Objective: To analyze the trends, gender, and age differences in the incidence of lip and oral cavity cancer in Chinese population from 1990 to 2021 and predict future incidence trends, providing a scientific basis for disease prevention and public health policy. Methods: Incidence data of lip and oral cavity cancer in Chinese population from the Global Burden of Disease (GBD) database from 1990 to 2021 were analyzed. The Joinpoint regression model was used to assess temporal trends, the age-period-cohort model was used to evaluate the independent effects of age, period, and cohort, and the Bayesian age-period-cohort model (BAPC) model was used to predict incidence trends from 2022 to 2044. Results: From 1990 to 2021, the age-standardized incidence rate of lip and oral cavity cancer in Chinese population increased from 2.39/100 000 to 3.76/100 000, and the crude incidence rate rose from 1.71/100 000 to 4.85/100 000. The incidence rate in males was higher and increased more rapidly than in females. Higher incidence rates were prevalent among older populations, a rapid increase in incidence rates occurred during 2003 to 2012, and earlier birth cohorts showed overall higher risks. BAPC predictions indicated a continued rise in incidence from 2022 to 2044. During this period, male incidence stabilized while female incidence increased at a relatively faster rate. Conclusion The incidence of lip and oral cavity cancer in Chinese population has revealed a continuous upward trend, particularly among males and older populations. Future prevention strategies should focus on these high-risk populations.

Objective:To analyse the clinical significance of selective single embryo transfer by time-lapse mo-nitoring(TLM)or conventional morphology assessment(CMA)in vitro fertilization/intracytoplasmic sperm in-jection and embryo transfer(IVF/ICSI-ET),and to initially explore the predictive value of Raman spectral analy-sis of embryo culture medium for clinical pregnancy rate.Methods:The study is a prospective randomized con-trolled clinical trial.We assigned 139 patients treated with IVF/ICSI-ET in Reproductive and Genetics Center of Suzhou Municipal Hospital from April 2019 to July 2020,which were randomly assigned to either the CMA or the TLM group.We performed selective single-embryo transfer(fresh cycle and FET)after selecting the optimal em-bryos with TLM or CMA respectively.If the patient's first embryo transfer was unsuccessful,a second one would be performed to compare the differences in the cumulative live birth rate of embryo transfer and other pregnancy outcomes between the two groups.Meanwhile,we collected 15 μl of embryo culture medium at day 3 after IVF/ISCI fertilization for Raman spectroscopy analysis.Results:There were no differences in cumulative live birth,cu-mulative clinical pregnancy,cumulative premature birth,cumulative early spontaneous abortion,cumulative ectopic pregnancy and LGA or SGA between TLM and CMA groups(P＞0.05).The Neonatal sex ratio in the TLM group was lower than that in the CMA group,but the difference was not significant(P＞0.05).Raman spectros-copy analysis of embryo culture medium predicted the clinical pregnancy rate with 67.21％accuracy.Conclu-sions:In young women with a good ovarian reserve,the advantage of using TLM to evaluate embryos is not obvi-ous,so we should remain vigilant that embryo selection based on morphokinetic parameters may affect the sex ratio.Raman spectroscopic analysis of embryo culture medium is not yet able to effectively predict the planting ability of embryos.

Objective:To investigate the correlation between non-traditional lipid parameters and in-hospital recurrence in patients with acute minor ischemic stroke (AMIS).Methods:Patients with AMIS admitted to three sub-central hospitals in Shanxi Province within 72 h of onset in March, June, September, and December of 2012, 2014, 2016, and 2018 were retrospectively included. The demographic information, clinical features, blood lipid parameters, and in-hospital stroke recurrence events were collected. Non-traditional lipid parameters included low density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C) ratio, total cholesterol (TC)/HDL-C ratio, triglycerides (TG)/HDL-C ratio, and non-HDL-C levels. Multivariate logistic regression analysis was used to determine the independent correlation between the non-traditional lipid parameters and the risk of in-hospitals stroke recurrence. Results:A total of 1 040 patients with AMIS were included, including 727 males (69.9%), aged 61.5±13.0 years old; 51 patients (4.904%) experienced in-hospital stroke recurrence, with an average time from admission to recurrence was 7.4±5.7 d. Four hundred and thirty-six (41.9%) AMIS patients complicated with ICAS, aged 61.0±12.5 years old, with 304 males (69.7%); 26 (6.0%) experienced recurrence of in-hospital stroke, and the time from admission to recurrence was 7.8±6.2 d. Multivariate logistic analysis showed that after adjusting for confounding variables, the higher TC/HDL-C ratio (odds ratio [ OR] 1.35, 95% confidence interval [ CI] 1.02-1.77; P=0.035) and non-HDL-C ( OR 1.37, 95% CI 1.02-1.77; P=0.045) were the independent risk factors for in-hospital stroke recurrence. In AMIS patients with intracranial atherosclerotic stenosis, only higher non-HDL-C was significantly and independently associated with the risk of in-hospital stroke recurrence ( OR 1.67, 95% CI 1.05-2.65; P=0.030). Conclusion:The higher non-traditional lipid parameters are associated with an increased risk of in-hospital stroke recurrence in patients with AMIS.

