Objective To explore the risk factors for vaginal stump recurrence after early cervical cancer surgery.Methods A total of 243 patients who underwent radical cervical cancer surgery in the First Affiliated Hospital of Henan University of Science and Technology from January 2018 to March 2020 were selected as the research subjects and divided into recurrence group(n=21)and non-recurrence group(n=22)based on whether vaginal stump recurrence occurred within 3 years after surgery.The clinical data of patients in the two groups,including age,pathological type,International Federation of Gynecology and Obstetrics(FIGO)staging of cervical cancer,degree of tissue differentiation,surgical approach,distance between surgical margin and tumor,muscle layer infiltration,presence or absence of lymph node involvement at diagnosis of cervical cancer,number of tumor budding,presence or absence of vascular cancer thrombus,vaginal resection length,and postoperative radiotherapy site were collected.One-way analysis of variance and binary logistic regression were used to analyze the risk factors for vaginal stump recurrence after early cervical cancer surgery.Results The recurrence rate of vaginal stumps within 3 years after early cervical cancer surgery was 8.64％(21/243).There were statistically significant differences in the pathological types,distance between surgical margin and tumor,muscle layer infiltration,number of tumor budding,vaginal resection length,and postoperative radiotherapy site of patients between the recurrence group and non-recurrence group(P＜0.05);there was no statistically significant difference in the age,FIGO stage,degree of tissue differentiation,surgical approach,presence or absence of lymph node involvement at diagnosis of cervical cancer,presence or absence of vascular cancer thrombus of patients between the two groups(P＞0.05).The binary logistic regression analysis showed that the distance between the surgical margin and the tumor≤3.5 mm,the number of tumor budding＞5,and the vaginal resection length≤2 cm were risk factors for vaginal stump recurrence after early cervical cancer surgery(P＜0.05),while postoperative pelvic radiotherapy combined with vaginal brachytherapy was a protective factor for vaginal stump recurrence after early cervical cancer surgery(P＜0.05).Conclusion The risk of vaginal stump recurrence after early cervical cancer surgery is high.The distance between the surgical margin and tumor≤3.5 mm,the number of tumor budding＞5,and the vaginal resection length≤2 cm are risk factors for vaginal stump recurrence after early cervical cancer surgery;pelvic radiotherapy combined with vaginal brachytherapy can reduce the risk of vaginal stump recurrence after early cervical cancer surgery.

Objective:To identify species type and analyze the homology of Brucella in a family cluster infection. Methods:Two patients with brucellosis from the same family who were treated at the First People's Hospital of Lianyungang City, Jiangsu Province in May 2022 were selected as the research subjects. Brucella strains (H4LYG01 and H2LYG02) were isolated through blood culture. The isolated strains were identified for species type and homology analysis using a fully automated microbial mass spectrometry detection system. Molecular typing of the isolated strains was performed using multiple locus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST). Results:H4LYG01 and H2LYG02 were both Brucella Maltese, and the credibility scores were 9.745 and 9.627, respectively, and the homology was 100%. The MLVA results showed that the gene loci of H4LYG01 and H2LYG02 were completely identical, with the same genotype. The MLST results showed that the sequence type (ST) of H4LYG01 and H2LYG02 were both ST8 types. Conclusion:The two isolated strains of Brucella from a family with clustered infections are both Brucella Maltese and from the same source.

AIM: To investigate the effect of electroacupuncture on the expression of matrix metalloproteinase-3(MMP-3), tissue inhibitor of metalloproteinase-3(TIMP-3)and collagen type III alpha 1(Col3α1)in the retina of guinea pigs with lens-induced myopia.METHODS:A total of 80 guinea pigs were randomly divided into the normal control(NC)group, negative lens-induced myopia(LIM)group, electro-acupuncture(EA)group, and sham group, with 20 guinea pigs in each group. The NC group did not receive any intervention, the LIM, EA and the sham groups were all wearing -6.0 D lens in the right eye and no lens in the left eye. The EA group was given electroacupuncture stimulation at Hegu Point and temple, and guinea pigs in the sham group were given intervention at false points. The refraction was measured by optometry, the axial length was measured by A-ultrasound, and the changes in retinal tissue structure were observed by HE staining. Quantitative polymerase chain reaction(Q-PCR)and western blot(WB)were used to detect the expression of MMP-3, TIMP-3, and Col3α1 at mRNA and protein levels before modeling and at 2 and 4 wk after modeling. RESULTS:The axial length of the negative LIM group was significantly increased compared with the NC group at 2 and 4 wk after modeling(all P<0.05), and the diopter was significantly decreased(all P<0.05); the axial length of the eye in the EA group was decreased compared with the negative LIM group(all P<0.05), and the diopter was increased(all P<0.05). HE staining showed that the boundaries of retinal tissue in the NC group were obvious and arranged regularly. The retinal thickness, the thickness of the inner and outer nuclear layers, and the number of cells were reduced and irregularly arranged in the negative LIM group. The overall structure of the retina in the group EA was relatively perfect, the arrangement was more regular, and the morphological structure of each layer of the tissue did not appear obvious abnormalities. Q-PCR and WB detection results showed that the mRNA and protein relative expression levels of MMP-3, TIMP-3, and Col3α1 in the negative LIM group were significantly higher than those in the NC group(all P<0.05); the expression levels of the EA group was significantly decreased after intervention compared with the negative LIM group(all P<0.05).CONCLUSION: Electroacupuncture can delay axial growth in negative LIM guinea pigs, and downregulate negative LIM induced expression of MMP-3, TIMP-3, and Col3α1 in the retina.

