Objective To investigate the detection rate and related influencing factors of gastrointestinal diseases in grass-roots personnel.Methods A total of 481 grass-roots personnel were enrolled and examined by magnetic-controlled capsule endoscopy(MCCE).Multivariate logistic regression were used to analyze the influencing factors of gastrointestinal diseases detected by MCCE.Results All personnel completed MCCE,and gastrointestinal diseases were detected in 154(32.0%)cases,including 106 cases of erosive gastritis,25 cases of chronic atrophic gastritis,17 cases of digestive tract polyp,16 cases of gastric ulcer,5 cases of reflux esophagitis,4 cases of cardia,1 case of duodenitis,and 1 case of enteritis.Gastrointestinal diseases was correlated with special operation posts,long-term tasks within recent 6 months,abdominal distension,belching,nausea and vomiting,diarrhea and other symptoms(all P＜0.05).Multivariate logistic regression analysis showed that the risk factors of gastrointestinal diseases were working in special operation posts,performing long tasks within 6 months,belching,nausea and vomiting symptoms(all P＜0.05).Conclusion The overall detection rate of gastrointestinal diseases(mainly acid related diseases)is relatively high,and its incidence is closely related to working in special operation posts and performing long-term tasks within recent 6 months.Personnel working in special operation posts should be more alert to gastrointestinal diseases.Gastrointestinal symptoms have reference value for the prediction of lesions,but more attention should be paid to the identification of functional gastrointestinal diseases with endoscopy.

Non-syndromic thoracic aortic aneurysm or aortic dissection(TAAD)is a cardiovascular disease with high lethality rate.Researches have indicated that TAAD has a definite genetic basis.Genetic mutations play a crucial role in the disease's development and are associated with the age of onset,clinical symptoms,and the risk of aortic dissection.The rate of disease progression and the therapeutic response of individuals may vary depending on the type of mutation.Genetic screening is a crucial tool for identifying high-risk populations,which provides a scientific basis for early disease intervention and management and facilitates the implementation of precision medicine.In this article,we present a systematic review of the latest advancements in the research on gene mutations associated with non-syndromic TAAD.

Non-syndromic thoracic aortic aneurysm or aortic dissection(TAAD)is a cardiovascular disease with high lethality rate.Researches have indicated that TAAD has a definite genetic basis.Genetic mutations play a crucial role in the disease's development and are associated with the age of onset,clinical symptoms,and the risk of aortic dissection.The rate of disease progression and the therapeutic response of individuals may vary depending on the type of mutation.Genetic screening is a crucial tool for identifying high-risk populations,which provides a scientific basis for early disease intervention and management and facilitates the implementation of precision medicine.In this article,we present a systematic review of the latest advancements in the research on gene mutations associated with non-syndromic TAAD.

Objective:To compare the effect of self-radiopaque markers guiding physician-modified fenestration, chimney technique and hybrid Ⅳb technique on reconstruction of left subclavian artery (LSA) in endovascular treatment of aortic dissection (TEVAR).Methods:The clinical and follow-up data of 312 TEVAR patients treated with LSA blood supply reconstruction technology from Jan 2016 to Dec 2019 at Fuwai hospital were retrospectively analyzed.Results:There were 35 patients in the hybrid Ⅳb technique group, 93 in the chimney technique group, and 184 in the in vitro fenestration group. The follow-up period ranged from 12 to 24 months. No artificial blood vessel and stent occlusion occurred in all patients during follow-up, and the LSA blood flow was unobstructed. A total of 19 patients had endoleak by the last follow-up, and there was no statistical difference between the three groups. Eleven patients underwent reintervention surgery, all were from chimney technique group and in vitro fenestration group, with no statistical difference ( P>0.05). Severe complications occurred in 28 patients during hospitalization, and the incidence of complications was the highest in the hybrid Ⅳb technique group ( P<0.01). During follow-up, 4 patients died in the bypass group, 6 died in the external window group, and 8 died in the chimney group, with no significant difference ( P>0.05). Conclusions:The safety and efficacy of the left subclavian artery flow reconstruction by in vitro fenestration and chimney technique were similar. The occurrences of early complications were lower than that of the hybrid Ⅳb technique, but the reintervention rate of endoleak was higher.

