ObjectiveTo identify the molecular biology of various species of Tibetan Codonopsis plants based on internal transcribed spacer（ITS）2 and psbA-trnH sequence barcode technology. MethodThe genomic DNA of 28 Tibetan Codonopsis plant samples from four species （Codonopsis canescens，C. foetens subsp. nervosa，C. pilosula， and C. thalictrifolia var. mollis） were extracted，and the ITS2 and psbA-trnH sequences were amplified and sequenced. The related sequences of 81 Tibetan Codonopsis plant samples belonging to 15 species were downloaded from GenBank， and MEGA 6.0 was used for sequence comparison and mutation site analysis. The GC content and genetic distance within and between species were calculated. Additionally， phylogenetic trees were constructed by maximum likelihood （ML） method， neighbor-joining （NJ） method，and unweighted pair-group method with arithmetic means （UPGMA） . ResultAccording to the mutation site，C. canescens， C. pilosula，C. pilosula subsp. tangshen， C. pilosula var. modesta，C. bhutanica，C. clematidea，C. lanceolata，C. subglobosa and C. foetens were distinguished. In the phylogenetic trees，the optimal clustering effects for ITS2 and psbA-trnH sequences were obtained using the ML method and the UPGMA method， respectively， and 12 species were effectively clustered. ConclusionITS2 and psbA-trnH sequences have a high identification rate for species of single origin，but there are still some limitations in identifying variants and original variants. This study provides basis for the identification of affinity relationship and clinical safety of Tibetan Codonopsis plants.

Objective:To explore the clinical effect of the composite reduction labiaplasty by divisional design.Methods:From January 2020 to February 2022, the clinical data of patients with complex labia minora and clitoris prepuce hypertrophy who were treated in the Medical Cosmetic Center of Beijing Friendship Hospital Affiliated to Capital Medical University were collected and analysed. The inner side of their labia minora showed no chalasis in the vertical direction, but the outer side were slack with folds, accompanied by clitoris prepuce hyperplasia. We adopted the composite reduction labiaplasty by divisional design. The outer side of the labia minora and the clitoral prepuce were considered as a whole, and a wedge-shaped incision line was designed to remove the excess tissue in the vertical direction. On this basis, an arc was projected on the inner side of the labia minora to form an arcuate incision line on the inner side. The composite reduction labiaplasty was performed with the combination of wedge resection and edge resection. The postoperative follow-up observations included: postoperative complications, the symmetry of the labia minora and clitoris prepuce, the improvement of frictional discomfort, the cleanliness of the labia minora and the clitoris prepuce, and the patient's satisfaction with the shape of the labia minora and clitoris prepuce. For patients with sexual experience, follow-up content also includes changes in sexual satisfaction.Results:A total of 17 female patients aged 20 to 35 years, with an average age of 27 years, were included in this study. Follow-up was conducted 2 months after the operation. All incisions healed by first intention with no sawtooth-like deformity at the incision margin, and had natural appearance. Patients felt that the bilateral labia minora and clitoral foreskin were completely symmetrical in 3 cases, basically symmetrical in 12 cases, and partially asymmetric in 2 cases. These 2 cases of partial asymmetry did not require further surgical repair. In all 17 patients, the frictional discomfort was completely resolved, and the labia minora and clitoral foreskin were easier to clean. The patients were very satisfied with the appearance in 5 cases, satisfied in 10 cases, and dissatisfied in 2 case. There were 15 patients with previous sexual life experience, of which 10 patients had improved sexual satisfaction, and 5 patients had no change in sexual satisfaction after the operation.Conclusions:Through the divisional design, wedge resection and edge resection are performed in the composite reduction labiaplasty, which can solve the friction and discomfort caused by the hyperplasia of labia minora and clitoris prepuce in a single operation, and achieve better aesthetic results at the same time.

