Objective:To compare the outcomes of simple hysterectomy(SH)and radical hysterectomy(RH)in elderly patients with cervical cancer.Methods:A retrospective cohort study was conducted, including 633 elderly patients with cervical cancer who underwent surgical treatment at Shangqiu First People's Hospital from January 2016 to December 2020.Among them, 247 patients underwent SH, and 215 patients underwent RH.Propensity score matching was applied, resulting in two groups: 125 patients in the SH group and 124 patients in the RH group.The primary outcome was the pelvic recurrence rate at 2 years of follow-up.Secondary outcomes included the incidence of urinary incontinence and urinary retention.Kaplan-Meier survival analysis was used to compare the recurrence rates between the two groups, and a Cox proportional hazards regression model was used to analyze the factors influencing recurrence rates.Results:After matching, the baseline characteristics of the two groups were similar and comparable(all P>0.05).Kaplan-Meier results showed that, although the pelvic recurrence rate in the SH group was higher than that in the RH group before matching(4.5% vs.2.3%, P<0.05), the pelvic recurrence rates were similar between the two groups after matching(3.2% vs.2.4%, P>0.05).The SH group had significantly lower postoperative complications, including urinary retention(1.6% vs.8.1%, P<0.05), compared to the RH group, while there was no significant difference in the incidence of urinary incontinence(4.0% vs.9.7%)and the risk of cervical cancer-related death(1.6% vs.0.8%)between the two groups( P>0.05).Multivariate Cox regression analysis showed that age( HR=1.254), tumor grade( HR=1.315), and FIGO stage( HR=1.203)were important factors influencing pelvic tumor recurrence during follow-up(all P<0.05). Conclusions:elderly patients with low-risk cervical cancer, the 2-year pelvic recurrence rates for SH and RH are similar.However, SH is associated with a lower risk of urinary incontinence and urinary retention.

Objective:To evaluate the correlation between preoperative platelet function and in-hospital mortality in patients with acute Stanford A aortic dissection(ATAAD) undergoing emergency surgery.Methods:ATAAD emergency surgical patients who underwent preoperative thromboelastography(TEG) examination at three cardiovascular disease hospitals from January 2018 to December 2023 were consecutively selected in this study. The patients were divided into two groups according to whether the patient survived to discharge.Results:867 patients were included in this study. The in-hospital mortality was 11.2%(97 cases). Compared with the DG group(97 cases), the age, pericardial effusion volume, lactate concentration, and MA value of patients in the SG group(770 cases) were higher( P<0.001). Factors independently associated with in-hospital mortality were age(>60 years old), coronary hypoperfusion, pericardial effusion volume(>200.00 ml), and MA value(<60.6 mm). There was a correlation between MA value and in-hospital mortality( P=0.012), and the mediating effect between MA value and platelet count was not significant. Conclusion:There is a correlation between preoperative platelet function and in-hospital in ATAAD patients, and improving platelet function may be one of the important ways to improve the clinical prognosis of those patients.

Objective To evaluate the clinical efficacy of platelet-rich plasma(PRP)in treat-ment of diabetic foot ulcers(DFU)using a meta-analysis approach.Methods Relevant literature on PRP for treatment of DFU was collected by searching databases including PubMed,Cochrane Library,Embase,Web of Science,NEJM,CNKI,Wanfang Data,VIP Database,and China Biology Medicine disc.Relevant literature on PRP for treatment of DFU was collected.The literature was read,and effect sizes were extracted.The extracted data were then subjected to a meta-analysis using RevMan 5.3 software.Results A total of 6 studies were included in this meta-analysis,involving 440 pa-tients.Among them,there were 208 patients in experimental group(PRP combined with conventional treatment)and 232 patients in control group(conventional treatment,blank control,or placebo treat-ment).The ulcer healing efficacy rate in the experimental group was higher than that in the control group(OR=1.29,95％CI,1.19 to 1.40,P＜0.05).The incidence of adverse reactions in the experimental group was lower than that in the control group(OR=0.33,95％CI,0.12 to 0.93,P=0.94).The healing time(MD=-14.37,95％CI,-23.12 to-5.62,P=0.001),thickness of granulation tissue on the ulcer surface(MD=1.60,95％CI,1.31-1.88,P＜0.000 01),coverage rate of granulation tissue on ulcer surface(MD=6.03,95％CI,3.79 to 8.26,P＜0.05),and level of vascular endothelial growth factor on the ulcer surface(MD=7.62,95％CI,1.57 to 13.67,P=0.01)in the experimental group were all superior to those in the control group.Con-clusion PRP treatment for DFU has the advantages of improving the ulcer healing efficacy rate,shortening the ulcer healing time,promoting the growth of granulation tissue on the ulcer surface,and reducing the incidence of adverse reactions.

