Objective:To establish 30-day of age transcutaneous bilirubin (TcB) reference curves for healthy neonates, and to investigate regional variations in bilirubin dynamics.Methods:A multicenter retrospective cohort study was conducted. A total of 220 950 healthy neonates born at a gestational age of 35-<42 weeks, with a birth weight ≥2 000 g, who did not receive phototherapy within 60 h after birth were recruited. All of them underwent remote TcB monitoring using the Bilibaby remote jaundice monitoring system between August 1 st, 2020 and December 31 st, 2024 in 426 hospitals. TcB data were collected within the period from birth to 30-day of age. The P40, P75, and P95 of TcB values were calculated, and dynamic TcB curves for 30-day of age were constructed. Patterns of bilirubin change, rates of change, and transition outcomes were described. Regional comparisons between South and North were conducted using linear mixed-effects models for TcB trajectories and Pearson′s chi-square test for outcome differences. Results:A total of 220 950 neonates were included, of whom 101 711 (46.03%) were female. Gestational age at birth was (38.75±1.12) weeks, and birth weight was (3 272±417) g. TcB levels increased rapidly within 3-day of age, peaked at 4-6-day of age, with peak values at P40, P75, and P95 of 200.6, 239.7 and 275.4 μmol/L (11.8, 14.1 and 16.2 mg/dl), respectively. TcB levels gradually declined thereafter and stabilized after 13-day of age, with values at P40, P75, and P95 fluctuating between 147.9-159.8, 190.4-200.6, and 231.2-239.7 μmol/L (8.7-9.4, 11.2-11.8, 13.6-14.1 mg/dl), respectively. Notably, among neonates categorized as low-or low-intermediate-risk within 3-day of age, 6 700 (12.76%) progressed to intermediate-high or high risk between 4 and 30 days of age. Before 13-day of age, TcB levels in the southern regions were consistently higher than those in the northern regions ( P=0.039); from 14 to 30 days of age, the overall TcB levels had no statistically difference, but the temporal changes in TcB still showed regional differences (degrees of freedom=3, all interaction P<0.05). Among neonates classified as low-or low-intermediate risk within 3-day of age, 25 326 were from southern regions, of whom 4 254 (16.80%) progressed to intermediate-high or high risk between 4 and 30 days of age. In northern regions, 27 193 neonates were classified as low-or low-intermediate risk within 3-day of age, among whom 2 446 (8.99%) progressed to intermediate-high or high risk. The risk progression between the 2 regions had statistically difference ( χ2=716.49, P<0.001). Conclusions:A TcB percentile curve for neonates within 30-day of age was established, revealing that both the overall TcB level and its temporal trend were higher in southern than in northern newborns. These findings provide baseline data to support continuous management of neonatal jaundice.

A 51-year-old male patient was admitted to People’s Hospital, Hubei University of Medicine due to multiple subcutaneous masses in the left upper limb and other body regions for over 50 years and was diagnosed as neurofibromatosis type Ⅰ (NF1) combined with a rare giant neurofibroma in the left upper limb. The patient had developed subcutaneous masses and café-au-lait spots since childhood, with the left upper limb mass rapidly enlarged to 56 cm × 38 cm over time, accompanied by hemorrhage and ulceration. Preoperative MRI revealed a soft tissue mass in the left upper limb. NF1 was diagnosed based on family history and clinical manifestations. Tumor resection was performed in stages, and the tumor tissue weighed 10.204 kg. During the operation, autologous blood reinfusion was adopted to avoid the consumption of a large amount of resources related to blood transfusion. The area around the wound was stripped to reduce the tension. The flap around the wound was sutured directly to close the wound. Neurofibroma was confirmed by postoperative pathology. The patient recovered well postoperatively, with normal blood supply to the left upper limb, survival of the skin flap, and significant functional improvement at the 2-month follow-up, leading to enhanced quality of life.

