Objective To explore the the correlation between cystatin C(Cys C),beta-2 microglobulin(β2-MG)and ischemic cerebral small vessel disease(CSVD)and its subgroups.Methods Totally 234 patients with CSVD were assigned to the study group,and 92 elderly people with no abnormal findings in head MRI were selected as controls.The CSVD patients were further divided into the subgroups of lacunar infarction(LI),white matter lesion(WML)and LI+WML.Each group was compared risk factors include the blood level of Cys C and β2-MG.Results There were statistically significant differences between CSVD group and control group in cystatin C(Cys C)and β2-MG(P<0.05).Cystatin C(Cys C)and β2-MG there were statistically significant differences between WML group and control group(P<0.05),and also between WML+LI group and control group(P<0.05).Logistic regression analysis and comparison across subgroups showed Cys C and β2-MG to be the common risk factors for WML group and WML+LI group inpatients with ischemic cerebral small vessel disease.Conclusion Cys C and β2-MG are the common risk factors for WML group and WML+LI group inpatients with ischemic cerebral small vessel disease.The risk factors vary across different CSVD subgroups.

OBJECTIVE To predict the amount of colorants used in the preparation of placebo of Chinese medicine by construc-ting particle swarm optimization-back propagation neural network PSO-BPNN compound granules,and to provide a new idea for the simulation of placebo color of Chinese medicine compound granules.METHODS The BP neural network was used to establish the model of sample color parameters L,a?,b?and pigment mass fraction.The global search ability of particle swarm optimization algo-rithm was used to optimize the weight and bias of BP neural network to prevent the local minimum value of the model.The linear reduc-tion weight coefficient method and the introduction of mutation operator were used to improve the global optimization ability of particle swarm optimization algorithm.The color comprehensive evaluation index(ΔE)was used as the objective evaluation standard to verify the test results.RESULTS The training results show that the fitting accuracy of the improved PSO-BP neural network was up to 98.31%.The prediction results show that the prediction error of the improved PSO-BP neural network was the smallest,and the mean absolute percentage error(MAPE),root mean square error(RMSE)and mean color difference(ΔE)were 0.411 5,2.164 6 and 2.56,respectively.The verification samples of three kinds of particles were prepared for verification.The ΔE of the verification sample and the model drug were 1.73,2.63 and 4.11,respectively.The color difference between the two groups and the model drug was small by visual evaluation.CONCLUSION The BP neural network based on the improved particle swarm optimization algorithm can simulate the prediction of the amount of colorants used in the preparation of Chinese medicine compound granules,and can be used as a recommended optimization model for placebo color matching research.

Objective:To investigate the cosmetic effect of biplane fixed technique for double-eyelid plasty.Methods:From September 2019 to June 2021, 80 patients, including 6 males and 74 females, aged 18-45 years with an average age of 31 years, were treated with single eyelid cosmetic surgery at the Medical Aesthetics Department of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University. All the cases were performed by the " biplane fixed technique", and the key point of the surgery was to fix the orbicularis labii muscle in biplane (hard fixation plus soft suspension). A questionnaire survey was conducted and preoperative and postoperative photos were collected for statistical analysis to evaluate postoperative outcomes. The patients were follow up for 6-12 months after surgery, and the incidence of postoperative complications were calculated.Results:The incisions of 80 patients all healed by first intention. 79 patients were satisfied, accounting for 98.75%. Physicians evaluated 78 cases as satisfactory, accounting for 97.50%. The Vancouver Scar Scale score was 2.31±1.80, and the Edema and Eczema Visual Simulation Scale score was 3.58±2.15. After surgery, there were no significant abnormalities when eyes opening or closing, and the shape of the double eyelid remained intact without shedding. The scar on the closed eye incision was mild and there was no obvious depression.Conclusions:The " biplane fixed technique" blepharoplasty can form a firm double eyelid line, which is not easy to fall off and has slight scars. The postoperative effect is stable and worthy of clinical application.

Smart manufacturing still remains critical challenges for pharmaceutical manufacturing. Here, an original data-driven engineering framework was proposed to tackle the challenges. Firstly, from sporadic indicators to five kinds of systematic quality characteristics, nearly 2,000,000 real-world data points were successively characterized from Ginkgo Folium tablet manufacturing. Then, from simplex to the multivariate system, the digital process capability diagnosis strategy was proposed by multivariate C_pk integrated Bootstrap-t. The C_pk of Ginkgo Folium extracts, granules, and tablets were discovered, which was 0.59, 0.42, and 0.78, respectively, indicating a relatively weak process capability, especially in granulating. Furthermore, the quality traceability was discovered from unit to end-to-end analysis, which decreased from 2.17 to 1.73. This further proved that attention should be paid to granulating to improve the quality characteristic. In conclusion, this paper provided a data-driven engineering strategy empowering industrial innovation to face the challenge of smart pharmaceutical manufacturing.

