Tufted angioma (TA) is a rare vascular endothelial cell tumor that often occurs in infants and early childhood and is rare in adults. There are currently no unified treatment guidelines, and treatment options for children with TA are limited and challenging. This report introduces a case of a child diagnosed with superficial TA in the left popliteal fossa. Topical 0.1% sirolimus cream was given in the early stage and combined with pulsed dye laser treatment in the later stage. The child’s skin lesions recovered well. The author reviews relevant literature reports to summarize the treatment of TA in children and provide relevant ideas and new options for the diagnosis and treatment of the disease.

Tufted angioma (TA) is a rare vascular endothelial cell tumor that often occurs in infants and early childhood and is rare in adults. There are currently no unified treatment guidelines, and treatment options for children with TA are limited and challenging. This report introduces a case of a child diagnosed with superficial TA in the left popliteal fossa. Topical 0.1% sirolimus cream was given in the early stage and combined with pulsed dye laser treatment in the later stage. The child’s skin lesions recovered well. The author reviews relevant literature reports to summarize the treatment of TA in children and provide relevant ideas and new options for the diagnosis and treatment of the disease.

Objective:To study the risk model of medical equipment maintenance and repair based on system dynamics,and to solve the problems of frequent risk of corruption,high transaction prices and low procurement timeliness in the process of medical equipment maintenance and repair.Methods:The risk matrix was formed by analyzing the procurement risk of medical equipment maintenance and warranty,and the risk matrix was drawn.The system dynamics model was constructed around the price risk,schedule risk and corruption risk of medical equipment maintenance procurement,and the causal relationship and feedback effect between the risk influencing factors of medical equipment maintenance procurement were revealed through the construction of causality diagram and stock flow diagram.The risk change effects of the PLA General Hospital's application of the system dynamics-based medical equipment maintenance and procurement risk model in practice in 2022 was compared.Results:After the application of risk management control based on system dynamics model,the increase of procurement price risk decreased from 0.54 before control to 0.27,the increase of corruption risk decreased from 0.27 before control to 0.05,and the increase of schedule risk decreased slowly.After lowering the risk threshold,the increase of price risk and price risk decrease significantly.When the risk threshold was reduced from 60 to 40,the project success rate was increased by 6.52%and the rate of doubts and complaints decreased by 6.61%.Conclusion:The medical equipment maintenance risk model based on system dynamics strictly manages the procurement demand side,implements price limit and price review management,and can effectively eliminate the corruption risk and schedule risk derived from price risk by optimizing the procurement method,building the negotiation price limit model and improving the price review and pricing mechanism.

Broca's aphasia is a common type of aphasia after stroke. Its etiology and pathogenes belong to deficient root and excessive superficial. Deficiency of qi and blood, liver and kidney yin is the origin of the disease, and wind, fire, phlegm and blood stasis are the symptoms. Acupuncture therapy aims to refresh the brain, dredge the orifices and amplify the sound, supplemented by benefiting qi and blood, removing phlegm and blood stasis, benefiting tongue. At present, scalp acupuncture, tongue acupuncture, electroacupuncture, characteristic acupuncture and acupuncture combined with other therapies are commonly used to treat the disease. It is observed that acupuncture combined with other therapies have showed advantages in reducing the disability, and realize the optimal principle.

Objective:To investigate the effects of total shoulder arthroscopy versus small-incision rotator cuff repair on shoulder range of motion, postoperative pain, and complications in patients with rotator cuff injury. Methods:The clinical data of 106 patients with rotator cuff injuries treated in Yiwu Central Hospital between June 2018 and July 2021 were retrospectively analyzed. These patients were divided into an observation group and a control group according to different treatment regimens, with 53 patients in each group. The control group underwent arthroscopic small-incision rotator cuff repair. The observation group underwent total shoulder arthroscopy. Perioperative indicators, pain (Visual Analogue Scale score) before surgery and 1, 3, and 6 months after surgery, shoulder range of motion and shoulder-elbow function before surgery, and 3 and 6 months after surgery and postoperative complications were compared between the two groups.Results:Operative time in the observation group was significantly longer than that in the control group [(98.67 ± 12.31) minutes vs. (85.72 ± 10.53) minutes, t = 5.82, P < 0.01). Intraoperative blood loss, postoperative passive shoulder expansion time, and hospital stay in the observation group were (28.66 ± 3.12) mL, (5.61 ± 1.03) days, and (14.17 ± 2.26) days, which were significantly shorter than (37.68 ± 3.59) mL, (7.22 ± 1.41) days and (17.21 ± 3.04) days in the control group ( t = 13.81, 6.71, 5.86, all P < 0.01). After surgery, the Visual Analogue Scale score in each group significantly decreased compared with that before surgery (both P < 0.05). At 1, 3, and 6 months after surgery, the Visual Analogue Scale score in the observation group was (2.46 ± 0.63) points, (1.53 ± 0.42) points, and (1.03 ± 0.26) points, respectively, which were significantly lower than (3.04 ± 0.74) points, (1.84 ± 0.51) points, and (1.21 ± 0.34) points in the control group ( t = 4.35, 3.42, 3.06, all P < 0.01). At 3 and 6 months after surgery, the ranges of motion of shoulder abduction, external rotation, and internal rotation in each group significantly increased compared with those before surgery (all P < 0.05). The scores of American Shoulder and Elbow Surgeons and the University of California Los Angeles in each group were significantly increased compared with those before surgery (both P < 0.05). After treatment, there were no significant differences in the scores of American Shoulder and Elbow Surgeons and the University of California Los Angeles between the two groups (both P < 0.05). By 6 months after surgery, the incidence of complications in the control group was 3.77%. No obvious complications were observed in the observation group. There was no significant difference in the incidence of complications between the two groups ( χ2 = 0.51, P > 0.05). Conclusion:Compared with small-incision rotator cuff repair, total arthroscopic rotator cuff repair has less invasive trauma and mild pain and is more conducive to postoperative shoulder function recovery.

