ObjectiveTo explore the effect of the medical-community linkage model on activities of daily living, psychological status and motor function of stroke patients in the community. MethodsA total of 60 stroke patients admitted to two community health service centers and their affiliated stations in Fengtai District, Beijing, from January, 2024 to August, 2025 were enrolled and randomly divided into control group (n = 30) and intervention group (n = 30). The control group received routine medicine, dietary care and rehabilitation management, while the intervention group underwent rehabilitation with the medical-community linkage model, for twelve weeks. They were assessed with modified Barthel Index (MBI), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Fugl-Meyer Assessment (FMA) before and after intervention. ResultsAfter intervention, the MBI, HAMA, HAMD and FMA scores of patients improved in both groups (|t| > 5.599, P < 0.001), and improved more in the intervention group than in the control group (P < 0.05), except MBI. The HAMA and HAMD scores of family members decreased in both groups (|t| > 10.333, P < 0.001), and decreased more in the intervention group than in the control group (t > 5.681, P < 0.001). ConclusionThe medical-community linkage model can further improve the motor function of stroke patients in community, as well as the psychological status of both patients and their family members.

Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

Objective:To retrospectively analyze the changes in the proportion of refined lymphocyte subsets in peripheral blood of patients with Graves disease (GD), and their correlation with the clinical characteristics and efficacy of GD, and to explore the immunological pathogenesis of Graves disease for seeking new therapeutic targets.Methods:A total of 97 newly diagnosed GD patients (GD group), 27 patients after treatment (treatment group), and 31 healthy individuals (control group) who visited the Fifth Medical Center of the PLA General Hospital from 2018 to 2021 were included in this study. The data of refined lymphocyte subsets, thyroid function, blood routine and clinical treatment of the three groups were compared and analyzed. The t-test and rank sum test were used to compare the proportions of lymphocyte subsets among different groups, and Pearson correlation analysis was used to analyze the correlation between the proportions of lymphocyte subsets and thyroid function indicators.Results:The proportion of B cells in GD group was higher than that in the control group [16.2%(11.8%, 21.8%) vs 10.2%(8.1%,13.6%)], while the proportion of natural killer (NK) cells was lower [9.4%(4.9%, 13.6%) vs 14.6%(12.1%,18.8%)], and the differences were statistically significant ( P<0.05). Abnormal T cell differentiation: the proportions of functional cells, including activated T cells, memory T cells, clustering antigen(CD)4+memory T cells, Th1 cells, and Tc1 cells, were lower than that in the control group [3.2%(2.1%, 5.7%) vs 5.8%(3.0%, 9.3%), P<0.05; 36.7% (29.9%, 48.1%) vs 48.0%(39.2%,57.7%), P<0.05; 23.1%(17.4%, 30.1%) vs 28.9%(23.3%,34.6%), P<0.05; 16.4% (11.8%, 23.6%) vs 24.3%(16.9%,28.5%), P<0.05; 28.5% (14.7%, 39.2%) vs 46.3%(21.6%,69.2%), P<0.05]. The proportion of activated T cells in the treatment group was higher than that in the GD group [6.5% (4.6%, 13.6%) vs 3.2% (2.1%, 5.7%), P<0.05]. The total triiodothyronine results showed positive correlations with B cells ( r=0.356, P<0.01) and negative correlations with NK cells ( r=?0.416, P<0.01), while the total thyroxine values showed negative correlations with NK cells and activated T cells ( r=?0.318,?0.335; P<0.01). Thyroid stimulating hormone and CD8+initial T cells were positively correlated ( r=0.382, P<0.01). The proportion of B cells, cytotoxic T cells and suppressor T cells in CD8+cells of patients with complications [such as Graves orbitopathy (GO), thyroid toxic cardiomyopathy, etc.] was significantly different from that of the simple GD patients [18.3% (14.1%, 27.1%) vs 14.6% (10.8%, 21.4%), Z=2.54, P<0.05; 73.4%(65.6%,83.6%)vs 65.0%(50.3%,79.3%), Z=2.93, P<0.05; 26.6%(16.4%, 37.5%)vs 35.0%(20.7%,49.7%), Z=?2.74, P<0.05]. The proportion of suppressor T cells in GO patients was lower than that in non-GO patients [6.1% (3.4%, 8.1%) vs 8.5% (4.9%, 13.6%), Z=?3.20 P<0.05]. Conclusion:There are significant alterations in the circulating immune cells of GD patients, suggesting that immunological abnormalities play a crucial role in the onset and progression of the disease.

