Objective: To establish a progressive research strategy for “colonic components analysis - efficacy verification and mechanism exploration - gut microbiota”, screen pharmacodynamic substances, and investigate their mechanism via gut microbiota. Methods: The pharmacodynamics of Gegen Qinlian decoction (GQD) were assessed using a mouse model of dextran sulfate sodium-induced ulcerative colitis (UC). Ultra-performance liquid chromatography-quadrupole-orbitrap mass spectrometer was used to identify the prototype and metabolic components of GQD in the colon during UC. To analyze the structure and function of characteristic genera of GQD and its active components, 16S rRNA sequencing was performed. Results: We identified 67 prototypic and 14 metabolic components of GQD in the UC colon. The primary prototype components are flavonoids and alkaloids, including puerarin (PUE), baicalin (BAI), and berberine (BER). The metabolism was predominantly sulfonation. Efficacy verification showed that the main active components, puerarin, baicalin, and berberine, had good therapeutic effects on UC. The results of 16S rRNA gene sequencing showed that GQD improved UC by regulating the structure and function of the gut microbiota. The abundance of gut microbiota involved in the metabolism of the prototype components was influenced by the corresponding components. The function prediction results showed that PUE was the most comparable to GQD, with 24 consistent pathways. BAI and BER showed comparable gut microbiota regulation pathways. Characteristic pathways of BER include glucometabolic processes. Conclusion This study focused on the key issues in the gut microbiota pathway and developed a progressive research strategy to understand the transformation mechanisms of colonic components. This research systematically analyzed the active components and metabolic transformation of GQD in the colon during the pathological state of UC, as well as changes in the structure and function of the gut microbiota, clarified the mechanism of GQD and its active components in improving UC via the gut microbiota pathway.

Objective:To explore the prognosis efficacy of psycho-cardiological therapy and management on patients with coronary atherosclerosis disease (CAD).Methods:This was a clinical randomized controlled study. This study included inpatients with CAD at the cardiology department in Beijing Anzhen Hospital, Capital Medical University from August 2021 to January 2024. The patients enrolled in this study were asked for basic information, and received measurements for depression, anxiety, sleep quality and living quality by the scales of Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder scale-7 (GAD-7), Athens Insomnia Scale (AIS), EuroQol 5-dimension 5-level (EQ-5D-5L) respectively. The patients were randomly grouped into a regular treatment group and a psycho-cardiological treatment group which included WeChat management or antidepressant/antianxiety medical therapy according to the situation. After the patients discharging from hospital for 2, 4, 12, 24, 48, 72, and 96 weeks, professional cardiovascular doctors would follow up by telephone, WeChat, and outpatient department, including scales (2-48 weeks), and cardiac events (2-96 weeks). Kaplan-Meier survival curve and multivariate Cox proportional hazards model were used for analyzing the association between psycho-cardiological treatment and cardiac events.Results:This study recruited a total of 552 patients with CAD, aged 61.0(54.0, 67.0) years, and 379 (68.7%) were male. There were 279(50.5%) in the regular treatment group and 273(49.5%) in the psycho-cardiological treatment group. After treatment for 4, 12 and 48 weeks, the PHQ-9 score in psycho-cardiological was significantly lower than the regular treatment group; After treatment for 12 weeks, the EQ-5D-5L effective value in psycho-cardiological group was higher than the regular treatment group; After treatment for 2, 4, 12, 24 and 48 weeks, the EQ-5D-5L VAS score in psycho-cardiological group was higher than the regular therapy group (all P<0.05). The Kaplan-Meier survival curve showed that, during the different follow-up periods, the rate of cardiac events in psycho-cardiological treatment group was lower than regular treatment group (log-rank P<0.001). The multivariate Cox proportional hazards model adjusted the factor of age, the psycho-cardiological treatment contributed to reducing the cardiac events rate by 80.3% ( HR=0.197, 95% CI: 0.067-0.582, P=0.003). Conclusion:Psycho-cardiological treatment is beneficial for improving psychological stress, living quality, and reducing cardiac events, and helps to improve prognosis and psycho-cardiological rehabilitation in CAD patients.

