Objective:To analyze the therapeutic efficacy and long-term outcomes of wire-assisted dynamic traction with corrective device for congenital nipple inversion.Methods:A retrospective study was conducted on 22 female patients (42 nipples) with congenital nipple inversion treated at the Department of Plastic Surgery, Peking Union Medical College Hospital from January to December 2017. The patients′ age was 18-54 (27.6±1.9) years. All patients underwent wire-assisted dynamic traction correction. Postoperative indicators including numerical rating scale (NRS) pain scores, nipple skin microcirculatory disorders, and traction duration were recorded. Follow-up assessments via telephone interviews were completed by September 20, 2022; mean follow-up time was (63.68±3.73) months. Evaluating questions included nipple retraction, fertility status and breastfeeding outcomes.Results:Pain in the operative area was non-radiating, and the pain level decreased over time. Mean NRS were (5.4±1.5) scores on surgery day, decreasing to (4.4±1.2) scores at postoperative day 1 and (3.3±1.7) scores at day 2. Microcirculatory assessments revealed Grade 0-I (intact skin) in 78.6% (33/42), Grade II (skin ulceration) in 14.3% (6/42), and Grade III (partial necrosis) in 7.1% (3/42) of the nipples, with no Grade IV necrosis observed. Successful device placement was achieved in all cases (42/42), with traction duration ranging 6-15 (9.6±0.6) months. Follow-up data from 12 patients (23 nipples) showed mild retraction in 3 nipples. Three patients subsequently delivered infants and successfully achieved breastfeeding.Conclusion:The wire-assisted dynamic traction method with corrective device demonstrates satisfactory therapeutic outcomes for congenital nipple inversion patients with favorable long-term maintenance and breastfeeding compatibility.

Objective:To analyze the therapeutic efficacy and long-term outcomes of wire-assisted dynamic traction with corrective device for congenital nipple inversion.Methods:A retrospective study was conducted on 22 female patients (42 nipples) with congenital nipple inversion treated at the Department of Plastic Surgery, Peking Union Medical College Hospital from January to December 2017. The patients′ age was 18-54 (27.6±1.9) years. All patients underwent wire-assisted dynamic traction correction. Postoperative indicators including numerical rating scale (NRS) pain scores, nipple skin microcirculatory disorders, and traction duration were recorded. Follow-up assessments via telephone interviews were completed by September 20, 2022; mean follow-up time was (63.68±3.73) months. Evaluating questions included nipple retraction, fertility status and breastfeeding outcomes.Results:Pain in the operative area was non-radiating, and the pain level decreased over time. Mean NRS were (5.4±1.5) scores on surgery day, decreasing to (4.4±1.2) scores at postoperative day 1 and (3.3±1.7) scores at day 2. Microcirculatory assessments revealed Grade 0-I (intact skin) in 78.6% (33/42), Grade II (skin ulceration) in 14.3% (6/42), and Grade III (partial necrosis) in 7.1% (3/42) of the nipples, with no Grade IV necrosis observed. Successful device placement was achieved in all cases (42/42), with traction duration ranging 6-15 (9.6±0.6) months. Follow-up data from 12 patients (23 nipples) showed mild retraction in 3 nipples. Three patients subsequently delivered infants and successfully achieved breastfeeding.Conclusion:The wire-assisted dynamic traction method with corrective device demonstrates satisfactory therapeutic outcomes for congenital nipple inversion patients with favorable long-term maintenance and breastfeeding compatibility.

