ObjectiveTo investigate the associations of multiple glycolipid metabolic indicators and their cumulative abnormality burden with incident colorectal cancer risk in a general population-based prospective cohort, and to examine the mediating role of glycolipid metabolic abnormalities in the relationships between smoking, alcohol consumption, physical activity, and colorectal cancer incidence. MethodsA total of 17 897 eligible participants recruited from the Taizhou Cohort between 2011 and 2014 were included. Cox proportional hazards regression models were used to assess the associations of conventional and derived glycolipid indicators, as well as a glycolipid abnormality index constructed from total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting plasma glucose, and insulin, with incident colorectal cancer risk. Restricted cubic spline models were applied to evaluate dose-response relationships for major indicators. Receiver operating characteristic curves were generated to compare predictive performance across indicators. Mediation analyses were conducted to assess the mediating effects of the glycolipid abnormality index on the associations of smoking, alcohol consumption, and physical activity with colorectal cancer incidence. ResultsDuring a median follow-up of 11.2 years, 102 incident colorectal cancer cases were identified, with an incidence density of 51.2 per 100 000 person-years. After adjustment for potential confounders, Cox proportional hazards regression analyses showed that decreased high-density lipoprotein cholesterol was associated with a 1.74-fold higher risk of colorectal cancer (HR=1.74, 95%CI: 1.03‒2.95), elevated low-density lipoprotein cholesterol was associated with a 1.78-fold higher risk (HR=1.78, 95%CI: 1.05‒3.02), and abnormal fasting plasma glucose was associated with a 1.86-fold higher risk (HR=1.86, 95%CI: 1.15‒3.02). Triglycerides and fasting plasma glucose showed an approximately linear increasing association with colorectal cancer risk in multivariable restricted cubic spline models. The glycolipid abnormality index showed a clear gradient association with colorectal cancer risk; participants with three or more abnormal indicators had a 3.08-fold higher risk than those without abnormalities (HR=3.08, 95%CI: 1.60‒5.92). The area under the curve was 0.795, higher than that of individual glycolipid indicators and other combined indices, and gender-stratified analyses showed generally consistent patterns. Glycolipid metabolic abnormalities partially mediated the associations of smoking, alcohol consumption, and physical activity with colorectal cancer incidence, with mediation proportions of 8.33%, 9.45%, and 9.04%, respectively. ConclusionGlycolipid metabolic abnormalities are associated with an increased risk of incident colorectal cancer. The glycolipid abnormality index shows an increasing relationship with colorectal cancer risk and demonstrates better discrimination, and it partially mediates the associations of smoking, alcohol consumption, and physical activity with colorectal cancer incidence in the overall population.

Objective To explore the preventive value of electroacupuncture combined with antithrombotic compression banding for deep venous thrombosis(DVT)in high-risk patients with neurocritical venous thromboembolism(VTE).Methods A total of 98 high-risk patients with neurocritical VTE who were admitted to the First Hospital of Jiaxing from April 2023 to May 2024 were selected as research subjects.They were divided into pressure band group and electroacupuncture group by random number table method,with 49 cases in each group.Both groups of patients were given low molecular weight heparin to prevent thrombosis.The pressure band group was given antithrombotic compression banding intervention,and electroacupuncture group was combined with electroacupuncture intervention on the basis of antithrombotic compression banding.Both groups were treated continuously for 14 days.The changes in levels of D-dimer(D-D),interleukin-6(IL-6),fibrinogen(FIB),intercellular adhesion molecule-1(ICAM-1),activated partial thromboplastin(APTT),tumor necrosis factor-α(TNF-α),prothrombin time(PT)and the scores of activity of daily living(ADL)scale of two groups of patients before treatment and after 7 days and 14 days of treatment were compared.The incidences of VTE,tenderness and superficial varicose veins of two groups of patients were statistically analyzed.Results After 7 days and 14 days of treatment,the levels of D-D,FIB,IL-6,ICAM-1,and TNF-α in both groups were significantly lower than those before treatment,APTT and PT were significantly longer than those before treatment,and ADL scores were significantly higher than those before treatment(P＜0.05).After 7 days and 14 days of treatment,the levels of D-D,FIB,IL-6,ICAM-1 and TNF-α in electroacupuncture group were significantly lower than those in pressure band group,and ADL score was significantly higher than that in pressure band group(P＜0.05).The APTT and PT of patients in electroacupuncture group after 7 days of treatment were significantly longer than those in pressure band group(P＜0.05).The incidences of VTE,tenderness and superficial varicose veins in electroacupuncture group were significantly lower than those in pressure band group(P＜0.05).Conclusion The application of electroacupuncture combined with antithrombotic compression banding in neurocritical VTE high-risk patients can alleviate inflammatory responses,improve coagulation function,and reduce the occurrence of VTE,tenderness,and superficial varicose veins.

