ObjectiveTo analyze the incidence and trend of stroke in Beilun District, so as to provide evidence for identifying influencing factors and reducing stroke incidence. MethodsStroke cases from 2012 to 2023 were extracted from the Ningbo Chronic Disease Collaborative Management System. Population information of Beilun District during the same period was also collected. The annual incidence and trends of stroke were analyzed. ResultsFrom 2012 to 2023, the age-standardized incidence rate of stroke in Beilun District, Ningbo City was 317.68/100 000, showing an increasing trend with an average annual percentage change (AAPC) of 2.267% (P=0.034). Among all subdistricts in Beilun District, two showed a downward trend in incidence, while the rest showed an upward trend. The crude incidence rate of stroke was significantly higher in males than that in females (P<0.001). The age-standardized incidence rate in males was 406.08/100 000, showing an increasing trend (AAPC=3.956%, P<0.001). The incidence of stroke also showed an increasing trend in the following age groups: 30‒<45 years (AAPC=6.340%, P=0.004), 45‒<60 years (AAPC=4.997%, P<0.001), and 60‒<75 years (AAPC=3.282%, P=0.042). Across all years, males had higher crude incidence rates in both ischemic and hemorrhagic stroke than females (P<0.05). The age-standardized incidence rate of ischemic stroke showed a rising trend in both males and the general population (male AAPC=4.905%, P<0.001; overall population AAPC=3.065%, P=0.001). ConclusionThe age-standardized incidence of stroke in Beilun District is on the rise, with higher crude incidence rate in males than that in females. The onset age of stroke is gradually declining. The age-standardized incidence rate of male ischemic stroke shows a clear upward trend.

Objective To investigate the clinical symptoms and psychological health status of migraine patients.Methods A total of 120 migraine patients admitted to Xingtai People's Hospital from September 14,2022 to July 30,2023 were selected and divided into mild pain group(0-3 points,51 cases),moderate pain group(4-6 points,48 cases),and severe pain group(7-10 points,21 cases)according to numerical rating scale.General clinical data,headache impact test-6(HIT-6),patient health questionnaire-9(PHQ-9),generalized anxiety disorder(GAD-7)and Pittsburgh sleep quality index(PSQI)were collected.Results The scores of HIT-6,PHQ-9,GAD-7,and PSQI of migraine patients were(56.33±11.30)points,(3.38±1.51)points,(3.01±0.58)points,and(4.73±0.78)points,respectively.There were statistically significant differences in the duration and total number of headache attacks among three groups(P＜0.05).With the aggravation of headache degree,the duration of headache attacks increased and the number of attacks increased.There were statistically significant differences in the scores of HIT-6 and GAD-7 among three groups(P＜0.05),and the scores of HIT-6 and GAD-7 increased with the aggravation of headache.Conclusion There are differences in the daily life impact,anxiety,pain duration and frequency of migraine in patients with different degrees of migraine.

Objective:To investigate the clinical effect of saphenous artery perforating branch flap in repairing anterior knee soft tissue defects with patella exposure.Methods:From July 2010 to September 2017, 12 patients whose patella exposed due to anterior soft tissue defects of knee were treated. The 12 cases included 8 males and 4 females, aged from 24 to 60 years (42.6 years on average). The causes of injury included car accident in 5 cases, rolling injury in 3 cases, burn and scald in 2 cases, and postoperative patella fracture in 2 cases. The areas of the wounds ranged from 6 cm × 5 cm to 8 cm × 7 cm. The wounds were repaired by saphenous artery perforating flaps with the area ranged from 7 cm × 6 cm to 9 cm × 8 cm, and the donor sites were repaired with free skin grafting.Results:All the 12 cases ended up with the wounds healed primarily and no postoperative complications. The 12 cases were followed up for 6 months to 24 months, with an average of 12 months. The color, texture and appearance of the flaps were good, the thickness of the flap were moderate, and the function of knee joint was recovered well. Skin flap sensation was graded according to the criteria of the British Medical Research Society: 2 cases for Grade S 3+, 6 cases for Grade S 3 and 4 cases for Grade S 2. Conclusions:Saphenous artery perforating flap is an effective method to repair anterior knee soft tissue defect and patella exposure.