Objective:To investigate the efficacy of high-flux hemodialysis combined with hemoperfusion in patients with uremia.Methods:Eighty patients with uremia who received treatment at the Quzhou Hospital Affiliated to Wenzhou Medical University (Quzhou People's Hospital) from January 2020 to December 2022 were selected for this prospective randomized controlled trial. Participants were grouped using a random number table method, with 40 patients in the study group receiving high-flux hemodialysis combined with hemoperfusion, and 40 patients in the control group receiving high-flux hemodialysis alone. Toxicity clearance, calcium-phosphate metabolism, immune function, and vascular endothelial function were assessed using competitive enzyme-linked immunosorbent assay, immunofluorescence assay, fully automated biochemical analyzers, and immunoturbidimetric assay. The differences in toxicity clearance, calcium-phosphate metabolism, immune function, and vascular endothelial function were compared between the two groups.Results:Compared with before treatment, both groups showed a significant decrease in parathyroid hormone (PTH), blood creatinine, β 2-microglobulin, blood urea nitrogen, blood phosphorus, advanced glycation end products (AGEs), intercellular adhesion molecule-1 (ICAM-1), and homocysteine (Hcy) after treatment. Specifically, PTH levels decreased from (353.28 ± 50.26) ng/L to (235.26 ± 31.51) ng/L in the control group and from (357.17 ± 52.18) ng/L to (174.16 ± 26.35) ng/L in the study group; blood creatinine decreased from (969.47 ± 110.44) μmol/L to (511.57 ± 91.96) μmol/L in the control group and from (957.58 ± 121.99) μmol/L to (414.37 ± 87.41) μmol/L in the study group; β 2-microglobulin decreased from (40.27 ± 7.98) mg/L to (22.06 ± 3.26) mg/L in the control group and from (41.65 ± 8.40) mg/L to (17.70 ± 3.43) mg/L in the study group; blood urea nitrogen decreased from (30.64 ± 5.63) mmol/L to (14.02 ± 2.80) mmol/L in the control group and from (30.04 ± 5.90) mmol/L to (10.07 ± 1.94) mmol/L in the study group; blood phosphorus decreased from (2.23 ± 0.49) mmol/L to (1.80 ± 0.36) mmol/L in the control group and from (2.26 ± 0.53) mmol/L to (1.53 ± 0.31) mmol/L in the study group ; Hcy decreased from (35.87 ± 5.34) μmol/L to (30.93 ± 4.65) μmol/L in the control group and from (36.21 ± 5.27) μmol/L to (20.26 ± 4.53) μmol/L in the study group; ICAM-1 decreased from (574.96 ± 56.81) ng/L to (419.87 ± 40.76) ng/L in the control group and from (569.84 ± 52.37) ng/L to (384.51 ± 35.12) ng/L in the study group; AGEs levels decreased from (330.41 ± 43.69) mg/L to (297.64 ± 38.59) mg/L in the control group and from (326.98 ± 41.25) mg/L to (165.42 ± 15.74) mg/L in the study group. Conversely, compared with before treatment,blood calcium, immunoglobulin G, immunoglobulin M, immunoglobulin A, CD 4+, CD 4+/CD 8+ ratio, complement 3, and complement 4 all increased after treatment. Specifically, blood calcium increased from (1.90 ± 0.43) mmol/L to (2.27 ± 0.32) mmol/L in the control group and from (1.93 ± 0.46) mmol/L to (2.61 ± 0.36) mmol/L in the study group; IgG increased from (7.73 ± 1.56) g/L to (9.21 ± 2.04) g/L in the control group and from (7.82 ± 1.62) g/L to (10.7 ± 2.02) g/L in the study group; IgM increased from (0.42 ± 0.07) g/L to (1.29 ± 0.11) g/L in the control group and from (0.40 ± 0.08) g/L to (1.52 ± 0.08) g/L in the study group; IgA increased from (0.44 ± 0.16) g/L to (1.54 ± 0.25) g/L in the control group and from (0.48 ± 0.19) g/L to (1.93 ± 0.38) g/L in the study group; CD 4+ increased from (32.77 ± 5.71)% to (38.18 ± 4.92)% in the control group and from (32.11 ± 5.34)% to (46.07 ± 4.95)% in the study group; the CD 4+/CD 8+ ratio increased from (1.07 ± 0.14) to (1.29 ± 0.15) in the control group and from (1.07 ± 0.17) to (1.61 ± 0.26) in the study group; C3 increased from (0.80 ± 0.12) g/L to (1.01 ± 0.20) g/L in the control group and from (0.79 ± 0.14) g/L to (1.19 ± 0.23) g/L in the study group; and C4 increased from (0.32 ± 0.15) g/L to (0.67 ± 0.17) g/L in the control group and from (0.33 ± 0.14) g/L to (0.86 ± 0.12) g/L in the study group. All these differences were statistically significant between the two groups ( t = 12.01, 19.47, 33.98, 33.72, 17.64, 20.36, 22.75, 24.28, 19.25, 22.77, 4.71, 29.54, 32.01, 27.39, -5.06, -11.39, -4.79, -9.65, -61.55, -97.13, -36.63, -32.21, -7.71, -16.90, -5.78, -11.34, -9.21, -13.28, -13.25, -33.73, all P < 0.05). Additionally, when compared with the control group, the study group showed superior results ( t = -9.40, -4.84, -5.82, -7.33, -3.59, -10.40, -4.16, -20.07, 4.47, 3.28, 5.43, 7.14, 6.73, 3.73, 5.76, all P < 0.05). Conclusions:High-flux hemodialysis combined with hemoperfusion for the treatment of uremia can effectively improve calcium and phosphorus metabolism and vascular endothelial function, as well as enhance immune function and toxicity clearance rate.

OBJECTIVE To analyze the occurrence characteristics and risk factors of adverse drug reactions(ADR)of gemcitabine for injection in national centralized volume-based procurement(hereinafter referred to as"centralized procurement"),and provide reference for clinical safe drug use.METHODS A retrospective study was conducted to collect the relevant case reports of gemcitabine for injection reported to the National Adverse Drug Reaction Monitoring System by Inner Mongolia Autonomous Region from January 2022 to December 2023;basic information of patients,drug use status,patient outcomes,rational drug use and other information were collected,and the occurrence characteristics of ADRs with leukopenia,myelosuppression,neutropenia,thrombocytopenia and liver dysfunction were analyzed.Univariate analysis and multivariate Logistic regression were used to analyze the correlation of gender,age,combination of antitumor drugs,original malignant tumor and drug dose with ADR.RESULTS A total of 315 cases reports(315 patients)of gemcitabine-induced ADR were included in this study,with a male-to-female ratio of 1.42∶1 and age of(61.17±9.13)years.The primary malignant tumor was pancreatic cancer(73 cases,23.17%).Leukopenia,myelosuppression and nausea were the most common ADR,followed by neutropenia,thrombocytopenia,liver dysfunction and so on.The severity grade of ADR was mainly 1-2,and the outcome of most ADR was good.Multivariate Logistic regression analysis showed that combination of antitumor drugs was a risk factor for myelosuppression and neutropenia(RR=2.154,95%CI:1.218-3.807,P=0.008;RR=3.099,95%CI:1.240-7.744,P=0.016);gender(female)was a risk factor for leukopenia and liver dysfunction(RR=0.508,95%CI:0.302-0.853,P=0.010;RR=0.301,95%CI:0.102-0.887,P=0.029).In terms of drug use rationality,there were 143 cases(45.40%)of drug use in accordance with the indications of the label,and 172 cases(54.60%)of off-label drug use.Among them,the primary malignant tumors were bladder cancer,bile duct cancer and ovarian cancer,which ranked the top three off-label drug use.CONCLUSIONS The ADR caused by gemcitabine in Inner Mongolia is mainly in the blood and digestive systems.The severity of ADRs is mainly classified as 1-2 levels,and most ADRs have good outcomes.Gender(female)and combination medication are risk factors for gemcitabine-induced ADR.Appropriate chemotherapy regimen should be selected according to the patient's condition and physical condition,and ADR monitoring in blood and digestive systems should be strengthened during medication of gemcitabine.

