Objective To assess the clinical effectiveness of Poly(p-dioxanone)(PPDO)bidirectional sawtooth inverted Ⅴ-shaped wiring and straight wiring in ameliorating nasolabial fold wrinkles within the context of facial rejuvenation.Methods Between March 2023 and January 2024,60 patients presenting with nasolabial fold wrinkles who underwent PPDO subcutaneous implantation and lifting in the Department of Plastic Surgery at the First Affiliated Hospital of Bengbu Medical University were randomly allocated into an observation group and a control group.At 4 weeks,12 weeks,and 24 weeks post-surgery,the clinical efficacy was statistically analyzed.The incidence of complications was documented to evaluate the safety of the procedure,and a satisfaction survey was carried out.Results In each time period,the Wrinkle Severity Rating Scale(WSRS)scores of both groups decreased significantly when compared to those prior to the operation(P<0.05).At each corresponding time point after surgery,there was a statistically significant difference in the WSRS scores between the two groups in the observation group(P<0.05).In both groups,the WSRS score was the lowest at 12 weeks post-surgery,and the score at 24 weeks post-surgery was significantly higher than that at 12 weeks post-surgery(P<0.05).The overall effective rate of facial improvement in the observation group was 93.33%,which was significantly higher than that in the control group(73.33%).The difference was statistically significant(χ2=4.320,P<0.05).No obvious complications occurred in either group.The satisfaction rate in the observation group was 4.067±0.828,which was significantly higher than that in the control group(3.400±0.932).The difference was statistically significant(t=2.929,P<0.05).Conclusions Both the PPDO two-way sawtooth line inverted Ⅴ-shaped wiring method and the straight wiring method can effectively improve nasolabial fold wrinkles.Compared with the straight wiring method,the inverted Ⅴ wiring method demonstrates a more pronounced improvement effect,higher subject satisfaction,and fewer consumables.The optimal results were achieved at 12 weeks after surgery for both wiring methods.Moreover,neither surgical procedure was associated with significant complications.

[Purpose]To analyze the trends of brain tumor incidence and age of onset in cancer registration areas of Jiangsu Province from 2009 to 2019.[Methods]The incidence data of brain tumors from 2009 to 2019 were obtained from 16 national cancer registration areas of Jiangsu Province.The crude incidence rate,age-standardized incidence rate by Chinese standard popula-tion(ASIRC),average age of onset,standardized age-specific incidence rate,and annual average percentage change(AAPC)by sexes and regions were calculated.[Results]The incidence rate of brain tumor in Jiangsu Province from 2009 to 2019 showed an increasing trend(AAPC=4.12％,95％CI:3.31％～4.95％),and the increase in female(AAPC=5.79％,95％CI:4.44％～7.15％)was higher than that in male(AAPC=2.31％,95％CI:1.66％～2.97％);and the increase in urban areas(AAPC=4.84％,95％CI:3.52％～6.18％)was higher than that in rural areas(AAPC=3.04％,95％CI:2.12％～3.98％).The ASIRC also showed an increasing trend(AAPC=2.14％,95％CI:1.27％～3.02％).Birth cohort analysis showed that within the same age group,the incidence rate of brain tumors increased with increasing birth years.The average age of onset for crude incidence showed a delaying trend of 0.43 years old per year(t=7.09,P＜0.001);that for ASIRC was 0.20 years old per year(t=3.33,P=0.009).The proportion of patients in the age group of 60 years old and above increased from 35.79％in 2009 to 44.18％in 2019.[Conclusion]The incidence of brain tumor in cancer registration areas of Jiangsu Province showed an increasing trend from 2009 to 2019 with a delaying trend of average age of onset.

ln the context of the high-quality development of public hospitals,research management is transitioning from a results-oriented approach to a full-process management model,necessitating the exploration of a governance system that integrates topic guidance,process support,and outcome transformation.Based on the Knowledge-to-Action and SECl model,it analyzes the construction logic and application effectiveness of the nursing research rounds mechanism at a teritary grade A hospital in Hainan Province.Through a"three-tier stratification+dual-track collaboration+full-process closed-loop"design,the mechanism bridges the chain from"clinical problem identification to research path optimization to outcome transformation",significantly enhancing research participation,research plan standardization,and research output.The findings validate the practical value of the research rounds mechanism in promoting knowledge transformation,capability enhancement,and organizational knowledge retention.

