Objective:To analyze the changes in the number of patients, incidence, mortality rate, disability-adjusted life year (DALY), years lived with disability (YLD), and years of life lost due to premature mortality (YLL) globally and in China from 1990 to 2021, and to predict future trends in the number of patients and DALY of inflammatory bowel disease (IBD) globally and in China.Methods:Descriptive epidemiology was applied. Data on globally and Chinese IBD burden indicators, including prevalence, incidence, mortality, DALY, YLL, and YLD were collected from the Global Burden of Disease (GBD) 2021 Database from 1990 to 2021, and the trends in the changes and distributions of age and gender were analyzed. The age-standardized rate was standardization based on the world standard population age structure estimated by GBD. Auto-regressive integrated moving average model was used to predict the number of IBD patients and DALY globally and in China from 2022 to 2030.Results:In 1990 and 2021, the global number of IBD patients was 2.170 2 and 3.830 1 million, respectively, while in China which was 62 100 and 168 100, respectively. The global crude incidence rate and age-standardized incidence rate were 3.74/100 000, 4.22/100 000, 4.75/100 000, and 4.45/100 000, respectively. The crude incidence rate and age-standardized incidence rate in China were 0.71/100 000, 0.74/100 000 and 1.75/100 000, 1.40/100 000, respectively. In 1990 and 2021, the global crude mortality rate and age-standardized mortality rate of IBD were 0.40/100 000, 0.60/100 000 and 0.54/100 000, 0.52/100 000, respectively; the crude mortality rate and age-standardized mortality rate in China were 0.37/100 000, 0.75/100 000 and 0.40/100 000, 0.33/100 000, respectively. Compared with those in 1990, the global crude DALY, YLD and YLL of IBD all increased in 2021, which were 1 510.8 thousand person-years vs. 948.9 thousand person-years, 579.2 thousand person-years vs. 330.9 thousand person-years, 931.6 thousand person-years vs. 618.0 thousand person-years; the age-standardized DALY, YLD and YLL all decreased, which were 18.07/100 000 vs. 21.54/100 000, 6.79/100 000 vs. 7.27/100 000, 11.27/100 000 vs. 14.27/100 000, respectively. Compared with those in 1990, the crude YLD and the age-standardized YLD in China both increased (26.9 thousand person-years vs. 10.1 thousand person-years, 1.47/100 000 vs. 0.91/100 000), while the crude DALY, the age-standardized DALY, crude YLL and the age-standardized YLL all decreased (136.9 thousand person-years vs. 162.2 thousand person-years, 7.68/100 000 vs. 18.38/100 000, 110 thousand person-years vs. 152 thousand person-years, 6.21/100 000 vs. 17.47/100 000).From 1990 to 2021, male and female age-standardized incidence and prevalence of IBD were all in upward trend. The difference in the incidence of IBD between males and females was relatively small, and the global age-standardized incidence of IBD in males were slightly higher than those in females, while in China the rates are similar between the two genders. The global and Chinese age-standardized prevalence in females were slightly higher than those in males. From 1990 to 2021, the estimated annual percentage change (EAPC) of age-standardized IBD incidence in global and China were 0.24 (95% confidence interval (95% CI): 0.16 to 0.31) and 1.55 (95% CI: 1.25 to 1.86), respectively; the EAPC of age-standardized DALY in global and China were -0.50 (95% CI: -0.58 to -0.41) and -2.71 (95% CI: -2.99 to -2.43), respectively. The age distribution of disease onset shifted towards middle-aged and old population. It was predicted that by 2030, the annual number of new IBD cases in global would increase to 410 100, while in China, it would decrease to 21 184. Furthermore, the global DALY of IBD would increase to 1 670 527 person-year, and in China which would be 140 563 person-year. Conclusions:From 1990 to 2021, the global and Chinese number of patients and the incidence of IBD both sustained increase. The age of IBD onset towards older population. The incidence trend of IBD was aging, with significant gender bias. The global community and China continue to face many severe challenges in IBD.