Objective:To investigate the molecular typing characteristics of patients with ovarian endometrioid adenocarcinoma(OEA)and its relationship with prognosis.Methods:A retrospective analysis was performed on the clinical medical records and follow-up outcomes of 176 patients with OEA admitted to the gynecology depart-ment of West China Second University Hospital of Sichuan University from June 1,2011 to December 31,2019.Based on the results of genetic testing and pathological immunohistochemical data,the molecular subtypes of the patients were determined and divided into three groups:mismatch repair deficiency(dMMR)group(22 cases),no specific molecular profile(NSMP)group(71 cases),and p53 mutation(p53abn)group(83 cases).The differences in clinicopathological characteristics among the three subgroups were compared.Kaplan-Meier method was used to draw survival curves.The overall survival(OS)and progression free survival(PFS)curves of pa-tients were compared in different molecular subtypes and different age groups using Log-rank test.Results:①There were no statistically significant differences among the three groups in age,body mass index(BMI),meno-pause,and the presence of internal medical comorbidities(P＞0.05).②There were no statistically significant differences among the three groups in tumor differentiation degree,International Federation of Gynecology and Obstetrics(FIGO)staging,preoperative carbohydrate antigen 125(CA125)level,preoperative neoadjuvant chemo-therapy,para-aortic lymph node metastasis,pelvic lymph node metastasis,concurrent endometrial cancer,and malignant transformation of ovarian endometriotic cysts(P＞0.05).③There were statistically significant differ-ences in 5-year OS and PFS among the three groups(P＜0.05).The 5-year OS and PFS of the dMMR group were superior to those of the p53abn group(P＜0.05).Conclusions:There were no significant differences in the baseline characteristics and the clinicopathological features of tumors among patients with different molecular sub-types of OEA.Patients with dMMR-type OEA exhibited more prominent advantages in PFS and OS compared with those with p53abn type.Formulating individualized treatment strategies based on the molecular typing charac-teristics of OEA may improve the clinical prognosis of patients.

Objective To explore the clinical efficacy and medical costs of high ligation and stripping of the great saphenous vein,simple foam sclerotherapy,and high ligation of the great saphenous vein combined with foam sclerotherapy for treating varicose of great saphenous vein.Methods The clinical data of patients with varicose of great saphenous vein undergoing high ligation and stripping of the great saphenous vein,simple foam sclerotherapy,or high ligation of the great saphenous vein combined with foam sclerotherapy were analyzed retrospectively.The evaluation included efficacy assessment,quality of life evaluation,hospitalization days and costs,postoperative complications,and recurrence after surgery.Results There were no statistical differences in gender,age,disease course and clinical etiology anatomy pathophysiology(CEAP)grading system among the three groups(P＞0.05).The clinical efficacy assessments in all patients among the three groups showed significant effects at 3 and 6 months postoperatively.One patient in the group treated with high ligation of the great saphenous vein combined with foam sclerotherapy suffered deep vein thrombosis of lower extremity after operation.In terms of quality of life,there was no statistically significant difference in venous clinical severity score(VCSS)among the three groups at 3 months postoperatively(P＞0.05).The group treated with simple foam sclerotherapy showed significantly shorter hospitalization days compared with the other two groups.Additionally,the group treated with simple foam sclerotherapy showed lower hospitalization expenses,which was not statistically significant when compared to the group treated with high ligation and stripping of the great saphenous vein group(P＞0.05),but there was a statistical difference compared to the group treated with high ligation of the great saphenous vein combined with foam sclerotherapy(P＜0.05).Conclusion There are no significant differences in clinical efficacy,postoperative pain,and quality of life evaluation among the three methods.However,simple foam scle-rotherapy may reduce the length of hospitalization stay and direct medical costs.

Objective Exploring alterations in regional homogeneity(ReHo)in the brain of adolescents with depression and suicide attempts.Methods Adolescent patients with depression were included.Those with at least one suicide attempt within one year were classified as the suicide attempt group(32 cases),and those without suicide attempts within one year were classified as the non-suicide attempt group(33 cases).Additionally,a healthy control group(31 individuals)was included.All subjects underwent resting-state functional magnetic resonance imaging(fMRI)scans,and the ReHo values were calculated.The severity of depressive symptoms and the suicide risk were evaluated using the patient health questionnaire-9(PHQ-9)and the mini-international neuropsychiatric interview(MINI)suicide scale,respectively.The ReHo values were compared across groups,and the correlations between ReHo values in distinct brain regions and the PHQ-9 and the MINI suicide scales were analyzed.Results Compared with the healthy control group,the ReHo values in the right and left thalamus,right and left precentral gyrus were decreased in the suicide attempt group(voxel level P<0.001,cluster level P<0.05,GRF corrected),while the ReHo value in the right superior temporal gyrus was increased(voxel level P<0.001,cluster level P<0.05,GRF corrected).Compared with the healthy control group,the ReHo values in the right midbrain and the right thalamus were decreased in the non-suicide attempt group(voxel level P<0.001,cluster level P<0.05,GRF corrected),while the ReHo values in the left middle frontal gyrus,right middle frontal gyrus,and right superior frontal gyrus were increased(voxel level P<0.001,cluster level P<0.05,GRF corrected).Compared with the non-suicide attempt group,the ReHo values in the right medial and paracingulate gyrus were decreased in the suicide attempt group(voxel level P<0.001,cluster level P<0.05,GRF corrected).ReHo values in the right superior temporal gyrus of the suicide attempt group showed a positive correlation with PHQ-9 scores(r=0.407,P=0.026).Conclusion Reduced ReHo values in the right medial and paracingulate gyrus at rest in the group with suicide attempt depression may be a potential neural mechanism for suicide in adolescent depressed patients.

