Objective : To investigate the fertility level of registered population in Baoshan District, Shanghai Municipality and the incidence of adverse birth outcomes of live births from 2013 to 2022, so as to provide the evidence for improving maternal and child health care strategies. Methods: The data pertaining to live births registered in Baoshan District from 2013 to 2022 were collected through the Shanghai Birth Medical Information System, including the basic information of live births and maternal fertility. The indicators such as fertility level, parity, birth age and incidence of adverse birth outcomes of live births were descriptively analyzed. The trend of crude birth rate and total fertility rate was analyzed by annual percent change (APC). Results: A total of 56 719 live births were registered in Baoshan District from 2013 to 2022. The crude birth rate was 6.54‰, the total fertility rate was 31.78‰, and the sex ratio at birth was 105.61. The crude birth rate showed a downward trend from 2016 to 2022 (APC=-11.054%, P<0.05), and the total fertility rate showed a downward trend from 2017 to 2022 (APC=-10.377%, P<0.05). The proportion of second parity and above showed an increasing trend from 2013 to 2017 (P<0.05) and a decreasing trend from 2017 to 2022 (P<0.05). The maternal childbearing age showed an increasing trend from 2013 to 2022 (P<0.05), the incidence of premature infants and low birth weight infants showed an increasing trend (both P<0.05). The incidence of premature infants and low birth weight infants increased with the rising childbearing age (both P<0.05). Conclusions The fertility level in Baoshan District was relatively low from 2013 to 2022. The proportion of second parity and above showed an upward trend followed by a downward trend. The incidence of premature infants and low birth weight infants increased with the rising childbearing age.

Objective: To analyze the results of colorectal cancer screening among residents in Baoshan District, Shanghai Municipality from 2013 to 2021, so as to provide the basis for promoting colorectal cancer screening and prevention. Methods: Permanent residents aged 50 to 74 years in Baoshan District from 2013 to 2021 were selected as the screening population. The initial screening was conducted using a risk assessment form and fecal occult blood test. Positive results on either the risk assessment form or fecal occult blood test were considered positive for the initial screening. Participants with positive initial screening results were invited to undergo colonoscopy. The positive rate of the initial screening, colonoscopy compliance rate, and colonoscopy results were analyzed. Results: A total of 264 907 individuals underwent the initial colorectal cancer screening in Baoshan District from 2013 to 2021, with 65 333 individuals (24.66%) testing positive. Among them, the positive rate of the risk assessment form was 12.16%, and the positive rate of fecal occult blood test was 14.64%. A total of 14 473 individuals completed colonoscopy, with a compliance rate of 22.15%. A total of 1 284 precancerous lesions were detected, with a detection rate of 8.87%, and 386 cases of colorectal cancer were identified, with a detection rate of 2.67%. The positive rate of the initial screening, colonoscopy compliance rate, precancerous lesion detection rate, and colorectal cancer detection rate were higher in males than in females (25.55% vs. 24.06%, 23.12% vs. 21.45%, 11.60% vs. 6.74%, 3.62% vs. 1.93%, all P<0.05). With increasing age, the positive rate of the initial screening increased, the colonoscopy compliance rate decreased, the precancerous lesion detection rate and colorectal cancer detection rate increased (all P<0.05). From 2013 to 2021, the positive rate of the initial screening among residents showed a downward trend, while the colonoscopy compliance rate showed an upward trend (both P<0.05). Conclusions The detection rate of precancerous lesions in colorectal cancer was 8.87%, and the detection rate of colorectal cancer was 2.67% in Baoshan District from 2013 to 2021. Male and older individuals were the key populations for screening, and the colonoscopy compliance among residents needs to be improved.

Melanoma is a common and highly malignant tumor with rapid development, poor prognosis and high mortality in the field of plastic surgery. The incidence rate around the world is increasing year by year and the mortality rate ranks first among skin and soft tissue tumors. The rapid development of targeted and immunotherapeutic drugs has greatly improved the prognosis of patients with advanced melanoma. Currently, the improvement of curative effect brought by monotherapy with mainstream targeted drugs is still limited, and the overall remission rate is about 20%. A large number of clinical trials of non first-line and potential targeted drugs have been carried out, showing the value of these drugs and potential targets to clinicians. This article mainly reviews the potential targets and clinical trials of melanoma, in order to help clinicians better understand the prospect of targeted treatments of the disease and find more effective therapeutic drugs.

Melanoma is a common and highly malignant tumor with rapid development, poor prognosis and high mortality in the field of plastic surgery. The incidence rate around the world is increasing year by year and the mortality rate ranks first among skin and soft tissue tumors. The rapid development of targeted and immunotherapeutic drugs has greatly improved the prognosis of patients with advanced melanoma. Currently, the improvement of curative effect brought by monotherapy with mainstream targeted drugs is still limited, and the overall remission rate is about 20%. A large number of clinical trials of non first-line and potential targeted drugs have been carried out, showing the value of these drugs and potential targets to clinicians. This article mainly reviews the potential targets and clinical trials of melanoma, in order to help clinicians better understand the prospect of targeted treatments of the disease and find more effective therapeutic drugs.

