ObjectiveTo improve the therapeutic effect of Buyang Huanwutang（BYHW） on diabetic kidney disease （DKD） and explore new methods for developing new Chinese medicine decoctions，we utilized 5-hydroxymethylcytosine （5hmC）-Seal sequencing technology and network pharmacology to modify BYHW. MethodsWe selected 14 diabetes mellitus （DM） patients and 15 DKD patients hospitalized in the Department of Endocrinology of Peking University Third Hospital in 2021. Circulating free DNA （cfDNA） in the patients’ plasma was sequenced. After data processing and screening， we performed temporal clustering analysis to select a DKD 5hmC gene set， which was then cross-validated with a DKD database gene set to obtain the DKD gene set. We retrieved target genes of the seven herbal components of BYHW from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and the Encyclopedia of Traditional Chinese Medicine （ETCM）， and performed cross-analysis with the DKD gene set to identify common genes shared by the disease and the Chinese medicines. A protein-protein interaction （PPI） network was constructed for the common genes to screen out the key genes. Chinese medicines targeting these key genes were searched against ETCM to identify removable Chinese medicines. Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis was performed on non-common DKD genes， and key genes in DKD-related pathways were selected based on machine learning. The GSE30529 dataset was used to verify the expression trends of 5hmC-modified genes and the feasibility of target genes as drug targets. TCMBank was used to search for target genes and obtain compounds targeting these genes and the corresponding Chinese medicines to construct a "key target-compound-Chinese medicine" network. Molecular docking was employed to verify the binding affinity of compounds with key targets. TCMSP and ETCM were used to search and count the candidate Chinese medicines targeting DKD-related genes， and a new decoction was formed by adding the selected Chinese medicines. A mouse model of DKD was established to examine the efficacy of the new decoction based on the mouse body mass， random blood glucose， urinary microalbumin （mALB）， serum creatinine （Scr）， and blood urea nitrogen （BUN） and by hematoxylin-eosin staining， periodic acid-Schiff staining， Masson staining， immunofluorescence assay， and Real-time PCR. ResultsThe cross-analysis results showed that the DKD gene set included 507 genes， of which 30 were target genes of BYHW. The PPI analysis indicated that the top 15% target genes regarding the degree were interleukin-6 （IL-6）， Toll-like receptor 4 （TLR4）， lactotransferrin （LTF）， lipoprotein lipase （LPL）， and sterol regulatory element-binding transcription factor 1 （SREBF1）. Persicae Semen and Pheretima in BYHW were unrelated to key genes and removed. Machine learning identified 10 potential target genes， among which TBC1 domain family member 5 （TBC1D5）， RAD51 paralog B （RAD51B）， and proteasome 20S subunit alpha 6 （PSMA6） had expression trends consistent with the GSE30529 dataset and could serve as drug targets. The "key target-compound-Chinese medicine" network and molecular docking results indicated that the compounds with good binding affinity to target proteins were arginine， glycine， myristicin， serine， and tyrosine， corresponding to 121 Chinese medicines. The top 10 Chinese medicines targeting DKD-related genes were Lycii Fructus， Ginseng Radix et Rhizoma， Dioscoreae Rhizoma， Rehmanniae Radix Praeparata， Isatidis Radix， Glehniae Radix， Ophiopogonis Radix， Allii Sativi Bulbus， Isatidis Folium， and Bolbostemmatis Rhizoma. Based on traditional Chinese medicine theory， the new decoction was obtained after removal of Persicae Semen and Pheretima and addition of Rehmanniae Radix Praeparata and Dioscoreae Rhizoma. Animal experiment results indicated that the modified BYHW improved the kidney function and inhibited renal fibrosis in DKD mice， with better effects than the original decoction. ConclusionThe BYHW modified based on 5hmC-Seal sequencing demonstrates better performance in inhibiting fibrosis and ameliorating DKD than the original decoction. This elucidates the biomedical theory behind the epigenetic modification of traditional Chinese medicine prescriptions， potentially offering new perspectives for the exploration of these prescriptions

ObjectiveTo improve the therapeutic effect of Buyang Huanwutang（BYHW） on diabetic kidney disease （DKD） and explore new methods for developing new Chinese medicine decoctions，we utilized 5-hydroxymethylcytosine （5hmC）-Seal sequencing technology and network pharmacology to modify BYHW. MethodsWe selected 14 diabetes mellitus （DM） patients and 15 DKD patients hospitalized in the Department of Endocrinology of Peking University Third Hospital in 2021. Circulating free DNA （cfDNA） in the patients’ plasma was sequenced. After data processing and screening， we performed temporal clustering analysis to select a DKD 5hmC gene set， which was then cross-validated with a DKD database gene set to obtain the DKD gene set. We retrieved target genes of the seven herbal components of BYHW from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and the Encyclopedia of Traditional Chinese Medicine （ETCM）， and performed cross-analysis with the DKD gene set to identify common genes shared by the disease and the Chinese medicines. A protein-protein interaction （PPI） network was constructed for the common genes to screen out the key genes. Chinese medicines targeting these key genes were searched against ETCM to identify removable Chinese medicines. Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis was performed on non-common DKD genes， and key genes in DKD-related pathways were selected based on machine learning. The GSE30529 dataset was used to verify the expression trends of 5hmC-modified genes and the feasibility of target genes as drug targets. TCMBank was used to search for target genes and obtain compounds targeting these genes and the corresponding Chinese medicines to construct a "key target-compound-Chinese medicine" network. Molecular docking was employed to verify the binding affinity of compounds with key targets. TCMSP and ETCM were used to search and count the candidate Chinese medicines targeting DKD-related genes， and a new decoction was formed by adding the selected Chinese medicines. A mouse model of DKD was established to examine the efficacy of the new decoction based on the mouse body mass， random blood glucose， urinary microalbumin （mALB）， serum creatinine （Scr）， and blood urea nitrogen （BUN） and by hematoxylin-eosin staining， periodic acid-Schiff staining， Masson staining， immunofluorescence assay， and Real-time PCR. ResultsThe cross-analysis results showed that the DKD gene set included 507 genes， of which 30 were target genes of BYHW. The PPI analysis indicated that the top 15% target genes regarding the degree were interleukin-6 （IL-6）， Toll-like receptor 4 （TLR4）， lactotransferrin （LTF）， lipoprotein lipase （LPL）， and sterol regulatory element-binding transcription factor 1 （SREBF1）. Persicae Semen and Pheretima in BYHW were unrelated to key genes and removed. Machine learning identified 10 potential target genes， among which TBC1 domain family member 5 （TBC1D5）， RAD51 paralog B （RAD51B）， and proteasome 20S subunit alpha 6 （PSMA6） had expression trends consistent with the GSE30529 dataset and could serve as drug targets. The "key target-compound-Chinese medicine" network and molecular docking results indicated that the compounds with good binding affinity to target proteins were arginine， glycine， myristicin， serine， and tyrosine， corresponding to 121 Chinese medicines. The top 10 Chinese medicines targeting DKD-related genes were Lycii Fructus， Ginseng Radix et Rhizoma， Dioscoreae Rhizoma， Rehmanniae Radix Praeparata， Isatidis Radix， Glehniae Radix， Ophiopogonis Radix， Allii Sativi Bulbus， Isatidis Folium， and Bolbostemmatis Rhizoma. Based on traditional Chinese medicine theory， the new decoction was obtained after removal of Persicae Semen and Pheretima and addition of Rehmanniae Radix Praeparata and Dioscoreae Rhizoma. Animal experiment results indicated that the modified BYHW improved the kidney function and inhibited renal fibrosis in DKD mice， with better effects than the original decoction. ConclusionThe BYHW modified based on 5hmC-Seal sequencing demonstrates better performance in inhibiting fibrosis and ameliorating DKD than the original decoction. This elucidates the biomedical theory behind the epigenetic modification of traditional Chinese medicine prescriptions， potentially offering new perspectives for the exploration of these prescriptions

Objective:To compare the variability of midpalatal suture maturation ratio of skeletal class Ⅰ malocclusion adults between genders,among positions and vertical skeletal patterns.Methods:173 skeletal class Ⅰ malocclusion adult patients were included and divided into 6 groups according to GoGn-SN Angle and gender:dolichofacial group(male 22,female 24)with GoGn-SN＞37.7°,me-sofacial Group(male 30,female 33)with 27.2°≤GoGn-SN≤37.7° and brachyfacial group(male 33,female 31)with GoGn-SN＜27.2°.The midpalatal suture maturation ratio in the corresponding area of anterior,medial and posterior region were measured and calculated by Mimics 21.0 software,the overlap of the anterior nasopalatine canal with the measurement site was recorded.Results:In the comparison of different genders,there was a statistically significant difference between males and females in the brachyfacial an-terior region(P＜0.001).In the comparison of different positions,except the females among the anterior,middle and posterior regions in brachyfacial group(P＞0.05),there were statistical differences in the fusion degree of the other parts of the palate suture(P＜0.05),and it gradually decreased from the posterior region to the anterior region.In the comparison of different vertical skeletal pat-terns,there was no statistical difference except the difference between the mesofacial and brachyfacial and dolichofacial groups in the middle area of males(P＞0.05),and the difference was significant among brachyfacial,dolichofacial and mesofacia groups in the ante-rior area of females(P＜0.05).Rates of anterior nasopalatine duct influence measurements were statistically significant in the compari-son between dolichofacial and brachyfacial males,and between brachyfacial males and brachyfacial females(P＜0.05),the remainder was not statistically significant(P＞0.05).Conclusion:In adult patients,the palatal suture is not completely fused,and palatal mi-croimplant anchorage should be avoided in the midpalatal suture.

