Objective:To evaluate the clinical value of three-dimensional(3D) printing-assisted fenestrated/branched endovascular aortic repair (F/B-TEVAR) for the treatment of endoleak after open surgery for type A aortic dissection.Methods:A multi-center retrospective case series analysis was conducted on 16 patients with anastomotic leakage following Stanford type A aortic dissection open repair, admitted to 12 medical centers between January 2019 and December 2023. All surgeries were led by the vascular surgery team from Department of Vascular Surgery, Nanjing Drum Tower Hospital. The study included 12 males and 4 females, with an age of (58.1±8.2) years (range: 42 to 75 years). Preoperative patient-specific 3D-printed models or 3D parametric surface topological guides were created based on aortic CT angiography data. These models assisted intraoperative external positioning of fenestration sites, combined with stent diameter selection and inner branch techniques to complete endovascular repair. Surgical procedures, complications, and clinical outcomes were evaluated, with follow-up CT imaging to assess efficacy.Results:All patients successfully underwent surgery without conversion to open repair. One patient had distal stent migration from a prior open repair, requiring intraoperative coverage of the main stent window and conversion to an in situ fenestration procedure. The mean operative time was (332.6±111.2)minutes (range: 80 to 460 minutes). No renal failure, paraplegia, or branch artery loss occurred. Postoperative follow-up ( M(IQR)) was 18(18) months(range: 6 to 36 months), with follow-up rates of 16/16 at 6 months, 10/16 at 12 months, 8/16 at 24 months, and 2/16 at 36 months. During follow-up, endoleak occurred in 3 patients, cerebral infarction in 1 patient, and death in 1 patient. The remaining patients demonstrated stable stent positioning, patent branches, and no endoleak. Conclusion:3D technology-guided F/B-TEVAR shows favorable mid-to short-term outcomes in treating anastomotic leakage after open repair of type A aortic dissection.

Objective:To evaluate the clinical value of three-dimensional(3D) printing-assisted fenestrated/branched endovascular aortic repair (F/B-TEVAR) for the treatment of endoleak after open surgery for type A aortic dissection.Methods:A multi-center retrospective case series analysis was conducted on 16 patients with anastomotic leakage following Stanford type A aortic dissection open repair, admitted to 12 medical centers between January 2019 and December 2023. All surgeries were led by the vascular surgery team from Department of Vascular Surgery, Nanjing Drum Tower Hospital. The study included 12 males and 4 females, with an age of (58.1±8.2) years (range: 42 to 75 years). Preoperative patient-specific 3D-printed models or 3D parametric surface topological guides were created based on aortic CT angiography data. These models assisted intraoperative external positioning of fenestration sites, combined with stent diameter selection and inner branch techniques to complete endovascular repair. Surgical procedures, complications, and clinical outcomes were evaluated, with follow-up CT imaging to assess efficacy.Results:All patients successfully underwent surgery without conversion to open repair. One patient had distal stent migration from a prior open repair, requiring intraoperative coverage of the main stent window and conversion to an in situ fenestration procedure. The mean operative time was (332.6±111.2)minutes (range: 80 to 460 minutes). No renal failure, paraplegia, or branch artery loss occurred. Postoperative follow-up ( M(IQR)) was 18(18) months(range: 6 to 36 months), with follow-up rates of 16/16 at 6 months, 10/16 at 12 months, 8/16 at 24 months, and 2/16 at 36 months. During follow-up, endoleak occurred in 3 patients, cerebral infarction in 1 patient, and death in 1 patient. The remaining patients demonstrated stable stent positioning, patent branches, and no endoleak. Conclusion:3D technology-guided F/B-TEVAR shows favorable mid-to short-term outcomes in treating anastomotic leakage after open repair of type A aortic dissection.