Objective:To investigate the clinical application value of a novel filter's retraction hook capture technique of pull-assisted method for the endovascular retrieval of conical inferior vena cava (IVC) filters whose hook attached to the wall.Methods:From January 2020 to December 2024, patients with conical filters whose hook attached to the wall admitted at Beijing Jishuitan Hospital were enrolled consecutively.Results:A total of 46 patients underwent filter retrieval using filter's retraction hook capture technique of pull-assisted method. Among these patients, 39 cases (84.8%) were successful in filter retrieval, with the penetration distance of cranial anchor vertex of 3.3(2.5, 4.4) mm, and 13 (33.3%) filters were deformed. The other 7 cases were unsuccessful, with a penetration distance of cranial anchor vertex of 5.0 (4.3, 5.0) mm, and 6 (85.7%) filters were deformed. There was a statistically significant difference between the two groups ( P<0.05). One case (2.2%) had IVC injury, one case (2.2%) experienced filter fracture, and no symptomatic pulmonary embolism occurred. Logistic regression analysis showed that filter deformation was an independent dangerous factor for filter's retraction. Conclusions:Filter's retraction hook capture technique of pull-assisted method is effective in removing conical filters whose hook attached to the wall, with no symptomatic PE occurring. This method can be considered as a new adjuvant technique for filter retrieval.

Liver cancer has high prevalence and mortality rates around the world， and its development and progression are closely associated with the interaction between the tumor microenvironment and tumor-associated macrophages （TAMs）. TAMs play a significant role in immune suppression， immune escape， cell proliferation， invasion， metastasis， and drug resistance in liver cancer. Traditional Chinese medicine （TCM）， with its unique therapeutic concepts and methods， has shown great potential in regulating TAMs and improving the prognosis of liver cancer. This article reviews the role and molecular mechanisms of TCM in regulating TAMs for the treatment of liver cancer， discusses the key role of TAMs in the progression of liver cancer， and analyzes the impact of Chinese medicinal components on the recruitment， polarization， and activity of TAMs and the expression of related factors based on TCM theory. Studies have shown that TCM can regulate the polarization state of TAMs， promote the formation of M1-type antitumor macrophages， and inhibit the activity of M2-type tumor macrophages， thereby playing a role in inhibiting the proliferation of liver cancer cells， promoting apoptosis， inhibiting angiogenesis， and enhancing immune response. In addition， this article also summarizes the molecular targets and mechanisms of action of TCM monomers， compound prescriptions， and novel preparations in the treatment of liver cancer， such as inhibiting the secretion of cytokines by TAMs， regulating signaling pathways， and affecting metabolic pathways， in order to provide a scientific basis for the application of TCM in liver cancer treatment and offer new ideas for immunotherapy for liver cancer.

Objective:To analyze the iodine nutrition status and its related factors among adults aged 18 years and above in Zhejiang Province in 2022.Methods:A multistage stratified sampling method was used to select 4 320 adults aged 18 years and above from 16 on-site survey sites in Zhejiang Province for the study. A questionnaire was used to investigate the general demographic information and personal dietary characteristics of the study participants. Household edible salt and urine samples were collected to detect salt iodine content and urinary iodine level by using direct titration and cerium arsenate-catalyzed spectrophotometry, respectively, to evaluate the iodine nutritional status according to the standard. The multiple-ordered logistic regression model was used to analyze the factors influencing the urinary iodine concentration.Results:The age of the 4 320 study participants was (51.19±15.33) years, with males accounting for 44.44% (1 920). About 40.16% of adults (1 735) were from coastal areas and 56.37% (2 435) from urban areas. The salt iodine content, M ( Q1, Q3), of the 4 320 household edible salt samples was 21.10 (0.00, 24.16) mg/kg, including 1 662 non-iodized salt samples, 182 unqualified iodized salt samples and 2 476 qualified iodized salt samples. The rate of iodized salt coverage was 61.53%, and the rate of qualified iodized salt consumption was 57.31%. There was a statistically significant difference in the proportion of qualified iodized salt in adult households among different regions ( P<0.001), with