Berberine ameliorates chronic kidney disease through inhibiting the production of gut-derived uremic toxins in the gut microbiota

At present, clinical interventions for chronic kidney disease are very limited, and most patients rely on dialysis to sustain their lives for a long time. However, studies on the gut-kidney axis have shown that the gut microbiota is a potentially effective target for correcting or controlling chronic kidney disease. This study showed that berberine, a natural drug with low oral availability, significantly ameliorated chronic kidney disease by altering the composition of the gut microbiota and inhibiting the production of gut-derived uremic toxins, including p-cresol. Furthermore, berberine reduced the content of p-cresol sulfate in plasma mainly by lowering the abundance of g_Clostridium_sensu_stricto_1 and inhibiting the tyrosine-p-cresol pathway of the intestinal flora. Meanwhile, berberine increased the butyric acid producing bacteria and the butyric acid content in feces, while decreased the renal toxic trimethylamine N-oxide. These findings suggest that berberine may be a therapeutic drug with significant potential to ameliorate chronic kidney disease through the gut-kidney axis.

Clinical Features and Differences of Miller Fisher Syndrome in Southern China: Retrospective Analysis of 72 Patients in 13 Provinces of Southern China

Background@#and Purpose We aimed to determine the clinical features of Miller Fisher syndrome (MFS) in southern China and compare them with those presenting in other countries. @*Methods@#We collected the medical records of patients diagnosed with MFS during 2013–2016.We analyzed the age, sex, onset season, precursor events, clinical symptoms and signs, findings of nerve conduction studies (NCS), cerebrospinal fluid (CSF), therapeutic remedies, nadir time, and length of hospital stay of patients with MFS in southern China. We concurrently compared the differences between urban and rural areas and between patients with incomplete ophthalmoplegia (IO) and complete ophthalmoplegia (CO). @*Results@#The study enrolled 72 patients: 36 from rural areas and 36 from urban areas, and 50 males and 22 females. The mean age at onset was 47.72 years, and 30 (41.7%) and 21 (29.2%) patients developed MFS in spring and winter, respectively. The typical triad of ophthalmoplegia, ataxia, and areflexia was observed in 50 (69.4%) patients. A history of upper respiratory tract infection 1 week before onset was found in 52.8% of the patients, while 5.6% experienced gastrointestinal infections and 48 (73.8%) exhibited albuminocytological dissociation in the CSF study. Only 26 (36.1%) patients presented abnormalities in NCS. Moreover, restricted outward eyeball movement presented in 83.5% of the patients with classic MFS and acute ophthalmoplegia, and bilateral symmetrical ophthalmoplegia presented in 64.2%. With the exception of the higher proportion of NCS abnormalities in urban areas (47.2% vs. 25.0%), urban and rural differences were insignificant regarding sex ratio, age at onset, high-incidence season, precursor events, disease characteristics, and albuminocytological dissociation in the CSF. Furthermore, patients with CO were older than those with IO (64.53±7.69 vs. 43.19±14.40 years [mean±standard deviation], p<0.001). @*Conclusions@#The patients with MFS were mostly male and middle-aged, and most presented in winter and (especially) spring. More than half of the patients had clear precursor events, most of which were classic MFS with the typical triad. More than 70% of the patients presented albuminocytological dissociation in the CSF. NCS abnormalities were uncommon in MFS. The age at onset was lower in patients with IO than in patients with CO; bilateral symmetrical extraocular muscle paralysis was the most common symptom, and the external rectus was the most frequently involved muscle.

Factors Influencing Alzheimer's Disease Risk: Whether and How They are Related to the APOE Genotype / 神经科学通报·英文版

Alzheimer's disease (AD) is the most prevalent neurodegenerative disease featuring progressive cognitive impairment. Although the etiology of late-onset AD remains unclear, the close association of AD with apolipoprotein E (APOE), a gene that mainly regulates lipid metabolism, has been firmly established and may shed light on the exploration of AD pathogenesis and therapy. However, various confounding factors interfere with the APOE-related AD risk, raising questions about our comprehension of the clinical findings concerning APOE. In this review, we summarize the most debated factors interacting with the APOE genotype and AD pathogenesis, depict the extent to which these factors relate to APOE-dependent AD risk, and discuss the possible underlying mechanisms.