Objective:To analyze the interim clinical efficacy of laparoscopic and open distal gastrectomy for gastric cancer in elderly patients.Methods:The prospective randomized controlled study was conducted. The clinicopathological data of 102 patients aged ≥65 years who underwent distal gastrectomy for gastric cancer in the Nanfang Hospital of Southern Medical University from September 2014 to May 2018 were collected. After excluding 6 patients, 96 patients were finally included. Based on random number table, patients were allocated into two groups. Patients undergoing laparoscopic distal gastrectomy were allocated into laparoscopic group, and patients undergoing open distal gastrectomy were allocated into open group, respectively. Obser-vation indicators: (1) grouping situations of the enrolled patients; (2) intraoperative situations; (3) postoperative situations; (4) follow-up. Follow-up using outpatient examination and telephone interview was conducted to detect complications in the postoperative 30 days up to July 2018. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M( P25, P75) or M(range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was analyzed using the non-parameter Mann-Whitney U test. Results:(1) Grouping situations of the enrolled patients: a total of 96 patients were selected for eligibility. There were 66 males and 30 females, aged from 65 to 85 years, with a median age of 69 years. There were 49 of 96 patients in the laparoscopic group and 47 patients in the open group. (2) Intraoperative situations: patients in the two groups underwent distal gastrectomy successfully with D 2 lymphadenectomy, without intra-operative conversion to laparotomy. The volume of intraoperative blood loss and surgical incision length were 50 mL(50 mL,100 mL) and (7.1±1.7)cm for the laparoscopic group, respectively, versus 100 mL(100 mL,200 mL) and (19.1±1.7)cm for the open group, showing significant differences between the two groups ( Z=?3.779, t=?34.880, P<0.05) . (3) Postoperative situations: the number of lymph node dissected, time to postoperative initial out-of-bed activities, time to postoperative first flatus, time to postoperative first liquid food intake, time to postoperative first semi-liquid food intake, time to drainage tube removal, duration of postoperative hospital stay were 49(35,62), 1.9 days(1.3 days,2.9 days), 2.6 days(2.2 days,2.9 days), 3.4 days(2.7days,4.0 days), 5.9 days(4.7 days,7.7 days), 4.9 days(3.5 days,6.8 days), 7.7 days(6.7 days,8.9 days) for the laparoscopic group, respectively, versus 40(27,51), 2.5 days (1.8 days,3.3 days), 2.6 days(2.2 days,2.9 days), 3.9 days(2.9 days,5.7 days), 4.9 days(3.9 days, 5.9 days), 6.3 days(4.7 days,8.9 days), 8.7 days(6.9 days,11.7 days), showing significant differences between the two groups ( Z=?2.354, ?2.210, ?2.743, ?2.474, ?2.906, ?2.503, ?2.359, P<0.05). (4) Follow-up: patients in the two groups received 30 days of follow-up. During the follow-up, 8 patients in the laparoscopic group had postoperative complications, including 1 case with Clavien-Dindo grade Ⅰ complications, 7 cases with Clavien-Dindo grade Ⅱ complications, and no patient with Clavien-Dindo grade Ⅲ complications. Thirteen patients in the open group had postoperative complications, including 2 cases with Clavien-Dindo grade Ⅰ complications, 10 cases with Clavien-Dindo grade Ⅱ complications, and 1 case with Clavien-Dindo grade Ⅲ complications. There was no significant difference in the above indicators between the two groups ( χ2=1.135, 1.973, 1.054, P>0.05). The overall complication rate was 16.3%(8/49) and 27.7%(13/47) for the laparoscopic group and open group, respectively, showing no significant difference between the two groups ( χ2=1.803, 99.7% confidence interval as ?∞ to 2.4%, P>0.05). The upper limit of 99.7% confidence interval was less than non-inferiority level of 15%, interim analysis of which showed that the complication rate of the laparoscopic group was non-inferior to the open group. Conclusion:For elderly patients undergoing laparoscopic or open distal gastrectomy for gastric cancer, laparoscopic surgery does not increase intraoperative or postoperative complications, and has advantages of minimally invasiveness, fine operation, quicker recovery, and shorter hospital stay. Registry: this study was registered at clinicaltrials.gov in United States, with the registry number of NCT02246153.