Objective:To explore the mediating role of self-perceptions of aging between frailty and cognitive function in community-dwelling older adults.Methods:From February to July 2021, a total of 528 elderly people in Xinxiang community were investigated with the frailty phenotype, the brief self-perceptions ageing questionnaire and the Mini-mental state examination(MMSE) scale.According to the MMSE total score and education level, the subjects were divided into cognitive impairment group (illiteracy≤17, primary school≤20, junior high school and above≤24, n=74) and cognitive normal group( n=454). SPSS 25.0 software was used for common method deviation test, descriptive statistics and correlation analysis, while AMOS 24.0 software was used to build structural equation model and Bootstrap method was used for intermediary effect test. Results:(1)The prevalence of cognitive impairment among the elderly in the community was 14.1%. The differences between the cognitively normal group and cognitively impaired group were statistically significant in terms of age, education, number of chronic diseases suffered and depression ( χ2=59.21, 6.53, 9.84, 25.47, all P<0.05). The differences were statistically significant in terms of frailty( χ2=75.65, P<0.001) and self-perceptions of aging ( t=77.67, P<0.001). (2)Self-perceptions of aging in the cognitively impaired group (47.39±8.66) was higher than that in the cognitively normal group (38.22±8.24) ( t=77.67, P<0.001) .Frailty score in cognitively impaired group (2.00 (1.00, 3.00)) was higher than that in the cognitively normal group (0.00 (0.00, 1.00))( Z=-8.63, P<0.001) . (3)Frailty was negatively correlated with cognitive function ( r=-0.492, P<0.01), and positively correlated with self-perceptions of aging ( r=0.540, P<0.01). Self-perceptions of aging was negatively correlated with cognitive function ( r=-0.541, P<0.01) . After controlling the influencing factors such as age, education level, chronic diseases and depression, the correlation was still significant (all P<0.01) . (4) Self-perceptions of aging played a partially mediating role in the relationship between frailty and cognitive function, the mediating effect accounted for 58.5% of the total effect. Conclusion:Frailty and self-perceptions of aging have a significant impact on the cognitive function of the elderly in the community, and self-perceptions of aging plays a partial intermediary role between the frailty and cognitive function of the elderly in the community.

The dynamic changes of cognitive function has been paid more and more attention by foreign scholars.Dynamic assessment based on ecological momentary assessment(EMA)can capture subtle changes in cognitive function and provide more comprehensive information for early identification and timely intervention of people with cognitive impairment, which is an effective supplement to traditional cognitive assessment.This paper reviewed the concept of ecological momentary assessment, its advantages in cognitive assessment, its feasibility and effectiveness, and its application status in the evaluation of cognitive function in the elderly, so as to provide a reference for making ecological assessment of the cognitive function for older adults that is in line with China's national conditions.

