Objective:To assess the efficacy of neoadjuvant treatment with PD-1 (programmed cell death protein 1) inhibitors combined with paclitaxel (albumin-conjugated) and cisplatin (TP regimen) for locally advanced hypopharyngeal squamous cell carcinoma and laryngeal organ function preservation.Methods:Data of 53 patients, including 51 males and 2 females, aged 38-70 years old, who were diagnosed with locally advanced hypopharyngeal squamous carcinoma confirmed by histology and enhanced CT at the Cancer Prevention and Control Center of Sun Yat-sen University during the initial treatment from January 1, 2019 to January 15, 2023, were retrospectively analyzed. All patients received neoadjuvant therapy with PD-1 inhibitors combined with albumin-bound paclitaxel (260 mg/m 2) and cisplatin (60 mg/m 2) for 3 to 4 cycles. The main outcome measures were larynx dysfunction-free survival (LDFS), overall survival (OS), and progression-free survival (PFS). Survival curves were plotted using the Kaplan-Meier method, and Cox multifactorial analysis was further performed if Cox univariate analysis was statistically significant. Results:The overall efficiency was 90.6% (48/53). The 1-year and 2-year LDFS rates were 83.8% (95% CI: 74.0% to 94.8%) and 50.3% (95% CI: 22.1% to 91.6%), the 1-year and 2-year OS rates were 95.2% (95% CI: 88.9% to 100.0%) and 58.2% (95% CI: 25.6% to 81.8%), and the 1-year and 2-year PFS rates were 83.9% (95% CI: 74.2% to 94.9%) and 53.5% (95% CI: 32.1% to 89.1%). Adverse events associated with the neoadjuvant therapy were mainly myelosuppression (45.3%), gastrointestinal reactions (37.7%) and hypothyroidism (20.8%). Conclusion:The neoadjuvant treatment of locally advanced hypopharyngeal squamous cell carcinoma using PD-1 inhibitors combined with paclitaxel and cisplatin can provide with a higher survival rate with a improved laryngeal organ function preservation rate.

Objective To analyze the predictive value of fecal form for the quality of bowel preparation in patients scheduled for colonoscopy,identify risk factors for bowel preparation failure,and develop and validate a risk prediction model.Methods This was a prospective cohort study using convenience sampling.Patients scheduled for colonoscopy in the Digestive Department of a tertiary A hospital in Jiangsu Province from June to December 2022 were included in the modeling cohort.General information sheet and the Bristol Stool Form Scale(BSFS)were used for data collection.Patients were categorized into a successful bowel preparation group and a bowel preparation failure group based on the quality of bowel preparation.The optimal cutoff value for BSFS was determined using the best cutoff value method.Logistic regression analysis was employed to identify risk factors for bowel preparation failure,and a nomogram risk prediction model was constructed.Patients undergoing colonoscopy in the same hospital from January to February 2023 were served as the validation cohort.Results The modeling cohort included 569 patients,and the validation cohort included 212 patients,with bowel preparation failure rates of 19.0％and 19.8％,respectively.The risk prediction model formula derived from logistic regression analysis was P=-2.209+0.619 × hospitalized patients+0.635 × age≥65 years-0.710 × previous colonoscopy history+2.031 × BSFS type 1～2.The area under the receiver operating characteristic curve for the model was 0.751,with a sensitivity of 54.6％,a specificity of 85.9％,and the optimal cutoff value was 0.225,corresponding to a risk score of 80 for bowel preparation failure.The Hosmer-Lemeshow test showed x2=4.429,P=0.351.External validation demonstrated an area under the receiver operating characteristic curve of 0.775,indicating good model fit and high predictive value.Conclusion The incidence of bowel preparation failure in colonoscopy patients is relatively high.Patients aged 65 years,hospitalized patients,those with no history of colonoscopy,and those with BSFS type 1～2 are more likely to experience bowel preparation failure.The risk prediction model developed in this study has good predictive performance and can provide a basis for clinical nurses to quickly assess the risk of bowel preparation failure in patients.