Current Status of Hyperbaric Oxygen Therapy and Its Application / 中国医疗器械杂志

Hyperbaric oxygen therapy is a method of breathing pure oxygen or high-concentration oxygen in a highpressure environment to treat hypoxic diseases and related diseases. According to clinical verification, this therapy has an irreplaceable effect on certain diseases and has gradually become a comprehensive clinical treatment. One of the main methods of certain diseases is widely recognized by the medical field at home and abroad. The development history, treatment principles, key technologies, and future development trends of hyperbaric oxygen are discussed in detail, provide a research direction for the development of hyperbaric oxygen therapy in the future, and at the same time, it has also improved physicians' awareness of hyperbaric oxygen therapy, so as to improving Industry influence.

The Effects of Different Adaptive Statistical Iterative Reconstruction-V and Convolution Kernel Parameters on Auto-Segmentation Stability in CT Images / 中国医疗器械杂志

Objective The study aims to investigate the effects of different adaptive statistical iterative reconstruction-V（ ASiR-V） and convolution kernel parameters on stability of CT auto-segmentation which is based on deep learning. Method Twenty patients who have received pelvic radiotherapy were selected and different reconstruction parameters were used to establish CT images dataset. Then structures including three soft tissue organs (bladder, bowelbag, small intestine) and five bone organs (left and right femoral head, left and right femur, pelvic) were segmented automatically by deep learning neural network. Performance was evaluated by dice similarity coefficient（ DSC） and Hausdorff distance, using filter back projection(FBP) as the reference. Results Auto-segmentation of deep learning is greatly affected by ASIR-V, but less affected by convolution kernel, especially in soft tissues. Conclusion The stability of auto-segmentation is affected by parameter selection of reconstruction algorithm. In practical application, it is necessary to find a balance between image quality and segmentation quality, or improve segmentation network to enhance the stability of auto-segmentation.

The role of SBAR communication model combined with scenario simulation in clinical teaching of blood purification center / 中华医学教育探索杂志

Objective:To explore the effect of SBAR (situation, background, assessment, recommendation) communication model combined with scenario simulation in clinical teaching of blood purification center.Methods:Sixty interns in the blood purification center from March 2019 to March 2020 were collected in the study, and randomly divided into experimental group ( n=30) and control group ( n=30). The two groups of students studied in two different treatment groups in the blood purification center. The control group used the method of traditional teaching, while the experimental group used SBAR communication combined with situational simulation for teaching on the basis of traditional teaching, with a total clinical practice time of two months. All trainees underwent theoretical examination, clinical operation examination, self-efficacy evaluation and teaching satisfaction survey after training. SPSS 22.0 was performed for t test. Results:Through SBAR communication model combined with situational simulation teaching, the scores of theoretical examination [(88.13±3.22) vs. (85.51±3.17)], clinical operation assessment [(91.31±3.48) vs. (84.17±4.94)], self-efficacy evaluation [(11.13±1.08) vs. (9.21±1.89)], teaching satisfaction [(95.71±2.87) vs. (91.18±3.08)], and communication ability [(12.27±1.13) vs. (8.63±1.45)] in the experimental group were higher than those in the control group; while there was no significant difference in the scores of theoretical assessment between the two groups ( P<0.05). Conclusion:SBAR communication model combined with situational simulation teaching can improve the learning ability, operation ability and comprehensive application ability of special training trainees, especially in communication ability, which is worthy of popularization and application in clinical teaching.