the proportion of non-iodized salt gradually decreasing from coastal to inland areas ( χ 2trend=618.458, P<0.001). The urinary iodine concentration M ( Q1, Q3) was 137.60 (86.85, 210.60) μg/L in 4 320 adult urine samples, with the urinary iodine levels of<100, 100-199, 200-299, and≥300 μg/L accounting for 31.64% (1 367), 40.56% (1 752), 17.66% (763), and 10.14% (438), respectively. There was a nonlinear positive correlation between household salt iodine content and urinary iodine level in adults aged 18 years and above by using the χ 2 test for trend ( χ 2regression=231.10, P<0.001 and χ 2skew=28.81, P<0.001). Urinary iodine concentrations were higher in men than in women ( P=0.029) and higher in adults in rural areas than in urban areas ( P<0.001). There were statistically significant differences in the distribution of iodine nutritional status among adults of different ages, regions, and urban and rural areas (all P<0.001). The proportion of those with urinary iodine levels<100 μg/L gradually increased with age ( χ 2trend=37.493, P<0.001), and gradually decreased from coastal areas to inland areas ( χ 2trend=71.381, P<0.001). The results of the multiple-ordered logistic regression model analysis showed that compared with adults aged 18 to 44 years and male adults, those aged 45 to 59 years and female adults had lower urinary iodine levels, with OR (95% CI) of 0.75 (0.68-0.83) and 0.85 (0.76-0.95), respectively. Compared with adults in coastal and urban adults, those in sub-coastal, inland and rural adults had higher levels of urinary iodine, with OR (95% CI) of 1.89 (1.63-2.19), 2.02 (1.72-2.37) and 1.46 (1.28-1.66), respectively. Conclusion:The overall iodine nutrition level of adults aged 18 years and above in Zhejiang Province in 2022 is generally appropriate. However, there is a potential risk of iodine deficiency among adults in coastal areas.

Objective To observe the effects of electroacupuncture at the Hegu(LI4)acupoint on refractive parame-ters and the expression of tumor necrosis factor-α(TNF-α)and interleukin-1 β(IL-1β)in the retinal tissue of mice with form-deprivation myopia(FDM).Methods Forty-eight SPF-grade,3-week-old healthy male C57BL/6J mice were ran-domly divided into four groups:normal control group,FDM group,sham acupuncture group,and Hegu group.Experimen-tal myopia was induced in the right eyes of mice in the latter three groups by wearing translucent diffuser goggles.Mice in the Hegu group received electroacupuncture stimulation at the Hegu(LI4)acupoint,while those in the sham acupuncture group received intervention with a non-penetrating blunt needle at the same location.Body weight,refractive error,and axial length were recorded for all mice before modeling and at 2 and 4 weeks after modeling.At 4 weeks post-modeling,mice were euthanized.Real-time quantitative PCR(RT-qPCR)and Western blot were used to detect the mRNA and protein expression levels of TNF-α and IL-1β,respectively,in the right retinal tissues.Retinal cell apoptosis was assessed by TUNEL staining.Results At 2 weeks post-modeling,compared with the normal control group,the refractive error of the right eyes was significantly decreased and the axial length was significantly increased in the FDM,sham acupuncture,and Hegu groups(all P＜0.01).At 4 weeks post-modeling,compared with the normal control group,the refractive error was significantly decreased and the axial length was significantly increased in the FDM and sham acupuncture groups(all P＜0.001).Compared with both the FDM and sham acupuncture groups,the Hegu group showed a significant increase in re-fractive error and a significant decrease in axial length(all P＜0.001).At 4 weeks post-modeling,RT-qPCR and Western blot results showed that the mRNA and protein expression levels of TNF-α and IL-1 β in the retina were significantly higher in the FDM and sham acupuncture groups compared to the normal control group(all P＜0.05).In contrast,the protein ex-pression level of TNF-α and the relative mRNA and protein expression levels of IL-1β in the Hegu group were significantly lower than those in the FDM group(all P＜0.05).TUNEL staining results showed that the retinal cell apoptosis rate was significantly higher in the FDM and sham acupuncture groups compared to the normal control group(all P＜0.001).Com-pared with the FDM and sham acupuncture groups,the retinal cell apoptosis rate was significantly lower in the Hegu group(all P＜0.001).Conclusion Electroacupuncture at the Hegu(LI4)acupoint can significantly inhibit the progression of myopia in mice.The mechanism may be related to the downregulation of TNF-α and IL-1β expression in the retinal tissue,thereby inhibiting retinal cell apoptosis.