Objective:To investigate the iodine nutritional status of pregnant women in Qingdao and the effect of prevention and treatment of iodine deficiency disorders (IDD), so as to provide a basis for residents to supplement iodine scientifically, and take targeted prevention measures and adjust intervention strategies.Methods:In accordance with the requirements of the "National Iodine Deficiency Disorders Surveillance Program (2016 edition)" and "Shandong Iodine Deficiency Disorders Surveillance Program", the cluster sampling method was adopted to select pregnant women from 10 districts (cities) in Qingdao from 2018 to 2020, to investigate their basic information and thyroid disease history. Meanwhile, household edible salt samples and random urine samples were collected to detect iodine content.Results:A total of 3 000 pregnant women were monitored from 2018 to 2020, the median age was 31 years, and the median gestational age was 18 weeks. There were significant differences in the distribution of age, gestational age, whether senile puerpera, and pregnancy in different years ( H/χ 2 = 29.35, 81.03, 65.62, 77.34, P < 0.001). The median salt iodine of edible salt ( n = 3 000) and iodized salt ( n = 2 700) in pregnant women's homes were 23.02 and 23.70 mg/kg, respectively. The qualified rate of iodized salt, the coverage rate of iodized salt and the consumption rate of qualified iodized salt were 89.59% (2 419/2 700), 90.00% (2 700/3 000) and 80.63% (2 419/3 000). The comparison of qualified rate of iodized salt, coverage rate of iodized salt and consumption rate of qualified iodized salt among different years was statistically significant (χ 2 = 48.09, 36.62, 61.08, P < 0.001), the coverage rate of iodized salt and the consumption rate of qualified iodized salt showed a downward trend year by year (χ 2trent = 35.54, 29.50, P < 0.001). A total of 3 000 urine samples were collected from pregnant women and the median urinary iodine of pregnant women was 147.85 μg/L. The urinary iodine level in the third trimester was lower than that in the first and second trimesters ( P < 0.001). The urinary iodine level in the non elderly group was higher than that in the elderly group ( Z = - 6.66, P < 0.001). The urinary iodine level in the group without thyroid disease was higher than that in the group with thyroid disease ( Z = - 1.99, P = 0.047). The urinary iodine level in iodized salt group was higher than that in non-iodized salt group ( Z = - 2.42, P = 0.015). Conclusions:The iodine nutrition of pregnant women in Qingdao is generally at an insufficient level, and the risk of iodine deficiency is high, which needs attention. In recent years, the coverage rate of iodized salt and the consumption rate of qualified iodized salt in Qingdao have shown a downward trend, and have failed to meet the requirements of national standards. In the future, we should strengthen the monitoring and health education of IDD in pregnant women.

Objective:To investigate the efficacy of total ankle arthroscopy for resection of the talus os trigonum and debridement of the synovium of flexor hallucis longus (FHL) in the treatment of osteogenic posterior ankle impingement syndrome (PAIS) complicated with flexor hallucis longus tenosynovitis (FHLT).Methods:The 14 patients with osteogenic PAIS and FHLT were retrospectively analyzed who had been treated at Department of Hand-Foot-Ankle Microsurgery, Xuzhou Central Hospital from July 2017 to July 2019. They were 8 men and 6 women, aged from 29 to 53 years (mean, 42.4 years). The talus os trigonum and the giant posterolateral process of the talus were resected under total ankle arthroscopy in the prone position of the posterior ankle while the FHL was released and cleared. The efficacy was evaluated by comparing the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Maryland functional score, and pain visual analog scale (VAS) between preoperation and one year postoperation.Results:All patients were followed up for 12 to 24 months (average, 15 months). For all patients, their plantar flexion and dorsal extension were improved significantly from preoperative 19.2°±4.0° and 14.2°±2.7° to postoperative 42.9°±2.7° and 24.5°±3.2°, their AOFAS score increased significantly from preoperative 42.1±4.2 to 91.6±2.7 at one year postoperation, their Maryland score increased significantly from preoperative 43.9±4.1 to 91.9±3.5 at one year postoperation, and their VAS score decreased significantly from preoperative 6 (6, 7) to 0 (0, 0) at one year postoperation (all P<0.05). Conclusion:In the treatment of osteogenic PAIS complicated with FHLT, total ankle arthroscopy for resection of the talus os trigonum and release of FHL can lead to fine efficacy and limited surgical invasion, resolving the FHL pathological inflammation and PAIS at the same time.

