Objective:To investigate the associations of onset age, diabetes duration, and glycated hemoglobin (HbA1c) levels with ischemic stroke risk in type 2 diabetes patients.Methods:The participants were from Comprehensive Research on the Prevention and Control of the Diabetes in Jiangsu Province. The study used data from baseline survey from December 2013 to January 2014 and follow-up until December 31, 2021. After excluding the participants who had been diagnosed with stroke at baseline survey and those with incomplete information on onset age, diabetes duration, and HbA1c level, a total of 17 576 type 2 diabetes patients were included. Cox proportional hazard model was used to calculate the hazard ratio ( HR) and 95% CI of onset age, diabetes duration, and HbA1c level for ischemic stroke. Results:During the median follow-up time of 8.02 years, 2 622 ischemic stroke cases were registered. Multivariate Cox proportional risk regression model showed that a 5-year increase in type 2 diabetes onset age was significantly associated with a 5% decreased risk for ischemic stroke ( HR=0.95, 95% CI: 0.92-0.99). A 5-year increase in diabetes duration was associated with a 5% increased risk for ischemic stroke ( HR=1.05, 95% CI: 1.02-1.10). Higher HbA1c (per 1 standard deviation increase: HR=1.17, 95% CI: 1.13-1.21) was associated with an increased risk for ischemic stroke. Conclusion:The earlier onset age of diabetes, longer diabetes duration, and high levels of HbA1c are associated with an increased risk for ischemic stroke in type 2 diabetes patients.

To investigate the associations of serum gamma-glutamyl transferase (GGT) levels with the risk of cardiovascular disease (CVD) and its subtypes in patients with type 2 diabetes mellitus (T2DM) in Jiangsu Province.Methods:The participants were enrolled in the Comprehensive Research project regarding 'Prevention and Control of Diabetes' in Jiangsu Province. The baseline survey was conducted from 2013 to 2014, and follow-up until December 31, 2021. After excluding the participants who self-reported with chronic liver disease/stroke/coronary heart disease at baseline survey and those with incomplete information on GGT, a total of 16 147 T2DM patients were included in the final analysis. Cox proportional hazard regression models were used to calculate the hazard ratio ( HR) and their 95% CI of GGT for CVD, myocardial infarction, and stroke. Restricted cubic spline models were applied to analyze the dose-response relationship between GGT and the risk of CVD and its subtypes. Results:During the median follow-up time of 8.02 years, 2 860 CVD cases were registered, including 196 cases of myocardial infarction and 2 730 cases of stroke. Multivariate Cox proportional risk regression model indicated that compared to the lowest serum GGT level group, the highest GGT level group had a 24% increased risk of CVD ( HR=1.24, 95% CI: 1.09-1.41) and a 23% increased risk of stroke ( HR=1.23, 95% CI: 1.08-1.40). The restricted cubic spline model showed a nonlinear dose-response relationship between GGT and the risk of CVD, myocardial infarction, and stroke in T2DM patients. Conclusions:High levels of GGT may be associated with an increased risk of cardiovascular disease in T2DM patients, which needs further exploration and validation in future clinical practice.

Frontal fibrosing alopecia is a primary lymphocytic cicatricial alopecia, and is generally considered to be a subtype of lichen planopilaris due to similar histopathological changes. Its etiology is still unclear. With the deepening of research on this disease, more and more cases of frontal fibrosing alopecia have been reported in China and other countries. This review summarizes research progress in pathogenesis, clinical and pathological characteristics, and treatment of frontal fibrosing alopecia.

