Objective To compare the clinical efficacy, safety, and patient’ prognosis of catheter-directed thrombolysis (CDT) via anterior tibial vein and popliteal vein approaches in the treatment of acute lower extremity deep vein thrombosis (DVT). Methods A retrospective analysis was conducted on the clinical data of 195 patients diagnosed with acute mixed lower extremity DVT and treated with CDT in the Department of Interventional and Vascular Surgery, Affiliated Hospital of Nantong University from January 2020 to December 2023. Patients were divided into an observation group (anterior tibial vein approach, n＝97) and a control group (popliteal vein approach, n＝98) according to the puncture route. Baseline data, thrombolysis-related indices (urokinase dosage, coagulation function indices), efficacy measures (degree of thrombus dissolution, leg circumference difference, visual analogue scale [VAS] score, venous clinical severity score [VCSS]), recovery parameters (time to ambulation, length of hospital stay), complication rates, and long-term prognosis measures (Villalta score, incidence of post-thrombotic syndrome [PTS]) were compared between the two groups. Results There was no statistically significant difference in urokinase dosage and levels of coagulation function indices between the two groups. Postoperatively, the leg circumference difference at 15 cm below the knee, VAS score, and VCSS score were significantly lower in the observation group than in the control group (P＝0.001). The observation group had higher grade Ⅲ dissolution rates in the popliteal and anterior tibial veins compared to the control group (P＜0.05), while differences of dissolution rates in the iliac and femoral veins were not statistically significant. The observation group had shorter length of hospital stay and earlier ambulation times than the control group (P＝0.001). There were no significant differences in complication rates, Villalta scores, or PTS incidence between the two groups. Conclusions CDT via the anterior tibial vein puncture approach for acute mixed lower extremity DVT is superior to the popliteal vein approach in promoting resolution of lower extremity swelling, alleviating pain, improving venous clinical symptoms, and achieving higher thrombus dissolution rates in the popliteal and anterior tibial veins. It also enables faster recovery and demonstrates good safety.

Traditional Chinese medicine （TCM） has unique advantages in alleviating the symptoms of diabetic kidney disease （DKD） and slowing its progression. However， traditional clinical trials often use the occurrence of end-stage renal disease as the end point， requiring long-term follow-up， which increases trial complexity and costs， thereby limiting the feasibility of TCM clinical studies. This paper suggested that in clinical trials of TCM for DKD， both the estimated glomerular filtration rate （eGFR） change rate （≥30%） and eGFR slope can serve as potential surrogate outcome measures. If the intervention course is short （＜1 year）， the eGFR change rate （≥30%） is recommended as a surrogate outcome measure， whereas in long-term interventional studies （≥1 year）， the eGFR slope may be more appropriate. Furthermore， based on biochemical indicators such as eGFR slope and urinary albumin-to-creatinine ratio （UACR） change rate， integrating TCM symptom evaluation， TCM syndrome evaluation， and quality of life scales can help develop internationally recognized patient-reported outcome measures （PROMs） for TCM clinical trials， which will be a key step in enhancing the evaluation system for the effectiveness of TCM in treating DKD.

Objective To examine the current status and trends of colorectal cancer (CRC) burden among Chinese residents from 1990 to 2021. Methods Data on CRC burden in China, Asia, and the global population from 1990 to 2021 were retrieved from the Global Burden of Disease database for descriptive analysis. An age-period-cohort model was employed to estimate the effects of age, period, and cohort on CRC mortality and to forecast changes in disease burden. Results In 2021, China’s age-standardized mortality rate, prevalence rate, and DALY rate for CRC were higher than global and Asian averages. The estimated annual percentage changes (EAPC) from 1990 to 2021 were −0.49% (95%CI: −0.55% to −0.43%) for mortality, 3.17% (95%CI: 3.03%−3.31%) for prevalence, and −0.62% (95%CI: −0.71% to −0.54%) for DALYs. Areas with high and medium-high sociodemographic indexes (SDIs) showed significant decreases in standardized mortality and DALY rates, but these rates remained higher compared with other regions. CRC mortality increased with age in the Chinese population, more prominently in males than in females. Using the 2002–2006 period as a reference (RR=1), the period effect on CRC mortality risk for women was higher than that for men until 2004, after which it declined considerably. With the 1957 birth cohort as a reference (RR=1), CRC mortality risk generally decreased across subsequent birth cohorts. Predictions indicate that by 2035, the standardized prevalence rate will be 267.21 per 100 000, and the standardized mortality rate will be 12.29 per 100 000. Conclusion From 1990 to 2021, China’s age-standardized CRC mortality and DALY rates have decreased, while the standardized prevalence rate has increased. These findings suggest the government to establish a comprehensive multi-level CRC prevention network.

