Objective: To investigate the association between plant-based diet and different types of obesity, so as to provide references for obesity prevention. Methods: Residents aged 35-75 years from 33 counties (cities, districts) in Zhejiang Province were selected as study subjects using a multistage stratified random sampling method between April and December 2024. Demographic information and living behaviors were collected using questionnaire surveys. Height, weight and waist circumference were measured, and body mass index (BMI) was calculated. BMI ≥28.0 kg/m2 was defined as obesity, waist circumference ≥90 cm in males or ≥85 cm in females was defined as central obesity, and individual with obesity who also had central obesity was defined as having compound obesity. Food intake over a 3-day period was collected using the consecutive 3-day 24-hour dietary recall method. The plant diet index (PDI), healthful plant diet index (HPDI), and unhealthful plant diet index (UPDI) were calculated, and categorized into quintiles (Q1-Q5) based on their distribution. Association between the PDI, PDI, UPDI and different types of obesity were analyzed using multivariable logistic regression models. Results: A total of 4 882 individuals were surveyed, including 2 233 males (45.74%) and 2 649 females (54.26%). The average age was (55.42±12.14) years. There were 537 individuals of obesity, 1 718 individuals of central obesity, and 500 individuals of compound obesity, with detection rates of 11.00%, 35.19%, and 10.24%, respectively. Multivariable logistic regression analysis showed that, after adjusting for demographic information and living behaviors, compared with Q1 group, HPDI Q5 group showed a 29.6% lower risk of obesity (OR=0.704, 95%CI: 0.525-0.943) and a 32.1% lower risk of compound obesity (OR=0.679, 95%CI: 0.502-0.918). Conversely, the UPDI Q5 group exhibited a 39.5% higher risk of obesity (OR=1.395, 95%CI: 1.032-1.886) and a 39.8% higher risk of compound obesity (OR=1.398, 95%CI: 1.025-1.907). No statistically significant association was found between PDI and obesity, central obesity, and compound obesity (all P>0.05). As HPDI increased, the risks of obesity and compound obesity showed decreasing trends; as UPDI increased, the risks of obesity and compound obesity showed increasing trends (all Ptrend<0.05). Conclusion A healthful plant-based diet is associated with reduced risks of obesity and compound obesity, while an unhealthful plant-based diet is associated with increased risks of obesity and compound obesity.

Psoriasis, a chronic, immune-mediated inflammatory disease characterized by hyperproliferation of keratinocytes, is difficult to cure and prone to relapse, often leading to systemic damage. Triptolide (TPL) can modulate cutaneous immune responses and inflammation, yet its therapeutic window is narrow with significant toxicity. To enhance skin targeting and retention of TPL while reducing systemic absorption and toxicity, a TPL/hyaluronic acid/phospholipid polymeric micelle (TPL/HA-DOPE) was constructed via HA's targeting of the CD44 receptor on skin cells. The prepared TPL/HA-DOPE exhibited a uniform spherical morphology with particle size of (130.4±1.23) nm, drug loading capacity of (19.74±0.084) %, and encapsulation efficiency of (85.53±1.34) %. Transdermal permeation studies in vitro and in vivo demonstrated that TPL/HA-DOPE not only enhanced uptake in HaCaT cells but also exhibited excellent skin retention. In a murine model of psoriasis, the TPL/HA-DOPE gel at the dose of 50 μg/(kg•d) showed the most significant improvement in erythema, scaling, and epidermal thickening. Histological analysis confirmed that TPL/HA-DOPE markedly reduced stratum corneum thickness, epidermal hyperplasia, and inflammatory cell infiltration. Ki67 immunostaining proved that its anti-inflammatory mechanism might be achieved by reducing the number of Ki67-positive cells and lowering the levels of inflammatory factors IL-6 and TNF-α. The above results demonstrate that HA-DOPE as a drug delivery carrier for the treatment of psoriasis-like skin diseases has high value of scientific research and good prospects for clinical application.