Objective To explore the incidence and risk factors of futile recanalization after in-travascular therapy in patients with acute anterior circulation occlusion.Methods Clinical materials of 176 patients with acute anterior circulation occlusion in the registration system of the Stroke Center of the Affiliated Hospital of Nantong University from August 2015 to December 2021 were retrospec-tively analyzed.All the patients received intravascular therapy to successfully achieve angiographic re-canalization[grade of modified thrombolysis in cerebral infarction(mTICI)≥2b],and were divided into futile recanalization group[score of modified Rankin Scale(mRS)was 3 to 6 points]and effec-tive recanalization group(mRS score was 0 to 2 points)based on functional independence at 90 days after surgery.Logistic regression analysis was used to identify predictors of futile recanalization after intravascular treatment.Results In the 176 patients,93 patients had futile recanalization,and 83 patients had effective recanalization.There were significant differences in age,gender,atrial fibrilla-tion,score of the National Institute of Health Stroke Scale(NIHSS)on hospital admission,ischemic time,bridging treatment and hemorrhagic transformation between the futile recanalization group and the effective recanalization group(P＜0.05).Multivariate Logistic regression analysis showed that high NIHSS score on hospital admission(OR=0.815,95％CI,0.760 to 0.874,P＜0.001)and ischemic time(OR=1.232,95％CI,1.020 to 1.488,P=0.030)were the independent predictors of futile recanalization.Conclusion The incidence of futile recanalization after intravascular treat-ment is relatively high in patients with acute anterior circulation occlusion,while age,gender,atrial fibrillation,high NIHSS score on hospital admission,ischemic time,bridging treatment and hemor-rhagic transformation are the risk factors for futile recanalization after intravascular treatment in AIS patients,and high NIHSS score on hospital admission and ischemic time are the independent predic-tive factors for futile recanalization after intravascular treatment in AIS patients.

Objective To explore the incidence and risk factors of futile recanalization after in-travascular therapy in patients with acute anterior circulation occlusion.Methods Clinical materials of 176 patients with acute anterior circulation occlusion in the registration system of the Stroke Center of the Affiliated Hospital of Nantong University from August 2015 to December 2021 were retrospec-tively analyzed.All the patients received intravascular therapy to successfully achieve angiographic re-canalization[grade of modified thrombolysis in cerebral infarction(mTICI)≥2b],and were divided into futile recanalization group[score of modified Rankin Scale(mRS)was 3 to 6 points]and effec-tive recanalization group(mRS score was 0 to 2 points)based on functional independence at 90 days after surgery.Logistic regression analysis was used to identify predictors of futile recanalization after intravascular treatment.Results In the 176 patients,93 patients had futile recanalization,and 83 patients had effective recanalization.There were significant differences in age,gender,atrial fibrilla-tion,score of the National Institute of Health Stroke Scale(NIHSS)on hospital admission,ischemic time,bridging treatment and hemorrhagic transformation between the futile recanalization group and the effective recanalization group(P＜0.05).Multivariate Logistic regression analysis showed that high NIHSS score on hospital admission(OR=0.815,95％CI,0.760 to 0.874,P＜0.001)and ischemic time(OR=1.232,95％CI,1.020 to 1.488,P=0.030)were the independent predictors of futile recanalization.Conclusion The incidence of futile recanalization after intravascular treat-ment is relatively high in patients with acute anterior circulation occlusion,while age,gender,atrial fibrillation,high NIHSS score on hospital admission,ischemic time,bridging treatment and hemor-rhagic transformation are the risk factors for futile recanalization after intravascular treatment in AIS patients,and high NIHSS score on hospital admission and ischemic time are the independent predic-tive factors for futile recanalization after intravascular treatment in AIS patients.

Objective: To investigate the spatio-temporal distribution characteristics of pulmonary tuberculosis in Ningbo City from 2015 to 2020, so as to provide insights into tuberculosis control. Methods: The data of pulmonary tuberculosis cases in Ningbo City from 2015 to 2020 were collected from Tuberculosis Management Information System of China Disease Control and Prevention Information System, and were linked with the geographic information database of Ningbo Planning Design and Research Institute. The software SaTScan version 10.3 was employed for monthly spatio-temporal scanning and cluster analysis of reported pulmonary tuberculosis cases, populations, longitude and latitude in 153 townships of Ningbo City from 2015 to 2020. Results: There were one class Ⅰ cluster and two class Ⅱ clusters of pulmonary tuberculosis cases in Ningbo City from 2015 to 2020, and the class Ⅰ cluster was centered in Song'ao Township and covered 37 townships, with aggregation time from January 1, 2015 to December 31, 2017, while class Ⅱ clusters were covered 38 tounships which were centered in Sanqishi Township of Yuyao County, and one township in Hangzhou Bay New Town. The aggregation time was from January to June in 2015 and 2016, from March to August between 2017 and 2019 and between May and October, 2020. The overall reported incidence of pulmonary tuberculosis appeared a tendency towards a decline in each township of Ningbo City from 2015 to 2020; however, the incidence of pulmonary tuberculosis was more than 80 per 100 thousand in Fuming Township of Yinzhou District and Juexi Township of Xiangshan County in 2020. Conclusions There were significant spatio-temporal clustering characteristics of pulmonary tuberculosis incidence at a township level in Ningbo City from 2015 to 2020, and the clusters were mainly concentrated in the central and eastern Ningbo City. The reported incidence of pulmonary tuberculosis is high in Fuming Township of Yinzhou District and Juexi Township of Xiangshan County, where targeted regional tuberculosis control strategies should be implemented.