Objective:To investigate the correlation between brain iron deposition and cognitive function in patients with carotid atherosclerosis stenosis (CAS) based on quantitative susceptibility mapping (QSM).Methods:This single-center prospective study was performed at the Department of Vascular Surgery, Nanjing Drum Tower Hospital from January 2022 to June 2022. Patients who met the ataxation criteria were divided into the CAS group ( n=16) and the CAS with mild cognitive impairment (CAS-MCI) group ( n=17) according to the Montreal Cognitive Assessment (MoCA) scores. All patients completed QSM imaging and whole-brain analyses were performed for absolute susceptibility values in cortical regions. Age, sex, education years, hypertension, and diabetes mellitus were included as covariates in all analyses. Partial correlation analyses were used to determine the correlation between bilateral CAS degrees and cortical susceptibility values. Further, mediation analyses were performed to determine whether and how cortical susceptibility values affect cognition in CAS patients. Receiver operating characteristic (ROC) curve analysis was also performed to evaluate the predictive worth of differential brain region susceptibility values for cognitive decline. Independent sample t test and Mann-Whitney U test was used to compare quantitative variables. The comparison of categorical variables was conducted using χ2 test, Fisher′s exact test or Wilcoxon rank sum test. Results:A total of 33 patients were included in the study, including 16 in the CAS group and 17 in the CAS-MCI group. There were 23 males and 10 females, aged (62.8±9.0) years (range: 48 to 88 years). CAS-MCI group showed higher right CAS grades ( Z=-2.037, P=0.042). Whole-brain cortical QSM analyses showed higher susceptibility values in the frontal pole ((-0.210±0.080)×10 -8vs.(-0.130±0.120)×10 -8; t=-2.187, P=0.037), superior frontal gyrus ((-0.604±0.243)×10 -8vs. (-0.428±0.203)×10 -8; t=-2.223, P=0.034), and temporal pole ((-0.081±0.115)×10 -8vs. (0.054±0.190)×10 -8; t=-2.417, P=0.022) in CAS-MCI group compared to CAS group. The susceptibility value of the frontal pole showed a positive correlation with the right CAS grade ( r=0.424, P=0.009),while a quasi-significant positive correlation with the left CAS ( r=0.313, P=0.070). The susceptibility values of the frontal and temporal poles were negatively correlated with the MoCA score (frontal pole: r=-0.391, P=0.027; temporal pole: r=-0.410, P=0.020). Mediation analysis showed the effect of right CAS on cognition was fully mediated by the susceptibility value of the frontal pole. The ROC curve revealed that the area under the curve of using hypertension combined with the susceptibility value of the frontal pole to predict cognitive decline was 0.882 (95% CI:0.763 to 0.989) with 82% of sensitivity and 83% of specificity. Conclusions:Multiple cortical regions show iron deposition in CAS-MCI patients. Right CAS plays an important role in cognitive decline, frontal pole iron deposition mediates the effect of right CAS on cognitive function. Quantified frontal pole susceptibility is useful for the diagnosis of cognitive decline in patients with CAS.

