Objective To analyze the predictive value of preoperative magnetic resonance imaging(MRI)indexes in patients with full thickness rotator cuff tear(FTRCT)undergoing arthroscopic rotator cuff repair(ARCR).Methods Clinical data of 451 patients with FTRCT undergoing ARCR from January 2020 to December 2023 were retrospectively included as the study objects.All patients were followed up for 1 year after surgery.Patients were divided into the shoulder joint function improvement group(n=415)and the shoulder joint function non-improvement group(n=36)according to scores of disabilities of the arm shoulder and hand(DASH).The preoperative MRI indicators and clinical indicators of the two groups were compared,and the risk factors of the outcome after ARCR in patients with FTRCT were analyzed by multivariate Logistic regression,and the receiver operating characteristic curve(ROC curve)was drawn.The predictive value of preoperative MRI indexes alone and in combination in patients with FTRCT undergoing ARCR was analyzed.Results 451 patients with FTRCT after ARCR were followed up for 1 year.The incidence of shoulder joint function non-improvement was 7.98％.Compared with the shoulder joint function improvement group,the shoulder joint function non-improvement group had longer preoperative tendon tear width and tendon retraction distance,higher degree of tendon degeneration,and shorter acromial humeral space(P＜0.05).Acromial humeral space ≤7.15 mm(OR=2.208,95％CI:1.255～3.883),tendon degeneration degree 2-3(OR=1.817,95％CI:1.066～3.096),tendon tear width＞2.16 cm(OR=2.246,95％CI:1.242～4.059)and tendon retraction distance＞2.10 cm(OR=2.186,95％CI:1.311～3.646)were risk factors for non-improvement of the shoulder joint in patients with FTRCT after ARCR(P＜0.05).Positive as shoulder joint function nonimprovement was included and negative as shoulder joint function improvement,ROC was drawn,and the predictive value of preoperative MRI indexes detection alone and combined in patients with FTRCT after ARCR was analyzed.The area under the curve(AUC)was 0.903,the sensitivity was 86.11％,and the specificity was 87.47％.Conclusion Patients with FTRCT who underwent ARCR surgery have better outcomes.Tendon tear width＞2.16 cm,tendon retraction distance＞2.10 cm,tendon degeneration degree of grade 2 to 3,acromial humeral space ≤7.15 mm are risk factors for poor outcomes,and the combined detection of preoperative MRI indexes has high predictive value.

Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in infants with hyaline membrane disease(HMD)and establish a predictive model.Methods A retrospective analysis was conducted on 551 hospitalized HMD infants at Kunming First People's Hospital from January 2018 to December 2022.Patients were randomly divided into a training set(n=413)and a validation set(138)at a 3∶1 ratio.The training set was further divided into a simple HMD group(n=339)and an HMD with BPD group(n=74).Univariate and multivariate Logistic regression prediction models were used to analyze the risk factors associated with HMD complicated by BPD,with subsequent validation in the validation set.Results Univariate analysis showed statistically significant differences between the two groups in birth conditions,perinatal conditions,maternal conditions,laboratory indicators,and treatment conditions(P<0.05).Multivariate analysis indicated that birth weight and oxygen exposure time were independent risk factors for HMD complicated by BPD(P<0.05).The ROC curve assessment showed an area under the curve(AUC)of 0.954,indicating a certain predictive value for the model.In the validation set,the AUC was 0.917,with a sensitivity of 92.00%and a specificity of 89.38%.Conclusion Neonatal birth weight and duration of oxygen therapy were identified as significant risk factors for bronchopulmonary dysplasia(BPD)complicating hyaline membrane disease(HMD).The risk prediction model for HMD with BPD has good predictive performance.

