Objective To compare the clinical efficacy between liposuction combined with circumareolar small incision and three-port endoscopic surgery for the treatment of Simon Ⅱ gynecomastia (GYN). Methods Comparative case data of 120 patients with GYN were retrospectively analyzed, 61 patients in the open group underwent circumareolar small incision mastectomy after liposuction, and 59 patients in the endoscopic group underwent three-port endoscopic mastectomy after liposuction. The two groups were compared in terms of surgery-related indexes, occurrence of postoperative complications and patient satisfaction. Results The unilateral operation time of the open group was shorter than that of the endoscopic group, the unilateral gland resection weight in the open group was more than that in the endoscopic group, the hospitalization cost of the open group was less than that of the endoscopic group (all P<0.01). There was no significant difference in unilateral liposuction volume, drainage volume on the first postoperative day, and time to drain removal between the two groups (P>0.05). The incidence of complications in the open group and the endoscopic group were 8.2% and 13.6% respectively, and there was no significant difference between the two groups (P>0.05). The difference in the overall satisfaction scores between the two groups was not statistically significant (P>0.05). Conclusions Liposuction combined with circumareolar small incision or three-port endoscopic surgery both has good cosmetic effects in the treatment of Simon Ⅱ GYN. The operation with circumareolar small incision is simple, has a shorter operation time, costs less, and does not require special equipment, which is suitable for promotion and application in medical institutions.

Objective To evaluate the cost-effectiveness of low-dose steroid combined with tacrolimus or cyclophosphamide in treating adult idiopathic membranous nephropathy(IMN).Methods A prospective cohort design was used to collect clinical data on IMN patients admitted to the Affiliated Hospital of Hebei University from December 2018 to April 2022.The patients were divided into the exposure group(low-dose steroid combined with tacrolimus)and control group(low-dose steroid combined with cyclophosphamide)according to the treatment regimen.Propensity score matching was employed to balance the baseline characteristics between the two groups.The total response rate was taken as the effect index,cost-effectiveness analysis was conducted by using the decision tree model,and single factor sensitivity analysis and probabilistic sensitivity analysis were used to verify the robustness of the cost-effectiveness analysis results.Results A total of 112 patients with IMN were included.After propensity score matching,46 patients were included in the exposed and control groups,respectively.The total remission rate of the exposure group was 84.78％,with the cost of 13,352.64 yuan and the cost-effectiveness ratio of 157.50.In the control group,the total remission rate was 80.43％,the cost was 8,154.18 yuan,and the cost-effectiveness ratio was 101.38.The incremental cost-effectiveness ratio of the two groups was 1 195.05,and the sensitivity analysis results were consistent with those of the cost-effectiveness analysis.Conclusion The two treatment schemes have their own advantages in the treatment of IMN.The cost-effectiveness ratio of low-dose hormone combined with tacrolimus is relatively higher,and the combination of low-dose hormone with cyclophosphamide is more economical.Both schemes have certain clinical promotion value..

Objective:To estimate the burden of influenza-associated outpatient consultations in China from 2011 to 2021 surveillance years to provide a reference for developing influenza prevention, control strategies, and vaccination policies.Methods:Data on influenza-like illness (ILI) and virological confirmation of sentinel specimens from 2011 to 2021 surveillance years were extracted from China's national sentinel surveillance system. Generalized additive models were fitted to estimate influenza-associated excess ILI outpatient burden, accounting for seasonal baselines and meteorological factors.Results:Influenza was associated with an average of 1.66 (95% CI: 1.51-1.80) excess ILI consultations per 1 000 person-years (py) in China each year from 2011 to 2021 surveillance years. The influenza-associated outpatient burden was similar across different virus types/subtypes. Influenza A(H1N1)pdm09 led to a higher rate of influenza- associated ILI consultations [0.65 (95% CI: 0.53-0.76) per 1 000 py] compared to other types/subtypes. The age groups with the highest burdens were children aged 0-4 years and 5-14 years, with excess outpatient consultation rates of 15.23 (95% CI: 13.73-16.73) per 1 000 py and 13.53 (95% CI: 12.49-14.52) per 1 000 py, respectively. Conclusions:Influenza caused many outpatient consultations in China, particularly among children aged 0-14. Continuous influenza monitoring and disease burden assessment should be conducted, and close attention should be paid to the changing trends of various influenza virus types/subtypes. When formulating vaccination strategies, priority should be given to recommending vaccination for high-risk populations, such as children.