Objective:To compare the outcomes of simple hysterectomy(SH)and radical hysterectomy(RH)in elderly patients with cervical cancer.Methods:A retrospective cohort study was conducted, including 633 elderly patients with cervical cancer who underwent surgical treatment at Shangqiu First People's Hospital from January 2016 to December 2020.Among them, 247 patients underwent SH, and 215 patients underwent RH.Propensity score matching was applied, resulting in two groups: 125 patients in the SH group and 124 patients in the RH group.The primary outcome was the pelvic recurrence rate at 2 years of follow-up.Secondary outcomes included the incidence of urinary incontinence and urinary retention.Kaplan-Meier survival analysis was used to compare the recurrence rates between the two groups, and a Cox proportional hazards regression model was used to analyze the factors influencing recurrence rates.Results:After matching, the baseline characteristics of the two groups were similar and comparable(all P>0.05).Kaplan-Meier results showed that, although the pelvic recurrence rate in the SH group was higher than that in the RH group before matching(4.5% vs.2.3%, P<0.05), the pelvic recurrence rates were similar between the two groups after matching(3.2% vs.2.4%, P>0.05).The SH group had significantly lower postoperative complications, including urinary retention(1.6% vs.8.1%, P<0.05), compared to the RH group, while there was no significant difference in the incidence of urinary incontinence(4.0% vs.9.7%)and the risk of cervical cancer-related death(1.6% vs.0.8%)between the two groups( P>0.05).Multivariate Cox regression analysis showed that age( HR=1.254), tumor grade( HR=1.315), and FIGO stage( HR=1.203)were important factors influencing pelvic tumor recurrence during follow-up(all P<0.05). Conclusions:elderly patients with low-risk cervical cancer, the 2-year pelvic recurrence rates for SH and RH are similar.However, SH is associated with a lower risk of urinary incontinence and urinary retention.

Objective:To evaluate the correlation between preoperative platelet function and in-hospital mortality in patients with acute Stanford A aortic dissection(ATAAD) undergoing emergency surgery.Methods:ATAAD emergency surgical patients who underwent preoperative thromboelastography(TEG) examination at three cardiovascular disease hospitals from January 2018 to December 2023 were consecutively selected in this study. The patients were divided into two groups according to whether the patient survived to discharge.Results:867 patients were included in this study. The in-hospital mortality was 11.2%(97 cases). Compared with the DG group(97 cases), the age, pericardial effusion volume, lactate concentration, and MA value of patients in the SG group(770 cases) were higher( P<0.001). Factors independently associated with in-hospital mortality were age(>60 years old), coronary hypoperfusion, pericardial effusion volume(>200.00 ml), and MA value(<60.6 mm). There was a correlation between MA value and in-hospital mortality( P=0.012), and the mediating effect between MA value and platelet count was not significant. Conclusion:There is a correlation between preoperative platelet function and in-hospital in ATAAD patients, and improving platelet function may be one of the important ways to improve the clinical prognosis of those patients.

Objective: To understand mental health status of middle school students in Weifang, and to analyze its association with health risk behaviors, and to provide a reference basis for the effective prevention of mental health problems. Methods: Using the self-designed questionnaire and Kessler l0 (K10), a total of 3 185 middle school students in Weifang selected by using stratified clustered sampling were investigated. Chi-square test and binary Logistic regression was used for statistical analysis. Results: Among the middle school students in Weifang, 1 634(51.3%) reported good mental health, 854(26.8%) in moderate level, 394(12.4%) reported poor mental health, and 303(9.5%) reported very poor mental health. Sleep duration and smoking were associated with mental health of middle school students (P<0.05). Logistic regression analyses showed that, compared with adolescents with sleep duration less than 8 h, mental health among students whose sleep duration ≥8 h was better(OR=0.36); compared with non-smokers, students who smoked showed worse mental health status (OR=3.53). Conclusion Health-risk behaviors are closely related to mental health of middle school students. Relevant departments should strengthen education and publicity of healthy lifestyles, and pay close attention to the impact of health risk behaviors on mental health.