Objective:To explore the clinical effect of the composite reduction labiaplasty by divisional design.Methods:From January 2020 to February 2022, the clinical data of patients with complex labia minora and clitoris prepuce hypertrophy who were treated in the Medical Cosmetic Center of Beijing Friendship Hospital Affiliated to Capital Medical University were collected and analysed. The inner side of their labia minora showed no chalasis in the vertical direction, but the outer side were slack with folds, accompanied by clitoris prepuce hyperplasia. We adopted the composite reduction labiaplasty by divisional design. The outer side of the labia minora and the clitoral prepuce were considered as a whole, and a wedge-shaped incision line was designed to remove the excess tissue in the vertical direction. On this basis, an arc was projected on the inner side of the labia minora to form an arcuate incision line on the inner side. The composite reduction labiaplasty was performed with the combination of wedge resection and edge resection. The postoperative follow-up observations included: postoperative complications, the symmetry of the labia minora and clitoris prepuce, the improvement of frictional discomfort, the cleanliness of the labia minora and the clitoris prepuce, and the patient's satisfaction with the shape of the labia minora and clitoris prepuce. For patients with sexual experience, follow-up content also includes changes in sexual satisfaction.Results:A total of 17 female patients aged 20 to 35 years, with an average age of 27 years, were included in this study. Follow-up was conducted 2 months after the operation. All incisions healed by first intention with no sawtooth-like deformity at the incision margin, and had natural appearance. Patients felt that the bilateral labia minora and clitoral foreskin were completely symmetrical in 3 cases, basically symmetrical in 12 cases, and partially asymmetric in 2 cases. These 2 cases of partial asymmetry did not require further surgical repair. In all 17 patients, the frictional discomfort was completely resolved, and the labia minora and clitoral foreskin were easier to clean. The patients were very satisfied with the appearance in 5 cases, satisfied in 10 cases, and dissatisfied in 2 case. There were 15 patients with previous sexual life experience, of which 10 patients had improved sexual satisfaction, and 5 patients had no change in sexual satisfaction after the operation.Conclusions:Through the divisional design, wedge resection and edge resection are performed in the composite reduction labiaplasty, which can solve the friction and discomfort caused by the hyperplasia of labia minora and clitoris prepuce in a single operation, and achieve better aesthetic results at the same time.

Objective:To explore the clinical effect of the composite reduction labiaplasty by divisional design.Methods:From January 2020 to February 2022, the clinical data of patients with complex labia minora and clitoris prepuce hypertrophy who were treated in the Medical Cosmetic Center of Beijing Friendship Hospital Affiliated to Capital Medical University were collected and analysed. The inner side of their labia minora showed no chalasis in the vertical direction, but the outer side were slack with folds, accompanied by clitoris prepuce hyperplasia. We adopted the composite reduction labiaplasty by divisional design. The outer side of the labia minora and the clitoral prepuce were considered as a whole, and a wedge-shaped incision line was designed to remove the excess tissue in the vertical direction. On this basis, an arc was projected on the inner side of the labia minora to form an arcuate incision line on the inner side. The composite reduction labiaplasty was performed with the combination of wedge resection and edge resection. The postoperative follow-up observations included: postoperative complications, the symmetry of the labia minora and clitoris prepuce, the improvement of frictional discomfort, the cleanliness of the labia minora and the clitoris prepuce, and the patient's satisfaction with the shape of the labia minora and clitoris prepuce. For patients with sexual experience, follow-up content also includes changes in sexual satisfaction.Results:A total of 17 female patients aged 20 to 35 years, with an average age of 27 years, were included in this study. Follow-up was conducted 2 months after the operation. All incisions healed by first intention with no sawtooth-like deformity at the incision margin, and had natural appearance. Patients felt that the bilateral labia minora and clitoral foreskin were completely symmetrical in 3 cases, basically symmetrical in 12 cases, and partially asymmetric in 2 cases. These 2 cases of partial asymmetry did not require further surgical repair. In all 17 patients, the frictional discomfort was completely resolved, and the labia minora and clitoral foreskin were easier to clean. The patients were very satisfied with the appearance in 5 cases, satisfied in 10 cases, and dissatisfied in 2 case. There were 15 patients with previous sexual life experience, of which 10 patients had improved sexual satisfaction, and 5 patients had no change in sexual satisfaction after the operation.Conclusions:Through the divisional design, wedge resection and edge resection are performed in the composite reduction labiaplasty, which can solve the friction and discomfort caused by the hyperplasia of labia minora and clitoris prepuce in a single operation, and achieve better aesthetic results at the same time.

Objective:To explore the clinical effect of the composite reduction labiaplasty by divisional design.Methods:From January 2020 to February 2022, the clinical data of patients with complex labia minora and clitoris prepuce hypertrophy who were treated in the Medical Cosmetic Center of Beijing Friendship Hospital Affiliated to Capital Medical University were collected and analysed. The inner side of their labia minora showed no chalasis in the vertical direction, but the outer side were slack with folds, accompanied by clitoris prepuce hyperplasia. We adopted the composite reduction labiaplasty by divisional design. The outer side of the labia minora and the clitoral prepuce were considered as a whole, and a wedge-shaped incision line was designed to remove the excess tissue in the vertical direction. On this basis, an arc was projected on the inner side of the labia minora to form an arcuate incision line on the inner side. The composite reduction labiaplasty was performed with the combination of wedge resection and edge resection. The postoperative follow-up observations included: postoperative complications, the symmetry of the labia minora and clitoris prepuce, the improvement of frictional discomfort, the cleanliness of the labia minora and the clitoris prepuce, and the patient's satisfaction with the shape of the labia minora and clitoris prepuce. For patients with sexual experience, follow-up content also includes changes in sexual satisfaction.Results:A total of 17 female patients aged 20 to 35 years, with an average age of 27 years, were included in this study. Follow-up was conducted 2 months after the operation. All incisions healed by first intention with no sawtooth-like deformity at the incision margin, and had natural appearance. Patients felt that the bilateral labia minora and clitoral foreskin were completely symmetrical in 3 cases, basically symmetrical in 12 cases, and partially asymmetric in 2 cases. These 2 cases of partial asymmetry did not require further surgical repair. In all 17 patients, the frictional discomfort was completely resolved, and the labia minora and clitoral foreskin were easier to clean. The patients were very satisfied with the appearance in 5 cases, satisfied in 10 cases, and dissatisfied in 2 case. There were 15 patients with previous sexual life experience, of which 10 patients had improved sexual satisfaction, and 5 patients had no change in sexual satisfaction after the operation.Conclusions:Through the divisional design, wedge resection and edge resection are performed in the composite reduction labiaplasty, which can solve the friction and discomfort caused by the hyperplasia of labia minora and clitoris prepuce in a single operation, and achieve better aesthetic results at the same time.