From the perspectives of the pathogenesis, diagnosis and treatment of cardiac graft vasculopathy(CGV), this review summarized the current understanding and cognition of its pathology, monitoring, diagnosis and treatment to provide rationales for better survivals of CGV.

Through the comparison of the residency training system between China and the United States in pre-training educational background, training policy and post-training career path, it is concluded that the cardiothoracic surgery residency training in the United States has a high admission threshold, long training cycle and high education cost, but it also has the advantages of professional management, outstanding specialty characteristics and perfect evaluation system, which are suitable for the training of cardiothoracic surgeons. However, the current residency training of cardiothoracic surgery in China needs to be further improved. Learning from the advantages of the United States residency training system, we can formulate a more reasonable and professional residency training program according to Chinese own characteristics, so as to train excellent cardiothoracic surgeons for our country.

Patent foramen ovale (PFO) is the most prevalent congenital heart disease, often accompanied by neurological symptoms as migraine, unexplained dizziness, and even anxiety and depression. Recent research findings indicate that the pathogenesis of neurological complications related to PFO involves abnormal embolism hypothesis, vasoactive substance hypothesis, impaired cerebral blood flow regulation and genetic inheritance. Treatments include primarily encompass pharmacological intervention and foramen ovale occlusion. This article summarizes the aforementioned research progress in order to provide clinical guidance for managing nervous system complications related to PFO.

Objective : To develop an extracellular vesicles ( EVs) co⁃loading system by synergistically deliver tumor necrosis factor related apoptosis inducing ligand (TRAIL) /verteporfin (VPF) combination to induce apoptosis and inhibit proliferation of OSCC cells . Methods : TRAIL/VPF co⁃loaded EVs (MSCT⁃EVs/VPF) was purified and collected though ultracentrifugation and dialysis . The expression of CD63 , CD9 and TRAIL was detected by BCA to confirm the origin of EVs . High performance liquid chromatography (HPLC) was used to detect the drug loading of VPF and draw the release curve in vitro . Cytotoxicity and half inhibitory concentration (IC50 ) were detected by MTT assay . The apoptosis rate was detected by flow cytometry . Finally , Western blot was used to detect the effects of MSCT⁃EVs/VPF on the expression of apoptosis related proteins and Yap in SCC25 cells . Results: MSCT⁃EVs/VPF particles were round and well dispersed with a diameter of about 100 nm . The drug loading of the nano system was about ( 15 . 43 ± 0. 44)% , 57. 8% of VPF was released in 10 h and 82. 5% in 45h ; MSCT⁃EVs and VPF could inhibit the growth of SCC25 tumor cells in a dose⁃depe~ndent manner , showing good synergistic effect in the ratio of 10 : 1 - 5 : 1 ( CI < 1 , wt% ) . At the ratio of 100 : 5 100 : 15 ( Mass ratio of MSCT⁃EVs to VPF , wt% ) , the IC50 of MSCT⁃EVs/VPF was significantly lower than that of free MSCT⁃EVs + free VPF group (P < 0. 05) , and showed a more effective inhibition . The high inhibitory effect of MSCT⁃EVs/VPF on squamous cell car cinoma cells was partly due to the regulation of Caspase⁃3 , Bax , BCL⁃2 , mTOR , p ⁃mTOR and YAP . Conclusion EVs delivery of a fixed proportion of TRAIL/VPF shows high inhibitory effect on oral squamous cell carcinoma cells , which provides a new idea for the treatment of multidrug⁃resistant tumors .