Objective: To investigate the epidemiological characteristics of pulmonary tuberculosis in Ningbo City from 2011 to 2020, so as to provide the evidence for developing the control measures of pulmonary tuberculosis. Methods: The data pertaining to pulmonary tuberculosis cases in Ningbo City from 2011 to 2020 were collected from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System. The temporal distribution, population distribution, regional distribution and case report by hospitals were descriptively analyzed. Results: Totally 38 305 pulmonary tuberculosis cases were reported in Ningbo City from 2011 to 2020, with an incidence rate of 48.71/105. The incidence of pulmonary tuberculosis appeared a tendency towards a decline ( P<0.05 ), with an annual reduction rate of 5.29%. There were 15 784 smear-positive cases ( 41.21% ), and the proportion of smear-positive cases appeared a tendency towards a reduction from 2011 to 2015 ( P<0.05 ), and a rise from 2016 to 2020 ( P<0.05 ). The number of reported pulmonary tuberculosis cases peaked from March to May (10 973 cases, 28.65%), and a higher incidence rate of pulmonary tuberculosis was found in men than in women ( 64.55/105 vs. 32.20/105, P<0.05 ). The highest incidence of pulmonary tuberculosis was found in cases at ages of 15 to 25 years ( 72.93/105 ), followed by in cases at ages of 65 years and greater ( 69.97/105 ), and farmers were the predominant occupation among the pulmonary tuberculosis patients ( 12 279 cases, 32.06% ). During the period from 2011 to 2020, pulmonary tuberculosis cases were reported across the 10 districts or counties of Ningbo City, and the top three high incidence of pulmonary tuberculosis were seen in Yinzhou District ( 59.91/105 ), Fenghua District ( 56.19/105 ) and Beilun District ( 56.01/105 ). The proportion of pulmonary tuberculosis cases reported by designated pulmonary tuberculosis hospitals increased from 72.16% in 2011 to 99.74% in 2020 in Ningbo City. Conclusions The incidence of pulmonary tuberculosis appeared a tendency towards a decline in Ningbo City from 2011 to 2020, and the annual decline rate meets the requirements of the WHO strategic goal of ending pulmonary tuberculosis; however, the control measures for pulmonary tuberculosis require to be intensified among men, youths, and farmers.

Objective : To analyze the screening results of Mycobacterium tuberculosis (MTB) and HIV co-infections in Ningbo City from 2012 to 2020, so as to provide insights into improving the tuberculosis control strategy. Methods : Data pertaining to HIV antibody testing among tuberculosis patients, MTB testing among HIV/AIDS patients, treatment of patients with MTB and HIV co-infections and prognosis of anti-tuberculosis therapy were collected from the annual working reports for the management of MTB and HIV co-infections in Ningbo City from 2012 to 2020, and the screening, treatment and prognosis of MTB and HIV co-infections were analyzed. Results : A total of 35 385 newly identified tuberculosis patients were reported in Ningbo City from 2012 to 2020, and there were 5 854 cases receiving HIV testing. The annual mean percentage of HIV screening was 17.57%, and the HIV screening rate appeared a tendency towards a rise in Ningbo City from 2012 to 2020 (χ2trend=4 926.309, P<0.001). Eleven patients were tested positive for HIV, with an annual mean HIV positive rate of 0.19%. A total of 26 043 HIV/AIDS patients received MTB screening, with an annual mean screening rate of 95.78%, and the annual screening rate of MTB appeared a tendency towards a rise in Ningbo City from 2012 to 2020 (χ2trend=79.077, P<0.001). A total of 81 tuberculosis patients were detected, with an annual mean detection rate of 0.31%. Among the 92 patients with MTB and HIV co-infections, there were 81 patients receiving anti-tuberculosis and antiviral therapy simultaneously (88.04%), 8 cases receiving anti-tuberculosis therapy alone (8.70%), 2 cases receiving antiviral therapy alone (2.17%) and 1 case without therapy (1.09%). Among the 89 MTB and HIV co-infected patients receiving anti-tuberculosis therapy, 27 cases were cured (30.34%), 53 cases completing the course of treatment (59.55%) and 7 cases died. Conclusions The MTB screening rate among HIV/AIDS patients and the percentage of MTB and HIV co-infected patients with successful anti-tuberculosis treatment were high in Ningbo City from 2012 to 2020; however, the HIV screening rate should be improved among tuberculosis patients.