To explore the association between hemoglobin and all-cause mortality in China elderly population varying level of body mass index. The data were from Chinese Longitudinal Healthy Longevity Survey 2008 to 2018. A total of 1 449 elderly participants were included with 247 lost to follow-up. According to the hemoglobin levels, the participants were divided into three groups: low hemoglobin group (male<120 g/L, female<110 g/L), normal hemoglobin group (120 g/L≤male<160 g/L, 110 g/L≤female<150 g/L), and high hemoglobin group (male≥160 g/L, female≥150 g/L). According to the BMI levels, the data was divided into three groups: overweight or obesity(BMI≥25 kg/m 2), normal weight(18.5 kg/m 2≤BMI<25 kg/m 2), and malnutrition (BMI<18.5 kg/m 2). Differences of association between hemoglobin and mortality were analyzed. In this dataset, the constituent ratio of anemia was 23.1%(334/1 449), and malnutrition was 26.6%(385/1 449). During the follow-up, a total of 778 participants died. Among whom, 233 cases(77.2%) were in the low hemoglobin group and 87 cases (55.4%) in the high hemoglobin group. In the BMI subgroup analysis, the people combined malnutrition and anemia had the highest cumulative mortality rate (79.1%), and the people with overweight and higher hemoglobin had a lower cumulative mortality rate (46.2%). In people with low BMI, increase in hemoglobin by one category reduced the risk of death by 0.572 (95% CI 0.446-0.734, P<0.001). In people with normal BMI, improvement in hemoglobin by one category reduced the risk of death by 0.717(95% CI 0.620-0.829, P<0.001). The reduction of hemoglobin levels increases the risk of all-cause mortality rate. And this correlation is particularly prominent in the population with low BMI.

Objective:To investigate the relationship between urinary glucose excretion, body mass index, and serum uric acid in type 2 diabetes mellitus, and to evaluate the association of interaction between uric glucose and body mass index on the risk of hyperuricemia.Methods:A total of 867 hospitalized patients with type 2 diabetes mellitus were included in this study. The height, weight, blood pressure and other general conditions were measured. 24-hour urine glucose quantification, glycolipid metabolism, and serum uric acid were collected. Multivariate linear regression analysis and multivariate logistic regression analysis were performed to determine the association of body mass index and urinary glucose with hyperuricemia.Results:After adjusting for age, sex, course of disease, blood pressure, HbA 1C, insulin, homeostasis model assessment for insulin resistance, fasting plasma glucose, 2 h postprandial blood glucose, total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, creatinine, and glomerular filtration rate, body mass index was positively associated with serum uric acid( β=4.281, 95% CI 2.645-5.917, P<0.001), and 24-hour urine glucose was negatively associated with serum uric acid( β=-0.435, 95% CI -0.708--0.162, P=0.002). Body mass index is an independent risk factor of hyperuricemia( P<0.01). There was a significant interaction between urine glucose and body mass index(interaction P<0.05). In the low urine glucose group, obese patients displayed odds ratio of 2.203 for hyperuricemia compared with non-obese patients, whereas the odds ratio was not significant in the high urine glucose group.The associations between body mass index and hyperuricemia were stronger in participants with low urine glucose than in those with high urine glucose. Conclusion:Urinary glucose excretion can weaken the positive correlation between body mass index and serum uric acid, suggesting that promoting urinary glucose excretion may be an effective strategy to control serum uric acid levels in type 2 diabetes mellitus, especially in obese patients.

