Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Objectives: . Considerable research has been focused on independent predictors of difficult laryngeal exposure (DLE) during suspension laryngoscopy. However, previous studies have yielded inconsistent results and conclusions. Consequently, we performed a meta-analysis of the existing literature with the aim of identifying significant parameters for a standardized preoperative DLE prediction system. Methods: . We systematically retrieved articles from the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wanfang databases up to October 2022. Data from eligible studies were extracted and analyzed using the R programming language. The effect measures included odds ratios (ORs) with 95% confidence intervals (CIs) for dichotomous variables and mean differences (MDs) with 95% CIs for continuous variables. Results: . The search yielded 1,574 studies, of which 18 (involving a total of 2,263 patients) were included. Pooled analysis demonstrated that patients with DLE during microsurgery tended to be male (OR, 1.73; 95% CI, 1.16–2.57); were older (MD, 5.47 years, 95% CI, 2.44–8.51 years); had a higher body mass index (BMI; MD, 1.19 kg/m2; 95% CI, 0.33–2.05 kg/m2); had a greater neck circumference (MD, 2.50 cm; 95% CI, 1.56–3.44 cm); exhibited limited mouth opening (MD, −0.52 cm; 95% CI, −0.88 to −0.15 cm); had limited neck flexibility (MD, −10.05 cm; 95% CI, −14.10 to −6.00 cm); displayed various other anatomical characteristics; and had a high modified Mallampati index (MMI) or test score (OR, 3.37; 95% CI, 2.07–5.48). Conclusion . We conducted a comprehensive and systematic analysis of the factors relevant to DLE. Ultimately, we identified sex, age, BMI, neck circumference, MMI, inter-incisor gap, hyomental distance, thyromental distance, sternomental distance, and flexion-extension angle as factors highly correlated with DLE.

Hypertrophic scar is the most common scar in clinic. Due to its high incidence, high rate of relapse and difficulty of complete removal, it has always been a big problem in burn and plastic surgery. In recent years, some scholars have found that botulinum toxin type A(BTX-A) can inhibit scar hyperplasia by reducing the tension around the wound, inhibiting the proliferation of fibroblasts, promoting their apoptosis, promoting the degradation of collagen fibers, reducing wound angiogenesis, reducing inflammation around the wound and other mechanisms. BTX-A has fewer adverse reactions and high safety. Additionally, its effect combined with triamcinolone acetonide and laser in treating scars is significant. Therefore, it has been widely used in the treatment of hypertrophic scars. In this paper, the research progress of BTX-A in the prevention and treatment of hypertrophic scar were reviewed in order to provide new ideas for the treatment of hypertrophic scar.

Hypertrophic scar is the most common scar in the clinic. Due to its high incidence, high rate of recurrence, and difficulty of complete removal, it has always been a major problem in the department of burn and plastic surgery. In recent years, some scholars have found that botulinum toxin type A(BTX-A) can inhibit scar hyperplasia by reducing the tension around the wound, inhibiting the proliferation of fibroblasts, promoting their apoptosis, promoting the degradation of collagen fibers, reducing wound angiogenesis, reducing inflammation around the wound and other mechanisms. BTX-A has fewer adverse reactions and high safety. Additionally, its effect combined with triamcinolone acetonide and laser in treating scars is significant. Therefore, it has been widely used in the treatment of hypertrophic scars. In this paper, the research progress of BTX-A in the prevention and treatment of hypertrophic scar was reviewed in order to provide new ideas for the treatment of hypertrophic scar.

Hypertrophic scar is the most common scar in clinic. Due to its high incidence, high rate of relapse and difficulty of complete removal, it has always been a big problem in burn and plastic surgery. In recent years, some scholars have found that botulinum toxin type A(BTX-A) can inhibit scar hyperplasia by reducing the tension around the wound, inhibiting the proliferation of fibroblasts, promoting their apoptosis, promoting the degradation of collagen fibers, reducing wound angiogenesis, reducing inflammation around the wound and other mechanisms. BTX-A has fewer adverse reactions and high safety. Additionally, its effect combined with triamcinolone acetonide and laser in treating scars is significant. Therefore, it has been widely used in the treatment of hypertrophic scars. In this paper, the research progress of BTX-A in the prevention and treatment of hypertrophic scar were reviewed in order to provide new ideas for the treatment of hypertrophic scar.

Hypertrophic scar is the most common scar in the clinic. Due to its high incidence, high rate of recurrence, and difficulty of complete removal, it has always been a major problem in the department of burn and plastic surgery. In recent years, some scholars have found that botulinum toxin type A(BTX-A) can inhibit scar hyperplasia by reducing the tension around the wound, inhibiting the proliferation of fibroblasts, promoting their apoptosis, promoting the degradation of collagen fibers, reducing wound angiogenesis, reducing inflammation around the wound and other mechanisms. BTX-A has fewer adverse reactions and high safety. Additionally, its effect combined with triamcinolone acetonide and laser in treating scars is significant. Therefore, it has been widely used in the treatment of hypertrophic scars. In this paper, the research progress of BTX-A in the prevention and treatment of hypertrophic scar was reviewed in order to provide new ideas for the treatment of hypertrophic scar.