Objective:To investigate the clinical experience of different types of femoral perforator flaps in the reconstruction of oral and maxillofacial head and neck defects.Methods:From January 2018 to January 2021, 573 patients with oral and maxillofacial head and neck defects reconstructed by femoral perforator flap were collected in the Department of Maxillofacial Oncology, the Third Affiliated Hospital of Air Force Military Medical University (age range of 21-76 years, with a male to female ratio of 1.23∶1). According to the type of perforator flap, the patients were divided into ALT group, AMT group, TFL flap group and free muscle flap group. The incidence of postoperative complications, wound healing time and drainage volume in femoral area were compared among the 4 groups.Results:The ALT flap was used in 527 cases: 22 flaps had vascular crisis, 14 flaps had infection, 8 flaps had necrosis, 519 flaps survived; the mean healing time of the wound was (14.50±3.19) days, and the mean drainage volume was (49.9±21.3) ml. 28 cases were repaired with AMT flap: 2 flaps had vascular crisis and 1 had infection. All the flaps survived; the mean healing time of the wound was (14.18±2.75) days, and the mean drainage volume was (50.3±23.0) ml. 11 cases were repaired by TFL flap: 1 flap had vascular crisis and 1 had infection. All the flaps survived. The mean healing time of the wound was (14.09±2.66) days, and the mean drainage volume was (54.1±25.0) ml. 7 cases were repaired by free muscle flap survived without vascular crisis, infection and other postoperative complications; the mean healing time of the wound was 14.14±1.86, and the mean postoperative drainage volume was (49.9±21.1) ml. There was no significant difference in complication rate (flap necrosis, vascular crisis, infection, etc.) and repair effect among 573 patients with different flap types. The postoperative follow-up was conducted for 6-24 months, and the donor area was smooth and good in appearance, without obvious scar or functional influence. The repair effect of the affected area was satisfactory.Conclusions:Although there is a certain proportion of perforator vessel variation in the femoral perforator flap, the flap can be designed freely according to different types of variation. The thigh perforator flap has an essential application value in the repair of oral and maxillofacial head and neck defects.

Objective: To compare diagnostic performance of traditional vertical section technique, horizontal section technique and modified Ho-Vert technique for classical lichen planopilaris. Methods: Clinical data were collected from patients with classical lichen planopilaris in Department of Dermatology, The Affiliated Wuxi People′s Hospital of Nanjing Medical University from January 1st 2015 to January 1st 2019. With the help of dermoscopy, 2 scalp specimens were obtained from each patient and sliced horizontally and vertically respectively by using modified Ho-Vert technique. The horizontal and vertical sections were read separately or simultaneously, and histopathological changes were observed. Results: Totally, 21 patients with classical lichen planopilaris were enrolled into this study, including 15 males and 6 females. Their age was 50.0 ± 13.6 years, and the average course of disease was 18 months. The patients mainly presented with multifocal or confluent patchy hair loss, and scalp atrophy, perifollicular hyperkeratosis, loss of follicular ostia, fibrous white dots and orbit sign were observed. On the horizontal sections, lichenoid lymphocytic infiltration around the infundibulum and isthmus of hair follicles and follicular micro-scars could be observed in all patients, and the dermo-epidermal interface could be seen in 7 patients. On the vertical sections, lichenoid lymphocytic infiltration around the infundibulum and isthmus of hair follicles only could be observed in 9 patients, follicular micro-scars could be seen in 4, and the dermo-epidermal interface could be observed in all patients. Moreover, the detection rates of interfollicular interface dermatitis, follicular keratotic plugs, lymphocytic infiltration around sebaceous glands, atrophy or disappearance of sebaceous glands and inflammatory infiltration around hair follicle bulbs were significantly different between the horizontal and vertical sections. In combination with clinical manifestations, 7 patients could be exactly diagnosed with lichen planopilaris according to findings from horizontal sections, and 9 could be diagnosed exactly according to findings from vertical sections, while 21 could be diagnosed exactly according to histopathological findings from both horizontal and vertical sections. Conclusion With the help of dermoscopy, modified Ho-Vert technique can improve the efficacy of pathological diagnosis of classical lichen planopilaris, by multidimensionally showing histopathological changes.