ObjectiveTo explore the importance of post-vaccination serological testing （PVST） for children exposed to hepatitis B virus （HBV）， and analyze the factors affecting the progress of PVST. MethodsThe study focused on hepatitis B surface antigen （HBsAg）-positive pregnant women and their newborns residing in Tongzhou District， Beijing， who delivered at various obstetric institutions from January 1， 2020 to March 31， 2022. The obstetric institutions and community health service centers conducted follow-up visits 1 to 2 months after the children had received three doses of the hepatitis B vaccine （HepB）. ResultsThe vaccination rate of hepatitis B immunoglobulin （HBIg） was 100.00% （800/800）， with a successful PVST follow-up rate of 85.88% （687/800） in Tongzhou District. The initial non-response rate to immunization was 0.29% （2/687）， but successful immunization was achieved after re-immunization. The mother-to-infant transmission rate of hepatitis B was 0. Children who did not undergo PVST accounted for 14.13% （113/800）， with the main reasons being delays due to the COVID-19 pandemic， parents’ reluctance to allow venous blood collection due to the young age of the children， and loss to follow-up because children moved back to their parents’ place of origin. Logistic regression analysis showed that the proportion of PVST was higher among high-risk children （OR=30.009，P=0.001）， children with family residing in Beijing （OR=2.218，P=0.002）， and children whose mothers were <35 years old （OR=1.687，P=0.020）. ConclusionPVST is necessary for assessing the status of HBV immune response in newborns after vaccination with HepB. The COVID-19 pandemic impacted the implementation of PVST for children exposed to HBV. Strengthening the management of non-high-risk children， those living outside Beijing， and children with mothers aged ≥ 35 years old may increase the rate of PVST in Tongzhou District.

Objective To clarify the effects of 5G mobile phone radiofrequency radiation exposure on male mouse fertility and to preliminarily explore the underlying mechanisms. Methods Healthy male C57BL/6 mice aged 7-8 weeks were randomly assigned to Sham group, 3.5 GHz radiofrequency radiation group, and 4.9 GHz radiofrequency radiation group, with 16 mice in each group. The mice were exposed to 3.5 GHz or 4.9 GHz mobile phone radiofrequency radiation for 42 consecutive days (1 h per day). The sperm quality was evaluated using sperm count, deformity rate, and motility. H&E staining was performed to assess testicular tissue structure by observing the morphology of spermatogenic cells at various development stages, the diameter of seminiferous tubules, and the thickness of seminiferous epithelium. The sperm mitochondrial function was assessed using sperm mitochondrial membrane potential and testicular ATP content. The fertility of mice was evaluated through fertility rate, litter size, and survival rate of offspring. The underlying mechanisms were explored by detecting the methylation of LRGUK gene and its mRNA and protein levels. Results Compared with the Sham group, there were no significant changes in sperm count in the 3.5 GHz and 4.9 GHz groups; however, the sperm abnormality rate significantly increased (P < 0.05) and sperm motility significantly decreased (P < 0.05). The structure of testicular tissue, the function of sperm mitochondria, and fertility of mice showed no significant changes as compared with the Sham group. The methylation level of LRGUK gene in the testes significantly increased, while the mRNA and protein expression levels significantly decreased. Conclusion Exposure to 3.5 GHz and 4.9 GHz mobile phone radiofrequency radiation for 42 consecutive days can lead to an increase in sperm deformity rate and a decrease in sperm motility in mice, but has no significant effect on fertility, which may be related to an increase in methylation level of the LRGUK gene in the testes.