Objective:To investigate the safety and the efficacy of percutaneous and surgical approach in femoro-femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) cannulation.Methods:All consecutive patients implanted with femoro-femoral VA-ECMO between January 2018 and December 2020 in Beijing Anzhen Hospital, Capital Medical University. Propensity score matching was used to compare outcomes of percutaneous and surgical groups while controlling for confounders.Results:Among the 276 patients who received femoro-femoral VA-ECMO (62 surgical and 214 percutaneous), propensity-score matching selected 52 pairs of patients with similar characteristics with mean age of(59.6±13.0)years old, in which 26 patients were female. There were a lower ECMO cannulation-associated complication (28.8% vs. 48.1%, P=0.044) and a lower hospital mortality (42.3% vs. 67.3%, P=0.010) in the percutaneous group. The circuit blood flow after ECMO initiation was similar in both groups[(3.3±0.8)L·min -1·kg -1 in percutaneous group vs. (3.2±0.7)L·min -1·kg -1 in surgical group, P=0.738]. The serum lactate was declined in both group after ECMO initiation[(5.4±5.8)mmol/L vs. (9.2±6.9)mmol/L, P<0.001 in percutaneous group; (6.3±6.2)mmol/L vs. (10.5±7.0)mmol/L, P=0.003 in surgical group]. Conclusion:Percutaneous approach is a safe and efficient technique in emoro-femoral VA-ECMO cannulation. Compared with surgical cannulation, percutaneous approach is associated with lower ECMO cannulation-associated complication and lower hospital mortality.

Objective:To investigate the characteristics of consonant among children with speech sound disorder (SSD) and to provide an empirical basis for the subsequent clinical evaluation and evidence-based intervention.Methods:In this retrospective research a total of 1 395 children diagnosed with SSD from the Language-Speech Clinic of the Department of Children Health Care, Children′s Hospital, Capital Institute of Pediatrics from January 2007 to December 2018 were enrolled and underwent the phonological examination on the lexical level with picture naming, according to phoneme development in Chinese mandarin. The Chi-square trend test was applied to analyze the differences and trends of the proportion of consonant error subtypes in children of different age groups. The Chi-square test was conducted to compare the proportion of consonant error subtypes in different gender.Results:The 1 395 children diagnosed with SSD included 1 044 boys and 351 girls, with an age of (5.1±0.8) years. The occurrence of consonant errors in different locations of articulation was the highest for blade-alveolar /l/ (71.8%, 1 002/1 395) and the lowest for labial/b/(9.3%, 130/1 395). The occurrence of consonant errors of labial/p/f/, supra-dental/z/c/s/, blade-alveolar/t/l/, blade-palatal/ch/r/, velar/k/h/, and lingua-palatal/q/decreased with age (all P<0.05). The occurrence of consonant errors of labial/b/m/, supra-dental/z/c/, blade-alveolar/n/l/, blade-palatal/sh/, velar/h/, and lingua-palatal/x/were higher in boys than those in girls (10.3% (108/1 044) vs. 6.3% (22/351), 11.4% (119/1 044) vs. 6.0% (21/351), 64.8% (676/1 044) vs. 51.9% (182/351), 67.8% (708/1 044) vs. 59.8% (210/351), 16.7% (174/1 044) vs. 8.8% (31/351), 73.7% (769/1 044) vs. 66.1% (232/351), 58.0% (606/1 044) vs. 47.6% (167/351), 24.0% (251/1 044) vs. 14.2% (50/351), and 39.9% (417/1 044) vs. 27.6% (97/351); χ2 =5.167, 8.533, 16.889, 7.447, 12.863, 7.412, 11.650, 14.900, and 17.099, all P<0.05). The error types of consonant were substitution, omission, and distortion. Omission was the main error type of blade-alveolar/l/(53.3%, 743/1 395), distortion was the main error type of velar/h/(11.8%, 165/1 395), and substitution was the main error type of all other consonants. Substitution with blade-palatal/ch/having the highest occurrence of error (60.2%, 840/1 395). Conclusions:The occurrence of the blade-alveolar/l/error is the highest in children with SSD, with boys demonstrating more serious articulation problems. The main error type of consonant is substitution, with blade-palatal/ch/having the highest occurrence of error. These results suggest the necessity of attending to preschoolers′ articulation development. Phonological training targeting blade-alveolar/l/and blade-palatal/ch/should be carried out as early as possible.