Abstract Genetic diagnosis and etiological analysis were performed on a patient with hypoxic-ischemic encephalopathy at birth. MRI technology was used to examine the brain of the child. G-band karyotype analysis technology was used to analyze the karyotype of the child and her parents. Chromosomal microarray analysis(CMA) was used to analyze the entire genome of the child and her parents for chromosomal copy number variation(CNV) and to identify the small supernumerary marker chromosomes. The results of MRI supported the diagnosis of hypoxic-ischemic encephalopathy of the child and found the appearance of Dandy-Walker malformation. Karyotype analysis showed that the mother's karyotype was 46, XX, t(10; 13)(p11. 1; q11)[11]/46, XX[19]. The karyotype of the father was normal. The karyotype of the child was 47, XX, + mar. The CMA results showed that there was no CNVs above 200 kb in the parents. The CMA results of the child showed that the chromosome 10 was repeated in p15. 3 p11. 1, and the fragment size was 38. 39 Mb. In conclusion, this study found a rare small supernumerary marker chromosome(sSMC) on chromosome 10. Its genetic pattern and pathogenicity were analyzed. It is considered that sSMC(10) is the cause of the patient.

Objective:To investigate the current status of work-related musculoskeletal disorders (WMSDs) in automobile assembly workers, as well as the distribution of WMSDs at multiple sites and related influencing factors.Methods:From March to July 2019, cluster sampling was performed to select 663 male automobile assembly workers as respondents, and the musculoskeletal injury questionnaire was used to investigate their general status and working condition. A multinomial logistic regression analysis was used to analyze the influencing factors for WMSDs at multiple sites.Results:The detection rate of WMSDs within the past 7 days was 37.9% (251/663) among the automobile assembly workers, and the detection rate of WMSDs within the past 1 year was 51.9% (344/663) . Of all workers, 13.6% (90/663) had WMSDs involving only 1 site, while 38.3% (254/663) had WMSDs involving 2 or more sites. The multinomial logistic regression analysis showed that frequent turns during work was a risk factor for WMSDs involving 1-3, 4-6, and 7-9 sites (odds ratio [ OR]=1.65, 2.47, and 3.65, respectively) . Repeated action of lower extremities and ankles was a risk factor for WMSDs involving 4-6 and 7-9 sites ( OR=2.15 and 2.98, respectively) . Working in an uncomfortable position was a risk factor for WMSDs involving 1-3, 4-6, and 7-9 sites ( OR=1.95, 2.67, and 3.04, respectively) . Prolonged standing during work was a risk factor for WMSDs involving 1-3 and 4-6 sites ( OR= 1.87 and 1.79, respectively) . Working overtime was a risk factor for WMSDs involving 7-9 sites ( OR=5.48) . Adequate time for rest was a protective factor against WMSDs involving 1-3 and 4-6 sites ( OR=0.50 and 0.31, respectively) . Conclusion:There is a high detection rate of WMSDs in automobile assembly workers, and WMSDs at multiple sites are more common than WMSDs at a single site. Poor position and organizational management factors are risk factors for occupational WMSDs at multiple sites.

Objective:To understand the mental health status of pregnant women in the third trimester of pregnancy, and explore the influencing factors.Methods:The general demographic information and pregnancy information of 575 pregnant women in the Chinese Pregnant Women Cohort Study were collected. The mental health status of pregnant women in the third trimester was investigated by using Edinburgh Postpartum Depression Scale, Self-Rating Anxiety Scale and University of California at Los Angeles. Multivariate unconditional logistic regression was used to analyze the influencing factors for mental health of pregnant women.Results:In the third trimester of pregnancy, the incidence of depression was 16.52%, the incidence of anxiety was 11.13%, and the incidence of feeling loneliness was 26.26%. Logistic regression analysis showed that compared with those with education level of junior high school below, those with education level of college or bachelor's degree ( OR=0.418, 95% CI: 0.184-0.950) and master's degree or above ( OR=0.116, 95% CI: 0.027-0.503) were less likely to feel loneliness. Pregnant women with higher annual family income (10 000 RMB yuan) were less likely to suffer from depression (≥20 vs. <10: OR=0.527, 95% CI: 0.279-0.998), anxiety (10-20 vs. <10: OR=0.363, 95% CI: 0.180-0.731; ≥20 vs. <10: OR=0.271, 95% CI: 0.132-0.554) and feeling loneliness (≥20 vs. <10: OR=0.477, 95% CI: 0.276-0.826). Conclusions:The education level and family income have impacts on the mental health status of pregnant women in the third trimester. Medical staff should give targeted psychological advice to pregnant women to improve their mental health status.