Objective To investigate indications,pacing modes,pacing parameters and postoperative complications of pacemaker implantation for patients aged 80 years or over.Methods Patients were recruited on a continuous basis and were assigned into two groups,with 112 patients in the very elderly (80-90 years old) group and 484 patients in the elderly (60-79 years old) group,which served as the control.Follow-up observations with the two groups were conducted concerning indications,mode selection,pacing parameters and postoperative complications.Results Compared with the control group,the very elderly group showed:1) a higher rate of coronary heart disease (58cases vs.163 cases or 51.8％ vs.33.7％ ; x2 =12.78,P＜0.01) ; 2) more single-chamber pacemaker implantations (63 cases vs.217 cases or 56.3％ vs.44.8％; x2=4.76,P＜0.05) and fewer dual-or multi-chamber pacemaker implantations (49 cases vs.267 cases or 43.8％ vs.55.2％ ; x2 =4.76,P＜0.05) ; 3) a higher rate of double bundles branch block (19 cases vs.31 cases or 17.0％ vs.6.4％ ; x2=13.20,P＜0.01); 4) a higher rate of postoperative acute cerebral infarction (x2 =8.34,P＜0.01) ; and 5) increased ventricular [(0.78±0.24)V vs.(0.55±0.16)V,P＜0.05]and atrial [(1.07±0.22)V vs.(0.84±0.28)V,P＜0.05]pacing thresholds.Conclusions Special considerations should be made when pacemaker implantation is planned for patients aged 80 or over.Pacemaker selection decisions ought to be based on a comprehensive evaluation of relevant clinical situations so that clinical benefits can be maximized.

Objective: To investigate the epidemiological characteristics of rabies-exposed populations in Anji County, Zhejiang Province from 2017 to 2021, so as to provide insights into rabies control in the county. Methods: All data pertaining to rabies were captured from Monthly Report of Rabies-exposed Populations in Huzhou City and Investigation Form of Multiple Dog Injuries reported by dog injury clinics in Anji County from 2017 to 2021, and the species of animals causing dog injuries, duration, degree and site of exposure, and post-exposure treatment of rabies-exposed populations were descriptively analyzed. Results: Totally 46 186 cases with rabies exposure were reported in dog injury clinics in Anji County from 2017 to 2021, and the rate of exposure appeared a tendency towards a decline year by year (Z=-23.249, P<0.001), with an annual mean exposure rate of 1 739.59/105. The number of cases with exposure to rabies peaked in July and August (10 066 cases, 21.79%). Dogs were predominant animals causing injuries (31 732 cases, 68.70%), and the rate of exposure to dog bites appeared a tendency towards a decline year by year (Z=-35.541, P<0.001). There were 11 350 cases with cat-causing injuries (24.57%), and the rate of exposure to cat bites appeared a tendency towards a rise (Z=14.834, P<0.001). Lower extremity was the main site of exposure (22 364 cases, 48.42%), and the proportions of grade Ⅱ and Ⅲ exposure to rabies were 72.85% and 25.23%, the rates of exposure both appeared a tendency towards a decline (Z=-14.522, P<0.001; Z=-21.820, P<0.001). The proportion of using human rabies immune globulin was 25.72% among populations with grade Ⅲ exposure, which appeared a tendency towards a rise (Z=6.636, P<0.001). Conclusions The rate of exposure to rabies appeared a tendency towards a decline in Anji County from 2017 to 2021. Dogs were predominant animals causing injuries, and the rate of cat bites appeared a tendency towards a rise from 2017 to 2021; however, the proportion of using human rabies immune globulin remains to be improved among populations with grade Ⅲ exposure.

Objective To visualize and analyze the studies on spleen-strengthening and dampness-expelling method for treating skin diseases in the past 20 years by using CiteSpace 6.3.R1 software,and to understand current status and hot spots of research on spleen-strengthening and dampness-expelling method for treating skin diseases,so as to provide reference for the treatment and research of skin diseases. Methods Literatures on the spleen-strengthening and dampness-expelling method for skin disease treatment,which were published from January 1,2004 to June 1,2024,were retrieved from China National Knowledge Network Infrustruction. Then,CiteSpace 6.3.R1 software was adopted to visualize the authors,distribution of research institutes,and keywords. Results A total of 1326 valid papers were included,and there was an overall increase in literature publication. The author with the largest number of publications was Liu Hongxia (31 papers) and Lu Chuanjian (11 papers),the institution with the largest number of publications was Beijing University of Traditional Chinese Medicine(66 papers),followed by Guangzhou University of Chinese Medicine (62 papers). In the keyword analysis,the current hot keywords in this field are Wuling San,external treatment method,treatment from the spleen,spleen deficiency and dampness accumulation,etc. The research hot spots in the literature mainly include the experience of famous doctors,the law of medication and the research on the mechanism of action,and the frontier trends mainly include the mechanism of action,inflammatory factors,and the same treatment of heterogeneous diseases. Conclusion The method of spleen-strengthening and dampness-expelling is an important rule of traditional Chinese medicine in treating dermatological diseases. The main research content in recent 20 years is clinical observation,experience of famous doctors and mechanism of action. The mechanism of action,inflammatory factors,and heterogeneity of the same treatment are the hot spots of the research. The multi-disciplinary integration may be future research direction. However,there are currently few core authors and institutions involved in the research,and the cooperation between regions needs to be strengthened.

Objective To observe the effect and mechanism of fibroblast growth factor 21 (FGF21) on rat vascular smooth muscle cells (VSMCs) calcification in vitro.Methods VSMCs was treated with calcification medium containing calcium chloride and β-glycerophosphate to induce rat VSMCs calcification in vitro.VSMCs were divided into 5 groups: the control group (cultured in normal medium), the calcification group (incubated in calcified medium), the FGF21 group (cultured in calcified medium and FGF21), the PD166866 group (cultured in calcified medium and FGF21 and PD166866, inhibitor of fibroblast growth factor receptor-1 (FGFR1)), the GW9662 group (cultured in calcified medium and FGF21 and GW9662, inhibitor of peroxisome proliferators activated receptor-γ (PPAR-γ)).The calcification of VSMCs was detected by calcium content, alkaline phosphatase activity and alizarin red staining.The protein and mRNA expression of FGFR1, β-Klotho, osteocalcin and smooth muscle 22α (SM22α) were determined by western blot analysis and realtime-PCR, respectively.Results (1) The mRNA (P ＜ 0.01) and protein expressions of β-Klotho and FGFR1 were significantly downregulated in calcification group compared with control group (P ＜ 0.05 or 0.01).(2)The protein levels and mRNA expression of calcium content, alkaline phosphatase activity and osteocalcin were significantly downregulated, while the protein levels and mRNA of SM22α were significantly increased in FGF21 group compared with calcification group (all P ＜ 0.05).Moreover, alizarin red staining verified positive red nodules on calcified VSMCs was significantly reduced in FGF21 group than in calcification group.(3)Calcium content, alkaline phosphatase activity and alizarin red staining were similar between PD166866 group and calcification group (all P ＞ 0.05).(4) Calcium content, alkaline phosphatase activity and alizarin red staining were similar between GW9662 group and calcification group (all P ＞ 0.05).Conclusion The inhibition of VSMCs calcification by FGF21 is mediated by further downregulating FGFR1 and β-Klotho while activating PPAR-γpathways.