Objective:To analyze the association between waist circumference (WC) and ischemic stroke (IS).Methods:The data for the present study were from the prospective cohort study of China Kadoorie Biobank in Qingdao. Using baseline information and IS events of the participants, the Cox proportional hazard regression model and restricted cubic spline (RCS) were used to analyze the association between WC and IS.Results:A total of 33 355 participants were included in the study, with 302 008.88 person-years of follow-up. A total of 1 093 new cases of IS were observed. Multivariate Cox proportional hazard regression model analysis showed that compared to the respondents with normal WC (male <85.0 cm, female <80.0 cm), respondents with excessive WC (male ≥85.0 cm, female ≥80.0 cm) had a 78% higher risk of IS incidence [hazard ratio( HR)=1.78, 95% CI: 1.51-2.10], and the risk increased by 72% ( HR=1.72, 95% CI: 1.40-2.12) and 83% ( HR=1.83, 95% CI: 1.40-2.39) in men and women. According to the RCS, the increase in WC and the risk of IS showed an "S" trend of nonlinear dose-response relationship. Conclusions:The risk of IS would increase with the WC. Keeping a normal WC is important for preventing IS.

Background::Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring’s cognitive development during early childhood. This study aimed to investigate the prospective associations between overall parental lifestyle and offspring’s cognitive performance during adolescence and young adulthood in China.Methods::We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies. A healthy parental lifestyle score (ranged 0-5) was constructed based on the following five modifiable lifestyle factors: Smoking, drinking, exercise, sleep, and diet. Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring’s fluid and crystallized intelligence in subsequent years (2012, 2014, 2016, and 2018).Results::Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence (multivariable-adjusted β = 0.53, 95% confidence interval [CI]: 0.29-0.77) and overall crystallized intelligence (multivariable-adjusted β = 0.35, 95% CI: 0.16-0.54) than those in the bottom tertile of parental healthy lifestyle scores. The results were similar after further adjustment for the offspring’s healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status. Additionally, maternal and paternal healthy lifestyle scores were independently associated with better offspring’s cognitive performance, with significant contribution observed for paternal never-smoking, weekly exercise, and diversified diet. When both parents and offspring adhered to a healthier lifestyle, we observed the highest level of the offspring’s overall crystallized intelligence. Conclusions::Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring’s cognitive performance during adolescence and early adulthood, regardless of socioeconomic status. These findings highlight the potential cognitive benefits of promoting healthy lifestyles among parents of adolescents.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Sodium alginate (SA) is a kind of natural polymer material extracted from kelp, which has excellent biocompatibility, non-toxicity, biodegradability and abundant storage capacity. The formation condition of sodium alginate gel is mild, effectively avoiding the inactivation of active substances. After a variety of preparation methods, sodium alginate microspheres are widely used in the fields of biomaterials and tissue engineering. This paper reviewed the common methods of preparing alginate microspheres, including extrusion, emulsification, electrostatic spraying, spray drying and coaxial airflow, and discussed their applications in biomedical fields such as bone repair, hemostasis and drug delivery.
Alginates ; Biocompatible Materials ; Drug Delivery Systems ; Microspheres ; Plastic Surgery Procedures