Objective To investigate the incidence and risk factors of acute kidney injury(AKI) requiring continuous renal replacement treatment(CRRT) in patients with acute type A aortic dissection after Sun's operation.Methods A retrospective analysis of consecutive patients with acute type A aortic dissection underwent Sun's operation in Beijing Anzhen Hospital,Capital Medical University from January 2009 to December 2015.These patients were divided into two groups according to whether had severe postoperative AKI requiring CRRT treatment:the dialysis group(AG,65 cases) and the control group(CG,618 cases),we compared the clinical outcomes of patients in two groups and analyzed the related risk factors.Results 50 patients(7.3％) died in hospital.Compared with patients in CG group,patients in AG group had higher age,more patients with preoperative coronary heart disease,pericardial tamponade,and higher rates of intraoperative coronary artery hypass surgery or valve surgery,the results were statistically different between the two groups(P ＜0.05).The patients in AG group had a higher mortality rate in hospital(26.2％ vs.5.3％),and the difference was statistically significant(P ＜0.001).The results of multiple regression analysis suggested that the age ＞ 50 years,preoperative history of pericardial tamponade,intraoperative need for combined coronary artery bypass grafting or valve surgery,and cerebral perfusion time ＞40 min were independent risk factors for CRRT treatment of postoperative severe AKI(P ＜0.05).Conclusion The incidence of severe AKI requiring CRRT treatment in patients with acute type A aortic dissection after Sun's operation was 9.5％,and the discharge survival rate in AG group was lower than that in CG group.An important way to reduce the incidence of severe AKI requiring CRRT after sun's surgery is to shorten the intraoperative cerebral perfusion time as much as possible.

Objective:To investigate the clinical, pathological, and prognostic characteristics of luminal B breast cancer patients with diabetes. Methods:A total of 479 luminal B breast cancer patients with diabetes and 3 392 luminal B breast cancer patients without diabetes who were treated between January 2002 and December 2006 were enrolled in this study. The luminal B breast cancer patients were further divided into the luminal B (high ki67) and luminal B (Her-2/neu+) subgroups. Each subgroup was further grouped into metformin-treated, non-metformin-treated, and non-diabetic groups. The indicators included cancer-specific mortality, clinical, pathological stage, lymph node status, chemotherapy, and endocrine therapy. The survival analysis of each group was performed using the Kaplan-Meier method, and the significance was determined using the logrank test. Cox proportional hazard model was used to examine the correlation between each factor and the prognosis. Results:The Kaplan-Meier analysis results revealed that the breast cancer mortality rates in the metformin-treated, non-metformin-treated, and non-diabetic groups were significantly different in both luminal B (high ki67) and luminal B (Her-2/neu+) subgroups (logrank test:P<0.001, P=0.035), and the respective five-year survival rates were 93.5%, 81%, and 89%for the luminal B (high ki67) subgroup and 84%, 77%, and 83%for the luminal B (Her-2/neu+) subgroup. The Cox multifactorial regression analysis results showed that compared with the metformin-treated group, the non-metformin-treated group was associated with a significantly increased risk of mortality (P<0.001, P=0.044) in the two subgroups. Meanwhile, the non-diabetic group was associated with an increased risk of mortality (P=0.038) in the luminal B (high ki67) subgroup only. The percentage of elderly (P<0.001), menopausal (P<0.001), obese (P<0.001), and patients with cardio-cerebrovascular complications (P<0.001) tended to be higher in the metformin-treated and non-metformin-treated groups than in the diabetic group. Moreover, the metformin-and non-metformin-treated groups in the luminal B (high ki67) subgroup were associated with high percentages of T3/4 pathological stage (P<0.001), lymph node metastasis (P=0.001). The non-metformin-treated group was associated with a lower percentage of invasive ductal carcinoma (P=0.001) compared with the other two groups. Conclusion:The non-metformin-treated group resulted in worse clinical outcomes in both subgroups compared with the metformin-treated group. Meanwhile, the non-diabetic group resulted in the worst prognosis among the three groups in the luminal B (high ki67) subgroup. These findings suggest that the choice of different anti-diabetic drugs may influence the prognosis of luminal B breast cancer patients with diabetes.