Objective Based on gender differences,this paper discusses the characteristics of facial color diagnosis in male and female patients with metaplastic chronic atrophic gastritis(CAG),and explores the pathological mechanism of different gender patients from the perspective of TCM pathogenesis,so as to provide personalized reference for TCM prevention and treatment of metaplastic CAG.Methods In this study,the complexion information of patients with chronic non atrophic gastritis(CNG)and CAG was collected by MT-BX-01 four-diagnostic instrument.The color colorimetric characteristics of male and female metaplastic CAG patients and CNG patients were analyzed by case-control study.Results In female patients,the L value and a value of liver region in CAG with mild intestinal metaplasia(IM)group,moderate and severe IM were significantly lower than those in CNG group(P<0.05).In male patients,the L value of spleen region in CAG with moderate and severe IM group was significantly higher than that in CNG group(P<0.05).Conclusion There is a certain gender difference in the facial color characteristics of patients with metaplastic CAG.The facial chromaticity value of female patients with metaplastic CAG changes most significantly in the liver area,while that of male patients mainly in the spleen area.It is suggested that the incidence of female metaplastic CAG is mostly related to liver,while that of male is mostly related to spleen,which provides a personalized method for clinical diagnosis and treatment of metaplastic CAG based on gender differences.

Objective To investigate the immediate brain effect of acupuncture at Fengchi using amplitude of low-frequency fluctuation(ALFF)and functional connectivity by the resting-state functional magnetic resonance imaging(rs-fMRI)in patients with posterior circulation ischemia vertigo(PCIV).Methods Twenty patients with PCIV were enrolled.The dizziness handicap inventory(DHI)was used to evaluate the severity of vertigo.The patients were randomly divided into acupuncture group and sham acupoint acupuncture group.Rs-fMRI scan was performed before and after acupuncture.MATLAB-based DPABI 6.1 software was used to analyze rs-fMRI data.Correlation analysis was used between the altered ALFF values and DHI scores.The regions of altered ALFF were taken as seeds to analyze functional connectivity.Results Compared with the sham acupoint acupuncture group,the increased ALFF values were mainly located on the left precuneus,left superior frontal gyrus and left caudate nucleus after acupuncture in the acupuncture group;the decreased ALFF values were mainly located on the left cerebellum and right inferior occipital gyrus.The ALFF value of the left superior frontal gyrus was negatively correlated with the DHI score(P=0.04).The increased functional connectivity was mainly found between left precuneus and the right middle frontal gyrus,the right superior frontal gyrus,the decreased functional connectivity was mainly found between left precuneus and the bilateral paracentral lobule and right cerebellum.Conclusion The ALFF value and functional connectivity are different before and after acupuncture,indicating that the vestibular network,visual and motor brain regions functional activities are changed after needling at Fengchi,which may be the brain functional basis of Fengchi for vertigo in PCIV.

Objective To study the application value of pneumonia severity index high-risk score (PSI-HR) in high risk patients and neutrophil-to-lymphocyte ratio (NLR) in the condition evaluation of the pa-tients with respiratory tract infection in ICU.Methods The clinical data of the patients with lower respiratory tract infection hospitalized in the department of intensive care medicine of this hospital from January 2020 to July 2023 were retrospectively analyzed.According to the ICU outcomes,the patients were divided into the im-provement group (n=77) and the poor prognosis group (n=25),and the receiver operating characteristic (ROC) curve was drawn to analyze the evaluation value of PSI-HR score combined with NLR,NLR,PSI-HR score,PSI-HR grade and PSI grade in the prognosis of the patients with lower respiratory tract infection. Results The case fatality rates of the patients with different grades of PSI were 40.00％ (16/40) for the grade 5,18.75％ (6/32) for the grade 4,22.22％ (2/9) for the grade 3 and 4.76％ (1/21) for the grade 2,re-spectively.There was no significant correlation between different PSI grades and case fatality rate (r=0.911,P=0.089).The case fatality rates of different grades of PSI-HR were 75.00％ (3/4) for the grade 6,46.67％ (7/15) for the grade 5,28.57％ (6/21) for the grade 4,17.24％ (5/29) for the grade 3,and 12.12％ (4/33) for the grade 2,respectively,and the PSI-HR grade was positively correlated with the case fatality rate of the patients (r=0.955,P=0.011).The area under the ROC curve (AUC) of predicting the prognosis of the pa-tients with lower respiratory tract infection from great to small was 0.828(95％CI:0.717-0.938,P<0.05) for PSI-HR score combined with NLR,0.754 (95％CI:0.637-0.871,P<0.05) for NLR,0.744 (95％CI:0.636-0.852,P<0.05) for PSI-HR score,and 0.706 (95％CI:0.584-0.829,P<0.05) for PSI-HR grade and 0.695 (AUC=0.695,95％CI:0.582-0.807,P<0.05) for PSI grade.Conclusion The PSI-HR grade has good correlation with the case fatality rate of the patients with lower respiratory tract infection.The effi-ciency of PSI-HR grade combined with NLR for predicting the prognosis in the patients with lower respiratory tract infection in ICU is better than that of single index.

