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 investigate the effects of peiminine B （PEI） on Streptococcus pneumoniae （SP）-induced alveolar epithelial cell injury by regulating the Ras-related C3 botulinum toxin substrate 1 in nucleus accumbens （Rac1）/protein kinase B （Akt）/nuclear factor κB （NF-κB） signaling pathway. METHODS Human alveolar epithelial cells （HPAEpiC） were taken and randomly divided into the Control group， SP group （1×108 cfu/mL SP bacterial solution）， low-， medium-， and high-concentration PEI groups （1×108 cfu/mL SP bacterial solution+0.05， 0.10， 0.20 mmol/L PEI）， and high-concentration PEI+Akt activator group （P-H+SC79 group， 1×108 cfu/mL SP bacterial solution+0.20 mmol/L PEI+10 μmol/L SC79）. Except for the Control group， the other groups of cells were treated with SP bacterial solution and/or corresponding drug solution. After 24 h of treatment， the levels of inflammatory factors （interleukin-6， -18， -1β） in the supernatant solution， the contents of oxidative stress indexes [lactate dehydrogenase （LDH）， reactive oxygen species （ROS） and superoxide dismutase （SOD）]， apoptosis rate， as well as the expressions of proliferation/apoptosis-related proteins [cyclin-dependent kinase 1 （CDK1）， B cell lymphoma-2 related X protein （Bax）] and pathway-related proteins （Rac1， Akt， phosphorylated Akt， NF-κB and phosphorylated NF-κB） were detected in each group. RESULTS Compared with the Control group， the levels of inflammatory factors in supernatant solution， LDH and ROS contents， apoptosis rate， the protein expressions of Bax and Rac1 and the phosphorylation levels of Akt and NF-κB in the SP group were significantly increased or up-regulated， while SOD content and the protein expression of CDK1 were significantly decreased or down-regulated （P＜0.05）. Compared with the SP group， the above indexes in PEI groups were significantly improved in a concentration-dependent manner （P＜0.05）. SC79 could significantly reverse the improvement effect of the high concentration of PEI （P＜0.05）. CONCLUSIONS PEI can alleviate SP-induced inflammation and oxidative stress damage of alveolar epithelial cells and inhibit apoptosis， which may be achieved by inhibiting Rac1/Akt/NF-κB signaling pathway.

OBJECTIVE To provide technical support for improving recognition rate of adverse drug events （ADEs） related to traditional Chinese medicine （TCM） formula granules and decoction pieces among inpatient patients. METHODS By referencing the global trigger tool （GTT） whitepaper， literature on adverse reactions to TCM， and expert review opinions， ADE trigger items for TCM formula granules and decoction pieces used in the inpatients were established. GTT was applied to analyze ADEs in inpatients who had used TCM formula granules and decoction pieces in our hospital from August 2013 to August 2023， utilizing the Chinese Hospital Pharmacovigilance System. The effectiveness of GTT and the characteristics of these ADEs were analyzed. RESULTS A total of forty-eight triggers were established， including thirty-two laboratory test indexes， thirteen clinical symptoms， and three antidotes. Among the 1 682 patients included， GTT identified 652 potential ADEs， 284 true positive ADEs，with a trigger rate of 38.76% and a positive predictive value of 43.56%. After review by the auditor， 278 cases of ADEs were finally confirmed， with an incidence rate of 16.53%， significantly higher than the number of spontaneously reported ADEs during the same period （0）. The 278 cases of ADEs were mostly grade 1 （223 cases）， mainly involving hepatobiliary system， gastrointestinal system， blood- lymphatic system， etc；a total of 219 types of TCMs are involved，and the top five suspected TCMs used at a frequency higher than 1% were Poria cocos， Codonopsis pilosula， Atractylodes macrocephala， fried Glycyrrhiza uralensis， and Scutellaria baicalensis. CONCLUSIONS The established GTT can improve the recognition rate of ADEs for hospitalized patients using traditional Chinese medicine formula granules and decoction pieces.

