Objective:To analyze the correlation between serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) and risk of all-cause death or cardiovascular disease (CVD) death among urban and rural elderly in Beijing.Methods:Based on the Beijing Healthy Aging Cohort Study, 9 022 participants with complete baseline data were enrolled, and their survival and death outcomes were followed up. Multivariable Cox proportional hazard regression model were used to analyze the associations between the UHR level and the risks of all-cause mortality and CVD mortality.Results:As of March 31, 2021, the median follow-up time M( Q1, Q3) was 6.18 (5.36, 6.75) years. There were 1 166 all-deaths, with a death density of 19.26 per 1 000 person-years, and 562 CVD deaths, with a death density of 9.28 per 1 000 person-years. After adjusting sociodemographic characteristics and lifestyle factors, multivariable Cox proportional hazard regression model showed that the risk of all-cause mortality increased by 3% ( HR=1.03, 95% CI: 1.02-1.04) and the risk of CVD mortality increased by 4% ( HR=1.04, 95% CI: 1.02-1.06) for every 1% increase in UHR. Compared with the T1 group of UHR tertiles, the T3 group had a 42% increase in the risk of all-cause death ( HR=1.42, 95% CI: 1.22-1.66) and a 53% increase in the risk of CVD death ( HR=1.53, 95% CI: 1.21-1.94). Conclusions:The UHR level is significantly associated with the risks of all-cause mortality and CVD mortality among urban and rural older adults in Beijing. The UHR level may be one of the potential predictors of death risk in community-dwelling older adults.

Objective To explore the application value of the"triple-low"(low radiation dose,low contrast medium and low con-trast flow rate)technique combined with the artificial intelligence iterative reconstruction(AIIR)in craniocervical computed tomo-graphy angiography(CTA).Methods Seventy patients undergoing head and neck CTA were prospectively enrolled and randomized into group A and group B,with 35 patients in each group.Group A was the"triple-low"technique group(80 kV,0.4 mL/kg,2.5 mL/s);group B was the control group(120 kV,0.7 mL/kg,5 mL/s).Group A images used AIIR and hybrid iterative reconstruction(HIR),and obtained group A1 and group A2;group B images used HIR.CT values,standard deviation(SD)values,signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR)at the level of the aortic arch,common carotid artery bifurcation,internal carotid artery segment C3 and middle cerebral artery segment M1 in the three groups of CTA images were measured and analyzed.The radiation dose and contrast medium were also compared.Two radiologists performed the double-blind evaluation of the image quality of differ-ent CTA segments in the three groups using a 5-point scale.Kappa analysis was used to analyze the compatibility of two people's scores.Results The radiation dose and contrast medium of group A were reduced by about 68.21%and 44.44%compared with those of group B,respectively.The differences were statistically significant(P<0.05).The SNR,CNR of group A1 were higher than those of group B and group A2,and the differences were statistically significant(P<0.05).The Kappa value of subjective score in group A1 was 0.688;the Kappa value of subjective score in group B was 0.499;the Kappa value of subjective score in group A2 was 0.571,which was in good agreement and statistically significant(P<0.05).Conclusion The"triple-low"technique combined with the AIIR in craniocervical CTA can significantly reduce the radi-ation dose and contrast medium.And its image quality is better than conventional scans which are reconstructed with HIR.

Raynaud syndrome is a clinical syndrome characterized by paroxysmal vasospasms of the acral small arteries,and its pathogenesis is closely associated with the dynamic imbalance of yin and yang as elucidated by the theory of"yang transforming qi and yin shaping up body."The theory of"yang transforming qi and yin shaping up body"originated in Huangdi Neijing,which is aimed at that yang can be tangible essence,blood,fluid,and other substances belonging to the yin into an invisible qi,promote the internal and external zang-fu organs and qi of the body's operation;yin qi is transformed into tangible substances under the gasification effect of yang qi to nourish the organism,to consolidate the essence of internal zang-fu organs,and to maintain the balance of yin and yang in the body.This study innovatively employs this theory to systematically elucidate the dynamic pathomechanism evolution of Raynaud syndrome:at the beginning of the disease,the ischemic stage is dominated by the deficiency of yang qi and the inability of qi to transform yin;then the disease enters into the hypoxic stage and the dilatation stage,which are mostly caused by the lack of yang depression,the blockage of qi,and the over-excessive formation of yin;and finally,the yang transforms qi too much and yin is damaged and weak,and then reaches the stage of complication.In Raynaud syndrome,the key mechanism and pathology of"yang transforming qi"and"yin shaping up body"as well as the stage of the disease should be clarified,so that yang qi can be used as the basis to make up for yang deficiency,yang depression can be stretched out,yin evils such as cold condensation,blood stasis and water dampness can be transformed,heat and toxin can be eliminated,yin fluids can be restored,and the extremities can be warmed up.The disease will be convalesced gradually.

