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 diagnostic value of black blood computed tomography(BBCT)in vulnerable plaques at the carotid bifurcation.Methods The imaging data of 73 patients with suspected carotid atherosclerosis were retrospectively analyzed.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of conventional computed tomography angiography(CTA)ima-ges and BBCT images were compared by paired sample t-test.The 5-level scoring method was applied to evaluate the image quality subjectively,and the Friedman test was used to compare the differences in the subjective evaluation of image quality among the groups.Taking high-resolution magnetic resonance vessel wall imaging(HRMR-VWI)as the gold standard,the diagnostic value between BBCT and conventional CTA was compared,and the consistency of BBCT and HRMR-VWI in the evaluation of vulnerable plaques was calculated.Results The standard deviation(SD)value of BBCT images was lower than that of conventional three-phase CTA images,indicating better quality of BBCT images(P＜0.001).The mean CT value and CNRplaque-lumen of non-calcified plaques were higher in BBCT images than those in conventional three-phase CTA images,suggesting that BBCT had a higher contrast with sur-rounding tissues and could better display the fine structure of non-calcified plaques(P＜0.001).BBCT images achieved the highest scores in the subjective evaluation of image quality(P＜0.001).Compared with conventional CTA images,BBCT had higher sensi-tivity(88.2％vs 29.4％)and accuracy(90.9％vs 54.5％)in identifying vulnerable plaques(P＜0.001).The Kappa value between BBCT and HRMR-VWI was 0.813,showed good consistency.Conclusion The image quality of neck BBCT is superior to that of conventional CTA.BBCT has a better effect than conventional CTA in identifying vulnerable plaques at the carotid bifurcation,which is comparable to HRMR-VWI.

Extracorporeal membrane oxygenation(ECMO)provides blood circulation with assisted breathing for patients with severe cardiopulmonary failure,and buys valuable time for the rescue of critical patients.However,extracorporeal membrane oxygenation is often associated with serious complications.Small animal models have the advantages of low price,wide source,high flexibility and good reproducibility,and are an effective platform for evaluating strategies for prevention and treatment of ECMO complications.In recent years,more and more experimental studies have been conducted using small animal ECMO models.In this paper,the current status of the construction and application of small animal ECMO models at home and abroad is summarized,in order to optimize the related strategies of small animal ECMO model construction and promote the application and development of small animal ECMO models.

Purpose To evaluate the effectiveness of deep learning image reconstruction(DLIR)algorithms in reconstructing lumbar vertebrae images from abdominal CT scans,aiming to reduce radiation dose and eliminate the need for repeat lumbar CT examinations.Materials and Methods A retrospective collection was conducted from March to May 2024 in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.Thirty-two patients who underwent both abdominal and lumbar CT scans in a supine head-first position were enrolled.The abdominal CT(DLIR group)utilized a tube voltage of 120 kVp and a current of 200 mA with high-intensity DLIR for lumbar reconstruction.The standard lumbar CT(lumbar group)used the same voltage with a tube current of 260 mA and was reconstructed using 60%weighted adaptive statistical iterative reconstruction.Objective assessments was used to measure the CT values,noise(standard deviation,SD value),signal-to-noise ratio and contrast-to-noise ratio(excluding adipose tissue)at the third lumbar vertebral pedicle level and the L2/L3 intervertebral disc level for muscle,adipose tissue,cancellous bone,intervertebral discs,dura mater and cortical bone.Subjective assessments employed a five-point scale to evaluate image contrast,noise and sharpness.Results The volume CT dose index in lumbar group and DLIR group were 15.25 mGy and 11.74 mGy,respectively.There was no statistical difference in CT values between the structures of both groups(all P>0.05).Compared with the lumbar group,the DLIR group showed significant reductions in SD values across the measured tissues by 31.09%,35.66%,13.48%,27.82%,24.93%and 15.09%(t=5.09-7.21,all P<0.05).The signal-to-noise ratio improved by 36.40%,52.31%,16.56%,34.13%,38.39%and 18.81%,and the contrast-to-noise ratio improved by 51.70%,51.32%,36.24%,34.47%and 53.56%(t=-9.58--4.23,all P<0.001).The DLIR group significantly outperformed the lumbar group in image contrast[4.45(4.00,5.00)points vs.4.75(4.00,5.00)points],image noise[4.06(4.00,4.00)points vs.4.39(4.00,5.00)points],and spatial resolution of fine structures[4.00(4.00,4.00)points vs.4.27(4.00,5.00)points](Z=-3.80,-4.38,-3.55,all P<0.001).Conclusion Using high-intensity DLIR for abdominal examinations can achieve high-quality lumbar CT images with a 25%reduction in radiation dose,enabling simultaneous abdominal and lumbar scanning in a single session.

