ObjectiveSleep-related painful erections （SRPE） is a rare sleep disorder characterized by repeated awakening due to painful interruptions of penile erections during nighttime sleep， and its etiology is currently unclear. The purpose of this study is to explore the impact of potential risk factors on the incidence of SRPE. MethodsInformation was collected through questionnaires administered to patients who presented at the urology department and suffered from SRPE or did not suffer from SRPE. A total of 290 participants completed the study， including 145 controls and 145 cases. Logistic regression analysis was used to assess the impact of age， occupation， sleep initiation time per night， frequency of sexual intercourse per week， psychological status， erectile dysfunction， chronic prostatitis， prostate enlargement， lumbar spine disease， central nervous system disease， hypertension， diabetes and family history on the onset of SRPE. ResultsSingle-factor logistic regression analysis found that a history of chronic prostatitis， intellectual labor occupation， central nervous system disease， late sleep onset， frequency of sexual activity， and anxiety status might be related to the onset of SRPE. After incorporating these factors into a multivariate regression analysis model， it was found that having sexual activity ≥2 times/week （OR 95%CI = 0.326（0.179，0.592） and late sleep onset （after 24：00） （OR 95%CI = 0.494（0.265，0.918）might be protective factors for SRPE， while a history of chronic prostatitis（OR 95%CI = 3.779（2.082，6.859） might be a risk factor for SRPE. However， there was no significant statistical difference in the impact of central nervous system diseases and occupation on multivariate analysis. ConclusionChronic prostatitis and anxiety status may be independent risk factors for SRPE； having sexual activity ≥2 times/week and delaying sleep time appropriately may be independent protective factors.

ObjectiveTo investigate reinfection or the third time infection with SARS-CoV-2 among the people tested for positive from December 2022 to January 2023 and the influencing factors through a follow-up survey on previous novel coronavirus nucleic acid positive individuals between March to May, 2022. MethodsEpidemiological data of 2 583 novel coronavirus nucleic acid test positive cases were analyzed from March to May, 2022, following a follow-up survey at the 8^th and 12^th month after the first nucleic acid test positivity. Pearson chi-square method was used to analyze the differences of reinfection and the third time infection rates among first-positive patients with different characteristics. Kaplan-Meier survival analysis and Cox regression were used to analyze the influencing factors of reinfection. ResultsA total of 2 264 valid questionnaires were collected in the 8^th month after nucleic acid tested positive, with a recovery rate of 87.7% and a reinfection rate of 9.7%. The third time infection was investigated among the individuals infected twice at the 12^th month after the first nucleic acid test positivity, with a third time infection rate of 4.6%. The median interval (P₂₅, P₇₅) between reinfection and the first nucleic acid test positive for the novel coronavirus was 261 (252, 268) days and the interval (P₂₅, P₇₅) between the third time infection and reinfection was 135 (111,157) days. Gender, age, occupation, smoking, drinking and underlying diseases were not statistically associated with the risk of reinfection (P>0.05). However, the the third time infection rate for medical staffs (20.0%) was higher than that for student /teachers (14.3%) and corporate employees (9.5%), with a statistically significant difference in the third infection rate between different occupations (P<0.05). The risk of reinfection in self-employed individual was lower than that in corporate employees (HR=0.52, 95%CI: 0.33‒0.83), and which was still lower after adjustment for gender and age. The risk of reinfection among those with underlying diseases was 1.54 times (95%CI: 1.08‒2.02) higher than those without underlying diseases, but even 1.85 times (95%CI: 1.25‒2.75) higher after adjustment for gender and age. ConclusionDue to the constant mutation and variants of the novel coronavirus, the risk of reinfection and the third time infection is unavoidable. The presence of underlying diseases and occupation are the main factors influencing reinfection or third time infection.

Objective:To discuss the clinical characteristic and treatment of laryngeal cysts in infants. Methods:The clinical data of 19 patients diagnosed with laryngeal cysts in Department of Otolaryngology, Sichuan Provincial Maternity and Child Health Care Hospital from November 2017 to April 2023 were retrospectively analyzed. Results:All of the 19 patients were diagnosed as laryngeal cysts, with clinical manifestations included respiratory distress, inspiratory dyspnea, difficulty in feeding and low and weak crying, etc. All of them were cured after surgical treatment. Conclusion:Misdiagnosis and missed diagnosis of laryngeal cysts are prone to occur in infants and young children. After diagnosis, patients should undergo early surgical treatment to remove airway obstruction and improve ventilation.
Pregnancy ; Infant ; Child ; Humans ; Female ; Child, Preschool ; Retrospective Studies ; Laryngeal Diseases/surgery* ; Airway Obstruction/surgery* ; Laryngoscopy ; Cysts/surgery* ; Dyspnea/surgery*

