Objective To explore the relationship between serum miRNA-21 and miR-27b levels and prognosis of patients with renal clear cell carcinoma.Methods A total of 118 patients with renal clear cell carcinoma admitted to the Qinghai University Hospital from February 2019 to April 2021 were selected as the study subjects,and another 118 healthy patients in the same period as the control group.Real time fluorescence quantitative polymerase chain reaction(PCR)was used to detect the expression of miR-21 and miR-27b in the serum of all subjects.The relative expression levels of serum miR-21 and miR-27b between the patients with renal clear cell carcinoma and healthy control patients were compared.The expression and correlation of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma of different pathological stages and Fuhrman grading were analyzed.The relationship between the expression of serum miR-21 and miR-27b and the survival and prognosis of the patients was explored as well.Results The expression levels of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma were higher than those in the healthy control group(P＜0.05).The serum miR-21 expression level in stage Ⅲ patients was higher than in stageⅠ(P＜0.05),while the serum miR-21 expression level in the stage Ⅳ patients was higher than that in stagesⅠ,Ⅱ,and Ⅲ(P＜0.05).The expression level of miR-27b in the serum of patients gradually increased across the four stages,with a significant difference(P＜0.05).The pathological staging was positively correlated with the expression of miR-21 and miR-27b(P＜0.001).The expression levels of miR-21 and miR-27b in serum of patients gradually increased across grades Ⅰ,Ⅱ and Ⅲ by Fuhrman grading,with significant difference(P＜0.05).Fuhrman grading was positively correlated with the serum miR-21 and miR-27b expression(P＜0.001).There was a statistically significant difference in the survival curve between the miR-21 high expression group and the low expression group(P＜0.05).There was a statistically significant difference in the survival curve between the high expression group and the low expression group of miR-27b(P＜0.05).Conclusion The expression levels of serum miR-21 and miR-27b in patients with renal clear cell carcinoma is indicative of the progression and prognosis of the patient's condition.

Objective:To describe and analyze suicide risk of patients with schizophrenia,major depressive disorder,and bipolar disorder.Methods:A total of 2 016 patients with schizophrenia,903 patients with major de-pressive disorder,and 381 patients with bipolar disorder from inpatients,clinics,or communities who met the diag-nostic criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition were recruited.All patients were interviewed by psychiatrists using the Mini International Neuropsychiatric Interview to diagnose mental disor-ders and assess suicide risk,as well as Clinical-Rated Dimensions of Psychosis Symptom Severity(CRDPSS)to as-sess symptoms.Differences and risk factors of suicide risk among three types of mental disorders were explored u-sing multivariate logistic regression analysis.Results:In the past one month,37 patients with schizophrenia(1.8％),516 patients with major depressive disorder(57.1％),and 102 patients with bipolar disorder(26.8％)had suicide risk.Compared with patients with schizophrenia,suicide risk in patients with major depressive disorder(OR=36.50)and bipolar disorder(OR=20.10)increased.Female(OR=1.87),smoking(OR=1.76),family history of suicide(OR=5.09),higher score of CRDPSS hallucination(OR=1.80),and higher score of CRDPSS depression(OR=1.54)were risk factors of suicide risk of patients.Conclusions:Suicide risk of patients with ma-jor depressive disorder and bipolar disorder is higher than that of patients with schizophrenia.In clinical practice,it is important to regularly assess suicide risk of patients.Patients who experience symptoms of hallucination and de-pression should be paid more attention to.

Objective:To evaluate direct and indirect costs for schizophrenia,major depressive disorder(MDD)and bipolar disorder,and to compare their differences of cost composition,and to explore the drivers of the total costs.Methods:A total of 3 175 inpatients with schizophrenia,MDD,and bipolar disorder were recruited.In-patient's self-report total direct of medical costs outpatient and inpatient,out-of-pocket costs,and direct non-medical costs were regarded as direct costs.Productivity loss and other loss caused by damaging properties were defined as indirect costs.The perspectives of this study included individual and societal levels.Multivariate regression analysis was applied for detecting the factors influencing disease costs.Results:The total cost of schizophrenia was higher than those of MDD and bipolar disorder at individual and societal levels.The indirect costs of three mental disorders were higher than the direct costs,and the indirect cost ratio of bipolar disorder was higher than those of schizophre-nia and MDD.Age,gender,working condition and marital status(P＜0.05)were the important drivers of total costs.Conclusion:The economic burden of the three mental disorders is relatively heavy.Schizophrenia has heaviest disease burden,and the productivity loss due to mental disorders is the driving force of the soaring disease cost