【Objective】 To identify the influencing factors of infant motor development, and to explore the potential interactive factors, so as to provide scientific basis for early prediction and targeted prevention of infant motor developmental delay. 【Methods】 Data of infants receiving "0~1 motor development screening" at 21 community health service centers in Tongzhou District, from January 1st, 2020 to August 31st, 2021 were collected through the Beijing Maternal and Child Information System.Using the method of nested case-control study, 416 infants with positive screening results were selected as case group, 416 infants with negative screening result were selected into the control group by 1∶1 case-control matching of screening age.Chi-square test, Logistic regression analysis, and Exhaustive CHAID decision tree model were used to explore the influencing factors of infant motor development, the interaction effect was investigated by using the additive and multiplicative interaction models. 【Results】 Multivariate Logistic analysis showed that birth weight<2 500g (OR=3.28), cesarean section (OR=1.63), outdoor activity≤ 1h/d (OR=3.07), and no supplementation of vitamin D (OR=2.68) were risk factors for positive screening results of infant motor development (P<0.01).The Exhaustive CHAID decision tree showed that low birth weight was the primary risk factor for infant with positive screening results, followed by outdoor activity, vitamin D supplementation and delivery.The interaction analysis showed that there was a multiplicative interaction (OR=13.76, 95% CI:1.20 - 158.08) and an additive interaction (RERI=10.22, 95%CI:5.05 - 15.38) between non supplementation of vitamin D and low birth weight on infant motor development with positive screening results. 【Conclusions】 Attention should be paid to the early motor development of infants with low birth weight and those born by cesarean section, with emphasis on the dosage of vitamin D supplementation and outdoor activity duration.Moreover, the early screening and hierarchical management of infant motor development should also be strengthened.

AIM: To explore the characteristics of astigmatism distribution among preschool children from Tongzhou District, Beijing, discuss its categorizations, severity, and the effect on preschoolers' vision, and clarify the influence of cycloplegic refraction on the detection of astigmatism.METHODS:In this cross-sectional study conducted from December 2021 to January 2022, a cluster random sampling method was utilized to assess 1 498 preschool children(2 996 eyes)from Tongzhou District, Beijing. The sample comprised 791 males and 707 females, with 222 children aged 3 to <4 years, 521 children aged 4 to <5 years, 647 children aged 5 to <6 years, and 108 children aged 6 to <7 years. Evaluations included visual acuity, anterior segment, computerized optometry, and cycloplegic refraction.RESULTS:Prior to cycloplegic refraction, the prevalence of astigmatism was found to be 61.88%(927/1498). For post-cycloplegic refraction, this percentage slightly increased to 64.02%(959/1498, P=0.095). Following cycloplegic refraction, the distribution of astigmatism severity was as follows: 51.87%(777/1498)had mild astigmatism, 9.41%(141/1498)had moderate astigmatism, and 2.74%(41/1498)had severe astigmatism. Astigmatism was predominantly with-the-rule across all age groups, with compound hyperopic astigmatism being the most frequent type. In cases of subnormal vision caused by astigmatism: low degree accounted for 9.38%, moderate degree accounted for 25.4%,and high degree accounted for 52.6%.CONCLUSION:The findings reveal a high incidence of astigmatism in preschool children, predominantly in a mild nature. Cycloplegic refraction was observed to have a negligible effect on the rate of astigmatism detection. Moreover, its impact on vision becomes more significant as the degree of astigmatism increases.

