfied in 10 cases, and dissatisfied in 2 case. There were 15 patients with previous sexual life experience, of which 10 patients had improved sexual satisfaction, and 5 patients had no change in sexual satisfaction after the operation.Conclusions:Through the divisional design, wedge resection and edge resection are performed in the composite reduction labiaplasty, which can solve the friction and discomfort caused by the hyperplasia of labia minora and clitoris prepuce in a single operation, and achieve better aesthetic results at the same time.

Objective:To explore the clinical effect of the composite reduction labiaplasty by divisional design.Methods:From January 2020 to February 2022, the clinical data of patients with complex labia minora and clitoris prepuce hypertrophy who were treated in the Medical Cosmetic Center of Beijing Friendship Hospital Affiliated to Capital Medical University were collected and analysed. The inner side of their labia minora showed no chalasis in the vertical direction, but the outer side were slack with folds, accompanied by clitoris prepuce hyperplasia. We adopted the composite reduction labiaplasty by divisional design. The outer side of the labia minora and the clitoral prepuce were considered as a whole, and a wedge-shaped incision line was designed to remove the excess tissue in the vertical direction. On this basis, an arc was projected on the inner side of the labia minora to form an arcuate incision line on the inner side. The composite reduction labiaplasty was performed with the combination of wedge resection and edge resection. The postoperative follow-up observations included: postoperative complications, the symmetry of the labia minora and clitoris prepuce, the improvement of frictional discomfort, the cleanliness of the labia minora and the clitoris prepuce, and the patient's satisfaction with the shape of the labia minora and clitoris prepuce. For patients with sexual experience, follow-up content also includes changes in sexual satisfaction.Results:A total of 17 female patients aged 20 to 35 years, with an average age of 27 years, were included in this study. Follow-up was conducted 2 months after the operation. All incisions healed by first intention with no sawtooth-like deformity at the incision margin, and had natural appearance. Patients felt that the bilateral labia minora and clitoral foreskin were completely symmetrical in 3 cases, basically symmetrical in 12 cases, and partially asymmetric in 2 cases. These 2 cases of partial asymmetry did not require further surgical repair. In all 17 patients, the frictional discomfort was completely resolved, and the labia minora and clitoral foreskin were easier to clean. The patients were very satisfied with the appearance in 5 cases, satisfied in 10 cases, and dissatisfied in 2 case. There were 15 patients with previous sexual life experience, of which 10 patients had improved sexual satisfaction, and 5 patients had no change in sexual satisfaction after the operation.Conclusions:Through the divisional design, wedge resection and edge resection are performed in the composite reduction labiaplasty, which can solve the friction and discomfort caused by the hyperplasia of labia minora and clitoris prepuce in a single operation, and achieve better aesthetic results at the same time.

Objective:To explore the clinical effect of the composite reduction labiaplasty by divisional design.Methods:From January 2020 to February 2022, the clinical data of patients with complex labia minora and clitoris prepuce hypertrophy who were treated in the Medical Cosmetic Center of Beijing Friendship Hospital Affiliated to Capital Medical University were collected and analysed. The inner side of their labia minora showed no chalasis in the vertical direction, but the outer side were slack with folds, accompanied by clitoris prepuce hyperplasia. We adopted the composite reduction labiaplasty by divisional design. The outer side of the labia minora and the clitoral prepuce were considered as a whole, and a wedge-shaped incision line was designed to remove the excess tissue in the vertical direction. On this basis, an arc was projected on the inner side of the labia minora to form an arcuate incision line on the inner side. The composite reduction labiaplasty was performed with the combination of wedge resection and edge resection. The postoperative follow-up observations included: postoperative complications, the symmetry of the labia minora and clitoris prepuce, the improvement of frictional discomfort, the cleanliness of the labia minora and the clitoris prepuce, and the patient's satisfaction with the shape of the labia minora and clitoris prepuce. For patients with sexual experience, follow-up content also includes changes in sexual satisfaction.Results:A total of 17 female patients aged 20 to 35 years, with an average age of 27 years, were included in this study. Follow-up was conducted 2 months after the operation. All incisions healed by first intention with no sawtooth-like deformity at the incision margin, and had natural appearance. Patients felt that the bilateral labia minora and clitoral foreskin were completely symmetrical in 3 cases, basically symmetrical in 12 cases, and partially asymmetric in 2 cases. These 2 cases of partial asymmetry did not require further surgical repair. In all 17 patients, the frictional discomfort was completely resolved, and the labia minora and clitoral foreskin were easier to clean. The patients were very satisfied with the appearance in 5 cases, satisfied in 10 cases, and dissatisfied in 2 case. There were 15 patients with previous sexual life experience, of which 10 patients had improved sexual satisfaction, and 5 patients had no change in sexual satisfaction after the operation.Conclusions:Through the divisional design, wedge resection and edge resection are performed in the composite reduction labiaplasty, which can solve the friction and discomfort caused by the hyperplasia of labia minora and clitoris prepuce in a single operation, and achieve better aesthetic results at the same time.

Objective:To investigate the effect of autologous fat grafting in hand rejuvenation and to provide effective clinical treatment for the aging hand.Methods:A total of 52 patients received autologous fat grafting in hand. Fat was collected by liposuction from the abdomen or thigh regions utilizing the superwet technique. The harvested fat was washed and injected to the dorsal hand. Standardized photographs were taken before and after the operation, and the patients＇ satisfaction was evaluated.Results:Picture scores between preoperative and postoperative had statistically significant differences ( P<0.01). The majority of patients (75%) were satisfied with their results. All patients were followed up for 6 months with no infection, fat liquefaction, cysts and other complications occurred. Conclusions:This study provides the clinical basis for fat grafting in hand rejuvenation with high satisfactory rates.