Objective To explore the application value of the"triple-low"(low radiation dose,low contrast medium and low con-trast flow rate)technique combined with the artificial intelligence iterative reconstruction(AIIR)in craniocervical computed tomo-graphy angiography(CTA).Methods Seventy patients undergoing head and neck CTA were prospectively enrolled and randomized into group A and group B,with 35 patients in each group.Group A was the"triple-low"technique group(80 kV,0.4 mL/kg,2.5 mL/s);group B was the control group(120 kV,0.7 mL/kg,5 mL/s).Group A images used AIIR and hybrid iterative reconstruction(HIR),and obtained group A1 and group A2;group B images used HIR.CT values,standard deviation(SD)values,signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR)at the level of the aortic arch,common carotid artery bifurcation,internal carotid artery segment C3 and middle cerebral artery segment M1 in the three groups of CTA images were measured and analyzed.The radiation dose and contrast medium were also compared.Two radiologists performed the double-blind evaluation of the image quality of differ-ent CTA segments in the three groups using a 5-point scale.Kappa analysis was used to analyze the compatibility of two people's scores.Results The radiation dose and contrast medium of group A were reduced by about 68.21%and 44.44%compared with those of group B,respectively.The differences were statistically significant(P<0.05).The SNR,CNR of group A1 were higher than those of group B and group A2,and the differences were statistically significant(P<0.05).The Kappa value of subjective score in group A1 was 0.688;the Kappa value of subjective score in group B was 0.499;the Kappa value of subjective score in group A2 was 0.571,which was in good agreement and statistically significant(P<0.05).Conclusion The"triple-low"technique combined with the AIIR in craniocervical CTA can significantly reduce the radi-ation dose and contrast medium.And its image quality is better than conventional scans which are reconstructed with HIR.

Objective:To analyze the correlation between serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) and risk of all-cause death or cardiovascular disease (CVD) death among urban and rural elderly in Beijing.Methods:Based on the Beijing Healthy Aging Cohort Study, 9 022 participants with complete baseline data were enrolled, and their survival and death outcomes were followed up. Multivariable Cox proportional hazard regression model were used to analyze the associations between the UHR level and the risks of all-cause mortality and CVD mortality.Results:As of March 31, 2021, the median follow-up time M( Q1, Q3) was 6.18 (5.36, 6.75) years. There were 1 166 all-deaths, with a death density of 19.26 per 1 000 person-years, and 562 CVD deaths, with a death density of 9.28 per 1 000 person-years. After adjusting sociodemographic characteristics and lifestyle factors, multivariable Cox proportional hazard regression model showed that the risk of all-cause mortality increased by 3% ( HR=1.03, 95% CI: 1.02-1.04) and the risk of CVD mortality increased by 4% ( HR=1.04, 95% CI: 1.02-1.06) for every 1% increase in UHR. Compared with the T1 group of UHR tertiles, the T3 group had a 42% increase in the risk of all-cause death ( HR=1.42, 95% CI: 1.22-1.66) and a 53% increase in the risk of CVD death ( HR=1.53, 95% CI: 1.21-1.94). Conclusions:The UHR level is significantly associated with the risks of all-cause mortality and CVD mortality among urban and rural older adults in Beijing. The UHR level may be one of the potential predictors of death risk in community-dwelling older adults.