Objective:To investigate the iodine nutrition status of pregnant women in Zhejiang Province, explore the impact of salt industry system reform on iodine nutrition level of pregnant women, and provide scientific basis for prevention and treatment of iodine deficiency disorders.Methods:From 2016 to 2021, a multi-stage stratified sampling method was used to select 100 pregnant women from 90 counties (cities, districts) in Zhejiang Province each year as survey subjects. Salt samples were collected from pregnant women's families, and one random urine sample was taken for salt iodine and urinary iodine level testing, respectively.Results:A total of 56 581 samples of household edible salt were collected from pregnant women, with a median salt iodine level of 23.20 mg/kg. Among them, 7 961 were non iodized salt, 45 803 were qualified iodized salt, and 2 817 were unqualified iodized salt. The iodized salt coverage rate was 85.93% (48 620/56 581), and the qualified iodized salt consumption rate was 80.95% (45 803/56 581). The proportion of non iodized salt increased from 10.05% (897/8 928) in 2016 to 15.09% (1 461/9 679) in 2021 (χ 2trend = 95.16, P < 0.001). A total of 56 581 urine samples were collected from pregnant women, with a median urinary iodine level of 130.50 μg/L. Among them, the proportions of urinary iodine levels < 150, 150 - 249, 250 - 499, and ≥500 μg/L were 58.32% (32 996/56 581), 27.24% (15 410/56 581), 12.24% (6 926/56 581), and 2.21% (1 249/56 581), respectively. The median urinary iodine level of pregnant women in inland areas was significantly higher than that in coastal areas ( Z = 19.15, P < 0.001). Furthermore, urinary iodine levels exhibited a non-linear decline as age increased (χ 2regression = 12.65, P < 0.001; χ 2partial = 22.65, P < 0.001) and as pregnancy progressed (χ 2regression = 37.28, P < 0.001; χ 2partial = 18.89, P < 0.001). Conclusions:The overall iodine nutrition status of pregnant women in Zhejiang Province is in a state of iodine deficiency (< 150 μg/L), and there is a greater risk in coastal areas compared to inland areas. However, in the context of the reform of the salt industry system, it is still necessary to strengthen the quality supervision of iodized salt, provide scientific iodine supplementation education, promote specialized iodized salt for pregnant women, and strengthen interventions for prevention and control of iodine deficiency disorders.

Objective To observe the effects of electroacupuncture at the Hegu(LI4)acupoint on refractive parame-ters and the expression of tumor necrosis factor-α(TNF-α)and interleukin-1 β(IL-1β)in the retinal tissue of mice with form-deprivation myopia(FDM).Methods Forty-eight SPF-grade,3-week-old healthy male C57BL/6J mice were ran-domly divided into four groups:normal control group,FDM group,sham acupuncture group,and Hegu group.Experimen-tal myopia was induced in the right eyes of mice in the latter three groups by wearing translucent diffuser goggles.Mice in the Hegu group received electroacupuncture stimulation at the Hegu(LI4)acupoint,while those in the sham acupuncture group received intervention with a non-penetrating blunt needle at the same location.Body weight,refractive error,and axial length were recorded for all mice before modeling and at 2 and 4 weeks after modeling.At 4 weeks post-modeling,mice were euthanized.Real-time quantitative PCR(RT-qPCR)and Western blot were used to detect the mRNA and protein expression levels of TNF-α and IL-1β,respectively,in the right retinal tissues.Retinal cell apoptosis was assessed by TUNEL staining.Results At 2 weeks post-modeling,compared with the normal control group,the refractive error of the right eyes was significantly decreased and the axial length was significantly increased in the FDM,sham acupuncture,and Hegu groups(all P＜0.01).At 4 weeks post-modeling,compared with the normal control group,the refractive error was significantly decreased and the axial length was significantly increased in the FDM and sham acupuncture groups(all P＜0.001).Compared with both the FDM and sham acupuncture groups,the Hegu group showed a significant increase in re-fractive error and a significant decrease in axial length(all P＜0.001).At 4 weeks post-modeling,RT-qPCR and Western blot results showed that the mRNA and protein expression levels of TNF-α and IL-1 β in the retina were significantly higher in the FDM and sham acupuncture groups compared to the normal control group(all P＜0.05).In contrast,the protein ex-pression level of TNF-α and the relative mRNA and protein expression levels of IL-1β in the Hegu group were significantly lower than those in the FDM group(all P＜0.05).TUNEL staining results showed that the retinal cell apoptosis rate was significantly higher in the FDM and sham acupuncture groups compared to the normal control group(all P＜0.001).Com-pared with the FDM and sham acupuncture groups,the retinal cell apoptosis rate was significantly lower in the Hegu group(all P＜0.001).Conclusion Electroacupuncture at the Hegu(LI4)acupoint can significantly inhibit the progression of myopia in mice.The mechanism may be related to the downregulation of TNF-α and IL-1β expression in the retinal tissue,thereby inhibiting retinal cell apoptosis.

