Objective To evaluate the clinical efficacy of second-stage endovascular therapy for patients with aortic intramural hematoma (IMH) who developed progression of the distal hematoma into dissection-like changes after an initial procedure. Methods A retrospective analysis was conducted on patients at the University of Hong Kong-Shenzhen Hospital from July 2020 to December 2022. These patients had previously undergone a first-stage procedure to treat the proximal lesion of an IMH. However, follow-up examinations revealed a persistent distal hematoma, the presence of a distal entry tear, and progression of the hematoma into localized or extensive dissection-like changes, which could be accompanied by localized contrast enhancement. These patients then underwent a second-stage stent-graft intervention. The initial procedures included open surgery with total aortic arch replacement or endovascular stent-graft placement to seal the proximal entry tear. In the second-stage procedure, the aorta was divided into three zones based on its anatomy, and zonal stent-graft placement was performed to seal the entry tear and promote thrombosis of the false lumen. Results A total of 18 patients (15 males, 3 females) were included, with a mean age of (53.5±10.6) years (range, 39 to 76 years). The median operation time was 38.0 (29.5, 58.5) min, and the median intraoperative blood loss was 20.0 (20.0, 30.0) mL. The technical success rate was 100.0%. Intraoperative and postoperative imaging confirmed successful exclusion of the distal entry tear of the IMH, with no endoleak, stenosis or occlusion of visceral branches. There were no major perioperative complications, such as death, paraplegia, or visceral ischemia. During follow-up, complete thrombosis or resolution of the false lumen was observed in all patients. Conclusion For patients with residual entry tears and new-onset dissection-like changes in the distal aorta after the first-stage procedure for IMH, second-stage stent-graft placement can effectively seal the entry tear, promote false lumen thrombosis and hematoma resolution, and improve distal aortic remodeling, demonstrating favorable short- to mid-term outcomes.

Liu Baoyi was a famous febrile disease expert in the late Qing Dynasty,who innovated the theory of latent febrile disease.Liu proposed that the deficiency of kidney essence and the deficiency of healthy qi were the prerequisites for the latent cold e-vil,and the exogenous cold evil was the inducement of the disease.He advocated the treatment of latent febrile disease based on the six meridians,with the two ideas of eliminating evil qi and strengthening healthy qi as the outline,and the general principle of treatment was to relieve heat,nourish yin and expel evil qi.He attached importance to the coordination of medicine and food,made good use of fresh medicine,attached importance to drug processing,emphasized the use of herb processed by herb,and adapted the medicine ac-cording to the syndromes.He preferred to use co-processed products for clinical use.The study of Liu's academic thoughts and medi-cation characteristics in treating latent febrile diseases is of great value in guiding the treatment and medication of various infectious and epidemic diseases with fever characteristics nowadays.

Objective To explore the efficacy of using a single branch stent-graft to treat primary intramural hematoma located at the distal arch or descending aorta in Stanford A type aortic intramural hematoma. Methods From July 2020 to November 2022, 10 patients with primary intramural hematoma of Stanford A type aortic intramural hematoma were treated with endovascular repair using a single branch stent-graft in the Department of Cardiovascular Surgery at The University of Hong Kong-Shenzhen Hospital. There were 9 males and 1 female, aged from 32 to 66 years, with a mean age of (47.0±10.4) years. All patients had intramural hematoma involving the ascending aorta and aortic arch, diagnosed as type A intramural hematoma, with the tear located in the descending aorta. Among them, 6 patients were complicated by ulceration of the descending aorta with intramural hematoma, and 4 patients had changes of the descending aortic dissection. All patients underwent endovascular stent repair, with 8 patients undergoing emergency surgery (≤14 days) and 2 patients undergoing subacute surgery (15 days to 3 months). Results There were no neurological complications, paraplegia, stent fracture or displacement, or limb or visceral ischemia during the perioperative period in all patients. One patient had continuous chest pain after surgery, and the stent had a new tear at the proximal end, requiring ascending aorta and partial arch replacement. As of the latest follow-up, all patients had obvious absorption or complete absorption of the intramural hematoma in the ascending aorta and aortic arch compared with before the operation. Conclusion Single branch stent-graft treatment of retrograde ascending aortic intramural hematoma is safe and effective, with good short-term results.