Objective To investigate the efficacy and safety of fluzopril in the treatment of platinum-sensitive recurrent epithelial ovarian cancer.Methods A total of 107 patients with platinum-sensitive recurrent epithelial ovarian cancer admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2019 to December 2020 were selected as the subjects.According to treatment methods,the patients were divided into control group(n=50)and observation group(n=57).The patients in the control group received a first-line chemotherapy regimen of paclitaxel combined with platinum:on the first day,intravenous infusion with paclitaxel injection 135 mg·m-2 was administered;on day 1-3,intravenous drip with cisplatin 50-60 mg·m-2 was administered;21 days was one chemotherapy cycle.On the basis of the treatment in the control group,the patients in the observation group were given fluzoparide capsules orally,150 mg each time,twice a day,and the treatment continued until disease progression or unacceptable toxic reactions occurred;21 days was one chemotherapy cycle.The patients in both groups received three consecutive chemotherapy cycles.The clinical efficacy,prognosis within 2 years after chemotherapy,Karnofsky Performance Status(KPS)score before and after chemotherapy,and incidence of adverse reactions during chemotherapy of patients between the two groups were compared.Results After 3 cycles of chemo-therapy,the disease control rate and objective remission rate of patients in the observation group were significantly higher than those in the control group(x2=5.420,4.220;P＜0.05).Following up to 24 months,the progression free survival of patients in the observation group was significantly longer than that in the control group(t=6.702,P＜0.05);there was no statistically significant difference in 1-year survival rate of patients between the two groups(x2=0.415,P＞0.05);the 2-year survival rate of patients in the observation group was significantly higher than that in the control group(x2=5.420,P＜0.05).Before chemotherapy,there was no statistically significant difference in KPS scores of patients between the two groups(t=0.537,P＞0.05);the KPS scores of patients in the two groups after three cycles of chemotherapy were significantly higher than those before chemotherapy(t=5.604,9.378;P＜0.05);after three cycles of chemotherapy,the KPS score of patients in the observation group was significantly higher than that in the control group(t=2.608,P＜0.05).The patients in both groups experienced hematological and non-hematological adverse reactions during chemotherapy;the main hematological adverse reactions was bone marrow suppression,most of which were Ⅲ ° and Ⅳ ° adverse reactions;the non-hematological adverse reactions included alo-pecia,gastrointestinal reactions,and liver and kidney dysfunction,most of which were Ⅰ°and Ⅱ°adverse reactions.There were no chemotherapy related deaths of patients in both groups.The incidence rates of anemia,thrombocytopenia,neutropenia,leuko-penia,lymphopenia,nausea,vomiting,fatigue,loss of appetite,hair loss,elevated serum creatinine,and elevated alanine amino-transferase(ALT)of patients during chemotherapy in the control group were 68.00％(34/50),72.00％(36/50),58.00％(29/50),68.00％(34/50),22.00％(11/50),26.00％(13/50),24.00％(12/50),46.00％(23/50),30.00％(15/50),50.00％(25/50),20.00％(10/50),10.00％(5/50),respectively;the incidence rates of anemia,thrombocytopenia,neutropenia,leukopenia,lymphopenia,nausea,vomiting,fatigue,loss of appetite,hair loss,elevated serum creatinine,and elevated ALT of patients during chemotherapy in the observation group were 61.40％(35/57),63.16％(36/57),49.12％(28/57),52.63％(30/57),21.05％(12/57),22.81％(13/57),24.56％(14/57),42.11％(24/57),29.82％(17/57),47.37％(27/57),21.05％(12/57),10.53％(6/57),respectively.There was no statistically significant difference in the incidences of anemia,thrombocytopenia,neutropenia,leukopenia,lymphopenia,nausea,vomiting,fatigue,loss of appetite,hair loss,elevated serum creatinine,and elevated ALT of patients during chemotherapy between the control group and the observation group(x2=0.047,0.000,0.041,0.694,0.056,0.000,0.208,0.041,0.184,0.160,0.233,0.102;P＞0.05).Conclusion For patients with platinum-sensitive recurrent ovarian cancer,the combination of paclitaxel and platinum chemo-therapy combined with fluzopril can effectively improve the anti-tumor effect,prolong the progression-free survival,improve survival rate and quality of life,and the adverse reactions are controllable.

Objective To investigate the prevalence and influencing factors of thyroid nodules in children aged 8-10 years in Suzhou , and to provide a scientific basis for the rational prevention and treatment of iodine deficiency disorders (IDD). Methods PPS sampling method was used in this study. Questionnaire survey, physical examination and thyroid B-ultrasound examination were conducted on students aged 8-10 years. Salt samples and urine samples were collected for laboratory detection of the salt iodine and urinary iodine. Univariate and multivariate logistic regression models were used to analyze the risk factors related to thyroid nodules. Results A total of 2 048 children aged 8-10 years were included in the present survey, and the prevalence of thyroid nodules was 23.34% (478/2 048). The prevalence of nodules in boys was 20.98% (218/1 039), and the prevalence of nodules in girls was 25.77% (260/1 009). Multivariate analysis showed that gender (OR=1.338, P=0.006), height (OR=1.993, P=0.001), frequency of iodine-rich food intake (OR=0.862, P=0.048) and nutritional supplements (OR=1.469, P=0.008) were correlated with the prevalence of thyroid nodules. Conclusion The prevalence rate of thyroid nodules in children aged 8-10 years old in Suzhou is 23.34%. Female gender, higher height, regular intake of iodine-rich foods and dietary supplements are statistically associated with the prevalence of thyroid nodules, which may be risk factors for the prevalence of thyroid nodules , but further research is needed to confirm.