Objective To analyze the predictive value of preoperative magnetic resonance imaging(MRI)indexes in patients with full thickness rotator cuff tear(FTRCT)undergoing arthroscopic rotator cuff repair(ARCR).Methods Clinical data of 451 patients with FTRCT undergoing ARCR from January 2020 to December 2023 were retrospectively included as the study objects.All patients were followed up for 1 year after surgery.Patients were divided into the shoulder joint function improvement group(n=415)and the shoulder joint function non-improvement group(n=36)according to scores of disabilities of the arm shoulder and hand(DASH).The preoperative MRI indicators and clinical indicators of the two groups were compared,and the risk factors of the outcome after ARCR in patients with FTRCT were analyzed by multivariate Logistic regression,and the receiver operating characteristic curve(ROC curve)was drawn.The predictive value of preoperative MRI indexes alone and in combination in patients with FTRCT undergoing ARCR was analyzed.Results 451 patients with FTRCT after ARCR were followed up for 1 year.The incidence of shoulder joint function non-improvement was 7.98％.Compared with the shoulder joint function improvement group,the shoulder joint function non-improvement group had longer preoperative tendon tear width and tendon retraction distance,higher degree of tendon degeneration,and shorter acromial humeral space(P＜0.05).Acromial humeral space ≤7.15 mm(OR=2.208,95％CI:1.255～3.883),tendon degeneration degree 2-3(OR=1.817,95％CI:1.066～3.096),tendon tear width＞2.16 cm(OR=2.246,95％CI:1.242～4.059)and tendon retraction distance＞2.10 cm(OR=2.186,95％CI:1.311～3.646)were risk factors for non-improvement of the shoulder joint in patients with FTRCT after ARCR(P＜0.05).Positive as shoulder joint function nonimprovement was included and negative as shoulder joint function improvement,ROC was drawn,and the predictive value of preoperative MRI indexes detection alone and combined in patients with FTRCT after ARCR was analyzed.The area under the curve(AUC)was 0.903,the sensitivity was 86.11％,and the specificity was 87.47％.Conclusion Patients with FTRCT who underwent ARCR surgery have better outcomes.Tendon tear width＞2.16 cm,tendon retraction distance＞2.10 cm,tendon degeneration degree of grade 2 to 3,acromial humeral space ≤7.15 mm are risk factors for poor outcomes,and the combined detection of preoperative MRI indexes has high predictive value.

Objective To investigate the safety and feasibility of peripheral vascular intervention via the ipsilateral transulnar access(TUA)due to failure of transradial access(TRA)puncture.Methods The clinical data of 2546 peripheral vascular interventions via TRA,which were performed at authors'hospital between January 2019 and December 2021,were retrospectively analyzed.Among the 2546 interventions,TRA puncture failed in 37 procedures,and in 27 of these patients the ipsilateral TUA puncture had to be adopted.The puncture success rate,surgical success rate and puncture approach-related complications of TUA of the 27 patients receiving ipsilateral TUA puncture were analyzed.Results The success rate of ipsilateral TUA puncture after TRA puncture failed was 96.3％(26/27),and in one patient transfemoral access(TFA)puncture had to be substituted because of the ulnar artery spasm.The total success rate of interventional procedures was 96.3％(26/27).No serious complications occurred,and the incidence of minor complications was 19.2％(5/26).Conclusion Preliminary results indicate that for the experienced TRA operators,using ipsilateral TUA puncture due to failure of TRA puncture is a safe and feasible strategy choice.

Objective To analyze the clinical features of children with EV71 positive hand,foot,and mouth disease(HFMD)and EV71 vaccination,and to explore the relationship between the occurrence of severe disease and the preventive effect of EV71 vaccine.Methods From January 1,2020 to December 31,2022,the clinical data of 131 children with HFMD diagnosed with EV71 infection in Kunming Children's Hospital were retrospectively analyzed.The stool samples of patients with clinically confirmed HFMD were selected for enterovirus nucleic acid detection.The clinical data and EV71 vaccination status of children with universal enterovirus positive and EV71 positive HFMD were analyzed.Results Among the 131 positive cases detected,there were 116 mild cases and 15 severe cases.Among the 80 children who received phone consultations about their EV71 vaccine status,17 were vaccinated,and 63 were not vaccinated.The vaccinated children were all mild cases,while among the unvaccinated children,6 were severe cases.From 2020 to 2022,the period from April to September each year is the peak period for detecting EV71-positive hand,foot,and mouth disease(χ2 = 125.705,P = 0.000).The positive detection rate for children under 1 year old and over 5 years old was higher than that for children aged 1 to 5 years(χ2 = 8.765,P = 0.033),and there was no significant difference in the positive detection rate between boys and girls(χ2 = 1.221,P = 0.269).Conclusion EV71 vaccine is of great significance in reducing the occurrence of severe cases.Combined with the current low vaccination rate in Kunming,Yunnan Province,it is suggested that relevant institutions should continue to increase the publicity of EV71 vaccination.