Objective To investigate the prognostic value of fibrinogen to albumin ratio (FAR) com-bined with triglyceride glucose product (TyG) on long-term adverse events in the patients with acute myocar-dial infarction.Methods A total of 325 patients with acute myocardial infarction treated by percutaneous cor-onary intervention (PCI) in the Second People's Hospital of Kashi Prefecture from January 2019 to January 2020 were selected as the study subjects.The patients were followed up for 1 year and divided into the study group (n=30) and control group (n=295) according to whether or not the major adverse cardiovascular e-vents (MACE) occurring.The medical case records of the patients such as blood lipid indexes and cardiac function indexes were recorded in detail.The multivariate Cox regression was used to analyze the risk factors affecting MACE occurrence in the patients with acute myocardial infarction.The receiver operating character-istic (ROC) curve was used to study the predictive value of FAR and TyG for the occurrence of MACE in the patients with acute myocardial infarction.Results The levels of FAR and TyG in the study group were higher than those in the control group,and the difference was statistically significant (P<0.05).The multivariate Cox regression analysis results showed that the FAR increase and TyG score increase were the independent risk factors for MACE occurrence in the patients with acute myocardial infarction (P<0.05).The ROC curve results showed that the prognosis in the patients with TyG≥7.943 and FAR≥0.086 was poorer than those with TyG<7.943 and FAR≥0.086,TyG≥7.943 and FAR<0.086,and TyG<7.943 and FAR<0.086,and the differences were statistically significant (P<0.05).Conclusion The increase of peripheral blood FAR and TyG is closely related to the prognosis of acute myocardial infarction.Early combined detection of FAR and TyG has the guidance significance in evaluating the prognosis of the patients with acute myocardial infarction.

AIM:To investigate the effect and mechanism of velvet antler polypeptide(VAP)on premature ovarian failure induced by cisplatin(DDP)in rats.METHODS:Female rats with normal estrous cycle were randomly di-vided into the control,model,and VAP groups,with 10 rats in each group.Premature ovarian failure was induced in the model and VAP groups by intraperitoneal injection of DDP(4 mg·kg-1·d-1)for 20 consecutive days,and the VAP group was treated with VAP(400 mg·kg-1·d-1)for 20 consecutive days.Hematoxylin and eosin(HE)staining was used to ob-serve the morphological manifestations of the ovary,and the number of developing follicles at all levels was counted.En-zyme-linked immunosorbent assay(ELISA)was performed to detect serum estradiol(E2),follicle-stimulating hormone(FSH),and anti-Mullerian hormone(AMH)levels.The levels of glutathione(GSH)and malondialdehyde(MDA)in ovarian tissues were detected by biochemical methods.The level of reactive oxygen species(ROS)in ovarian tissue was detected by the probe labeling method.Prussian blue staining was performed to observe the iron accumulation in ovarian tissue,as well as the ferrous ion(Fe2+)level was detected by Fe2+content analysis kit.Immunohistochemistry and West-ern blot analysis were performed to detect the expressions of solute carrier family 7 member 11(SCL7A11),glutathione peroxidase 4(GPX4),and acyl-CoA synthetase long-chain family member 4(ACSL4)in the ovarian tissue.The fertility of rats was monitored in each group.RESULTS:Compared with control group,the model group showed ovarian atrophy,iron accumulation(P<0.01),reduced development of follicles at all levels and total follicles(P<0.05),increased atretic follicles(P<0.01),reduced litter size(P<0.01),decreased serum E2 and AMH levels(P<0.01),increased FSH levels(P<0.01),decreased GSH level and SCL7A11 and GPX4 protein expression levels in the ovarian tissue(P<0.01),and increased levels of Fe2+,MDA,and ROS and expression levels of ACSL4(P<0.01).Compared with model group,the VAP group had improvement in these aforementioned changes caused by DDP(P<0.01).CONCLUSION:Treatment with VAP can improve ovarian function,maintain normal follicle development,and improve fertility in cisplatin-induced premature ovarian failure rats,and the mechanism may be related to the inhibition of lipid peroxidation and ferroptosis.

