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 review the risk factors for early and medium-term complications of fenestration-branch endovascular thoracic aortic repair (F/B-TEVAR) in patients with complex aortic arch disease.Methods:The clinical and follow-up data of 202 patients undergoing F/B-TEVAR treatment from Feb 2019 to Sep 2023 in these centers were retrospectively analyzed .Results:There were 46 cases suffering from postoperative complications (22.8%). The risk factors with statistical significance included aortic atherosclerotic plaque [ OR=2.843; 95% CI (1.4-5.6); P<0.01], aortic intramural thrombosis [ OR=2.358; 95% CI (1.2-4.6), P=0.011], the aortic dilatation [ OR=4.219; 95% CI (1.6-11.3), P<0.01], the history of stroke [ OR=2.088; 95% CI (1.1-4.1), P=0.032], smoking history [ OR=2.680; 95% CI: (1.3-5.5); P<0.01], duration of surgery [ OR=1.9; 95% CI: (1.2-2.9); P=0.042].While the application of 3D printing assistive technology [ OR=0.392; 95% CI: (0.2-0.9); P=0.048] was in a negative correlation with postoperative complication. Conclusions:The independent risk factors for complications after F/B-TVAR included aortic atherosclerotic plaque, aortic intramural thrombosis, the aortic dilatation, the history of stroke, smoking history,duration of surgery.The application of 3D printing technology can effectively reduce the complication rate.

Objective:To evaluate the real-world short-term effectiveness of ixekizumab in the treatment of psoriasis, and to investigate factors influencing the effectiveness.Methods:Baseline data and short-term effectiveness evaluation results were retrospectively collected from patients with psoriasis, who received ixekizumab treatment in Department of Dermatology, Xiangya Hospital from November 2019 to September 2021. A descriptive analysis was performed on the baseline characteristics of patients, continuous data were described as median (lower quartile, upper quartile), and categorical data were described as percentages. Comparisons of disease severity scores before and after the treatment with ixekizumab were performed using Wilcoxon signed-rank test or paired McNemar test. Multivariable logistic regression analysis was conducted to explore factors influencing the effectiveness of 4-week ixekizumab treatment.Results:A total of 118 patients with psoriasis were included, including 94 males and 24 females, and their age [ M ( Q1, Q3) ] was 43.4 (32.5, 53.0) years; plaque psoriasis (99 cases, 83.9%) and severe psoriasis (72 cases, 68.6%) predominated among the 118 patients, and skin lesions were mainly located on the scalp (59/116, 50.9%). Among the 49 patients who had received 2-week ixekizumab treatment, 27 (55.1%) achieved a 50% improvement in the psoriasis area and severity index (PASI) score (PASI50) ; after 4-week treatment, 44 (89.8%), 30 (61.2%), 13 (26.5%) and 10 (20.4%) patients achieved PASI50/75/90/100 respectively, and their PASI scores (2.1 [1.1, 7.1]), involved body surface area (3.9% [0.5%, 14.5%]), dermatology life quality index scores (1.0 [0.0, 2.0]) and physician global assessment (PGA) scores (1.0 [1.0, 3.0]) were significantly lower than the corresponding scores at baseline (12.4 [8.8, 23.2], 22.0% [11.3%, 43.4%], 6.0 [3.0, 11.0], 4.0 [3.0, 5.0], respectively; all P < 0.001]. Multivariable logistic regression analysis showed that the baseline body mass index was significantly associated with the PASI75 response rate ( OR = 0.814, 95% CI: 0.659 - 0.958, P = 0.029) and the proportion of patients with PGA0/1 ( OR = 0.743, 95% CI: 0.562 - 0.917, P = 0.017) after 4-week ixekizumab treatment, and the baseline BSA score was significantly associated with the proportion of patients with PGA0/1 after 4-week ixekizumab treatment ( OR = 0.924, 95% CI: 0.870 - 0.968, P = 0.003) . Conclusion:The 4-week ixekizumab treatment significantly decreased the severity of psoriasis, and may be more effective in patients with lower disease severity and lower body mass index at baseline.