Objective To analyze the trends in the disease burden of pertussis in China from 1990 to 2021, and to provide a basis for the development of effective prevention and control strategies. Methods Using the 2021 Global Burden of Disease Study (GBD) database, the incidence, mortality, and disability-adjusted life years (DALYs), as well as the age-standardized rates of pertussis in China from 1990 to 2021 were analyzed. Descriptive statistical methods were employed to analyze the characteristics of the pertussis disease burden, and the Joinpoint regression model was used to analyze the trends in pertussis disease burden. Results From 1990 to 2021, the incidence, mortality, and DALYs of pertussis in China decreased from 1 503 800 cases, 10 951 deaths, and 954 900 person-years to 65 400 cases, 548 deaths, and 46 500 person-years, representing a decrease of 95.65%, 95.00%, and 95.13%, respectively. The corresponding age-standardized rates also decreased by 93.58%, 92.47%, and 92.53%, respectively. The Joinpoint regression model revealed a significant downward trend in the age-standardized incidence, mortality, and DALYs rates for pertussis (AAPCs were -8.32%, -9.65%, and -9.58%, respectively, P<0.001). The disease burden was slightly higher in females than in males, with the majority of cases occurring in children under 10 years old, particularly in infants under 1 year old, where the burden was the heaviest. As age increased, the disease burden decreased. Conclusion Between 1990 and 2021, the overall disease burden of pertussis in China showed a significant downward trend, with gender and age differences. Special attention should be given on the prevention and control of pertussis in children under 10 years old, especially in infants under 1 year old.

Bone repair remains an important target in tissue engineering, making the development of bioactive scaffolds for effective bone defect repair a critical objective. In this study, β-tricalcium phosphate (β-TCP) scaffolds incorporated with processed pyritum decoction (PPD) were fabricated using three-dimensional (3D) printing-assisted freeze-casting. The produced composite scaffolds were evaluated for their mechanical strength, physicochemical properties, biocompatibility, in vitro pro-angiogenic activity, and in vivo efficacy in repairing rabbit femoral defects. They not only demonstrated excellent physicochemical properties, enhanced mechanical strength, and good biosafety but also significantly promoted the proliferation, migration, and aggregation of pro-angiogenic human umbilical vein endothelial cells (HUVECs). In vivo studies revealed that all scaffold groups facilitated osteogenesis at the bone defect site, with the β-TCP scaffolds loaded with PPD markedly enhancing the expression of neurogenic locus Notch homolog protein 1 (Notch1), vascular endothelial growth factor (VEGF), bone morphogenetic protein-2 (BMP-2), and osteopontin (OPN). Overall, the scaffolds developed in this study exhibited strong angiogenic and osteogenic capabilities both in vitro and in vivo. The incorporation of PPD notably promoted the angiogenic-osteogenic coupling, thereby accelerating bone repair, which suggests that PPD is a promising material for bone repair and that the PPD/β-TCP scaffolds hold great potential as a bone graft alternative.
Calcium Phosphates/chemistry* ; Animals ; Bone Regeneration ; Rabbits ; Tissue Scaffolds ; Printing, Three-Dimensional ; Humans ; Human Umbilical Vein Endothelial Cells ; Neovascularization, Physiologic ; Osteogenesis ; Tissue Engineering/methods* ; Biomimetic Materials ; Cell Proliferation ; Angiogenesis

Atherosclerosis(As)is one of the main causes of death in the global population.The main causes are hyperlipidemia,hypertension,obesity,etc.However,after avoiding traditional risks,As may still progress.In recent years,the role of microbial infection factors in As has been increasingly valued.This article reviews the correlation be-tween infection and As,and focuses on introducing the research progress on the mechanisms by which microbial infections such as Helicobacter pylori,Chlamydia pneumoniae,human immunodeficiency virus(HIV),and cytomegalovirus promote the development of As,aiming to discover the correlation between microbial infections and As and provide new ideas for the prevention and treatment of As.

