Objective To investigate the relationship between serum amyloid A(SAA),interleukin-10(IL-10),interleukin-21(IL-21)levels and the first acute exacerbation in patients with chronic obstructive pulmo-nary disease(COPD)with pneumothorax.Methods A total of 102 patients with stable COPD complicated with pneumothorax admitted to the hospital from January 2020 to January 2023 were selected.They were treated with closed thoracic drainage,anti-inflammatory,antiasthmatic,expectorant,and high-flow nasal hu-midification oxygen therapy(HFNC).The patients were divided into two groups according to whether they had the first acute exacerbation within 1 year after treatment,the first acute exacerbation group(32 patients had the first acute exacerbation within 1 year of follow-up)and the non-first acute exacerbation group(70 pa-tients had no first acute exacerbation within 1 year of follow-up).Serum SAA,IL-10 and IL-21 levels and blood gas indexes were compared between the two groups after treatment.Multivariate Logistic regression a-nalysis was used to analyze the influencing factors of the first acute exacerbation after HFNC treatment.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum SAA,IL-10 and IL-21 levels after treatment for the first acute exacerbation of COPD patients with pneumothorax.Results There were significant differences in hypoproteinemia,smoking,underlying diseases,forced vital ca-pacity(FVC),forced expiratory volume in one second(FEV1)as a percentage of predicted value(FEV1%),FEV1 to FVC ratio(FEV1/FVC),arterial partial pressure of oxygen(PaO2),arterial partial pressure of car-bon dioxide(PaCO2),SAA,IL-10,IL-21 between the two groups(P<0.05).Multivariate Logistic regression analysis showed that hypoproteinemia,smoking,underlying diseases,PaCO2,SAA,IL-10 and IL-21 were the risk factors for the first acute exacerbation after HFNC treatment(P<0.05).FVC,FEV1%,FEV1/FVC and PaO2 were protective factors for the first acute exacerbation after treatment(P<0.05).ROC curve results showed that the area under the curve(AUC)of SAA,IL-10 and IL-21 levels after treatment to predict the first acute exacerbation of COPD patients with pneumothorax was 0.755,0.726 and 0.674,respectively.When the cut-off values of SAA,IL-10 and IL-21 were 171.06 g/L,26.46 pg/mL and 244.79 pg/mL,the sen-sitivity was 76.51%,60.84%and 56.90%,and the specificity was 66.73%,74.49%and 74.52%,respective-ly.The AUC of combined prediction was 0.860,the sensitivity was 80.44%,and the specificity was 76.51%.Conclusion The serum SAA,IL-10 and IL-21 levels in COPD patients with pneumothorax have certain pre-dictive value for the first acute exacerbation of COPD patients with pneumothorax.

Objective:To compare and analyze the effects of time-restricted feeding (TRF) and exercise intervention on postoperative outcomes in obese children with concealed penis following corrective surgery, and to identify more effective postoperative management strategies.Methods:A retrospective study was conducted on the clinical data of obese boys aged 6-12 years who underwent modified Devine surgery for concealed penis in the Department of Pediatric Surgery, the Second Affiliated Hospital of Shandong First Medical University, between October 1, 2022, and June 30, 2024. According to the postoperative weight management intervention, patients were divided into three groups: an exercise group, a TRF group, and a non-intervention group. The exercise and TRF groups received 6 months of structured exercise or TRF-based weight management, respectively. During TRF intervention, all caloric intake was confined to a 10-hour period each day, with no energy intake during the remaining 14 hours. Postoperative follow-up was conducted daily for 6 months. The preoperative suprapubic fat thickness (h1) and penile length (d1), immediate postoperative penile length (d2), and 6-month postoperative suprapubic fat thickness (h2) and penile length (d3) were measured. At 6 months after surgery, changes in body mass index (BMI), penile exposure increment (Δd = d3-d1), and suprapubic fat thickness were compared among the three groups. Statistical analyses were performed using SPSS version 27.0.1. Data conforming to a normal distribution were expressed as Mean ± SD. One-way analysis of variance (ANOVA) or Welch’s ANOVA was used for intergroup comparisons, followed by independent sample t-test and Bonferroni correction or Games-Howell tests for post hoc multiple comparisons when significant differences were identified. A P value < 0.05 was considered statistically significant. Results:A total of 101 male patients were enrolled: 35 in the exercise group, 31 in the TRF group, and 35 in the non-intervention group. No significant differences were observed among the three groups in age, preoperative BMI, h1, d1, or d2 (all P > 0.05), indicating comparable baseline characteristics. At 6 months postoperatively, the BMI of the TRF group was significantly lower than that of the exercise and non-intervention groups [(20.82±1.19) kg/m 2 vs. (22.46±2.00) kg/m 2 vs. (23.52±2.52) kg/m 2,P < 0.05]; the BMI in the exercise group showed a decreasing trend compared with the non-intervention group, although the difference was not statistically significant ( P>0.05); the penile exposure increment (Δd) was greater in the TRF group than in the exercise and non-intervention groups [(2.08±0.43) cm vs. (1.68 ± 0.37) cm vs. (1.47 ± 0.16) cm], while the suprapubic fat thickness (h2) was smaller [(8.65±1.96) mm vs. (10.43±1.32) mm vs. (11.26±1.53) mm]; the exercise group also demonstrated a larger Δd and a smaller h2 than the non-intervention group, and these differences were statistically significant (all P<0.05). Conclusion:Both TRF and regular exercise are effective postoperative weight management interventions for maintaining surgical outcomes in obese children with concealed penis after modified Devine surgery. Among these approaches, TRF demonstrates superior efficacy.