We report a case of fetal diencephalic-mesencephalic junction dysplasia (DMJD) diagnosed prenatally. Prenatal ultrasound at 24 gestational weeks showed that the fetus was small, about the size at 22 weeks' gestation, with short biparietal diameter and enhanced echo at the anterior border of thalamus. Fetal MRI showed short T2 signal shadow in the left choroid plexus, and hemorrhage and midbrain dysplasia were suspected. A pathogenic homozygous mutation variant in protocadherins 12 gene (c.1558C>T) was found in this fetus by whole exome sequencing and both parents carried the same heterozygous variation revealed by Sanger sequencing. All of the above information lead to the diagnosis of fetal DMJD, and the pregnancy was terminated after genetic counseling.

Objective:To investigate the clinical features and characteristics of gene mutation of patients with neurodevelopmental disorder caused by CTNNB1 gene. Method:Genetic mutation analysis of the patients were obtained by using the whole exome sequencing and Sanger sequencing. We reviewed the literatures for the clinical and genetic features of CTNNB1 related neurodevelopmental disorder. Results:Six inpatients, three boys and three girls, who came for speech impairment motor delay were included in this study. The average age for the patients was 17.8±11.1 months. The main clinical manifestations of the patients were craniofacial dysmorphism, microcephaly, hypertonia or spasm, speech impairment motor delay, esotropia and valgus. WES showed that 6 patients carried de novo mutations of CTNNB1 gene, which were c.1057delA, c.1493_1494insA, c.418_424del, c.1985_1988del, c.1420C>T and c.1550T>C. No abnormality was found in the patients′ parents. Conclusions:The clinical manifestation of CTNNB1 related neurodevelopmental disorder involves multiple systems. We found five unreported variants and expanded the variation spectrum of the CTNNB1 gene.

Objective:To explore the safety and reliability of retrosigmoid approach BONEBRIDGE implantation in patients with auricle reconstruction using skin expansion flap.Methods:A retrospective analysis was conducted on 43 congenital aural atresia cases (43 ears) who underwent BONEBRIDGE implantation from September 2019 to January 2023 in Beijing Tongren Hospital. 30 males and 13 females were included in this work. The implantation age was 9-36 years old (median age=10 y/o). All cases underwent auricle reconstruction surgery using the posterior ear flap expansion method, with 36 cases using the single expanded postauricular flap method and 7 cases using two-flap method. BONEBRIDGE implant surgery was performed during the third stage of auricle reconstruction or after all stages. The hearing improvements were evaluated by comparing the changes in pure tone hearing threshold and speech recognition rate of patients before and after BONEBRIDGE implantation. Routine follow-up was conducted to observe the hearing results and complications. SPSS 14.0 software was applied for data statistical analysis.Results:All 43 patients healed well and had no surgical complications when discharge. The average bone conduction hearing threshold after surgery was (8.2±6.6) dBHL, and there was no statistically significant difference compared to the preoperative [(8.1±5.7) dBHL] ( P=0.95). After surgery, the threshold of hearing assistance with power on was significantly lower than that without hearing assistance [(32.8±4.6) dBHL vs (60.5±5.5) dBHL], and the difference was statistically significant ( P<0.001). The speech recognition rate of monosyllable words, disyllabic words and short sentences in quiet environment increased to 72%, 84%, and 98% respectively. The differences were statistically significant ( P<0.001). The speech recognition rate of monosyllabic words, disyllabic words, and short sentences in noise environment was significantly increased by 70%, 80%, and 92% respectively ( P<0.001). After a follow-up of 4 to 47 months (median=24 months), the hearing results were stable and the aesthetic outcomes were satisfying. One patient had delayed hematoma around coil of the implant. After aspiration and compressed dressing for one week, hematoma was not recurrent. Conclusion:For patients after auricle reconstruction using expanded postauricular flap, the preference of retrosigmoid approach is a good choice in terms of safety and reliability of operation, as well as aesthetic appearance.