Objective:To investigate the efficacy and safety of transurethral incision for the treatment of ureterocele in infants.Methods:A retrospective analysis of 28 cases of ureterocele admitted from March 2012 to May 2023 were reviewed, all of which were less than 1 year old, 16 male and 12 female, with an average age of(5.7±3.5)months. The ureterocele was located on the left side in 8 cases, on the right side in 15 cases, and bilaterally in 5 cases. There were 12 cases of single system ureterocele, of which 7 cases were unilateral and 5 cases were bilateral. Duplex system ureterocele was observed in 16 cases, all of which were unilateral. Clinical manifestations: urinary tract infection in 13 cases, 11 cases of ureterocele or hydronephrosis and ureteral dilation were found during antenatal examination, and 4 cases of ureterocele were found after birth. Urological ultrasound, intravenous pyelography(IVP) and voiding cystourethrography(VCUG) were performed in all children, and 17 cases underwent magnetic resonance urolography (MRU), and confirm the diagnosis of ureterocele preoperatively. All of the cases were performed the transurethral incision.The ureterocele was punctured and incised 1-2 mm at the base of the bulge, and 2-4 points were punctured according to the bulge atrophy. Bilateral ureteroceles were punctured and incised simultaneously. Postoperative urine routine test, urinary tract color ultrasound and VCUG were performed to determine if there is urinary tract infection, hydronephrosis, ureteral dilation and bulging, and whether a second surgery is needed.Results:All operations were conducted successfully. The intraoperative bleeding was less than 3 ml and no intraoperative complications. The operative time was (28.4±10.3) min. The median postoperative follow-up was 34 (32, 36) months. Six cases underwent postoperative VCUG examination. Eleven children were recovered well with single systemic ureterocele. One child developed grade Ⅳ vesicoureteral reflux(VUR)and combined with bladder diverticulum, and ureterocele underwent open diverticulotomy and ureteral reimplantation six months after surgery. Nine children were recovered well with duplex systemic ureterocele. Six cases of children developed infection, of which 2 cases had an infection once within one month after TUI, and the other four cases still had intermittent infections after six months and VCUG was performed, and one case showed grade Ⅲ VUR of the lower ureter, which was observed conservatively, while the other three cases had enlarged cysts but no VUR, and upper heminephrectomy was performed, and the patients recovered well after surgery. Except for these 6 exceptions, in another case, after ten years of follow-up, the ureterocele became larger but no VUR, and the results were good after a second transurethral incision. There was no significant difference in the postoperative infections, new VUR cases, and secondary surgeries between the two groups.Conclusions:Transurethral incision has good surgical effect on children with single system ureterocele and duplex system ureterocele, and has advantages of easy operation, less trauma, safety and effectiveness, and few complications. It deserves to be recommended as the treatment of choice, especially for infants and young children.