Objective To explore the preventive value of electroacupuncture combined with antithrombotic compression banding for deep venous thrombosis(DVT)in high-risk patients with neurocritical venous thromboembolism(VTE).Methods A total of 98 high-risk patients with neurocritical VTE who were admitted to the First Hospital of Jiaxing from April 2023 to May 2024 were selected as research subjects.They were divided into pressure band group and electroacupuncture group by random number table method,with 49 cases in each group.Both groups of patients were given low molecular weight heparin to prevent thrombosis.The pressure band group was given antithrombotic compression banding intervention,and electroacupuncture group was combined with electroacupuncture intervention on the basis of antithrombotic compression banding.Both groups were treated continuously for 14 days.The changes in levels of D-dimer(D-D),interleukin-6(IL-6),fibrinogen(FIB),intercellular adhesion molecule-1(ICAM-1),activated partial thromboplastin(APTT),tumor necrosis factor-α(TNF-α),prothrombin time(PT)and the scores of activity of daily living(ADL)scale of two groups of patients before treatment and after 7 days and 14 days of treatment were compared.The incidences of VTE,tenderness and superficial varicose veins of two groups of patients were statistically analyzed.Results After 7 days and 14 days of treatment,the levels of D-D,FIB,IL-6,ICAM-1,and TNF-α in both groups were significantly lower than those before treatment,APTT and PT were significantly longer than those before treatment,and ADL scores were significantly higher than those before treatment(P＜0.05).After 7 days and 14 days of treatment,the levels of D-D,FIB,IL-6,ICAM-1 and TNF-α in electroacupuncture group were significantly lower than those in pressure band group,and ADL score was significantly higher than that in pressure band group(P＜0.05).The APTT and PT of patients in electroacupuncture group after 7 days of treatment were significantly longer than those in pressure band group(P＜0.05).The incidences of VTE,tenderness and superficial varicose veins in electroacupuncture group were significantly lower than those in pressure band group(P＜0.05).Conclusion The application of electroacupuncture combined with antithrombotic compression banding in neurocritical VTE high-risk patients can alleviate inflammatory responses,improve coagulation function,and reduce the occurrence of VTE,tenderness,and superficial varicose veins.

Low-altitude unmanned technology represented by unmanned aerial vehicle (UAV) has shown broad application prospects in the medical field. Since June 2023, Affiliated Hospital of Jiaxing University The First Hospital of Jiaxing, focusing on the demand for medical supplies transport among hospitals, has led the construction and operation practice of a low-altitude transfer system for medical supplies featuring UAV. By establishing a management organizational structure, building a low-altitude digital intelligence platform, constructing UAV take-off and landing platforms, formulating and approving flight routes, and improving the medical supply distribution process, it successfully achieved the transportation of medical blood and biological specimens between Jiaxing Central Blood Station and relevant medical institutions, as well as among different campus and medical alliance units of Affiliated Hospital of Jiaxing University The First Hospital of Jiaxing. As of June 2024, a total of 6 routes have been opened within the Jiaxing municipal area, with a cumulative flight distance exceeding 5 000 km. A total of 64 flights for medical blood, 720 flights for blood specimens, and 5 flights for pathological specimens have been transported. Compared with land transportation methods, UAV transportation effectively shortened transportation time, enhanced the service capabilities and diagnosis and treatment quality of grassroots medical institutions, and also saved costs. It can provide a reference for other medical institutions to carry out low-altitude medical supplies distribution.