Role of non-coding RNAs in vascular smooth muscle cell calcification / 生理学报

Vascular calcification, the deposition of calcium in the arterial wall, is often linked to increased stiffness of the vascular wall. Vascular calcification is one of the important factors for high morbidity and mortality of cardiovascular and cerebrovascular diseases, as well as an important biomarker in atherosclerotic cardiovascular events, stroke and peripheral vascular diseases. The mechanism of vascular calcification has not been fully elucidated. Recently, non-coding RNAs have been found to play an important role in the process of vascular calcification. In this paper, the main types of non-coding RNAs and their roles involved in vascular smooth muscle cell calcification are reviewed, including the changes of osteoblast-related proteins, calcification signaling pathways and intracellular Ca2+.

Aesthetic reconstruction of distal segment of finger with modified second toe nail flap without sacrifice a toe / 中华显微外科杂志

Objective:To explore the method and effect of aesthetic reconstruction of distal segment of finger with modified second toe nail flap while retains the full length of the second toe.Methods:From April 2018 to June 2020, 16 patients with degloving injury of distal segment of fingers were treated. The patients were 11 males and 5 females aged 18 to 45 years in an average of 29 years. All injuries were degloving injury of the distal segment of finger, including 5 index fingers, 7 middle fingers, 3 ring fingers and 1 little finger. The time from injury to operation was 0.5-3.0 hours, with an average of 1.5 hours. The second toe nail flap was used for the reconstruction. After the dorsal flap of the second toe was rotated to the plantar side of the foot, the donor site defect was repaired by a skin graft. The regular follow up reviews were carried out.Results:All 16 flaps survived except 1 flap had necrosis and underwent toe amputation of the distal segment of the second toe. All patients entered follow-up for 4-12 months, with an average of 5.7 months. The blood supply of all flaps was good. After the flaps having atrophied, they were equivalent to the diameter of the body of normal fingers with the TPD at 6.5(4-10) mm; All patients returned to work. According to the Evaluation Standard of Upper Limb Function of Chinese Hand Surgery Society, 13 cases were graded as excellent, 2 were good and 1 was fair.Conclusion:The techniques of modified second toe toenail flap in aesthetic reconstruction of the distal segment of a finger can effectively restore the length and aesthetic appearance of the affected finger, without sacrificing the donor toe. Clinical application of it should be promoted.

Clinical significance of No.11p posterior lymph nodes dissection in gastric cancer surgery / 中华胃肠外科杂志

Objective: To analyze the association of No.11p posterior lymph node metastasis with clinicopathological features and its prognostic significance in gastric cancer. Methods: A single-center retrospective cohort study was conducted. Clinicopathological data of patients with primary gastric cancers undergoing No.11p posterior lymph node dissection from January 2016 to December 2020 were retrieved from the Database of Gastric Cancer, West China Hospital, Sichuan University. Case inclusion criteria: (1) gastric cancer proved by pathology; (2) radical resection with intraoperative No.11p posterior lymph node dissection; (3) operations performed by the same surgical team; (4) no previous history of other malignant tumors and no concurrent malignant tumors. Those with stump gastric cancer, history of gastrectomy, neoadjuvant chemotherapy, incomplete clinicopathological data and lost to follow-up were excluded. During the operation, the upper edge of the pancreas was retracted forward to expose the area between the upper edge of the pancreas and the splenic vessels. The proximal segment of the splenic artery was skeletonized to remove lymphatic tissue anterior and superior to the splenic artery for No.11p lymph node dissection. For patients with lymphadenopathy in the area between the splenic artery and the splenic vein, dissection was performed. The enlarged lymph nodes were labeled with titanium clips and named as No.11p posterior lymph node. Pathological examination was performed separately after the specimen was isolated. Statistical analysis was performed using R software. Results: A total of 127 gastric cancer patients, who underwent No.11p posterior lymph nodes dissection were included in this study, of which 120 patients without No.11p posterior lymph nodes metastasis (No.11p posterior lymph nodes negative) and 7 patients with No.11p posterior lymph nodes metastasis (No.11p posterior lymph nodes positive). A total of 8 metastatic No.11p posterior lymph nodes were detected in 7 patients, metastasis rate and with a ratio of 5.5% (7/127) and 6.8% (8/127), respectively. In the subgroup analysis of T3-4 stage patients, the metastasis rate and ratio of No.11p posterior lymph nodes were 9.0% (7/78) and 10.7% (8/75), respectively. Compared to negative cases, patients with No.11p posterior lymph nodes metastasis had larger tumor (P=0.002), higher proportion of Borrmann type Ⅲ and Ⅳ tumors (P=0.005), more metastatic lymph nodes (P<0.001), more advanced T stage (P=0.043), N stage (P=0.004) and TNM stage (P=0.015). In survival analysis, patients with No.11p posterior lymph node metastasis had a significantly worse prognosis than those without metastasis after adjusting for TNM stage (hazard ratio=3.009, 95% confidence interval: 1.824-4.964, P<0.001). Conclusions: The No.11p posterior lymph node metastasis in gastric cancer is associated with worse prognosis. For patients of T3-4 stage gastric cancer, No.11p posterior lymph node dissection should be emphasized during radical operation.

