BACKGROUND:Heterotopic ossification is a dynamic growth process.Diverse heterotopic ossification subtypes have diverse etiologies or induction factors,but they exhibit a similar clinical process in the intermediate and later phases of the disease.Acquired heterotopic ossification produced by trauma and other circumstances has a high incidence. OBJECTIVE:To summarize the molecular biological mechanisms linked to the occurrence and progression of acquired heterotopic ossification in recent years. METHODS:The keywords"molecular biology,heterotopic ossification,mechanisms"were searched in CNKI,Wanfang,PubMed,Embase,Web of Science,and Google Scholar databases for articles published from January 2016 to August 2022.Supplementary searches were conducted based on the obtained articles.After the collected literature was screened,131 articles were finally included and summarized. RESULTS AND CONCLUSION:(1)The occurrence and development of acquired heterotopic ossification is a dynamic process with certain concealment,making diagnosis and treatment of the disease difficult.(2)By reviewing relevant literature,it was found that acquired heterotopic ossification involves signaling pathways such as bone morphogenetic protein,transforming growth factor-β,Hedgehog,Wnt,and mTOR,as well as core factors such as Runx-2,vascular endothelial growth factor,hypoxia-inducing factor,fibroblast growth factor,and Sox9.The core mechanism may be the interaction between different signaling pathways,affecting the body's osteoblast precursor cells,osteoblast microenvironment,and related cytokines,thereby affecting the body's bone metabolism and leading to the occurrence of acquired heterotopic ossification.(3)In the future,it is possible to take the heterotopic ossification-related single-cell osteogenic homeostasis as the research direction,take the osteoblast precursor cells-osteogenic microenvironment-signaling pathways and cytokines as the research elements,explore the characteristics of each element under different temporal and spatial conditions,compare the similarities and differences of the osteogenic homeostasis of different types and individuals,observe the regulatory mechanism of the molecular signaling network of heterotopic ossification from a holistic perspective.It is beneficial to the exploration of new methods for the future clinical prevention and treatment of heterotopic ossification.(4)Meanwhile,the treatment methods represented by traditional Chinese medicine and targeted therapy have become research hotspots in recent years.How to link traditional Chinese medicine with the osteogenic homeostasis in the body and combine it with targeted therapy is also one of the future research directions.(5)At present,the research on acquired heterotopic ossification is still limited to basic experimental research and the clinical prevention and treatment methods still have defects such as uncertain efficacy and obvious side effects.The safety and effectiveness of relevant targeted prevention and treatment drugs in clinical application still need to be verified.Future research should focus on clinical prevention and treatment based on basic experimental research combined with the mechanism of occurrence and development.

Basic research and interdisciplinary application of traditional Chinese medicine （TCM） have been continuously extended and rapidly developed with the continuous funding and promotion of basic research on TCM supported by the National Natural Science Foundation of China （NSFC）， and the overall level of basic research on TCM has been significantly improved， which has made important contributions to the diagnosis and treatment mechanism of TCM by "clarifying， identifying， and interpreting"， providing benchmark guarantees for basic research and industry development of TCM. This article focused on the application and funded projects of NSFC in 2023 under the H31 application code of TCM. It analyzed the project types， branch codes， research question categories， supporting units and regions， research directions， and keywords and summarized the characteristics of the currently funded projects in H31. At the same time， it analyzed the relevant problems in the project application process and put forward several suggestions， so as to provide a reference for scholars in the field of TCM. In 2023， a total of 8 334 applications for three types of projects （general projects， projects for young scholars， and regional projects） under the H31 code have been received by NSFC， which is the highest number in the past five years. However， the proportion of funding is still on a downward trend， and there is fierce competition among applicants. Finally， 804 projects for the three categories under the H31 code have been funded. The total funding decreased in 2022， and the average funding amount of the general project and the regional project has dropped to the lowest in the past five years. It is found that the development of branch research and the research questions under the H31 code is unbalanced. Few projects have focused on the original theory of TCM. Some projects are detached from the characteristics and research laws of TCM. Most researchers lack innovative research ideas， and the applications they write are filled with routines and patterns. In addition， the issue of scientific integrity remains a primary principle for project applicants.

