Objective:To explore the relationship between long-term blood pressure variability and arteriosclerosis in women with a history of hypertensive disorders in pregnancy (HDP).Methods:This study was a retrospective cohort study. Data were obtained from the Kailuan Research Database. Women with a history of HDP who delivered between January 1990 and December 2020 and completed brachial-ankle pulse wave velocity (baPWV) measurement in the postpartum period were enrolled. Baseline data were obtained from the first post-delivery health examination, while the outcome measure was the baPWV recorded during the last follow-up visit, synchronized with blood pressure measurements. Based on long-term blood pressure variability, the enrolled study subjects were divided into the first, second, and third tertile groups in ascending order using the tertile method, and intergroup differences in clinical characteristics were compared. Multivariable logistic regression was performed to evaluate the impact of long-term blood pressure variability levels on arteriosclerosis risk in women with a history of HDP. Sensitivity analyses excluded individuals with multiple deliveries to validate the robustness of findings. Subgroup analyses were conducted based on delivery age (<40 vs. ≥40 years) and blood pressure measurement frequency (3 vs. >3 times) to explore the potential impact of different population characteristics on the study results.Results:A total of 421 study subjects were enrolled, aged (36.07±6.05) years, with a baPWV value of (1 376.80±238.18) cm/s. Long-term blood pressure variability was 4.66 (3.41, 6.50) mmHg (1 mmHg=0.133 kPa). The first, second and third quartile group included 140, 141 and 140 individuals, respectively. In the total population, the incidence of arteriosclerosis was 40.4% (170/421). The incidence rates in the first, second, and third tertile groups were 34.3% (48/140), 39.0% (55/141), and 47.9% (67/140), respectively. Multivariate logistic regression analysis showed that increased long-term blood pressure variability was an independent risk factor for arteriosclerosis in women with a history of HDP ( OR=1.702, 95% CI 1.018-2.844, P=0.043). The results of sensitivity analyses were consistent with that of the primary analysis ( OR=1.758, 95% CI 1.044-2.959, P=0.034). Subgroup analyses further indicated that in the subgroups with delivery age <40 years ( OR=2.116, 95% CI 1.153-3.885, P=0.016) and blood pressure measurement frequency >3 times ( OR=1.894, 95% CI 1.069-3.355, P=0.029), the association between long-term blood pressure variability and arterial stiffness risk was more significant. Conclusions:For women with a history of HDP, elevated long-term blood pressure variability may increase the risk of arteriosclerosis, and this effect is more pronounced in younger women (delivery age <40 years) and those with high-frequency blood pressure measurements (>3 times). Enhanced monitoring and management of blood pressure variability in this population are crucial to improving long-term cardiovascular health outcomes.

Objective:To investigate the clinical effect of the divisional design in composite labia minora and clitoral hood reduction.Methods:A retrospective analysis was performed on 57 patients diagnosed with labia minora and clitoral hood hypertrophy at Department of Plastic Surgery, Nanjing Medical University Friendship Plastic Surgery Hospital between July 2018 and May 2021. The ages of the patients ranged from 24 to 45 years with an average of (31.0±8.2) years. Preoperative symptoms and surgical demands included: appearance concerns in 57 cases (100%), irritation during friction in 49 cases (86.0%), and discomfort during intercourse in 22 cases (38.6%). The complex hypertrophy was divided into simple labia minora hypertrophy and clitoral hood hypertrophy. Then the reduction of clitoris hood was performed according to the prepuce morphology, and labiaplasty was performed using edge resection. The operative effects, patient satisfaction, and postoperative complications were assessed.Results:All incisions healed primarily with no flap necrosis or marginal infections. Hematoma occurred in 1 case which recovered well after timely treatment. All patients were followed up for 3-12 months. 54 cases were satisfied with the labia minora and clitoral hood shape and reported no sensory abnormality. Bilateral asymmetry occurred in 2 cases, one of which required further surgical repair. Scar hyperplasia occurred and was gradually softened after 6 months in 1 case. Of the 57 patients with appearance concerns, 55 (96.5%) patients reported improved appearance postoperatively. Of the 49 patients with preoperative friction discomfort, 47 (95.9%) patients achieved symptom relief. Of the 22 patients reporting sexual discomfort, 15 (68.1%) patients noted enhanced sexual satisfaction postoperatively. Overall, 54 (94.7%) patients were satisfied, 2 (3.5%) patients were moderately satisfied, and 1 (1.8%) patient was unsatisfied.Conclusions:For patients with labia minora and clitoral hood hypertrophy, the application of divisional design is surgically simple and safe. It achieves satisfactory outcomes with no severe adverse reactions.