Objective:The traction method for correcting congenital nipple inversion was observed to induce varying degrees of hemodynamic compromise in the nipple skin microcirculation after surgery. In this study, the laser Doppler scattering flowmetry was employed to measure the postoperative nipple skin microcirculation perfusion to verify the difference in nipple skin microcirculation perfusion with different grades of hemodynamic disorders. Furthermore, we aimed to describe the trend of postoperative nipple skin microcirculation perfusion and to elucidate the patterns of nipple breast skin microcirculation in healthy women.Methods:From October 2016 to October 2022, the Department of Plastic and Reconstructive Surgery of Peking Union Medical College Hospital performed traction correction of 72 congenital inverted nipples using wire braces in 37 women. The age of the patients in the surgical group ranged from 21 to 51 years with a mean age of 27.4±1.8 years. Concurrently, the control group consisted of 65 normal nipples of 34 healthy women aged between 18 to 50 years (mean age 26.5±1.7 years). In both groups, nipple and areola skin microcirculatory perfusion was measured using a laser Doppler scatter flow meter PeriCam PSI system. The control group underwent a single measurement whereas the surgical group was evaluated three times postoperatively at two days, five days, and one month.Results:In the control group, the mean value of nipple skin microcirculation perfusion was 137.77±22.94, significantly higher than that for breast skin, which stood at 68.94±10.43 ( t=-14.116, P<0.001). The mean value of nipple skin microcirculation perfusion in the surgical group was 179.57±41.48 at two days postoperatively, which resulted in a significant increase in postoperative nipple skin microcirculation perfusion compared to the control group nipple skin microcirculation perfusion (137.77±22.94), and a decrease in nipple skin microcirculation perfusion at five days postoperatively (167.28±38.16), which was normalized at one month postoperatively (131.45±39.64). Notably, instances of hemodynamic disturbances such as skin breakdown or partial necrosis, the nipple skin microcirculation perfusion were significantly reduced (118.63±58.66), supporting the postoperative nipple hemodynamic classification. Conclusions:The nipple skin microcirculation perfusion in healthy female is significantly higher than breast skin microcirculation perfusion. Surgical interventions for correcting congenital inverted nipples markedly enhance nipple skin microcirculatory perfusion, though the perfusion rate is prone to reduction in the case of postoperative hemodynamic disorders, manifesting as nipple skin breakdown or localized necrosis. The integrity of nipple skin can be used as a crucial metric for clinical evaluation. Notably, following postoperative dressing changes, all instances of nipple skin breakdowns heal with the microcirculation perfusion values reverting to normal by one month.

Blood deficiency syndrome (BDS) refers to a pathological state with blood dysfunction and organ dystrophy in traditional Chinese medicine. Danggui Wuji granules (DWG) was developed from a formula containing Angelicae Sinensis Radix and Musculus et Os Galli Domestici. Herein, we investigated the mechanism of DWG in treating BDS by modulating gut microbiota. We found that DWG protected mice from BDS by elevating the levels of red blood cell count, hemoglobin, and hematocrit in peripheral blood and increasing the erythrocyte membrane Na⁺-K⁺-ATPase activity. Danggui Wuji granules changed the composition and metabolites of colonic flora. Notably, Lactobacillus, Muribaculaceae, and Alistipes were the main genera showing changes after DWG treatment. Our findings revealed that DWG presented a positive therapeutic effect on BDS in mice by regulating the gut microbiota and metabolites. The protective mechanism of DWG was associated with pathways such as metabolic pathways, biosynthesis of secondary metabolites, ABC transporters, ribosome, thyroid hormone synthesis, lysine degradation, galactose metabolism, tyrosine metabolism, etc.

Objective:To investigate the relationship of lipid peroxide (LPO), total oxidation state (TOS), apolipoprotein (a) [apolipoprotein(a), Apo(a)] and pregnancy outcome in patients with polycystic ovarian syndrome (PCOS) treated by ovulation induction-in vitro fertilization-embryo transfer (IVF-ET).Methods:The clinical of 215 patients with PCOS treated by IVF-ET who were admitted to Hengshui People′s Hospitalfrom May 2017 to February 2020 were collected and they were divided into clinical pregnancy group (155 cases) and biochemical pregnancy group (60 cases) according to pregnancy outcome. The levels of LPO, TOS, and Apo(a) in the peripheral blood of the two groups were detected and the data were analyzed.Results:The levels of LPO and TOS before ovulation induction and human chorionic gonadotropin (HCG) dayin the biochemical pregnancy group were higher than those in the clinical pregnancy group: (10.35 ± 3.67) μmol/L vs. (7.16 ± 1.59) μmol/L, (17.98 ± 3.15) mmol H 2O 2 equiv/L vs. (15.03 ± 3.21) mmol H 2O 2 equiv/L; (12.81 ± 4.09) μmol/L vs. (7.38 ± 2.14) μmol/L, (19.66 ± 3.02) mmol H 2O 2 equiv/L vs. (15.19 ± 3.34) mmol H 2O 2 equiv/L; and the level of Apo(a) was lower than that in the clinical pregnancy group: (379.8 ± 95.9) mg/L vs. (486.5 ± 100.3) mg/L, (335.8 ± 84.7) mg/L vs. (473.5 ± 112.9) mg/L, the differences were statistically significant ( P<0.05). LPO and TOS before ovulation induction and HCG day were negatively correlated with the number of high-quality embryos ( P<0.01), and Apo(a) was positively correlated with the number of high-quality embryos ( P<0.01). The risk of non-clinical pregnancy for those with LPO, TOS, Apo(a) higher than the average before ovulation induction was 1.435, 1.233, 0.678 times of those with lower than the average ( P<0.05). The risk of non-clinical pregnancy for those with LPO, TOS, and Apo(a) higher than the average on HCG day was 1.443, 1.689, 0.762 times of those with lower than average ( P<0.05). After receiver operating characteristic (ROC) curve analysis, the area under the curve(AUC) of all indicators before ovulation induction combined to predict clinical pregnancy was 0.844. The AUC of all indicators on HCG day combined to predict clinical pregnancy was 0.894. Conclusions:Peripheral blood LPO, TOS, Apo(a) levels are closely related to the number of high-quality embryos, and are the main influencing factors of pregnancy outcome. Therefore, dynamic monitoring of the above-mentioned index levels can provide a reference for the clinical improvement of the treatment plan.