Objective:To investigate the correlation between brain iron deposition and cognitive function in patients with carotid atherosclerosis stenosis (CAS) based on quantitative susceptibility mapping (QSM).Methods:This single-center prospective study was performed at the Department of Vascular Surgery, Nanjing Drum Tower Hospital from January 2022 to June 2022. Patients who met the ataxation criteria were divided into the CAS group ( n=16) and the CAS with mild cognitive impairment (CAS-MCI) group ( n=17) according to the Montreal Cognitive Assessment (MoCA) scores. All patients completed QSM imaging and whole-brain analyses were performed for absolute susceptibility values in cortical regions. Age, sex, education years, hypertension, and diabetes mellitus were included as covariates in all analyses. Partial correlation analyses were used to determine the correlation between bilateral CAS degrees and cortical susceptibility values. Further, mediation analyses were performed to determine whether and how cortical susceptibility values affect cognition in CAS patients. Receiver operating characteristic (ROC) curve analysis was also performed to evaluate the predictive worth of differential brain region susceptibility values for cognitive decline. Independent sample t test and Mann-Whitney U test was used to compare quantitative variables. The comparison of categorical variables was conducted using χ2 test, Fisher′s exact test or Wilcoxon rank sum test. Results:A total of 33 patients were included in the study, including 16 in the CAS group and 17 in the CAS-MCI group. There were 23 males and 10 females, aged (62.8±9.0) years (range: 48 to 88 years). CAS-MCI group showed higher right CAS grades ( Z=-2.037, P=0.042). Whole-brain cortical QSM analyses showed higher susceptibility values in the frontal pole ((-0.210±0.080)×10 -8vs.(-0.130±0.120)×10 -8; t=-2.187, P=0.037), superior frontal gyrus ((-0.604±0.243)×10 -8vs. (-0.428±0.203)×10 -8; t=-2.223, P=0.034), and temporal pole ((-0.081±0.115)×10 -8vs. (0.054±0.190)×10 -8; t=-2.417, P=0.022) in CAS-MCI group compared to CAS group. The susceptibility value of the frontal pole showed a positive correlation with the right CAS grade ( r=0.424, P=0.009),while a quasi-significant positive correlation with the left CAS ( r=0.313, P=0.070). The susceptibility values of the frontal and temporal poles were negatively correlated with the MoCA score (frontal pole: r=-0.391, P=0.027; temporal pole: r=-0.410, P=0.020). Mediation analysis showed the effect of right CAS on cognition was fully mediated by the susceptibility value of the frontal pole. The ROC curve revealed that the area under the curve of using hypertension combined with the susceptibility value of the frontal pole to predict cognitive decline was 0.882 (95% CI:0.763 to 0.989) with 82% of sensitivity and 83% of specificity. Conclusions:Multiple cortical regions show iron deposition in CAS-MCI patients. Right CAS plays an important role in cognitive decline, frontal pole iron deposition mediates the effect of right CAS on cognitive function. Quantified frontal pole susceptibility is useful for the diagnosis of cognitive decline in patients with CAS.

Objective To study the serum expression of interleukin-36α(IL-36α),C1q/tumor necrosis factor-related protein 6(CTRP6)levels in patients with polycystic ovary syndrome(PCOS)and their diagnostic value.Methods A total of 98 PCOS patients diagnosed and treated in the Fifth Affiliated Hospital of Xinjiang Medical University from April 2019 to April 2022 were taken as the PCOS group,and 70 healthy women were taken as the control group.Enzyme-linked immunosorbent assay was applied to detect serum IL-36 α and CTRP6 level expression.The correlation between the expression of serum IL-36 α,CTRP6 levels and clinical indicators was analyzed by Pearson correlation analysis.Multivariate logistic regression analysis was used to analyze factors affecting the occurrence of PCOS.Receiver operating characteristic curve was used to evaluate the diagnostic efficacy of serum IL-36α,CTRP6 and combination in PCOS.Results Serum CTRP6(18.25±3.67μg/L),FPG(5.71±0.49nmol/L),FINS(18.96±2.68mIU/L),HOMA-IR(4.72±0.46),LH(6.17±1.44IU/L),T(1.32±0.42nmol/L),ovarian number(17.86±5.20)and ovarian volume(9.29±2.14cm3)in the PCOS group were higher,while serum IL-36 α(0.67±0.13ng/L)and FSH((4.27±1.33IU/L)were lower compared with those in the control group(5.14±1.28μg/L,4.76±0.54mmol/L,8.63±1.65mIU/L,1.83±0.33,4.92±1.39IU/L,0.86±0.28nmol/L,6.76±1.94 个,5.26±1.31cm3,2.11±0.38ng/L,5.42±1.67IU/L),with significant differences(t/x2=4.962～44.934,all P<0.05).Serum IL-36α(0.87±0.15ng/L,0.70±0.12ng/L,0.51±0.11ng/L,0.42±0.10ng/L)levels in patients with type 1,type 2,type 3,and type 4 PCOS were decreased sequentially,while CTRP6(14.07±3.35 μg/L,17.66±3.97 μg/L,21.16±3.67 μg/L,24.08±3.53 μg/L)were increased sequentially,with significant differences(F=61.281,33.854,all P<0.05).There was a negative correlation between serum IL-36 α and ovarian number,ovarian volume,FINS and HOMA-IR(r=-0.661,-0.621,-0.554,-0.671,all P<0.05).Serum CTRP6 was positively correlated with ovarian number,ovarian volume,FINS and HOMA-IR(r=0.625,0.631,0.537,0.738,all P<0.05).CTRP6(OR=1.327,95%CI:1.104～1.596)was an independent risk factor affecting the occurrence of PCOS,while IL-36 α(OR=0.707,95%CI:0.547～0.914)was a protective factor.The area under the curve(95%CI)of combination of IL-36 α and CTRP6 for the diagnosis of PCOS was 0.933(0.872～0.969),which was greater than that of IL-36 α,CTRP6 alone[0.870(0.821～0.926),0.898(0.854～0.940)],with significant differences(Z=4.258,4.119,all P<0.05).Conclusion The decrease of serum IL-36α and the increase of CTRP6 in PCOS patients are related to the severity of PCOS,and the combined detection of the two may have high diagnostic value for PCOS.