Objective:To verify the validity of the atopic dermatitis control tool (ADCT) in assessing disease control in patients with atopic dermatitis (AD) .Methods:Based on a cross - sectional study, demographic data, comorbidities and information on disease assessment - related scales such as the ADCT, the pruritus numerical rating scale (NRS), the patient-oriented eczema measure (POEM), and the dermatological life quality index (DLQI) were collected from patients with AD at Tianjin Medical University General Hospital from June 2021 to March 2023. The reliability and validity of the ADCT were assessed using these data. The discrimination power of the ADCT total score was evaluated by comparing the differences in the mean ADCT total scores among adjacent POEM/DLQI subgroups based on POEM/DLQI response classifications (POEM: clear or almost absent, mild, moderate, severe, very severe; DLQI: no effect, mild effect, moderate effect, serious effect, very serious effect). According to the ADCT scores, the AD patients were divided into an uncontrolled AD group (ADCT scores ≥ 7 points) and a controlled AD group (ADCT scores < 7 points). Differences between the above two groups were analyzed in terms of ADCT item scores, mean pruritus NRS scores, POEM total scores, DLQI total scores, and DLQI dimension scores to evaluate the validity of the ADCT in assessing AD disease control.Results:A total of 338 patients with AD were included, comprising 170 (50.30%) males and 168 (49.70%) females, and they were aged 17 to 89 (41.36 ± 17.63) years. Reliability analysis showed that the Cronbach′s α coefficient and split-half reliability coefficient of the ADCT were 0.886 and 0.878 respectively (both > 0.70), and the test- retest reliability coefficient was 0.977 (> 0.70, P < 0.001). Content validity analysis showed that the Pearson correlation coefficients between the ADCT item scores and the ADCT total score ranged from 0.753 to 0.852 (all P < 0.001) ; confirmatory factor analysis revealed that the Chi-square to degree of freedom ratio ( χ2/df) was 2.896 (< 5), the Tucker-Lewis index was 0.976 (> 0.9), the comparative fit index was 0.991 (> 0.9), the standardized root mean square residual was 0.026 (< 0.08), and the root-mean-square error of approximation was 0.075 (< 0.08) ; convergent validity analysis showed that the standardized factor loadings of all observed variables ranged from 0.689 to 0.905 (all > 0.500), combined reliability coefficient was 0.896 (> 0.700), and the average extracted variance value was 0.591 (> 0.500) ; criterion validity analysis showed that the correlation coefficients of the ADCT total score with other patient - reported outcome measures (the mean pruritus NRS scores, peak pruritus NRS scores, POEM total scores, and DLQI total scores) and DLQI dimension scores ranged from 0.649 to 0.730 and from 0.303 to 0.647, respectively (all P < 0.001). Analysis of the discrimination power of the ADCT total score showed significant differences in the mean ADCT total scores among adjacent POEM/DLQI subgroups (all P ≤ 0.001). The uncontrolled AD group (287 cases) showed significantly increased ADCT item scores, mean pruritus NRS score, POEM total score, DLQI total score, and DLQI dimension scores compared with the controlled AD group (51 cases, all P<0.001) . Conclusion:The ADCT exhibited good reliability, validity and discriminability based on the cross-sectional study, and can efficiently and reliably assess disease control in AD patients.

