Distant cutaneous metastasis of primary lung squamous cell carcinoma is an exceedingly rare event,with scalp metastasis as the initial clinical presentation even rarer.Scalp skin metastases are prone to be misdiagnosed as other scalp disorders,yet their appearance signifies the deterioration and poor prognosis of lung cancer.This case report documents a female patient presenting initially with scalp folliculitis in dermatology,who was subsequently diagnosed with malignant lung tumor through radiological imaging and referred to Department of Thoracic Surgery.Pathological examination of the excised lesion from the scalp revealed distant metastasis of lung cancer.A review of similar cases reported in literature was conducted.This article aims to enhance understanding and awareness of skin metastasis in lung cancer,to emphasize the importance of this condition,and to improve early recognition and precise diagnosis.It is crucial to prevent clinical misdiagnosis and ensure ap-propriate treatment,finally leading to improve the prognosis of the patients.

Objective:To investigate the intelligence status of children aged 10 - 12 in rural areas of Linxia Hui Autonomous Prefecture (referred to as Linxia) in Gansu Province.Methods:From September to November 2019, a cross-sectional study was carried out to investigate the intelligence status of children aged 10 to 12 in 8 counties (cities) of Linxia. Chinese Raven's Progressive Matrices (rural version) was used for intelligence test and children's intelligence quotient (IQ) was calculated by regular mold to evaluate children's intelligence level.Results:A total of 1 721 children in Linxia were tested for intelligence, with an average IQ of 103.2. Among them, low intelligence (≤69) accounted for 1.0% (18/1 721), borderline (70 - 79) accounted for 3.0% (52/1 721), middle and lower (80 - 89) accounted for 8.4% (144/1 721), moderate (90 - 109) accounted for 56.6% (974/1 721), middle and upper (110 - 119) accounted for 21.9% (377/1 721), excellent (120 - 129) accounted for 7.8% (135/1 721), extremely excellent (≥130) accounted for 1.2% (21/1 721). There were 635, 598 and 488 children aged 10, 11 and 12, respectively, with an average IQ of 106.1, 103.3 and 99.2. There were 919 males and 802 females, with an average IQ of 102.9 and 103.4, respectively.Conclusion:In 2019, the intelligence of children aged 10 to 12 in rural areas of Linxia has reached the moderate level.

Objective To develop a radiomics nomogram based on contrast-enhanced CT (CECT) for preoperative prediction of high-risk and low-risk thymomas. Methods Clinical data of patients with thymoma who underwent surgical resection and pathological confirmation at Northern Jiangsu People's Hospital from January 2018 to February 2023 were retrospectively analyzed. Feature selection was performed using the Pearson correlation coefficient and least absolute shrinkage and selection operator (LASSO) method. An ExtraTrees classifier was used to construct the radiomics signature model and the radiomics signature. Univariate and multivariable logistic regression was applied to analyze clinical-radiological characteristics and identify variables for developing a clinical model. The radiomics nomogram model was developed by combining the radiomics signature and clinical features. Model performance was evaluated using area under the curve (AUC), sensitivity, specificity, accuracy, negative predictive value, and positive predictive value. Calibration curves and decision curves were plotted to assess model accuracy and clinical values. Results A total of 120 patients including 59 females and 61 males with an average age of 56.30±12.10 years. There were 84 patients in the training group and 36 in the validation group, 62 in the low-risk thymoma group and 58 in the high-risk thymoma group. Radiomics features (1 038 in total) were extracted from the arterial phase of CECT scans, among which 6 radiomics features were used to construct the radiomics signature. The radiomics nomogram model, combining clinical-radiological characteristics and the radiomics signature, achieved an AUC of 0.872 in the training group and 0.833 in the validation group. Decision curve analysis demonstrated better clinical efficacy of the radiomics nomogram than the radiomics signature and clinical model. Conclusion The radiomics nomogram based on CECT showed good diagnostic value in distinguishing high-risk and low-risk thymoma, which may provide a noninvasive and efficient method for clinical decision-making.

