ObjectiveTo investigate the clinical efficacy and safety of state-target formula Angelica and Safflower spot removal essence in the treatment of melasma. MethodsA randomized，double-blind，placebo-controlled parallel-group trial was conducted，selecting patients with Qi stagnation and blood stasis type of melasma who visited the dermatology outpatient department of Beijing Hospital of Integrated Traditional Chinese and Western Medicine from September 2022 to February 2023. In accordance with the double-blind principle，a random number table was generated to randomly divide the patients into an experimental group （50 cases） and a control group （50 cases）. The experimental group applied the Angelica and Safflower spot removal essence topically，while the control group applied a placebo topically，with continuous treatment for 8 weeks and a follow-up of 1 month. Melasma Area and Severity Index （MASI），Physician Global Assessment （PGA），patient self-assessment scoring，VISIA detection and scoring were performed before medication and on the first day after stopping medication，and all adverse events were recorded. ResultsIn a study involving 100 patients，87 cases were included in the analysis. The experimental group consisted of 45 cases，with 5 dropouts，and the control group had 42 cases，with 8 dropouts. The baseline data of the patients in both groups were consistent，with no statistically significant differences. After treatment，the total effective rate of the experimental group was 75.56% （34/45），significantly higher than the control group's 2.38% （1/42），and the difference was statistically significant （χ²=48.38，P<0.01）. Compared with before treatment，after treatment，the MASI score，VISIA image spot，brown spot，and red area score of the experimental group patients were significantly reduced （P<0.05，P<0.01），while there was no statistically significant difference in the control group patients. Compared with the control group after treatment，the experimental group showed more significant improvement （P<0.05，P<0.01）. VISIA image analysis showed that after 8 weeks of treatment，the experimental group showed significant improvement in surface spots，deep spots，and red areas，while the control group remained unchanged or showed an increasing trend. 42.22% （19/45） of the experimental group had a PGA score of 3 or below，while 88.89% （40/45） had a PGA score of 4 or below. 80.95% （34/42） of the control group had a PGA score of 5 or above，and the difference between the two groups was statistically significant （χ²=38.26，P<0.01）. There was no statistically significant difference in the recurrence rate and adverse reaction rate within one month between the experimental group and the control group. ConclusionThe state-target formula Angelica and Safflower spot removal essence is clinically effective and safe in the treatment of melasma.

Background::Breast cancer is ranked among the most prevalent malignancies in the Chinese female population. However, comprehensive reports detailing the latest epidemiological data and attributable disease burden have not been extensively documented.Methods::In 2018, high-quality cancer surveillance data were recorded in 700 population-based cancer registries in China. We extracted data on female breast cancers (International Classification of Diseases, Tenth Revision [ICD-10]: C50) and estimated the incidence and mortality in 2022 according to the baseline data and corresponding trends from 2010 to 2018. Pathological types were classified according to the ICD for Oncology, 3rd Edition codes. Disability-adjusted life years (DALYs) were calculated as the sum of the years of life lost (YLLs) and years lived with disability (YLDs).Results::In 2022, approximately 357,200 new female breast cancer cases and 75,000 deaths occurred in China, accounting for 15.59% and 7.94% of total new cancer cases and deaths, respectively. The age-standardized incidence rate (ASIR) was 33.04 per 100,000. When analyzed by pathological type, the ASIRs for papillary neoplasms, invasive breast carcinoma, rare and salivary gland-type tumors, and other types were 1.13, 29.79, 0.24, and 1.88 per 100,000, respectively. The age-standardized mortality rate (ASMR) was 6.10 per 100,000. A total of 2,628,000 DALYs were found to be attributable to female breast cancer in China, comprising 2,278,300 YLLs and 349,700 YLDs. The ASIR, ASMR, and age-standardized rate (ASR) for DALYs in urban areas were consistently higher than those in rural areas. We observed a four-fold increase in the ASIR and ASR for DALYs and an eight-fold increase in the ASMR among females over 55 years compared with those aged under 55 years.Conclusion::These data provide invaluable insights into the latest epidemiology of female breast cancer in China and highlight the urgency for disease prevention and control strategy formulation.

