Objective: To investigate the efficacy and safety of pedunculated rectus abdominis combined with bilateral ureteral extravestheter drainage in the treatment of refractory bladder-vaginal stump fistula. Methods: The clinical data of 8 cases of the refractory bladder-vaginal stump fistula were admitted to the Second Hospital of Hebei Medical University and Henan Cancer Hospital and underwent the clinical treatment of bladder-vaginal stump from December 2019 to December 2022 were collected. The reason of refractory bladder-vaginal stump fistula was analyzed, the operation manner of pedunculated rectus abdominis combined with peduncle and bilateral ureter for the treatment of bladder-vaginal stump through extrabladder drainage was explored. The operation time, bleeding volume and clinical effect were record. Results: The median operation time of 8 patients was 150 minutes(120~180 min), and the median blood loss was 400 ml(200~600 ml). During the perioperative period, there were 2 cases of incision infection, delayed healing by debridement and dressing, 2 cases of incision rupture and suture wound healing after reoperation, and 2 cases of urinary tract infection were cured by anti-infection. When followed up for 6 months, 8 cases of vesicovaginal stump fistula were cured. Conclusion: Bilateral ureteral external drainage of the rectus abdominis muscle, has a practical effect in the treatment of refractory bladder-vaginal stump fistula, which can be one of the clinical repairing treatment.
Female ; Humans ; Urinary Bladder/surgery* ; Ureter/surgery* ; Rectus Abdominis ; Drainage ; Fistula

Objective: To investigate the efficacy and safety of pedunculated rectus abdominis combined with bilateral ureteral extravestheter drainage in the treatment of refractory bladder-vaginal stump fistula. Methods: The clinical data of 8 cases of the refractory bladder-vaginal stump fistula were admitted to the Second Hospital of Hebei Medical University and Henan Cancer Hospital and underwent the clinical treatment of bladder-vaginal stump from December 2019 to December 2022 were collected. The reason of refractory bladder-vaginal stump fistula was analyzed, the operation manner of pedunculated rectus abdominis combined with peduncle and bilateral ureter for the treatment of bladder-vaginal stump through extrabladder drainage was explored. The operation time, bleeding volume and clinical effect were record. Results: The median operation time of 8 patients was 150 minutes(120~180 min), and the median blood loss was 400 ml(200~600 ml). During the perioperative period, there were 2 cases of incision infection, delayed healing by debridement and dressing, 2 cases of incision rupture and suture wound healing after reoperation, and 2 cases of urinary tract infection were cured by anti-infection. When followed up for 6 months, 8 cases of vesicovaginal stump fistula were cured. Conclusion: Bilateral ureteral external drainage of the rectus abdominis muscle, has a practical effect in the treatment of refractory bladder-vaginal stump fistula, which can be one of the clinical repairing treatment.
Female ; Humans ; Urinary Bladder/surgery* ; Ureter/surgery* ; Rectus Abdominis ; Drainage ; Fistula

Genome-wide association studies (GWASs) are the most widely used method to identify genetic risk loci associated with orofacial clefts (OFC). However, despite the increasing size of cohort, GWASs are still insufficient to detect all the heritability, suggesting there are more associations under the current stringent statistical threshold. In this study, we obtained an integrated epigenomic dataset based on the chromatin conformation of a human oral epithelial cell line (HIOEC) using RNA-seq, ATAC-seq, H3K27ac ChIP-seq, and DLO Hi-C. Presumably, this epigenomic dataset could reveal the missing functional variants located in the oral epithelial cell active enhancers/promoters along with their risk target genes, despite relatively less-stringent statistical association with OFC. Taken a non-syndromic cleft palate only (NSCPO) GWAS data of the Chinese Han population as an example, 3664 SNPs that cannot reach the strict significance threshold were subjected to this functional identification pipeline. In total, 254 potential risk SNPs residing in active cis-regulatory elements interacting with 1 718 promoters of oral epithelium-expressed genes were screened. Gapped k-mer machine learning based on enhancers interacting with epithelium-expressed genes along with in vivo and in vitro reporter assays were employed as functional validation. Among all the potential SNPs, we chose and confirmed that the risk alleles of rs560789 and rs174570 reduced the epithelial-specific enhancer activity by preventing the binding of transcription factors related to epithelial development. In summary, we established chromatin conformation datasets of human oral epithelial cells and provided a framework for testing and understanding how regulatory variants impart risk for clefts.
Chromatin ; Cleft Lip/genetics* ; Cleft Palate/genetics* ; Epithelium ; Genome-Wide Association Study ; Humans