Objective:To compare demographic characteristics,clinical characteristics,therapeutic characteris-tics and physiological indicators of patients with bipolar Ⅰ disorder and bipolar Ⅱ disorder.Methods:A total of 381 patients with bipolar disorder(BD)diagnosed by the Diagnostic and Statistical Manual of Mental Disorders 5 th Edi-tion(DSM-5)were selected,including 302 patients with BD-Ⅰ(79.27％),74 patients with BD-Ⅱ(19.42％)and 5 patients with other specific and related disorders(1.31％).Demographic and clinical characteristics were collected with self-designed clinical information questionnaire.Multivariate logistic regression and multivariate linear regres-sion analysis were used for analysis.Results:Compared with patients with BD-Ⅱ,patients with BD-Ⅰ had more risk to have psychotic features(OR=5.75,95％CI:2.82-11.76),longer disease duration,and more repeated transcra-nial magnetic therapy(OR=3.09,95％CI:1.02-9.35),higher uric acid,total cholesterol and high-density lipo-protein.BD-Ⅰ in Han nationality was more common(OR=11.50,95％CI:1.76-75.30),and had lower education level(OR=10.22,95％CI:1.16-89.77),and less family history of psychosis(OR=2.34,95％CI:1.01-5.42).Conclusion:There are significant differences between BD-Ⅰ and BD-Ⅱ in demographic and clinical charac-teristics,treatment status,and physiological indicators,which could provide clues for exploring the pathogenesis of bipolar disorder.

Objective:To explore the effect of knee arthroscopic operation training simulation system in clinical teaching of traditional Chinese medicine osteomatology resident doctor standardized training students.Methods:A total of 40 trainees were selected in Department of Orthopedics and Traumatology of the First Affiliated Hospital of Tianjin University of Chinese Medicine from January 2023 to September 2023. The trainees were divided into an experimental group and a control group according to the random number table method, with 20 in each group. Trainees in the control group was taught by presentations and video demonstrations. Trainees in the experimental group was taught by knee arthroscopic operation training simulation system. Trainees in each group were taught by a same teacher for a total of 2 weeks, with 2 class hours per week. After the teaching, the results of the assessment of theoretical knowledge, the results of the questionnaire survey on the mastery of teaching content and the results of the questionnaire survey on the evaluation of teaching methods were recorded. Then compared the results between the two groups.Results:Compared with the control group, there was no significant difference in the initial theoretical assessment scores between the two groups ( P > 0.05). The improvement rate of the test group was higher than that of the control group, with statistical significance ( P < 0.05). In terms of the mastery of teaching content, the experimental group was higher than the control group in three aspects: whether the teaching method was beneficial to the study of knee anatomy, imaging and surgical procedure, the difference was statistically significant ( P < 0.05); whether the teaching method was beneficial to the study of the selection of surgical indications, there was no statistically significant difference between the two groups ( P > 0.05). In the evaluation of teaching methods, there was no significant difference in the scores of teaching participation between the two groups ( P > 0.05), and the scores of the experimental group in six aspects of teaching interest, teaching effectiveness, teaching understanding, learning initiative, teaching course evaluation and course satisfaction were higher than those of the control group, with statistical significance ( P < 0.05). Conclusions:The application of knee arthroscopic operation training simulation operating system can significantly improve the theoretical achievements of traditional Chinese medicine bone injury training students, which is beneficial to master clinical teaching content and improve clinical teaching satisfaction.

Objective:To provide references for the application of finite element model in the study of cervical vertebra by statistically analysing the frequency, numerical value, properties, and boundary setting of the finite element model and the corresponding material features as well as boundary settings in the literature.Methods:The literature on cervical vertebra-related finite element models was collected from CNKI, Wanfang, VIP, PubMed, Web of Science, and Embase databases from January 2013 to December 2023. The quality assessment was followed by manual screening. The data sources, application classification, material properties (Young’s modulus and Poisson’s ratio), and boundary conditions of cervical vertebra, cervical intervertebral, and cervical ligaments were statistically analyzed.Results:A total of 102 papers were included. The finite element models of the cervical vertebra were derived from medical image reconstruction modeling techniques, predominantly CT plain scan and magnetic resonance imaging. Among the 102 cervical vertebra models, the C3-C7 (lower cervical segment) model appeared with the highest frequency (19). The Young’s modulus of the cortical bone, cancellous bone, and posterior structure of cervical vertebrae were set at about 12 000 or 10 000, 440, and 3 600 MPa, respectively, and the Poisson’s ratios were mainly set at about 0.29 or 0.30, 0.29, and 0.29. The Young’s modulus of the cervical intervertebral disc endplate, nucleus pulposus, and annulus fibrosus were concentrated around 500 or 2 000, 1, and 100 MPa, respectively, and the Poisson’s ratios were set at about 0.40, 0.50, and 0.40, respectively. The Young’s modulus of the anterior longitudinal ligament, posterior longitudinal ligament, transverse ligament, ligamentum flavum, interspinous ligament, capsular ligament, and articular cartilage of the cervical spine were set around 30, 20, 20, 6-10, 4-8, 10 or 20, 10 MPa, and the Poisson’s ratios were set at aoubt 0.30, 0.30, 0.30, 0.30, 0.30, 0.40, and 0.30, respectively. The Young’s modulus of the upper cervical interdental ligament, lamina, cruciate ligament, nuchal ligament, and pterygoid ligament were set at about 10, 10, 10 or 20, 20, and 5 MPa, respectively, and the Poisson’s ratios were set at about 0.30. Head weight settings were more common at 50, 74, and 100 N.Conclusions:The finite element model of the cervical vertebra has great value in the study of cervical spondylosis, but further optimization is still needed in the assignment of material properties, mesh division, and model verification to improve the accuracy and clinical applicability of the model.