Objective:To evaluate the clinical efficacy and safety of a cream containing madecassoside, 5% panthenolon skin repairing after nonablative fractional 1 565 nm laser therapy.Methods:A total of 84 patients who received nonablative fractional laser surgery in our hospital from April 2017 to April 2018 were included as research objects. The patients were divided into observation group and control group by random number table method, 42 cases in each group. The control group was treated with routine facial intervention after operation, while the observation group was treated with a cream containing madecassoside, 5% panthenolon skin repairing on the basis of routine intervention. The postoperative skin barrier function of the two groups were recorded and compared through skin property system and VISIA complexion analysis system.Results:At 1 and 2 weeks after operation, the sebum content and cuticle water content in the observation group were higher than those in the control group, and the transdermal water loss in the observation group was less than that in the control group, and the differences were statistically significant ( t=4.927, 7.833, 12.430, 4.538, 10.083, 8.017, P<0.05). The erythema index (EI) and melanin index (MI) of the observation group were lower than those of the control group at 1 and 2 weeks after operation, and the incidence of complications was significantly lower than that of the control group ( t=2.392, 2.807, 3.485, 3.009, P<0.05). Conclusions:The application of a cream containing madecassoside, 5% panthenolon in skin repairing is helpful to enhance the moisturizing effect, reduce the complications and promote the early recovery of patients with skin trauma after fractional laser operation.

Purpose: Effective predictors of the response to neoadjuvant chemotherapy (NAC) are still insufficient. This study aimed to investigate the predictive value of serum lipid profiles for the response to NAC in breast cancer patients. Methods: A total of 533 breast cancer patients who had received NAC were retrospectively studied. The pretreatment of serum lipids, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and lipoprotein-α, and clinicopathological characteristics were collected to assess their predictive roles. Results: Breast cancer patients had significantly lower TC, TG, HDL-C, and LDL-C levels than normal individuals. Among these indicators, TG and LDL-C levels and HDL-C level increased and decreased significantly after NAC, respectively. In estrogen receptor (ER)-positive patients, increased LDL-C level was associated with better outcomes. Moreover, the receiver operating characteristic curve analyses suggested that TG and HDL-C levels at diagnosis can be used as predictors of the response to NAC only in the ER-positive subgroup.According to univariate analyses, patients with low TG level (< 1.155 mmol/L) or high HDL-C level (≥ 1.305 mmol/L) in the ER-positive subgroup had more favorable clinical responses than the other patients in the subgroup. Furthermore, according to multivariate analyses, a high HDL-C level (≥ 1.305 mmol/L, p = 0.007) was an independent predictor of NAC efficacy. Conclusion High HDL-C level (≥ 1.305 mmol/L) before NAC and increased LDL-C level after NAC were associated with the better treatment response in ER-positive breast cancer patients.These results are potentially considered beneficial in establishing treatment decisions.