ObjectiveThis study explores the efficacy and pharmacological mechanism of Wujiwan in rats with inflammatory bowel disease （IBD） from the perspectives of the peroxisome proliferator-activated receptor γ （PPARγ） signaling pathway and T-cell immunity， providing reference for the treatment of IBD with traditional Chinese medicine. MethodThe study involved administering 2，4，6-trinitrobenzenesulfonic acid （TNBS） enemas to 35 rats to induce acute IBD. After 24 hours， the animals were divided into the following groups： normal group， model group， Wujiwan treatment group， and positive drug control group. Each group received gastric gavage for 8 consecutive days before the rats were dissected to compare the disease activity index （DAI） of the rat colon tissue， the colon mucosal damage index （CMDI）， and the spleen index. Enzyme-linked immunosorbent assay （ELISA） was used to measure the levels of interleukin-1β （IL-1β）， interleukin-10 （IL-10）， and tumor necrosis factor-α （TNF-α） in the serum. Quantitative real-time polymerase chain reaction （Real-time PCR） was used to determine the mRNA expression levels of T-bet （T-box expressed in T cells） and Gata3 （Gata-binding protein-3） in the colon tissue. Western blot analysis was conducted to detect the protein expression levels of PPARγ， T-bet， and nuclear factor-κB p65 （NF-κB p65） in the rat colon. ResultThe rat model of IBD was successfully established. Compared with the model group， the Wujiwan treatment group showed reduced DAI， CMDI， and spleen index， decreased content of TNF-α in the serum（P<0.01）， significantly increased content of IL-10（P<0.01）， and elevated mRNA content of T-bet and Gata3（P<0.05） in the colon tissue. The expression of PPARγ protein was augmented（P<0.05）， and the expression of T-bet and NF-κB p65 protein was decreased（P<0.05，P<0.01）. ConclusionWujiwan activates or upregulates PPARγ expression in IBD rats to inhibit the generation of pro-inflammatory factors， participates in the inflammatory immune process， and alleviates inflammatory reactions. Its mechanism may involve regulating the NF-κB pathway through PPARγ， enhancing Th2 cell transcription expression， and reducing Th1 cell transcription.

Traditional Chinese medicine （TCM） has a long history of application in China and has consistently played a vital role in treating diseases and saving lives. TCM prescriptions （compounds） constitute the primary form of clinical TCM treatment and significantly differ from western medicine （chemicals） due to the diverse composition and chemical constituents of TCM （compounds）. Nevertheless， the potential multi-component， multi-target， and multi-pathway action characteristics of TCM prescriptions also demonstrate their possible （complementary） therapeutic advantages when compared with single-component chemical drugs. Therefore， driven by the development of modern science and technology and the demands of the modernization and internationalization of TCM， modern theories regarding the complexity of TCM prescription effects have been continuously proposed： Different from the abstract language of traditional prescription theory， the modern TCM prescription theory is more inclined to illustrate the connotation of prescription compatibility concretely and vividly from an experimental and scientific perspective. In this paper， new theories on the complexity of TCM prescriptions proposed in recent years are summarized to provide research references and ideas for the greater role of TCM prescriptions and a better scientific understanding.

Neuropathic pain is a clinical symptom with complex mechanisms and high incidence. The commonly used analgesics have limited efficacy and can cause serious side effects. The theory of chronic pain entering collaterals was proposed by YE Tianshi， a famous physician focusing on warm diseases in the Qing dynasty， on the basis of the ancient therapies for pain. This theory is particularly suitable for the diagnosis and treatment of neuropathic pain in view of the clinical course and manifestations. The chronic neuropathic pain can enter the Yin collateral in deeper sites. The pathogenesis of neuropathic pain is summarized as a deficiency in origin and excess in superficiality. The root cause is the dysfunction of Zang-Fu organs， mainly the liver, kidney and heart， while the superficial causes are phlegm and stasis caused by the obstructed Qi and blood movement due to the consumption of Qi and blood in collaterals. Accordingly， the therapies such as dispelling blood stasis， resolving phlegm， and dredging collaterals should be adopted. This paper expounds the traditional Chinese medicine （TCM） pathogenesis and treatment of neuropathic pain， enriching the knowledge and providing new ideas for the TCM prevention and treatment of this disease as a collateral disease.