Objective To investigate the causal relationship between 41 inflammatory factors and hepatocellular carcinoma(HCC).Methods A two-sample Mendelian randomization(MR)analysis was conducted using genome-wide association study(GW AS)data from the UK Biobank(GCST90043858,n=456 348)and a Finnish population-based GW AS dataset of 41 inflammatory factors(n=8 293).Genetic variants significantly associated with the 41 inflammatory factors were selected as instrumental variables(IVs).The inverse-variance weighted(IVW)method was used as the primary analysis,supplemented by MR Egger regression,weighted median method,and pleiotropy tests to ensure the robustness of the results.Results Genetically predicted IL-5(OR:2.15,95％CI:1.05-4.39,P=0.036)and IL-17(OR:3.35,95％CI:1.36-8.25,P=0.008)were significantly associated with an increased risk of liver cancer.Conclusion IL-5 and IL-17 exhibit a causal relationship with hepatocellular carcinoma risk,suggesting their potential as biomarkers for liver cancer.Targeting inflammatory signaling pathways may provide novel strategies for the prevention and treatment of HCC.

Objective To investigate the causal relationship between 41 inflammatory factors and hepatocellular carcinoma(HCC).Methods A two-sample Mendelian randomization(MR)analysis was conducted using genome-wide association study(GW AS)data from the UK Biobank(GCST90043858,n=456 348)and a Finnish population-based GW AS dataset of 41 inflammatory factors(n=8 293).Genetic variants significantly associated with the 41 inflammatory factors were selected as instrumental variables(IVs).The inverse-variance weighted(IVW)method was used as the primary analysis,supplemented by MR Egger regression,weighted median method,and pleiotropy tests to ensure the robustness of the results.Results Genetically predicted IL-5(OR:2.15,95％CI:1.05-4.39,P=0.036)and IL-17(OR:3.35,95％CI:1.36-8.25,P=0.008)were significantly associated with an increased risk of liver cancer.Conclusion IL-5 and IL-17 exhibit a causal relationship with hepatocellular carcinoma risk,suggesting their potential as biomarkers for liver cancer.Targeting inflammatory signaling pathways may provide novel strategies for the prevention and treatment of HCC.

Objective:To investigate the clinical effect of the divisional design in composite labia minora and clitoral hood reduction.Methods:A retrospective analysis was performed on 57 patients diagnosed with labia minora and clitoral hood hypertrophy at Department of Plastic Surgery, Nanjing Medical University Friendship Plastic Surgery Hospital between July 2018 and May 2021. The ages of the patients ranged from 24 to 45 years with an average of (31.0±8.2) years. Preoperative symptoms and surgical demands included: appearance concerns in 57 cases (100%), irritation during friction in 49 cases (86.0%), and discomfort during intercourse in 22 cases (38.6%). The complex hypertrophy was divided into simple labia minora hypertrophy and clitoral hood hypertrophy. Then the reduction of clitoris hood was performed according to the prepuce morphology, and labiaplasty was performed using edge resection. The operative effects, patient satisfaction, and postoperative complications were assessed.Results:All incisions healed primarily with no flap necrosis or marginal infections. Hematoma occurred in 1 case which recovered well after timely treatment. All patients were followed up for 3-12 months. 54 cases were satisfied with the labia minora and clitoral hood shape and reported no sensory abnormality. Bilateral asymmetry occurred in 2 cases, one of which required further surgical repair. Scar hyperplasia occurred and was gradually softened after 6 months in 1 case. Of the 57 patients with appearance concerns, 55 (96.5%) patients reported improved appearance postoperatively. Of the 49 patients with preoperative friction discomfort, 47 (95.9%) patients achieved symptom relief. Of the 22 patients reporting sexual discomfort, 15 (68.1%) patients noted enhanced sexual satisfaction postoperatively. Overall, 54 (94.7%) patients were satisfied, 2 (3.5%) patients were moderately satisfied, and 1 (1.8%) patient was unsatisfied.Conclusions:For patients with labia minora and clitoral hood hypertrophy, the application of divisional design is surgically simple and safe. It achieves satisfactory outcomes with no severe adverse reactions.