The successes with immune checkpoint blockade (ICB) and chimeric antigen receptor(CAR)-T-cell therapy in treating multiple cancer types have established immunotherapy as a pow-erful curative option for patients with advanced cancers.Unfortunately,many patients do not derive benefit or long-term responses,highlighting a pressing need to perform complete investiga-tion of the underlying mechanisms and the immunotherapy-induced tumor regression or rejection.In recent years,a large number of single-cell technologies have leveraged advances in characterizing immune system,profiling tumor microenvironment,and identifying cellular heterogeneity,which establish the foundations for lifting the veil on the comprehensive crosstalk between cancer and immune system during immunotherapies.In this review,we introduce the applications of the most widely used single-cell technologies in furthering our understanding of immunotherapies in terms of underlying mechanisms and their association with therapeutic outcomes.We also discuss how single-cell analyses help to deliver new insights into biomarker discovery to predict patient response rate,monitor acquired resistance,and support prophylactic strategy development for toxicity man-agement.Finally,we provide an overview of applying cutting-edge single-cell spatial-omics to point out the heterogeneity of tumor-immune interactions at higher level that can ultimately guide to the rational design of next-generation immunotherapies.

Objective:To investigate the clinical effect of saphenous artery perforating branch flap in repairing anterior knee soft tissue defects with patella exposure.Methods:From July 2010 to September 2017, 12 patients whose patella exposed due to anterior soft tissue defects of knee were treated. The 12 cases included 8 males and 4 females, aged from 24 to 60 years (42.6 years on average). The causes of injury included car accident in 5 cases, rolling injury in 3 cases, burn and scald in 2 cases, and postoperative patella fracture in 2 cases. The areas of the wounds ranged from 6 cm × 5 cm to 8 cm × 7 cm. The wounds were repaired by saphenous artery perforating flaps with the area ranged from 7 cm × 6 cm to 9 cm × 8 cm, and the donor sites were repaired with free skin grafting.Results:All the 12 cases ended up with the wounds healed primarily and no postoperative complications. The 12 cases were followed up for 6 months to 24 months, with an average of 12 months. The color, texture and appearance of the flaps were good, the thickness of the flap were moderate, and the function of knee joint was recovered well. Skin flap sensation was graded according to the criteria of the British Medical Research Society: 2 cases for Grade S 3+, 6 cases for Grade S 3 and 4 cases for Grade S 2. Conclusions:Saphenous artery perforating flap is an effective method to repair anterior knee soft tissue defect and patella exposure.

Objective To compare the surgical effects between minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider and open anterior ondontoid screw fixation in the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ.Methods From July 2011 to July 2016,28 adults with odontoid fracture of Anderson-D'Alonzo type Ⅱ were treated at Department Ⅱ of Spinal Surgery,Hospital of 89 Army Group of Chinese PLA.Of them,15 were treated by minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider (guider group) while the other 13 by open anterior ondontoid screw fixation (open group).All the patients were male,aged from 31 to 59 years (average,42.7 years).The 2 groups were compared in terms of incision length,operation time,intraoperative bleeding,intraoperative fluoroscopic frequency and hospital stay.Results There were no significant differences between the 2 groups of patients in their preoperative general data,indicating they were compatible (P ＞ 0.05).All the patients were followed up for 12 to 45 months (average,22.1 months).The internal fixation was in good place and clinical union achieved in all the 28 patients.The incision length (2.2 ± 0.1 cm),operation time (45.0 ± 3.1 min),intraoperative bleeding (29.0 ± 2.3 mL) and intraoperative fluoroscopic frequency (15.5 ± 1.9 times) for the guider group were all significantly less than those (2.9 ±0.7 cm,61.6±3.8 min,51.6±3.9 mL and 21.7±3.2 times,respectively) for the open group (P ＜0.05),but there was no significant difference between the 2 groups in hospital stay (6.5 ± 0.5 d versus 6.5 ± 0.6 d) (P ＞ 0.05).Conclusion In the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ,compared with open anterior ondontoid screw fixation,the minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider may lead to a smaller incision,shorter operation time,less blood loss and a lower fluoroscopic frequency.