Objective To observe the simulation of a finite element model of healthy adult female anal sphincter complex(ASC)established based on MRI.Methods One healthy adult female was prospectively enrolled,and an ASC geometric model was constructed using Mimics 3D reconstruction software based on anal MRI.Then the model was meshed with finite elements,and the parameters of the anal sphincter experiment in vitro and normal human anorectal pressure data were referenced to establish a finite element model,and its physiological characteristics and stress distribution were analyzed.Results After applying boundary loads to the ASC finite element model,under resting-state,the contraction deformation occurred on external anal sphincter,with the maximum displacement of 0.02 mm for anal canal and the smaller maximum displacement for internal anal sphincter,and a significant low stress zone in front of the upper inner surface of anal canal was observed.Under forced state,significant dilation and deformation occurred on anal canal,with the maximum displacement of 4.16 mm for the inner surface of anal sphincter.Under contracted state,the anal canal was compressed,and the maximum displacement of 1.89 mm for the inner surface of anal sphincter.Under both resting-state and contracted state,internal and external anal sphincters wholly moved forward.Conclusion The established ASC finite element model based on MRI could simulate the physiological activities and stress distribution of actual female adult muscle to some extent.

Objective:To investigate the effect of right stellate ganglion block (RSGB)-serratus anterior plane block (SAPB) combined with general anesthesia in thoracoscopic radical resection of lung cancer.Methods:A total of 90 patients who planned to undergo thoracoscopic radical resection of lung cancer in Xiangya Changde Hospital from March 2020 to September 2021 were prospectively selected and divided into 3 groups by random number table method: general anesthesia group (G group), (SAPB)+ general anesthesia group (SG group), RSGB+ SAPB+ general anesthesia group (RSG group), 30 cases in each group. The SG group received SAPB on the operative side before general anesthesia, and the RSG group received RSGB+ SAPB on the operative side before general anesthesia. After the blocking effect was determined, all patients were given general anesthesia in the same scheme according to their weight, and patients were given patient-controlled intravenous analgesia (PCIA) after surgery. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia (T 0), before intubation (T 1), 1 min after intubation (T 2), 5 min after intubation (T 3), at extubation (T 4) and 5 min after extubation (T 5). The intraoperative dosage of remifentanil, incidence of nausea and vomiting (PONV) within 24 hours after surgery, number of additional PCIA within 24 hours, the Visual Analogue Scale (VAS) of static and dynamic pain, the Bruggrmann Comfort Scale (BCS) and Richard Campbell Sleep Questionnaire (RSCQ) 24 hours after surgery were recorded. Results:Compared with T 0, the MAP and HR in 3 groups were increased 1 min after intubation (T 2) and at extubation (T 4), but the increases in RSG group were significantly less than those in G and SG groups (all P<0.05). The remifentanil dosage, PONV incidence and PCIA supplemental times in SG and RSG groups were less than those in G group, and the BCS score and RSCQ score were higher than those in G group (all P<0.05); the BCS score and RSCQ score in RSG group were higher than those in SG group (all P<0.05). Conclusions:RSGB+ SAPB combined with general anesthesia in thoracoscopic radical resection of lung cancer has little circulation fluctuation, good postoperative analgesia effect, less adverse reactions and high comfort level.

Objective:To explore the prognostic value of tumor deposits (TD) by number and anatomical distribution in gastric cancer (GC) patients without lymph node metastasis.Methods:From Aug 2012 to Aug 2018 all 91 GC patients undergoing radical gastrectomy and without nodal metastasis at Yijishan Hospital of Wannan Medical College were enrolled in this study. Patients were divided into L1, L2, and L3 groups according to the number of TD and into Q1 and Q2 groups according to the anatomical regions of the TD.Results:The 3-year overall survival (OS) rates of groups L1, L2, and L3 were 58.9%, 52.1%, and 31.5%, respectively ( χ2=9.769, P=0.008). The 3-year OS rates of groups Q1 and Q2 were 58.9% and 7.1% ( χ2=46.310, P<0.001). The number of TD, their distribution, neural invasion, vascular invasion, tumor size, and pT stage were all related to prognosis by univariate analysis (all P<0.05). Tumor size>4 cm ( HR=2.460, 95% CI:1.307-4.629, P=0.005), distribution of TD (non-perigastric)( HR=3.959, 95% CI:2.077-7.545, P<0.001), neural invasion ( HR=4.299,95% CI:1.953-9.461, P<0.001), and pT 4 stage ( HR=2.283, 95% CI:1.250-4.171, P=0.007) were independent risk factors for prognosis by multivariate analysis. Conclusion:The distribution of TD (non-perigastric) is an independent risk factor for poor prognosis in gastric cancer patients after radical gastrectomy and with negative lymph node metastasis.