Objective To investigate the indications of optic canal decompression in the patients with front-orbital fibrous dysplasia and the methods of intraoperative optic canal localization and decompression. Methods We collected 30 cases of fibrous dysplasia. All patients had sufficient images assessment. Patients with symptoms underwent surgery, including front-orbital cranioplasty and optic canal decompression. The frontotemporal epidural approaches were used. If there was a proptosis, the approach was extended with the removal of superior orbital ridge. Six patients undertook intraoperative CT and MRI fusion navigation, assisting in confirming the trunk, orbital and cranial orifice of optic nerve. During the operation, the optic canals were decompressed by three-bits method, to confirm the position of optic nerve. Results There were 30 cases of optic canal decompression and one case of vision loss. The visual acuity and vision field of the remaining patients improved to varying degrees. The proptosis disappeared or alleviated after the operation. Thirteen cases were reconstructed with normal internal plate, five cases with titanium plate, nine cases without reconstruction, and two cases were paved with proliferative broken bone on the orbital top; one case recurred with exophthalmos again after five years, but the visual acuity did not decline. Conclusion For the patients with front-orbital fibrous dysplasia, active surgical treatment should be taken, optic canal decompression should be chosen for diminution of vision, craniofacial anaplasty and orbital decompression should be performed in patients with facial deformity. The epidural approach is a good option to locate the optic nerve from the orbital orifice or cranial orifice. Combined with the three-bits method, we can achieve safe and meticulous optic nerve decompression.

Objective To compare the effect of transplant islets between the subcutaneous inguinal white adipose tissues and renal capsule in the treatment of type 1 diabetes mellitus in mouse models. Methods The mice with type 1 diabetes mellitus undergoing islet transplantation were divided into the white adipose group (n=10) and renal capsule group (n=10). The islets were isolated, purified and transplanted to the subcutaneous white adipose tissues of inguinal region and renal capsule. The random blood glucose level and glucose tolerance function of the recipient mice in two groups were continuously monitored after operation. Islet grafts of the surviving recipient mice were harvested at postoperative 100 d for histopathological examination. Results In the white adipose group, the blood glucose levels of 6 recipient mice were restored to normal at 1 month after transplantation, whereas the blood glucose levels of the other 4 recipient mice were high, which died before the end of monitoring. In the renal capsule group, the blood glucose levels of 10 recipient mice returned to normal within 10 d after transplantation. Islet grafts of the recipient mice in two groups could lower the blood glucose levels, whereas the islet grafts in the white adipose group required a longer time to exert the effect. The glucose tolerance function of the mice in the renal capsule group was significantly better than that of those in white adipose group (P < 0.05). Histopathological examination demonstrated that the insulin of the islet grafts was normally expressed in two groups. Conclusions The islets transplanted into the subcutaneous white adipose tissues of inguinal region can play an effective role in regulating the changes of blood glucose level. Although the blood glucose-lowering function is slightly weaker than that of the islets graft in the renal capsule, it has multiple advantages resembling the ideal islet transplantation sites, which is a promising replacement site for islet transplantation.

Objective To investigate the efficacy of suprapatellar versus infrapatellar approach in tibial intramedullary nail fixation for tibial fracture. Methods Clinical trials that evaluated suprapatellar approach and infrapatellar approach for tibia intramedullary nailing fixation were searched in PubMed, EMBASE, Cochrane Central Register of Controlled Trials ( CENTRAL ) , Chinese Biology Medicine ( CBM) , Wanfang, Weipu and CNKI databases. Methodological qualities of the included studies were assessed using the Cochrane Collaboration tool and Newcastle-Ottawa Scale. Sensitivity analyses were performed to determine whether overall results were reliable. Publication bias was detected using Begg's test and Egger's test. Lysholm score, reoperation rate, Hospital for Special Surgery ( HSS ) score, operation time, intraoperative blood loss and hospital stay were selected to evaluate the clinical effect of suprapatellar approach and infrapatellar approach in tibial intramedullary nail fixation for tibial fracture. Results Two randomized controlled trials and six case-controlled studies involving 787 patients were included in the analysis. Sensitivity analyses indicated that the results were statistically significant. No significant publication bias was detected by Begg's test or Egger's test. Our meta-analysis indicated that suprapatellar approach had significantly higher Lysholm score ( MD=1. 04, 95％CI 0. 82 -1. 26, P<0. 05, I2 =10. 5％) and HSS score ( MD =0. 97, 95％CI 0. 65 -1. 30, P <0. 05, I2 =0 ) than infrapatellar approach ( P <0. 05 ) . Additionally, there were no statistical differences between the two procedures in reoperation rate, operation time, intraoperative blood loss and hospital stay (P>0. 05). Conclusion Compared with infrapatellar approach, suprapatellar approach in intramedullary nail fixation for tibial fracture can better relieve the pain, keep stability and motion of the knee joint and promote function recovery of knee joint.

Osteoarthritis is one of the most common chronic diseases in orthopedics.With increasing populations of aging and obese people,its incidence has risen year by year and become a major public health problem.The hallmark of osteoarthritis is cartilage destruction,the main cause of which is degradation of extracellular matrix by catabolic enzymes and death of chondrocytes caused by apoptosis or autophagy.Articular cartilage is a hypoxic environment because it lacks blood supply and the joint cavity is relatively closed.A hypoxic environment induces chondrocytes to produce a series of hypoxia-related molecules which can regulate the expression of catabolic enzymes,autophagy and apoptosis of chondrocytes for osteoarthritis.This paper aims to review recent reports on the relationship between hypoxic-related molecules and pathogenesis of osteoarthritis and discuss the role of hypoxia-related molecules in the pathogenesis of osteoarthritis.