Objective:To understand the pathogenic composition and epidemiological characteristics of febrile respiratory syndrome (FRS) in elderly people aged 60 and above in China, and to provide a reference basis for the scientific and precise prevention and control of FRS in the elderly.Methods:Based on FRS cases surveillance data from information management system of National Technical Platform for Infectious Disease Surveillance, National Science and Technology Major Project of China, the surveillance pathogens included 8 viruses, including influenza virus (IFV), respiratory syncytial virus (RSV), adenovirus (HAdV), parainfluenza virus (HPIV), metapneumovirus (HMPV), coronavirus (HCoV), bocavirus and rhinovirus (HRV); 7 bacterias, namely Streptococcus pneumoniae ( S.pneumoniae), Staphylococcus aureus ( S.aureus), Klebsiella pneumoniae ( K.pneumoniae), Pseudomonas aeruginosa ( P.aeruginosa), Group A Streptococcus ( GAS), Haemophilus influenzae ( H.influenzae) and Legionella pneumophila ( L. pneumophila), in addition to Chlamydia pneumoniae ( C. pneumoniae) and Mycoplasma pneumoniae ( M. pneumoniae). A descriptive epidemiological approach was used to analyze the pathogenic composition and major epidemiological characteristics of FRS cases aged 60 years and older nationwide from 2009 to 2021. Results:The predominant viruses of FRS cases aged≥60 years accounted for 87.93% of the pathogen spectrum in China, including IFV (42.42%), HRV (16.71%), HPIV (11.53%), HCoV (9.52%), and RSV (7.75%), while the pathogen spectrum of the major bacteria accounted for 94.60%, including S. pneumoniae (25.71%), P. aeruginosa (24.97%), K. pneumoniae (22.47%), H. influenzae (12.23%), and S. aureus (9.22%). Influenza viruses have always been at the top of the viral pathogen spectrum, and P. aeruginosa, K. pneumoniae and S. pneumoniae, ranked high in the bacterial pathogen spectrum. Among them, the proportions of HRV, HPIV, RSV, K. pneumoniae, and H. influenzae fluctuated and increased during the 13 years of observation. The positive rate of any pathogen in FRS cases was higher in out patient emergencies (32.83%) than in hospitalized cases (27.26%) ( χ2 =125.89, P<0.001). The positive rate of IFV was higher in cases aged 60-74 years (13.66%). The positive rate of P. aeruginosa and K. pneumoniae were higher in cases aged ≥90 years (10.71%, 9.40%) and in northern regions (8.32%, 7.30%). The positive rate of any pathogen in FRS cases was higher in winter (33.82%) than in other seasons ( χ2=212.03, P<0.001). The positive rate of IFV and HRV were higher in winter (22.87%) and autumn (5.98%) and the positive rate of P.aeruginosa (8.11%) and K.pneumoniae (8.30%) were higher in summer. Conclusions:IFV, HRV, HPIV, S. pneumoniae, P. aeruginosa and K. pneumoniae were respectively the top three pathogens in the viral and bacterial pathogen spectrum of FRS cases aged 60 years and above in China from 2009 to 2021, and the positive rate of these main pathogens showed differences between age groups, seasons, and geographic regions. In the future, the dynamic surveillance of various pathogens in the elderly with respiratory tract infections should be continuously strengthened.

Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

Objective:To investigate the effect of insulin-like growth factor 1 (IGF-1) on acute lung injury in septic mice and its underlying molecular mechanism.Methods:Twenty SPF male C57BL/6J mice aged 6-8 weeks were randomly (random number) divided into the sham-operated group, sham-operated + IGF-1 group, sepsis group and sepsis + IGF-1 group, with 5 mice in each group. IGF-1 [60 μg/(kg·d)] was injected via the tail vein for 3 consecutive days in the sham-operated + IGF-1 group and sepsis + IGF-1 group, and mice in the sham-operated group and sepsis group were injected with an equal volume of saline. The tissue of the upper lobe of the right lung was taken to calculate the wet-to-dry ratio, and the upper lobe of the left lung was subjected to HE staining to analyze pathological changes and evaluate lung injury. The levels of interleukin (IL)-6 and IL-1β in the bronchoalveolar lavage fluid (BALF) and serum of mice were detected by ELISA. The expression of p-PI3K, PI3K, p-AKT and AKT in lung tissues was determined via Western blotting. The quantitative data with a normal distribution and homogeneity of variance were compared between the two groups by two independent sample t test. Results:Lung volume was reduced in the sepsis group than in the sham-operated group, obvious surface congestion, dark red color, large bruises and hemorrhagic foci were observed under the pericardium, and the wet-to-dry ratio was significantly elevated ( P<0.05). Compared with the sepsis group, the sepsis + IGF-1 group had slightly increased lung volume, less congestion, darker red color, fewer bruises and hemorrhagic foci, and a lower wet-to-dry ratio ( P<0.05). There was no significant change in lung tissue morphology in the sham-operated + IGF-1 group compared with the sham-operated group. HE staining and lung histopathological scores showed that lung tissue was significantly damaged in the sepsis group than the sham-operated group ( P<0.001), and the pathological score of lung tissue was less damaged in the sepsis + IGF-1 group compared with the sepsis group ( P<0.01). The ELISA results demonstrated that the serum levels of IL-6 and IL-1β were markedly decreased in the sepsis + IGF-1 group than in the sepsis group [(26.22±1.60) pg/mL vs. (45.61±7.85) pg/mL, P<0.05; (87.99±11.80) pg/mL vs. (181.26±10.11) pg/mL, P<0.001]. Moreover, the IL-6 and IL-1β contents in the BALF of the sepsis + IGF-1 group were notably lower than those in the BALF of the sepsis group [(7.67±0.42) pg/mL vs. (20.25±0.43) pg/mL, P<0.001; (17.00±6.08) pg/mL vs. (108.61±5.18), pg/mL P <0.001]. Western blot analysis revealed that the expression of p-PI3K, PI3K, p-AKT and AKT in the lung tissues of mice in the sepsis+IGF-1 group were markedly lower than that in the sepsis group [(0.71±0.05) vs. (1.21±0.09), P<0.05; (0.57±0.08) vs. (1.24±0.22), P<0.01; (0.29±0.07) vs. (1.10±0.04), P<0.001; (0.65±0.17) vs. (1.19±0.07), P<0.01]. Conclusion:IGF-1 ameliorates sepsis-induced acute lung injury in mice, and its protective effect may be achieved by inhibiting the PI3K/AKT pathway.

Objective: To investigate the potential therapeutic mechanisms of kaempferol , an active component in the traditional Chinese medicine gardenia , for lung cancer treatment using a network pharmacology approach . Methods: The main active ingredients and potential targets of Gardenia jasminoides were obtained through the Tra⁃ditional Chinese Medicine Pharmacology Database and Analysis Platform (TCMSP) , and combined with the lung cancer related target information collected from Gene Cards and OMIM databases , the intersection targets of Garde⁃nia jasminoides and lung cancer treatment were determined by drawing Venn diagrams . Further screening of core targets was conducted through PPI network analysis , and gene ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes ( KEGG) pathway enrichment analysis were performed using the Metascape platform . Auto dock software was used to evaluate the binding affinity between the active ingredients of Gardenia jasminoides and target proteins . In terms of experiments , cell proliferation ability was evaluated through CCK⁃8 assay , cell migration and invasion ability were detected through cell scratch healing assay and Transwell assay , and the expression levels of epithelial mesenchymal transition ( EMT) protein and inflammatory factors were detected by Western blot and RT⁃qPCR . Results: The active ingredient kaempferol in Gardenia jasminoides exhibited significant binding ability invasion of lung cancer cells . The results of Western blot and RT⁃qPCR further confirmed that kaempferol could promote an increase in E ⁃cadherin , a decrease in N ⁃cadherin and Vimentin , and reduce the expression of inflam⁃matory factors . Conclusion The active ingredient of Gardenia jasminoides , kaempferol , inhibits the proliferation ,migration and invasion of lung cancer cells by targeting BCL⁃2 , while reversing EMT progression and suppressing the expression levels of inflammatory cytokines in lung cancer cells , thus preventing lung cancer progression .

Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

Objective:To estimate the burden of influenza-associated outpatient consultations in China from 2011 to 2021 surveillance years to provide a reference for developing influenza prevention, control strategies, and vaccination policies.Methods:Data on influenza-like illness (ILI) and virological confirmation of sentinel specimens from 2011 to 2021 surveillance years were extracted from China's national sentinel surveillance system. Generalized additive models were fitted to estimate influenza-associated excess ILI outpatient burden, accounting for seasonal baselines and meteorological factors.Results:Influenza was associated with an average of 1.66 (95% CI: 1.51-1.80) excess ILI consultations per 1 000 person-years (py) in China each year from 2011 to 2021 surveillance years. The influenza-associated outpatient burden was similar across different virus types/subtypes. Influenza A(H1N1)pdm09 led to a higher rate of influenza- associated ILI consultations [0.65 (95% CI: 0.53-0.76) per 1 000 py] compared to other types/subtypes. The age groups with the highest burdens were children aged 0-4 years and 5-14 years, with excess outpatient consultation rates of 15.23 (95% CI: 13.73-16.73) per 1 000 py and 13.53 (95% CI: 12.49-14.52) per 1 000 py, respectively. Conclusions:Influenza caused many outpatient consultations in China, particularly among children aged 0-14. Continuous influenza monitoring and disease burden assessment should be conducted, and close attention should be paid to the changing trends of various influenza virus types/subtypes. When formulating vaccination strategies, priority should be given to recommending vaccination for high-risk populations, such as children.

Objective:To understand the pathogenic composition and epidemiological characteristics of febrile respiratory syndrome (FRS) in elderly people aged 60 and above in China, and to provide a reference basis for the scientific and precise prevention and control of FRS in the elderly.Methods:Based on FRS cases surveillance data from information management system of National Technical Platform for Infectious Disease Surveillance, National Science and Technology Major Project of China, the surveillance pathogens included 8 viruses, including influenza virus (IFV), respiratory syncytial virus (RSV), adenovirus (HAdV), parainfluenza virus (HPIV), metapneumovirus (HMPV), coronavirus (HCoV), bocavirus and rhinovirus (HRV); 7 bacterias, namely Streptococcus pneumoniae ( S.pneumoniae), Staphylococcus aureus ( S.aureus), Klebsiella pneumoniae ( K.pneumoniae), Pseudomonas aeruginosa ( P.aeruginosa), Group A Streptococcus ( GAS), Haemophilus influenzae ( H.influenzae) and Legionella pneumophila ( L. pneumophila), in addition to Chlamydia pneumoniae ( C. pneumoniae) and Mycoplasma pneumoniae ( M. pneumoniae). A descriptive epidemiological approach was used to analyze the pathogenic composition and major epidemiological characteristics of FRS cases aged 60 years and older nationwide from 2009 to 2021. Results:The predominant viruses of FRS cases aged≥60 years accounted for 87.93% of the pathogen spectrum in China, including IFV (42.42%), HRV (16.71%), HPIV (11.53%), HCoV (9.52%), and RSV (7.75%), while the pathogen spectrum of the major bacteria accounted for 94.60%, including S. pneumoniae (25.71%), P. aeruginosa (24.97%), K. pneumoniae (22.47%), H. influenzae (12.23%), and S. aureus (9.22%). Influenza viruses have always been at the top of the viral pathogen spectrum, and P. aeruginosa, K. pneumoniae and S. pneumoniae, ranked high in the bacterial pathogen spectrum. Among them, the proportions of HRV, HPIV, RSV, K. pneumoniae, and H. influenzae fluctuated and increased during the 13 years of observation. The positive rate of any pathogen in FRS cases was higher in out patient emergencies (32.83%) than in hospitalized cases (27.26%) ( χ2 =125.89, P<0.001). The positive rate of IFV was higher in cases aged 60-74 years (13.66%). The positive rate of P. aeruginosa and K. pneumoniae were higher in cases aged ≥90 years (10.71%, 9.40%) and in northern regions (8.32%, 7.30%). The positive rate of any pathogen in FRS cases was higher in winter (33.82%) than in other seasons ( χ2=212.03, P<0.001). The positive rate of IFV and HRV were higher in winter (22.87%) and autumn (5.98%) and the positive rate of P.aeruginosa (8.11%) and K.pneumoniae (8.30%) were higher in summer. Conclusions:IFV, HRV, HPIV, S. pneumoniae, P. aeruginosa and K. pneumoniae were respectively the top three pathogens in the viral and bacterial pathogen spectrum of FRS cases aged 60 years and above in China from 2009 to 2021, and the positive rate of these main pathogens showed differences between age groups, seasons, and geographic regions. In the future, the dynamic surveillance of various pathogens in the elderly with respiratory tract infections should be continuously strengthened.