Objective:To investigate the iodine nutritional status of children in Qingdao City and the effects of prevention and treatment measures on iodine deficiency disorders (IDD), and to provide a scientific basis for guiding residents to scientifically supplement iodine, taking timely targeted prevention and control measures, and scientifically adjusting intervention strategies.Methods:According to "National Iodine Deficiency Disorders Surveillance Program (2016 edition)" and "Iodine Deficiency Disorders Surveillance Program of Shandong Province", from 2018 to 2020, using the cluster sampling method, children aged 8-10 years in Qingdao City were chosen to test their household salt iodine content and random urinary iodine content, and to examine their thyroid volume by B-ultrasonography, and the correlation between thyroid volume and physical development indexes was analyzed.Results:From 2018 to 2020, a total of 6 057 children were monitored, including 3 068 boys and 2 989 girls. The median of salt iodine and iodized salt iodine of children was 23.50 and 24.10 mg/kg. The qualified rate of iodized salt was 89.95% (4 832/5 372), the coverage rate of iodized salt was 88.69% (5 372/6 057), and the consumption rate of qualified iodized salt was 79.78% (4 832/6 057). There were significant differences in the qualified rate of iodized salt, the coverage rate of iodized salt and the consumption rate of qualified iodized salt between different years (χ 2 = 135.26, 314.71, 342.87, P < 0.001). A total of 6 057 urine samples were collected from children, and the median of urinary iodine was 193.92 μg/L, of which 16.2% (979/6 057) were < 100 μg/L, and 22.5% (1 361/6 057) were ≥300 μg/L. There were statistically significant differences in the medians of urinary iodine between different years, gender and whether eating iodized salt ( H/Z = 37.25,-3.89,-5.69, P < 0.001), the median of urinary iodine in boys was higher than that of girls, and the median of urinary iodine in eating iodized salt group was higher than that of eating non-iodized salt group. There was no significant difference in the median of urinary iodine between different age ( H = 4.33, P = 0.119). The rate of goiter in children was 3.45% (71/2 057), and the difference between different years was statistically significant (χ 2 = 42.68, P < 0.001). The incidence of goiter in 2020 [7.31% (45/616)] was significantly higher than that in 2018 and 2019 [2.81% (18/641), 1.00% (8/800), P < 0.001]. Thyroid volume of children was positively correlated with height and weight ( r = 0.20, 0.22, P < 0.001). Conclusions:The iodine nutritional level of children aged 8-10 years in Qingdao City is appropriate. However, the incidence of goiter in children in some years is relatively high. The qualified rate of iodized salt, the coverage rate of iodized salt and the consumption rate of qualified iodized salt are all lower than the national standard for elimination of IDD, which should be paid attention to.

Objective:To evaluate the effect of prevention and control measures to drinking-water-borne endemic fluorosis in Qingdao, and to provide scientific basis for formulating prevention and control strategies.Methods:From 2019 to 2021, a full coverage surveillance was carried out in 1 146 villages in 7 drinking-water-borne endemic fluorosis areas in Qingdao, including the operation status of the water improvement and fluoride reduction project, the water fluoride content in the villages, and the prevalence of dental fluorosis among children aged 8-12 years.Results:From 2019 to 2021, all the 1 146 affected villages in Qingdao had improved their water supply, and the rates of water fluoride exceeding the standard were 7.16% (82/1 146), 1.40% (16/1 146) and 3.84% (44/1 146), respectively, and the differences between years were statistically significant (χ 2 = 48.36, P < 0.001). The detection rates of dental fluorosis in children aged 8-12 years were 3.11% (803/25 856), 2.68% (629/23 460) and 3.00% (655/21 846), respectively, and the differences between years were statistically significant (χ 2 = 8.26, P = 0.016). The detection rate of dental fluorosis among children in villages with qualified water fluoride (2.85%, 1 986/69 565) was lower than that in villages with excessive water fluoride (6.32%, 101/1 597), with a statistically significant difference (χ 2 = 67.74, P < 0.001). Conclusions:From 2019 to 2021, the effect of prevention and control measures to drinking-water-borne endemic fluorosis in Qingdao is significant and the detection rate of dental fluorosis in children is low, the detection rate of dental fluorosis in villages with qualified water fluoride is significantly lower than that in villages with excessive water fluoride. In the future, we should continue to strengthen water fluoride monitoring and engineering maintenance to ensure that the water fluoride content continues to be qualified and effectively reduce the harm of fluorosis.