OBJECTIVE To study the repair effect and mechanism of Zhixu burn ointment on deep second-degree burned model rats. METHODS The deep second-degree burned model was established with a temperature-controlled apparatus. The model rats were randomly divided into model group， Jingwanhong ointment group and Zhixu burn ointment high-dose， medium-dose and low-dose groups （specifications were 20 g core+20 mL wetting agent， 10 g core+20 mL wetting agent， 5 g core+20 mL wetting agent， respectively）. Another blank control group （only dehairing treatment， no modeling） was set up， with 10 rats in each group. The rats in each administration group were given corresponding drugs， the rats in the blank control group were not treated， and the rats in the model group were given normal saline once a day for 21 d. The healing of burn wounds and histomorphological changes of burned skin in each group of rats were observed， and the healing rate of wounds was calculated； the levels of vascular endothelial growth factor （VEGF）， interleukin-1β （IL-1β）， IL-6 and tumor necrosis factor-α（TNF-α） in the wound skin tissue of rats were detected by enzyme-linked immunosorbent assay； immunohistochemical method was used to detect the expression levels of VEGF and platelet endothelial cell adhesion molecule-1 （CD31） protein in burned skin tissue. RESULTS Compared with model group， the wound area of the rats in the Jingwanhong ointment and Zhixu burn ointment groups gradually decreased and healed significantly by day 21， and the wound healing rate was significantly higher （P＜0.05 or P＜0.01）； thicker new epidermal layer was seen in the skin tissue， and connective tissue and new blood vessels were significantly increased in the dermis； the expression levels of IL-1β， IL-6 and TNF-α were significantly decreased （P＜0.05 or P＜0.01）， and the expression levels of VEGF and CD31 protein were significantly increased （P＜0.05 or P＜0.01） in the burned skin tissue. CONCLUSIONS Zhixu burn ointment can repair the skin of deep second-degree burned model rats， and the mechanism may be related to reducing the inflammatory response of burn wound and promoting the angiogenesis.

Objective To explore the ability of waist circumference (WC) to predict hypertension risk in overweight and non-overweight middle school students in Suzhou. Methods The height, weight，WC and blood pressure values of 963 students from 8 middle schools in Suzhou were collected by a combination of questionnaire survey and physical examination. Logistic regression analysis was applied to explore the correlation between WC and high blood pressure in middle school students. Results Logistic regression analysis showed that before and after adjusting for confounding factors, for every 1 cm change in WC, the risk of high blood pressure increased to 1.08 (1.03-1.14) and 1.07 (1.02-1.13) for non-overweight students, and 1.05 (1.02-1.09) and 1.05 (1.01-1.08) for overweight students, respectively. Conclusion There was a positive correlation between WC and high blood pressure in both non-overweight and overweight middle school students in Suzhou. The risk of high blood pressure was higher for non-overweight students than overweight students for every 1 cm WC change. Targeted intervention measures should be taken to reduce the prevalence rates of hypertension for middle school students.

: To assess the relationship between high blood pressure (HBP) and body mass index (BMI), waist circumference (WC), and waist-height ratio (WHtR) among children and adolescents in Suzhou. Methods: A total of 3 150 children and adolescents aged 7-17 years were enrolled through stratified cluster sampling from September to October, 2019. Questionnaire survey was conducted, and height, weight, WC and BP were measured to calculate BMI and WHtR, relationship of HBP and adiposity indicators were evaluated. Results: The prevalence of HBP was 11.3%, overweight/obesity rate was 28.5%, and centrality obesity based on WC and WHtR was 20.6% and 23.7%, respectively. There were significant relationships between HBP and BMI, WC, and WHtR (χ2=157.80,105.87,124.17,P<0.01). As Logistic regression showed, compared to normal weight group, overweight/obesity based on BMI had positive relation with HBP (OR=3.89, 95%CI=3.09-4.90); compared to normal WC/WHtR, centrality obesity showed positive association with HBP (WC: OR=3.05, 95%CI=2.41-3.86; WHtR: OR=3.35, 95%CI=2.67-4.21). Meanwhile, BMI had joint effects on HBP with WC/WHtR. Specifically subjects with overweight/obesity and center obesity had higher risk of HBP, compared to normal BMI and WC subjects(OR=4.28, 95%CI=3.31-5.53). Conclusion Significant relationships between HBP and BMI, WC, and WHtR were found. BMI had joint effects on HBP with WC/WHtR. Keeping normal body weight and WC/ WHtR would have significant effects on HBP.

Objective:To explore the pathogenesis and treatment of severe hematuria after sexual activity in men.Methods:A retrospective analysis of 10 patients with severe hematuria after sexual activity who were admitted from January 2017 to January 2020, including 4 cases from Peking University People’s Hospital, 3 cases from Donghua Hospital Affiliated to Sun Yat-sen University, 2 cases from Second Hospital of Tianjin Medical University, and 1 case from Tianjin Jinnan Hospital. The average age of the patients was (33.5±7.6) years old. All 10 cases had severe hematuria and blood clots within 1 hour after sexual activity. The blood routine examination revealed that there were different degrees of hemorrhagic anemia after 24 hours of admission, and the average hemoglobin was(95.8±8.9)g/L. Ten patients underwent transurethral cystoscopy electrosurgical resection and / or electrocoagulation under subarachnoid anesthesia or epidural anesthesia. All patients were confirmed to be bleeding from posterior urethral lesions, including 4 cases located in the distal seminal caruncle, 5 cases in the prostate, and 1 case in proximal seminal caruncle. Three cases whose bleeding from varicose veins in the prostate urethra were treated with electrocoagulation in order to stop the bleeding, and lesions were removed in the other 7 cases for pathological examination. The F16 urinary catheter was indwelt after the operation.Results:All 10 operations in this group were successfully completed. Six cases of posterior urethral hemangioma rupture and 1 case of posterior urethral polyp were confirmed by the pathological examination in 7 cases. The urinary catheter was successfully removed 1 week after operation. Abstinence was required for 1 month after operation. There was no recurrence of hematuria after resuming sexual activity, and no complications such as dysuria or urinary incontinence.Conclusion:Severe hematuria after sexual activity is mostly caused by rupture or bleeding of abnormal blood vessels in the posterior urethra. Transurethral resection and/or electrocoagulation are the first choice for treatment. The effect is reliable and the prognosis is satisfactory.

