ObjectiveTo construct a group-based trajectory model (GBTM) for early medication adherence check-in, and to analyze the relationship between different trajectories and treatment outcomes in tuberculosis patients using data that were generated from smart tools for monitoring their medication adherence and check-in. MethodsFrom October 1, 2022 to September 30, 2023, a total of 163 pulmonary tuberculosis patients diagnosed in Fengxian District were selected as the study subjects. The GBTM was utilized to analyze the weekly active check-in trajectories of the subjects during the first 4 weeks and establish different trajectory groups. The χ² tests were employed to compare the differences between groups and logistic regression analysis was conducted to explore the relationship between different trajectory groups and treatment outcomes. ResultsA total of four groups were generated by GBTM analyses, of which a low level of punch card was maintained in group A, 6% of the drug users increased rapidly from a low level in group B, 17% of drug users increased gradually from a low level in group C, and 18% of drug users maintained a high level of punch card in group D. The trajectory group was divided into two groups according to homogeneity, namely the low level medication punch card group (group A) and the high level medication punch card group (group B, group C, and group D). The results of multivariate logistic regression analyses revealed that low-level medication check-in (OR=3.250, 95%CI: 1.089‒9.696), increasing age (OR=1.030, 95%CI: 1.004‒1.056), and not undergoing sputum examination at the end of the fifth month (OR=2.746, 95%CI: 1.090‒7.009) were significantly associated with poor treatment outcomes. ConclusionThe medication check-in trajectory of pulmonary tuberculosis patients within the first 4 weeks is correlated with adverse outcomes, or namely consistent low-level medication adherence check-ins are associated with poor treatment outcomes, while high-level medication adherence check-ins are associated with a lower incidence of adverse outcomes.

Skin flaps are frequently employed in plastic and reconstructive surgery to address tissue defects.However,their low survival rates remain a challenge,attributed to vascular crisis and necrosis.Despite numerous studies investigating drugs to alleviate flap necrosis,a comprehensive analysis of the research trend in this critical area is lacking.To gain a deeper understanding of the current status,research focal points,and future trends in drugs aimed at enhancing flap survival,a thorough retrospective analysis is imperative.This study aims to employ bibliometric methods to scrutinize the evolution,mechanisms,and forthcoming trends of drugs targeting flap survival improvement.Using VOSviewer software,we quantitatively and visually depict 1)annual temporal trends in the number of documents and citations;2)national/regional publications and their collaborations;3)institutional and authors'contribution;4)journal contribution and relevance;and 5)analysis of research hotspots and directions derived from keywords.Ultimately,we discussed the prospects and challenges of future advances and clinical trans-lation of drugs designed to enhance skin flap survival.In conclusion,the field of pharmacology dedicated to improving skin flap survival is expanding,and this study aims to offer a fresh perspective to promote the advancement and clinical application of such drugs.

Objective:To investigate cases of delayed lactation initiation in women with transvaginal delivery and the influencing factors, in order to provide a basis for effective control of delayed lactation initiation and promotion of breastfeeding.Methods:Inpatients who were admitted to the obstetric ward of Affiliated Hospital of Jining Medical College from November 6, 2020 to January 16, 2021 were selected for the study using convenience sampling method and investigated by general information questionnaire and Chindbirth Experience Questionnaire (CEQ). Binary Logistic regression analysis was used to determine the factors influencing delayed lactation initiation.Results:The incidence of delayed lactation initiation in 622 women with transvaginal delivery was 38.75% (241/622). Binary Logistic regression analysis showed that age 20-35 years, full-term delivery, labor and delivery, use of labor analgesia, and good experience of transvaginal delivery were protective factors for delayed lactation initiation ( OR values were 0.012 to 0.868, all P<0.05); age >35 years, excessive weight gain during pregnancy, presence of pregnancy complications, use of induction of labor during delivery, long labor process, and damage to perineal skin after delivery were risk factors for delayed lactation initiation ( OR values were 1.097 to 13.235, all P<0.05). Conclusions:The high incidence of delayed lactation initiation in women with transvaginal delivery is influenced by a number of factors, which reminds the clinic that lactation in women after transvaginal delivery also needs to be taken into account, with priority assessment and prevention for those who are elderly (age≥35 years), primiparous, have other diseases during pregnancy, have gained too much weight during pregnancy, have preterm delivery, have a long duration of labor, have not received labor analgesia, have had a single or combined induction of labor, have had an episiotomy or perineal laceration during labor, and have a poor transvaginal delivery experience.

