Objective: To evaluate the efficacy and prognosis of loop cutaneous ureterostomy (LCU) in the treatment of primary obstructive megaureter (POM) with severe hydroureteronephrosis (HUN) in infants under 1 year of age，so as to provide reference for infants unsuitable for stage-Ⅰ ureteral reimplantation. Methods: A retrospective analysis was conducted on 12 infants with POM and severe HUN treated with LCU in our hospital during Jan.2019 and Dec.2023.The clinical characteristics，surgical techniques，indications，postoperative complications，stage-Ⅱ surgical approaches，and follow-up outcomes were summarized. Results: All operations were successful，with an average operation time of (37.08±7.53) min (6 left-sided LCU and 6 right-sided LCU).During the mean follow-up of (10.12±2.70) months，all infants showed clinical improvement，with complete resolution or significant alleviation of hydronephrosis，reduced ureteral diameter，and increased renal cortical thickness.Complications included asymptomatic bacteriuria in 3 cases (25%) and urinary tract infection (UTI) in 1 case，all resolved with oral antibiotics.Four cases developed peristomal rashes，which improved with topical treatment.Eleven infants underwent stage-Ⅱ Cohen ureterovesical reimplantation at a mean age of (15.20±2.07) months.Notably，27.3%(3/11) required ureteral tailoring or plication during reimplantation，which reduced the risk of ischemic necrosis from excessive trimming.During the follow-up of (22.17±13.93) months，hydronephrosis and renal function improved，and no febrile UTI or bladder dysfunction occurred. Conclusion: LCU is a safe and effective method，which can provide adequate urinary drainage，relieve obstruction，stabilize renal function，and allow time for ureteral maturation and renal parenchymal recovery.LCU also facilitates subsequent stage-Ⅱ surgery by reducing ureteral dilation.

Objective:To investigate the perioperative impact of closure of mesenteric fissure in laparoscopic right hemicolectomy.Methods:The prospective randomized controlled trial was conducted. The clinical data of 320 patients who underwent laparoscopic right hemicolectomy in 11 medical centers, including The First Affiliated Hospital of China Medical University et al, from November 2022 to August 2023 were selected. Based on block randomization, patients were alloca-ted into the mesenteric fissure non-closure group and the mesenteric fissure closure group. Observa-tion indicators: (1) grouping of the enrolled patients; (2) intraoperative conditions; (3) postopera-tive conditions. Measurement data with skewed distribution were represented as M( Q1, Q3) and com-parison between groups was conducted using the Mann-Whitney U test. Count data were represen-ted as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher's exact probability. Comparison of ordinal data was conducted using the rank sum test. Comparison of visual analog scores was analyzed using generalized estimating equations. Results:(1) Grouping of the enrolled patients. A total of 320 patients with colon cancer were screened for eligibility, including 156 males and 164 females, aged 68(59,73)years. All the 320 patients were allocated into the mesenteric fissure non-closure group with 164 cases and the mesenteric fissure closure group with 156 cases. There was no significant difference in the age, body mass index, American Society of Anesthesiologist score, maximum tumor diameter, anastomosis location, anastomosis method, surgical approach, range of lymph node dissection, tumor staging between the two groups ( P>0.05) and there was a significant difference in the sex between them ( P<0.05). (2) Intraoperative conditions. There was no significant difference between the mesenteric fissure closure group and the mesenteric fissure non-closure group in the volume of intraoperative blood loss, operation time, conversion to laparotomy, intraoperative complication ( P>0.05). Three patients in the mesenteric fissure non-closure group were converted to laparotomy. One patient in the mesenteric fissure closure group was converted to laparotomy, and 2 cases with intraoperative complication were mesenteric hematoma. (3) Postoperative conditions. There was no significant difference between the mesenteric fissure non-closure group and the mesenteric fissure closure group in the overall postoperative complications ( χ2=0.28, P>0.05). There was no significant difference in the occurrence of postoperative intestinal obstruction, abdominal distension, ascites, pleural effusion, gastric paralysis, anastomotic bleeding, anastomotic leakage, or surgical wound infection between the two groups ( P>0.05). There was no significant difference between the two groups in the reoperation, postoperative gastric tube replacement. There was no significant differ-ence in time to postoperative first flatus, time to postoperative initial liquid food intake, time to post-operative resumption of bowel movements, duration of postoperative hospital stay, total hospital expenses between the two groups ( Z=-0.01, 0.43, 1.04, -0.54, -0.36, P>0.05). One patient in the mesenteric fissure non-closure group received reoperation. No perioperative internal hernia or death occurred in either group. The visual analog score decreased with time in both groups. There was no significant difference in the visual analog score between the mesenteric fissure closure group and the mesenteric fissure non-closure group [ β=-0.20(-0.53,0.13), P>0.05]. Conclusion:Compared with closure of mesenteric fissure, non-closure of mesenteric fissure during laparoscopic right hemi-colectomy dose not increase perioperative complications or postoperative management risk.