Objective Exploring alterations in regional homogeneity(ReHo)in the brain of adolescents with depression and suicide attempts.Methods Adolescent patients with depression were included.Those with at least one suicide attempt within one year were classified as the suicide attempt group(32 cases),and those without suicide attempts within one year were classified as the non-suicide attempt group(33 cases).Additionally,a healthy control group(31 individuals)was included.All subjects underwent resting-state functional magnetic resonance imaging(fMRI)scans,and the ReHo values were calculated.The severity of depressive symptoms and the suicide risk were evaluated using the patient health questionnaire-9(PHQ-9)and the mini-international neuropsychiatric interview(MINI)suicide scale,respectively.The ReHo values were compared across groups,and the correlations between ReHo values in distinct brain regions and the PHQ-9 and the MINI suicide scales were analyzed.Results Compared with the healthy control group,the ReHo values in the right and left thalamus,right and left precentral gyrus were decreased in the suicide attempt group(voxel level P<0.001,cluster level P<0.05,GRF corrected),while the ReHo value in the right superior temporal gyrus was increased(voxel level P<0.001,cluster level P<0.05,GRF corrected).Compared with the healthy control group,the ReHo values in the right midbrain and the right thalamus were decreased in the non-suicide attempt group(voxel level P<0.001,cluster level P<0.05,GRF corrected),while the ReHo values in the left middle frontal gyrus,right middle frontal gyrus,and right superior frontal gyrus were increased(voxel level P<0.001,cluster level P<0.05,GRF corrected).Compared with the non-suicide attempt group,the ReHo values in the right medial and paracingulate gyrus were decreased in the suicide attempt group(voxel level P<0.001,cluster level P<0.05,GRF corrected).ReHo values in the right superior temporal gyrus of the suicide attempt group showed a positive correlation with PHQ-9 scores(r=0.407,P=0.026).Conclusion Reduced ReHo values in the right medial and paracingulate gyrus at rest in the group with suicide attempt depression may be a potential neural mechanism for suicide in adolescent depressed patients.

Objective To explore the clinical efficacy and medical costs of high ligation and stripping of the great saphenous vein,simple foam sclerotherapy,and high ligation of the great saphenous vein combined with foam sclerotherapy for treating varicose of great saphenous vein.Methods The clinical data of patients with varicose of great saphenous vein undergoing high ligation and stripping of the great saphenous vein,simple foam sclerotherapy,or high ligation of the great saphenous vein combined with foam sclerotherapy were analyzed retrospectively.The evaluation included efficacy assessment,quality of life evaluation,hospitalization days and costs,postoperative complications,and recurrence after surgery.Results There were no statistical differences in gender,age,disease course and clinical etiology anatomy pathophysiology(CEAP)grading system among the three groups(P＞0.05).The clinical efficacy assessments in all patients among the three groups showed significant effects at 3 and 6 months postoperatively.One patient in the group treated with high ligation of the great saphenous vein combined with foam sclerotherapy suffered deep vein thrombosis of lower extremity after operation.In terms of quality of life,there was no statistically significant difference in venous clinical severity score(VCSS)among the three groups at 3 months postoperatively(P＞0.05).The group treated with simple foam sclerotherapy showed significantly shorter hospitalization days compared with the other two groups.Additionally,the group treated with simple foam sclerotherapy showed lower hospitalization expenses,which was not statistically significant when compared to the group treated with high ligation and stripping of the great saphenous vein group(P＞0.05),but there was a statistical difference compared to the group treated with high ligation of the great saphenous vein combined with foam sclerotherapy(P＜0.05).Conclusion There are no significant differences in clinical efficacy,postoperative pain,and quality of life evaluation among the three methods.However,simple foam scle-rotherapy may reduce the length of hospitalization stay and direct medical costs.

Objective:To investigate the molecular typing characteristics of patients with ovarian endometrioid adenocarcinoma(OEA)and its relationship with prognosis.Methods:A retrospective analysis was performed on the clinical medical records and follow-up outcomes of 176 patients with OEA admitted to the gynecology depart-ment of West China Second University Hospital of Sichuan University from June 1,2011 to December 31,2019.Based on the results of genetic testing and pathological immunohistochemical data,the molecular subtypes of the patients were determined and divided into three groups:mismatch repair deficiency(dMMR)group(22 cases),no specific molecular profile(NSMP)group(71 cases),and p53 mutation(p53abn)group(83 cases).The differences in clinicopathological characteristics among the three subgroups were compared.Kaplan-Meier method was used to draw survival curves.The overall survival(OS)and progression free survival(PFS)curves of pa-tients were compared in different molecular subtypes and different age groups using Log-rank test.Results:①There were no statistically significant differences among the three groups in age,body mass index(BMI),meno-pause,and the presence of internal medical comorbidities(P＞0.05).②There were no statistically significant differences among the three groups in tumor differentiation degree,International Federation of Gynecology and Obstetrics(FIGO)staging,preoperative carbohydrate antigen 125(CA125)level,preoperative neoadjuvant chemo-therapy,para-aortic lymph node metastasis,pelvic lymph node metastasis,concurrent endometrial cancer,and malignant transformation of ovarian endometriotic cysts(P＞0.05).③There were statistically significant differ-ences in 5-year OS and PFS among the three groups(P＜0.05).The 5-year OS and PFS of the dMMR group were superior to those of the p53abn group(P＜0.05).Conclusions:There were no significant differences in the baseline characteristics and the clinicopathological features of tumors among patients with different molecular sub-types of OEA.Patients with dMMR-type OEA exhibited more prominent advantages in PFS and OS compared with those with p53abn type.Formulating individualized treatment strategies based on the molecular typing charac-teristics of OEA may improve the clinical prognosis of patients.

