Objective:To explore the value of magnetic resonance diffusion tensor imaging (DTI) in evaluating cerebrovascular small vessel disease (CSVD) in patients with systemic lupus erythematosus (SLE).Methods:Eighty-two patients with SLE combined with CSVD treated at Yixing People's Hospital from January to December 2022 were selected. They were divided into acute phase infarction group (16 cases), chronic phase infarction group (26 cases), and chronic ischemic lesion group (40 cases) based on routine MRI examination results. All patients underwent DTI examination to obtain the average diffusion coefficient (DCavg) and anisotropy score (FA) of the affected and contralateral normal white matter areas, and the evaluation value of DTI for CSVD in SLE patients was analyzed.Results:The DCavg value on the affected side of 82 patients was significantly higher than that on the healthy side: (11.10 ± 3.48) 10 -3 mm 2/s vs. (8.18 ± 2.42) 10 -3 mm 2/s, and the FA value on the affected side was significantly lower than that on the healthy side: 0.28 ± 0.05 vs. 0.45 ± 0.08, with a statistical significant differences ( P<0.05). The DCavg values of the acute infarction group, chronic infarction group, and chronic ischemic focus group were (11.88 ± 3.50), (9.69 ± 3.24) and (8.52 ± 2.34) 10 -3 mm 2/s, respectively, with statistical significant differences ( P<0.05). The FA values of the acute infarction group, chronic infarction group, and chronic ischemic focus group were 0.28 ± 0.04, 0.33 ± 0.06 and 0.40 ± 0.07, respectively, with statistical significant differences ( P<0.05). The receiver operating characteristic curve was drawn, and the results showed that the area under the curve (AUC) of the acute phase infarction group and the chronic phase infarction group evaluated by DCavg and FA alone and in combination were 0.757, 0.756, and 0.820, respectively. The AUC of the chronic phase infarction group and the chronic ischemic focus group evaluated by DCavg and FA were 0.772, 0.776, and 0.813, respectively. The AUC value of the combined evaluation was relatively large. Conclusions:DTI has good evaluation value for CSVD in SLE patients and can accurately determine the type of CSVD.

Objective:To explore the application of nasal aesthetic polygon theory in the reconstruction of new domes on nasal tip with autogenous costal cartilage.Methods:From June 2019 to June 2021, 116 patients (26 males and 90 females) received rhinoplasty, CT-assisted examination of the costal cartilage, nasal bone and nasal cartilage was performed, and the autogenous costal cartilaginous cortex was used to make dome reconstruction grafts that were transplanted to the original alar cartilage and partially fixed to the original nasal septum cartilage to form a satisfactory and natural nasal shape.Results:All the patients were followed up for 6-24 months. No cartilaginous, overrotated or underrotated appearance was found in nasal tip. The shape of nasal tip was clear and good, with an obvious performance point and full lower lobule. The nose was tall and straight, and looked natural and beautiful in three dimensions.Conclusions:The nasal aesthetic polygon theory is used to guide the reconstruction of new domes with autogenous costal cartilage in nasal tip surgery. Compared to the cap and shield grafts, the nasal tip is more close to the normal anatomical structure, the shape and texture are more similiar to the natural state and the nasal tip is softer by using autogenous costal cartilage, and so it is an ideal surgical procedure for nasal tip reconstruction.