Objective:By investigating the demand of " Internet-based health education" for urban and rural residents, to identify the main functions of " Internet-based health education" platform and the priority order that platform design should follow, in an effort to help promote the accurate dissemination of health education.Methods:Since April 2019, a stratified random sampling method was used to collect urban and rural residents in 3 counties and cities of a city. The survey mainly investigated the importance of the preliminary function and the specific demand of residents for " Internet-based health education" . With data collected and based on Kano model, the Better-Worse coefficient was used for quantitative analysis.Results:There are 14 main functions of the function item identification and discovery platform; among them, privacy, and without product placement are regarded requisites of the platform, while simple and stable operation among others rank the expected functions. in addition, artistic interface, fun experience, etc. were seen as the undifferentiated functions.Conclusions:The platform design for " Internet-based health education" should follow the priority order of privacy, without product placement, simple and stable operation, information authority, low attrition, comprehensive functions, perfect supervision, free service and high popularity.

Objective:To explore the effects of gaseous formaldehyde exposure on male Sprague-Dawley rat brain function and synaptic protein expression, as well as the neuroprotective effects of resveratrol.Methods:Eighty-four male Sprague-Dawley rats were randomly divided into seven group with 12 in each group: control group (N), gaseous formaldehyde accumulation low concentration group (FL group), gaseous formaldehyde accumulation medium concentration group (FM group), gaseous formaldehyde accumulation high concentration group (FH group), gaseous formaldehyde accumulation low concentration + resveratrol group (FLR group), gaseous formaldehyde accumulation concentration + resveratrol group (FMR group) and gaseous formaldehyde accumulation high concentration + resveratrol group (FHR group). The animal model of gaseous formaldehyde accumulation was established by gas formaldehyde exposure method.Learning and memory function was tested by Morris water maze. Cortical and hippocampal neurogranin (Ng) protein expression in brain cortex and hippocampus was measured by Western blot.Results:(1) Compared with the escape latency and original platform retention time of rats in group N ((19.75±4.08) s, (43.47±2.43) s), the escape latency of rats in FM and FH groups was prolonged ((25.52±2.98) s, (27.45±2.39) s, t=-4.97, -5.82; both P<0.01), the retention time of the original platform was shortened ((30.99±4.21) s, (18.70±2.58) s, t=10.24, 25.71; both P<0.01). Compared with the corresponding formaldehyde accumulation groups such as the FM and FH groups, the escape latency of the rats in the FMR and FHR groups was significantly longer ((21.37±3.80) s, (24.26±3.56) s, t=1.86, 3.93; both P<0.05), the retention time of the original platform was significantly prolonged ((40.33±3.63)s, (23.46±4.73)s, t=-7.50, -3.95; both P<0.01). (2) Compared with the expression of Ng in cortex and hippocampus of rats in group N ((0.99±0.03), (1.07±0.03)), the expression of Ng protein in cortex and hippocampus of rats in FM and FH groups was significantly reduced((0.62±0.06), (0.39±0.03), (0.77±0.09), (0.46±0.10), t=11.55, 14.08, 11.51, 13.17; all P<0.01). Compared with the corresponding formaldehyde accumulation groups such as the FM and FH groups, the expressions of Ng in the cortex and hippocampus of the rats in the FMR and FHR groups were significantly increased ((0.94±0.11), (0.48±0.04), (0.95±0.05), (0.60±0.09), t=-5.26, -2.09, -5.32, -2.21; all P<0.05). Conclusion:Resveratrol can improve the learning and memory function of rats caused by the accumulation of gaseous formaldehyde.The mechanism may be related with the upregulation of Ng.

Alopecia is a common disease in dermatologic clinics.The diagnosis of some hair diseases does not rely on pathological examinations,and with the development of science and technology,the role of many new non-invasive detection instruments,such as dermoscopy,hair scanners and skin CT,is increasingly valued in the diagnosis and treatment of hair diseases.However,the role of pathological examination is still irreplaceable.Because of the particularity of hair diseases,hair pathology differs from common skin pathology in the aspects of scalp biopsy sites,biopsy methods and techniques,tissue-slicing methods and pathological report content.This review systematically discusses the role of scalp pathological biopsy in the diagnosis and treatment of alopecia.