Tracheobronchial adenoid cystic carcinoma （TACC） is a low-grade malignant tumor originating from the airway mucosa. Despite its slow progression，it is characterized by high invasiveness，frequent recurrence，and a strong tendency for metastasis. Preclinical studies have shown that vascular-targeted therapy holds significant potential. However，an effective systemic treatment for TACC has not been established yet. This study explored TACC from the perspective of "Feiji" in traditional Chinese medicine （TCM） as the starting point. It deeply investigated the mechanisms of abnormal collaterals and tumor vascular recruitment and further elaborated on the theoretical connection between abnormal collaterals and tumor vascular recruitment. Firstly，collateral hyperactivity led to disordered and erratic pulmonary collaterals. Their abnormal structures were similar to the disorderly and tortuous nature of tumor （pseudo）angiogenesis. This resulted in imbalances in the functions of circulation，perfusion，and reverse injection of the pulmonary collaterals，and then led to unrestrained collateral dysfunction and the accumulation of pathogenic factors. Secondly，the remodeling of the extracellular matrix （ECM） and epithelial-mesenchymal transition （EMT） in TACC were critical processes in vascular co-option （VCO），representing the micro-level manifestation of the displacement of nutrient and defense. During this process，ECM remodeling made TACC cells more likely to hijack normal blood vessels，creating a complex vascular microenvironment conducive to tumor growth. In terms of treatment，this study proposed a TCM strategy of "regulating collaterals to expel pathogenic factors and nourishing collaterals to strengthen the healthy Qi"，and listed potential TCM. These were intended to regulate the Qi and blood in the collaterals，repair the functions of abnormal collaterals，and intervene in the vascular recruitment process of TACC. Future research should focus on improving the TCM clinical syndrome characteristics of TACC. Through modern molecular biology techniques，it is necessary to deeply analyze the micro-level pattern of vascular recruitment in TACC. This would enrich the understanding of the profound connection between abnormal collaterals and tumor vascular recruitment，providing empirical evidence for TCM-targeted therapies for vascular recruitment in TACC.

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 explore the causal relationship between air pollution and the risk of Alzheimer's disease(AD)by using two-sample Mendelian randomization(MR).Methods·Based on the data from the genome-wide association study(GWAS),a two-sample MR analysis was conducted to evaluate the causal relationship between air pollution and the risk of AD.Air pollution indicators,including particulate matter 2.5(PM2.5),particulate matter 2.5-10(PM2.5-10),particulate matter 10(PM10),nitrogen dioxide and nitrogen oxides,were used as exposure factors,and summarized data were aggregated from the UK Biobank database.The PM2.5 dataset included 423 796 cases,with correlation analysis conducted on 9 851 867 single nucleotide polymorphisms(SNPs);the PM2.5-10 dataset included 423 796 cases,with correlation analysis conducted on 9 851 867 SNPs;the PM10 dataset included 455 314 cases,with correlation analysis conducted on 9 851 867 SNPs;the nitrogen dioxide dataset included 456 380 cases,with correlation analysis conducted on 9 851 867 SNPs;the nitrogen oxides dataset included 456 380 cases,with correlation analysis conducted on 9 851 867 SNPs.AD was used as the outcome factor,and data were obtained from the International Genomics of Alzheimer's Project(IGAP).The AD dataset included 25 580 cases and 48 466 controls,with correlation analysis of 7 067 513 SNPs.SNPs significantly associated with AD were used as instrumental variables.The main analysis was conducted by using the inverse variance weighted(IVW)method,and four methods including weighted median,MR-Egger regression,mode-based simple estimation and mode-based weighted estimation were used for quality control.Heterogeneity testing,gene pleiotropy testing and sensitivity analysis were conducted to assess the reliability of the study results.Results·Heterogeneity testing indicated no evidence of heterogeneity among SNPs associated with air pollution indicators and AD(both IVW and MR-Egger results,P＞0.05).Gene pleiotropy testing did not detect any pleiotropic effects(MR-Egger results,P＞0.05).Sensitivity analysis confirmed the stability of the PM2.5 results.IVW analysis revealed a statistically significant association between PM2.5 and AD in European populations(P＜0.001),while no statistically significant associations were observed between PM2.5-10(P=0.664),PM10(P=0.664),nitrogen dioxide(P=0.284),nitrogen oxides(P=0.567)and AD.Conclusion·There is a significant causal relationship between PM2.5 exposure and the risk of AD,with PM2.5 exposure increasing the incidence of AD.However,no evidence has been found to suggest that PM2.5-10,PM10,nitrogen dioxide or nitrogen oxides cause an increased risk of AD.