Objective:To apply combined serological diagnostic methods for anti-BP180-type and anti-laminin 332 (Ln332) -type mucous membrane pemphigoid (MMP), and to summarize their clinical and immunoserological characteristics.Methods:A retrospective analysis was conducted on the data from 52 patients clinically suspected of having MMP at the Hospital of Dermatology, Chinese Academy of Medical Sciences from January 2017 to February 2022. Serum samples were collected, and combined serological tests, including indirect immunofluorescence on salt-split skin, enzyme-linked immunosorbent assay, and immunoblotting, were performed to analyze the immunoserological and clinical characteristics of the patients. The Fisher′s exact test was used to compare the lesion occurrence rates between groups.Results:Among the 52 patients clinically suspected of MMP, 32 (61.5%) were diagnosed with anti-BP180-type MMP, 10 (19.2%) with anti-Ln332-type MMP, and 4 (7.7%) with anti-BP180- and anti-Ln332-type MMP due to the presence of both anti-BP180 and anti-Ln332 antibodies; 2 tested positive for IgG on the epidermal side of salt-split skin, but no target antigens were identified by serological tests, and they were diagnosed with MMP (subtype pending) ; 4 tested negative by immunoserological tests. Ocular involvement was observed in 6 out of 10 patients with anti-Ln332-type MMP, whereas only 6 out of 32 anti-BP180-type MMP patients (18.8%) had ocular symptoms, and there was a significant difference in the occurrence rate of ocular involvement between the two groups ( P = 0.02) ; the occurrence rates of nasal involvement and multi-mucosal involvement were significantly higher in the anti-Ln332-type MMP patients (50%[5/10], 90%[9/10], respectively) than in the anti-BP180-type MMP patients (0, 25%[8/32], respectively, both P < 0.001). Scar formation occurred in 6 out of 10 anti-Ln332-type MMP patients, but occurred in only 6 out of 32 anti-BP180-type patients (18.8%, P = 0.02) . Conclusion:The combination of indirect immunofluorescence on salt-split skin, enzyme-linked immunosorbent assay, and immunoblotting could effectively identify anti-BP180 and anti-Ln332 autoantibodies in MMP patients, with BP180 being the most common target antigen; compared with anti-BP180-type MMP, anti-Ln332-type MMP appeared to be more frequently involve the ocular and nasal mucosae, associated with the involvement of multiple mucosal sites, carrying a higher risk of scar formation.

Objective:To apply combined serological diagnostic methods for anti-BP180-type and anti-laminin 332 (Ln332) -type mucous membrane pemphigoid (MMP), and to summarize their clinical and immunoserological characteristics.Methods:A retrospective analysis was conducted on the data from 52 patients clinically suspected of having MMP at the Hospital of Dermatology, Chinese Academy of Medical Sciences from January 2017 to February 2022. Serum samples were collected, and combined serological tests, including indirect immunofluorescence on salt-split skin, enzyme-linked immunosorbent assay, and immunoblotting, were performed to analyze the immunoserological and clinical characteristics of the patients. The Fisher′s exact test was used to compare the lesion occurrence rates between groups.Results:Among the 52 patients clinically suspected of MMP, 32 (61.5%) were diagnosed with anti-BP180-type MMP, 10 (19.2%) with anti-Ln332-type MMP, and 4 (7.7%) with anti-BP180- and anti-Ln332-type MMP due to the presence of both anti-BP180 and anti-Ln332 antibodies; 2 tested positive for IgG on the epidermal side of salt-split skin, but no target antigens were identified by serological tests, and they were diagnosed with MMP (subtype pending) ; 4 tested negative by immunoserological tests. Ocular involvement was observed in 6 out of 10 patients with anti-Ln332-type MMP, whereas only 6 out of 32 anti-BP180-type MMP patients (18.8%) had ocular symptoms, and there was a significant difference in the occurrence rate of ocular involvement between the two groups ( P = 0.02) ; the occurrence rates of nasal involvement and multi-mucosal involvement were significantly higher in the anti-Ln332-type MMP patients (50%[5/10], 90%[9/10], respectively) than in the anti-BP180-type MMP patients (0, 25%[8/32], respectively, both P < 0.001). Scar formation occurred in 6 out of 10 anti-Ln332-type MMP patients, but occurred in only 6 out of 32 anti-BP180-type patients (18.8%, P = 0.02) . Conclusion:The combination of indirect immunofluorescence on salt-split skin, enzyme-linked immunosorbent assay, and immunoblotting could effectively identify anti-BP180 and anti-Ln332 autoantibodies in MMP patients, with BP180 being the most common target antigen; compared with anti-BP180-type MMP, anti-Ln332-type MMP appeared to be more frequently involve the ocular and nasal mucosae, associated with the involvement of multiple mucosal sites, carrying a higher risk of scar formation.