Liu Baoyi was a famous febrile disease expert in the late Qing Dynasty,who innovated the theory of latent febrile disease.Liu proposed that the deficiency of kidney essence and the deficiency of healthy qi were the prerequisites for the latent cold e-vil,and the exogenous cold evil was the inducement of the disease.He advocated the treatment of latent febrile disease based on the six meridians,with the two ideas of eliminating evil qi and strengthening healthy qi as the outline,and the general principle of treatment was to relieve heat,nourish yin and expel evil qi.He attached importance to the coordination of medicine and food,made good use of fresh medicine,attached importance to drug processing,emphasized the use of herb processed by herb,and adapted the medicine ac-cording to the syndromes.He preferred to use co-processed products for clinical use.The study of Liu's academic thoughts and medi-cation characteristics in treating latent febrile diseases is of great value in guiding the treatment and medication of various infectious and epidemic diseases with fever characteristics nowadays.

Atherosclerosis(As)is one of the main causes of death in the global population.The main causes are hyperlipidemia,hypertension,obesity,etc.However,after avoiding traditional risks,As may still progress.In recent years,the role of microbial infection factors in As has been increasingly valued.This article reviews the correlation be-tween infection and As,and focuses on introducing the research progress on the mechanisms by which microbial infections such as Helicobacter pylori,Chlamydia pneumoniae,human immunodeficiency virus(HIV),and cytomegalovirus promote the development of As,aiming to discover the correlation between microbial infections and As and provide new ideas for the prevention and treatment of As.

Objective To explore the value of integrating CT image features and quantitative dual-energy computed tomography(DECT)parameters in predicting cervical lymph nodes metastasis from laryngeal and hypopharyngeal squamous cell carcinoma(LHSCC).Methods The clinical and imaging data of 99 patients with LHSCC confirmed by pathology were retrospectively analyzed.All patients were divided into metastatic group(41 cases)and non-metastatic group(58 cases).The CT image features,including location,size and depth,were analyzed,respectively.The quantitative DECT parameters in the arterial and venous phases including iodine concentration(IC)and normalized iodine concentration(NIC)were measured.The rank sum test or independent-samples t-test were used to compare the difference of CT image features and quantitative DECT parameters between the two groups.The multivariate logistic regression analysis was used to build the models based on CT image features(image feature model)and combination of CT image features and quantitative DECT parameters(combined model).The receiver operating characteristic(ROC)curve was performed to analyze and compare the difference of predictive efficiency between the two groups.Results There were significant differences in tumor location between the non-metastatic group and the metastatic group(χ2=21.736,P<0.001).Size(33.20 mm vs 24.95 mm,P<0.001),depth(21.10 mm vs 13.15 mm,P<0.001)and NIC in the arterial phase(0.18 vs 0.14,P<0.001)in the metastatic group were significantly higher than those in the non-metastatic group.The area under the curve(AUC),sensitivity,specificity,positive predictive value,negative predictive value,accuracy of the combined model were 0.851,75.6%,82.8%,58.5%,87.9%and 75.8%for predicting cervical lymph nodes metastasis.The AUC,sensitivity,specificity,positive predictive value,negative predictive value,accuracy of the image feature model were 0.792,95.1%,56.9%,53.7%,81.0%and 69.7%,respectively.The prediction performance of the combined model was better than that of the image feature model(Z=-2.028,P=0.043).Conclusion Integrating CT image features and quantitative DECT parameters has important value for predicting cervical lymph nodes metastasis from LHSCC.

With the inclusion of health services for patients with chronic obstructive pulmonary disease (COPD) in national basic public health programs, the number of elderly individuals undergoing pulmonary function testing (PFT) in primary healthcare institutions is expected to increase significantly. Adverse reactions during PFT, such as dyspnea and dizziness, increase the risk of falls among the elderly during testing. Based on the Healthcare Failure Mode and Effect Analysis (HFMEA) model, our research team developed an improved protocol for PFT procedures for elderly patients in primary healthcare institutions and conducted a preliminary evaluation of its effectiveness. The results demonstrate that advanced medical risk management tools can optimize PFT procedures in primary healthcare settings, offering valuable insights for enhancing PFT services for the elderly.