Objective:To analyze the current status, influencing factors and action pathways of quality of life in patients with cardiovascular disease.Methods:From July 2023 to June 2024, a convenience sampling method was used to obtain 2 702 patients with cardiovascular disease from 9 hospitals in Guangxi Zhuang Autonomous Region.The general information questionnaires, item short form health survey, self-rating depression scale, self-rating anxiety scale, type D personality scale-14, and type A behavior pattern scale were used for investigation.SPSS 26.0 and AMOS 24.0 softwares were used for data statistical analysis.The current status of quality of life were analyzed through descriptive statistics, the influencing factors of quality of life were analyzed using multiple linear regression analysis models, and the relationship between statistical variables was analyzed through paths.Results:The overall quality of life score of patients with cardiovascular disease was (59.29±17.59).Compared with the domestic normal population norm, the 8 factors had statistically significant differences ( t=16.50-44.16, all P<0.001).The results of multiple regression analysis showed that age, marital status, low per capita monthly income, lack of exercise, irregular daily life, poor appetite, unhealthy diet, poor sleep quality, hypertension, coronary heart disease, chronic heart failure, heart valve disease, multiple types of medication taken daily, anxiety level, depression level, type D personality, and type A personality all had negative predictive effects on quality of life ( B=-0.862--0.205, all P<0.05).Demographic and life factors affected the quality of life through 4 paths, and their direct effect and indirect effect were -0.183, 0.224 respectively (there was a masking effect).Disease-related factors affected life through 2 paths, and its direct effect and indirect effect were -0.341, 0.255 respectively (there was a masking effect).Psychological factors directly and negatively affected the quality of life through one path, and its effect value was -0.651. Conclusion:The quality of life of patients with cardiovascular disease is generally at a moderate to low level.The factors that affect the quality of life of patients with cardiovascular disease produce effects through multiple pathways in a multi-combined state.

Objective To evaluate the sensitivity,repeatability,anti-degradation ability,in vivo temporal stability,and tissue specificity of the DNA methylation sequencing panel constructed in our previous study for height inference,so as to provide a reference for forensic application.Methods Sensitivity:different initial template quantities(50 ng,40 ng,30 ng,20 ng)were set for sequencing.Repeatability:DNA from the same sample was sequenced three times.Anti-degradation ability:whole blood was used to make blood stains,and DNA was extracted and sequenced at 0,3,6 and 9 months,respectively.In vivo temporal stability:the blood was collected at 0,3,6,and 9 months for sequencing.Tissue specificities:published data and findings were used to analyze the tissue specificities of CpGs in the panel.Results The sensitivity test showed that the initial template quantities of 20 ng detected all the CpG sites and still obtained accurate prediction results.The results of the three repeated predictions of the same sample are stable,and the differences are mainly due to the randomness of the DNN model,indicating good detection repeatability.A complete methylation profile was obtained for the blood stains left at room temperature for 9 months,and the predicted results showed a small range of fluctuations.The three samples were predicted to fluctuate within a range of 1.5 cm or less over nine months.Tissue-specific analyses showed a high correlation between blood and saliva,but can not apply to other tissues.Conclusion The DNA methylation detection system we developed in our previous study has good sensitivity,repeatability,anti degradation ability,in vivo time stability,as well as strong tissue specificity,making it suitable for height inference of blood samples.This supports the feasibility of using targeted DNA methylation analysis on whole blood samples to infer height in the field of forensic science.

Objective To explore the ability of different regions of interest(ROI)location settings for the detection of bronchial artery and pulmonary vascular lesions in children with hemoptysis via computed tomography angiography(CTA)examination.Methods The hemoptysis group(79 cases)who underwent chest CTA examination and the control group(79 cases)with negative CTA results were retrospectively selected.The ROI of the hemoptysis group were placed in the pulmonary trunk,left ventricle,ascending aorta and descending aorta,which were defined as groups 1,2,3 and 4 respectively.Clinical data(age,sex)and CT parameters,including bronchial artery diameter,ascending aorta CT value,pulmonary artery CT value,△CTA-PA,bronchial artery image score,pulmonary artery image score,were recorded and analyzed,respectively.Results There was a statistically significant difference in the diameter of the left and right bronchial arteries between the hemoptysis group and the control group(P＜0.05).In the hemoptysis group,there were statistically significant differences in the image scores of the left and right bronchial arteries,pulmonary artery image scores,and△CTA-PA among the four subgroups(P＜0.05).According to post-hoc comparison results,there was a statistically significant difference in the overall mean scores of the right bronchial artery image score(x2=11.333,P＜0.05)and left bronchial artery image score(x2=8.111,P＜0.05)between groups 2 and 3.Conclusion When ROI is placed in the ascending aorta,bronchial artery lesions and pulmonary vascular lesions can be detected simultaneously in CTA examination,which is helpful for the diagnosis of hemoptysis vascular etiology in children.

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.