Chaetocin:a review of its anticancer potential and mechanisms / 中国药理学与毒理学杂志

Chaetocin is a natural metabolite product with various biological activities and pharmacological functions isolated from Chaetomium species fungi belonging to the thiodiketopyrazines. Numerous studies have demonstrated a wide range of antitumor activities of chaetocin in vitro and in vivo. Several studies have demonstrated that chaetocin sup?presses the growth and proliferation of various tumour cells by regulating multiple signalling pathways related to tumour initiation and progression, inducing cancer cell apoptosis (intrinsic and extrinsic), enhancing autophagy, inducing cell cycle arrest, as well as inhibiting tumour angiogenesis, invasion and migration. The antitumor effects and molecular mechanisms of chaetocin are reviewed and analysed in this paper, and the prospective applications of chaetocin in cancer prevention and therapy are also discussed. Our review provides the theoretical basis for exploiting the clinical applica?tion of chaetocin in cancer treatment.

A primary study on construction of urban unmanned aerial vehicle emergency blood distribution system / 中华急诊医学杂志

Objective:To explore the feasibility and effectiveness of the construction of urban unmanned aerial vehicle (UAV) blood distribution system, and to provide a novel way for the distribution of emergency blood.Methods:The study was completed in Hangzhou from April 2019 to January 2021, and the main participants were from the Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province Blood Center and Hangzhou Fast Ant Network Technology Co., Ltd. Firstly, an unmanned aircraft delivery system was built for urban emergency blood and a special blood storage box for drones were developed. The drone was used to deliver blood products from Zhejiang Province Blood Center to Binjiang Campus, the Second Affiliated Hospital of Zhejiang University School of Medicine, and the following indicators were obtained: (1) flight time of the drone blood delivery; (2) real-time temperature of blood products during transportation; (3) Baidu map software was used to measure the blood delivery time of road traffic, which was compared with the flight time of the drone.Results:The urban drone blood delivery system consists of intelligent logistics drones, cryogenic blood storage tanks, unmanned logistics hub stations, and cloud-based operation control platforms. The drone route distance from Zhejiang Provincial Blood Center to Binjiang Campus, the Second Affiliated Hospital of Zhejiang University School of Medicine was 2.36±0.06 km, and the ground distance was 5.8 km, with 27 flights from April 12, 2019 to January 29, 2021, and the drone flight time was, shorter than the road travel time for a round trip [(6.37±0.35) min vs. (17.00±1.94) min]. At different time points of the day, UAV blood delivery could save 15.98-4.28 min, with an average saving of 10.62±1.87 min. Conclusions:Urban UAV blood delivery systems have the advantages of being fast, unaffected by ground traffic conditions, and can ensure the safety of blood products during transportation, and are worthy of further exploration.