Objective:To explore the relationship between dietary pattern and sexual function in people of childbearing age.Methods:This study adopted a cross-sectional method and included all women and men who visited Reproduction Center of Maanshan Maternal and Child Health Hospital, Reproductive Medicine Center of the 901th Hospital of the Joint Logistics Support Force of People's Liberation Army and Reproduction Center of Anhui Wanbei Coal Power Group General Hospital from December 2020 to March 2022. The Female Sexual Function Index (FSFI) and International Index of Erectile Function-15 (IIEF-15) were used to assess sexual function. Factor analysis was used to establish dietary patterns, and multivariate logistic regression was used to analyze the association between dietary patterns and sexual function.Results:A total of 1 290 females and 1 331 males were included in the study, including 1 031 females and 899 males with sexual dysfunction. There were 289 women and 272 men with balanced dietary pattern, 473 women and 395 men with traditional dietary pattern, 272 women and 324 men with processed dietary pattern, and 256 women and 340 men with beverage dietary pattern. After adjusting for confounding factors such as residence and age, it was found that balanced dietary pattern was negatively correated with female sexual desire disorder ( OR=0.904, 95% CI: 0.820-0.995, P=0.039), sexual arousal disorder ( OR=0.840, 95% CI: 0.759-0.929, P=0.001), vaginal lubrication disorder ( OR=0.833, 95% CI: 0.710-0.979, P=0.026), orgasmic disorder ( OR=0.764, 95% CI: 0.680-0.858, P<0.001), low sexual satisfaction ( OR=0.887, 95% CI: 0.796-0.987, P=0.028), sexual dysfunction ( OR=0.805, 95% CI: 0.714-0.907, P<0.001), and male orgasmic disorder ( OR=0.859, 95% CI: 0.763-0.967, P=0.012). The traditional dietary pattern was negatively correlated with female sexual desire disorder ( OR=0.879, 95% CI: 0.786-0.983, P=0.024), sexual arousal disorder ( OR=0.884, 95% CI: 0.784-0.995, P=0.042), male erectile disorder ( OR=0.736, 95% CI: 0.634-0.855, P<0.001), sexual desire disorder ( OR=0.753, 95% CI: 0.648-0.876, P<0.001), and sexual dysfunction ( OR=0.769, 95% CI: 0.653-0.907, P=0.020). The processed dietary pattern was positively correlated with erectile disorder ( OR=1.162, 95% CI: 1.049-1.287, P=0.004), orgasmic dysfunction ( OR=1.207, 95% CI: 1.091-1.337, P<0.001), sexual desire disorder ( OR=1.199, 95% CI: 1.081-1.330, P=0.001) and sexual dysfunction ( OR=1.134, 95% CI: 1.020-1.261, P=0.002). Beverage dietary pattern was not associated with sexual dysfunction in men and women (all P>0.05). Conclusion:Balanced, traditional dietary patterns were related to the reduce risk of sexual dysfunction in both women and men of childbearing age, while processed dietary patterns were related to the increased risk of sexual dysfunction in men of childbearing age.