Objective:To analyze the effects of the disease and injury spectrum on health-adjusted life expectancy (HALE) among permanent residents aged 55 and above in Shenzhen from 2016 to 2030.Methods:Based on the mortality surveillance data and the permanent resident population data in Shenzhen from 2016 to 2022, the Sullivan method was used to calculate the HALE during 2016—2022. The Bayesian age-period-cohort model and the grey system model were used to predict the HALE during 2023—2030. The HALE changes in the two periods were decomposed into the contributions of 20 categories of diseases and injuries, respectively.Results:From 2016 to 2022, the HALE increased from 31.41 years (95% CI: 30.50-32.32) to 33.57 years (95% CI: 32.47-34.67). During this period, the mortality effect of neurological disorders slowed the increase of HALE, with a reduction of 0.27 years. By 2030, it is anticipated that the HALE will reach 36.40 years (95% CI: 34.78-38.01). This is expected to be influenced by the mortality effects of nutritional deficiencies (-0.40 years) and mental disorders (-0.29 years), as well as the disability effects of musculoskeletal disorders (-0.66 years), skin and subcutaneous diseases (-0.21 years) and nutritional deficiencies (-0.13 years). Conclusion:The HALE of permanent residents aged 55 years and above in Shenzhen demonstrated an increasing trend over time. Greater attention should be paid to the adverse effects of neurological disorders, nutritional deficiencies, mental disorders, musculoskeletal disorders, and skin and subcutaneous diseases on the continuous increase of HALE in this population.

Objective To observe the value of synthetic MRI(SyMRI)MAGnetic resonance image Compilation(MAGiC)sequence parameters for differentiating cervical squamous cell carcinoma and cervical adenocarcinoma.Methods Sixty-six patients with pathologically confirmed cervical cancer were retrospectively enrolled and divided into cervical squamous cell carcinoma group(n=56)and cervical adenocarcinoma group(n=10).Quantitative MAGiC parameters were collected and compared between groups,and those being significantly different were combined to construct a logistic regression model.The performance of each parameter alone and their combination for differentiating cervical squamous cell carcinoma and cervical adenocarcinoma was evaluated with receiver operating characteristic(ROC)curve and the area under the curve(AUC).Results In cervical adenocarcinoma group,lesions's T1 and T2 were higher,while R1 and R2 were lower than those in cervical squamous cell carcinoma group(all P＜0.05).No statistically significant difference of proton density was found between groups(P＞0.05).The AUC of T1,T2,R1,R2 alone and their combination for differentiating cervical squamous cell carcinoma and cervical adenocarcinoma was 0.959,0.945,0.961,0.942 and 0.996,respectively,and no significant difference was found between each two ones(Z=0.267 to 1.396,all P＞0.05).Conclusion SyMRI had high value for differentiating cervical squamous cell carcinoma and cervical adenocarcinoma.

To investigate the therapeutic effect and related mechanisms of hordenine on ovalbumin (OVA)-induced allergic rhinitis (AR) in rats, HE and AB-PAS staining were used to detect the improvement of pathological damage to the nasal mucosa induced by hordenine. ELISA was employed to detect the effect of hordenine on OVA-sIgE in serum and IL-4 in the nasal mucosa supernatant of rats. IHC and Western blot experiments were undertaken to examine the effect of hordenine on Th1/Th2 cell balance. Bioinformatics analysis was performed to predict pathways, which were verified by in vivo and in vitro experiments. The experimental results showed that hordenine could alleviate the behavioral manifestations of OVA-induced AR rats, alleviate nasal mucosal pathological damage caused by AR, and reduce the secretion of OVA-sIgE and IL-4. In addition, hordenine could regulate the Th1/Th2 balance. Bioinformatics analysis results showed that the potential pathway of action of hordenine on AR was the phosphoinositide 3 kinase (PI3K)/protein kinase B (Akt) signaling pathway. The in vivo experimental results showed that the expression of PI3K and p-Akt proteins in the nasal mucosa of the model group rats was significantly increased (P < 0.01), and that the protein expression level was significantly decreased after the administration of hordenine, which was also confirmed by an in vitro experiment. This study suggests that hordenine may regulate Th1/Th2 cell balance through the PI3K/Akt signaling pathway, thereby exerting an alleviating effect on OVA-induced AR.