Objective:To investigate the relationship between body mass index (BMI) and gestational hypertension using two-sample Mendelian randomization analysis.Methods:The summary level data for BMI and gestational hypertension were obtained from the genome-wide association study (the deadline for data inclusion was October 31, 2023). All data were analyzed by inverse variance weighting, MR-Egger regression, weighted median, simple model and weighted model methods. Cochrane Q test was used to evaluate heterogeneity, MR-Egger regression intercept test and funnel plot were used to assess horizontal pleiotropy. Results:Inverse variance weighting result under fixed effects and random effects models showed that the risk of gestational hypertension increased with the increase of BMI ( OR = 1.62 and 1.62, 95% CI 1.39 to 1.88 and 1.39 to 1.88, P<0.01). Sensitivity analysis results including MR-Egger regression, weighted median and weighted model methods showed that BMI increased the risk of gestational hypertension ( OR = 1.51, 1.56 and 1.71; 95% CI 1.01 to 2.26, 1.23 to 1.99 and 1.09 to 2.69; P<0.05 or <0.01). Although Cochrane Q test result showed evidence of heterogeneity ( P = 0.04), inverse variance weighting under a random model suggested that BMI increased the risk of gestational hypertension. Horizontal pleiotropy was not observed in the above analysis ( P = 0.73). Conclusions:Obesity may increase the risk of gestational hypertension. Pregnant women should pay attention to weight control to decrease the risk of gestational hypertension.

In order to provide basic information for the utilization and development of famous classical formulas containing Bletillae Rhizoma， this article systematically analyzes the historical evolution of the name， origin， harvesting and processing of Bletillae Rhizoma by reviewing the ancient materia medica， prescription books， medical books and modern literature. The research results showed that Baiji（白及） was the main name， some scholars took Baiji（白芨） as its main name， and there were many other names such as Baiji（白给）， Baigen（白根）， Baiji（白苙）. The mainstream source of Bletillae Rhizoma was the tubers of Bletilla striata， and drying， large， white， solid， root-free and skin removed completely were the good quality standards. With the promotion of wild to cultivated medicinal materials， there were certain differences between their traits， and the quality evaluation indexes should be adjusted accordingly. The origin of records in the past dynasties was widely distributed， with Guizhou and Sichuan having high production and good quality in modern times. The harvesting period is mostly in spring and autumn， and harvested in autumn was better. The processing and processing technology is relatively simple， and it was used fresh or powdered in past dynasties， while it is mainly sliced for raw use in modern times. Based on the results， it is suggested that the tubers of Bletilla striata of Orchidaceae should be used in the famous classical formulas， and it should be uniformly written as Baiji（白及）. And if the original formula indicates the requirement of processing， it should be operated according to the requirement， if the requirement of processing is not indicated， it can be used in raw form as medicine.

AIM: To assess the accuracy of predicting intraocular lens(IOL)power after myopic refractive surgery using the Pentacam system's true net power(TNP)in the 3 mm zone combined with the SRK/T formula [i.e. TNP 3 mm(SRK/T)].METHODS: Retrospective study. This study enrolled 35 cases(50 eyes)of patients undergoing cataract surgery after laser assisted in situ keratomileusis(LASIK)or photorefractive keratectomy(PRK)from July 2019 to December 2021. Preoperatively, IOL power of 50 eyes, 34 eyes and 41 eyes was calculated by TNP 3 mm(SRK/T), Barrett True-K and Olsen 2 formulas, respectively, with at least 2 formulas used to calculate IOL power for each patient. The actual diopter was recorded 3 mo postoperatively. Prediction errors(PE)of IOL power were compared among the three calculation methods, and the proportion of eyes with PE within ±0.5 D and ±1.0 D was analyzed.RESULTS: The PE at 3 mo postoperatively for TNP 3 mm(SRK/T), Barrett True-K, and Olsen 2 was -0.02±0.63, -0.54±0.80, and 0.25±0.80 D, respectively(P<0.001). The proportions of PE within ±0.5 D were 66%(33/50), 44%(15/34)and 37%(15/41), respectively(P<0.05); the proportions of PE within ±1.0 D were 88%(44/50), 71%(24/34)and 80%(33/41), respectively(P>0.05).CONCLUSION: The Pentacam TNP 3 mm(SRK/T)method is simple to operate and provides accurate calculation of IOL power after corneal refractive surgery.