Background and Aims:As a core data source in the development of medical informatization,the front page of inpatient medical records plays a crucial role in determining the usability of research data and the scientific quality of clinical decision-making.Given the relatively standardized diagnostic and treatment protocols for thyroid malignancies,this disease serves as a representative model for evaluating the data quality of medical record front sheets.This study aimed to systematically assess the accuracy of diagnostic and surgical procedure coding for thyroid malignancies on the medical record front page,identify existing problems,and explore strategies for improvement and the potential for future application in clinical research.Methods:A total of 3 361 patients who underwent initial surgical treatment and were pathologically confirmed with thyroid cancer at the Department of Thyroid Surgery,the First Affiliated Hospital of Kunming Medical University from January 2018 to December 2020 were retrospectively included.Postoperative pathology reports and surgical records were used as reference standards to evaluate the accuracy of primary and secondary diagnosis codes,as well as primary and secondary surgical procedure codes on the medical record front page.Results:The accuracy rate of primary diagnosis coding reached 98.8%.However,among 1 368 patients with cervical lymph node metastasis,only 31.2%had correctly recorded secondary diagnosis codes and metastatic sites,with an omission rate as high as 67.8%.The overall accuracy rate for primary surgical procedure coding was 90.4%,with thyroid lobectomy(TL)and total thyroidectomy(TT)coding accuracies of 85.5%and 96.0%,respectively.Among the coding errors,70.0%involved TL procedures being incorrectly coded as TT.Secondary surgical procedure codes—mainly for lymph node dissection—were highly inconsistent,with up to 14 different coding types,reflecting a lack of standardization and unified input criteria.Notably,the error rate for primary surgical coding in 2020 increased significantly compared with the previous two years,suggesting subjectivity and variability in manual data entry.Conclusion:This study highlights major accuracy deficiencies in surgical procedure coding for thyroid malignancies on the medical record front page,which may compromise the scientific validity of real-world data.Going forward,leveraging artificial intelligence technologies to support structured documentation and automated coding,alongside establishing a proactive quality control system through multidisciplinary collaboration,may significantly improve data accuracy.These efforts are essential for strengthening data foundations for precision treatment,performance evaluation,insurance payment,and clinical research on thyroid cancer.

Objective·To investigate the causal relationship between type 2 diabetes mellitus(T2DM)and cognitive dysfunction using two-sample Mendelian randomisation(MR).Methods·Instrumental variables associated with T2DM were pooled from a large-scale genome-wide association study(GWAS)dataset.Inverse variance weighting was used as the primary analytical technique,supplemented by MR-Egger regression,weighted median and simple median analyses.Meta-analysis was jointly applied to combine different endpoints and to analyse the possibility of a causal relationship between T2DM and dementia,Alzheimer's disease,and Parkinson's dementia.Horizontal pleiotropy was examined by MR-PRESSO global test and MR-Egger analysis.Results·There was a causal relationship between genetically predicted T2DM and dementia(OR=1.11,95%CI 1.02～1.20,P=1.96×10-2)and AD(OR=1.16,95%CI 1.04～1.30,P=8.41×10-3).Meta-analysis also supported the association between T2DM and cognitive impairment(OR=1.12,95%CI 1.05～1.20,P=4.22×10-4).A series of sensitivity analyses suggested the absence of heterogeneity and horizontal pleiotropy.Reverse MR analysis showed no significant causal relationship of various types of dementia on T2DM.Conclusion·T2DM is positively associated with the risk of developing various types of dementia,suggesting that T2DM may be an important risk factor for cognitive impairment.

Objective:To explore the short-term clinical effects of deep cervical lymph node-venous anastomosis in the treatment of Alzheimer’s disease (AD).Methods:A prospective exploratory study was conducted on the treatment of AD patients using the cervical deep lymph node-venous anastomosis technique in Scar and Wound Treatment Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from September to October 2024. The patients underwent high-frequency ultrasound to locate deep cervical lymph nodes and the external jugular vein. Under general anesthesia, bilateral deep cervical lymph node-venous anastomoses were performed. Indocyanine green (ICG) lymphography was conducted via subcutaneous injection behind the ear to visualize lymph nodes in levels Ⅱ and Ⅲ. After making a skin incision along the posterior margin of the sternocleidomastoid muscle, the external jugular vein, internal jugular veins, and associated lymph nodes were exposed. Adjacent veins were selected for anastomosis of lymph node. Using microsurgical techniques, end-to-side or end-to-end anastomosis was completed for lymph nodes in levels Ⅱ and Ⅲ. Preoperative assessments included the mini-mental state examination (MMSE, a higher score indicates better cognitive function), Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog, a higher score indicates greater impairment of cognitive function), Alzheimer’s disease cooperative study scale for activities of daily living (ADCS-ADL, a higher score indicates better ability to perform daily activity), and neuropsychiatric inventory (NPI, a higher score indicates more severe behavioral and emotional symptom). Postoperative follow-up included the same scales to observe changes in cognitive function, activities of daily living, and emotional communication.Results:Four patients (1 male, 3 females, aged 58-79 years) with AD were included. All were diagnosed based on cerebrospinal fluid biomarkers. All patients successfully underwent bilateral deep cervical lymph node-venous anastomoses. On average, 4.3 (2-7 per person) anastomoses were performed per patient. Surgical procedures lasted an average of 6.5 h (5.5-8.5 h) with minimal blood loss (less than 50 ml). Patients resumed normal activity within 6 hours postoperatively and were discharged after an average of 4.1 d (3.5-5.0 d). Postoperative complications included one case each of aspiration pneumonia, lower limb venous thrombosis, and transient delirium, all of whom resolved without long-term effects. Clinical symptoms, including memory decline, mood swings, and anxiety, showed varying degrees of improvement. Patients reported enhanced quality of life, emotional stability, and social engagement, confirming the procedure’s safety and potential cognitive benefits. At one month postoperatively, the MMSE scores of the four patients increased by an average of 0.8 points compared to preoperative levels. Additionally, the two patients who completed the ADAS-Cog assessments showed a decrease in their scores (reduced by 1.0 points and 11.3 points, respectively, compared to preoperative scores), indicating a certain degree of improvement in cognitive function during this period. The ADCS-ADL and NPI scores of four patients varied significantly, without showing any clear pattern.Conclusion:Lymphovenous anastomosis of the deep cervical lymph node-venous anastomosis may provide a new surgical intervention approach for AD, but further large-scale studies and long-term follow-up are needed to validate its safety and effectiveness.