Objective To analyze the incidence and disease burden of substance use disorder(SUD)in China from 1990 to 2019,to evaluate the impact of different ages,periods and birth cohorts on the disease burden of SUD,and to predict disease burden of SUD from 2020 to 2034,so as to provide strategies for the prevention of SUD.Methods Based on the Global Burden of Disease Study 2019(GBD 2019)database,the disease burden was described by incidence,years of life lost(YLLs),years lived with disability(YLDs)and disability-adjusted life years(DALYs).The Joinpoint regression model was used to analyze the trend of standardized incidence and standardized DALYs rate of SUD.Based on the age-period-cohort model,the age,period and cohort effects of SUD were discussed.The grey prediction model GM(1,1)was used to fit the trend of the incidence and standardized incidence of SUD and the trend of disease burden,and to predict the incidence and disease burden of SUD in 2020-2034.Results From 1990 to 2019,the standardized incidence of SUD of amphetamines[average annual percentage change(AAPC)=-0.9％]and cocaine(AAPC=-0.5％)in China showed a downward trend(P＜0.001),and the standardized incidence of SUD of cannabis(AAPC=0.9％)showed an increasing trend year by year(P＜0.001).The trend of standardized incidence of opioid abuse disorders was not obvious(P＞0.05).The DALYs rate caused by the 4 SUD showed a decreasing trend year by year(AAPCamphetamines=-2.2％,AAPCcocaine=-1.5％,AAPCcannabis=-1.0％,AAPCopioids=-1.0％,P＜0.001).The results of age-period-cohort effect showed that the peak incidence of amphetamine,cocaine,cannabis and opioid use disorders was in the 25-30 age group.The DALYs rate caused by cannabis SUD increased with age,while the DALYs rates of amphetamines,cocaine and opioids SUD reached the peak in the 25-29,30-34 and 35-39 age groups,respectively.The results of period effect showed that the risk of SUD in propylamines,cocaine and cannabis decreased first and then increased,while the risk of SUD in opioids increased and then decreased and increased again.The results of birth cohort effect showed that the risk of SUD of amphetamines,cocaine and opioids showed a decreasing trend as a whole except for a small fluctuation in individual birth cohorts.The risk of DALYs rate caused by SUD of amphetamines,cocaine and opioids showed a decreasing trend as a whole,while the risk of DALYs rate caused by SUD of cannabis showed an increasing trend year by year.The prediction results showed that the incidence of SUD of amphetamines,cocaine and opioids showed a downward trend from 2020 to 2034,and the incidence of SUD of cannabis showed a fluctuating upward trend.The DALYs attributed to SUD of amphetamines,cocaine,cannabis and opioids showed a decreasing trend year by year.Conclusion The disease burden of SUD in China is decreasing year by year in the future.The incidence and disease burden are affected by age effect,period effect and cohort effect to varying degrees.Early prevention and effective intervention are the key measures to control SUD.

Objective The leptin receptor,encoded by the LEPR gene,is involved in tumorigenesis.A potential functional variant of LEPR,rs1137101(Gln223Arg),has been extensively investigated for its contribution to the risk of digestive system(DS)cancers,but results remain conflicting rather than conclusive.Here,we performed a case-control study and subsequent meta-analysis to examine the association between rs1137101 and DS cancer risk. Methods A total of 1,727 patients with cancer(gastric/liver/colorectal:460/480/787)and 800 healthy controls were recruited.Genotyping of rs1137101 was conducted using a polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)assay and confirmed using Sanger sequencing.Twenty-four eligible studies were included in the meta-analysis. Results After Bonferroni correction,the case-control study revealed that rs1137101 was significantly associated with the risk of liver cancer in the Hubei Chinese population.The meta-analysis suggested that rs1137101 is significantly associated with the risk of overall DS,gastric,and liver cancer in the Chinese population. Conclusion The LEPR rs1137101 variant may be a genetic biomarker for susceptibility to DS cancers(especially liver and gastric cancer)in the Chinese population.