Objective:To explore the surgical treatment strategy of stent graft infection after interventional treatment of major iliac artery related diseases.Methods:Retrospective analysis was performed on the clinical data of 6 patients with secondary stent graft infection after interventional treatment for major iliac artery related diseases admitted to the Department of Vascular Surgery,Affiliated Drum Tower Hospital,Medical School of Nanjing University from November 2021 to August 2022.There were 5 males and 1 female,with a mean age of 64 years (range:49 to 79 years).The infection time was 53 days to 3 165 days.All the 6 patients received surgical treatment,including 3 patients who underwent anatomic bypass grafting (axillary arterial-femoral artery bypass,femoral arterial-femoral artery bypass) using artificial vessels,and 3 patients who underwent in situ abdominal aorta reconstruction using bovine pericardium.The perioperative situation,postoperative infection and the occurrence of serious adverse events were recorded,and the safety of different treatment methods and materials was evaluated.Results:All patients successfully completed the operation and no death occurred during hospitalization.Intraoperative blood loss was 2 000 to 5 000 ml,and intraoperative blood transfusion was 1 600 to 5 350 ml.All the patients were followed up for 81 to 395 days after surgery,and the incision healed well,and no reinfection occurred.Postoperative gastrointestinal bleeding occurred in 1 patient,secondary surgery (retroperitoneal hematoma removal) was performed in 1 patient due to postoperative bleeding at the vascular anastomosis,both lower limb amputations were performed in 1 patient due to postoperative lower limb ischemia,and intermittent claudication occurred in 2 patients.All patients were alive at the last follow-up.Conclusion:For patients with aortic stent graft infection,when the infection is not serious and there is enough space to block the proximal and distal aorta,in situ aortic reconstruction is an effective treatment,and different materials can achieve satisfactory results in a short period of time.

Objective:To explore the surgical treatment strategy of stent graft infection after interventional treatment of major iliac artery related diseases.Methods:Retrospective analysis was performed on the clinical data of 6 patients with secondary stent graft infection after interventional treatment for major iliac artery related diseases admitted to the Department of Vascular Surgery,Affiliated Drum Tower Hospital,Medical School of Nanjing University from November 2021 to August 2022.There were 5 males and 1 female,with a mean age of 64 years (range:49 to 79 years).The infection time was 53 days to 3 165 days.All the 6 patients received surgical treatment,including 3 patients who underwent anatomic bypass grafting (axillary arterial-femoral artery bypass,femoral arterial-femoral artery bypass) using artificial vessels,and 3 patients who underwent in situ abdominal aorta reconstruction using bovine pericardium.The perioperative situation,postoperative infection and the occurrence of serious adverse events were recorded,and the safety of different treatment methods and materials was evaluated.Results:All patients successfully completed the operation and no death occurred during hospitalization.Intraoperative blood loss was 2 000 to 5 000 ml,and intraoperative blood transfusion was 1 600 to 5 350 ml.All the patients were followed up for 81 to 395 days after surgery,and the incision healed well,and no reinfection occurred.Postoperative gastrointestinal bleeding occurred in 1 patient,secondary surgery (retroperitoneal hematoma removal) was performed in 1 patient due to postoperative bleeding at the vascular anastomosis,both lower limb amputations were performed in 1 patient due to postoperative lower limb ischemia,and intermittent claudication occurred in 2 patients.All patients were alive at the last follow-up.Conclusion:For patients with aortic stent graft infection,when the infection is not serious and there is enough space to block the proximal and distal aorta,in situ aortic reconstruction is an effective treatment,and different materials can achieve satisfactory results in a short period of time.