Objective To evaluate the effects of early tracheostomy and late tracheostomy on the prognosis of patients with cervical spinal cord injury,so as to provide evidence based guidance for the timing of tracheostomy.Methods Relevant literatures studying the timing of tracheostomy in patients with cervical spinal cord injury were searched in PubMed,Embase,Medline,Cochrane Library,Chinese Biological Medical Literature database (CBM),China National Knowledge Infrastructure database (CNKI),and VIP journal database with time range from journal establishment to March 2018.The retrieved articles were screened according to the inclusion and exclusion criteria.The article quality was rigorously evaluated according to the Newcastle-Ottawa scale (NOS).Meta analysis was conducted using Review Manager 5.3 software to compare the mechanical ventilation time,ICU stay,incidence of pneumonia,incidence of complications,and mortality between early and late tracheostomy in patients with cervical spinal cord injury.Results A total of eight articles of cohort study including 466 patients were included,with 241 patients in the early tracheostomy group and 225 patients in the late tracheostomy group.The eight articles were all determined as high quality studies according NOS.The results of Meta analysis showed that there were significant differences between the two groups in terms of the total mechanical ventilation time (MD =-12.28,95％ CI-20.09--4.47,P ＜ 0.01),post tracheostomy mechanical ventilation time (MD =-9.92,95％ CI-14.27--5.57,P ＜ 0.01),total ICU stay (MD =-10.30,95％ CI-17.12--3.47,P ＜ 0.01),post tracheostomy ICU stay (MD =-5.79,95％ CI -6.53--5.05,P ＜ 0.01),incidence of complications (RR =0.56,95％ CI 0.38-0.83,P ＜ 0.01),and mortality (RR =0.34,95％ CI 0.15-0.78,P ＜ 0.05).However,no significant differences were detected between the two groups in the incidence of total pneumonia (RR =0.77,95％ CI 0.57-1.05,P ＞0.05) and the incidence of post tracheostomy pneumonia (RR =0.80,95％ CI 0.51-1.26,P ＞0.05).Conclusion Early tracheostomy can shorten the mechanical ventilation time,ICU stay,incidence of complications,and mortality,but it cannot reduce the incidence of pneumonia.

Objective: Hepatitis B surface antigen (HBsAg) loss is seldom achieved with nucleos(t)ide analog (NA) therapy in chronic hepatitis B patients but may be enhanced by switching to finite pegylated-interferon (Peg-IFN) alfa-2a. We assessed HBsAg loss with 48- and 96-week Peg-IFN alfa-2a in chronic hepatitis B patients with partial response to a previous NA. Methods: Hepatitis B e antigen (HBeAg)-positive patients who achieved HBeAg loss and hepatitis B virus DNA < 200 IU/mL with previous adefovir, lamivudine or entecavir treatment were randomized 1:1 to receive Peg-IFN alfa-2a for 48 (n = 153) or 96 weeks (n = 150). The primary endpoint of this study was HBsAg loss at end of treatment. The ClinicalTrials.gov identifier is NCT01464281. Results: At the end of 48 and 96 weeks' treatment, 14.4% (22/153) and 20.7% (31/150) of patients, respectively, who switched from NA to Peg-IFN alfa-2a cleared HBsAg. Rates were similar irrespective of prior NA or baseline HBeAg seroconversion. Among those who cleared HBsAg by the end of 48 and 96 weeks' treatment, 77.8% (14/18) and 71.4% (20/28), respectively, sustained HBsAg loss for a further 48 weeks. Baseline HBsAg < 1 500 IU/mL and week 24 HBsAg < 200 IU/mL were associated with the highest rates of HBsAg loss at the end of both 48- and 96-week treatment (51.4% and 58.7%, respectively). Importantly, extending treatment from 48 to 96 weeks enabled 48.3% (14/29) more patients to achieve HBsAg loss. Conclusion Patients on long-term NA who are unlikely to meet therapeutic goals can achieve high rates of HBsAg loss by switching to Peg-IFN alfa-2a. HBsAg loss rates may be improved for some patients by extending treatment from 48 to 96 weeks, although the differences in our study cohort were not statistically significant. Baseline and on-treatment HBsAg may predict HBsAg loss with Peg-IFN alfa-2a.

Objective To investigate the therapeutic effect of lateral homodigital flap combined with pedicled cross finger flap for repairing degloving injury of fingertip.Methods From February 2012 to July 2015,14 cases with degloving injury of fingertip were treated with lateral homodigital flap combined with vascular pedicled cross finger flap.21 days after operation,the pedicle was cut off,followed by functional exercise.Results All of the 14 patients were followed up for 3 to 9 months.The texture and appearance of all the flaps were satisfactory.Sense and function of finger recovered well.Two-point discrimination distance ranged from 10 to 13 mm (mean,11.5 mm).Conclusions Degloving injury of fingertip can be treated by lateral homodigital flap combined with pedicled cross finger flap with satisfactory results.

Objective To investigate the therapeutic effect of lateral homodigital flap combined with pedicled cross finger flap for repairing degloving injury of fingertip.Methods From February 2012 to July 2015,14 cases with degloving injury of fingertip were treated with lateral homodigital flap combined with vascular pedicled cross finger flap.21 days after operation,the pedicle was cut off,followed by functional exercise.Results All of the 14 patients were followed up for 3 to 9 months.The texture and appearance of all the flaps were satisfactory.Sense and function of finger recovered well.Two-point discrimination distance ranged from 10 to 13 mm (mean,11.5 mm).Conclusions Degloving injury of fingertip can be treated by lateral homodigital flap combined with pedicled cross finger flap with satisfactory results.