To investigate the recent prevalence and molecular epidemiological characteristics of por-cine diarrhea viruses in Sichuan Province,this study used fluorescence quantitative PCR to detect porcine diarrhea samples from multiple regions in Sichuan Province from 2021 to 2023.RT-PCR was used to identify the genotypes of PEDV,PoRVA,PDCoV,and PTV,and their genetic variabil-ity,evolutionary characteristics,and recombination events were analyzed.The results showed that PEDV,PoRVA,PDCoV,and PTV were still prevalent in Sichuan region,with overall positive rates of 14.2％(40/281),13.2％(37/281),15.6％(44/281),and 12.5％(35/281),respectively.PEDV mixed infection with other pathogens was the most common.This study obtained a total of six strains of G2b PEDV,three strains of G3 PDCoV,three strains of G9P[13]PoRVA,one strain of G3P[13]PoRVA,three strains of Type 5 PTV,and one strain of Type 9 PTV.Compared to the seven vaccine strains including CV777,DR13,KPEDV-9,Chinju99,KNU-0801,AJ1102,and LW/L,the 6 PEDV strains showed multiple amino acid mutation sites in the COE region and S1D epitope region.Among them,the strains PSCLZ01 and PSCMY04 formed a separate branch in the phylogenetic tree.The three PDCoV strains have a closer genetic evolution distance to the previ-ously prevalent strains in Sichuan,but they also have 6-48 amino acid mutations compared to them.The four PoRVA strains have 104-108 amino acid variations in the VP4 gene compared to the early vaccine strain LLR,and they have 25 common amino acid variations in the VP7 gene.From the phylogenetic tree,the VP7 gene of RSCMY01/G3P[13]belongs to the same branch as the Heilongjiang strain LNCY,but its VP4 gene clusters with the Sichuan strain SCYA-C7,indica-ting that this PoRVA strain may have undergone genetic reassortment during inter-provincial transmission between different genotypes.It is worth noting that in the detected samples of PTV-5 and PTV-9,other diarrheal viruses tested negative,indicating that these two genotypes of PTV may be important pathogens causing porcine diarrhea.Additionally,the S gene of PEDV PSCLZ01 strain and PDCoV PCSCMY02 strain have undergone recombination events,and their parental strains come from different regions,both domestic and international.These findings reveal the main types of porcine diarrheal viruses,as well as their genetic diversity and variations in Sichuan Province in recent years.This study enriches the molecular epidemiological data of porcine diarrhe-al pathogens in the region and provides an important theoretical basis for the prevention,control,and purification of porcine diarrhea in the local area.

Objective:To evaluate and summarize the relevant evidence of comprehensive detumescence treatment of lower limb lymphedema in patients with gynecological malignant tumors, and to provide evidence-based basis for clinical intervention of comprehensive detumescence treatment of lymphedema.Methods:This study was an evidence - based nursing research. Databases such as BMJ Best Practice, UpToDate, PubMed, CNKI, Wanfang and other domestic and foreign databases, as well as websites such as the Australian Lymphology Society, the International Lymphedema, and the European Clinical Oncology Association were searched for relevant evidence and evaluation of comprehensive treatment of gynecological malignant tumor-related lower limb lymphedema. The search time was from the establishment of the database to April 1, 2022.Results:A total of 18 articles were included, including 2 guidelines, 5 systematic reviews, 4 expert consensus, 2 evidence summaries, 4 randomized controlled trials and 1 best practice. Twenty-eight evidence were summarized from 7 aspects : treatment cycle and edema stage, free-hand lymphatic drainage, graduated compression stockings, skin care, elastic socks, functional exercise and health education.Conclusions:The evidence summarized in this study can provide reference for clinical medical staff to formulate comprehensive treatment plans for lower limb lymphedema. Evidence-based practice should consider the individual status of patients and clinical scenarios, and provide personalized comprehensive treatment plans for patients with lower limb lymphedema of gynecological malignant tumors as soon as possible to improve the quality of life of patients.

Objective:To retrieve, obtain and summarize the best evidence for the prevention of recurrence in patients with diabetic foot, and to provide reference for clinical practice.Methods:According to the "6S" model of evidence-based resources, JBI, UpToDate, BMJ Best Practice, Cochrane Library, International Working Group on the Diabetic Foot, International Diabetes Federation, National Istitute for Health and Clinical Excellence, PubMed, EmBase, China National Knowledge Internet, Wanfang and China Biology Medicine disc were searched by computer for the prevention of recurrence of diabetic foot patients. The retrieval time limit was from the establishment of the database to April 2022. Two researchers independently evaluated the included literature and extracted the literature that met the quality standards.Results:Totally 12 articles were included at last, including 5 guidelines, 3 expert consensus and 4 Meta-analysis. From the six dimensions of the necessity and risk factors of recurrence prevention in diabetic foot patients, decompression brace prevention, surgery and wound management prevention, nutritional therapy prevention, health education and lifestyle prevention, monitoring and analysis, 18 pieces of best evidence were summarized.Conclusions:The best evidence for the prevention of recurrence of diabetic foot patients was summarized to provide evidence-based basis for management decision makers and decision implementers to prevent recurrence of diabetic foot. In the process of practice, medical workers should also fully evaluate the promoting factors and hindering factors in order to ensure that evidence can be better applied to clinical practice and serve patients.