Objective:To retrospectively analyze the changes in the proportion of refined lymphocyte subsets in peripheral blood of patients with Graves disease (GD), and their correlation with the clinical characteristics and efficacy of GD, and to explore the immunological pathogenesis of Graves disease for seeking new therapeutic targets.Methods:A total of 97 newly diagnosed GD patients (GD group), 27 patients after treatment (treatment group), and 31 healthy individuals (control group) who visited the Fifth Medical Center of the PLA General Hospital from 2018 to 2021 were included in this study. The data of refined lymphocyte subsets, thyroid function, blood routine and clinical treatment of the three groups were compared and analyzed. The t-test and rank sum test were used to compare the proportions of lymphocyte subsets among different groups, and Pearson correlation analysis was used to analyze the correlation between the proportions of lymphocyte subsets and thyroid function indicators.Results:The proportion of B cells in GD group was higher than that in the control group [16.2%(11.8%, 21.8%) vs 10.2%(8.1%,13.6%)], while the proportion of natural killer (NK) cells was lower [9.4%(4.9%, 13.6%) vs 14.6%(12.1%,18.8%)], and the differences were statistically significant ( P<0.05). Abnormal T cell differentiation: the proportions of functional cells, including activated T cells, memory T cells, clustering antigen(CD)4+memory T cells, Th1 cells, and Tc1 cells, were lower than that in the control group [3.2%(2.1%, 5.7%) vs 5.8%(3.0%, 9.3%), P<0.05; 36.7% (29.9%, 48.1%) vs 48.0%(39.2%,57.7%), P<0.05; 23.1%(17.4%, 30.1%) vs 28.9%(23.3%,34.6%), P<0.05; 16.4% (11.8%, 23.6%) vs 24.3%(16.9%,28.5%), P<0.05; 28.5% (14.7%, 39.2%) vs 46.3%(21.6%,69.2%), P<0.05]. The proportion of activated T cells in the treatment group was higher than that in the GD group [6.5% (4.6%, 13.6%) vs 3.2% (2.1%, 5.7%), P<0.05]. The total triiodothyronine results showed positive correlations with B cells ( r=0.356, P<0.01) and negative correlations with NK cells ( r=?0.416, P<0.01), while the total thyroxine values showed negative correlations with NK cells and activated T cells ( r=?0.318,?0.335; P<0.01). Thyroid stimulating hormone and CD8+initial T cells were positively correlated ( r=0.382, P<0.01). The proportion of B cells, cytotoxic T cells and suppressor T cells in CD8+cells of patients with complications [such as Graves orbitopathy (GO), thyroid toxic cardiomyopathy, etc.] was significantly different from that of the simple GD patients [18.3% (14.1%, 27.1%) vs 14.6% (10.8%, 21.4%), Z=2.54, P<0.05; 73.4%(65.6%,83.6%)vs 65.0%(50.3%,79.3%), Z=2.93, P<0.05; 26.6%(16.4%, 37.5%)vs 35.0%(20.7%,49.7%), Z=?2.74, P<0.05]. The proportion of suppressor T cells in GO patients was lower than that in non-GO patients [6.1% (3.4%, 8.1%) vs 8.5% (4.9%, 13.6%), Z=?3.20 P<0.05]. Conclusion:There are significant alterations in the circulating immune cells of GD patients, suggesting that immunological abnormalities play a crucial role in the onset and progression of the disease.