Objectives:To evaluate the clinical value of the Paris system for reporting urinary cytology (TPS) in the diagnosis of urothelial carcinoma (UC).Methods:A total of 1 744 cytological diagnostic records (from 751 cases) were collected retrospectively. All specimens were voided urines and histopathology as the gold standard. The sensitivity and specificity of urinary cytological diagnosis of UC and risk of high grade malignant (ROHM) in each diagnostic category were compared.Results:There were 360 cases with histopathology. The percentage of negative for high-grade urothelial carcinoma (NHGUC) was 30.1% (226/751), atypical urothelial cells (AUC) was 29.8% (224/751), suspicious for high-grade urothelial carcinoma (SHGUC) was 16.8% (126/751), high grade urothelial carcinoma (HGUC) was 21.2% (159/751), and non-urothelial malignancy (NUM) was 2.1% (16/751). The histpathologic ROHM corresponding to each cytological diagnosis category were 27.3% for NHGUC, 32.7% for AUC, 74.7% for SHGUC, 96.6% for HGUC and 100.0% for NUM, respectively. ROHM of SHGUC was significantly higher than that of AUC group, and the difference between the two groups was statistically significant ( P＜0.001). ROHM of HGUC group was significantly higher than that of SHGUC group, and the difference was statistically significant ( P＜0.001). With SHGUC as the cut-off value, the sensitivity and specificity of cytological diagnosis of HGUC were 76.7% (165/215) and 85.7% (18/21), and with HGUC as the cut-off value, the sensitivity and specificity of cytological diagnosis of HGUC were 53.0% (114/215) and 100.0% (21/21), respectively. Conclusions:Urine cytology has high sensitivity and specificity in the diagnosis of HGUC. The malignant risk of TPS varies with different diagnosis category. The high malignant risk population in cancer hospital leads to the relatively high malignant proportion and ROHM in each diagnosis category. Urinary cytology TPS reporting system is helpful to clinical management and has good clinical application value.

Objective:To investigate the clinical effect of progressive transfer of penile flap combined with local scrotal flap in correction of severe concealed penis in children.Methods:The clinical data of children with severe concealed penis admitted to the Children’s Hospital Affiliated to Zhengzhou University from July 2021 to July 2023 were retrospectively analyzed. The concealed penis was corrected by progressive transfer of penile flap combined with local scrotal flap. During the operation, a small amount of excess inner prepuce was removed and the outer prepuce was cut in the middle of the dorsal side of the penis. Then the penile flap was transferred from dorsal to ventral, gradually covering the wound without tension. The local scrotal flap was lifted upwards and sutured to the frenulum for covering the ventral foreskin defect of the penis. The amount of blood loss during the operation was recorded. The pain tolerance, the duration of prepuce edema, the length of penis extension and the healing of skin flap were observed. The appearance of the penis was followed up to observe whether the penis was retracted, and the satisfaction of the children and their guardians was recorded.Results:A total of 32 male children were enrolled, ranging in age from 3 to 10 years, with an average age of 7.2 years. The penis of all the children had a conical appearance, and the penile shaft was buried under the subcutaneous anterior pubis, which was difficult to palpate in its natural state. The average intraoperative blood loss was about 5 ml. All patients had pain after the operation. Two patients needed a pump to relieve pain, and the rest could tolerate it after rectum administration of indomethacin suppositories. The edema of the prepuce was mild after the operation, and the edema basically disappeared when the patient was discharged 7-9 days later. The penis could be lengthened by 1.5-3.0 cm under static conditions, averaging about 2.0 cm. After surgery, only 1 patient had a small area (about 5 mm × 4 mm) of infection in the scrotal flap and poor incision healing, and scar healing after dressing change and intensive nursing. The other flaps healed well. After 6 to 12 months of follow-up, the penis length of 2 cases was slightly retracted from the time of discharge, and the remaining 30 cases had no significant change. The patients and their guardians were satisfied with the operation results.Conclusion:The progressive transfer of penile flap combined with local scrotal flap correction of severe concealed penis in children can fully lengthen the penile body, and the degree of postoperative retraction is low, the appearance of the penis is good, and the patient satisfaction is high.