Objective:To explore the interleukin-31 protein expression in the hypertrophic scar of incision tissue after surgery and its underlying pathological impact.Methods:From February 2022 to February 2023, three HS patients scar tissue (HS) and their normal skin tissue (Control, NS) were obtained. Two patients were female and one patient was male. The tissues were fixed in 4% formalin and embedded in paraffin. Haematoxylin-eosin (HE) stain and immunohistochemical stain were used to evaluate the epidermal thickness, myofibroblasts of dermis and the expression level of IL-31 between HS and NS.Results:The epidermis thickness was (303.88±46.03) μm in HS group, while (133.02±17.40) μm in NS group ( t=12.60, P<0.001). The expression level of IL-31 protein was measured by IRS score and positive cell density. The IRS score was 9.89±2.03 of the basal layer in HS group and was 4.33±1.66 of the basal layer in NS group. The positive cell density was 786 343.83±159 627.97 of the basal layer in HS group ( P<0.001) and was 555 457.61±128 097.21 of the basal layer in NS group ( P=0.014). In the dermis layer, the IRS score was 7.11±1.05 in HS group and was 4.33±0.71 in NS group, the positive cell density was 156 760.97±26 046.10 in HS group ( P<0.001) and was 49 576.01±52 369.33 in NS group ( P<0.001). In the dermis layer, the count of myofibroblasts was 120.44±15.75 in HS group while was 27.39±14.89 in NS group ( t=23.79, P<0.001). Conclusions:Our study demonstrates that both myofibroblast count and IL-31 protein expression level are notably increased in HS patients. The expression of IL-31 protein is prominent in the cytoplasm of myofibroblasts, basal cells, macrophages and mast cells which could implicate that IL-31 may be a potential therapeutic target to enhance the resolution of HS.

Objective:To prove the effect of double V-Y procedure for paramedian tubercles plasty in patients with thin lower lips and dissatisfied appearance of lower lips.Methods:From 2013 to 2019, 127 Chinese cases of thin and dissatisfied appearance of lower lips were included. A double V-Y procedure for paramedian tubercles plasty was performed. Objective data of lip morphology before and after operation were measured, and subjective satisfaction survey and long-term follow-up were conducted.Results:The midline lower red lip height, the height of paramedian tubercles of lower-lip and the protrusion of lower-lip were significantly higher than that before the operation. The time of apocatastasis, scar softening of incision, natural expression recovery and local numbness relief were evaluated by following up at 7 d, and 3-24 months after operation, and it showed 73.2% of subjective satisfaction. The time of detumescence was 6-32 (15.2±3.5) days; the time of incision scar softening was 2-10 (5.1±2.3) months; the time of expression recovery was 1-7 (3.1±0.9) months; the time of numbness disappearance was 5 d-2 years (158.2±82.6) days.Conclusions:The double V-Y advancement of vermilion mucosa flap procedure for paramedian tubercles plasty displays a significant effect in improving volume and shape of lower lips. It is recommended for further clinical application.

Objective:To observe and evaluate reductional M-shaped plasty method in patients with thick lips and dissatisfied lip appearance.Methods:From 2013 to 2019, 415 Chinese cases of thick upperlip without clear vermilion curve and tubercle were included. A reduction method for upper lip M-shaped plasty was performed. Objective data of lip morphology before and after operation were measured, and subjective satisfaction survey and long-term follow-up were conducted.Results:According to the statistics of 415 patients, the time of detumescence was 3-21 (11.8±2.6) days; the time of incision scar softening was 1-24 (2.6±0.8) months; the time of expression recovery was 1-24 (3.1±1.4) months; the time of numbness disappearance was 1-2 years. Three months after the operation, there was no significant change in the height of the central part of the upper red lip compared with that before the operation, the height of the red lip at the peak of the lip was significantly reduced, the height of the red lip was (13.3±2.2) mm before the operation, and (11.4±1.7) mm after the operation; the relative height of the dome point was significantly increased, the height was (0.4±1.0) mm before the operation, and the height was (2.1±0.5) mm after the operation. After more than 6 months of follow-up, patients' satisfaction rate of one operation was 72.0%, the satisfactory rate of upper lip shape was 75.4%, the long-term complications included obvious scars or discomfort (3.6%), local numbness (1.7%), and unnatural expression (0.7%).Conclusions:The reduction method for upper lip M-shaped plasty displays a significant effect in improving the shape of upper vermilion with thick and normal lips. The complications are slight and repairable. This lip cosmetology and rejuvenation procedure is recommended for further clinical application.