Raynaud syndrome is a clinical syndrome characterized by paroxysmal vasospasms of the acral small arteries,and its pathogenesis is closely associated with the dynamic imbalance of yin and yang as elucidated by the theory of"yang transforming qi and yin shaping up body."The theory of"yang transforming qi and yin shaping up body"originated in Huangdi Neijing,which is aimed at that yang can be tangible essence,blood,fluid,and other substances belonging to the yin into an invisible qi,promote the internal and external zang-fu organs and qi of the body's operation;yin qi is transformed into tangible substances under the gasification effect of yang qi to nourish the organism,to consolidate the essence of internal zang-fu organs,and to maintain the balance of yin and yang in the body.This study innovatively employs this theory to systematically elucidate the dynamic pathomechanism evolution of Raynaud syndrome:at the beginning of the disease,the ischemic stage is dominated by the deficiency of yang qi and the inability of qi to transform yin;then the disease enters into the hypoxic stage and the dilatation stage,which are mostly caused by the lack of yang depression,the blockage of qi,and the over-excessive formation of yin;and finally,the yang transforms qi too much and yin is damaged and weak,and then reaches the stage of complication.In Raynaud syndrome,the key mechanism and pathology of"yang transforming qi"and"yin shaping up body"as well as the stage of the disease should be clarified,so that yang qi can be used as the basis to make up for yang deficiency,yang depression can be stretched out,yin evils such as cold condensation,blood stasis and water dampness can be transformed,heat and toxin can be eliminated,yin fluids can be restored,and the extremities can be warmed up.The disease will be convalesced gradually.

ObjectiveTo investigate the effect and mechanism of Biejiajian Wan on liver fibrosis by regulating the polarization of macrophages. MethodRaw264.7 cells were cultured in vitro by serum pharmacological method， and the hypoxia model of RAW264.7 cells was established by stimulating RAW264.7 cells with cobalt chloride （CoCl₂）. The cells were randomly divided into blank group， CoCl₂ hypoxia model group （200 mmol·L^-1）， Biejiajian Wan low-dose group （200 mmol·L^-1+0.55 g·kg^-1 Fuzheng Quyu capsules）， medium-dose group （200 mmol·L^-1+1.1 g·kg^-1 Biejiajian Wan）， and high-dose group （200 mmol·L^-1+2.2 g·kg^-1 Biejiajian Wan） and Fuzheng Quyu capsule group （200 mmol·L^-1+0.56 g·kg^-1 Biejiajian Wan）. Cell proliferation was detected by cell counting kit-8 （CCK-8）， and the gene expression of hypoxia inducible factor-1α （HIF-1α）， interleukin-1β （IL-1β） and interleukin-6 （IL-6） in macrophages was detected by real time fluorescence quantitative polymerase chain reaction （Real-time PCR）. The expression of macrophage polarization-related protein and HIF-1α/nuclear factor-kappa B （NF-κB） signaling pathway-related protein was tested by Western blot， and the distribution and expression of NF-κB signaling pathway-related protein and HIF-1α were determined by cell immunofluorescence. ResultCompared with the conditions in the blank group， the proliferation of RAW264.7 cells was inhibited after CoCl₂ stimulation for 24 hours （P<0.05）， the mRNA expression of HIF-1α， IL-1β and IL-6 in the model group were increased （P<0.05）， the protein expression of HIF-1α and M1 macrophage phenotypic proteins IL-6 and tumor necrosis factor-α （TNF-α） was boosted while that of M2 macrophage phenotypic protein interleukin-10 （IL-10） was reduced （P<0.05）， the protein expression of NF-κB p65， phosphorylation （p）-NF-κB p65， phosphorylated NF-κB inhibits protein kinase α/β （p-IKKα/β） and phosphorylated NF-κB inhibits protein α (p-IκBα） was elevated （P<0.05）， the nuclear expression of HIF-1α and NF-κB p65 was promoted. Compared with the conditions in the model group， after 24 hours of treatment with corresponding drug-containing serum， each treatment group promoted the proliferation of RAW264.7 cells （P<0.05）， the mRNA expression levels of HIF-1α， IL-1β and IL-6 in macrophages were reduced （P<0.05）， the protein expression of HIF-1α， IL-6 and TNF-α was decreased， while that of CD163 and IL-10 was increased （P<0.05）， the protein expression of NF-κB p65， p-NF-κB p65， p-IKKα/β and p-IκBα was lowered （P<0.05）， the nuclear expression of HIF-1α and NF-κB p65 was inhibited. ConclusionBiejiajian Wan could modulate the polarization of macrophages， attenuate the injury of macrophage-associated inflammatory response under hypoxia， and thus delay the progression of liver fibrosis， which might be related to its regulation of HIF-1α/NF-κB signaling pathway.

