Objective To study the locations, types and causes of different pseudoaneurysms in order to find out the optimal individualized treatment for different pseudoaneurysms. Methods Different methods were applied in treating 21 patients with pseudoaneurysm, which were located at limb (n = 11 ), spleen (n =3), kidney (n = 2) , common lilac artery (n = 1), internal iliac artery (n = 1), gallbladder (n = 1) and penis (n = 1 ). Different managements were employed in treating these pseudoaneurysms. Temporary obstruction of blood circulation with balloon together with arterial anastomosis or direct incision neoplasty was performed in 9 cases with pseudoaneurysms at limb arteries close to the larger joints. Endovascular stent graft was used to isolate the trunk type of pseudoaneurysm in 4 cases, in 2 of them branch arterial embolism and stent graft endovascular exclusion were applied as they had common iliae artery trunk type of pseudoaneurysm at the opening of internal iliac artery. Gelfoam together with metallic coils embolization was employed in 6 cases with terminal type of pseudoaneurysms. Results After different treatments, tumor cavities disappeared in the 21 cases with pseudoaneurysms. Distal arterial pulse returned to normal and no nerve damage occurred in 11 cases with limb pseudoaneurysms. No internal hemorrhage was observed and distal blood circulation returned to normal after graft endovascular exclusion in 2 eases with pseudoaneurysms at spleen artery trunk and in 2 cases with pseudoaneurysms at iliac artery trunk. In 6 cases with terminal type of pseudoaneurysms,the tumor cavity disappeared, hemorrhage stopped and no ischemic necrosis of organ occurred. But one of them with multiple traumatic pseudoaneurysms located at the second grade branch died one week after embolism due to a serious pelvic trauma accompanied with serious infection. Conclusion Based on the locations, types and causes of pseudoaneurysms, different individualized treatment should be adopted in order to obtain optimal results with least damages.

Objective To explore the effects of Yisui Jianpi Decoction combined with XELOX chemotherapy on immune function and gut microbiota in patients with colorectal cancer. Methods Eighty patients with colorectal cancer (CRC) were selected as the study subjects, and were randomly divided into control group (40 cases, XELOX chemotherapy) and observation group (40 cases, Yisui Jianpi Decoction based on the control group). The disease control rate, immune function indicators[CD3⁺, CD4⁺, CD8⁺, and CD4⁺-to-CD8⁺ratio(CD4⁺/CD8⁺)], tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and carbohydrate antigen 199 (CA199)], gut microbiota indicators (Lactobacillus, Bifidobacterium, Escherichia coli), and occurrence of adverse reactions were compared between the two groups. Results After treatment, the disease control rate in the observation group was 85.00% (34/40), which was obviously higher than 65.00% (26/40) in the control group (P < 0.05); after treatment, the number of T lymphocyte subsets CD3⁺, CD4⁺, CD4⁺/CD8⁺, the number of Lactobacillus and Bifidobacterium in the two groups obviously increased, and the observation group were higher than the control group (P < 0.05); after treatment, the levels of CD8⁺, CEA, CA125, CA199, and the number of Escherichia coli in both groups decreased, and the observation group was lower than the control group (P < 0.05). The total incidence of adverse reactions in the observation group was 17.50% (7/40), which was lower than 42.50% (17/40) in the control group (P < 0.05). Conclusion The combination of Yisui Jianpi Decoction and XELOX chemotherapy can improve the therapeutic effect of colorectal cancer, adjust the distribution of intestinal flora, improve immune function, and reduce incidence of adverse reactions.

Objective To clarify the incidence and survival of colorectal carcinoma (CRC) patients among permanent residents in Yangpu district of Shanghai,from 2002 to 2012.Methods Data of CRC patients in permanent residents of Yangpu district were collected from the database of the registration and management system in Shanghai city.Temporal trend in the incidence of CRC was analyzed by using Annual Percent Change (APC) model.Kaplan-Meier analysis with Log-rank testing was employed to estimate the survival.Incidence and mortality rates were standardized on age composition of standard population from 2000 nationwide census.Results A total of 5 881 CRC cases were diagnosed from 2002 to 2012 with crude incidence as 50.60/105 and standardized one as 31.21/105.The crude incidence rates of colon cancer and rectal cancer were 31.09/105 and 18.27/105,respectively and the standardized rates were 14.49/105 and 8.83/105,respectively.The incidence rates of colon cancer were not significantly different between different gender.However,the incidence of rectal cancer in males was significantly higher than in females (P＜0.001).The incidence rates of CRC significantly increased in the age group older than 50 years.However,the standardized incidence rate did not change significantly (APC=0.39).A total of 3 735 cases died of CRC in this period.The annual crude mortality of CRC was 31.35/105 with the standardized rate as 13.72/105.The mortality kept increasing significantly in the population older than 60 years.Mortality of rectal cancer was significantly higher in males than in females (P＜0.001).The 5-year survival rates in both colon cancer and rectal cancer patients were 48.88％ and 54.16％,respectively.Survivals were significantly higher in those who had received surgical treatments than in those without surgical treatments (colon cancer:58.10％ vs.37.22％,P＜0.001 ; rectal cancer:66.18％ vs.39.37％,P＜0.001).Conclusion Age seemed to have contributed to an increased morbidity and mortality of CRC in Yangpu district of Shanghai.The mortality of CRC appeared higher than the incidence.Surgical treatment could significantly prolong the survival of CRC patients.