Cholangiocarcinoma is a malignant tumor originating from the bile duct epithelium, with the increasing incidence year by year. Its early symptoms are atypical and the diagnosis rate is low. Most of the patients are already in advanced stage when they are diagnosed, losing the best surgery period. Currently, the conservative treatments for unresectable extrahepatic cholangiocarcinoma include stent placement, radiofrequency ablation, radiotherapy and chemotherapy, targeted and immunotherapy and other systemic treatments. But due to the high malignancy of biliary tract tumors, the tendency to develop drug resistance and the limited population benefited from the emerging treatment modalities, we urgently need to explore new treatment strategies to break this bottleneck. As a new treatment for cholangiocarcinoma, photodynamic therapy has attracted much attention for its clinical application and therapeutic effects. In this paper, we summarize the principles of photodynamic therapy, the combination of photodynamic and other therapeutic modalities, especially the combination of photodynamic with emerging immune and targeted therapies, and describe the current hotspot directions of photodynamic therapy research at home and abroad to provide reference for clinical treatment and research.

Objective: To analyse of risk factors for early complications after pancreaticoduodenectomy. Methods: Retrospective analysis of 280 cases of pancreaticoduodenectomy in the First Affiliated Hospital, Sun Yat-sen University from January 1999 to October 2009, including 175 males and 105 females; the average age was 57 years, the range is 19 to 81 years old. Observe the perioperative condition and postoperative complications of the patient. Logistic regression analysis was used to analyze risk factors associated with early postoperative complications. Results: Among the 280 patients, 81.1% had preoperative jaundice with obstructive jaundice, the median operation time was 5.5 h. the intraoperative blood loss was (558.0±35.0) ml, 16 patients underwent multiple organ resection. The total postoperative complications was 31.1%. Common postoperative complications were abdominal infection/abscess (10.4%), hemorrhage (7.1%), and pancreatic fistula (2.1%). The pancreaticoenterostomy was mainly performed with a nested end-to-end anastomosis (87.1%) and a bundled pancreaticojejunostomy (7.9%). Logistic regression analysis showed that age, comorbidity, jaundice, preoperative yellowing, pancreatic texture, pancreatic duct placement, prophylactic application of somatostatin, combined organ resection and pancreaticojejunostomy were not predictor of major postoperative complications. Conclusions The incidence of early abdominal complication after pancreaticoduodenectomy is high. There is no significant correlation between the common risk factors in perioperative period and the occurrence of serious complications in the early postoperative period.

Objective: The related literatures on supra acetabular spinal pedicle screws and a subcutaneous connecting rod (INFIX) in recent years was reviewed, and the overall prognosis was analyzed by meta analysis. Methods: literatures were obtained by searching the PubMed, Google Scholar, and Wanfang Full-text Database according to the criteria of inclusion and exclusion. The two members independently screened the qualified literature, evaluated the quality of the literature and extracted the data information. The data information includes demographic and surgical information, main results and secondary results. A large number of data in the selected articles were analyzed and summarized by meta. Results: A total of 20 studies were included, including 567 patients. The clinical results were evaluated by Majeed standard in 6 articles, of which 5 articles described the number of excellent and general prognosis, including 185 patients. The excellent and good prognosis rate was 91% (95%CI: 80%-103%) by meta analysis. The general prognosis rate was 9% (95%CI: 3%-14%). Among the prognostic complications, the incidence of lateral femoral cutaneous nerve damage and heterotopic ossification was higher, and the incidence of other complications was less than 5%. There were 13 articles about the complications of ectopic ossification, of which 1 did not mention the specific number of asymptomatic heterotopic ossification, and the remaining 12 included 424 cases, including 132 cases of ectopic ossification. The incidence of ectopic ossification was 26% (95%CI: 11%-40%). Among the 567 cases, obvious symptoms of lateral femoral cutaneous nerve injury were reported. The patients with lateral femoral cutaneous nerve injury accounted for 25% (95%CI: 17%-32%), and the temporary nerve damage was found in 124 cases. The incidence of temporary agitation after subgroup analysis was 21% (95%CI: 14%-28%). Five articles mentioned the manifestations of postoperative femoral nerve damage, including 10 patients, the incidence of femoral nerve damage was 3% (95%CI: -1%-6%). A total of 18 articles on surgical site-related infections were reported, including 534 patients, of which 15 were infected, with an infection rate of 3% (95%CI: 2%-4%). 19 articles clearly reported the failure of internal fixation after INIFX operation, including 32 patients who needed reoperation for different reasons. The failure of internal fixation was 3% (95%CI: 2%-4%). A total of 585 cases of fracture non-prognosis data were reported, of which 473 cases were cured and 3 cases had bone nonunion. The non-union rate of fracture was 3% (95%CI: 1%-5%). Conclusion After InFix pelvic surgery, the patient's clinical follow-up prognosis score and imaging findings showed that the postoperative recovery was good, and the new technique also avoided the inconvenience and postoperative complications caused by many traditional pelvic external fixation techniques. However, it was also found that the lateral femoral cutaneous nerve damage and the incidence of heterotopic ossification were also higher.