Objective:To explore the effect of placing drainage or not on rapid rehabilitation after total knee arthroplasty (TKA). Methods:From January, 2018 to September, 2020, 80 patients with knee osteoarthritis who underwent primary TKA in our hospital were analyzed retrospectively, and they were divided into groups A and B, with 40 cases in each group. Drainage was placed routinely in group A and not in group B. The postoperative serum inflammatory factors, postoperative pain score, postoperative complication rate, postoperative time out of bed, hospital stay, knee function score, range of motion of knee and World Health Organization Quality Of Life-abbreviated version score (WHOQOL-BREF) were compared between two groups. Results:There was no significant difference in the levels of C-reactive protein between two groups on the 1st to 3rd day after operation (t < 0.410, P > 0.05). There was no significant difference in Visual Analogue Score between two groups from 12 h to 48 h after operation (t < 0.300, P > 0.05). The incidences of postoperative complications were 5.0% in group A and 2.5% in group B, with no significant difference between two groups (χ² = 0.346, P > 0.05). The time of getting out of bed and hospital stay was significantly shorter in group B than in group A (t > 4.863, P < 0.001). The scores of knee joint function, range of motion of knee and WHOQOL-BREF significantly increased after operation in both groups (t > 6.099, P < 0.001), however, there was no significant difference between two groups (P > 0.05). Conclusion:Placement or non-placement of drainage after primary TKA does not affect postoperative complications, knee joint function and quality of life of patients with knee osteoarthritis, however, non-placement of drainage can promote postoperative recovery and discharge.

Objective To identify new genes that correlate with prognosis of clear-cell renal cell carcinoma (ccRCC)

Objective: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. Methods: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. Results: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.
Aged ; Asian Continental Ancestry Group ; Blood Glucose/analysis* ; China/epidemiology* ; Cohort Studies ; Diabetes Mellitus/blood* ; Female ; Glucose Tolerance Test ; Glycated Hemoglobin A/analysis* ; Glycemic Index ; Humans ; Male ; Middle Aged ; Uric Acid/blood*

ObjectiveTo assess the screening ability of two new anthropometric indices： a body shape index （ABSI） and body roundness index （BRI） for metabolic associated fatty liver disease （MAFLD） in adults， and to determine the optimal cut-off value. MethodsBased on the valid baseline data collected from March 2018 to October 2019 in Dongguan City， Guangdong Province by South China Cohort （SCC） project， a total of 9 214 adults were included， with physical examination， ultrasound and laboratory tests. MAFLD was diagnosed according to the consensus statement of international experts. Body mass index （BMI）， waist circumference （WC） and waist-height-ratio （WHtR） were used as reference to evaluate the screening ability of ABSI and BRI. Spearman rank test and logistic regression model were used to compare the correlation between each index and MAFLD. The receiver operating characteristic curve （ROC） was used to compare the area under the curve （AUC）. ResultsThe prevalence of MAFLD was 31.41%， which increased linearly across the quartile of each index except ABSI. There was a positive correlation between each index and MAFLD but ABSI was the weakest （r_s=0.069 in males and r_s=0.045 in females） while BRI was stronger （r_s=0.409 in males and r_s=0.413 in females）. A multivariate logistic regression analysis of the presence of MAFLD for the highest quartile vs. the lowest quartile of each anthropometric measure， showed that ABSI had the lowest OR without statistical significance. The OR and 95%CI was 1.09 （0.85， 1.41） in males and 0.90 （0.74， 1.08） in females， respectively. BRI was similar to WHtR， and BMI had the strongest association whose OR and 95%CI was 61.15 （35.12， 106.47） in males and 20.07 （15.24， 26.43） in females， respectively. ABSI had the lowest AUC for MAFLD （0.55 in males and 0.53 in females） and the cut-off value was respectively 0.080 5 in males and 0.078 2 in females. BRI had a higher AUC （0.77 in males and 0.75 in females）， equal to WHtR and similar to WC （0.79 in males and 0.77 in females） but lower than BMI （0.81 in males and 0.79 in females）. The optimal cut-off value for BRI was 4.10 in males and 4.51 in females. BRI also showed a certain screening ability on MAFLD in lean/normal weight population （0.73 in males and 0.69 in females）， patients with diabetes （0.73 in males and 0.71 in females） and subjects with lean/normal weight and metabolic dysfunction （0.60 in males and 0.55 in females）. ConclusionsBRI can effectively identify MAFLD （AUC>0.7） and the optimal cut-off value is 4.10 for males and 4.51 for females， while ABSI performs poorly. Considering the screening on MAFLD in population with different characteristics， BRI shows a potential for use in early screening of MAFLD.