Objective:To evaluate the effect of inhaled medication compliance intervention in elderly patients with chronic obstructive pulmonary disease (COPD) based on integrated theory of health behavior change.Methods:A total of 117 elderly COPD patients who visited Respiratory Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University from July to December 2021 were selected by the convenient sampling method. According to the random number table method, they were divided into the experimental group and the control group. 7 cases fell off during follow-up, and a total of 110 cases were finally included in the study, of which 55 cases were in the experimental group and 55 cases in the control group. The control group adopted the conventional health education method, while the experimental group adopted the intervention plan of inhalation medication compliance of elderly COPD patients based on the integrated theory of health behavior change. The accuracy of inhalation device use, inhalant medication compliance, forced expiratory volume in the first second (FEV 1) and Chronic Obstructive Pulmonary Diseases Assessment Test (CAT) scores were compared between the two groups before intervention and 3 months after intervention. Results:After 3 months of intervention, the inhalation device use accuracy, inhalation medication compliance in experimental group were higher than those in the control group, the score of CAT in experimental group was lower than that in the control group, the differences were statistically significant ( P<0.05). There was no statistically significant difference in FEV 1 between two groups ( P>0.05) . Conclusions:The intervention plan for inhalation medication compliance in elderly patients with chronic obstructive pulmonary disease based on the integrated theory of health behavior changes can improve their inhalation medication compliance and improve their quality of life.

OBJECTIVE：  To improve the method for the content determination of astragaloside Ⅳ in Xiangju granules， and to evaluate the consistency of relevant preparations with the components of original formulation， so as to provide evidence for the modern preparation of TCM compound. METHODS： HPLC-ELSD method was established for the content determination of astragaloside Ⅳ in Xiangju granules， and compared with original standard TLC scanning. Using critrinin， ferulic acid， calycosin glucoside， liquiritin， glycyrrhizic acid， rosmarinic acid， buddleoside and magnoline as control， HPLC method was used to determine the release components of self-made Xiangju granules， Xiangju capsules， Xiangju tablets in water. Fingerprint characteristics chromatogram of different Xiangju preparations and original formulation extract were compared by using Similarity Evaluation System for Chromatographic Fingerprint of TCM （2012 version）. At the same time， HPLC-ELSD method was used to determine and compare the release rate of astragaloside Ⅳ from different Xiangju preparations and original formulation extract in water. RESULTS： Established HPLC-ELSD method was specific. The linear range of astragaloside Ⅳ was 0.13-2.10 mg/mL. RSDs of precision， repeatability and stability tests were all lower than 3％ （n＝6）， and average recovery was 97.66％ （RSD＝1.01％，n＝6）. Average content of astragaloside Ⅳ by this method was 0.398 mg/g （RSD＝1.01％， n＝3）， which had better reproducibility than TLC scanning. The comparative results of characteristic fingerprints showed that the similarity among Xiangju granules， Xiangju capsules， Xiangju tablets and the original formulation dry extract powder was more than 0.850. Average release rates of astragaloside Ⅳ in Xiangju granules， Xiangju capsules， Xiangju tablets and the original formulation extract were 0.392， 0.358， 0.349， 0.389 mg， respectively. Compared with original formulation extract， there was no statistical significance in release rate of astragaloside Ⅳ in Xiangju granules （P＞0.05）， while there was statistical significance in Xiangju capsules and Xiangju tablets （P＜0.01）. CONCLU- SIONS： Established HPLC-ELSD method is accurate and feasible， and is suitable for the content determination of astragaloside Ⅳ in Xiangju granules. The main components of Xiangju granules are consistent with original formulation.