Objective:To explore the relationship between dietary pattern and sexual function in people of childbearing age.Methods:This study adopted a cross-sectional method and included all women and men who visited Reproduction Center of Maanshan Maternal and Child Health Hospital, Reproductive Medicine Center of the 901th Hospital of the Joint Logistics Support Force of People's Liberation Army and Reproduction Center of Anhui Wanbei Coal Power Group General Hospital from December 2020 to March 2022. The Female Sexual Function Index (FSFI) and International Index of Erectile Function-15 (IIEF-15) were used to assess sexual function. Factor analysis was used to establish dietary patterns, and multivariate logistic regression was used to analyze the association between dietary patterns and sexual function.Results:A total of 1 290 females and 1 331 males were included in the study, including 1 031 females and 899 males with sexual dysfunction. There were 289 women and 272 men with balanced dietary pattern, 473 women and 395 men with traditional dietary pattern, 272 women and 324 men with processed dietary pattern, and 256 women and 340 men with beverage dietary pattern. After adjusting for confounding factors such as residence and age, it was found that balanced dietary pattern was negatively correated with female sexual desire disorder ( OR=0.904, 95% CI: 0.820-0.995, P=0.039), sexual arousal disorder ( OR=0.840, 95% CI: 0.759-0.929, P=0.001), vaginal lubrication disorder ( OR=0.833, 95% CI: 0.710-0.979, P=0.026), orgasmic disorder ( OR=0.764, 95% CI: 0.680-0.858, P<0.001), low sexual satisfaction ( OR=0.887, 95% CI: 0.796-0.987, P=0.028), sexual dysfunction ( OR=0.805, 95% CI: 0.714-0.907, P<0.001), and male orgasmic disorder ( OR=0.859, 95% CI: 0.763-0.967, P=0.012). The traditional dietary pattern was negatively correlated with female sexual desire disorder ( OR=0.879, 95% CI: 0.786-0.983, P=0.024), sexual arousal disorder ( OR=0.884, 95% CI: 0.784-0.995, P=0.042), male erectile disorder ( OR=0.736, 95% CI: 0.634-0.855, P<0.001), sexual desire disorder ( OR=0.753, 95% CI: 0.648-0.876, P<0.001), and sexual dysfunction ( OR=0.769, 95% CI: 0.653-0.907, P=0.020). The processed dietary pattern was positively correlated with erectile disorder ( OR=1.162, 95% CI: 1.049-1.287, P=0.004), orgasmic dysfunction ( OR=1.207, 95% CI: 1.091-1.337, P<0.001), sexual desire disorder ( OR=1.199, 95% CI: 1.081-1.330, P=0.001) and sexual dysfunction ( OR=1.134, 95% CI: 1.020-1.261, P=0.002). Beverage dietary pattern was not associated with sexual dysfunction in men and women (all P>0.05). Conclusion:Balanced, traditional dietary patterns were related to the reduce risk of sexual dysfunction in both women and men of childbearing age, while processed dietary patterns were related to the increased risk of sexual dysfunction in men of childbearing age.

Objective: To investigate the factors influencing small intestinal ischemia in elderly patients with incarcerated hernia. Methods: The clinical data of 105 elderly patients admitted for surgical procedures of incarcerated hernia at Department of General Surgery, Huadong Hospital between January 2014 and December 2021 were retrospectively analyzed. There were 60 males and 45 females, aged (86.1±4.3) years (range: 80 to 96 years). They were divided into normal group (n=55) and ischemic group (n=50) according to intraoperative intestinal canal condition. The t test, χ² test and Fisher's exact probability method were used for the univariate analysis of the factors that influence intestinal ischemia in patients, and Logistic regression was used for multifactorial analysis. Results: In all patients, 18 patients (17.1%) had irreversible intestinal ischemia with bowel resection. Six patients died within 30 days, 3 cases from severe abdominal infection, 2 cases from postoperative exacerbation of underlying cardiac disease, and 1 case from respiratory failure due to severe pulmonary infection. The results of the univariate analysis showed that there were differences in gender, history of intussusception, duration of previous hernia, white blood cell count, neutrophil percentage, C-reactive protein, type of incarcerated hernia, and preoperative intestinal obstruction between the two groups (all P<0.05). The Logistic regression results showed that the short time to the previous hernia (OR=0.892, 95%CI 0.872 to 0.962, P=0.003), high C-reactive protein (OR=1.022, 95%CI 1.007 to 1.037, P=0.003), non-indirect incarcerated hernia (OR=10.571, 95%CI 3.711 to 30.114, P<0.01) and preoperative intestinal obstruction (OR=6.438, 95%CI 1.762 to 23.522, P=0.005) were independent risk factors for the development of intestinal ischemia in elderly patients with incarcerated hernia. Conclusions: The short duration of the previous hernia, the high values of C-reactive proteins, the non-indirect incarcerated hernia, and the preoperative bowel obstruction are influencing factors for bowel ischemia in elderly patients with incarcerated hernia. A timely operation is necessary to reduce the incidence of intestinal necrosis and improve the prognosis.