Objective:To investigate the clinical features and influencing factors of early-onset gout.Methods:Male patients with gout admitted to Department of Endocrinology and Metabolism were recruited from 2015 to 2018. Patients with gout onset before age 30 were defined as the " early-onset" group, and those with onset at 30~60 years were defined as the "late-onset" group. Clinical characteristics were compared between two groups. Factors associated with early-onset gout were analyzed.Results:A total of 1 243 male patients were enrolled in this study; 480 individuals were in the early-onset, and 763 in the late-onset groups. Compared with the late-onset group, patients with early-onset gout had higher consumption rates of sugar-sweetened beverage(28.0% vs 15.0%, P=0.001), a higher homeostasis model assessment for insulin resistance level(3.78±2.93 vs 3.10±2.39, P<0.01), and larger proportions of family histories of diabetes(30.8% vs 20.4%, P<0.01)and hypertension(51.2% vs 42.6%, P=0.003). Logistic regression analysis showed that factors associated with early-onset gout were drinking sugar-sweetened beverage( P=0.012), family history of diabetes( P=0.037). Conclusion:Early-onset gout was associated with a family history of diabetes. Patients with family histories of diabetes are more likely to have early-onset gout, which may be associated with a common genetic basis.

Objective: The current study aimed to determine the prevalence of high blood pressure (HBP) among children and adolescents aged 7-17 years in Suzhou by using different references, and to provide a reference for the application of standard of blood pressure among children. Methods: Data of 6 972 children and adolescents aged 7 to 17 years were collected by stratified cluster random sampling method to determine the prevalence of HBP based on 2017 AAP Guidelines for Childhood Hygertension(America 2017), National Blood Pressure Reference for Chinese Han Children based on Chinese National Survey on Students’ Constitution and Health in 2010 (Ma 2017), blood pressure guidelines based on their investigation in mainland children and adolescents (Mi 2017) and blood pressure guidelines based on data from the China Health and Nutrition Survey during the year of 1999-2009 (CHNS 2013). Results: Referred to Ma 2017 reference, the prevalence of HBP was highest with 12.7%, followed by America 2017 with 16.3%, Mi 2017 with 17.4%, and CHNS2013 with 25.5%. In boys, HBP prevalence based on America 2017 was close to that using Mi 2017 among children younger than 13 years old, and was close to that using Ma 2017 among those≥14 years old. In girls, HBP prevalence based on America 2017 was close to that using Mi 2017 among those≤12 years old, and was close to that using Ma 2017 among those ≥13 years old. Compared with America 2017 reference, kappa value based on Mi 2017 was better than Ma 2017 in boys(0.81, 0.77), opposite result was found in girls(0.86, 0.85). Kappa value were the lowest based on CHNS 2013. Conclusion The prevalence of HBP among children in Suzhou achieve a high level. Ma 2017, Mi 2017, and CHNS2013 references show different advantages among various gender and age groups.

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) in the treatment of rectal laterally spreading tumors (LSTs) .Methods:The clinical data of 20 patients with LSTs ,who were admitted in Jiangyin Tradi‐tional Chinese Medicine Hospital from September 2012 to September 2014 ,were retrospectively analyzed .According to the su‐perficial morphology of rectal mucosa ,the subtypes of LSTs were determined by endoscopy .Tumor size and morphological characteristics ,pathological features and operation time of ESD were counted .Furthermore ,postoperative complications and recurrence were followed up and statistically analyzed .Results:There were 8 (40% ) cases of LST granular type and 12 (60% ) cases of LST nongranular type .There were 18 cases of adenomas associated with low grade neoplasia and 2 (10% ) cases of high grade intraepithelial neoplasia .There were 7 cases of tubulovillous adenoma and 13 cases of tubular adenoma .The mean diameter of lesions was (33 .9 ± 11 .5) mm .The enbloc resection rate was 100% and the average time of ESD operations was (40 ± 15) min .The postoperative bleeding rate was 10% (2/20) and no perforation occurred .The mean follow‐up period was 12 .6 months ,during which no recurrence was found .Conclusions:With high enbloc resection rate and low complication rate ,ESD is a safe and efficacious treatment for rectal LSTs ,especially for the lesions larger than 2 cm which have higher potential of malignancy .