Objective:To evaluate the clinical efficacy of kidney-invigorating and asthma-relieving granules in treating kidney deficiency type of bronchial asthma patients in persistent.Methods:A total of 100 patients with bronchial asthma admitted to Shanghai Municipal Hospital of TCM from March 2020 to August 2020 were selected as the research subjects. The patients were divided into control group and treatment group by random and double blind method, 50 in each group. Both groups were treated by routine basic treatment. The control group was treated with Kidney-invigorating and asthma-relieving Placebo, while the observation group was treated with kidney-invigorating and asthma-relieving granules. All the treatment lasted for 6 weeks. The TCM syndromes scores, Asthma Control Test (ACT) scores, Peak expiratory flow/predicted value (PEF%) and eosinophil in peripheral blood before and after treatment were observed.Results:A total of 91 patients completed the clinical study. There were 45 patients in the control group and 46 in the treatment group. The total effective rate in the treatment group was 93.5% (43/46), while that in the control group was 77.8% (35/45), and the difference was statistically significant ( χ2=4.579, P=0.032). After the treatment, the scores of integral efficacy on syndromes in Chinese medicine, ACT and PEF% in the treatment group were significantly higher than those in the control group ( t values were 2.802, 3.420 and 8.938, respectively, all Ps<0.01). The eosinophil in peripheral blood of patients in the treatment group was significantly lower than that of the control group ( t=3.481, P=0.001). Conclusion:On the basis of conventional treatment of western medicine, kidney-invigorating and asthma-relieving granules can relieve the clinical symptoms of asthma, improve the control level of asthma, enhance the level of PEF, reduce airway inflammation.

Objective This study was to evaluate the safety of 640 corneal donors by analysing the serological testing results.Methods We retrospectively analyzed the serological testing results from Changsha Aier Eye Bank and Chengdu Kangqiao Aier Eye Bank from January 2011 to December 2015,hepatitis B virus surface antigen (HBsAg),hepatitis C virus (HCV),treponema pallidum (TP) and human immunodeficiency virus (HIV) were detected by colloidal gold or enzyme-linked immunosorbent assay (ELISA).Results There were 83 out of 640 serum samples showed positive immuno-reaction assayed markers,the positive rate was 12.97％,including HBsAg(n=60,9.38％),HCV(n=3,0.47％),TP(n=11,1.72％) and HIV(n=2,0.31％).Moreover,3 corneal donors were both positive against HBsAg and HCV,2 donors positive against HCV and TP,1 donor positive against HBsAg and HIV,1 donor positive against HBsAg and TP.Conclusions There is a high proportion of positive results of blood-borne diseases in cornea donors,which is a potential threat to corneal receptors and eye bank workers.Therefore,it is very important to detect serological test strictly for corneal donors.

Objective To study port-externalized tissue expansion technique and to provide a safe,simple and effective skin tissue expansion for extensive skin lesion reconstruction.Methods A lot of 247 patients with extensive skin lesion were chosen for the study.400-1000 ml tissue expanders were used for overexpansion and repeated expansion.Expanders were inserted into subcutaneous pockets through mini-invasive incisions and intermittent injection was carried out 4 days after first stage operation.After expansion finished,expanded skin flaps were transplanted for skin lesion reconstruction.During inflation period,complications and expander failures were observed.Results In 741 expanders of 247 patients,complication rate was 16.5 ％ with total 122 cases of complications.Expansion success rate was 98.9 ％ with 8 expander failures.Expanders were inflated successfully between 64-113 days,with average 92.7 days.The inflated saline volume was 2.38 times of marked expander capacity.In this group of 733 expanded skin flaps,721 flaps were well survived with 98.4％ success rate.276 expanded flaps of 116 patients were followed up for one to five years post-operation.The width of incision scar was between 0.3-1.2 mm.Conclusions The port-externalized overexpansion with giant expanders is a safe,simple and feasible technique,which is worthy of further clinical application.

Objective To investigate the association between the value of α-thalassemia minor and the outcomes in pregnant women.Methods A total of 445 pregnant women with α-thalassemia minor were selected as thalassemia group in the Pingguo County Maternal and Child Health Hospital of Guangxi from January 2011 to December 2015,with ratio of 1 ∶ 4 healthy pregnant women was randomly recruited as non-thalassemia group.Clinical characteristics and pregnancy outcomes of the two groups were retrospectively analyzed using methods including t test,x2 test,and logistic regression model and ROC curve.Results There were no significant differences noticed in factors as age,BMI,gestational age and educational level of the two groups.Hemoglobin of the thalassemia group was significantly lower than that of the non-thalassemia group (P＜0.001).Differences on parity,ethnicities or occupation were statistically significant.Results from univariate analysis showed that the proportions of low birth weight,small for date infant and 1 min Apgar score ＜7 were higher in the thalassemia group,but the ratio of adverse pregnancy outcomes was comparable on parameters as preterm birth,stillbirth,macrosomia.Findings from the unconditional logistic regression showed that pregnancy complicated with α-thalassemia minor appeared a risk for both newboms with low birth weight (aOR=2.29,95％CI:1.32-3.95) and small for date infant (aOR=2.11,95％ CI:1.16-3.84).The ROC curve showed that α-thalassemia minor combined with multiple indicators presented a certain predictive value on neonatal birth weight.Conclusion Pregnancy complicated with α-thalassemia minor was likely to increase the risk of birth weight loss in newborns,suggesting that prenatal care for pregnant women with thalassemia be strengthened,in order to reduce the incidence of adverse pregnancy outcomes.