Objective To analyze the results of longitudinal pancreaticojejunostomy in treatment of paediatric chronic pancreatitis with dilated pancreatic ducts.Methods A retrospective study was carried out on 13 patients with paediatric chronic pancreatitis complicated with dilated pancreatic ducts treated with longitudinal pancreaticojejunostomy in Children's Hospital of Chongqing Medical University from December 2011 to January 2017.The perioperative morbidity and mortality rates,long-term treatment results and postoperative growth of these children were analyzed.Results The 13 patients all underwent successful surgery.In 11 patients,the serum and urine amylase levels returned to normal after 8 days of operation,and the abdominal pain disappeared completely.In 1 patient,the abdominal pain gradually disappeared in 1 year,and the serum and urine amylase levels gradually returned to normal.This patient gained weight well.In the remaining patient who had severe pancreatic atrophy,the patient took high-fat diets before and after surgery,and drank alcohol occasionally.The patient developed repeated attacks of abdominal pain with occasional increase in serum and urine amylase levels and had poor weight gain.There were no complications such as postoperative bleeding,pancreatic leakage and intestinal obstruction in this study.The body weight and growth rates of the whole group of patients before and 1 year after surgery were different.Conclusion Longitudinal pancreaticojejunostomy for paediatric chronic pancreatitis complicated with dilated pancreatic ducts was safe and effective in alleviating symptoms,improving quality of life,and resulted in normal growth of these children.

Objective: To summarize and update the terminology of the lip and perioral morphological aesthetic subunits and aesthetic landmarks in the domestic medical aesthetics field. Methods: 36 English literatures, 13 Chinese literatures, 3 foreign academic compositions, 2 domestic academic compositions, 1 domestic medical aesthetics textbook, and 14 websites of the medical aesthetic field have been included. We summarized the commonly seen terminology of the lip and perioral morphological aesthetic subunits and aesthetic landmarks. Moreover, for the aesthetic subunits and aesthetic landmarks which are commonly used in clinical practice but have not yet been named in Chinese term are named following the current Chinese terminology rule. We summarized not only the terminology of lips but also the anatomical acknowledge of the commonly used aesthetic subunits. Results: There are 17 standard nomenclatures for aesthetic subunits, 8 standard nomenclatures with abbreviations for aesthetic surface landmarks, 20 standard terms for aesthetic measurement and distance. Moreover, we named 5 aesthetic subunits and 6 aesthetic surface landmarks for which there are no standard Chinese medical terms. Conclusions The standard terminology for the aesthetic subunits and landmarks is the foundation for the lip and perioral measurement and evaluation. Besides, it also provides a reference basis for the development of lip cosmetic and perioral rejuvenation treatment programs.

Objective To explore the methods and means to improve standardized management of regional quality control using quantitative indicators and information technology.Method The Quality Management and Control Indicators for Beijing health and medical institutions were converted into secondary and tertiary entries for quantitative scoring in accordance with the principles of standardization and management in the Integrated Management System of Health Examination under the regional information platform (Beijing Physical Examination Information Platform).APP was downloaded and applied in the on-site quality inspection.The data were obtained in paper forms completed on-site at 185 medical institutions with valid quality inspection scores in Beijing in 2014 and from the 2016 Beijing medical institutions' physical examination quality inspection.The inclusion criteria were as follows:185 institutions were divided into three groups (Level 3,Level 2,Level 1 and below),and each group was further divided into three subgroups with scores of 0-360,361-480,and 481-600;a total of 63 institutions were randomly selected from seven subgroups.Experts used the Integrated Management System of Health Examination Quality Control mobile app for the inspection.The two data groups were compared to check for quality improvement and the consistency of the quality inspection experts.Results The total quality score of medical institutions at Level 1 and below in 2016 (510.02±42.95) was higher than that in 2014 (483.16±79.06),and the difference was statistically significant (t=2.431,P＜0.05).There was no statistically significant difference between Level 2 and Level 3 medical institutions in 2014 and 2016.The scores of institutions at different levels are higher in the laboratory internal quality control and external quality assessment,and the difference was statistically significant (P＜0.05),whereas the score of physical health examination quality management organization only improved in the medical institutions at Level 1 and below,with statistically significant difference (P＜0.05).The changes of scores in the consistency of quality inspection experts was reduced after the application of the system,and the difference in institutions at Level 3 and Level 1 and below was statistically significant (P＜0.05),while not statistically significant in institutions at Level 2 (P=0.840).Conclusion Quantitative indicators and information technology are effective in regional standardized management of physical examination quality,and worthy of further exploration.