Objective:To analyze the clinical characteristics of patients with spontaneous low intracranial pressure (SIH).Methods:The study is a retrospective series. The clinical data of patients with SIH who visited Beijing Hospital from May 2017 to March 2022, including gender, age, symptoms, signs, imaging findings, treatment and outcome, were collected and their clinical characteristics were analyzed.Results:Finally, 8 patients with SIH, 6 females and 2 males, aged (33.5±7.3) years, were included. There were 6 cases of acute onset, 1 case of subacute onset, and 1 case of chronic onset. Four cases had pre-onset triggers, 3 cases were exertional and 1 case was exercise. All 8 cases had orthostatic headache. Three cases were accompanied by neck pain. Six cases were accompanied by autonomic dysfunction, 1 case with blurred vision and neck resistance, and 1 case with tinnitus in both ears. There were no obvious abnormalities in blood routine, liver and kidney function, electrolytes, and coagulation function in 8 cases. The results of the lumbar puncture showed that the cerebrospinal fluid pressure was≤60 mmH 2O(1 mmH 2O=0.009 8 kPa) in 7 cases, and 2 cases were so low that they were undetectable. One patient had normal cerebrospinal fluid pressure (90 mmH 2O). The routine results of cerebrospinal fluid showed 4 cases of an increased number of red blood cells and 2 cases of leukocytosis. The biochemical results of cerebrospinal fluid in all 8 cases were normal. All 8 patients underwent non-contrast MRI scan of the head, and 6 cases found abnormalities, including 2 cases of subdural hematoma, 1 case of subarachnoid hemorrhage, 1 case of brain tissue sinking, and 3 cases of intracranial venous sinus dilation (including 1 case with subdural hematoma). All 8 patients underwent MRI enhancement scan of the head, and 5 patients showed diffuse dural enhancement. Three patients underwent digital subtraction angiography myelogram and computed tomography myelogram, and 2 cases found dural cerebrospinal fluid leakage. One patient underwent magnetic resonance water imaging and no cerebrospinal fluid leakage was found. Eight patients were followed up for 38.5 (10.3, 63.0) months, after conservative treatment, 6 cases of headache relief or disappearance, 1 case relapsed and was admitted 1 week after discharge, non-targeted epidural blood patching (EBP) did not relapse, 1 case underwent non-targeted EBP after conservative treatment failure, headache relief, recurrence after 2 months, thoracic spine 3-4 space targeted EBP, headache disappeared, did not recur. Conclusions:The present study indicate that SIH prevalence in young age is common, the main symptom is orthostatic headache, accommodated with multiple clinical symptoms with various imaging abnormalities. Most patients with SIH can be treated conservatively, if the effect is not good, non-targeted or targeted EBP is feasible.

【Objective】 To analyze the commonality and characteristics between voluntary blood donors and hematopoietic stem cell donors in this region, and explore the potential for integration and development between China Marrow Donors Program (CMDP) and voluntary blood donors, especially platelet donor databases, so as to improve recruitment success rate and inventory rate. 【Methods】 The database modeling and comparison methods were used to screen and stratify the matching and integration degree between the voluntary blood donors in recent 10 years and the marrow donors in the Shaanxi Branch of CMDP. The frequencies of HLA-A,-B alleles, HPA alleles and haplotypes were calculated with Arlequin 3. 5. 2. 2 software, and the matching probability of different platelet donor reserve pools was conducted according to the phenotypic frequencies. 【Results】 Among the voluntary donors with known HLA genotypes in this region, according to their blood donation behavior,the active blood donors excavated were divided into the first, second, third and fourth echelons of platelet donor reserve pools, with 696, 2 752, 9 092 and 12 028 donors, respectively. The first echelon had the highest proportion of 10-50 times of platelet donations and 10-20 times of whole blood donations, with 13.65% and 26.01%, respectively. The second echelon had 10-20 times of whole blood donations and 10-50 times of platelet donations, accounted for 15.04% and 1.38%, respectively, which were significantly different from other echelons' blood donation characteristics (P<0.05). With a database size of the existing platelet donor bank adding the first and second echelons (n=4 955), there was a 69.02% probability of matching at least one donor with matching HLA-A-B phenotype. When considering the matching ABO and HPA phenotypes, the probability of finding at least one donor with fully matching HLA, HPA and ABO isotype (type B as an example) was 48. 73%. 【Conclusion】 The three groups of whole blood donation, apheresis platelet donation and marrow donation in Xi'an area have a large cross-distribution. Compared with expanding the storage capacity from scratch, the active blood donors in CMDP database are the largest back-up force of platelet donors. While expanding the effective storage capacity, it can minimize the cost of building platelet donor bank and the demand for resources.