OBJECTIVE: To identify MARCO gene knockout mouse model by genotyping,sequencing and Western blotting.METHODS: A total of 16 base-knockout MARCO~(-/-)C57 BL/6 mice( 8 female and 8 male) were obtained by clustered regularly interspaced short palindromic repeats( CRISPR)/CRISPR associated protein 9( Cas9) technique with MARCO~(+/+)C57 BL/6 mice(8 female),and their offspring MARCO~(+/-)mice were obtained. Then MARCO~(+/-)mice were inter-crossed to get a sufficient number of MARCO~(-/-)homozygous mice. The genotypes of mice were identified by gene sequencing and the relative expression of MARCO protein was detected by Western blotting. RESULTS: After one year of breeding,a total of 5 generations were bred. There were 5 types of MARCO~(-/-)genotypes(-11,-25,-36,-46,-61 bp) stably inherited; MARCO~(-/-)∶ MARCO~(+/-)∶ MARCO~(+/+)= 1 ∶ 2 ∶ 1,which was consistent with Mendelian's law of heredity. Using MARCO(-11 bp) as an example,42 MARCO~(-/-)mice,92 MARCO~(+/-)mice and 48 MARCO~(+/+)mice were obtained from the 5 th generation( F5 generation); and there was no significant difference in body mass of the above 3 genotypes of F5 generation mice at the 4 th,the 6 th and the 8 th weeks after birth( P > 0. 05). The relative expression of MARCO protein in MARCO~(-/-)(-11 bp) and MARCO~(-/-)(-46 bp) mice was significantly down-regulated,compared with that of MARCO~(+/+),MARCO~(-/-)(-36 bp) and MARCO~(-/-)(-61 bp) mice(P < 0. 05). MARCO~(-/-)(-11 bp)and MARCO~(-/-)(-46 bp) mice were chosen as the MARCO gene knockout mice. CONCLUSION: MARCO gene knockout mice were successfully identified,which laid a foundation for further study on the role and regulatory mechanism of MARCO gene in silicotic fibrosis in mice.

Temporomandibular disorders (TMD) are a heterogeneous group of diseases that affect the temporomandibular joint, chewing muscle system, dental occlusion, and even various structures throughout the body, with significant characteristics of biological-psychological-social pattern. TMD related chronic pain, as the most important clinical symptom, can result in negative emotions seriously affecting patients′ quality of life and physical and mental health. Although a variety of therapies have been previously reported to treat TMD related chronic pain, there is a lack of widely recognized therapies. Professor Jason W Busse (from Michael G DeGroote National Pain Centre, McMaster University, Hamilton ON, Canada) took the lead and collaborated with multiple internationally renowned schools/hospitals of stomatology to develop an international consensus on the management of chronic pain associated with TMD, a clinical practice guideline, which took two years and was published in December 15th, 2023 in a global top journal of clinical research The British Medical Journal. This clinical practice guideline explored the comparative effectiveness of available therapies for chronic pain associated with TMD, conditionally recommended the specific intervention for different treatment or pain relief, proposed a comprehensive, agreed, and standardized clinical practice guideline. This present article describes the methodology and key elements of the clinical practice guideline to help clinicians fully understand and appropriately apply this guidance, which could provide the references for clinical practice of TMD associated chronic pain in China.

【Objective】 To study the effect of perioperative allogeneic blood transfusion on patients with oral squamous cell carcinoma (OSCC) after first-stage free flap transplantation. 【Methods】 A total of 306 OSCC patients who accepted primary repair and reconstruction using free flap admitted to our affiliation from January 2010 to January 2019 were selected as the research objects and retrospectively analyzed. According to their clinical data, they were divided into three groups: no transfusion group (n=98), 1-2 U transfusion group (n=131) and 3 + U transfusion group (n=77), respectively. The incidence of complications including flap infection, blood circulation disorder and hematoma in the three groups were compared. The five-year survival rate of the three groups was calculated by Kaplan-Meier analysis, and the relative risk of death was analyzed by Cox regression. 【Results】 There was no statistically significant difference among the three groups of patients (P>0.05) regarding such baseline data as embracing gender, age, primary location, degree of differentiation, adjuvant radiotherapy and chemotherapy. The complication rate of patients with 3 + U transfusion (25.97%) was significantly higher than that of no transfusion (6.12%) and 1-2 U transfusion (10.86%) (P<0.05); and the five-year survival rate of patients with 3 + U transfusion (51.95%) was significantly lower than that of no transfusion (69.38%) and 1-2 U transfusion (62.60%) (P<0.05). The results of univariate analysis showed that age, adjuvant radiotherapy, degree of tissue differentiation, collateral infiltration, vascular invasion and blood transfusion were all factors influencing the quality of prognosis after repair and reconstruction of first-stage free flap transplantation treating OSCC (P<0.05). The results of multivariate analysis showed that adjuvant chemoradiotherapy was an independent protective factor for the prognosis and survival quality of postoperative OSCC patients (P<0.01); the degree of differentiation, vascular invasion and blood transfusion were independent risk factors for the prognosis and survival quality of postoperative OSCC patients (P<0.05). 【Conclusion】 Perioperative allogeneic transfusion in OSCC patients can increase the risk of postoperative complications and directly affect their prognostic quality. It can be regarded as an important risk factor for OSCC patients.