Role of 15-lipoxygenase/15-hydroxyeicosatetraenoic acid in hypoxic pulmonary arterial hypertension / 生理学报

Pulmonary arterial hypertension (PAH) is a rare disease with a complex aetiology characterized by elevated pulmonary artery resistance, which leads to progressive right ventricular failure and ultimately death. The aberrant metabolism of arachidonic acid in the pulmonary vasculature plays a central role in the pathogenesis of PAH. The levels of 15-lipoxygenase (15-LO) and 15-hydroxyeicosatetraenoic acid (15-HETE) are elevated in the pulmonary arterial endothelial cells (PAECs), pulmonary smooth muscle cells (PASMCs) and fibroblasts of PAH patients. Under hypoxia condition, 15-LO/15-HETE induces pulmonary artery contraction, promotes the proliferation of PAECs and PASMCs, inhibits apoptosis of PASMCs, promotes fibrosis of pulmonary vessels, and then leads to the occurrence of PAH. Here, we review the research progress on the relationship between 15-LO/15-HETE and hypoxic PAH, in order to clarify the significance of 15-LO/15-HETE in hypoxic PAH.

Metabolism characteristics and pharmacological insights of flavonoids based on the intestinal bacteria / 药学学报

The gut microbiota takes part in many in vivo important physiological activities of host, such as the substance metabolism and energy exchange, etc. The interaction between the host and the intestinal microorganisms has attracted scholars' attention. Flavonoids are a group of polyphenol compounds widely found in natural plants, with the bioactive effect of regulation of glucose and lipid metabolism, anti-inflammation. However, their low bioavailability cause difficulty to clarify the effective substances and the mechanism of flavonoids. Apart from the metabolic effects of liver on flavonoids, recent studies have shown that the gut microbiota can interact with flavonoids. On the one hand, flavonoids can be metabolized by gut microbiota and subsequent metabolites can produce pharmacological activities different from the parent components. On the other hand, flavonoids and their metabolites can in turn regulate the composition and physiological activities of the intestinal flora, which seems to provide a new insight for the research on the effective substances of flavonoids. In this review, we introduced the metabolic characteristics of flavonoids under the actions of intestinal bacteria, and the regulation effects of flavonoids on gut microbiota was also summarized. Meanwhile, the therapeutic effect of flavonoids under the action of intestinal bacteria was discussed.

Methodological exploration of health Impact assessment of public policy / 公共卫生与预防医学

Objective This article takes a cosmetics factory in Yichang City as an example, uses a variety of methodologies to explore methods of health impact assessment and provides methodological references for future health evaluation of related public policies. Methods By analyzing the environmental assessment report of the cosmetic renovation project, an indicator system was established and expert consultation meetings were conducted to score the impact of the corresponding indicators on health. The impact of the renovation project of the factory on the factory workers, surrounding residents and the sustainable development of the environment was analyzed by means of the Kaiser model with the risk matrix and the Borda value. Results The risk values of the five influencing factors of industrial wastewater, domestic wastewater, industrial waste gas, industrial waste and noise were 5.11%, 5.43%, 10.6%, 6.71% and 7.02% respectively. All the influencing factors were in the green zone of the risk matrix. The Borda values of the five influencing factors of industrial waste water, domestic waste water, industrial waste gas, industrial waste residue and noise were 4, 5, 10, 7 and 5 respectively. Conclusion The multiple methodologies adopted in the factory renovation project are feasible, and can provide new ideas for the health impact assessment of public policies in the future.

Study on the epidemic status and risk factors of type 2 diabetes mellitus complicated with nephropathy in Nanchong, Sichuan / 公共卫生与预防医学

Objective To explore and analyze the risk factors of type 2 diabetes with kidney disease in Nanchong, Sichuan. Methods A retrospective analysis of 192 cases of type 2diabetic nephropathy (study group) and 224 cases of simple type 2 diabetes (control group) in Nanchong area was conducted. The general data and laboratory test results of the two groups were compared, and logistic regression analysis was used to explore the risk factors. Results In this study, there were a total of 353 patients with type 2diabetes complicated with kidney disease, and the incidence rate was 13.46%. The proportion of smoking and drinking, BMI, fasting blood glucose, glycosylated hemoglobin, total cholesterol, creatinine and blood uric acid in the diabetic nephropathy group were higher than those in the simple diabetes group. The course of disease in the diabetic nephropathy group was longer than that in the simple diabetes group. Course of diabetes, smoking-history, BMI, glycosylated hemoglobin, total cholesterol, and serum uric acid were independent risk factors for type 2 diabetic kidney disease. Conclusion The occurrence and development of diabetic kidney disease is the result of the interaction of multiple factors such as the disease course, smoking, obesity, poor blood glucose control, total cholesterol and serum uric acid. Early detection and control of risk factors can delay the progression of diabetic kidney disease.