Objective:To investigate the clinicopathological characteristics of early-onset colorectal cancer.Methods:The retrospective and descriptive study was conducted. The clincopatholo-gical data of 59 206 patients with colorectal cancer in the Surveillance, Epidemiology, and End Results Program of the United States of America From January 1,2010 to December 31,2019 were collected. There were 33 213 males, 25 993 males, aged (50±7)years. Observation indicators: (1) demographic and oncological characteristics of colorectal cancer patients; (2) comparison of clinico-pathological characteristics between early-onset and late-onset colorectal cancer. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison among groups was conducted using the Kruskal-Wallis H test. Count data were described as absolute numbers, and comparison among groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the non-parameter H test. Patients with early-onset colorectal cancer were segmented by age, and missing data for categorical variables is set as unknown. Results:(1) Demographic and oncological characteristics of colorectal cancer patients. Of 59 206 patients, there were 23 104 cases with early-onset colorectal cancer and 36 102 cases with late-onset colorectal cancer, and cases aged 13-29 years, cases aged 30-34 years, cases aged 35-39 years, cases aged 40-44 years, cases aged 45-49 years, cases aged 55-59 years were 1 041, 1 740, 3 288, 6 050, 10 985, 15 303,20 799, respectively. (2) Comparison of clinicopathological charac-teristics between early-onset and late-onset colorectal cancer. ① There were significant differences in gender, tumor location, degree of tumor differentiation, tumor histological type, tumor TNM staging, tumor T staging, tumor N staging, tumor M staging, preoperative carcinoembryonic antigen (CEA), perineural invasion, cancer nodule, tumor diameter between patients with early-onset and late-onset colorectal cancer ( P<0.01). Results of further analysis showed that cases with tumor located in ileocecal region, ascending colon, colon liver region, transverse colon were 2 329, 2 139, 579, 1 303 in the 6 350 patients with early-onset right colon cancer. The above indicators were 4 563, 3 945, 902, 1 951 in the 11 361 patients with late-onset right colon cancer. There was a significant difference in the above indicators between the two groups of patients ( χ2=114.27, P<0.01). Cases with tumor located in splenic region of the colon, descending colon, sigmoid colon, rectum sigmoid junction were 553, 1 354, 6 404, 2 431 in the 10 742 patients with early-onset left colon cancer. The above indicators were 865, 1 798, 9 668, 3 610 in the 15 941 patients with late-onset left colon cancer. There was a significant difference in the above indicators between the two groups of patients ( χ2=35.60, P<0.01). ②Of 23 104 patients with early-onset colorectal cancer, cases aged 13-29 years, cases aged 30-34 years, cases aged 35-39 years, cases aged 40-44 years, cases aged 45-49 years were 1 041, 1 740, 3 288, 6 050, 10 985, respectively. There were significant differences in gender, degree of tumor differentiation, tumor histological type, tumor TNM staging, tumor T staging, tumor N staging, pre-operative CEA, perineural invasion, cancer nodule, tumor diameter among patients of different age groups ( P<0.01). Results of further analysis showed that cases with tumor located in ileocecal region, ascending colon, colon liver region, and transverse colon were 91, 117, 45, 69 in the 6 350 early-onset right colorectal cancer patients aged 13-29 years. The above indicators were 165, 136, 47, 115, 304, 313, 93,201, 614, 535, 151, 330, 1 155, 1 038, 243, 588 in early-onset right colorectal cancer patients aged 30-34, 35-39, 40-44, 45-49 years, respectively. There was a significant difference in the above indicators among the five groups of patients ( H=36.63, P<0.01). Cases with tumor located in splenic region of the colon, descending colon, sigmoid colon, rectum sigmoid junction were 32, 83, 260, 95 in the 10 742 early-onset left colorectal cancer patients aged 13-29 years. The above indica-tors were 53, 112, 452, 171, 95, 230, 867, 342, 149, 337, 1 702, 665, 224, 592, 3 123, 1 158 in the 10 742 early-onset left colorectal cancer patients aged 30-34, 35-39, 40-44, 45-49 years, respectively. There was a significant difference in the above indicators among the five groups of patients ( H=47.84, P<0.01). Conclusions:Compared with late-onset colorectal cancer, early-onset colorectal cancer are more likely to occur in the left colon and rectum, with poorly differentiated and undifferentiated tumors, histological type of mucinous adenocarcinoma, TNM staging of stage Ⅲ and Ⅳ, higher proportion of nerve infiltration and cancer nodules, and larger tumor diameter. There are significant differences in clinicopathological characteristics of tumors among patients with early-onset colorectal cancer of different age groups.

Objective:To investigate the effect of pulmonary rehabilitation therapy on the exercise capacity and dyspnea of persons with chronic obstructive pulmonary disease (COPD).Methods:One hundred COPD patients were randomly divided into a control group and an observation group, each of 50. Both groups were given routine medication, while the observation group was additionally provided with health guidance, oxygen therapy, respiratory physiological therapy and exercise for 3 months. Before and after the intervention, both groups′ forced expiratory volume in 1 second (FEV1) and the first and second forced expiratory volume as a percentage of FEV (FEV1%) were measured. The subjects′ motor functioning was evaluated using the 6-minute walk test. Enzyme-linked immunosorbent assays and immunoturbidimetry quantified their expression of inflammatory factors. And their ability in the activities of daily living (ADL) was evaluated using the Barthel index. The COPD quality of life questionnaire (CRQ) was also used to assess their life quality.Results:After the intervention, the average clinical efficacy in the observation group was 96%, significantly higher than that of the control group (80%). Moreover, the average FEV1, FEV1%, 6-minute walk test time of the former group were all significantly better than before the intervention and better than the control group′s results after the intervention. Their average CRP, IL-6 and TNF-α levels were all significantly lower as well. After the intervention, the observation group′s average total CRQ score and its average scores on the instrument′s emotion, fatigue, wheezing and disease control components were all better than the control group′s averages. The observation group′s average ADL score was also significantly higher than that of the control group.Conclusions:Supplementing conventional medication with pulmonary rehabilitation therapy can effectively improve the lung function, motor functioning and life quality of COPD patients. It can also lower their level of serum inflammatory factors.