The Brodmann area(BA)-based map is one of the most widely used cortical maps for studies of human brain functions and in clinical practice;however,the molecular architecture of BAs remains unknown.The present study provided a global multiregional proteomic map of the human cerebral cortex by analyzing 29 BAs.These 29 BAs were grouped into 6 clusters based on similarities in proteomic patterns:the motor and sensory cluster,vision cluster,auditory and Broca's area cluster,Wernicke's area cluster,cingulate cortex cluster,and heterogeneous function cluster.We identified 474 cluster-specific and 134 BA-specific signature proteins whose functions are closely associated with specialized functions and disease vulnerability of the corresponding clus-ter or BA.The findings of the present study could provide explanations for the functional connec-tions between the anterior cingulate cortex and sensorimotor cortex and for anxiety-related function in the sensorimotor cortex.The brain transcriptome and proteome comparison indicates that they both could reflect the function of cerebral cortex,but show different characteristics.These pro-teomic data are publicly available at the Human Brain Proteome Atlas(www.brain-omics.com).Our results may enhance our understanding of the molecular basis of brain functions and provide an important resource to support human brain research.

Objective:To observe the effect of early rehabilitation exercise on blood pressure of elderly patients with septic shock.Methods:A single-center, prospective, randomized controlled study was conducted in elderly patients with septic shock who were hospitalized in the department of critical care medicine of Huangshan Shoukang Hospital (High-tech Zone Central Hospital of Huangshan) from December 2018 to November 2020. According to the principle of simple random, all patients were divided into control group and intervention group. Both groups were treated with lower limb barometry to prevent deep vein thrombosis, 3 times a day, 30 minutes each time. After comprehensive treatment in the intensive care unit (ICU), the severity of patients was gradually improved, the hemodynamics was relatively stable, and the norepinephrine was reduced to 0.5 μg·kg -1·min -1. The control group continued to receive lower limb barometric treatment without rehabilitation training, while the intervention group began rehabilitation training when the dose of norepinephrine was reduced to 0.5 μg·kg -1·min -1. The duration of norepinephrine use, the length of ICU stay, and the occurrence of adverse events during rehabilitation training in intervention group was recorded. Results:Seventy-two patients were included in the final analysis, 35 in intervention group and 37 in control group. There was no significant difference in gender, age, Oxford acute severity of illness score (OASIS), acute physiology and chronic health evaluationⅡ (APACHEⅡ), mean arterial pressure (MAP) of 3 times and underlying diseases between two groups. Compared with control group, the length of ICU stay and duration of dose of norepinephrine ≤0.5 μg·kg -1·min -1 in intervention group were significantly shorter [length of ICU stay (hours): 193.0 (145.5, 312.0) vs. 242.5 (180.0, 483.5), P < 0.05; duration of dose of norepinephrine ≤0.5 μg·kg -1·min -1 (hours): 120.0 (72.0, 144.0) vs. 144.5 (120.0, 192.0), Z = 2.976, P = 0.003]. In intervention group, 35 patients did not show acute myocardial infarction, arrhythmia, syncope, central venous catheter detachment, and gastric tube detachment during the rehabilitation period, except 1 patient suffered from naked hematuria due to urinary catheter traction, which disappeared the next day after symptomatic treatment. Conclusion:The early rehabilitation exercise was beneficial to the recovery of autonomic blood pressure in elderly patients with septic shock, shorten the time of norepinephrine use and ICU stay.

3D bioprinting has been widely used in the field of regenerative medicine since its introduction in 2004. Due to its advantages of personalized customization, it is broadly applied in plastic surgery. This paper introduces 3D bioprinting materials (bioink) and bioprinting method currently used in the field of otoplasty and rhinoplasty, analyzes the clinical application of bioink, presents the challenges in 3D bioprinting technology in this field, and prospects the future development of the technology.

3D bioprinting has been widely used in the field of regenerative medicine since its introduction in 2004. Due to its advantages of personalized customization, it is broadly applied in plastic surgery. This paper introduces 3D bioprinting materials (bioink) and bioprinting method currently used in the field of otoplasty and rhinoplasty, analyzes the clinical application of bioink, presents the challenges in 3D bioprinting technology in this field, and prospects the future development of the technology.