Virtual avatar possesses unique advantages such as high degree of realism,immersion and visualization,and the research on applying it to the assessment and treatment of anorexia nervosa is increasing year by year.In terms of assessment,there are mainly avatar versions of the figure rating scales,yes-no tasks and its variations,method of adjustment,and the use of virtual cylinder technique.In terms of treatment,there are mainly intervention methods based on virtual avatar exposure therapy,body swapping illusions,perceptual/attention training and self-empowerment,as well as some new potential interventions.Overall,the current research around anorexia nervosa using virtual avatar techniques is still in its early stages and there is still a lot of room for further exploration.

Objective To evaluate the prevention and control effectiveness of four major chronic diseases in Youyang County, and find the weak link of prevention and control, and to provide theoretical support for improving prevention and control strategies. Methods Based on the death data of permanent residents from 2012 to 2020 extracted from the cause-of-death registration and reporting system of Youyang County, a statistical analysis was conducted using SPSS19.0. The annual percentage change (APC) was tested by t-test. Results From 2012 to 2020, the mortality rate of and the standardized mortality rate of the four major chronic diseases and the premature mortality rate of diabetes in males showed an increasing trend (APC was 3.05%, 1.82% and 27.12%, respectively, P < 0.05). The mortality rate of the four chronic diseases in females increased (APC was 2.53%, P < 0.05), while the proportion of premature death of the four chronic diseases and the probability of premature death of cardiovascular and cerebrovascular diseases in females decreased (APC was -2.37%, -5.73%, P < 0.05). The standardized mortality rate and premature death rate of the four major chronic diseases were higher in males than those in females. The mortality rate of the four major chronic diseases and the premature death rate of diabetes in the whole population were on the rise (APC was 2.84% and 12.86%, P < 0.05). It was expected that the early death probability of the four major chronic diseases in Youyang County would be 12.65% in 2030, higher than the target value of 12.59% of ^“Healthy China 2030^”. Conclusion The future focus of Youyang County is to prevent and control malignant tumors and diabetes, especially to strengthen the prevention and control of male diabetes.

Objective: To explore the prevalence of screening myopia and depressive symptom among primary and secondary school students in Xuzhou, and to explore the association of sleep and screen time on the coexistence of screening myopia and depressive symptom, so as to provide scientific references for developing intervention strategies to address the development of myopia and promote mental health in children and adolescents. Methods: From September to October 2024, a stratified cluster random sampling method was used to select 6 605 students in grade 4 to 12 in 2 urban and 2 suburban districts in Xuzhou. The students health condition and influencing factors questionnaire were used to assess students basic information, sleep time, and screen time. The Center for Epidemiological Studies Depression Scale (CES-D) was used to assess primary and secondary school students depressive symptom.Unaided distance visual acuity examination was conducted, and refractive assessment was performed using an automated refractometer without cycloplegic agents. The Chi-square test and multiple Logistic regression analysis were used to evaluate the association of sleep and screen time with the coexistence of screening myopia and depressive symptom. Results: The detection rates of screening myopia, depressive symptom, and screening myopia and depressive symptoms co morbidity among primary and secondary school students in Xuzhou were 60.35%, 4.45% and 18.61% respectively. Results from the multinomial Logistic regression analysis, using the healthy group as the reference and after adjusting for confounding factors, showed that students with insufficient sleep duration were more likely to have depressive symptom ( OR=1.57, 95%CI =1.08-2.27) and the coexistence of screening myopia and depressive symptom ( OR=1.85, 95%CI =1.45-2.36). Students with daily screen time≥2 h were more likely to have depressive symptom only ( OR=1.41, 95%CI =1.04-1.93) and the coexistence of screening myopia and depressive symptom ( OR=1.31, 95%CI =1.06-1.61). Further stratified analysis based on sufficient and insufficient sleep duration revealed that only in the insufficient sleep duration group, students with daily screen time≥2 h had an increased risk of depressive symptom only ( OR=1.49, 95%CI =1.07-2.07) and the coexistence of screening positive myopia and depressive symptom ( OR=1.40, 95%CI =1.11- 1.77 ) (all P <0.05). Conclusions Primary and secondary school students with insufficient sleep duration and daily screen time≥2 h have higher risks of depressive symptoms and the coexistence of screening myopia and depressive symptoms. It is recommended to ensure adequate sleep duration and limit screen time for children and adolescents.