Objective: To understand the prevalence of alcohol use and related factors in HIV positive and HIV negative males. Methods: Baseline data were from the prospective cohort study of comparative HIV and aging research in Taizhou of Zhejiang province from January to December, 2017. The information about alcohol use in the last month was collected through a face-to-face questionnaire interview. Participants were categorized into non-current drinkers, light/moderate drinkers and heavy drinkers according to the US National Institute on Alcoholism and Alcohol Abuse (NIAAA) standard. Results: A total of 1 367 HIV positive males and 2 418 HIV negative males were included. Current alcohol use rate (35.2%, 481/1 367) and heavy alcohol use rate (5.0%, 24/481) were significantly lower in HIV positive males than in HIV negative males (48.0%, 1 161/2 418; 23.5%, 273/1 161), but the proportion of drinking wine and yellow rice wine were significantly higher (21.8%, 105/481; 9.1%, 44/481) in HIV positive males than in HIV negative males (13.5%, 157/1 161; 5.8%, 67/1 161). The multivariate multinomial logistic regression analysis results showed that larger waist circumference, current smoking and regular physical exercise were associated with heavy alcohol use behavior in HIV positive males, and age ≥30 years, current smoking, regular physical exercise, higher score of depressive symptoms, heterosexual transmission route and baseline CD₄⁺T cells counts of 200-499 cells/μl were significantly associated with mild/moderate alcohol use behavior in HIV positive males. Conclusions The alcohol use rate was significantly lower in HIV positive males than in HIV negative males in Taizhou. It is important to strengthen intervention on alcohol drinking behavior and chronic disease risk factors, such as larger waist circumference, smoking and so on.

Objective: To understand the characteristics of sleep disorder in HIV positive and negative individuals, and compare the distributions and epidemiologic characteristic of different subtypes of sleep disorder between two groups. Methods: Baseline data were from the prospective cohort study of comparative HIV and aging research in Taizhou of Zhejiang province from January to December, 2017. A total of 459 HIV positive patients and 798 HIV negative controls with sleep disorders (Pittsburg Sleep Quality Index >5 or at least one question with answers of "most nights" or "every night" for Jenkins Sleep Scale) were included in the analysis. Cluster analysis was conducted to identify the different subtypes of sleep disorder based on 15 sleep-related questions. Results: A total of 1 257 participants were divided into three groups (clusters), i.e. difficulty falling asleep and sleep keeping group (cluster 1), the mild symptoms group (cluster 2), and restless night and daytime dysfunction group (cluster 3), accounting for 19.4% (89/459), 63.8% (293/459) and 16.8% (77/459) in HIV positive group and 13.8% (110/798), 60.5% (483/798) and 25.7% (205/798) in HIV negative group (χ²=16.62, P<0.001). In HIV positive group, the patients in cluster 1 and 3 were older and had higher frailty score, the patients in cluster 1 had highest level of depression, and the more patients in cluster 3 had low body weight or overweight (χ²=13.29, P=0.039; χ²=23.33, P<0.001; χ²=25.71, P<0.001; χ²=15.37, P=0.004). In HIV-negative group, similar findings were found for age, depressive symptoms and frailty score. In addition, the proportion of those who were illiteracy or with primary school education level was significantly high in cluster 1, and the proportion of abnormal waist-to-hip ratio was significantly higher in cluster 1 and 3 (χ²=30.59, P<0.001; χ²=11.61, P=0.003). Conclusions The proportion of every subtype of sleep disorder in HIV positive individuals were different to those in HIV negative individuals. Mental and physical health status were the main factors affecting the prevalence of sleep disorder. It is necessary to conduct targeted interventions to improve sleep quality.