Objective:To investigate and compare the therapeutic effect of Foley catheter balloon dilation and the traditional open reduction in the treatment of intussusception in children.Methods:A total of 68 children with intussusception treated by Foley catheter balloon dilatation by laparoscopic surgery or traditional open reduction in Department of Pediatric Surgery, the Second Hospital of Lanzhou University from August 2015 to July 2019 were retrospectively analyzed.Among them, there were 32 cases in the Foley catheter group and 36 cases in the traditional laparotomy group.Foley catheter group were treated with laparoscopic Foley catheter balloon dilatation, while the traditional open group were treated with traditional open surgery which was performed with finger dilatation.The results of surgical treatment, postoperative recovery, short-term complications, patient satisfaction and long-term complications were compared between the two groups.Results:Among the indexes of surgical treatment effect, the operation time[(0.4±1.1) h], intraoperative bleeding volume[(10.2±3.4) mL], incision size[(0.5±0.4) cm] and incidence of the rupture of intestine[6.3%(2/32 cases)] in the Foley catheter group were significantly lower than those in the traditional open group[(1.3±2.9) h, (40.5±2.1) mL, (5.1±0.7) cm, 30.6%(11/36 cases)], and the differences were statistically significant (all P< 0.05). Among the indexes of postoperative recovery and short-term complications, recovery time of gastrointestinal function[(1.2±3.1) d], length of hospital stay[(6.7±1.8) d], incidence of incision infection[9.4%(3/32 cases)]and incidence of incisional hernia(0) in the Foley catheter group were significantly lower than those in the traditional open group[(3.3±6.4) d, (7.3±0.9) d, 36.1%(13/36 cases), 16.7%(6/36 cases)], and the differences were statistically significant (all P<0.05). Among the indexes of family satisfaction and long-term complications, the score of family satisfaction in the Foley catheter group [(8.7±1.2) scores]was significantly higher than that in the traditional open group[(6.6±3.1) scores], and the incidence of adhesive intestinal obst-ructionin the Foley catheter group (0)was significantly lower than that in the traditional open group[0 vs.19.4%(7/36例)], and the differences were statistically significant(all P<0.05). Conclusions:Compared with traditional open reduction in the treatment of intussusception in children, Foley catheter balloon dilation has the advantages of short operation time, safe operation, low incidence of intestinal injury, less bleeding, and so on, and also has the advantages of small incision, fast recovery, short hospitalization time, high satisfaction of parents.In addition, the Foley catheter balloon dilation has a lower incidence of incisional infection, incisional hernia, postoperative intestinal adhesion and other complications.

Objective To explore the application effect of amelioration of pterygium combined with free autogenous conjunctival flap transplantation in patients with primary pterygium.Methods 90 cases (90 eyes) of primary pterygium treated in our hospital were grouped according to random number table.45 cases in control group were treated with traditional pterygium excision,and 45 cases in observation group were treated with pterygium combined with free autogenous conjunctival flap transplantation.The operative condition (length of operation,incision size,blood loss during operation,healing time of corneal epithelium),the effect of operation and corneal astigmatism [corneal dispersion (CAD)],naked eye [uncorrected visual acuity (UCVA)] and tear film rupture time [break up time (BUT)] before and after operation were observed and compared.The incidence of complications,recurrence rate and quality of life (SF-36) before and after operation were compared between the two groups.Results The incision size,operative time,intraoperative blood loss and corneal epithelial healing time in the observation group were smaller than those in the control group (P ＜0.05).The total effective rate of the observation group was 93.33％ (42/45),which was higher than that of the control group 75.56％ (34/45) (P ＜0.05).3 months after operation,the UCVA of the observation group was larger than that of the control group,while CAD was less than that of the control group (P ＜ 0.05).The BUT 3 months after the operation was greater than that before operation (P ＜0.05),but the difference was insignificant (P ＞ 0.05).The complication rate in the observation group was 2.22％ (1/45),which was lower than that in the control group 17.78％ (8/45) (P ＜ 0.05).The recurrence rate of the observation group was 2.22％ (1/45),which was lower than that of the control group 17.78％ (8/45) (P ＜0.05).3 months after operation,the SF-36 scores of the two groups were all higher than those before operation,and the SF-36 score of the observation group was higher than that of the control group 3 months after operation (P ＜ 0.05).Conclusions Free autogenous conjunctival flap transplantation combined with amelioration of pterygium can improve corneal astigmatism and visual function of the patients with primary pterygium,and promote corneal epithelial healing,with small incision,less bleeding and longer operation,which can reduce the incidence of postoperative complications and the recurrence rate,and help to improve the quality of life of the patients.