Objective:To analyze the iodine nutrition status and its related factors among adults aged 18 years and above in Zhejiang Province in 2022.Methods:A multistage stratified sampling method was used to select 4 320 adults aged 18 years and above from 16 on-site survey sites in Zhejiang Province for the study. A questionnaire was used to investigate the general demographic information and personal dietary characteristics of the study participants. Household edible salt and urine samples were collected to detect salt iodine content and urinary iodine level by using direct titration and cerium arsenate-catalyzed spectrophotometry, respectively, to evaluate the iodine nutritional status according to the standard. The multiple-ordered logistic regression model was used to analyze the factors influencing the urinary iodine concentration.Results:The age of the 4 320 study participants was (51.19±15.33) years, with males accounting for 44.44% (1 920). About 40.16% of adults (1 735) were from coastal areas and 56.37% (2 435) from urban areas. The salt iodine content, M ( Q1, Q3), of the 4 320 household edible salt samples was 21.10 (0.00, 24.16) mg/kg, including 1 662 non-iodized salt samples, 182 unqualified iodized salt samples and 2 476 qualified iodized salt samples. The rate of iodized salt coverage was 61.53%, and the rate of qualified iodized salt consumption was 57.31%. There was a statistically significant difference in the proportion of qualified iodized salt in adult households among different regions ( P<0.001), with the proportion of non-iodized salt gradually decreasing from coastal to inland areas ( χ 2trend=618.458, P<0.001). The urinary iodine concentration M ( Q1, Q3) was 137.60 (86.85, 210.60) μg/L in 4 320 adult urine samples, with the urinary iodine levels of<100, 100-199, 200-299, and≥300 μg/L accounting for 31.64% (1 367), 40.56% (1 752), 17.66% (763), and 10.14% (438), respectively. There was a nonlinear positive correlation between household salt iodine content and urinary iodine level in adults aged 18 years and above by using the χ 2 test for trend ( χ 2regression=231.10, P<0.001 and χ 2skew=28.81, P<0.001). Urinary iodine concentrations were higher in men than in women ( P=0.029) and higher in adults in rural areas than in urban areas ( P<0.001). There were statistically significant differences in the distribution of iodine nutritional status among adults of different ages, regions, and urban and rural areas (all P<0.001). The proportion of those with urinary iodine levels<100 μg/L gradually increased with age ( χ 2trend=37.493, P<0.001), and gradually decreased from coastal areas to inland areas ( χ 2trend=71.381, P<0.001). The results of the multiple-ordered logistic regression model analysis showed that compared with adults aged 18 to 44 years and male adults, those aged 45 to 59 years and female adults had lower urinary iodine levels, with OR (95% CI) of 0.75 (0.68-0.83) and 0.85 (0.76-0.95), respectively. Compared with adults in coastal and urban adults, those in sub-coastal, inland and rural adults had higher levels of urinary iodine, with OR (95% CI) of 1.89 (1.63-2.19), 2.02 (1.72-2.37) and 1.46 (1.28-1.66), respectively. Conclusion:The overall iodine nutrition level of adults aged 18 years and above in Zhejiang Province in 2022 is generally appropriate. However, there is a potential risk of iodine deficiency among adults in coastal areas.