Diagnostic value of three-dimensional reconstruction technique in new classification criteria of lung adenocarcinoma / 中国胸心血管外科临床杂志

@#Objective    To evaluate the application value of three-dimensional (3D) reconstruction in preoperative surgical diagnosis of new classification criteria for lung adenocarcinoma, which is helpful to develop a deep learning model of artificial intelligence in the auxiliary diagnosis and treatment of lung cancer. Methods    The clinical data of 173 patients with ground-glass lung nodules with a diameter of ≤2 cm, who were admitted from October 2018 to June 2020 in our hospital were retrospectively analyzed. Among them, 55 were males and 118 were females with a median age of 61 (28-82) years. Pulmonary nodules in different parts of the same patient were treated as independent events, and a total of 181 subjects were included. According to the new classification criteria of pathological types, they were divided into pre-invasive lesions (atypical adenomatous hyperplasia and and adenocarcinoma in situ), minimally invasive adenocarcinoma and invasive adenocarcinoma. The relationship between 3D reconstruction parameters and different pathological subtypes of lung adenocarcinoma, and their diagnostic values were analyzed by multiplanar reconstruction and volume reconstruction techniques. Results    In different pathological types of lung adenocarcinoma, the diameter of lung nodules (P<0.001), average CT value (P<0.001), consolidation/tumor ratio (CTR, P<0.001), type of nodules (P<0.001), nodular morphology (P<0.001), pleural indenlation sign (P<0.001), air bronchogram sign (P=0.010), vascular access inside the nodule (P=0.005), TNM staging (P<0.001) were significantly different, while nodule growth sites were not (P=0.054). At the same time, it was also found that with the increased invasiveness of different pathological subtypes of lung adenocarcinoma, the proportion of dominant signs of each group gradually increased. Meanwhile, nodule diameter and the average CT value or CTR were independent risk factors for malignant degree of lung adenocarcinoma. Conclusion    Imaging signs of lung adenocarcinoma in 3D reconstruction, including nodule diameter, the average CT value, CTR, shape, type, vascular access conditions, air bronchogram sign, pleural indenlation sign, play an important role in the diagnosis of lung adenocarcinoma subtype and can provide guidance for personalized therapy to patients in clinics.

Feasibility of Evaluating Result of Auto-segmentation of Target Volumes in Radiotherapy with Medical Consideration Index / 中国医疗器械杂志

OBJECTIVE@#To explore the feasibility of using the bidirectional local distance based medical similarity index (MSI) to evaluate automatic segmentation on medical images.@*METHODS@#Taking the intermediate risk clinical target volume for nasopharyngeal carcinoma manually segmented by an experience radiation oncologist as region of interest, using Atlas-based and deep-learning-based methods to obtain automatic segmentation respectively, and calculated multiple MSI and Dice similarity coefficient (DSC) between manual segmentation and automatic segmentation. Then the difference between MSI and DSC was comparatively analyzed.@*RESULTS@#DSC values for Atlas-based and deep-learning-based automatic segmentation were 0.73 and 0.84 respectively. MSI values for them varied between 0.29~0.78 and 0.44~0.91 under different inside-outside-level.@*CONCLUSIONS@#It is feasible to use MSI to evaluate the results of automatic segmentation. By setting the penalty coefficient, it can reflect phenomena such as under-delineation and over-delineation, and improve the sensitivity of medical image contour similarity evaluation.