Objective:To explore the relationship between long-term blood pressure variability and arteriosclerosis in women with a history of hypertensive disorders in pregnancy (HDP).Methods:This study was a retrospective cohort study. Data were obtained from the Kailuan Research Database. Women with a history of HDP who delivered between January 1990 and December 2020 and completed brachial-ankle pulse wave velocity (baPWV) measurement in the postpartum period were enrolled. Baseline data were obtained from the first post-delivery health examination, while the outcome measure was the baPWV recorded during the last follow-up visit, synchronized with blood pressure measurements. Based on long-term blood pressure variability, the enrolled study subjects were divided into the first, second, and third tertile groups in ascending order using the tertile method, and intergroup differences in clinical characteristics were compared. Multivariable logistic regression was performed to evaluate the impact of long-term blood pressure variability levels on arteriosclerosis risk in women with a history of HDP. Sensitivity analyses excluded individuals with multiple deliveries to validate the robustness of findings. Subgroup analyses were conducted based on delivery age (<40 vs. ≥40 years) and blood pressure measurement frequency (3 vs. >3 times) to explore the potential impact of different population characteristics on the study results.Results:A total of 421 study subjects were enrolled, aged (36.07±6.05) years, with a baPWV value of (1 376.80±238.18) cm/s. Long-term blood pressure variability was 4.66 (3.41, 6.50) mmHg (1 mmHg=0.133 kPa). The first, second and third quartile group included 140, 141 and 140 individuals, respectively. In the total population, the incidence of arteriosclerosis was 40.4% (170/421). The incidence rates in the first, second, and third tertile groups were 34.3% (48/140), 39.0% (55/141), and 47.9% (67/140), respectively. Multivariate logistic regression analysis showed that increased long-term blood pressure variability was an independent risk factor for arteriosclerosis in women with a history of HDP ( OR=1.702, 95% CI 1.018-2.844, P=0.043). The results of sensitivity analyses were consistent with that of the primary analysis ( OR=1.758, 95% CI 1.044-2.959, P=0.034). Subgroup analyses further indicated that in the subgroups with delivery age <40 years ( OR=2.116, 95% CI 1.153-3.885, P=0.016) and blood pressure measurement frequency >3 times ( OR=1.894, 95% CI 1.069-3.355, P=0.029), the association between long-term blood pressure variability and arterial stiffness risk was more significant. Conclusions:For women with a history of HDP, elevated long-term blood pressure variability may increase the risk of arteriosclerosis, and this effect is more pronounced in younger women (delivery age <40 years) and those with high-frequency blood pressure measurements (>3 times). Enhanced monitoring and management of blood pressure variability in this population are crucial to improving long-term cardiovascular health outcomes.

Objective:To explore the application of spiral tracheoplasty in the repair of large tracheal defects after the resection of trachea invaded by thyroid cancer.Methods:A retrospective analysis was performed on the clinical data of 11 patients, including 4 males and 7 females, aged from 36 to 67 years old, with large tracheal defects after tracheal resection due to thyroid papillary carcinoma invading the trachea in the Department of Otorhinolaryngology Head and Neck Surgery, Second Xiangya Hospital, Central South University from January 2019 to January 2022. The range of tracheal defects, time of tracheal reconstruction, postoperative complications and airway were recorded, and the patients were followed up for more than 24 months.Results:All patients underwent total thyroidectomy and tracheal resection and spiral reconstruction, and 2 of the cases underwent cricoid cartilage resection on the invaded side of cartilage. The tracheal defect accounted for 40%-60% of the circumference, and the lengths of the tracheal defects were 5.0 cm×7.5 cm and 6-9 tracheal rings, with 2 cases combined with partial defects of the cricoid cartilage. The reconstruction time was 30-60 min, with an average of 41.81 min. Among the 11 patients, 3 had recurrent laryngeal nerve paralysis, and 2 underwent tracheotomy. Four patients presented with hypocalcemia within one month after the operation. Followed up for 24-60 months, no tracheal stenosis occurred, the 2-year survival rate was 100%, the 2-year local control rate of the trachea was 100%, and the 2-year tumor-free survival rate was 81.8%.Conclusion:Spiral tracheoplasty is a safe and effective method that can reduce the tension at the tracheal anastomosis and expand the tracheal cavity, which can be used for tracheal reconstruction after extensive resection of trachea invaded by locally advanced thyroid cancer.

