The number of female patients undergoing genital cosmetic procedures has gradually increased in recent years due to the growing awareness of sexual culture and evolving aesthetic preferences. By surgical modification of the clitoral hood and labia minora, psychological issues can be positively impacted, in addition to improving function. However, there is a lack of systematic evaluation in China regarding changes in female sexual function following labiaplasty and clitoral hoodoplasty, particularly in the investigation of sexual sensitivity. This article explores the role of the labia minora and clitoral anatomy in sexual arousal and erection and summarizes methods for measuring and assessing sexual sensitivity. The aim is to provide a reference for the evaluation of related sexual functions and psychological changes after female genital cosmetic procedures.

Objective:To analyze the risk factors for prolonged hospital stay in inpatients based on data from nutritionDay worldwide survey 2020 to 2022 conducted in China and to construct and validate a prediction model for clinical decision-making.Methods:This study was a retrospective study, the data source was the China's multi-centered nutritionalDay worldwide database for nutrition status in inpatients. A total of 2 335 cases registered in the database from 2020 to 2022 were selected for the study, comprising individuals aged 18 and above, with valid response for the 30-day prognosis questionnaires, and with complete clinical data. The demographic characteristics, nutrition-related indicators, disease information, and outcome indicators of the participants were collected. Based on the 75th percentile of hospitalization duration, the participants were divided into the prolonged length of stay group (570 cases) and the normal length of stay group (1 765 cases). A nomogram prediction model was constructed using the least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate Logistic regression analysis. Area under the curve ( AUC), calibration curve, Hosmer-Lemeshow test, and clinical decision curve were used to verify discriminative ability, goodness-of-fit, and clinical effectiveness of the model. Results:Seven independent risk factors for prolonged length of stay were identified, namely body mass index (BMI), whether surgery occurred during hospitalization, intensive care unit admission during hospitalization, Nutrition Risk Screening 2002 score, ambulatory independence, previous hospitalization frequency, and weight loss in the past 3 months. A nomogram prediction model was established accordingly. The AUC of training set was 0.783 (95% CI: 0.759 - 0.807), and the AUC of validation set was 0.797 (95% CI: 0.746 - 0.849). Calibration curves and Hosmer-Lemeshow tests ( P=0.735 for training set, P=0.431 for validation set) indicated good model fitting. The clinical decision curve demonstrated the favorable clinical utility of the nomogram. Conclusions:BMI, whether they had surgery during hospitalization, whether they were admitted to the ICU during hospitalization, NRS 2002 score, whether they were able to walk independently, number of previous hospitalizations, and weight loss in the past 3 months were risk factors for longer stay in Chinese hospitalized patients. The nomogram prediction model developed in this study can forecast the risk of prolonged length of stay among Chinese inpatients, providing a basis for early identification and intervenion in high-risk patients.

Objective:To analyze the risk factors for prolonged hospital stay in inpatients based on data from nutritionDay worldwide survey 2020 to 2022 conducted in China and to construct and validate a prediction model for clinical decision-making.Methods:This study was a retrospective study, the data source was the China's multi-centered nutritionalDay worldwide database for nutrition status in inpatients. A total of 2 335 cases registered in the database from 2020 to 2022 were selected for the study, comprising individuals aged 18 and above, with valid response for the 30-day prognosis questionnaires, and with complete clinical data. The demographic characteristics, nutrition-related indicators, disease information, and outcome indicators of the participants were collected. Based on the 75th percentile of hospitalization duration, the participants were divided into the prolonged length of stay group (570 cases) and the normal length of stay group (1 765 cases). A nomogram prediction model was constructed using the least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate Logistic regression analysis. Area under the curve ( AUC), calibration curve, Hosmer-Lemeshow test, and clinical decision curve were used to verify discriminative ability, goodness-of-fit, and clinical effectiveness of the model. Results:Seven independent risk factors for prolonged length of stay were identified, namely body mass index (BMI), whether surgery occurred during hospitalization, intensive care unit admission during hospitalization, Nutrition Risk Screening 2002 score, ambulatory independence, previous hospitalization frequency, and weight loss in the past 3 months. A nomogram prediction model was established accordingly. The AUC of training set was 0.783 (95% CI: 0.759 - 0.807), and the AUC of validation set was 0.797 (95% CI: 0.746 - 0.849). Calibration curves and Hosmer-Lemeshow tests ( P=0.735 for training set, P=0.431 for validation set) indicated good model fitting. The clinical decision curve demonstrated the favorable clinical utility of the nomogram. Conclusions:BMI, whether they had surgery during hospitalization, whether they were admitted to the ICU during hospitalization, NRS 2002 score, whether they were able to walk independently, number of previous hospitalizations, and weight loss in the past 3 months were risk factors for longer stay in Chinese hospitalized patients. The nomogram prediction model developed in this study can forecast the risk of prolonged length of stay among Chinese inpatients, providing a basis for early identification and intervenion in high-risk patients.