Objective:To investigate the effects of warm compresses with Jianlou Decoction combined with aspirin enteric coated tablets on the function of autologous arteriovenous fistula (AVF) and hemodynamics in patients with uremia. Methods:A prospective study was conducted involving 90 patients with uremia who underwent AVF creation at Quzhou Hospital Affiliated to Wenzhou Medical University (Quzhou People's Hospital), from January 2018 to December 2023. The patients were randomly divided into a control group (45 patients receiving aspirin enteric coated tablets) and a study group (45 patients receiving warm compresses with Jianlou Decoction combined with aspirin enteric coated tablets). The internal diameter and blood flow of the fistula, vascular endothelial function, hemodynamics, the presence of vascular murmurs, elasticity, fistula patency and function, and the occurrence of complications were compared between the two groups. Results:After 1 month of treatment, the internal diameter of AVF increased in each group [study group: (6.69 ± 1.93) mm vs. (5.02 ± 1.56) mm; control group: (5.69 ± 1.78) mm vs. (4.93 ± 1.30) mm] compared with before treatment ( t = 8.29, 2.63, both P < 0.05). The blood flow of AVF increased in each group [study group: (530.49 ± 91.88) mL/min vs. (236.51 ± 21.84) mL/min; control group: (418.16 ± 53.87) mL/min vs. (242.36 ± 22.33) mL/min] compared with before treatment ( t = 23.85, 28.69, both P < 0.05). After 1 month of treatment, the internal diameter and blood flow of AVF in the study group were greater compared with those in the control group ( t = 2.55, 7.07, both P < 0.05). After 1 month of treatment, the levels of endothelin-1 in each group significantly decreased compared with before treatment [control group: (64.83 ± 11.80) μmol/L vs. (102.48 ± 16.60) μmol/L; study group: (49.48 ± 12.15) μmol/L vs. (104.60 ± 16.52) μmol/L] compared with before treatment ( t = -19.13, -23.51, both P < 0.05). The levels of nitric oxide [control group: (95.65 ± 14.87) ng/L vs. (78.56 ± 13.47) ng/L; study group: (86.36 ± 14.68) ng/L vs. (76.59 ± 13.56) ng/L], vascular diameter [control group: (7.20 ± 0.63) mm vs. (2.53 ± 0.50) mm; study group: (5.42 ± 0.66) mm vs. (2.47 ± 0.55) mm], vascular wall thickness [control group: (0.82 ± 0.05) mm vs. (0.28 ± 0.07) mm; study group: (0.60 ± 0.05) mm vs. (0.29 ± 0.10) mm], and blood flow [control group: (825.00 ± 65.00) mL/min vs. (314.84 ± 72.75) mL/min; study group: (623.71 ± 74.19) mL/min vs. (321.24 ± 71.62) mL/min] in each group significantly increased compared with before treatment ( t = 9.50, 4.99, 48.94, 26.89, 48.33, 22.11, 55.92, 29.50, all P < 0.05). Additionally, after 1 month of treatment, the levels of endothelin-1 in the study group were significantly lower than those in the control group ( t = 6.08, P < 0.05). The levels of nitric oxide, vascular diameter, vascular wall thickness, and blood flow in the study group were greater than those in the control group ( t = 2.98, 13.15, 21.99, 13.69, all P < 0.05). After 1 month of treatment, the shear stress of the radial artery in each group decreased significantly compared with before treatment [control group: (42.96 ± 6.54) dyne/cm2 vs. (47.62 ± 7.36) dyne/cm2; study group: (34.31 ± 6.71) dyne/cm2 vs. (46.71 ± 7.56) dyne/cm2, t = -13.30, -4.67, both P < 0.05]. The blood flow velocity at the venous end of the anastomosis significantly increased in both groups compared with pre-treatment levels [control group: (85.51 ± 8.48) cm/s vs. (74.60 ± 10.80) cm/s; study group: (119.18 ± 10.27) cm/s vs. (73.27 ± 10.37) cm/s, t = 35.92, 10.03, both P < 0.05]. The shear stress of the radial artery in the study group was lower ( t = -6.18, P < 0.05), while the blood flow velocity at the venous end of the anastomosis was higher ( t = 16.95, P < 0.05) compared with the control group. The incidence of vascular murmurs [11.11% (5/45) vs. 28.89% (13/45)] and the failure/reconstruction rate of the fistula [4.44% (2/45) vs. 24.44% (11/45)] were significantly lower compared with the control group ( Z = -2.10, -2.68, both P < 0.05). The rate of good vascular elasticity [93.33% (42/45) vs. 71.11% (32/45)] and the patency rate of the AVF [93.33% (42/45) vs. 73.33% (33/45) in the study group were significantly higher compared with the control group ( Z = 2.74, 2.53, both P < 0.05). The total incidence of complications in the study group was significantly higher than that in the control group [2.22% (1/45) vs. 20.00% (9/45), χ2 = 7.20, P < 0.05). Conclusions:Warm compresses with Jianlou Decoction combined with aspirin enteric coated tablets can increase the internal diameter and blood flow of AVF in patients with uremia, improve endothelial function and hemodynamics, reduce thrombus formation, enhance fistula function and patency rates, and decrease the incidence of fistula failure/reconstruction and complications.