Objective:To identify objective markers between the Parkinson variant of multiple system atrophy (MSA-P) and Parkinson′s disease (PD).Methods:Retrospective analysis was performed on 10 patients with MSA-P, 15 patients with PD, and 15 healthy control group during the period from August 2016 to February 2019 in Baoshan Branch of Shanghai First People′s Hospital.We combined the novel tract based spatial statistics (TBSS) and region of interest (ROI) analyses for the first time to investigate three groups with diffusion tensor imaging. By TBSS, we performed pairwise comparisons of mean diffusivity and fractional anisotropy (FA) maps. The clusters with significant differences between MSA-P and PD were used as ROIs for further analyses.Results:FA values in the left anterior thalamic radiation(ATR) (ROI values were 0.371(0.287-0.535), 0.472(0.390-0.594), 0.473(0.388-0.555); P values were 0.008, 0.008) and left superior longitudinal fasciculus (SLF)(ROI values were 0.397(0.291-0.469), 0.456(0.338-0.560), 0.473(0.427-0.530); P values were 0.013,<0.001) were significantly decreased in MSA-P compared with PD or controls, and significantly correlated with clinical data(( r =-0.807, P =0.005),( r =-0.455, P =0.022)). Conclusion:Our findings indicate the abnormalities of left ATR and left SLF as specific biomarkers for differential diagnosis.

Objective:To investigate the clinical effect of the subbrow blepharoplasty by fixing and folding inward the orbicularis oculi muscle in a single point to improve the upper eyelid skin laxity.Methods:From May 2016 to February 2019, 109 patients (16 males and 93 females)underwent subbrow blepharoplasty combined with single point orbicularis oculi muscle fixing and folding (SBB-soff)in the Outpatient Department of Plastic Surgery Northern Jiangsu People’s Hospital. During the operation, the spindle skin below the eyebrow was excised, and the orbicularis oculi muscle (OOM) was retained. Then we made a small incision at the supraorbital rim, deep down to the periosteum. The OOM was folded inward and fixed on the periosteum in a single point through this small incision. The effect of the operation was evaluated by a questionnaire survey and statistical analysis of preoperative and postoperative photographs.The height margins of the upper eyelids and eyebrow position were evaluated by a questionnaire survey and statistical analysis of preoperative and postoperative photographs (use the iris diameter as one unit). Repeated measures t test was used for analyzing normal distribution data, the non-parametric Wilcoxon test was used for statistical analysis of abnormal distribution data, and P<0.05 was considered to be statistically significant. Results:The incisions of all the 109 cases had primary healing. The postoperative follow-up period averaged a period of (9.57±6.13)months (3 months to 3 years). 85.3% of patients (93 of 109) were followed up for more than 6 months. The subjective questionnaire survey showed that patients’ satisfaction rate was 99.1% (108 of 109) at one month postoperatively, and there were no serious postoperative complications in the sensory function of the forehead, the motor function of eyebrows and upper eyelids, etc.The upper eyelid margins at the sites above the mid pupil points elevated from (0.466±0.149) units to(0.600±0.126) units ( t=-16.186, P<0.001). The upper eyelid margins at the sites above the lateral limbus elevated from(0.387±0.156)units to (0.568±0.166) units ( t=-31.882, P<0.001). The upper eyelid margins at the sites above the lateral canthus elevated from (0.214±0.087) units to (0.446±0.098) units ( t=-49.332, P<0.001). In addition, all the differences were statistically significant.A total of 86 patients were followed up for 6 months without intraoperative eyebrow position adjustment. The data from each measuring point of the statistical baseline to the inferior edge of the eyebrow showed that the eyebrow height at 6 months postoperatively descended slightly, but the difference was not statistically significant ( P>0.05). The periodic appearance and function were significantly improved after the operation. Conclusions:SBB-soff can improve the dermatochalasis and aging signs of the upper eyelid tissue and make no negative effects on the position of eyebrows. In addition, it has the advantages of uncomplicated operation, less trauma, and persistent effect.