Objective: The metaanalysis aims to estimate the prevalence of suicide plan among college students in mainland China, and to provide more clues and reference for control and prevention of suicide. Methods: The relevant studies were systematically searched via electronic databases (PubMed，Embase，CNKI，Wan Fang Data，VIP). We only selected original articles that either reported on Chinese retrieval words of "college students" "undergraduate" "university" "college" "colleges and universities" "suicide plans" "detection rate" "prevalence" "report rate", and the English retrieval words of "undergraduate" "college" "university" "suicide" "suicidality" "suicide plans" "suicidal plans suicide intending" "prevalence" "report rate" "detection rate" "China" "Chinese". And Stata 12.0 software was used to make a metaanalysis of the data. Results: A total of 18 eligible studies, with 47 071 college students, were finally included. The maximum and minimum reported prevalence of suicidal plan among college students in China mainland was 4.4%(95%CI: 3.4%-5.4%).Subgroup analyses showed that the pooled estimate of suicidal plan of boys(5.4%) was higher than girls’(4.2%); The prevalence among college students from earth, middle and west areas were 5.1%，2.7%，4.5%, respectively; The prevalence among college students in 2010 and after (4.4%)was higher than that before 2010(4.3%), The prevalence among college students of life time suicide plan (4.9%)was higher than that during the past 12 months(4.0%), but there was no statistical significance in the subgroup(P>0.05) . Sensitivity analysis suggested that the results of metaanalysis were relatively stable, while funnel plot analysis suggested that publication bias might exist. Conclusion Prevalence of suicidal plans among college students in mainland China is respectively low, and there was no statistical significance in gender, region, the period of time and simple size.

Objective To study the clinical efficacy of micro-plasma radiofrequency with joint electron-beam radiation treatment for keloids.Methods A total of 15 patients with keloids over half a year were treated with single time micro-plasma radiofrequency technology by roller tip at 80-100 watts.The hypofractionated electron-beam was used,with 9 Gy dose per time covering the scar with a 1 cm margin,within 24 hours and 1 week after the micro-plasma treatment.The Vancouver Scar Scales (VSS) were assessed before and 6 months after the treatment.Patients' satisfaction and the adverse reactions were evaluated 6 months after the treatment.Results There was astatistically significant difference between the mean VSS of 15 patients pre-and 6 months posttreatment (from 11.73± 1.12 to 3.87±2.53,P＜0.05).The degree of improvement was:excellent in 1 case,good 10 cases,fair 3 cases,and poor 1 case.Patients' assessment was:extremely satisfied in 6 cases,satisfied 6 cases,approximately satisfied 2 cases and dissatisfied 1 case.The adverse reactions included hyperpigmentation within the radiation field on the anterior chest wall in 1 case and delayed healing of 1 patient 's scar wound.Conclusions Micro-plasma radiofrequency combined with electron-beam radiation therapy is highly effective and safe on keloids with good clinical application value.

Objective To study the application effect of insulin aspart alone or in combination with metformin to treat diabetes.Methods 80 patients with diabetes from February 2014 to February 2015 were studied.They were randomly divided into observation group and control group,40 cases in each group.The observation group was given insulin aspart therapy combined with metformin hydrochloride tablets.The control group was treated with insulin aspart.The blood glucose levels,insulin dosage were recorded,the incidence of hypoglycemia was analyzed in the two groups.Results After treatment,the blood glucose levels in the two groups were lower than before treatment,the decrease of the observation group was more significant than the control group,the difference was statistically significant (P <0.05).The two groups showed no significant difference in mean blood glucose and glycemic lowest (P >0.05), the highest blood glucose value of the observation group was lower than the control group [(7.3 ±1.1)mmol/L vs (8.5 ±1.8)mmol/L)],there was statistically significant difference (t =3.597 8,P =0.000 2).The average blood glucose level of the observation group was also shorter than the control group,there was statistically significant differ-ence (t =10.880 3,P =0.000 2).After treatment,NIHSS scores of the two groups were decreased,NIHSS score reduce the magnitude of the observation after treatment was significantly higher than the control group (4.33 ± 0.82)vs.(5.24 ±1.25),there was significant difference(t =3.849 8,P =0.000 2).The effect of improving lipid levels observed were significantly better than the control group,the difference was statistically significant (P <0.05). Conclusion Combination of insulin aspart and metformin hydrochloride tablets in the treatment of patients with dia-betes to control blood sugar levels is better than the effect of single treatment with insulin aspart,insulin aspart therapy combined with metformin hydrochloride tablets in patients with diabetes can reduce postprandial 2h,fasting glucose, reduce the incidence of hypoglycemia,it should be popularized and used in the clinical.