Objective: To study clinicopathological features,diagnosis and differential diagnosis of myxoid lipoblastoma. Methods: Four cases of myxoid lipoblastoma, from 2010 to 2017 at Wuxi People′s Hospital of Nanjing Medical University, the Affiliated Hospital of Xuzhou Medical University and Binhai People′s Hospital, were studied by clinicopathological analysis, immunohistochemistry and in situ hybridization along with a literature review. Results: The age of the patients ranged from 1 to 6 years. Histologically, all tumors had thin fibrous capsule and irregular lobules separated by fibrous septa. The individual lobules consisted of myxoid stroma,prominent plexiform capillary network and stellate or spindle mesenchymal cells. Lipoblasts (S-100 positive) and mature adipocytes varies among different lobules. FISH revealed PLAG1 disruption in all 4 cases. MDM2 or CHOP alterations were not detected. None of the patients had tumor recurrence upon follow up from 12 to 80 months. Conclusions Myxoid lipoblastoma is a very rare tumor, usually in the first 5 years of life. The clinical features of myxoid lipoblastoma and lipoblastoma are similar, while myxoid lipoblastoma has prominent myxoid change, a plexiform vascular pattern and rare mature fat cells. The patient age,S-100 positive lipoblasts and cytogenetic alteration are the key diagnostic features.

Objective To study clinicopathological features,diagnosis and differential diagnosis of myxoid lipoblastoma. Methods Four cases of myxoid lipoblastoma,from 2010 to 2017 at Wuxi People′s Hospital of Nanjing Medical University, the Affiliated Hospital of Xuzhou Medical University and Binhai People′s Hospital, were studied by clinicopathological analysis, immunohistochemistry and in situ hybridization along with a literature review. Results The age of the patients ranged from 1 to 6 years. Histologically, all tumors had thin fibrous capsule and irregular lobules separated by fibrous septa. The individual lobules consisted of myxoid stroma,prominent plexiform capillary network and stellate or spindle mesenchymal cells. Lipoblasts (S?100 positive) and mature adipocytes varies among different lobules. FISH revealed PLAG1 disruption in all 4 cases. MDM2 or CHOP alterations were not detected. None of the patients had tumor recurrence upon follow up from 12 to 80 months. Conclusions Myxoid lipoblastoma is a very rare tumor, usually in the first 5 years of life. The clinical features of myxoid lipoblastoma and lipoblastoma are similar, while myxoid lipoblastoma has prominent myxoid change, a plexiform vascular pattern and rare mature fat cells. The patient age,S?100 positive lipoblasts and cytogenetic alteration are the key diagnostic features.