Objective To investigate the effects of edaravone dextran combined with argatroban on neurological function,blood rheology and posterior circulation hemodynamics in patients with acute cerebral infarction in the posterior circulation.Methods One hundred and fifty-six patients with acute cerebral infarction in the posterior circulation were collected and randomly divided into the conventional treatment group,edaravone dextranol treatment group(EDD treatment group)and edaravone dextranol combined with argatroban treatment group(combined treatment group),with 52 cases in each group.The general data of patients in the three groups were collected,and the changes of NIHSS score and Barthel index,blood rheology and posterior circulation hemodynamics were evaluated before and after treatment in the three groups.Results After treatment,NIHSS scores and Barthel index were significantly lower in all three groups than before treatment(all P＜0.01).The NIHSS score and Barthel index of the combined treatment group were significantly lower than those of the EDD treatment group and the conventional treatment group after treatment(all P＜0.05).The difference in total effective rate among the three groups was statistically significant(P＜0.05),and the total effective rate among in combined treatment group was significantly better than those in the EDD treatment group and the conventional treatment group(all P＜0.05).The platelet aggregation rate,erythrocyte pressure volume,whole blood specific viscosity and plasma specific viscosity in the three groups after treatment were significantly lower than those before treatment(all P＜0.01).After treatment,the platelet aggregation rate,erythrocyte pressure volume,whole blood specific viscosity and plasma specific viscosity of combined treatment group were lower than those of EDD treatment group and conventional treatment group(all P＜0.05).Peak systolic blood flow velocity(Vs)of basilar artery,vertebral artery and posterior cerebral artery in the three groups after treatment were significantly higher than those before treatment(all P＜0.01),and resistance index(RI)was significantly lower than that before treatment(all P＜0.01).The Vs of basilar,vertebral and posterior cerebral arteries in the combined treatment group were significantly higher than those in the conventional treatment group and the EDD treatment group(all P＜0.05),and the RI was significantly lower than that in the EDD treatment group and the conventional treatment group(all P＜0.05).There was no significant difference in the comparison of adverse reactions among the three groups(all P＞0.05).Conclusion Edaravone dextranol combined with argatroban can exert a good protective effect on neurological function in patients with acute cerebral infarction in the posterior circulation by improving blood rheology and posterior circulation hemodynamics.

ObjectiveTo investigate the epidemiological characteristics of respiratory disease mortality in Baoshan residents during the period of 2009‒2020. MethodsRespiratory disease deaths of Baoshan residents from 2009‒2020 were collected. ICD-10 codes were used to classify the causes of death， and R-4.2.1 was applied for statistical analysis. The average annual percent change （AAPC） of standardized mortality rates of different respiratory diseases were analyzed by using Joinpoint 4.9.0.0. ResultsThe average annual mortality rate of respiratory diseases in Baoshan from 2009 to 2020 was 58.86/10⁵， and the standardized mortality rate was 35.62/10⁵， which was the 3rd leading cause of mortality. The mortality rate of respiratory diseases was higher in men than in women （χ²=46.70， P<0.001）. COPD ranked first among respiratory diseases in Baoshan from 2009 to 2020， followed by pneumonia， asthma and pneumoconiosis in that order. The standardized mortality rate for COPD decreased from 38.66/10⁵ in 2009 to 19.88/10⁵ in 2020 （AAPC=-6.6%， 95%CI： -8.2% to -4.9%， P<0.001）. The standardized mortality rate of asthma decreased from 2.86/10⁵ in 2009 to 1.43/10⁵ in 2020 （AAPC=-5.8%， 95%CI： -8.8% to -2.8%， P<0.01）. The standardized mortality rate of pneumoconiosis decreased from 0.64/10⁵ in 2009 to 0.12/10⁵ in 2020 （AAPC=-7.4%， 95%CI： -13.0% to -1.5%， P<0.05）. The standardized mortality rate for pneumonia decreased from 2.63/10⁵ in 2009 to 0.70/10⁵ in 2020 （AAPC=-6.2%， 95%CI： -12.2% to 0.2%， P=0.056）， but not statistically significant. The annual average mortality rates of COPD， pneumonia and asthma were all highest in January. Crude mortality rates for COPD （χ²=2 669.01， P<0.001）， pneumonia （χ²=217.82， P<0.001）， asthma （χ²=100.09， P<0.001）， pneumoconiosis （χ²=26.46， P<0.001） and all categories of respiratory diseases （χ²=2 995.84， P<0.001） increased with age showed an increasing trend. The crude mortality rates for COPD （χ²=101.69， P<0.001）， pneumonia （χ²=7.39， P<0.01） and asthma （χ²=7.41， P<0.01） were higher in the central than in the northern part of Baoshan District， while the crude mortality rate for COPD （χ²=19.97， P<0.001） was higher in the central than in the southern part. ConclusionThe attention should be focused on COPD； increased detection in males and the elderly， especially in winter and spring； and a good balance between environmental and economic when planning the regional development.