Male ; Aged ; Female ; Humans ; Retrospective Studies ; C-Reactive Protein ; Intestinal Obstruction/etiology* ; Hernia, Inguinal/surgery* ; Mesenteric Ischemia/surgery* ; Ischemia/surgery* ; Herniorrhaphy/adverse effects*

OBJECTIVE: To assess the efficacy and safety of Bushen Huoxue Formula (BSHXF) for the treatment of discogenic low-back pain (DLBP). METHODS: This was a parallel, double-blind, randomized, clinical trial performed between May 2019 and June 2020. Seventy patients were assigned by computerized random number table to the treatment group (lumbar traction and BSHXF, 35 cases) or the control group (lumbar traction and placebo, 35 cases). The patients received intervention for 3 weeks. Assessment was conducted before treatment and at week 1, 2, 3 during treatment. Primary outcome was the self-reported score of Oswestry Disability Index (ODI). Secondary outcomes included Visual Analog Scale (VAS), clinical efficacy rate by minimal clinically important difference (MCID) as well as lumbar tenderness, muscle tone and lumbar spine mobility. Adverse reactions were recorded. Follow-up was performed at 1 and 3 months after the end of treatment. RESULTS: In the treatment group, ODI score was significantly decreased compared with baseline (P<0.05) and the control group at 2- and 3- week treatment. Similarly, VAS score decreased compared with the baseline (P<0.05) and was lower than that in the control group at 2- and 3- week treatment (P<0.05). The clinical efficacy rate of the treatment group was higher than that of the control group after treatment [32.35% (11/34) vs. 3.13% (1/32), P<0.05). Moreover, the tenderness, and muscle tone, as well as the back extension and left flexion in lumbar spine mobility in the treatment group at 3-week treatment were significantly improved compared with the control group (P<0.05). Follow-up showed that at 1-month after treatment, the treatment group had better outcomes than the control group with regard to a total score of ODI and VAS scores, as well as clinical efficacy rate (all P<0.05). Moreover, VAS score was still significantly lower than the control group at 3-month follow-up (P<0.05). No adverse reactions were reported during the study. CONCLUSION BSXHF combined with lumbar traction can significantly improve the clinical symptoms including pain intensity, functionality, muscle tone, and lumbar spine mobility in DLBP patients. (Registration No. ChiCTR1900027777).
Humans ; Intervertebral Disc Degeneration/therapy* ; Low Back Pain/drug therapy* ; Lumbar Vertebrae ; Pain Measurement ; Treatment Outcome

BACKGROUND: Thyroid dysfunction is associated with cardiovascular diseases. However, the role of thyroid function in lipid metabolism remains partly unknown. The present study aimed to investigate the causal association between thyroid function and serum lipid metabolism via a genetic analysis termed Mendelian randomization (MR). METHODS: The MR approach uses a genetic variant as the instrumental variable in epidemiological studies to mimic a randomized controlled trial. A two-sample MR was performed to assess the causal association, using summary statistics from the Atrial Fibrillation Genetics Consortium (n = 537,409) and the Global Lipids Genetics Consortium (n = 188,577). The clinical measures of thyroid function include thyrotropin (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) levels, FT3:FT4 ratio and concentration of thyroid peroxidase antibodies (TPOAb). The serum lipid metabolism traits include total cholesterol (TC) and triglycerides, high-density lipoprotein, and low-density lipoprotein (LDL) levels. The MR estimate and MR inverse variance-weighted method were used to assess the association between thyroid function and serum lipid metabolism. RESULTS: The results demonstrated that increased TSH levels were significantly associated with higher TC (β = 0.052, P = 0.002) and LDL (β = 0.041, P = 0.018) levels. In addition, the FT3:FT4 ratio was significantly associated with TC (β = 0.240, P = 0.033) and LDL (β = 0.025, P = 0.027) levels. However, no significant differences were observed between genetically predicted FT4 and TPOAb and serum lipids. CONCLUSION Taken together, the results of the present study suggest an association between thyroid function and serum lipid metabolism, highlighting the importance of the pituitary-thyroid-cardiac axis in dyslipidemia susceptibility.