Objective:To observe the efficacy and safety of the M receptor antagonist Bencycloquidium bromide nasal spray in treatment of seasonal allergic rhinitis with runny nose as the main symptom. Methods:From August 2021 to September 2021, 134 patients with seasonal allergic rhinitis were enrolled in the otolaryngology Outpatient Department of Peking University Third Hospital, First Affiliated Hospital of Harbin Medical University and China-Japanese Friendship Hospital of Jilin University, including 71 males and 63 females, with a median age of 38 years. TNSS score and visual analogue scale（VAS） of total nasal symptoms were observed during 2 weeks of treatment with Bencycloquidium bromide nasal spray. Results:TNSS score decreased from （8.89±3.31） on day 0 to （3.71±2.51） on day 14（P<0.001）, VAS score of nasal symptoms decreased from （24.86±7.40） on day 0 to （6.84±5.94） on day 14（P<0.001）, VAS score of rhinorrhoea decreased from （6.88±2.06） on day 0 to （1.91±1.81） on day 14（P<0.001）. Rhinoconjunctivitis quality of life questionnaire（RQLQ） score decreased from （94.63±33.35） on day 0 to （44.95±32.28） on day 14（P<0.001）. The incidence of adverse reaction was low and no serious adverse events occurred during the whole experiment. Conclusion:Bencycloquidium bromide nasal spray has significant efficacy and good safety in the treatment of seasonal allergic rhinitis.
Male ; Female ; Humans ; Adult ; Rhinitis, Allergic, Seasonal/drug therapy* ; Nasal Sprays ; Quality of Life ; Administration, Intranasal ; Rhinorrhea ; Double-Blind Method ; Treatment Outcome ; Rhinitis, Allergic/drug therapy*

Objective The aim of this study was to investigate the risk factors for delayed postoperative ileus(PPOI)in colon cancer patients undergoing complete laparoscopic right hemicolectomy combined with intraperitoneal thermal perfusion chemotherapy(HIPEC),and establish a risk prediction model.Methods A retrospective analysis was performed on the case data of 68 colon canc-er patients who underwent complete laparoscopic right hemicolectomy combined with HIPEC at the Department of General Surgery,the First Medical Center of PLA General Hospital from January 2018 to January 2021.The incidence of PPOI was statistically analyzed,and its risk factors were analyzed.A nomogram of risk prediction model was constructed and the effectiveness was verified.Results Among the 83 patients,26 cases(31.3％)developed PPOI.Multivariate logistic regression analysis showed that diabetes(OR=14.820,95％CI:2.819-77.918),previous abdominal surgery(OR=6.514,95％CI:1.433-29.604),preoperative Hb＜9 g/L(OR=5.338,95％CI:1.197-23.809),intraoperative hemorrhage more than 200 mL(OR=4.869,95％CI:1.213-19.544),and not close the mesangial hiatal(OR=5.462,95％CI:1.408-21.186)were the risk factors for PPOI.Based on the results of multiva-riate analysis,a risk prediction model for ROC curve and PPOI nomogram was constructed.The internal validation consistency index(C-index)was 0.85(95％CI:0.735-0.957).Conclusion The risk factors for PPOI after complete laparoscopic right hemicolec-tomy combined with HIPEC are diabetes,previous abdominal surgery,preoperative Hb＜9 g/L,intraoperative hemorrhage more than 200 mL,and failure to close the mesangial hiatal.The constructed nomogram of risk prediction model for PPOI after complete laparo-scopic right hemicolectomy has a good evaluating effect and clinical application value.