Background Tinnitus is a common symptom in workers exposed to noise, and no specific treatment is available yet. Paying attention to the influencing factors of tinnitus is very important to prevent tinnitus. Objective To investigate the situation of tinnitus among noise-exposed workers and its influencing factors. Methods Using a cross-sectional study design, 1011 noise-exposed male workers in Hangzhou were studied. Tinnitus status, age, education, personal protection, smoking history, drinking history, and family history of the participants were surveyed by questionnaires. Binaural pure tone hearing threshold test was performed on all study subjects. The environmental noise in the workplace was measured. The relationships of tinnitus with noise exposure intensity, noise exposure time, noise exposure category, cumulative noise exposure, and wearing hearing protectors among the noise-exposed workers were analyzed by logistic regression. Results The prevalence of tinnitus among the noise-exposed workers was 36.1%. The mean hearing thresholds at 500, 3000, 4000, and 6000 Hz in the right and left ears were higher in the tinnitus group than in the non-tinnitus group (P<0.05); the hearing threshold at 2000 Hz in the right ear was higher in the tinnitus group than in the non-tinnitus group (P<0.05). There was no statistically significant difference between the two groups in the prevalence of monaural speech-frequency hearing loss or monaural high-frequency hearing loss (P>0.05). The on-site noise intensity was divided into three groups: ＜85, 85-＜95, and ≥95 dB(A); the prevalence of tinnitus in the three groups was 19.6%, 40.5%, and 66.7% respectively. The years of noise exposure was divided into three groups: ＜1, 1-＜5, and ≥5 years; the prevalence of tinnitus in the three groups was 17.9%, 34.0%, and 45.4% respectively. The cumulative noise exposure was divided into six groups: ＜80, 80-＜85, 85-＜90, 90-＜95, 95-＜100, and ≥100 dB(A)·year; the prevalence of tinnitus in the six groups was 6.8%, 25.0%, 31.0%, 39.6%, 43.1%, and 46.7% respectively. The prevalence of tinnitus was higher in the non-stationary noise group (42.5%) than in the stationary noise group (26.8%) (χ²=26.18, P<0.01), and the prevalence in the group without or with hearing protection was 39.7% and 35.5% respectively. The results of logistic regression showed that workers exposed to higher intensity, longer noise exposure, higher cumulative noise exposure, and non-stationary noise (reference: stationary noise) resulted in a higher risk of tinnitus (P_trend<0.01 or P<0.01); workers wearing of hearing protection device versus those not showed a lower risk of tinnitus (P<0.05). Conclusion Higher intensity, longer exposure to noise, and more cumulative noise exposure associate with a higher risk of tinnitus. Wearing hearing protective device can reduce the risk of tinnitus. Tinnitus in noise-exposed workers can precede the presentation of abnormal hearing loss.

Objective:To review clinical outcomes of extended V-Y latissimus dorsi myocutaneous flap in reconstruction of chest wall defects.Methods:Patients receiving chest wall defect reconstruction with extended V-Y latissimus dorsi myocutaneous flap at Fudan University Zhongshan Hospital from January 2016 to December 2018 were enrolled. Patients were followed up for more than 6 months to detect complications such as blood supply disorder of the flap, wound dehiscence, seroma or tumor recurrence.Results:A total of 16 patients, aged 28-78 years, with an average age of 54.8 years, were included. The chest wall defect size ranged from 10 cm×15 cm to 19 cm×26 cm. Among these cases, 1 case had venous congestion in the distal triangle area of the flap, 1 case had partial wound dehiscence of the flap, 2 cases developed seroma on the back and 2 cases under the flap. All cases healed after changing dressing and drain placement. All the other cases had complete flap survival and primary wound healing. All cases were followed up from 7 to 29 months, with good flap appearance and function and patient satisfaction with results.Conclusions:Chest wall defect reconstruction with V-Y latissimus dorsi myocutaneous flap is safe and reliable. It can repair a large chest wall wound and allow primary closure of the donor site simultaneously, which is worthy of being popularized in chest wall reconstruction.

Objective:To review clinical outcomes of extended V-Y latissimus dorsi myocutaneous flap in reconstruction of chest wall defects.Methods:Patients receiving chest wall defect reconstruction with extended V-Y latissimus dorsi myocutaneous flap at Fudan University Zhongshan Hospital from January 2016 to December 2018 were enrolled. Patients were followed up for more than 6 months to detect complications such as blood supply disorder of the flap, wound dehiscence, seroma or tumor recurrence.Results:A total of 16 patients, aged 28-78 years, with an average age of 54.8 years, were included. The chest wall defect size ranged from 10 cm×15 cm to 19 cm×26 cm. Among these cases, 1 case had venous congestion in the distal triangle area of the flap, 1 case had partial wound dehiscence of the flap, 2 cases developed seroma on the back and 2 cases under the flap. All cases healed after changing dressing and drain placement. All the other cases had complete flap survival and primary wound healing. All cases were followed up from 7 to 29 months, with good flap appearance and function and patient satisfaction with results.Conclusions:Chest wall defect reconstruction with V-Y latissimus dorsi myocutaneous flap is safe and reliable. It can repair a large chest wall wound and allow primary closure of the donor site simultaneously, which is worthy of being popularized in chest wall reconstruction.