Objective:By collecting and analyzing the clinical data of patients with micropapillary thyroid carcinoma, the ultrasound characteristics of the lesions and the mutation results of preoperative serum thyroid stimulating hormone (TSH) and BRAFV600 E genes, to investigate the high-risk factors of cervical lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC) and its predictive value. Methods:Retrospectivly analyzed the clinical data of 382 patients with PTMC confirmed by surgical pathology from January 2019 to September 2022 in the Fifth Clinical Medical College of Shanxi Medical University, including 142 male and 240 female, whose age was (43.24±11.27) years old, ranged from 16 to 67 years old. All patients were classified into cervical lymph node non-metastatic group ( n=195) and metastatic group ( n=187), according to postoperative pathology, unifactorial and multifactorial analyses were applied to analyze the risk factors for CLNM in patients with PTMC. Results:The differences between the 2 groups were statistically significant when comparing patients′ age, gender, serum TSH, tumor margins, morphology, microcalcifications, and maximum diameter of the tumor ( P<0.05), while all of the above factors were independent risk factors for CLNM in patients with PTMC( P<0.05). The risk of developing CLNM in the presence of microcalcifications was also 2.129 times higher than that in the absence of microcalcifications, so the presence of microcalcifications was a significant risk factor for the development of CLNM in PTMC ( P<0.05). Conclusion:Age, gender, routine ultrasound characteristics, and serum TSH have good predictive value for the development of cervical lymph node metastasis in patients with micropapillary thyroid carcinoma.

Objective:To explore the development and interaction between chronotype and depressive symp-toms among middle school students in Chongqing.Methods:A total of 1208 middle school students(613 in grade 7,595 in grade 10)were surveyed for three follow-ups at 6-month intervals.Periods T1-T3 represented baseline,6 months later,and 12 months later,respectively.Chronotype and depressive symptoms were measured by the Morn-ing and Evening Questionnaire-5(MEQ-5)and the Patient Health Questionnaire-9(PHQ-9).Analyses were per-formed using SPSS 26.0 and Mplus 8.3.Results:The MEQ-5 scores were lower in T1 than in T3,and the scores were lower in T2 than in T1 and T3(F=20.08,P＜0.001),suggesting a fluctuating trend of chronotype shifting to the Evening-type first after baseline and then to the Morning-type.The PHQ-9 scores exhibited a significant differ-ence among the three-time measurements(x2/df=9.77/2,P＜0.01).But pairwise comparisons did not yield any statistically significant findings(P＞0.05).The cross-lagged panel model showed that pathways of Ti MEQ-5 scores negatively predicted Ti+1 PHQ-9 scores(βTi-Ti+1=-0.12/-0.09,P＜0.05)and TiPHQ-9 scores nega-tively predicted Ti+1 MEQ-5 scores(βTi-Ti+1=-0.07/-0.11,P＜0.05).Conclusion:Chronotype and depressive symptoms show some changes in adolescents.The more inclined adolescents are to the Evening-type,the higher the likelihood of depressive symptoms occurring later.The more severe the depressive symptoms,the greater the likeli-hood of a subsequent shift to the Evening-type.