Objective:To assess the operation and usage conditions of all water improvement projects in Qingdao, master the water fluoride content and the prevalence of dental fluorosis in children in drinking-water-borne endemic fluorosis villages, evaluate the prevention and control effect of water improvement project.Methods:From April to October in 2020, all drinking-water-borne endemic fluorosis villages in 7 cities (districts) of Qingdao were selected to investigate the operation and usage conditions of water improvement project, water fluoride and prevalence of dental fluorosis of 8 to 12 years old children. The prevention and control effect of water improvement project on drinking-water-borne endemic fluorosis in Qingdao was evaluated according to the control contents and criteria of drinking-water-borne endemic fluorosis.Results:There were 1 146 drinking-water-borne endemic fluorosis villages, the water improved rate of villages was 100.00% (1 146/1 146), the rate of normal operation of water improvement project was 99.91% (1 145/1 146). There were 1 130 villages with qualified water fluoride and the qualified rate was 98.60% (1 130/1 146). A total of 23 473 children aged 8 - 12 years old were examined, and 631 children were detected with dental fluorosis. The detection rate of dental fluorosis was 2.69% (631/23 473), the dental fluorosis index was 0.048, and the prevalence was negative. The detection rate of dental fluorosis of children in villages with excessive water fluoride (7.03%, 40/569) was higher than that in villages with qualified water fluoride (2.58%, 591/22 904, χ 2 = 41.235, P < 0.01). Conclusion:The operation and usage conditions of water improvement projects in 7 drinking- water-borne endemic fluorosis cities (districts) in Qingdao are good, and the detection rate of dental fluorosis in children is low, which has reached the national control standard.

Objective To observe the digestive system related symptoms in patients with early-middle stage Parkinson's disease (PD) and healthy subjects,and investigate the incidence of the symptoms and the influencing factors.Methods One hundred and eight PD patients with early and middle stage (Hoehn-Yahr staging 1-3) were admitted to Xuzhou Central Hospital and followed up for a long time.A questionnaire,including seven items of digestive system related symptoms selected from the PD Non-Motor Symptom Scale and the Scale for Outcomes in PD for Autonomic Symptoms (taste abnormalities,swallowing disorders,salivation,easy or early satiety,constipation,loose stools,fecal incontinence),and additional five items of digestive system related symptoms (loss of appetite,dry mouth,oral pain,nausea,vomiting),totally 12 items,was used in a survey on PD patients.Seventy-six healthy subjects in the physical examination center of the hospital served as control group,and conducted the same questionnaire survey.Results There was no statistically significant difference in age,gender,height,weight,body mass index (BMI) between the PD and control groups.In 108 PD patients,dry mouth accounted for 64 cases (59.26％),constipation 53 cases (49.07％) and taste abnormalities 40 cases (37.04％),followed by loss of appetite 35 cases (32.41％) and early satiety 26 cases (24.07％),swallowing disorders 20 cases (18.52％),nausea 11 cases (10.19％),salivation 10 cases (9.26％),oral pain seven cases (6.48％),vomiting four cases (3.70％),loose stools one case (0.87％).In 76 controls,taste abnormalities accounted for 13 cases (17.11％),early satiety six cases (7.89％),loss of appetite six cases (7.89％),nausea five cases (6.58％),salivation three cases (3.95％),oral pain one case (1.32％),and the rest zero.The incidence of constipation (x2=52.390,P＜0.01),dry mouth (x2=69.050,P＜0.01),early satiety (x2=8.128,P=0.004),loss of appetite (x2=16.010,P＜0.01),taste abnormalities (x2=8.642,P=0.003) and swallowing disorders (x2=15.790,P＜0.01) showed statistically significant difference between the two groups.Analysis of the influencing factors showed that male had an effect on constipation (95％CI 1.371-7.495,OR=3.205),early satiety (95％CI 4.227-282.913,OR=34.582),taste abnormalities (95％CI 6.620-88.942,OR=24.260) and swallowing disorders (95％CI 2.784-88.475,OR=22.906),while other factors such as age,body mass index,disease duration and motor symptom types had no effect on the occurrence of digestive system related symptoms.Conclusions Digestive system related symptoms in patients with PD include dry mouth,constipation,taste abnormalities,loss of appetite,early satiety,and swallowing disorders,which may be their unique symptoms.Male is a risk factor for taste abnormalities,swallowing disorders,early satiety and constipation.