Objective:To explore the relationship between the subcomponents of executive function and situation awareness.Methods:A total of 73 cadets of our school were selected to complete a flight simulation mission. The situation awareness rating technique (SART) scores, situation awareness global assessment technique (SAGAT) scores and flight performance were recorded as dependent variables. Spatial n-back task, Go/Nogo task, Stroop task and digital shifting task were used to measure the subcomponents of executive functions and perform independent multiple linear regression analysis as predictive variables.Results:Pearson correlation analysis showed that updating score was significantly and positively correlated with response inhibition, SART, SAGAT and flight performance ( r=0.235, 0.285, 0.298, 0.264, P=0.049, 0.016, 0.012, 0.025), response inhibition score was significantly and positively correlated with SAGAT and flight performance ( r=0.349, 0.243, P=0.003, 0.041), interference control score was only negatively correlated with cognitive shifting and flight performance ( r=-0.350, -0.235, P=0.003, 0.045), cognitive shifting score was significantly and positively correlated with SART, SAGAT and flight performance ( r=0.249, 0.275, 0.364, P=0.039, 0.019, 0.002). Further regression analysis indicated that updating score has a significant predictive effect on SART ( t=2.201, P=0.031), updating and response inhibition scores have significant predictive effects on SAGAT ( t=2.270, 2.546, P=0.026, 0.013), and updating and cognitive shifting scores have significant predictive effects on flight performance ( t=2.508, 2.553, P=0.015, 0.013). Conclusions:The subcomponents of executive function are significantly with the level of situation awareness and have predictive significance.

Objective:To evaluate the effect of acupuncture with invigorating viscera and purging fu, replenishing qi and nourishing yin for the T2DM patients with qi and yin deficiency syndrome.Methods:A total of 59 patients who met the inclusion criteria from January 1, 2019 to December 31, 2020 in the Endocrinology Department of the Second Affiliated Hospital of Anhui University of Chinese Medicine were divided into the acupuncture group with 30 cases and a control group with 29 cases, according to the random number table method. The control group received conventional hypoglycemic treatment. And the acupuncture group was treated with acupuncture on the basis of the control group treatment. Both groups were treated for 4 weeks. TCM syndrome scores were performed before and after treatment, respectively. Serum IL-6 was measured by ELISA, serum CRP by immunoturbidimetry, and serum fasting blood glucose (FPG), 2 hPG, HbAlc, TC, TG, HDL-C, LDL-C levels by spectrophotometry. The BMI, clinical effect rates were calculated.Results:The total effective rate was 96.7% (29/30) in acupuncture group and 75.9% (22/29) in control group, and the difference was statistically significant ( χ2=5.96, P<0.01). After treatment, the scores of fatigue, dryness of mouth and pharynx, spontaneous sweating and night sweating, shortness of breath and lazy speech in acupuncture group were significantly lower than those in the control group ( t values were 6.02, 4.31, 4.34, 3.63, respectively, all Ps<0.01). The serum CRP level in acupuncture group was significantly lower than that of the control group at 21, 48 d after treatment ( t values were -4.36, -3.75, respectively, all Ps<0.01), and IL-6 level was significantly lower than that of the control group at 14, 21, 28 d after treatment ( t values were -2.92, -5.35, -8.71, respectively, all Ps<0.01). After treatment, the serum TC [(4.62±0.68) mmol/L vs. (5.56±0.72) mmol/L, t=5.16], TG [(1.48±0.42) mmol/L vs. (2.12±0.89) mmol/L, t=3.55], LDL-C [(2.48±0.84) mmol/L vs.(3.02±0.95) mmol/L, t=2.32] in the acupuncture group were significantly lower than those in the control group ( P<0.05), HDL-C [(1.39±0.27) mmol/L vs. (1.26±0.22) mmol/L, t=-2.02] in the acupuncture group was significantly higher than that of the control group ( P<0.05). The serum FPG level at 21 d [(6.12±0.67) mmol/L vs. (6.57±0.61) mmol/L, t=-4.96], 28 d [(5.78±0.52) mmol/L vs. (6.49±0.58) mmol/L, t=-2.70] in acupuncture group were significantly lower than those in the control group ( P<0.01). The 2h PG level at 14 d after treatment [(10.23±1.06) mmol/L vs. (11.76±1.34) mmol/L, t=-4.87], 21 d [(9.05±0.98) mmol/L vs. (10.53±1.24) mmol/L, t=-5.10], 28 d [(7.45±0.69) mmol/L vs. (9.31±0.78) mmol/L, t=-9.71] in the acupuncture group were significantly lower than those in the control group ( P<0.01), and HbA1c level were decreased 14 d [(7.93±0.86)% vs. (8.52±0.97)%, t=-2.47], 21 d [(7.63±0.85)% vs. (8.15±0.92)%, t=-2.26], 28 d [(6.47±0.51)% vs. (7.51±0.62)%, t=-7.05] significantly lower than those in the control group ( P<0.01), BMI [(22.13±1.57) kg/m 2vs. (24.16±1.82) kg/m 2, t=-4.59] 28 d after treatment was significantly lower than that of the control group ( P<0.01). Conclusion:Acupuncture therapy of nourishing viscera and purging fu, nourishing qi and nourishing yin can regulate the disorder of glucose and lipid metabolism in patients with T2DM and syndrome of qi and yin deficiency.