Objective:To study the use of the da Vinci robot in distal pancreatectomy.Methods:The data of 53 patients who underwent minimally invasive distal pancreatectomy at the Department of General Surgery of the Affiliated Hospital of Xuzhou Medical University from February 2017 to March 2022 were retrospectively analysed. There were 16 males and 37 females, aged (48.2±16.9) years. These patients were divided into the robot assisted pancreatectomy group (the robot group, n=18) and the laparoscopic pancreatectomy group (the laparoscopic group, n=35) based on the surgical treatment methods. The operations were performed by the same team of surgeons. All patients were diagnosed to have benign or borderline malignant tumors of body and tail of pancreas by preoperative examinations. The success rate of spleen preservation distal pancreatectomy, operation time, intraoperative bleeding, and postoperative complications (including pancreatic fistula, postoperative bleeding, abdominal infection) were compared between the two groups. Results:Spleen preserving distal pancreatectomy was successfully carried out in 13 patients (72.2%) in the robot group and 15 patients (42.9%) in the laparoscopic group. The rate of spleen preservation in the robot group was significantly higher than that in the laparoscopic group (χ 2=4.11, P=0.043). Intraoperative blood loss (104.4±69.3) ml and time to first postoperative passage of flatus were (3.7±1.0) d in the robot group were significantly better than the laparoscopic group (199.4±102.9) ml and (4.8±1.3) d, respectively (both P<0.05). The total incidence of complications in the robot group was 7 cases (38.9%), compared with 14 cases (40.0%) in the laparoscopic group, with no significant difference between the two groups(χ 2=0.006, P=0.938). Conclusions:Robotic-assisted distal pancreatectomy was safe and feasible, and it had advantages in resulting in better spleen preservation than laparoscopic distal pancreatectomy.

A 62-year-old female osteoporosis patient received alendronate sodium 70 mg orally once a week (taking the drug 30 minutes before breakfast with plenty of water and keeping upright during and after taking drug for a while). After taking the drug for 3 times, the patient developed retrosternal pain on swallowing with occasional acid aversion and epigastric dull pain. Gastroscopy showed multiple shallow ulcers, with yellow and white fur on the surface, in the esophagus 20 cm to 37 cm from the incisors. Esophagitis was considered, which might be related to alendronate sodium. Alendronate was stopped, and the treatments of acid suppression, mucosal repair, proper rehydration, and total liquid intake were given. Two days later, the stabbing pain behind the sternum was relieved; 7 days later, the pain was obviously relieved and symptoms of the acid aversion and epigastric dull pain disappeared; 1 month later, the retrosternal pain on swallowing disappeared.

A 62-year-old female osteoporosis patient received alendronate sodium 70 mg orally once a week (taking the drug 30 minutes before breakfast with plenty of water and keeping upright during and after taking drug for a while). After taking the drug for 3 times, the patient developed retrosternal pain on swallowing with occasional acid aversion and epigastric dull pain. Gastroscopy showed multiple shallow ulcers, with yellow and white fur on the surface, in the esophagus 20 cm to 37 cm from the incisors. Esophagitis was considered, which might be related to alendronate sodium. Alendronate was stopped, and the treatments of acid suppression, mucosal repair, proper rehydration, and total liquid intake were given. Two days later, the stabbing pain behind the sternum was relieved; 7 days later, the pain was obviously relieved and symptoms of the acid aversion and epigastric dull pain disappeared; 1 month later, the retrosternal pain on swallowing disappeared.