Objective:To systematically and comprehensively retrieve studies on urethra care for patients with urinary catheter at home and abroad, so as to provide a reference for removing low-value care measures in the future.Methods:Arksey and O'?Malley scoping review method was used to systematically search the China National Knowledge Infrastructure, China Biology Medicine disc, WanFang Data, VIP, PubMed, Cochrane Library, CINAHL, Embase, and Web of Science. The search period was from database establishment to January 1, 2024. Literature was screened based on inclusion and exclusion criteria, and catheter care site, disinfection/cleaner type, frequency, institutional norms, and determinants were independently extracted by two researchers, where determinants were framed based on the theoretical domains framework.Results:A total of 21 papers were included. Urethra low-value care measures were reflected in the selection of nursing solutions that differed significantly from guideline recommendations and were inconsistently standardized across hospitals. Thirteen strategies were proposed to remove urethra low-value care measures. Factors that influenced the removal of low-value care behaviors included knowledge, reinforcement, environment and resources, social influences, personal roles and identities, outcome beliefs and memories, and attention and decision-making processes.Conclusions:Future researchers should further refine the evidence on urethra care and develop contextualized care for complex, multilevel healthcare settings to achieve continuous improvement and high quality care at low cost.

Objective:To study echinococcosis in the population and canine Echinococcus infection in Yushu City, Qinghai Province, and to explore the current epidemic situation and main transmission species of Echinococcus. Methods:In June 2023, a multi-stage sampling method was used to select 2 villages each in Shanglaxiu Township and Longbao Town, Yushu City, Qinghai Province. Each village included at least 100 permanent residents who had lived locally for at least 1 year and were 2 years old or older as the survey subjects. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum antibodies against Echinococcus larvae in the population, and B-mode ultrasound was used for abdominal organ scanning. Meanwhile, on the main roads of Shanglaxiu Township and Longbao Town, canine feces were collected in designated areas at intervals. ELISA was used to detect the antigen of canine fecal Echinococcus, and PCR was used to detect the types of parasites ( Echinococcus multilocularis, Echinococcus granulosus and Echinococcus shiquicus). Results:A total of 511 residents were investigated in Yushu City, and the positive rate of serum Echinococcus larvae antibodies in the population was 26.22% (134/511), and the detection rate of echinococcosis B-mode ultrasound was 1.37% (7/511). Among them, the detection rates of B-mode ultrasound for cystic echinococcosis (CE) and alveolar echinococcosis (AE) were 1.17% (6/511) and 0.20% (1/511), respectively. The positive rate of Echinococcus antigen in 543 canine feces detected by ELISA was 12.89% (70/543). PCR was used to test 497 canine feces, and the detection rate of Echinococcus was 3.02% (15/497). Among them, the detection rate of Echinococcus multilocularis was higher than that of Echinococcus granulosus [2.82% (14/497) vs 0.20% (1/497)], and the difference was statistically significant (χ 2 = 11.44, P < 0.001). No Echinococcus shiquicus was detected. Conclusions:The positive rates of Echinococcus larvae antibodies in the population and canine Echinococcus antigen in Yushu City, Qinghai Province are both relatively high. There is a mixed epidemic of CE and AE, with Echinococcus multilocularis being the main species.