Objective:To verify the validity of the atopic dermatitis control tool (ADCT) in assessing disease control in patients with atopic dermatitis (AD) .Methods:Based on a cross - sectional study, demographic data, comorbidities and information on disease assessment - related scales such as the ADCT, the pruritus numerical rating scale (NRS), the patient-oriented eczema measure (POEM), and the dermatological life quality index (DLQI) were collected from patients with AD at Tianjin Medical University General Hospital from June 2021 to March 2023. The reliability and validity of the ADCT were assessed using these data. The discrimination power of the ADCT total score was evaluated by comparing the differences in the mean ADCT total scores among adjacent POEM/DLQI subgroups based on POEM/DLQI response classifications (POEM: clear or almost absent, mild, moderate, severe, very severe; DLQI: no effect, mild effect, moderate effect, serious effect, very serious effect). According to the ADCT scores, the AD patients were divided into an uncontrolled AD group (ADCT scores ≥ 7 points) and a controlled AD group (ADCT scores < 7 points). Differences between the above two groups were analyzed in terms of ADCT item scores, mean pruritus NRS scores, POEM total scores, DLQI total scores, and DLQI dimension scores to evaluate the validity of the ADCT in assessing AD disease control.Results:A total of 338 patients with AD were included, comprising 170 (50.30%) males and 168 (49.70%) females, and they were aged 17 to 89 (41.36 ± 17.63) years. Reliability analysis showed that the Cronbach′s α coefficient and split-half reliability coefficient of the ADCT were 0.886 and 0.878 respectively (both > 0.70), and the test- retest reliability coefficient was 0.977 (> 0.70, P < 0.001). Content validity analysis showed that the Pearson correlation coefficients between the ADCT item scores and the ADCT total score ranged from 0.753 to 0.852 (all P < 0.001) ; confirmatory factor analysis revealed that the Chi-square to degree of freedom ratio ( χ2/df) was 2.896 (< 5), the Tucker-Lewis index was 0.976 (> 0.9), the comparative fit index was 0.991 (> 0.9), the standardized root mean square residual was 0.026 (< 0.08), and the root-mean-square error of approximation was 0.075 (< 0.08) ; convergent validity analysis showed that the standardized factor loadings of all observed variables ranged from 0.689 to 0.905 (all > 0.500), combined reliability coefficient was 0.896 (> 0.700), and the average extracted variance value was 0.591 (> 0.500) ; criterion validity analysis showed that the correlation coefficients of the ADCT total score with other patient - reported outcome measures (the mean pruritus NRS scores, peak pruritus NRS scores, POEM total scores, and DLQI total scores) and DLQI dimension scores ranged from 0.649 to 0.730 and from 0.303 to 0.647, respectively (all P < 0.001). Analysis of the discrimination power of the ADCT total score showed significant differences in the mean ADCT total scores among adjacent POEM/DLQI subgroups (all P ≤ 0.001). The uncontrolled AD group (287 cases) showed significantly increased ADCT item scores, mean pruritus NRS score, POEM total score, DLQI total score, and DLQI dimension scores compared with the controlled AD group (51 cases, all P<0.001) . Conclusion:The ADCT exhibited good reliability, validity and discriminability based on the cross-sectional study, and can efficiently and reliably assess disease control in AD patients.

[Objective]To develop a classification model based on complete blood count(CBC)parameters combined with clinical factors to predict severe respiratory infections caused by Human adenovirus(HAdV)in pediatric patients.[Methods]From September 2023 to September 2024,the CBC parameters and related clinical data from pediatric patients diagnosed with HAdV infection were collected.Principal component analysis and random forest models were used to identify potential predictors of severe cases.[Results]A total of 668 pediatric patients were included,with 564 cases assigned to the training cohort and 104 cases to the validation cohort.Severe cases were defined as pneumonia and/or fever lasting≥5 days(pneumonia or prolonged fever,PorPF).Principal component analysis and feature importance analysis(Mean Decrease Gini value)identified the monocytosis ratio(PMono),red blood cell count(RBC),and platelet count(PLT)as the most critical CBC parameters.Logistic regression analysis revealed that oxygen therapy(OR=4.367,95%CI:1.568-12.161)and increased work of breathing(OR=3.904,95%CI:2.146-7.101)were relative risk factors for PorPF.Meanwhile,higher PMono(OR=0.696,95%CI:0.640-0.757),RBC(OR=0.201,95%CI:0.124-0.325),and PLT(OR=0.990,95%CI:0.987-0.994)were protective factors.When PMono was used as a predictive marker for PorPF,the area under the receiver operating characteristic curve(AUC)was 0.648 and 0.705,respectively.A random forest model incorporating four risk factors[PMono,RBC,PLT,and hematocrit(HCT)]was constructed to classify PorPF and general cases,achieving AUCs of 0.688 and 0.768,respectively.[Conclusions]PMono,RBC,and PLT may serve as characteristic CBC indicators for predicting pneumonia or prolonged fever in children with HAdV infection.A risk factor model built using PMono,RBC,PLT,and HCT offers a relatively simple and accurate approach to predicting severe cases in pediatric HAdV infections.