[Objective] To understand the characteristics of dietary diversity of urban families in Ningbo city and analyze the related factors of dietary diversity level. [Methods] The project was carried out based on the baseline survey project of the primary health comprehensive experimental area of the National Health Commission in 2021. Multi-stage stratified cluster random sampling was adopted and household face-to-face inquiry was conducted. The survey questionnaire was divided into four parts: basic information, dietary knowledge and attitudes, dietary consumption frequency, and 24-hour dietary intake. The generalized estimating equation was used to analyze the influencing factors of dietary diversity score. [Results] A total of 632 people were surveyed. Among the nine groups of food (except cooking oils), foods consumed weekly in frequency from high to low were cereals, vegetables, fruits, fish, meat, eggs, beans, and dairy. The overall dietary diversity score (DDS) was 5.78±1.693. Among the surveyed, 9% had insufficient DDS, 62.2% had moderate DDS, and 28.8% had adequate DDS. Age, dietary knowledge acquisition attitude behavior, and family role were significantly correlated with DDS. DDS was 0.70 higher in the group under 40 years old than in the group over 60 years old (P<0.05), and DDS in the group between 40 and 59 years old was 0.46 higher than that in the group over 60 years old (P<0.05). DDS in the occasionally or never actively collected group was 0.93 lower than that in the frequently actively collected group (P<0.001). Among the family role factors, DDS of ordinary family members was 0.32 higher than that of family opinion leader (P<0.05). [Conclusion] The dietary patterns in this region have the characteristics of plant-based and coastal characteristic dietary ones. The intake level of fruits and fish is relatively good, while the intake of legumes and dairy is relatively low, which needs attention.

[Objective] To summarize various treatment methods and experiences of bladder and urethral foreign bodies in children. [Methods] A total of 15 children with bladder and urethral foreign bodies admitted to our hospital during Aug.2015 and Feb.2024 were selected.The characteristics, clinical manifestations, surgical methods, surgical skills and postoperative recovery were analyzed. [Results] The patients aged 7-13 (11.0±1.6) years, including 14 males and 1 female.Preoperative diagnosis was confirmed with color Doppler ultrasound and abdominal standing plain film.Emergency surgery was performed in 14 cases, and open surgery in 1 case with concurrent pyuria, whose foreign bodies were removed after 2 days of anti-infection treatment.Among the 15 children, 9 had foreign bodies removed through cystoscopy, 2 through cystoscopy combined with percutaneous renal puncture kit, 2 through cystoscopy combined with a small incision on the pubic bone, 1 through cystoscopy combined with a scrotal incision, and 1 through cystoscopy combined with a perineal incision.The average surgical time was (63.3±50.5) min, blood loss (1.9±1.9) mL, and postoperative hospitalization (5.8±3.8) days.No complications such as urinary extravasation, urinary fistula, bladder diverticulum, or urinary disorders occurred.Postoperative follow-up of 1 and 3 months showed no complications such as abnormal urination or urinary tract infections. [Conclusion] The onset of bladder and urethra foreign bodies in children is concealed.Once the diagnosis is confirmed, surgery should be performed as soon as possible.The surgical method should be selected based on the comprehensive evaluation of the location, size, shape, and number of foreign bodies and presence of calculi.Minimally invasive surgery can be performed in most cases.