Objective To examine the feasibility and early effects of unilateral pedicle screw fixation in combination with contralateral translaminar facet screw fixation plus interbody fusion through the channel-assisted muscle-splitting approach for the treatment of degenerative lumbar spine diseases in elderly patients.Methods A total of 82 elderly patients with degenerative lumbar spine diseases received treatment between January 2015 and June 2016.Of these patients,25 had lumbar spinal stenosis,42 had degenerative lumbar instability,13 had giant lumbar disc herniation,and two had recurrent lumbar disc herniation;There were 69 cases of single segment and 13 cases of double segment lesions.Perioperative evaluation,imaging evaluation,and clinical evaluation were performed,and surgical complications were analyzed.Results The average length of incision was (2.6 ± 0.4) cm in cases of single segment lesions and (4.4±0.5) cm in cases of two segment lesions.The mean operation time was (98.3±19.6) minutes and peri-operation blood loss was (232.2±25.8) ml.The post-operation height of the intervertebral disc space significantly increased at the last follow-up(P ＜ 0.05);the height of the intervertebral disc space was restored and well maintained with internal fixation showing no loosening,breakage or Cage shift.The post-operation lumbar coronal Cobb angle decreased(P＜0.05)while the sagittal Cobb angle increased(P＜0.05)at the last follow-up.There was no significant difference in the area and grade of the multifidus muscle on MRI 12 months after operation.Seventy-two patients were followed up for 12-18 months (mean =16.8 months),and there were 67 cases of intervertebral fusion (93.1％).The last follow-up showed a Japanese Orthopaedic Association(JOA) score of (25.8 ± 1.7),which was significantly higher than the pre-operation score (10.6±1.3),with an excellence rate of 88.9 ％.The Oswestry Disability Index score was significantly reduced,from (50.9±21.6) at pre-operation to (9.6± 4.8) at the last follow-up.There were 78 patients with primary wound healing,three cases of superficial wound necrosis,one case of dural tear,and one case of nerve root injury.No cardiovascular or cerebrovascular incident was observed during or after operation.Conclusions Combined pedicle/facet screw fixation plus interbody fusion through the channel-assisted muscle-splitting approach shows satisfactory short-term effects when used for the treatment of degenerative lumbar spine diseases in the elderly and possesses advantages such as minimal invasiveness,limited bleeding,quick recovery,high fusion rates and significantly improved clinical outcomes.However,further clinical studies are required to assess its medium-and long-term efficacy.

Objective To investigate the effect of Ginsensode Rgl on the expression of Neurogranin (Ng) and behavioral alteration in cortex and hippocampus of rats with chronic stress model.Methods A total of 36 adult male SD rats were randomly divided into control group (CON),model group (CUS) and treatment group (CUS-G).The chronic stress model was established by chronic unpredictable stress.The Morris water maze was used to study the learning and memory ability.The content of Ng in cortex,hippocampus was detected by RT-PCR and Western blot.Results The water maze test showed that after chronic stress,animal learning and memory ability decreased significantly,while the treatment group rats escape latency was significantly reduced (P＜0.05);after 6 weeks of stress,the cortex and hippocampus Ng mRNA levelschronic stress rats were markedly lower than that of model rats respectively (P＜0.05,P＜0.01,P＜0.05).The cerebral cortex and hippocampus Ng mRNA levels in treatment group were significantly increased compared with that of model group respectively (P＜0.01,P＜ 0.05,P＜0.05);The cerebral cortex and hippocampus Ng levels of chronic stress rat were significantly decreased when compared with that of the model rats respectively (P＜0.05,P＜0.01,P＜0.05),The cerebral cortex and hippocampus Ng content were significantly increased in treatment group compared with the model group respectively (P＜0.01,P＜0.05).Conclusions Chronic stress can change the behaviors of nice in recognization and memory The contents of Ng and the supplement of Ginsensode Rg1 have positive adjustment.