Low-altitude unmanned technology represented by unmanned aerial vehicle (UAV) has shown broad application prospects in the medical field. Since June 2023, Affiliated Hospital of Jiaxing University The First Hospital of Jiaxing, focusing on the demand for medical supplies transport among hospitals, has led the construction and operation practice of a low-altitude transfer system for medical supplies featuring UAV. By establishing a management organizational structure, building a low-altitude digital intelligence platform, constructing UAV take-off and landing platforms, formulating and approving flight routes, and improving the medical supply distribution process, it successfully achieved the transportation of medical blood and biological specimens between Jiaxing Central Blood Station and relevant medical institutions, as well as among different campus and medical alliance units of Affiliated Hospital of Jiaxing University The First Hospital of Jiaxing. As of June 2024, a total of 6 routes have been opened within the Jiaxing municipal area, with a cumulative flight distance exceeding 5 000 km. A total of 64 flights for medical blood, 720 flights for blood specimens, and 5 flights for pathological specimens have been transported. Compared with land transportation methods, UAV transportation effectively shortened transportation time, enhanced the service capabilities and diagnosis and treatment quality of grassroots medical institutions, and also saved costs. It can provide a reference for other medical institutions to carry out low-altitude medical supplies distribution.

Traumatic main bronchus rupture is a relatively rare injury in thoracic trauma, which is extremely critical, with a mortality rate as high as 70% - 80%. The complete rupture and displacement of the traumatic cervical trachea can lead to asphyxia, hypoxia, and cardiac arrest, even death of the patient in a short time. We performed emergency surgery with the support of extracorporeal membrane oxygenation for a case of traumatic cervical tracheal trunk complete rupture and displacement combined with cardiac arrest and achieved a successful rescue. We summarized our experience and found that timely surgical reconstruction of the airway is the key to increasing the traumatic main bronchus rupture survival of patients.
Humans ; Extracorporeal Membrane Oxygenation ; Heart Arrest/etiology* ; Rupture ; Trachea/surgery*

OBJECTIVES: To investigate the clinical features and gene mutation characteristics of combined oxidative phosphorylation deficiency type 7 (COXPD7) caused by mutations in the C12orf65 gene, and to enhance the awareness of this disease. METHODS: A child diagnosed with COXPD7 in the Department of Neurology, Children's Hospital Affiliated to Zhengzhou University in 2021 was included, along with 10 patients reported in the literature. All subjects were analyzed for their genotypes and clinical phenotypes. RESULTS: A total of 11 patients with COXPD7 were included, comprising 1 reported in this study and 10 from the literature. Among the 11 patients, 9 had homozygous mutations in the C12orf65 gene, while 2 had compound heterozygous mutations, which were identified as frameshift or nonsense mutations. The age of onset ranged from 1 day to 2 years, and clinical manifestations included optic nerve atrophy and delays in intellectual and motor development. Eight patients exhibited external ophthalmoplegia, and five patients displayed spastic paralysis. Cranial magnetic resonance imaging revealed optic nerve atrophy in all 11 patients, abnormal brainstem signals in 10 patients, and a lactate peak on brainstem magnetic resonance spectroscopy scans in 3 patients. CONCLUSIONS COXPD7 associated with the C12orf65 gene results from homozygous or compound heterozygous mutations, with primary clinical manifestations of optic nerve atrophy and delays in intellectual and motor development. Some patients may also present with spastic paralysis or external ophthalmoplegia. Cranial imaging reveals symmetrical abnormal signals in bilateral basal ganglia and brainstem, and a lactate peak is observed on brainstem magnetic resonance spectroscopy scans.
Child, Preschool ; Female ; Humans ; Infant ; Male ; Mitochondrial Diseases/genetics* ; Mitochondrial Proteins/genetics* ; Mutation ; Oxidative Phosphorylation ; Infant, Newborn