The patient in this study was a 3 years 8 month old boy. The patient presented with facial dysmorphism including wide eye distance and flat nose. The major clinical manifestations were poor response, backward language and motor development; and his fingers cannot be bent. Moreover, the patient′s hands were also uncoordinated. In addition the patient suffered from congenital myopia and nystagmus; and the teeth were fall off easily. The abnormal reproductive system was characterized by small penis and small testicle. No obvious abnormality was found in liver and kidney function and serum immunoglobulin level through laboratory biochemical test. The results of the spine X-Ray examination indicates scoliosis. Results from brain MRI showed cerebellar dysplasia. Compound heterozygous variants in COG5 gene (c.1039C>T and c.928+3A>G), each inheranted from his parents were found in this patient by high-throughput sequencing and Sanger sequencing. After a clear diagnosis, the patient received language rehabilitation training and motor rehabilitation training. In this study, we found two new variants in COG5 gene and increased the mutation spectrum of this gene.

Objective: To discuss the safety and efficacy of simultaneous procedures of vibrant soundbridge implantation and auricular reconstruction with congenital external and middle ear malformation. Methods: This is a retrospective study, including 6 patients, 5 boys and 1 girl, aged 7-12 years. All patients received simultaneous operations of vibrant soundbridge implantation and auricular reconstruction. The mean preoperative air conduction threshold was 64.8 dB HL at 0.5, 1, 2, and 4 kHz. The VSB was placed in the third stage of auricle reconstruction, if the soft tissue expansion was performed; otherwise, the VSB was implanted in the second stage. The satisfaction with reconstructed auricle, surgical complications, hearing improvement and speech discrimination scores were evaluated 6 months after surgery. Results: All patients and their families reported satisfaction with their reconstructed auricle. There was no complications, including cartilage framework exposion, infection, hematoma, skin flap necrosis, facial paralysis, tinnitus, vertigo or others. Post-operatively, mean VSB-aided hearing threshold was 36.7 dB HL, which was reduced by 28.1 dB HL. The mean speech discrimination scores measured in a sound field with a presentation level of 65 dB SPL and 80 dB SPL were improved. Conclusions The simultaneous operations of auricle reconstruction and Vibrant Soundbridge implantation is an alternative method for patients with congenital microtia and atresia.

Objective To investigate clinical features of Peutz-Jeghers syndrome(PJS)and genetic change in STK11. Methods Clinical data and genetic change in STK11 gene of four PJS children were retrospectively analyzed.Results Four patients have hyperpigmentation on their lips, buccal mucosa or fingers. Intestinal polyposis was found at different locations of gastrointestinal tract. Polypectomy was performed in four patients and pathological section displayed the muscle fibers of the muscularis mucosae form a dendritic structure. And we found 4 heterozygous mutations (c.582C>A,c.580G>A,c.719C>G and c.879insA)on STK11 gene in these patients.Conclusions The PJS patients have typical clinical features;gene detection is helpful to early diagnosis,and we found a novel mutation(c.879insA) in STK11 gene.

Objective: To evaluate the impact of CO₂ pneumoperitoneum in operating rooms on the health of medical staffs. Methods: In June 2016, the thirty-three medical staffs in operating rooms were chosen as the object of the research.Seventeen people who took part in the pneumoperitoneum operation were selected as a exposure group and sixteen people who took part in the laparotomy operation were selected as a control group.Vital signs and arterial blood gases of medical staffs in the two groups were both measured in pre-operation and post-operation. Occupational Health Questionnaires were conducted to collect information on age, weight and postoperative symptoms. The level of CO₂ in operating room was determined by a portable infrared CO₂ analyzer. Results: Compared with the control group, the concentration of CO₂ in the exposed group was higherat T₁, T₂ and T₃ (t=22.227, 13.583, 17.408, P<0.05) . Heart rates and PaCO₂ in the exposure group raised greatly (t=2.132, 2.129, P<0.05) , while pH decreased (t=-3.015, P<0.05) . The differences between the two groups were statistically significant. Conclusion The increase of mild acidosis and thesense of job burnout in medical staffs could be caused by CO₂ pollution in the operating rooms.