The impact of parental obesity on offspring health attracts increasing attention with the rising obese population worldwide. Much more studies have concentrated on the influences of maternal obesity, while studies regarding paternal obesity were relatively few and mainly focused on glucose and insulin regulation, adiposity, etc. Several large cohort studies and animal experiments have shown that paternal obesity can damage the neuropsychological development in offspring, which has become a risk factor for autistic spectrum disorders, cognitive disorders, and lower intelligence quotient, and epigenetic studies have explored the related mechanisms. This review summarizes the progress in this field, aiming to provide a reference for basic and clinical research in the future.

Objective:To investigate the occurrence of human papillomavirus (HPV) single and multiple infections in different cervical lesions, and to analyze the distribution of HPV types in patients with single infection and the change of viral load before and after treatment.Methods:A total of 4 783 HPV-DNA-positive cases who were detected by cervical exfoliated cells HPV-DNA testing from May 2017 to March 2019 in Shanxi Provincial People's Hospital were retrospectively analyzed, of which 3 728 cases met the criteria and were included in this study. Fluorescence quantitative polymerase chain reaction (PCR) was used to determine HPV genotype and viral load, and liquid-based thin-layer cytology (TCT) test and colposcopic histopathological diagnosis were performed. According to the histopathological results, the patients were divided into chronic cervicitis+cervical intraepithelial neoplasia (CIN) Ⅰ group, CIN Ⅱ+CIN Ⅲ group and cervical cancer group.Results:A total of 3 364 cases had HPV single infection, of which chronic cervicitis+CIN Ⅰ accounted for 78.27% (2 633/3 364), CIN Ⅱ+CIN Ⅲ accounted for 18.73% (630/3 364), and cervical cancer accounted for 3.00% (101/3 364); 364 cases had HPV multiple infections, of which chronic cervicitis+CIN Ⅰ accounted for 51.65% (188/364), CIN Ⅱ+CIN Ⅲ accounted for 42.58% (155/364), and cervical cancer accounted for 5.77% (21/364). The difference in the proportion of cervical lesions with different pathological grades in HPV single infection and multiple infections was statistically significant ( χ2 = 127.21, P < 0.01). The top four HPV single infection genotypes in chronic cervicitis+CINⅠ group and CINⅡ+CINⅢ group were type 16, 52, 58 and 53, and their proportions were 17.05% (449/2 633), 12.91% (340/2 633), 9.08% (239/2 633) and 8.89% (234/2 633) in chronic cervicitis+CINⅠ group, and 32.22% (203/630), 10.32% (65/630), 8.41% (53/630) and 5.87% (37/630) in CINⅡ+CINⅢ group. In the cervical cancer group, the top two HPV single infection genotypes were type 16 and 18, and their proportions were 81.19% (82/101) and 6.93% (7/101). The viral load of 120 patients with HPV infection was 4.89±1.14 before treatment and 2.86±1.63 after treatment, and the difference was statistically significant ( t = 13.260, P < 0.01). Conclusions:HPV multiple infections are more likely to aggravate the degree of cervical lesions than single infection. Common HPV infection subtypes in different cervical lesions include type 16, 52, 58, 53 and 18.