Objective:To explore the distribution characteristics of common clinical manifestations of elbow joint in patients with endemic fluorosis and their correlation with the influencing factors.Methods:A cross-sectional survey was conducted on all permanent adult residents in 13 endemic fluorosis villages in Gaotai and Gaolan counties of Gansu province. The survey included: ① Demographic information, family history, and current medical history. ② Physical examination specifically focued on the orthopedic clinical presentations. ③Taking DR films of the forearm (including elbow joint) and calf (including knee joint), and classify the elbow joint to grade K-L based on X-ray manifestations. ④ Measuring height and weight, and calculating BMI index. ⑤Applying the Mayo elbow joint rating scale to evaluate elbow joint function. Based on the survey results, the distribution characteristics of clinical symptoms and signs of elbow joint in patients with skeletal fluorosis, as well as the distribution characteristics and correlation of factors affecting elbow joint function such as age, gender, disease course, BMI, K-L grade, etc were described. The comparison of counting data and rates were analyzed with χ2 test or Fisher exact probability test. Pearson′s test was used for correlation analysis of continuous data that conforms to normal distribution, and Spearman test was used for non-normal distribution measurement and counting data. The correlation analysis of ordered hierarchical data was conducted using Kendall′s Tau- b test. Results:①Among 501 patients with skeletal fluorosis, a total of 465 cases (92.8%) were diagnosed with elbow joint pain. A total of 185 cases (36.9%) were with elbow joint tenderness, 300 cases (59.9%) were with elbow joint enlargement, 415 cases (82.8%) were with morning stiffness of the elbow joint, 102 cases (20.4%) were with cubital tunnel syndrome, 153 cases (30.5%) were with positive forearm extensor tendon traction test, and 97 cases (19.4%) were with positive forearm flexor tendon traction test. The detection rate of elbow joint rotation limitation was the highest among those with ROM ranging from 30 ° to 70 ° (261/501, 52.1%), and the detection rate of elbow joint extension and flexion limitation was the highest among those with ROM ranging from 50 ° to 90 °(274/501, 54.7%). ②Among 501 patients with skeletal fluorosis, a total of 465 cases were found to have symptoms and positive signs in the elbow joint, with the detection rate in males being lower than that in females, with a significant difference ( χ2=41.19, P<0.001). The majority of patients were between the ages of 50 and 65 (274/501, 58.9%), with a body mass index of <18 (217, 46.67%), K-L arthritis with a radiologic grade of Ⅲ (256/501, 55.0%), and a disease course of >30 years (217/501, 46.67%). ③The correlation between clinical characteristics, the Mayo score, and various influencing factors of skeletal fluorosis found a high correlation between pain and age ( r=0.79, P<0.001) and pain and disease course ( r=0.71, P<0.001). The ROM of extension and flexion was negatively correlated with age ( r=-0.43, P<0.001), K-L grade ( r=-0.67, P<0.001), and disease course ( r=-0.48, P<0.001); Elbow tunnel syndrome was positively correlated with age ( r=0.72, P<0.001). The Mayo functional score was negatively correlated with age ( r=-0.35, P<0.001). Conclusion:Early morning stiffness of the elbow joint (<30 min), limited rotation of the elbow joint, limited extension and flexion of the elbow joint, and cubital tunnel syndrome (degree Ⅰ) have a high detection rate in the population with skeletal fluorosis. Age, course of disease, and degree of joint degeneration have a significant impact on elbow joint function in patients with fluorosis.

The biological samples of oral genetic diseases and rare diseases are extremely precious. Collecting and preserving these biological samples are helpful to elucidate the mechanisms and improve the level of diagnose and treatment of oral genetic diseases and rare diseases. The standardized construction of biobanks for oral genetic diseases and rare diseases is important for achieving these goals. At present, there is very little information on the construction of these biobanks, and the standards or suggestions for the classification and coding of biological samples from oral and maxillofacial sources, and this is not conducive to the standardization and information construction of biobanks for special oral diseases. This consensus summarizes the background, necessity, principles, and key points of constructing the biobank for oral genetic diseases and rare diseases. On the base of the group standard "Classification and Coding for Human Biomaterial" (GB/T 39768-2021) issued by the National Technical Committee for Standardization of Biological Samples, we suggest 76 new coding numbers for different of biological samples from oral and maxillofacial sources. We hope the consensus may promote the standardization, and smartization on the biobank construction as well as the overall research level of oral genetic diseases and rare diseases in China.