Inflammatory bowel disease (IBD) is a formidable disease due to its complex pathogenesis. Macrophages, as a major immune cell population in IBD, are crucial for gut homeostasis. However, it is still unveiled how macrophages modulate IBD. Here, we found that LIM domain only 7 (LMO7) was downregulated in pro-inflammatory macrophages, and that LMO7 directly degraded 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3) through K48-mediated ubiquitination in macrophages. As an enzyme that regulates glycolysis, PFKFB3 degradation led to the glycolytic process inhibition in macrophages, which in turn inhibited macrophage activation and ultimately attenuated murine colitis. Moreover, we demonstrated that PFKFB3 was required for histone demethylase Jumonji domain-containing protein 3 (JMJD3) expression, thereby inhibiting the protein level of trimethylation of histone H3 on lysine 27 (H3K27me3). Overall, our results indicated the LMO7/PFKFB3/JMJD3 axis is essential for modulating macrophage function and IBD pathogenesis. Targeting LMO7 or macrophage metabolism could potentially be an effective strategy for treating inflammatory diseases.

Objective:To analyze the risk factors of newly developed non-alcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD) based on a propensity score matching (PSM) analysis.Methods:The clinicopathological data of 219 patients with pancreatic or periampullary tumors undergoing PD in the Ningbo Medical Center Lihuili Hospital from December 2015 to December 2021 were retrospectively analyzed, including 129 males and 90 females, aged (63.68±11.07) years old. The patients were divided into two groups according to the newly occurrence of NAFLD within one year after PD: the NAFLD group ( n=57) and non-NAFLD group ( n=162). A caliper value of 0.1 was employed for 1∶1 matching, resulting in a well-balanced PSM between the groups. Results:A total of 144 patients were successfully matched by PSM. Univariate analysis indicated that gender, body mass index, preoperative serum triglyceride and operative time were risk factors for newly developed NAFLD after PD. Multivariate analysis showed that female ( OR=6.493, 95% CI=2.631-16.129, P<0.001), preoperative serum triglycerides ≥1.5 mmol/L ( OR=3.055, 95% CI=1.220-7.654, P=0.017) and operative time ≥300 min ( OR=5.092, 95% CI=1.374-18.865, P=0.015) were the independent risk factors for newly developed NAFLD after PD. Conclusion:Based on PSM analysis, female, preoperative triglyceride ≥1.5 mmol/L and operative time ≥300 min were independent risk factors for newly developed NAFLD after PD.

Objective:To investigate the clinical profile of primary bilateral macronodular adrenal hyperplasia(PBMAH) and sex difference.Methods:One hundred and forty cases of PBMAH were recruited in our center from 2014, and all patients were evaluated for hormone secretion, adrenal imaging, and metabolic parameters.Results:Overt Cushing′s syndrome accounted for 76.4% of PBMAH cohort and 47.9% were female. The overt group had higher serum cortisol and 24 h urinary free cortisol levels, lower adrenocorticotropic hormone, higher serum cortisol after low-dose dexamethasone suppression tests, larger total adrenal size, and a higher percentage of obesity, hypertension, diabetes mellitus, and hypokalemia than the subclinical group(all P<0.05). When compared with the male group, the female group had smaller adrenal size( P<0.001), lower HbA 1C( P=0.003), higher total cholesterol( P=0.005), and lower density lipoprotein-cholesterol levels( P=0.035). Further, 24 h urinary free cortisol in the male group was found to be positively correlated with diastolic blood pressure, fasting glucose, 2 h postprandial glucose after oral glucose tolerance test(OGTT), and HbA 1C after adjusted for age, body mass index, and onset duration, and was negatively correlated with body mass index and potassium levels. While 24 h urinary free cortisol in the female group was positively correlated only with diastolic blood pressure, fasting glucose, and 2 h postprandial glucose after OGTT(all P<0.05). During follow-up, 80.0% of patients achieved remission after unilateral adrenalectomy, with a recurrence rate of 17.9%. Conclusion:PBMAH related metabolic disorder is more pronounced in overt Cushing′s syndrome and males. Unilateral adrenalectomy as an effective treatment can benefit the majority of patients.