Objective:To investigate the effect of the distance of the circumferential resection margin (CRM) on postoperative recurrence after laparoscopic radical resection of colon cancer.Methods:The clinical data of 83 patients who underwent laparoscopic radical resection of colon cancer in Yiwu Central Hospital from January 2020 to January 2022 were retrospectively included. They were divided into recurrent group (16 cases) and non-recurrent group (67 cases) according to the recurrence within 1 year after operation. The clinical data, postoperative CRM distance and laboratory indicators of the two groups were collected to analyze the influence of CRM distance on postoperative recurrence after laparoscopic radical resection of colon cancer.Results:The proportion of patients treated with postoperative chemotherapy, and postoperative CRM distance in the recurrent group were lower than those in the non-recurrent group: 9/16 vs. 83.58 % (56/67), (0.85 ± 0.23) mm vs. (1.64 ± 0.76) mm. The levels of CEA and CA19-9 at admission were higher than those in the non-recurrent group: (156.74 ± 11.58) μg/L vs. (149.96 ± 10.26) μg/L, (15.63 ± 2.77) kU/L vs. (14.04 ± 2.35) kU/L, and the differences were statistically significant ( P<0.05). Point binary correlation analysis showed that there was a negative correlation between CRM distance and postoperative recurrence after laparoscopic radical resection of colon cancer ( r = - 0.412, P<0.01). Multivariate Logistic regression analysis showed that the long distance of CRM was the protective factor of recurrence after laparoscopic radical resection of colon cancer ( OR<1, P<0.05). The results of the receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of the CRM distance to predict the recurrence after laparoscopic radical resection of colon cancer was 0.833>0.7, and the predictive value was good. When the optimal threshold was 1.080 mm, the ideal sensitivity and specificity could be obtained 87.50% and 81.00%. Conclusions:The shorter the CRM distance after laparoscopic radical resection of colon cancer, the higher the risk of recurrence. The CRM distance can be used as a predictor of recurrence after laparoscopic radical resection of colon cancer.

Objective:To understand the radioactivity levels of water source in five key cities of Chengdu, Yibin, Mianyang, Guangyuan, Leshan in Sichuan province, and evaluate the radiation safety of these water sources.Methods:From 2016 to 2020, the measuring site selection, sampling and analysis were made for measuring the radioactivity levels of total alpha, total beta, 90Sr, 137Cs, 226Ra, U, Th in drinking water sources in these five cities. Reference was made, respectively, to the national standards Determination of total α radioactivity concentration in water thick source method (EJ/T 1075-1998), Determination of total β radioactivity in water evaporation method (EJ/T 900-1994), Radiochemical analysis method of strontium-90 in water and biological samples ash (HJ 815-2016), radiochemical analysis of cesium-137 in the ash of water and biological samples (HJ 816-2016), Analysis and determination of radium-226 in water (GB 11214-1989), Analysis of trace uranium in environmental samples -3 laser fluorescence law (HJ 840-2017), and Food safety in the test of radioactive substances in food determination of natural thorium and uranium (GB 14883.7-2016). Results:The activity concentration ranges from 0.011 to 0.076 Bq/L for total alpha, 0.027 to 0.098 Bq/L for total beta, 0.21 to 0.45 mBq/L for 137Cs, 1.0 to 2.4 mBq/L for 90Sr, 6.1 to 16.0 mBq/L for 226Ra, 0.06 to 0.21 μg/L for Th, and 0.73 to 3.30 μg/L for U. There were no significant differences in the concentrations of total alpha, total beta, 90Sr, 137Cs, 226Ra, U and Th in different water sources and different years ( P>0.05). There were no significant differences in the concentrations of total alpha, total beta, 90Sr, 137Cs and 226Ra during different water periods ( P>0.05). There were statistical differences in U activity concentration in different water periods ( H=16.53, P<0.05), and statistical differences in Th activity concentration in different water periods ( H=15.61, P<0.05). Conclusions:The survey showed that the total alpha, total beta, 90Sr, 137Cs, 226Ra, U and Th radioactivity levels in drinking water sources in Chengdu, Yibin, Mianyang, Guangyuan and Leshan of Sichuan province were at the same level as the relevant data in the Natural environmental radioactivity level in China published by the State Environmental Protection Bureau in 1995. All of there values were within the data range released by the 2013-2021 National Radiation Environment Monitoring Quality Report issued by the Radiation Environment Monitoring Technology Center of the Ministry of Ecology and Environment. The radioactivity level in water sources in the five key cities was at a safe level.