Objective:To investigate the epidemiological situation of drinking water-type endemic fluorosis in Gansu Province, and scientifically evaluate the effectiveness of water improvement and fluoride reduction projects in preventing and controlling the disease.Methods:The drinking water-type endemic fluorosis areas in Gansu Province were divided into five regions according to different ecological types: the Longzhong Loess Plateau Hilly Area in central Gansu, the Longdong Loess Plateau Gully Area in eastern Gansu, the Longnan Qinling Zhongshan Canyon Area in southern Gansu, the Gobi area of the Hexi Desert, and the Alpine Grassland Meadow Area in southern Gansu. In 2021, a survey was conducted on the basic situation, running situation of the water improvement and fluoride reduction projects, fluoride content in drinking water(fluorine ion-selective electrode), and the prevalence of dental fluorosis (Dean) among children aged 8 to 12 in all drinking water-type endemic fluorosis villages in the five regions. The pertinent assessments were executed in accordance with national guidelines such as the "Standards for Drinking Water Quality" (GB 5749-2006) and "Diagnosis of Dental Fluorosis" (WS/T 208-2011).Results:A total of 2 000 villages in drinking water-type endemic fluorosis areas were monitored, among which 1 999 villages had implemented water improvement and fluoride reduction projects, with a coverage rate of 99.95% (1 999/2 000). All water improvement and fluoride reduction projects were operating normally, with no intermittent operation or scrapping. A total of 34 616 children aged 8 to 12 were investigated for dental fluorosis. The detection rate of dental fluorosis was 4.18% (1 448/34 616), and the dental fluorosis index was 0.09. There was a statistically significant difference in the detection rate of dental fluorosis among children of different ages (χ 2 = 69.77, P < 0.001). The difference in the detection rate of dental fluorosis among children of different ecological types of areas was statistically significant (χ 2 = 775.11, P < 0.001). The dental fluorosis index of children aged 8 - 12 was significantly correlated with the historical water fluoride level ( r = 0.29, P = 0.042). The water improvement time in the Gobi area of the Hexi Desert was significantly correlated with the detection rate of dental fluorosis in local children ( r = - 0.48, P = 0.023). Conclusions:In 2021, the prevention and control of drinking water-type endemic fluorosis in all villages in Gansu Province has reached the national control standards. However, due to the different ecological characteristics and changes in water source distribution in different ecological types of areas, it is still necessary to further strengthen the monitoring of the condition of drinking water-type endemic fluorosis in all the affected villages and consolidate the existing prevention and control achievements.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Objective To investigate the clinical efficacy of endoscopic resection,laparoscopic resection and open resection in the treatment of gastric stromal tumor (GIST).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 254 GIST patients who were admitted to the First Affiliated Hospital of Army Medical University between January 2007 and June 2017 were collected.The endoscopic submucosal dissection (ESD) and laparoscopic or open wedge resection of GIST were performed according to the patients' conditions.Observation indicators:(1) surgical and postoperative recovery situations;(2) postoperative pathological examination;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative adjuvant therapy and survival up to June 2017.Measurement data with normal distribution were represented as-x±s.Measurement data with skewed distribution were described as M (range).Results (1) Surgical and postoperative recovery situations:of 254 patients,112 underwent ESD,including 111 with successful operation and 1 with intraoperative conversion to open surgery due to excessive bleeding-induced blurred operating view,93 underwent successful laparoscopic wedge resection of GIST and 49 underwent successful open wedge resection of GIST.The operation time,volume of intraoperative blood loss,time for initial fluid diet intake,duration of hospital stay and hospital expenses were respectively (75±21) minutes,(6.9±0.5)mL,(2.8±0.9)days,(5.5 ± 0.2)days,(22 167±1 364) yuan in patients with ESD and (137±65) minutes,(48.1±2.6)mL,(3.9±1.4) days,(8.3 ± 2.2)days,(32 937±1 823) yuan in patients with laparoscopic operation and (168± 60) minutes,(157.2± 10.3) mL,(5.8± 1.7) days,(11.3 ± 3.5) days,(38 462± 1 961) yuan in patients with open operation.Two patients with ESD had subcutaneous emphysema and didn't receive special treatment,and then emphysema disappeared after 2 days.No complication was detected in patients with laparoscopic or open operations.(2) Postoperative pathological examination:tumor diameter in patients with ESD,laparoscopic operation and open operation was respectively (2.6± 1.6)cm,(6.1 ±2.2)cm and (6.4±2.3) cm.The cases with positive CD117,discovered on GIST-1 (DOG1),CD34 and smooth muscle actin (SMA) were 106,105,86,17 with ESD and 89,87,59,11 with laparoscopic operation and 46,47,30,8 with open operation,respectively.The extremely low risk,low risk,medium risk and high risk were respectively detected in 67,42,3,0 patients with ESD and 16,36,23,18 patients with laparoscopic operation and 7,20,14,8 in patients with open operation.(3) Follow-up and survival situations:210 of 254 patients were followed up for 6.0-120.0 months,with an average time of 36.0 months,including 86 with ESD,82 with laparoscopic operation and 42 with open operation.During the follow-up,of patients with ESD,3 patients with medium risk respectively received imatinib therapy for 7.0 months,1.5 years and 2.0 years,and postoperative gastroscopy reexaminations every 6 months,without tumor recurrence;81 with extremely low risk and low risk received postoperative gastroscopy reexaminations every 6 months and didn't receive targeted therapy,without tumor recurrence;2 died of non-stromal tumor.The postoperative average survival time,1-,3-and 5-year survival rates were respectively 56.3 months,98.8％ (81/82),91.5％ (75/82),74.4％ (61/82) in patients with laparoscopic surgery and 52.4 months,97.6％ (41/42),85.7％ (36/42),81.0％ (34/42) in patients with open surgery.Conclusions According to patients' conditions,endoscopic resection,laparoscopic resection and open resection are safe and feasible in the treatment of GIST.Endoscopic resection of GIST should be selectively applied to patients with smaller diameter,with advantages of lower hospitalization expenses and better long-term prognosis.