Objective To explore mycocardial protection effect of sevoflurane post-conditioning in off-pump coronary artery bypass grafting (OPCABG) surgery,and the mechanism of mycocardial protection of sevoflurane post-conditioning.Methods Thirty six patients undergoing OPCABG were randomly divided into three groups:at 1.5 MAC (minimum alveolar concentration) for 5 minutes first,with an interruption control group (Cont group),sevoflurane preconditioning group (SPC group),and sevoflurane postconditioning group (SPO group).All patients were administrated by intravenous anesthetic drug,both for induction and maintenance.No special interventions were used in Cont group.However,in SPC group,12 patients inhaled sevoflurane for 10 minutes,then continued for 5 minutes,total 10 minutes before the anastomotic between mammary artery and anterior descending artery.In SPO group,12 patients inhaled sevoflurane at 1.5 MAC for 2 minutes before the anastomosis of last one coronary artery,and continued for 8 minutes.Four time points were focused on including T1 (accomplishment of induction),T2 (1 hour after the coronary revascularization),T3 (6 hour after the coronary revascularization),and T4 (24 hour after the coronary revascularization).Blood samples were drawn from the internal jugular vein for the measurement of the plasma concentrations of TNT-hs (highly sensitive cardiac troponin T),CK-MB (creatine phosphokinase isoenzyme),NT-proBNP (N-Terminal fragment of the prohormone Brain-Type Natri-uretic Peptide),and TNF-α (tumornecrosis factor-α).Results All the patients completed the trials without significant adverse effects.The age,gender,ejection fraction,and operative time among three groups were no statistically significant difference (P ＞ 0.05).Stay time in postoperative ICU and hospital were significantly less than Cont group (P ＜ 0.05).Compared to the pre-operative baseline,all patients'plasma concentrations of TNT-hs,CK-MB,NT-proBNP,and TNF-α were significantly increased at 1 h,6 h,and 24 h after coronary revascularization (P ＜0.05).TNT-hs in Cont group showed a persistent increase,while in other two groups (SPC and SPO),TNT-hs reached the peak concentrations at 6 hours after the coronary revascularization,which were same with CK-MB,TNF-α,and MDA in all groups;NT-proBNP reached the peak at coronary revascularization after 24 h.Compared to Cont group,TNT-hs,CK-MB,and TNF-α in groups SPC and SPO were significantly lower at 6 h,24 h after coronary revascularization; NT-proBNP was significantly lower only at 24 h after coronary revascularization.Conclusions Sevoflurane post-conditioning in OPCABG has identified myocardial protection,which was comparable with sevoflurane preconditioning.

Objective To investigate a new technique for small wound repairs on the faces.Methods 71 skin lesions of 42 patients were selected in the study and removed with ring-cutting drills.The new formed small wounds were treated with nature repair technique under the help of bFGF and hyaluronic acid (HA).The bFGF and HA were applied on the wounds 3 times a day until the wounds were healed completely.The early and long-term healing effects were estimated.Results The wounds were all cured with very small scars.The wounds were healed within 15 days for the size of 7 mm × 7 mmand25 days for the size of 15 mm × 15 mm.63 lesion spots from 35 patients were followed up 12 months later.Compared with original skin lesion,the small scar contracted about 50％in size with flat appearance and similar skin color.Conclusions The tissue regeneration and nature repair technique is an ideal surgical procedure for small wounds on the faces with good appearance in quality and aesthetics.

Objective To develop a technique of aesthetic repair procedures for the skin and soft tissue defect after injury.Methods Nineteen cases of patients with skin and soft tissue defects after injury were chosen in this study,in which there were 19 wounds involved.Thirty-seven expanders were inserted into the subcutaneous pockets beside the wounds in the right time and were inflated by a fast expansion model (one time every two days). After completion of inflation,the expanded skin flaps were made and transferred to repair the wounds.Results All the 37 expanders were inflated successfully in duration of 46-63 days.Five expansion areas presented complications that were correctly controlled.All of the wounds were covered and healed well after the expanded skin flap transplantation.Twelve patients were followed up for 6 months after operation.The long-term results showed that the color and texture of the flaps matched the recipient sites well without swelling.The aesthetic appearance of the repaired sites looked satisfactory.Conclusions The rapid tissue expansion is a better option for repairs of some skin and soft tissue defects after injury in certain areas.