Objective:To compare and analyze the effects of time-restricted feeding (TRF) and exercise intervention on postoperative outcomes in obese children with concealed penis following corrective surgery, and to identify more effective postoperative management strategies.Methods:A retrospective study was conducted on the clinical data of obese boys aged 6-12 years who underwent modified Devine surgery for concealed penis in the Department of Pediatric Surgery, the Second Affiliated Hospital of Shandong First Medical University, between October 1, 2022, and June 30, 2024. According to the postoperative weight management intervention, patients were divided into three groups: an exercise group, a TRF group, and a non-intervention group. The exercise and TRF groups received 6 months of structured exercise or TRF-based weight management, respectively. During TRF intervention, all caloric intake was confined to a 10-hour period each day, with no energy intake during the remaining 14 hours. Postoperative follow-up was conducted daily for 6 months. The preoperative suprapubic fat thickness (h1) and penile length (d1), immediate postoperative penile length (d2), and 6-month postoperative suprapubic fat thickness (h2) and penile length (d3) were measured. At 6 months after surgery, changes in body mass index (BMI), penile exposure increment (Δd = d3-d1), and suprapubic fat thickness were compared among the three groups. Statistical analyses were performed using SPSS version 27.0.1. Data conforming to a normal distribution were expressed as Mean ± SD. One-way analysis of variance (ANOVA) or Welch’s ANOVA was used for intergroup comparisons, followed by independent sample t-test and Bonferroni correction or Games-Howell tests for post hoc multiple comparisons when significant differences were identified. A P value < 0.05 was considered statistically significant. Results:A total of 101 male patients were enrolled: 35 in the exercise group, 31 in the TRF group, and 35 in the non-intervention group. No significant differences were observed among the three groups in age, preoperative BMI, h1, d1, or d2 (all P > 0.05), indicating comparable baseline characteristics. At 6 months postoperatively, the BMI of the TRF group was significantly lower than that of the exercise and non-intervention groups [(20.82±1.19) kg/m 2 vs. (22.46±2.00) kg/m 2 vs. (23.52±2.52) kg/m 2,P < 0.05]; the BMI in the exercise group showed a decreasing trend compared with the non-intervention group, although the difference was not statistically significant ( P>0.05); the penile exposure increment (Δd) was greater in the TRF group than in the exercise and non-intervention groups [(2.08±0.43) cm vs. (1.68 ± 0.37) cm vs. (1.47 ± 0.16) cm], while the suprapubic fat thickness (h2) was smaller [(8.65±1.96) mm vs. (10.43±1.32) mm vs. (11.26±1.53) mm]; the exercise group also demonstrated a larger Δd and a smaller h2 than the non-intervention group, and these differences were statistically significant (all P<0.05). Conclusion:Both TRF and regular exercise are effective postoperative weight management interventions for maintaining surgical outcomes in obese children with concealed penis after modified Devine surgery. Among these approaches, TRF demonstrates superior efficacy.

Pseudomonas aeruginosa is a common pathogen of respiratory infections. The conventional diagnostic methods for Pseudomonas aeruginosa have certain weakness, for example, sputum culture is time-consuming and of low sensitivity; and polymerase chain reaction cannot be popularized clinically due to its high cost. Meanwhile, detection of volatile organic compounds is a sensitive, rapid, portable and inexpensive diagnostic method. This review focuses on the detection of volatile organic compounds in the diagnosis of Pseudomonas aeruginosa respiratory infection, discusses the existing problems, and puts forward relevant suggestions to provide reference for clinical application and future researches.