Objectives:To evaluate the clinical value of the Paris system for reporting urinary cytology (TPS) in the diagnosis of urothelial carcinoma (UC).Methods:A total of 1 744 cytological diagnostic records (from 751 cases) were collected retrospectively. All specimens were voided urines and histopathology as the gold standard. The sensitivity and specificity of urinary cytological diagnosis of UC and risk of high grade malignant (ROHM) in each diagnostic category were compared.Results:There were 360 cases with histopathology. The percentage of negative for high-grade urothelial carcinoma (NHGUC) was 30.1% (226/751), atypical urothelial cells (AUC) was 29.8% (224/751), suspicious for high-grade urothelial carcinoma (SHGUC) was 16.8% (126/751), high grade urothelial carcinoma (HGUC) was 21.2% (159/751), and non-urothelial malignancy (NUM) was 2.1% (16/751). The histpathologic ROHM corresponding to each cytological diagnosis category were 27.3% for NHGUC, 32.7% for AUC, 74.7% for SHGUC, 96.6% for HGUC and 100.0% for NUM, respectively. ROHM of SHGUC was significantly higher than that of AUC group, and the difference between the two groups was statistically significant ( P＜0.001). ROHM of HGUC group was significantly higher than that of SHGUC group, and the difference was statistically significant ( P＜0.001). With SHGUC as the cut-off value, the sensitivity and specificity of cytological diagnosis of HGUC were 76.7% (165/215) and 85.7% (18/21), and with HGUC as the cut-off value, the sensitivity and specificity of cytological diagnosis of HGUC were 53.0% (114/215) and 100.0% (21/21), respectively. Conclusions:Urine cytology has high sensitivity and specificity in the diagnosis of HGUC. The malignant risk of TPS varies with different diagnosis category. The high malignant risk population in cancer hospital leads to the relatively high malignant proportion and ROHM in each diagnosis category. Urinary cytology TPS reporting system is helpful to clinical management and has good clinical application value.

Objective:To summarize the clinical effect of laparoscopic medial umbilical ligament dissection in two-stage Fowler-Stephens orchiopexy (FSO).Methods:A case-series study was conducted.Clinical data of children who underwent two-stage FSO from March 2020 to July 2022 in the Department of Urology, Children′s Hospital Affiliated to Zhengzhou University were retrospectively analyzed.Indexes such as operation time, amount of blood loss, degree of postoperative pain in the operative area, testicular position, size, texture and parental satisfaction at the operative side 1 month, 6 months and 1 year after surgery were collected.Measurement data of normal distribution were expressed as Mean± SD and compared using the independent sample and paired sample t-tests. Results:A total of 18 children with complete clinical data were included in this study.Their age ranged from 7 months to 10 years, with an average of 2 years.There were 10 cases of FSO on the left side and 8 cases on the right side.Twelve cases (group A) had the testis directly descending to the scrotum without amputation of the umbilical medial ligament during the operation, including 7 cases on the left side and 5 cases on the right side; 6 cases (group B) with testis not descending to the scrotum received amputation of the umbilical medial ligament, and the testicle was pulled into the scrotum without tension, including 3 cases on the left side and 3 cases on the right side.The age of patients in group A [(0.88±0.26) years] was lower than that in group B [(4.32±2.96) years] ( t=-4.11, P<0.05).The operation time of patients in group B was (47.50±1.87) min, slightly longer than that in group A [(46.17±1.47) min] ( t=-1.66, P>0.05).The intraoperative bleeding volume in group B was (5.18±0.42) mL, slightly higher than that in group A [(4.96±0.20) mL] ( t=-1.56, P>0.05).Patients in both groups had mild pain in the operative area, which could be tolerated by the children.There were no significant differences in testicular position, size, texture and satisfaction between the two groups 1 month after surgery.Reexamination at 6 months after operation showed that 1 case in group A had mild testicular retraction, located above the scrotum; no significant testicular retraction was observed in group B; the size and texture of testis in both groups had no significant change compared with those before operation, and the blood supply was normal according to the color ultrasound findings; parental satisfaction was high.Reexamination at 1 year after operation showed that 1 case of testis in group A was located above the scrotum, 2 cases had no obvious development, and the rest cases had increased testis size [(0.51±0.03) mL] compared with before operation [(0.31±0.02) mL] ( t=-22.97, P<0.05); all cases of testis in group B returned to normal position, 1 case had no obvious development, and the rest cases had increased testis size [(0.45±0.02) mL] compared with before operation [(0.24±0.01) mL] ( t=-32.87, P<0.05).There was no significant difference in testicular size increase between group A [(0.20±0.03) mL] and group B [(0.20±0.01) mL] ( t=-1.19, P>0.05). Conclusions:In the case that the medial umbilical ligament obviously affects the testicular descent, it can be dissected, which significantly shortens the distance of testis descending to the scrotum.The testicular position after surgery is normal, and the two-stage FSO does not affect the testicular development.