A 51-year-old male patient was admitted to People’s Hospital, Hubei University of Medicine due to multiple subcutaneous masses in the left upper limb and other body regions for over 50 years and was diagnosed as neurofibromatosis type Ⅰ (NF1) combined with a rare giant neurofibroma in the left upper limb. The patient had developed subcutaneous masses and café-au-lait spots since childhood, with the left upper limb mass rapidly enlarged to 56 cm × 38 cm over time, accompanied by hemorrhage and ulceration. Preoperative MRI revealed a soft tissue mass in the left upper limb. NF1 was diagnosed based on family history and clinical manifestations. Tumor resection was performed in stages, and the tumor tissue weighed 10.204 kg. During the operation, autologous blood reinfusion was adopted to avoid the consumption of a large amount of resources related to blood transfusion. The area around the wound was stripped to reduce the tension. The flap around the wound was sutured directly to close the wound. Neurofibroma was confirmed by postoperative pathology. The patient recovered well postoperatively, with normal blood supply to the left upper limb, survival of the skin flap, and significant functional improvement at the 2-month follow-up, leading to enhanced quality of life.

Objective:To establish 30-day of age transcutaneous bilirubin (TcB) reference curves for healthy neonates, and to investigate regional variations in bilirubin dynamics.Methods:A multicenter retrospective cohort study was conducted. A total of 220 950 healthy neonates born at a gestational age of 35-<42 weeks, with a birth weight ≥2 000 g, who did not receive phototherapy within 60 h after birth were recruited. All of them underwent remote TcB monitoring using the Bilibaby remote jaundice monitoring system between August 1 st, 2020 and December 31 st, 2024 in 426 hospitals. TcB data were collected within the period from birth to 30-day of age. The P40, P75, and P95 of TcB values were calculated, and dynamic TcB curves for 30-day of age were constructed. Patterns of bilirubin change, rates of change, and transition outcomes were described. Regional comparisons between South and North were conducted using linear mixed-effects models for TcB trajectories and Pearson′s chi-square test for outcome differences. Results:A total of 220 950 neonates were included, of whom 101 711 (46.03%) were female. Gestational age at birth was (38.75±1.12) weeks, and birth weight was (3 272±417) g. TcB levels increased rapidly within 3-day of age, peaked at 4-6-day of age, with peak values at P40, P75, and P95 of 200.6, 239.7 and 275.4 μmol/L (11.8, 14.1 and 16.2 mg/dl), respectively. TcB levels gradually declined thereafter and stabilized after 13-day of age, with values at P40, P75, and P95 fluctuating between 147.9-159.8, 190.4-200.6, and 231.2-239.7 μmol/L (8.7-9.4, 11.2-11.8, 13.6-14.1 mg/dl), respectively. Notably, among neonates categorized as low-or low-intermediate-risk within 3-day of age, 6 700 (12.76%) progressed to intermediate-high or high risk between 4 and 30 days of age. Before 13-day of age, TcB levels in the southern regions were consistently higher than those in the northern regions ( P=0.039); from 14 to 30 days of age, the overall TcB levels had no statistically difference, but the temporal changes in TcB still showed regional differences (degrees of freedom=3, all interaction P<0.05). Among neonates classified as low-or low-intermediate risk within 3-day of age, 25 326 were from southern regions, of whom 4 254 (16.80%) progressed to intermediate-high or high risk between 4 and 30 days of age. In northern regions, 27 193 neonates were classified as low-or low-intermediate risk within 3-day of age, among whom 2 446 (8.99%) progressed to intermediate-high or high risk. The risk progression between the 2 regions had statistically difference ( χ2=716.49, P<0.001). Conclusions:A TcB percentile curve for neonates within 30-day of age was established, revealing that both the overall TcB level and its temporal trend were higher in southern than in northern newborns. These findings provide baseline data to support continuous management of neonatal jaundice.