Objective:To investigate the iodine nutrition status of pregnant women in Zhejiang Province, explore the impact of salt industry system reform on iodine nutrition level of pregnant women, and provide scientific basis for prevention and treatment of iodine deficiency disorders.Methods:From 2016 to 2021, a multi-stage stratified sampling method was used to select 100 pregnant women from 90 counties (cities, districts) in Zhejiang Province each year as survey subjects. Salt samples were collected from pregnant women's families, and one random urine sample was taken for salt iodine and urinary iodine level testing, respectively.Results:A total of 56 581 samples of household edible salt were collected from pregnant women, with a median salt iodine level of 23.20 mg/kg. Among them, 7 961 were non iodized salt, 45 803 were qualified iodized salt, and 2 817 were unqualified iodized salt. The iodized salt coverage rate was 85.93% (48 620/56 581), and the qualified iodized salt consumption rate was 80.95% (45 803/56 581). The proportion of non iodized salt increased from 10.05% (897/8 928) in 2016 to 15.09% (1 461/9 679) in 2021 (χ 2trend = 95.16, P < 0.001). A total of 56 581 urine samples were collected from pregnant women, with a median urinary iodine level of 130.50 μg/L. Among them, the proportions of urinary iodine levels < 150, 150 - 249, 250 - 499, and ≥500 μg/L were 58.32% (32 996/56 581), 27.24% (15 410/56 581), 12.24% (6 926/56 581), and 2.21% (1 249/56 581), respectively. The median urinary iodine level of pregnant women in inland areas was significantly higher than that in coastal areas ( Z = 19.15, P < 0.001). Furthermore, urinary iodine levels exhibited a non-linear decline as age increased (χ 2regression = 12.65, P < 0.001; χ 2partial = 22.65, P < 0.001) and as pregnancy progressed (χ 2regression = 37.28, P < 0.001; χ 2partial = 18.89, P < 0.001). Conclusions:The overall iodine nutrition status of pregnant women in Zhejiang Province is in a state of iodine deficiency (< 150 μg/L), and there is a greater risk in coastal areas compared to inland areas. However, in the context of the reform of the salt industry system, it is still necessary to strengthen the quality supervision of iodized salt, provide scientific iodine supplementation education, promote specialized iodized salt for pregnant women, and strengthen interventions for prevention and control of iodine deficiency disorders.

OBJECTIVE To explore the clinical efficacy and safety of Huangkui capsule combined with cyclophosphamide and prednisone in the treatment of immunoglobulin A(IgA)nephropathy with renal insufficiency.METHODS A total of 117 patients with IgA nephropathy and renal insufficiency who were hospitalized in the department of nephrology of the Second Affiliated Hospital of Dalian Medical University from February 2021 to March 2024 were divided into prednisone group(n=38),cyclophosphamide group(n=39)and Huangkui group(n=40)according to the random number table method.On the basis of standardized basic treatment,the three groups were treated with prednisone,prednisone+cyclophosphamide,and prednisone+cyclophosphamide+Huangkui capsule,respectively,with a course of 6 months.The clinical efficacy,renal function indexes,immunoglobulin levels,inflammatory factor levels before and after treatment,and the incidence of adverse reactions during treatment were compared among the three groups.RESULTS Finally,107 patients completed the study(35 in prednisone group,37 in cyclophosphamide group,and 35 in Huangkui group).After 6 months of treatment,there was a statistically significant difference in the total effective rate among the three groups(P=0.028),and the total effective rate of the Huangkui group was significantly higher than that of the prednisone group(P=0.023).In terms of renal function,the levels of blood urea nitrogen(BUN),serum creatinine(Scr),and urinary microalbumin(Umalb)in the three groups after treatment were significantly lower than those before treatment,while the estimated glomerular filtration rate(eGFR)was significantly higher than that before treatment(P＜0.05).Among them,the Huangkui group was superior to the other two groups in reducing BUN level(P＜0.05),and both the Huangkui group and cyclophosphamide group were superior to the prednisone group in improving Scr,Umalb and eGFR(P＜0.05).In terms of immunology,both the Huangkui group and cyclophosphamide group were superior to the prednisone group in increasing IgG level and decreasing IgA and IgM levels(P＜0.05).In terms of inflammatory factors,the Huangkui group was superior to the prednisone group and cyclophosphamide group in reducing tumor necrosis factor-α level(P＜0.05),and superior to the prednisone group in reducing interleukin-6 level(P＜0.05).There was no statistically significant difference in the total incidence of adverse reactions among the three groups(P＞0.05).CONCLUSIONS Huangkui capsule combined with cyclophosphamide and prednisone has a good therapeutic effect on IgA nephropathy with renal insufficiency.It can further improve patients'renal function and immune function,regulate inflammatory status,and has good safety.