Objective:To explore the relationship between the subcomponents of executive function and situation awareness.Methods:A total of 73 cadets of our school were selected to complete a flight simulation mission. The situation awareness rating technique (SART) scores, situation awareness global assessment technique (SAGAT) scores and flight performance were recorded as dependent variables. Spatial n-back task, Go/Nogo task, Stroop task and digital shifting task were used to measure the subcomponents of executive functions and perform independent multiple linear regression analysis as predictive variables.Results:Pearson correlation analysis showed that updating score was significantly and positively correlated with response inhibition, SART, SAGAT and flight performance ( r=0.235, 0.285, 0.298, 0.264, P=0.049, 0.016, 0.012, 0.025), response inhibition score was significantly and positively correlated with SAGAT and flight performance ( r=0.349, 0.243, P=0.003, 0.041), interference control score was only negatively correlated with cognitive shifting and flight performance ( r=-0.350, -0.235, P=0.003, 0.045), cognitive shifting score was significantly and positively correlated with SART, SAGAT and flight performance ( r=0.249, 0.275, 0.364, P=0.039, 0.019, 0.002). Further regression analysis indicated that updating score has a significant predictive effect on SART ( t=2.201, P=0.031), updating and response inhibition scores have significant predictive effects on SAGAT ( t=2.270, 2.546, P=0.026, 0.013), and updating and cognitive shifting scores have significant predictive effects on flight performance ( t=2.508, 2.553, P=0.015, 0.013). Conclusions:The subcomponents of executive function are significantly with the level of situation awareness and have predictive significance.

Objective: To examine the prevalence of depression and anxiety symptoms, and the related factors in family members of schizophrenic patients in a Shanghai community. Methods: From March to May 2017, the family members of 206 schizophrenic patients registered in Xuhui district Kangjian community of Shanghai were enrolled in this cross-sectional survey. The participants were evaluated with Patient Health Questionnaire Self-rating Depression Scale (PHQ-9) and the Anxiety Screening Scale (GAD-7). The factors related to depression and anxiety symptoms were analyzed. Results: The detection rates of depressive symptoms and anxiety symptoms in the family members of schizophrenia patients were 40.3%(83/206) and 37.9%(78/206), respectively.Univariate analysis showed that the relationship with the patient, education levels were the influencing factors of depressive symptoms (χ²=17.045, 9.702; P<0.01); while age, relationship with the patient, education levels were factors related to the occurence of anxiety symptoms (χ²=11.862, 22.042, 15.060; P<0.01). Multivariate regression analysis showed that the parents of patient was more prone to depressive symptoms than spouses (OR=2.861, P<0.01); higher education was more prone to be depressive than primary education (OR=10.071, P<0.01). Age group 18-40 years were more prone to anxiety than the age group ≥66 years (OR=0.060, P<0.05); sibling relationship is more prone to anxiety than spouse relationship (OR=10.018, P<0.01), followed by parental relationship (OR=7.467, P<0.01); higher education was more prone to anxiety than primary education (OR=5.119, P<0.05). Conclusions There is high prevalence of depression and anxiety symptoms in family members of schizophrenic patients, which is related to the relationship with the patient, the education level of family members and other factors.

Objective To investigate the clinical effect of locking plate fixation in treatment of proximal humeral fractures in the elderly.Methods This retrospective case control study enrolled 96 patients with closed proximal humeral fractures admitted from October 2013 and October 2015.There were 52 males and 44 females,with age of (68.2 ± 1.4) years (range,62-74 years).According to the Neer classification of proximal humeral fractures,two-part fractures were noted in 27 patients,three-part fractures in 57,and four-part fractures in 12.According to the surgical methods,the patients were assigned to locking plate fixation (observation group) and anatomic plate fixation (control group),with 48 cases each.Operation time,intraoperative blood loss,hospitalization time,fracture healing time,varus angle of the humeral head,visual analogue score (VAS),Neer shoulder score for shoulder function and related complications were observed.Results All patients were followed up for 13-24 months (mean,18.5 months).Better results were observed in observation group than control group in aspects of operation time [(51.2 ± 14.8) minutes vs.(73.2 ±27.3)minutes],intraoperative bleeding[(158.3 ±32.9)ml vs.(270.9 ± 34.8) ml],hospitalization time [(8.2 ± 2.9) days vs.(13.1 ± 2.2) days],fracture healing time [(93.7 ±18.4)days vs.(122.9±18.9)days],varus angle of the humeral head [(2.2±1.8)° vs.(4.2± 1.3) °],VAS [(2.0 ± 0.7) points vs.(5.1 ± 1.2) points],excellence rate of Neer score (98％ vs.90％) and postoperative complication incidence (10％ vs.21％) (P ＜ 0.05).Conclusion Compared with the anatomical plate,locking plate fixation has advantages of shorter operation time,less intraoperative bleeding,earlier bone healing,better shoulder movement and less postoperative complications in treatment of proximal humeral fractures.