Lipid Metabolism/genetics* ; Mendelian Randomization Analysis ; Thyroid Function Tests ; Thyroid Gland ; Thyrotropin ; Thyroxine ; Triiodothyronine

Objective: To investigate the current status of screen time in preschoolers during the outbreak of Corona Virus Disease 2019 (COVID-19), and the influences of parent-child active play and school online education on screen time. Methods: A total of 2 370 preschoolers were chosen through clustering sampling from 7 kindergartens in Wuxi urban areas. Questionnaire survey was administered to parents for child screen time, active play, online education as well as characteristics information. Results: A total of 1 428(60.3%) preschoolers reported more than 1 hour screen time a day, and 1 915(80.8%) preschoolers reported more than 20 minutes consecutive screen time. Compared with the weekend before the COVID-19 outbreak, 1 551(65.4%) preschoolers reported an increase of 10 minutes in screen time perday, and 1 444(60.9%) reported an increase of 5 minutes for one sersion. Logistic regression analysis showed that after controlling for confounding factors, high frequency of parent-child active play, parents’ exercise habits, online education from kindergartens and children’s active participation in the online education were negatively associated with preschoolers’ excessive and increased screen time during this period(OR=0.39-0.79, P<0.05). Conclusion During the COVID-19 outbreak, preschoolers’ media use in Wuxi city is worrisome. Parent-child active play, parents’ exercise and online education from kindergartens may play a positive role in reducing preschoolers’ media use.

To scientifically evaluate the intervention effect of Chinese medicine preventive administration(combined use of Huo-xiang Zhengqi Oral Liquid and Jinhao Jiere Granules) on community population in the case of coronavirus disease 2019(COVID-19), a large cohort, prospective, randomized, and parallel-controlled clinical study was conducted. Total 22 065 subjects were included and randomly divided into 2 groups. The non-intervention group was given health guidance only, while the traditional Chinese medicine(TCM) intervention group was given two coordinated TCM in addition to health guidance. The medical instructions were as follows. Huoxiang Zhengqi Oral Liquid: oral before meals, 10 mL/time, 2 times/day, a course of 5 days. Jinhao Jiere Granules: dissolve in boiling water and take after meals, 8 g/time, 2 times/day, a course of 5 days, followed up for 14 days, respectively. The study found that with the intake of medication, the incidence rate of TCM intervention group was basically maintained at a low and continuous stable level(0.01%-0.02%), while the non-intervention group showed an overall trend of continuous growth(0.02%-0.18%) from 3 to 14 days. No suspected or confirmed COVID-19 case occurred in either group. There were 2 cases of colds in the TCM intervention group and 26 cases in the non-intervention group. The incidence of colds in the TCM intervention group was significantly lower(P<0.05) than that in the non-intervention group. In the population of 16-60 years old, the incidence rate of non-intervention and intervention groups were 0.01% and 0.25%, respectively. The difference of colds incidence between the two groups was statistically significant(P<0.05). In the population older than 60 years old, they were 0.04% and 0.21%, respectively. The incidence of colds in the non-intervention group was higher than that in the intervention group, but not reaching statistical difference. The protection rate of TCM for the whole population was 91.8%, especially for the population of age 16-60(95.0%). It was suggested that TCM intervention(combined use of Huoxiang Zhengqi Oral Liquid and Jinhao Jiere Granules) could effectively protect community residents against respiratory diseases, such as colds, which was worthy of promotion in the community. In addition, in terms of safety, the incidence of adverse events and adverse reactions in the TCM intervention group was relatively low, which was basically consistent with the drug instructions.
Adolescent ; Adult ; Betacoronavirus ; Coronavirus Infections ; drug therapy ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Pandemics ; Pneumonia, Viral ; drug therapy ; Prospective Studies ; Young Adult