Objective: To use vertical and humidity correcting method to calibrate aerosol optical depth (AOD), and to explore the feasibility of calibrated-AOD as exposure index to measure the level of air pollutants from the ground and to establish the exposure-response relationship between calibrated-AOD and people's health outcomes.Methods: First of all, we interpolated AOD, PM2.5, relative humidity and planetary boundary layer height using Kriging method to obtain data at different locations and matched different data with respiratory death in Beijing by geographical coordinates.Then, the planetary boundary layer height and aerosol hygroscopic growth factor calculated based on relative humidity was used to calbrate the AOD.To compare the effects of calibrated-AOD and PM2.5, we used standardization method to get non dimensionless calibrated-AOD and PM2.5.At last, we used the generalized additive mixed model (GAMM) to estimate the acute effects of calibrated-AOD and PM2.5 on respiratory death and chronic obstructive pulmonary disease (COPD) death, after controlling the time trend, temperature and humidity effects, days of the week effect and holiday effects.Results: The correlation coefficient between calibrated-AOD and PM2.5 was 0.72.The effects of calibrated-AOD on respiratory death and COPD death was the strongest at lag 0-3, one unit of calibrated-AOD increases was associated with 3.64% (95%CI: 0.58%-6.78%) increase of respiratory death and 4.92% (95%CI: 1.81%-8.14%) increase of COPD death.As for PM2.5, the strongest effects appeared at lag 0-1, one unit of PM2.5 (about 155 μg/m3) increases was associated with excess risks of 3.96% (95%CI: 0.82%-7.19%) and 6.12% (95%CI: 1.44%-11.02%) for respiratory death and COPD death respectively.Compared with PM2.5, the effects of calibrated-AOD on respiratory death and COPD death had narrower confidence intervals.The calibrated-AOD was sensitive to capture the lag effects, and the cumulative lag effects of calibrated-AOD were all significant on multiple lag days which indicated that the calibrated-AOD was sensitive to capture cumulative lag effects of air pollutants on respiratory death and COPD death as well.Conclusion: We believe that calibrated-AOD can be used as an index to reflect the effects of air pollutants on respiratory death in Beijing.In the absence of ground monitoring, calibrated-AOD can be used to mea-sure the relationship between air pollutants and some health outcomes.

OBJECTIVETo explore the concentration-response relationship between ambient concentration of PM2.5 and daily total hospital emergency room visits in Beijing during 2012 and 2013. This study also examined the effects of ambient PM2.5 during heavy polluted days on emergency room visits compared with the light polluted days.

METHODSWe collected the daily meteorological factors monitoring data and concentrations of air pollutants in Beijing during October 1, 2012 to December 31, 2013. We also collected the daily emergency room visits from a tertiary hospital in Beijing in the same time period. Generalized additive model was fitted to estimate the association between the ambient PM2.5 and the hospital emergency room visits, by using the smooth function to adjust long term trend of time, public holidays and day of week. In addition, constrained piecewise linear function was then used to estimate the excess risk for different segment of concentration-response function.

RESULTSThe annual average concentration of PM2.5 was 90.9 µg/m(3) during October 1, 2012 and December 31, 2013. There were total 64 260 cases for total emergency room visits, of which respiratory disease had 9 849 cases and cardiovascular disease had 11 168 cases. PM2.5 was positive related with PM10, NO2 and SO2. The corresponding correlation coefficients were 0.87, 0.78 and 0.62, respectively (P<0.05). And PM2.5 was positively related with relative humidity, with correlation coefficient 0.45 (P<0.05). But PM2.5 was negatively related with mean temperature (r=-0.17, P< 0.05) and wind speed (- 0.32, P<0.05). In the single polluted model, after adjusting the effects of temperature, relative humidity and wind, every 10 µg/m(3) increase of concentration of ambient PM2.5, the corresponding excess risk of daily emergency room visits was 0.25% (95% CI: 0.07-0.43). In the two-pollutant model PM2.5+SO2 and PM2.5+NO2, every 10 µg/m(3) increase of concentration of ambient PM2.5, the corresponding excess risk of daily emergency room visits were 1.07% (95%CI:0.83-1.30) and 0.56% (95%CI: 0.32-0.80) respectively, which were higher than the effect in single pollutant model. Average concentration of ambient particulate matters (PM2.5) was 204.16 µg/m(3) during heavy pollution, higher than control period (85.24 µg/m(3)). When PM2.5 as the primary air pollutants during heavy polluted days, we observed a significant increase in emergency room visits, and the odd ratios was 1.16 (95% CI:1.09-1.22).

CONCLUSIONThere were positive correlation between high concentration of ambient particulate matters (PM2.5) and increasing daily emergency room visits. Especially during the heavy polluted days, the effects of elevated concentration of PM2.5 on hospital emergency room visits were much larger.

Air Pollutants ; analysis ; Beijing ; Cardiovascular Diseases ; diagnosis ; Emergency Service, Hospital ; statistics & numerical data ; Humans ; Meteorological Concepts ; Particulate Matter ; analysis ; Respiratory Tract Diseases ; diagnosis ; Temperature ; Tertiary Care Centers

Objective:To establish a method for the determination of trace nickel in agomelatine. Methods:An inductive coupled plasma atomic emission spectrometry method was applied in the determination at 221. 648 nm. The sample solution was prepared by the ignited residue of agomelatine. The content of nickel was determined using the standard curve. Results:The linear range was 0. 025-1. 000 μg·ml-1(r=0. 999 8). The RSD of precision was 0. 63%. The detection limit was 0. 000 8μg·ml-1. The quantitative limit was 0. 003μg·ml-1 . The average recovery was 99. 4% with RSD of 2. 20%. The RSD of repeatability was 1. 33%. Conclusion:The method is simple, sensitive and accurate in the determination of trace nickel in agomelatine.