To investigate the relationship between single nucleotide polymorphisms (SNPs) of CACNA1C (SNPs rs58619945, rs7316246 and rs216008) and susceptibility of chronic spontaneous urticaria (CSU) as well as the curative effect of non-sedating antihistamine drugs.
 Methods: Peripheral blood were extracted from 191 CSU patients to collect DNA. Urticaria Activity Score 7 (UAS7) and Dermatology Life Quality Index (DLQI) changes were collected from these patients with different non-sedating antihistamine drugs. PubMed retrieval system was used to select the 3 SNPs (rs58619945, rs7316246 and rs216008) of CACNA1C. Susceptibility of CSU and curative effect of non-sedating antihistamine drugs (desloratadine, mizolastine, fisofenadine) in 189 CSU patients and 105 controls with different SNPs were compared with Chi-squared test. Data of 105 southern Chinese controls were extracted from the 1 000 genome database.
 Results: Frequency of rs58619945 G allele in the CSU patients was significantly higher than that in the controls [OR(95%CI)=0.660(0.470-0.925), P=0.016]. However, there was no significant differences in rs7316246 and rs216008 between the CSU patients and the controls. Meanwhile there was no significant difference in general curative effect of the 3 drugs in the 3 SNPs (rs58619945: OR=0.843, P=0.454; rs7316246: OR=2.103, P=0.102; rs216008: OR=0.237, P=0.363). There was significant difference in different alleles of rs216008 in the patients administered by desloratadine [OR(95%CI)=0.480(0.247-0.933), P=0.029]. No difference was shown in the 3 SNPs in patients administered by mizolastine.
 Conclusion: The rs58619945 A/G might be related to susceptibility of CSU, and the rs216008 mutation might affect drug response of desloratadine.
Calcium Channels, L-Type ; genetics ; Chronic Disease ; Genetic Predisposition to Disease ; Histamine H1 Antagonists, Non-Sedating ; therapeutic use ; Humans ; Loratadine ; analogs & derivatives ; therapeutic use ; Polymorphism, Single Nucleotide ; Prognosis ; Retrospective Studies ; Urticaria ; drug therapy ; genetics

Objective To investigate the clinical efficacy of vinpocetine in the treatment of coronary heart disease (CHD).Methods 70 patients with CHD were selected,and they were randomly divided into observation group(35 cases) and control group (35 cases) according to the digital table.The control group received routine treatment,the observation group received vinpocetine therapy combined with fluoxetine on the basis of routine treatment.The changes of serum high sensitivity C reactive protein(hs-CRP) and interleukin 6(IL-6) were observed before and after treatment in the two groups,and the clinical efficacy of the two groups was compared.Results Before treatment,there were no statistically significant differences in hs-CRP and IL-6 levels between the two groups (all P ＞ 0.05).Mter treatment,the serum hs-CRP and IL-6 levels in the observation group were (4.18 ± 0.67) mg/mL,(4.42 ±0.52) pg/mL,respectively,which in the control group were (4.51 ± 0.54) mg/mL,(5.96 ± 0.73) pg/mL,respectively,there were statistically significant differences between the two groups(t =2.376,3.218,all P ＜ 0.05).The effective rate of the observation group was 94.3％,which was significantly higher than 80.0％ of the control group,there was statistically significant difference between the two groups (x2 =4.841,P ＜ 0.05).Conclusion On the basis of routine treatment,vinpocetine in the treatment of CHD can significantly reduce the serum levels of hs-CRP and IL-6,and improve the clinical efficacy.