Objective: To investigate the awareness of HIV non-occupational post-exposure prophylaxis (nPEP) among residents in Yangzhou City, Jiangsu Province, so as to provide basis for further publicity and application of nPEP in genenral population. Methods: Community residents at ages of 18 years and older in Yangzhou City were sampled using the multi-stage random sampling method from January to June, 2022, and a cross-sectional survey was conducted to collect their demographic information, acquired immune deficiency syndrome (AIDS)-related knowledge, attitude and behaviors and awareness of nPEP. A multivariable logistic regression model was used to identify factors affecting awareness of nPEP. Results: Totally 1 488 questionnaires were allocated, and 1 447 valid questionnaires were recovered, with an effective recovery rate of 97.24%. There were 644 males and 803 females, with mean age of (36.33±11.90) years. There were 585 residents (40.43%) employed by government agencies, enterprises and public institutions; 750 residents (51.83%) with awareness of AIDS; 413 (28.54%), 651 (44.99%) and 383 residents (26.47%) had low, medium and high levels of AIDS discrimination, respectively; 201 residents (13.89%) with HIV detection experience; and 792 residents (54.73%) with regular health checkup. The awareness rate of nPEP was 47.89%. Multivariable logistic regression analysis identified career (government agencies, enterprises and public institutions, OR=1.530, 95%CI: 1.170-1.999; students, OR=1.450, 95%CI: 1.027-2.047), awareness of AIDS (OR=3.201, 95%CI: 2.495-4.106), having HIV detection experience (OR=1.908, 95%CI: 1.339-2.719), regular health checkup (OR=2.308, 95%CI:1.807-2.949) and discrimination against AIDS (medium, OR=0.703, 95%CI: 0.532-0.928; high, OR=0.699, 95%CI: 0.502-0.974) as factors affecting awareness of nPEP. Conclusions The awareness of nPEP among residents in Yangzhou City needs to be improved. Employees in government agencies, enterprises and public institutions and students have higher awareness of nPEP.

The infra-acetabular channel is a channel parallel to the quadrilateral body of the pelvis that passes through the anterior and posterior columns at the medial side of the hip joint. With the widespread use of infra-acetabular channel screws, the acetabular frame screw fixation technique has been proposed to provide stronger fixation for acetabular fractures. There are gender differences in the anatomical parameters of the infra-acetabular channel screws (the length and diameter of the infra-acetabular channel in males are larger than those in females, and the angle between the long axis of the channel and the sagittal plane is smaller). Due to the narrow infra-acetabular channel, it may increase the risks of screw insertion into the hip joint and iatrogenic injury. 3D navigation system-guided placement of infra-acetabular channel screws improves the precision of nail placement. The application of infra-acetabular screws in the fixation of anterior and posterior column fractures has been proved by biomechanical experiments, however, in bicolumnar fractures and T-shaped fractures is still controversial. In order to standardize the placement of infra-acetabular channel screws and to clarify their indications, many studies have been conducted to observe the anatomical parameters of the infra-acetabular channel screws, the surgical technique of placement, biomechanics, and clinical efficacy. This article reviews these studies in order to provide theoretical basis and guidance for the application of infra-acetabular channel screws in acetabular fractures.

Objective: To analyse the influencing factors of myopia correction among primary and secondary school students with myopia and to compare the quality of visionrelated survival of students with different correction conditions. Methods: A total of 3 649 students from eight primary and secondary schools in a district of Chongqing were selected for myopia screening and vision related survival quality questionnaires using a stratified cluster random sampling method. Results: Univariate analysis showed that there were statistically significant differences in the rate of wearing eyeglasses among myopic students with different gender, school, educational stage, academic stress, and parenting style ( χ 2=10.98, 31.63, 31.86, 11.28, 9.59, all P <0.05). The fully vision correction rate among students wearing eyeglasses differed in educational stage, academic stress and parenting style ( χ 2= 11.77, 9.92, 8.69, all P <0.05). Multivariate Logistic regression analysis showed that gender, school and educational stage were all influencing factors of the rate of wearing eyeglasses (all P <0.01). Myopic students total scores on the Quality of Survival Scale were significantly higher than those of non myopic students ( t =20.07, P <0.01). There were significant differences in the scores of physical, emotional, visual and physical functioning and the total score of quality of survival scores among the three groups of myopic students without wearing eyeglasses, students with undercorrection and students with full vision correction ( F=49.93, 49.38, 28.14, 67.31, P <0.01). Conclusion Myopic students have low rates of wearing eyeglasses and fully vision correction. The rate of wearing glasses is different in urban and rural areas, gender and educational stage. The quality of life among myopic students is decreased by wearing eyeglasses, and the quality of life of undercorrected students is lower than that of fully corrected students. We should pay attention to the correction of myopia and improve the quality of life among myopic students.