Objective To investigate the radiation dose to phantoms of thick dense breasts (compression thickness ＞ 65 mm) and the influence of Molybdenum-Rhodium (Mo-Rh) and Wolfram Rhodium (W-Rh)) target-filter combination on image quality in full field digital mammography (FFDM).Methods An aluminium plate was placed on polymethyl methacrylate (PMMA) plates to simulate dense breasts.Two of 68 mm in-depth phantoms were used to simulate photography condition of thick dense breasts with 0.1 and 0.2 mm aluminium plates respectively.The two phantoms were exposed automatically,half-automatically and manually.The parameters were recorded for each exposure including the target-filter(T-F),tube voltage (kV),tube current (mAs),average glandular dose (AGD),entrance surface dose (ESD) and the image quality figure inverse (IQFInv).Pearson correlation and regression was used to analyze the influence of AGD on IQFInv.Paired sample t-test was used to analyze the influence of different target-filters on IQFInv and AGD.Results AGD had a positive correlation with IQFInv (r =0.806-0.953,P ＜ 0.05).For the phantom of 0.1 mm aluminium,when the tube current was fixed at 100 mAs or the tube voltage was fixed at 28 kVp,AGD and IQFInv had statistically significant difference for two target-filters(t =3.162-8.028,P ＜0.05).For the phantom with 0.2 mm aluminium,when the tube current was fixed at 100 mAs under different tube voltage,AGD and IQFInv had statistically significant difference for two target-filters(t =4.768-8.028,P ＜ 0.05);when tube voltage was fixed at 28 kVp under different tube current,AGD had statistically significant difference for two target-filters(t =7.730,P ＜ 0.05),while there was no statistical difference in IQFInv(P ＞ 0.05).In addition,when tube current was 100 mAs,IQFInv had statistically significant difference for two phantoms in W-Rh(t =2.345,P ＜ 0.05).Conclusions W-Rh target-filter combination can achieve lower radiation dose under the guarantee of the image quality compared with Mo-Rh target-filter combination.At the same tube current,W-Rh target-filter combination can provide a better image quality under a relatively high tube voltage.

Objective To evaluated the role of postoperative radiotherapy (PR) after surgery in patients with uterine sarcoma,and analyzed the prognostic factors.Methods A total of 182 patients with uterine sarcoma were included between June 1994 and October 2014.Radiotherapy dose were 30-50 Gy/10-25 fractions/5 fractions/week.The LRFFS and OS were calculated with Kaplan-Meier method,and difference was analyzed with log-rank method.Cox regression analyses were used to determine prognosticators.Results There were 114 patients which survived more than 5-years in this whole group,including PR 24 cases and no PR 90 cases.The 5-year LRRFS and OS were 62.1％ and 56.2％,respectively.The 5-year LRRFS were 78.0％ and 55.3％ on PR and no PR (P=0.013);with OS 64.1％ and 51.7％ on PR and no PR (P=0.070).A multivariate analysis showed that pathological types,histological grade and clinical stage were associated with LRRFS and OS (P=0.032,0.008,0.000 and 0.046,0.000,0.000).PR was significant influencing factor for OS (P=0.013).Conclusions Uterine sarcoma patients treated with PR after surgery had an improved LRRFS compared to those treated with surgery,especially those with leiomyosarcoma.The role of PR personalized radiation for uterine sarcoma still needs to be further discussed.