Objective:To evaluate the 1-year postoperative efficacy of four bariatric procedures, namely sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S), and biliopancreatic diversion with duodenal switch (BPD/DS) for treating super obesity.Methods:In this retrospective observational study, we analyzed the clinical data of 40 patients with super obesity (body mass index [BMI]≥50 kg/m 2) who had undergone bariatric surgery in the China-Japan Union Hospital of Jilin University from November 2015 to December 2020. The study cohort consisted of 21 men and 19 women of average age 31.7±9.0 years. The preoperative weight and BMI were (159.2±16.9) kg and (53.4±3.0) kg/m 2, respectively. Prior to the surgery, 30 individuals had hypertension, 27 hyperuricemia, 15 type 2 diabetes, 10 abnormally high total cholesterol, 20 abnormally high triglycerides, and 24 abnormally high low-density lipoprotein. We divided the participants into four groups according to the type of operation: SG group ( n=16), RYGB group ( n=9), SADI-S group ( n=9) and BPD/DS group ( n=6). We examined the following factors: weight, BMI, excess weight loss (%), total weight loss (%), and remission of preoperative metabolic diseases (including hypertension, hyperuricemia, type 2 diabetes, and hyperlipidemia) 3, 6, and 12 months after surgery. The variables assessed for hypertension were systolic and diastolic blood pressure; for type 2 diabetes, glycated hemoglobin; and for hyperlipidemia, total cholesterol, triglycerides, and low-density lipoprotein 1-year after the surgery. The safety of surgery was also assessed. Results:All patients successfully completed laparoscopic procedures, none of them requiring conversion to laparotomy. The amount of blood loss during surgery was less than 50 mL. Postoperative hospital stay was 6–16 days. There were no deaths during the perioperative period. However, two postoperative complications occurred in the RYGB group, namely bleeding and anastomotic leakage. No complications were detected in the other groups. At 3, 6, and 12 months after surgery, percentage of excess weight loss was 36.6±11.0, 62.4±15.7, and 68.2±16.0 ( F=21.830, P<0.001) in the SG group; 30.6±6.9, 42.5±5.8, and 50.6±11.1 ( F=13.222, P<0.001) in the RYGB group; 39.7±7.8, 54.6±12.7, and 81.9±12.0 ( F=33.821, P<0.001) in the SADI-S group; and 40.2±4.8, 57.7±11.8, and 82.8±14.9 ( F=21.552, P<0.001), respectively, in the BPD/DS group. The percentage of excess weight loss increased significantly over the 12-month observation period in all groups . Compared with before surgery, hypertension and hyperuricemia in the SG, SADI-S, and BPD-DS groups showed significant improvement after one year (all P<0.05). However, only the SADI-S group exhibited a significant decrease in glycosylated hemoglobin concentrations ( P=0.038). Only the BPD-DS group showed significant decreases in various indicators of hyperlipidemia (all P<0.05). The improvements in obesity-related complication indexes did not reach statistical significance in the RYGB group (all P>0.05). Conclusion:SG, RYGB, SADI-S and BPD/DS are all safe and effective treatments for super obesity. All of these procedures can improve the associated metabolic diseases to a certain extent.

Objective:To explore the predictive value of lactic acid for the adverse prognostic outcomes in patients with acute-on-chronic liver failure combined with infection.Methods:A retrospective analysis was conducted on the clinical data of 208 cases of ACLF combined with infection who were hospitalized from January 2014 to March 2016. Patients were divided into a survival group ( n = 83) and a mortality group ( n = 125) according to the results of a 90-day follow-up. The clinical data were statistically analyzed between the two groups. Multivariate logistic regression with two categorical variables was used to analyze the independent risk factors for 90-day disease mortality and establish a new prediction model. The receiver operating characteristic curve (ROC curve) was used to evaluate the predictive value of lactic acid, the MELD score, the MELD-Na score, lactic acid combined with the MELD score, lactic acid combined with the MELD-Na score, and the new model. Results:The 90-day mortality rate of 208 cases of ACLF combined with infection was 60.1%. There were statistically significant differences in white blood cell count, neutrophil count, total bilirubin (TBil), serum creatinine (Cr), blood urea nitrogen (BUN), blood ammonia, the international normalized ratio (INR), lactic acid (LAC), procalcitonin, the MELD score, the MELD-Na score, hepatic encephalopathy (HE), acute kidney injury (AKI), and bleeding between the two groups. Multivariate logistic regression analysis showed that TBil, INR, LAC, HE, and bleeding were independent risk factors for 90-day mortality in patients with ACLF combined with infection. After the establishment of MELD-LAC, MELD-Na-LAC, and a new prediction model, the ROC curve revealed that the AUC (95% confidence interval) of MELD-LAC and MELD-Na LAC were 0.819 (0.759 ~ 0.870) and 0.838 (0.780 ~ 0.886), respectively, and was superior than the MELD score [0.766 (0.702 ~ 0.823)] and MELD-Na score [0.788 (0.726 ~ 0.843)], with P < 0.05, while the new model had an AUC of 0.924, the sensitivity of 83.9%, specificity of 89.9%, and accuracy of 87.8%, which was higher than LAC, MELD score, MELD-Na score, MELD-LAC, and MELD-Na-LAC ( P < 0.01). Conclusion:Lactic acid is an independent risk factor for mortality in patients with ACLF combined with infection, and it improves the clinical predictive value of MELD and MELD-Na for the prognosis of mortality.