Application of stem cells, tissue engineering scaffolds and neurotrophic factors in the treatment of spinal cord injury / 中国组织工程研究

BACKGROUND: Stem cells have multi-directional differentiation potential. Tissue engineering scaffolds can provide support for them. Neurotrophic factors can promote the differentiation of stem cells. The combination of the three therapies to promote the functional recovery of spinal cord injury is one of the current research hotspots. OBJECTIVE: To review the research progress of stem cells, tissue engineering scaffolds, neurotrophic factors and their combined transplantation in the treatment of spinal cord injury in recent years. METHODS: The authors searched PubMed, ScienceDirect, Medline, and CNKI for original articles from January 2000 to October 2019. The key words were “spinal cord injury, mesenchymal stem cells, issue engineering, neurotrophic factor” in English and Chinese, respectively. Totally 712 studies were retrieved. After strict screening, 79 studies that met the requirements were classified and reviewed. RESULTS AND CONCLUSION: Stem cell transplantation alone cannot reconstruct the complex structure and stability of the spinal cord. Biological materials or neurotrophic factors alone cannot replace the loss of neurons during spinal cord injury. Therefore, combined transplantation is the research direction of spinal cord injury treatment. However, due to the differences in the location of spinal cord injury, the tissue of injury and the nutritional requirements of its repair, the characteristics of various stem cells, tissue engineering scaffolds and neurotrophic factors are different. How to optimize the combination of the three is still a huge challenge.

Correlation between neck circumference and stable coronary artery disease: A cross-sectional study / 西安交通大学学报(医学版)

Objective To investigate the relationship between neck circumference and stable coronary artery disease (SCAD). Methods A total of 1638 patients who had undergone coronary angiography in our hospital from June 2016 to June 2018 were enrolled into this study and analyzed retrospectively. Of them, 756 patients were diagnosed with SCAD and 882 patients were diagnosed with non-CAD. We measured the patients' body fat indexes such as neck circumference and recorded their clinical data and biochemical examination results. The correlation between neck circumference and SCAD in male and female patients was compared by gender. Logistic regression was used to analyze the independent association between the four different neck circumference groups and the occurrence of SCAD. Results Individuals with greater length of neck circumference tended to have a significantly higher prevalence of SCAD in the males (P<0.001), but no significant difference in the female patients. Univariate logistic regression analysis suggested that the risk of SCAD increased gradually with the increase of neck circumference in the males. After adjustment by the factors, multivariate logistic regression analysis indicated that Q2 (OR=1.870, 95% CI: 1.200-2.915, P=0.006), Q3 (OR=1.978, 95% CI: 1.246-3.140, P=0.004) and Q4 (OR=2.299, 95% CI: 1.439-3.674, P<0.001) were associated with the occurrence of SCAD in the males. However, no significant difference was found between the different neck circumference and the occurrence of SCAD in the females. Conclusion The risk of SCAD increased gradually in men with an increased neck circumference. Men with neck circumference above 41.50 cm had the highest prevalence of SCAD. In women, neck circumference was not associated with the prevalence of SCAD.

Application of a modified paramedian lower lip-submandibular approach in maxillary (subtotal) total resection / 华西口腔医学杂志

OBJECTIVE@#To investigate the clinical efficacy of a modified paramedian lower lip-submandibular approach for maxillary (subtotal) total resection.@*METHODS@#Eleven patients of maxillary tumors underwent maxillary (subtotal) total resection through the modified paramedian lower lip-submandibular approach. Clinical follow-up visits were conducted to evaluate appearance restoration, facial nerve functional status, parotid gland functional status, and orbital region complication.@*RESULTS@#During the follow-up period of 6-36 months, the appearance of all 11 patients recovered well. All cases presented hidden scars. No facial nerve and parotid duct injury, lower eyelid edema, lower eyelid ectropion, or epiphora in all cases was observed.@*CONCLUSIONS@#Applying modified paramedian lower lip-submandibular approach to maxillary (subtotal) total resection effectively reduces incidence of orbital region complications including lower eyelid edema, lower eyelid ectropion, and epiphora, which often occur to traditional approach. The modified approach produces more subtle scars than other methods and should be applied to treatment of maxillary (subtotal) total resection.