Objective:To investigate the clinical effect of the subbrow blepharoplasty by fixing and folding inward the orbicularis oculi muscle in a single point to improve the upper eyelid skin laxity.Methods:From May 2016 to February 2019, 109 patients (16 males and 93 females)underwent subbrow blepharoplasty combined with single point orbicularis oculi muscle fixing and folding (SBB-soff)in the Outpatient Department of Plastic Surgery Northern Jiangsu People’s Hospital. During the operation, the spindle skin below the eyebrow was excised, and the orbicularis oculi muscle (OOM) was retained. Then we made a small incision at the supraorbital rim, deep down to the periosteum. The OOM was folded inward and fixed on the periosteum in a single point through this small incision. The effect of the operation was evaluated by a questionnaire survey and statistical analysis of preoperative and postoperative photographs.The height margins of the upper eyelids and eyebrow position were evaluated by a questionnaire survey and statistical analysis of preoperative and postoperative photographs (use the iris diameter as one unit). Repeated measures t test was used for analyzing normal distribution data, the non-parametric Wilcoxon test was used for statistical analysis of abnormal distribution data, and P<0.05 was considered to be statistically significant. Results:The incisions of all the 109 cases had primary healing. The postoperative follow-up period averaged a period of (9.57±6.13)months (3 months to 3 years). 85.3% of patients (93 of 109) were followed up for more than 6 months. The subjective questionnaire survey showed that patients’ satisfaction rate was 99.1% (108 of 109) at one month postoperatively, and there were no serious postoperative complications in the sensory function of the forehead, the motor function of eyebrows and upper eyelids, etc.The upper eyelid margins at the sites above the mid pupil points elevated from (0.466±0.149) units to(0.600±0.126) units ( t=-16.186, P<0.001). The upper eyelid margins at the sites above the lateral limbus elevated from(0.387±0.156)units to (0.568±0.166) units ( t=-31.882, P<0.001). The upper eyelid margins at the sites above the lateral canthus elevated from (0.214±0.087) units to (0.446±0.098) units ( t=-49.332, P<0.001). In addition, all the differences were statistically significant.A total of 86 patients were followed up for 6 months without intraoperative eyebrow position adjustment. The data from each measuring point of the statistical baseline to the inferior edge of the eyebrow showed that the eyebrow height at 6 months postoperatively descended slightly, but the difference was not statistically significant ( P>0.05). The periodic appearance and function were significantly improved after the operation. Conclusions:SBB-soff can improve the dermatochalasis and aging signs of the upper eyelid tissue and make no negative effects on the position of eyebrows. In addition, it has the advantages of uncomplicated operation, less trauma, and persistent effect.

The insufficiency of the examined number of lymph nodes after surgery for gastric cancer may undermine the stage of lymph node metastasis, which would have a significant impact on prognostic evaluation and strategy formulation of adjuvant therapy. Under the premise of standard D2 lymphadenectomy, the number of harvested lymph nodes is mainly dependent on the procedures of lymph node examination. Since 2013, our center has set up a special lymph node examination team. In the same year, the average number of harvested lymph nodes in each sample was 46, which was significantly higher than before (average 18 nodes/case in 2004-2012). After continuous quality improvement and regular quality control in 2014, average number of retrieved lymph nodes was 64 per specimen. Therefore, this paper summarizes the methods and experience of lymph node examination in gastric cancer specimens of general surgery in Southern Hospital. The overall construction of the lymph node examination team of gastric cancer in our center mainly includes three parts: establishment of a specialized lymph node examination team, effective standard operating procedures (SOP), and long-term and sustained quality control. The specialized lymph node examination team consists of postgraduate students who are not involved in surgery but have been trained by surgeons. Standard procedures include theoretical reserve of gastric anatomy, surgical observation to correspond to specimens in vitro and in vivo, and standardized specimen processing procedures. Long-term and sustained quality control requires periodic report of lymph node examination data and continuous feedback optimization of the process. Intraoperative lymph node tracing navigation and specimen lymph node intensification are carried out with nanocarbon and indocyanine green dye staining, and then lymph nodes are harvested based on the traditional methods, which can improve the examination rate of lymph nodes, especially for small lymph nodes. Research on lymph node tracing methods, requires multidisciplinary cooperation in particular, will become a hot topic.

The insufficiency of the examined number of lymph nodes after surgery for gastric cancer may undermine the stage of lymph node metastasis, which would have a significant impact on prognostic evaluation and strategy formulation of adjuvant therapy. Under the premise of standard D2 lymphadenectomy, the number of harvested lymph nodes is mainly dependent on the procedures of lymph node examination. Since 2013, our center has set up a special lymph node examination team. In the same year, the average number of harvested lymph nodes in each sample was 46, which was significantly higher than before (average 18 nodes/case in 2004?2012). After continuous quality improvement and regular quality control in 2014, average number of retrieved lymph nodes was 64 per specimen. Therefore, this paper summarizes the methods and experience of lymph node examination in gastric cancer specimens of general surgery in Southern Hospital. The overall construction of the lymph node examination team of gastric cancer in our center mainly includes three parts: establishment of a specialized lymph node examination team, effective standard operating procedures (SOP), and long ? term and sustained quality control. The specialized lymph node examination team consists of postgraduate students who are not involved in surgery but have been trained by surgeons. Standard procedures include theoretical reserve of gastric anatomy, surgical observation to correspond to specimens in vitro and in vivo , and standardized specimen processing procedures. Long?term and sustained quality control requires periodic report of lymph node examination data and continuous feedback optimization of the process. Intraoperative lymph node tracing navigation and specimen lymph node intensification are carried out with nanocarbon and indocyanine green dye staining, and then lymph nodes are harvested based on the traditional methods, which can improve the examination rate of lymph nodes, especially for small lymph nodes. Research on lymph node tracing methods, requires multidisciplinary cooperation in particular, will become a hot topic.