Objective:To provide references for standardizing the post-operative aeromedical assessment of heart valve disease of flying personnel by analyzing the pathogenesis characteristics and treatment.Methods:The case data of flying personnel with heart valve disease hospitalized in Air Force Medical Center from November of 2010 to December of 2021 were collected, which was called the clinical group; the relevant cases of heart valve disease in domestic flying personnel reported in the literature were retrieved, which was called the literature group. The retrospective study was carried out and the data was analyzed according to the aircraft type, lesion location, treatment method and identification results.Results:There were 20 cases in the clinical group. According to the number of detected cases, the valve positions order was the aortic valve (12 cases), the mitral valve (7 cases), the tricuspid valve (4 cases, all concomitant), and the pulmonary valve (1 case). The literature group had 11 cases, mainly were aortic valve disease (10 cases) and tricuspid valve (1 case). Most of these aortic valve lesions were based on the pathology of bicuspid aortic valve (BAV). Among the cases of aortic valve disease, 12 cases were flight-qualified, 1 case was restricted flight, 1 case of fighter aircraft was transferred to fly transporter, 3 cases were temporary unqualified for flight, 3 cases were unqualified for flight, and 2 cases were waivered. Among the cases of mitral valve disease, 3 cases were flight-qualified, 4 cases were temporary unqualified for flight, 1 case of tricuspid valve and 1 case of pulmonary valve were qualified for flight.Conclusions:The lesion site of valve is the main factor influencing the aeromedical assessment result. The aortic valve is the most common site of valve disease among flying personnel, and BAV is the most common pathologic type. It should be strengthened physical examination identification and prevention.

Objective:To provide references for standardizing the post-operative aeromedical assessment of heart valve disease of flying personnel by analyzing the pathogenesis characteristics and treatment.Methods:The case data of flying personnel with heart valve disease hospitalized in Air Force Medical Center from November of 2010 to December of 2021 were collected, which was called the clinical group; the relevant cases of heart valve disease in domestic flying personnel reported in the literature were retrieved, which was called the literature group. The retrospective study was carried out and the data was analyzed according to the aircraft type, lesion location, treatment method and identification results.Results:There were 20 cases in the clinical group. According to the number of detected cases, the valve positions order was the aortic valve (12 cases), the mitral valve (7 cases), the tricuspid valve (4 cases, all concomitant), and the pulmonary valve (1 case). The literature group had 11 cases, mainly were aortic valve disease (10 cases) and tricuspid valve (1 case). Most of these aortic valve lesions were based on the pathology of bicuspid aortic valve (BAV). Among the cases of aortic valve disease, 12 cases were flight-qualified, 1 case was restricted flight, 1 case of fighter aircraft was transferred to fly transporter, 3 cases were temporary unqualified for flight, 3 cases were unqualified for flight, and 2 cases were waivered. Among the cases of mitral valve disease, 3 cases were flight-qualified, 4 cases were temporary unqualified for flight, 1 case of tricuspid valve and 1 case of pulmonary valve were qualified for flight.Conclusions:The lesion site of valve is the main factor influencing the aeromedical assessment result. The aortic valve is the most common site of valve disease among flying personnel, and BAV is the most common pathologic type. It should be strengthened physical examination identification and prevention.