Objective To analyze the treatment and follow-up of congenital coronary artery fistula (CAF) with giant coronary artery aneurysm (GCAA) in children.Methods The clinical data were analyzed retrospectively in 13 patients who were diagnosed as congenital CAF with GCAA between July 2009 and December 2016 in Guangzhou Women and Children's Medical Center.There were 8 boys and 5 girls.The median age was 18 months,ranging from 40 days to 12 years old.The body weight ranged from 3.8 kg to 29.0 kg with a median of 8.8 kg.Fistulas originated from right coronary artery accounted in 8 patients,with 5 from left coronary artery.Fistulas drained into right atrium in 3 patients,right ventricular in 8 patients and left ventricular in 2 patients.Single fistula occurred in 12 patients and multiple fistulas in 1 patient.The diameter of coronary artery aneurysm ranged from 8 mm to 16 mm with a median of 9.2 mm.Results One patient had tachypnea and growth retardation without heart murmur.The other 12 patients were asymptomatic with heart murmurs occasionally found in routine physical examination.One patient underwent fistula ligation without cardiopulmonary bypass (CPB).The remaining 12 cases received fistula correction with beating heart CPB.Direct suture was used in 10 patients and autologous pericardial patch in other 2 patients.Two patients were associated with atrial septal defect (ASD) and underwent repair of ASD concurrently.The coronary artery aneurysm remained original shape without any intervention during the operation.The mean hospital delay was (11.0 ± 2.5) days.Two patients had decreased ejection fraction as low as 38％ within 3 days after the operation,but went up to over 50％ in follow-up 1 month later.Transient T wave change occurred in 7 patients,and another 2 patients showed a residual shunt with size of 1 to 2 millimeters through the fistula without further intervention after the surgical closure.All 13 patients had antiplatelet therapy with 12 taking Aspirin and one taking Dipyridamole.The dosage was 3-5 mg/(kg · d) with duration ranging from 3 days to 13 months with a median of 1 month.During the perioperative period and the follow-up period (3 months to 8 years),all patients were asymptomatically alive.Transthoracic echocardiography showed normal cardiac function.Compared with preoperative status,the diameter of dilated coronary arteries was not changed after the operation.There was no formation of thrombus in the coronary arteries.Electrocardiography showed no ST-T changes or arrhythmia or myocardial ischemia.Conclusions GCAA can be combined with congenital CAF in children,so it needs early operation.The evidence-based intervention of coronary artery aneurysm and usage of anticoagulant and antiplatelet therapy in pediatric patients was still lacking,which needs long-term follow-up.

Objective: To understand the iodine content of drinking water in Ningxia, and provide a basis for promoting scientific iodine supplementation. Methods: In 2017, 22 counties (cities, districts) of Ningxia Hui Autonomous Region were surveyed by township (town, street office) as the unit. Water samples were collected and iodine content was detected according to the unified centralized water supply, mixed water supply and all the scattered water supply methods. Among them, the investigation at township (town and street office) level found that the median of iodine in water was > 10 μg/L, and then the water samples were collected in administrative villages (neighborhood committees) and the content of iodine in water was detected. Results: A total of 242 townships (town, street office) were surveyed at the township level water iodine, and a total of 1 048 water samples were collected, the median water iodine was 6.6 μg/L, the range was 0.0-97.8 μg/L. There were 75 townships with a median water iodine > 10 μg/L, and an administrative village level water iodine survey was conducted. A total of 1 169 water samples were collected, the median water iodine was 14.5 μg/L, and the range was 0.0-97.4 μg/L. The median water iodine at the township level, unified centralized water supply, mixed water supply, and all the scattered water supply was 6.9, 6.8, and 4.5 μg/L, respectively. The difference was statistically significant (χ² = 7.08, P < 0.05). The median water iodine at the administrative village level, unified centralized water supply, mixed water supply, and all the scattered water supply was 15.8, 8.4, and 11.6 μg/L, respectively. The difference was statistically significant (χ² = 35.23, P < 0.05). Conclusion The iodine content of drinking water in Ningxia residents is low, which is consistent with the fact that Ningxia is in the iodine deficient area.

Objective To investigate the characteristics of implicit and explicit memory in patients with obsessive compulsive disorder (OCD) and its relationship with obsessive-compulsive symptoms.Methods Thirty-one patients with OCD and thirty healthy participants matched with sex,age,years of education were enrolled in present study.All participants were conducted vocabulary perception speed task and vocabulary recognition task to evaluate the ability of implicit memory and explicit memory toward neutral,positive and moral disgust words.The accuracy and response time during tasks were recorded to index memory performance.The obsessive-compulsive symptoms were assessed with Padovar scale-Washington State University revised edition (PI-WSUR).Results There was significant difference in the response time of implicit memory between two groups ((2 926.63± 1 718.31) ms for OCD group,(2 587.13±1 054.56) ms for controls group,t=0.926,P=0.358).There was significant difference two groups in the accuracy of implicit memory for moral disgust words ((0.607±0.267) for OCD group,(0.777±0.159) for controls group,t=-3.306,P =0.004),positive words ((0.528±0.265) for OCD group,(0.695±0.152) for controls group,t=-3.048,P=0.004) and all words ((0.597±0.248) for OCD group,(0.731±0.145) for controls group,t=-2.582,P=0.013).The response time of explicit memory in OCD group was significantly correlated with PI-WSUR (r=-0.410,P=0.022),OTAHSO (r=-0.470,P=0.008).Conclusion Compared with healthy controls,the implicit memory of OCD patients was impaired,especially the implicit memory of positive emotion words and moral disgust words.There is no correlation between implicit memory and obsessive-compulsive symptoms in OCD patients.Compared with healthy controls,the implicit memory of OCD patients is not impaired,but there is a correlation between explicit memory and obsessive-compulsive symptoms in OCD patients.