Objective:To explore the application of spiral tracheoplasty in the repair of large tracheal defects after the resection of trachea invaded by thyroid cancer.Methods:A retrospective analysis was performed on the clinical data of 11 patients, including 4 males and 7 females, aged from 36 to 67 years old, with large tracheal defects after tracheal resection due to thyroid papillary carcinoma invading the trachea in the Department of Otorhinolaryngology Head and Neck Surgery, Second Xiangya Hospital, Central South University from January 2019 to January 2022. The range of tracheal defects, time of tracheal reconstruction, postoperative complications and airway were recorded, and the patients were followed up for more than 24 months.Results:All patients underwent total thyroidectomy and tracheal resection and spiral reconstruction, and 2 of the cases underwent cricoid cartilage resection on the invaded side of cartilage. The tracheal defect accounted for 40%-60% of the circumference, and the lengths of the tracheal defects were 5.0 cm×7.5 cm and 6-9 tracheal rings, with 2 cases combined with partial defects of the cricoid cartilage. The reconstruction time was 30-60 min, with an average of 41.81 min. Among the 11 patients, 3 had recurrent laryngeal nerve paralysis, and 2 underwent tracheotomy. Four patients presented with hypocalcemia within one month after the operation. Followed up for 24-60 months, no tracheal stenosis occurred, the 2-year survival rate was 100%, the 2-year local control rate of the trachea was 100%, and the 2-year tumor-free survival rate was 81.8%.Conclusion:Spiral tracheoplasty is a safe and effective method that can reduce the tension at the tracheal anastomosis and expand the tracheal cavity, which can be used for tracheal reconstruction after extensive resection of trachea invaded by locally advanced thyroid cancer.

Objective To evaluate the diagnostic value of quantitative detection of cytomegalovirus (CMV) DNA from different sources [plasma, sputum and bronchoalveolar lavage fluid(BALF)] for CMV pneumonia after allogeneic hematopoietic stem cell transplantation. Methods Clinical data of 405 recipients undergoing allogeneic hematopoietic stem cell transplantation were retrospectively analyzed. Among them, 19 recipients diagnosed with CMV pneumonia were assigned into the CMV pneumonia group, and 229 recipients with CMV viremia alone, 11 recipients without CMV pneumonia who received fiberoptic bronchoscopy and 16 recipients diagnosed with bacterial or fungal pneumonia based on pathogenic evidence receiving sputum culture were assigned into the control A, B and C groups, respectively. The incidence of CMV pneumonia was summarized. The CMV DNA load of specimens from different sources (plasma, sputum and BALF) of recipients with CMV pneumonia was analyzed. The clinical prognosis of recipients with CMV pneumonia was evaluated. Results Among 405 recipients undergoing allogeneic hematopoietic stem cell transplantation, 19 cases developed CMV pneumonia, and the overall incidence of CMV pneumonia was 4.7%(19/405). The CMV DNA load in the plasma, sputum and BALF of recipients with CMV pneumonia was higher than those in the control A, B and C groups (all P < 0.05). In the 19 recipients, 12 cases were cured after antiviral treatment and 7 died from treatment failure(3 cases abandoned treatment). The fatality was 37%(7/19). Conclusions Quantitative detection of CMV DNA in the plasma, sputum and BALF may increase the diagnostic rate of CMV pneumonia, thereby improving clinical prognosis of recipients undergoing allogeneic hematopoietic stem cell transplantation.