Objective:To investigate the size of thyroid of children aged 8 - 10 in Suzhou City and explore its influencing factors.Methods:According to the requirements of the "Jiangsu Province Iodine Deficiency Disorders Monitoring Plan", a stratified multi-stage sampling method was conducted in 10 counties (cities, districts) under the jurisdiction of Suzhou City in five directions: east, west, south, north, and middle from May 2019 to July 2020. Forty children aged 8 - 10 (age balanced, half male and half female) were selected from each primary school for thyroid volume examination, height and weight measurement, and questionnaire survey. At the same time, salt samples from children's homes and random urine samples were collected for iodine content testing, and explore the influencing factors of the thyroid volume.Results:A total of 2 046 children aged 8 - 10 were selected, including 1 038 boys and 1 008 girls. The thyroid volume of children was (3.183 ± 1.042) ml, while the total goiter rate (TGR) was 2.93% (60/2 046). Univariate analysis showed that there were statistically significant differences in thyroid volume among groups with different age, height, weight, body mass index (BMI), presence or absence of nodules, and different dietary frequencies (eating solid snacks, iodine-rich foods, cruciferous vegetables, and meat at different frequencies, P < 0.05). Correlation analysis showed that thyroid volume was positively correlated with age, height, weight, BMI, body surface area (BSA), thyroid nodules, consumption of iodine-rich foods and cruciferous vegetables ( r = 0.24, 0.34, 0.32, 0.21, 0.35, 0.19, 0.05, 0.04, P < 0.05), while negatively correlated with consumption of meat ( r = - 0.04, P = 0.047). Multivariate linear regression analysis showed that age, BSA, thyroid nodules, consumption of solid snacks and cruciferous vegetables entered the equation, with standardized partial regression coefficient values were 0.11, 0.30, 0.16, 0.05, 0.05, respectively. Conclusions:The thyroid volume of children aged 8 - 10 in Suzhou City is not only influenced by age, but also by factors such as BSA, thyroid nodules, consumption of solid snacks, and cruciferous vegetables.

This article reports a case of adrenal tumor in a reproductive-aged woman with hyperandrogenism misdiagnosed as polycystic ovary syndrome. The patient presented with menstrual disorder, elevated testosterone levels, and polycystic ovaries, initially diagnosed as polycystic ovary syndrome. Menstrual regularity was achieved after intermittent use of ethinylestradiol/cyproterone acetate and progesterone. Five years later, during a physical examination, a mass was discovered in the right adrenal gland, accompanied by elevated testosterone levels, polycystic ovaries, obesity, and insulin resistance. Laparoscopic resection of the right adrenal tumor was performed, and the pathological diagnosis was adrenal cortical oncocytoma. Postoperatively, menstrual regularity was restored, and testosterone levels normalized. This case highlights the importance of considering adrenal tumors secreting androgens in patients clinically diagnosed with polycystic ovary syndrome, and emphasizes the need for regular adrenal imaging follow-up.

Objective To investigate the relationship between atrial fibrillation and left heart structure change in patients with hemodialysis combined with hemoperfusion.Methods A total of 60 patients with end-stage renal disease who underwent hemodialysis combined with hemoperfusion treatment in Ganzhou Hospital of Traditional Chinese Medicine from December 2020 to December 2021 were selected.Thirty patients with atrial fibrillation were included in observation group,and thirty patients without atrial fibrillation were included in control group.The left heart structure indexes of two groups were compared,and the relationship between atrial fibrillation and left heart structure change in patients with hemodialysis combined with hemoperfusion was analyzed.Results Left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left atrium diameter(LAD),interventricular septal thickness(IVST),and left ventricular posterior wall thickness(LVPWT)in observation group were higher than those in control group,and left ventricular ejection fraction(LVEF)was lower than that in control group(P<0.05).Logistic regression analysis showed that the decrease of LVEF and the increase of LVEDD,LVESD,LAD,IVST and LVPWT were associated with atrial fibrillation in patients with hemodialysis combined with hemoperfusion(P<0.05).The results of receiver operating characteristic curve showed that area under the curve of LVEDD,LVESD,LAD,LVEF,IVST and LVPWT in diagnosing atrial fibrillation in patients with hemodialysis combined with hemoperfusion were 0.724,0.708,0.760,0.761,0.762 and 0.758,respectively,which had certain diagnostic value.Conclusion Atrial fibrillation in patients with hemodialysis combined with hemoperfusion is related to the change of left heart structure,and the left heart structure indexes are helpful to assist the diagnosis of atrial fibrillation.