Objective:To evaluate the mid-term complication rates of the Hui-Jing one-stage procedure (lingual mucosa combined with longitudinal preputial island flap onlay urethroplasty + tubularized incised plate glansplasty)versus the classic Bracka staged surgery for children with severe hypospadias.Methods:A retrospective analysis was conducted on clinical data of 75 children with proximal hypospadias who were treated at the Seventh Medical Center of PLA General Hospital from March 2017 to June 2022. Of these patients, 31 cases (15 cases penoscrotal type and 16 cases perineal type) were underwent the Bracka two-stage surgery with a median age of 38 months (24.0, 44.5) and 44 cases underwent the Hui-Jing one-stage procedure (23 cases penoscrotal type and 21 perineal type) with a median age of 40.5 months (20.75, 90.5). The length of urethral plate defect after correction of penile curvature was (4.30±0.84)cm in the Bracka group and (4.56±0.79)cm in the Hui-Jing group, which also showed no significant difference.There was no statistically significant difference of the median age and the position of preoperative urethral opening between the two groups( P=0.47, P=0.74). The first stage of Bracka repair consists of orthoplasty and urethral bed substitution with free preputial graft. After 6 months, the urethral plate created from free graft was tabularized to form neourethra; Hui-Jing procedure group used the free lingual mucosal as urethral plate substitution, then we conducted longitudinal preputial island flap Onlay and Snodgrass phalloplasty. The incidence of postoperative urethral fistula, urethral stricture and urethral diverticulum was compared between the two groups of cases and the difference in efficacy between the two procedures was assessed. Results:Among the 75 patients included in the study, there was no statistically significant difference in age or location of urethral meatus between the Bracka and Hui-Jing groups. In Bracka group, 9 cases of urethral stricture (29.0%), 6 case of urethral fistula (19.4%), and 2 cases of urethral diverticulum (6.5%) occurred after surgery, while 12 cases of urethral fistula (27.3%) and 3 case of urethral fistula (6.8%) occurred in the Hui-Jing group. No urethral stricture occurred in Hui-Jing group. There was no statistically significant difference in overall incidence of complications between the two groups [17/31(54.8%) vs.15/44(34.1%), P=0.12]. The incidence of urethral fistula and urethral diverticulum show no significant differences between two groups(19.4% vs 27.3, P=0.61, 6.5% vs. 6.8%, P=0.13). The number of operation in Bracka group was (2.68±1.03) and the hospitalization cost was (12 984.63±3 808.15) Yuan, while the number of operation in Hui-Jing group was (1.36±0.53) and the hospitalization cost was (8 490.54±3 136.84) Yuan. Conclusions:The Hui-Jing one-stage procedure can be used for the surgical treatment of children with severe hypospadias. There is no urethral stricture happened in Hui-Jing group, while the general complication incidence and incidence of urethral fistula and diverticulum show no differences.

Objective To investigate the content of thorium (Th) in surface water in Sichuan Province, China, and to evaluate Th-associated health risk via water intake for residents. Methods Twenty-three monitoring sections were set in main surface water bodies in Sichuan Province. From 2016 to 2021, the Th radioactivity level in the water bodies was measured during dry and normal-water seasons. The health risk of residents was evaluated by calculating radioactive Th intake from the surface water bodies combined with the use of a health risk assessment model. Results The Th radioactivity level of the surface water bodies in Sichuan Province was 0.02-0.67 μ./L. There was no significant difference in the Th radioactivity level of different years or different surface water bodies (P > 0.05). A significant difference was observed in the Th radioactivity level of different water seasons (P < 0.05). The total mean annual committed effective doses of Th in all age groups caused by drinking water and water immersion ranged from 3.14 × 10⁻⁸ to 8.75 × 10⁻⁷ Sv, all lower than the World Health Organization (WHO)-recommended reference level of 0.1 mSv. The overall carcinogenic risks for residents in all age groups ranged from 3.93 × 10⁻¹⁰ to 1.09 × 10⁻⁸, all below the most rigorous control limits issued by WHO and International Commission on Radiological Protection. Conclusion The Th-associated health risk via direct water intake and water immersion in main surface water bodies of Sichuan Province is at an acceptable level. Th in main surface water bodies of Sichuan Province is safe for all age groups.