Objective:To explore the influence of social-psychological factors on outcome of joint rehabilitation. Methods:From October, 2015 to April, 2017, 64 inpatients accepting joint rehabilitation were divided into anxiety group and non-anxiety group, and depression group and non-depression group, according to the scores of Hamilton Anxiety Scale and Hamilton Depression Scale. They were assessed with routine joint scores as initial and final stages of joint rehabilitation, as well as Symptom Checklist-90 (SCL-90) and World Health Organization Disability Assessment Schedule 2.0 (WHO-DAS 2.0). The correlation of joint scores to scores of SCL-90 and WHO-DAS 2.0 was analyzed with Spearman correlation analysis. Results:There were significant differences in joint scores between the depression and the non-depression groups initially and finally (|t| > 2.106, P < 0.05). The joint score at the initial stage was negatively correlated with the interpersonal factor score of SCL-90 (r = -0.257, P < 0.05). The joint score at the final stage was negatively correlated (P < 0.05) with the dimension one (r = -0.257) and four (r = -0.278) of WHO-DAS 2.0, total score (r = -0.263), and interpersonal (r = -0.328) and hostile (r = -0.385) factor scores of SCL-90. Improvement of joint score negative correlated with dimension one of WHO-DAS 2.0 score (r = -0.249, P < 0.05). Conclusion:The social-psychological factors affect the outcome of joint rehabilitation. It is necessary to explore the way to take the the social-psychological assessment into the routine three stage evaluation of the joint rehabilitation protocol.

Seasonal outbreaks of airsacculitis in China's poultry cause great economic losses annually. This study tried to unveil the potential role of Avian metapneumovirus (AMPV), Ornithobacterium rhinotracheale (ORT) and Chlamydia psittaci (CPS) in avian airsacculitis. A serological investigation of 673 breeder chickens and a case-controlled study of 430 birds were undertaken. Results showed that infection with AMPV, ORT, and CPS was highly associated with the disease. The correlation between AMPV and CPS were positively robust in both layers and broilers. Finally, we determined the co-infection with AMPV, ORT, and CPS was prevalent in the sampled poultry farms suffering from respiratory diseases and the outbreak of airsacculitis was closely related to simultaneous exposure to all three agents.
Air Sacs ; microbiology ; pathology ; Animals ; Antibodies, Bacterial ; blood ; Antibodies, Viral ; blood ; Case-Control Studies ; Chickens ; Chlamydia ; Chlamydia Infections ; microbiology ; pathology ; veterinary ; Coinfection ; Flavobacteriaceae Infections ; microbiology ; pathology ; veterinary ; Humans ; Metapneumovirus ; Ornithobacterium ; Paramyxoviridae Infections ; pathology ; veterinary ; virology ; Poultry Diseases ; microbiology ; pathology ; virology ; Respiratory Tract Diseases ; microbiology ; veterinary ; virology ; Seroepidemiologic Studies

OBJECTIVETo analyze the correlation between the hallux valgus angle and arch X-ray parameters change, plantar pressure by measuring the X-ray indexes and foot-pressure indexes in patients with hallux valgus, as well as to study the main cause factors for the pain under the second metatarsal head.

METHODSA retrospective study of 254 patients(477 feet) treated in Wangjing Hospital from January 2012 to June 2013 was performed. The pain under the second metatarsal head and age distribution were recorded. All the patients were divided into two groups according to the second plantar bone pain: pain group and no pain group. The following indexes were measured and compared: HAVA(hallux abductor valgus angle), IMA1-2(the inter-metatarsal angle between the first and second metatarsals), IMA1-5(the inter-metatarsal angle between the first and fifth metatarsals), TAOTMLA (top angle of the medial longitudinal arch), AAOTMLA (anterior angle of the medial longitudinal arch), SMRL (the second metatarsal relative length than the first), and the plantar pressure indicators including TPUM (touch the ground time percentage under the second metatarsal head), PPUM (peak pressure under the second metatarsal head), and IUM(impulse under the second metatarsal head). All the factors were evaluated by Logistic regression analysis.

RESULTSSpearman rank correlation test showed that there were statistical significance in correlation between HAVA and IMA1-2, IMA1-5, TAOTMLA, AAOTMLA, TPUM(<0.05, r=0.647, 0.553, 0.127, -0.165, 0.158). Factors including the HAVA, SMRL and the TPUM were the risks for the pain under the second metatarsal head in patients with hallux valgus(<0.05, ORj=1.030, 1.069, 1.060).

CONCLUSIONSIncrease of the hallux valgus angle causes the collapse of hallux valgus arch, extending the weight bearing time of the second metatarsal and increasing the possibility of the pain under the second metatarsal.