Objective:To evaluate the effect of anthracyclines on myocardial work in patients with breast cancer by left ventricular pressure strain loop (PSL).Methods:From April 2019 to June 2020, 30 breast cancer patients treated with AC-T regimen(Adriamycin/epirubicin+ cyclophosphamide+ docetaxel) in the Second Affiliated Hospital of Harbin Medical University were selected as case group, and 30 healthy volunteer were selected as control group. Transthoracic echocardiography was performed in the case group at 3 time points: before chemotherapy (T0 phase), after the third cycle of chemotherapy (T1 phase), and after the sixth cycle of chemotherapy (T2 phase) respectively. Conventional ultrasonic parameters were collected. Left ventricular PSL was used to evaluate the left ventricular myocardial work index, including global work index (GWI), global constructive work (GCW), global work waste (GWW) and global work efficiency (GWE). The same examination was performed in the control group, and the results between T0 phase and control group, among different phases were compared.Results:①There were no statistically significant differences of general information, conventional ultrasound parameters, left ventricular strain and myocardial work parameters between T0 phase and control group (all P>0.05). ②There were no statistically significant differences of LVEF, GLS, GWI, GCW, GWE and GWW between T1 phase and T0 phase (all P>0.05). ③There were no statistically significant differences in LVEF between T2 phase and T0 phase ( P>0.05). The absolute values of GLS, GWI, GCW and GWE decreased, but GWW increased, the difference was statistically significant (all P<0.05). ④There were no significant differences in LVEF between T2 phase and T1 phase ( P>0.05), but the absolute values of GLS, GWI, GCW and GWE decreased, while GWW increased (all P<0.05). Conclusions:Left ventricular PSL can effectively evaluate the myocardial work of anthracycline chemotherapy in breast cancer patients, which is superior to LVEF and provide a new evaluation method for asymptomatic patients.

Objective:To explore the application value of urine γ-synuclein (SNCG) in the diagnosis of bladder cancer.Methods:A total of urine samples from 129 patients with bladder cancer (malignant lesion group), 157 patients with urinary system benign lesions (benign lesion group), and 177 healthy people (the healthy control group) from January 2017 to April 2020 in the Fifth Clinical Medical College of Shanxi Medical University and Shanxi Provincial Cancer Hospital were collected. The concentration of SNCG in the collected urine was detected by using enzyme-linked immunosorbent assay. The receiver operating characteristic (ROC) curve was drawn to determine its sensitivity, specificity and accuracy for the diagnosis of bladder cancer.Results:The urine SNCG concentration in malignant lesion group [4.28 ng/ml (0.53-8.79 ng/ml)] was higher than that in healthy controls [1.44 ng/ml (0.56-3.51) ng/ml, H = 122.9, P < 0.01] and benign lesion group [1.97 ng/ml (0.51-5.87) ng/ml, H = 88.2, P < 0.01], and the concentration of urine SNCG in benign lesion group was higher than that in healthy controls ( H = 17.1, P < 0.01). ROC area under the curve (AUC) of urine SNCG in differentiating benign lesion group from healthy controls was 0.871(95% CI 0.819-0.923, P < 0.01), the best cut-off value was 2.79 ng/ml, the diagnostic sensitivity and specificity was 0.798 and 0. 977, respectively. AUC of urine SNCG in differentiating malignant lesion group from benign lesion group was 0.823(95% CI 0.769-0.877, P < 0.01), the best cut-off value was 3.54 ng/ml, the diagnostic sensitivity and specificity was 0.713 and 0.917, respectively. AUC of urine SNCG in differentiating malignant lesion group from healthy controls plus benign lesion group was 0.848 (95% CI 0.797-0.899, P < 0.01), the best cut-off value was 2.87 ng/ml, the diagnostic sensitivity and specificity was 0.791 and 0.901, respectively. Conclusions:The concentration of SNCG in urine of patients with bladder cancer is higher than that of patients with benign urinary lesions and healthy people. Urine SNCG has a good application value in the diagnosis of bladder cancer.

Objective:To investigate the characteristics, production mechanism and treatment of facial injected filler removal surgery.Methods:A retrospective analysis of 138 cases of facial injected filler removal surgery was conducted in Peking Union Medical College Hospital. The patient’s filler substances, injection site, adverse reaction symptoms, duration, examination result, surgical method and times, and pathological and bacterial examination result were analyzed.Results:All cases were women, aged from 25 to 67 years old, with a course ranging from 6 months to 19 years. Most of the injected substances were polyacrylamide hydrogel, growth factor, and hydroxyapatite. Most of the injection sites were jaw, temporal, nose, and nasolabial fold. Regarding the clinical manifestations, patients presented different levels of anxiety, depression, or other mental symptoms, with the local symptoms of induration, swelling, pain, and itchy mainly. All patients underwent the ultrasound examination, showing subcutaneous hypoechoic without blood flow. The excision of the tissue was routinely sent for pathological and bacterial tests. Tissue culture of 13 patients showed a combined S. aureus infection. Twenty-four patients underwent excision for more than once due to residue filler or mental symptoms. We propose a brief diagnosis and treatment process to provide a reference for clinical practice.Conclusions:The facial injected filler removal surgery plan should be formulated according to the material, injection site, and examination result, symptoms of the patients, to properly select the incision and the removal method, perioperative use of antibiotics and psychotherapy.