The number of female patients undergoing genital cosmetic procedures has gradually increased in recent years due to the growing awareness of sexual culture and evolving aesthetic preferences. By surgical modification of the clitoral hood and labia minora, psychological issues can be positively impacted, in addition to improving function. However, there is a lack of systematic evaluation in China regarding changes in female sexual function following labiaplasty and clitoral hoodoplasty, particularly in the investigation of sexual sensitivity. This article explores the role of the labia minora and clitoral anatomy in sexual arousal and erection and summarizes methods for measuring and assessing sexual sensitivity. The aim is to provide a reference for the evaluation of related sexual functions and psychological changes after female genital cosmetic procedures.

Objective:To develop evidence-based postoperative nausea and vomiting (PONV) management program, so as to provide a reference for standardizing PONV management in Anesthesiology Department and reduce PONV incidence and severity of patients.Methods:From January to November 2021, based on the evidence clinical transformation model chart, the PONV management program in Anesthesiology Department was developed through evidence retrieval, quality evaluation, evidence summary, obstacle factor analysis and other methods, and 2 rounds of clinical practice reform were carried out. The implementation of quality review indicators of medical staff and the incidence of postoperative nausea, postoperative vomiting and PONV of patients and severity of postoperative nausea, postoperative vomiting were evaluated.Results:At baseline, after the first review and the second review, the implementation rate of quality review indicators of medical staff gradually increased, and the differences were statistically significant ( P<0.05) . After the second review, the incidence of postoperative nausea, postoperative vomiting and PONV and severity of postoperative nausea, postoperative vomiting decreased compared with the first review, and the differences were statistically significant ( P<0.05) . Conclusions:Evidence-based PONV management program can standardize the PONV management behavior of anesthesiology medical staff, reduce the incidence of postoperative nausea, postoperative vomiting and PONV and severity of postoperative nausea, postoperative vomiting, and improve the quality of PONV management.

Correspondinga uthor:Wan Chun, Email:mdchunwan@163.com
[Absrt act] Obj ective To summarize the clinical experience with isolated complete resection of he-patic caudate lobe in 14 patients. Mte hods The clinical data of 14patients with isolated complete resection of hepatic caudate lobe carried out in our hospital from December 2007 to March 2015 were retrospectively analyzed .During the operation , selective hepatic vascular occlusion slings , and supra-and infra-hepatic in-ferior vena cava slings were placed after full mobilization of the liver .Isolated complete resection of the he-patic caudate lobe was performed through the left and /or the right , the anterior liver-splitting or the retro-grade approaches .Results The mean operation time was (227 ±64) min.The mean amount of blood loss was (530 ±325) ml.The mean vascular occlusion time was (19.5 ±18.6) min.The mean diameter of ne-oplasm was (15 4.±9 .2) cm. All the operations were successfully carried out .There were no massive hem-orrhage, bile leakage or perioperative death .Hydrothorax occurred in 3 patients and ascites in 2.The mean stay in hospital was (21 ±9) days.All the patients were cured and discharged home .Conclusion Isolated complete resection of hepatic caudate lobe was feasible in clinical practice .

Objective To evaluate the safety of mesohepatectomy for centrally located large hepatic tumors.Methods The clinical data of 37 patients who underwent hepatectomy for centrally located large liver tumors in our hospital from October 2010 to August 2015 were retrospectively analyzed.During the operation,the left and right hemilivers were mobilized.Slings for the improved liver hanging maneuver and for selective hepatic vascular occlusion were placed.These slings were used when necessary in order to minimize occlusion and ischemia time to the residual liver,and to maximize the volume of functional liver remnant.Mesohepatectomy was carried out using a microwave hemostatic separator.The feasibility,its effects on preventing hemorrhage,the degree of liver damage and the postoperative complications were evaluated.Results The mean diameter of the neoplasms was (12.6 ± 7.2) cm.The vascular inflow occlusion time of the left and right hemilivers were (12.2 ±3.5) min and (18.5 ±7.1) min,respectively.The blood loss was (487 ± 352) ml.The amount of red blood cell transfusion was (2.7 ± 1.9) U.The operation time was (215 ± 72) min.TBIL,ALT and AST reached their peak levels on the 1 st day after operation and they were higher than before surgery (P ＜ 0.01).The levels were then significantly decreased on the 3rd day after operation.However,the TBIL (P ＜ 0.05),ALT (P ＜ 0.01) and AST (P ＜ 0.05) were higher than the preoperative level,and only returned to normal or were close to the preoperative value on the 7th day after operation (P ＞ 0.05).The initial increase in ALT was quick and then it slowed down,while the initial increase in AST was slow but it decreased quickly.Conclusions Mesohepatectomy for centrally located large hepatic tumors could safely be carried out using the liver hanging maneuver combined with selective hepatic vascular occlusion and a microwave hemostatic separator.This method has the advantages of causing less bleeding,liver damage and rapid recovery.