Objective:To analyze clinical, immunoserological, and therapeutic features of patients with anti-p200 pemphigoid.Methods:Clinical data were collected from patients with confirmed anti-p200 pemphigoid at the Hospital of Dermatology, Chinese Academy of Medical Sciences from January 2015 to February 2024. Their clinical, immunoserological, and therapeutic characteristics were retrospectively analyzed.Results:A total of 35 patients were included, with a male-to-female ratio of 2.5∶1 (25 males and 10 females) and ages of 57.74 ± 17.12 years. Two (5.71%) patients were accompanied by psoriasis. In these patients, anti-p200 pemphigoid exhibited heterogeneous clinical phenotypes, mimicking classic bullous pemphigoid (20 cases, 57.14%), linear IgA bullous dermatosis (8 cases, 22.86%), or eczema (4 cases, 11.43%). The positive rates of direct immunofluorescence (DIF), indirect immunofluorescence on salt-split skin (ss-IIF), Western blot analysis with dermal extracts as substrates, and Western blot analysis with laminin γ1 C-terminal region (Lnγ1C) as substrates were 100% (24/24), 82.86% (29/35), 100% (35/35), and 80.64% (25/31), respectively. Among the 35 patients, treatment and follow-up information was available for analysis in 33. Six patients (18.18%) received non-glucocorticoid systemic therapy and topical glucocorticoid therapy, with a follow-up period ( M [ Q1, Q3]) of 19.50 (6.50, 69.25) months, and 1 withdrew the drugs. Sixteen patients received systemic glucocorticoids combined with traditional anti-inflammatory drugs, with a follow-up period of 13.50 (4.25, 18.00) months, the initial dose of glucocorticoids was equivalent to 0.30 - 0.50 mg·kg -1·d -1 of prednisone, and the time to disease control was 15.31 ± 5.23 days; among the 16 patients, 3 experienced fluctuations in disease condition which were alleviated by adding dapsone, and 1 discontinued glucocorticoids. Five patients (15.15%) received systemic glucocorticoids combined with immunosuppressants, with a follow-up period of 26.00 (14.00, 90.00) months, the initial dose of glucocorticoids was equivalent to 0.50 - 0.75 mg·kg -1·d -1 of prednisone, and the time to disease control was 10.20 ± 3.27 days; among the 5 patients, 2 received maintenance treatment with glucocorticoids (5 - 10 mg/d prednisone), 2 withdrew the drugs, and 1 relapsed after discontinuing glucocorticoids. One patient (3.03%) received systemic glucocorticoids combined with rituximab therapy, with a follow-up period of 53 months, and discontinued glucocorticoids thereafter. One patient (3.03%) received systemic glucocorticoids combined with dupilumab therapy, which proved to be effective. Four patients (12.12%) received systemic glucocorticoids combined with Janus kinase inhibitors, and 3 responded well. Conclusions:Anti-p200 pemphigoid presented a heterogeneous clinical profile in this series of patients, but scarring and milia were rare. Some patients showed negative results in Western blot analysis with Lnγ1C as substrates. The prognosis of anti-p200 pemphigoid was usually favorable, and most patients could achieve complete remission and ultimately discontinue medication.