Objective:To investigate the clinical characteristics and risk factors of frailty syndrome in elderly patients undergoing maintenance hemodialysis (MHD) and the effect of frailty syndrome on all-cause mortality.Methods:This was a prospective cohort study. MHD patients aged≥60 years in 5 hemodialysis centers in Beijing from April to June 2017 were selected as the study subjects. Baseline data were collected and compared, and the patients were then classified into non-frailty, pre-frailty and frailty syndrome groups according to the Fried criteria and followed up until June 2018. The end point event was all-cause death. Multivariate logistic regression was used to analyze the independent risk factors of frailty syndrome. Kaplan-Meier survival analysis was used to compare the difference in the cumulative survival rate among the 3 groups. A multivariate Cox regression model was used to analyze the independent risk factors of all-cause mortality.Results:A total of 204 patients aged (71.65±5.89) years (60-81 years) were enrolled into this study, including 123 males (60.29%), 147 patients (72.06%) in the frailty syndrome group, 41 patients (20.10%) in the pre-frailty group, and 16 patients (7.84%) in the non-frailty group. Patients with frailty syndrome tended to be older, longer dialysis vintage, a higher proportion of diabetes, lower urea clearance index (Kt/V) and lower serum albumin level (all P<0.05). Multivariate Logistic regression showed that factors independently associated with frailty syndrome included age ( OR=1.393, 95% CI 1.241-1.563, P<0.001), history of diabetes ( OR=3.610, 95% CI 1.262-10.327, P=0.017), dialysis vintage ( OR=1.011, 95% CI 1.002-1.020, P=0.019), Kt/V ( OR=0.711, 95% CI 0.516-0.979, P=0.037), serum albumin ( OR=0.754, 95% CI 0.644-0.882, P<0.001) and intact parathyroid hormone (iPTH, OR=1.344, 95% CI 1.024-1.763, P=0.033). Kaplan-Meier survival analysis showed that the cumulative survival rate in frailty syndrome group was significantly lower than those of pre-frailty (Log-rank χ2=7.265, P=0.007) and non-frailty groups (Log-rank χ2=5.238, P=0.022). Multivariate Cox regression analysis indicated that frailty syndrome ( HR=3.832, 95% CI 1.116-13.157, P=0.033), age ( HR=1.074, 95% CI 1.014-1.136, P=0.014), history of diabetes ( HR=2.009, 95% CI 1.067-3.784, P=0.031), cognitive impairment (Montreal cognitive assessment<26, HR=2.627, 95% CI 1.142-6.042, P=0.023), Kt/V ( HR=0.701, 95% CI 0.545-0.902, P=0.006), serum albumin ( HR=0.891, 95% CI 0.806-0.986, P=0.025) and iPTH ( HR=1.226, 95% CI 1.100-1.367, P<0.001) were independently associated with all-cause mortality. Conclusions:The prevalence of frailty syndrome in elderly patients undergoing hemodialysis is high. Ageing, diabetes history, long dialysis vintage, low levels of Kt/V and serum albumin, and elevated iPTH level are independent risk factors for frailty syndrome in such patients. Frailty syndrome is independently associated with an increased risk of all-cause mortality.

Objective:To investigate the incidence, risk factors, and outcomes of acute kidney injury (AKI) in cancer patients receiving immune checkpoint inhibitors (ICIs).Methods:A retrospective analysis was performed on the inpatients who received ICIs therapy in Beijing Shijitan Hospital, Capital Medical University from October 2015 to December 2020. According to the Kidney Disease: Improving Global Outcomes (KDIGO) definition of AKI, patients were divided into AKI group and non-AKI group, and the patients in the AKI group were further divided into ICIs related AKI (ICIs-AKI) and AKI due to other etiologies. The clinical characteristics of the patients were compared. Multivariate logistic regression was used to analyze the influencing factors of AKI, and sensitivity analysis was used to evaluate the influencing factors of ICIs-AKI.Results:A total of 279 cancer patients over 18 years old were included in this study, in which 175(62.7%) were males. There were 41 patients (14.70%) in AKI group, including 25 patients (8.96%) in ICIs-AKI group and 16 patients (5.73%) in AKI due to other etiologies group. Patients in the AKI group were characterized by higher proportions of hypertension, diuretics use and baseline eGFR<60 ml·min -1·(1.73 m 2) -1, extrarenal immune-related adverse events (irAEs) and a lower plasma albumin level (all P<0.05). The patients in the ICIs-AKI group had higher proportions of new aseptic leukocyturia, blood eosinophil count>500/ml, combined extrarenal irAEs, glucocorticoid use and discontinued ICIs treatment (all P<0.05). Multivariate logistic regression results showed that hypertension ( OR=3.424, 95% CI 1.559-7.522, P=0.002), use of diuretics ( OR=4.620, 95% CI 2.111-10.112, P<0.001), baseline eGFR<60 ml·min -1·(1.73 m 2) -1 ( OR=3.668, 95% CI 1.336-10.070, P=0.012) and extrarenal irAEs ( OR=9.909, 95% CI 4.198-23.391, P<0.001) were associated with AKI in cancer patients receiving ICIs therapy. Sensitivity analysis indicated that the risk factors of ICIs-AKI included use of diuretics and baseline eGFR<60 ml·min -1·(1.73 m 2) -1, similar to the results of the above analysis, extrarenal irAEs ( OR=17.572, 95% CI 6.302-48.995, P<0.001) were also associated with ICIs-AKI independently. Conclusions:AKI is not uncommon in patients treated with ICIs. Concomitant hypertension, baseline eGFR<60 ml·min -1·(1.73 m 2) -1 and use of diuretics are independent risk factors for AKI in such patients. Patients should be alert to the risk of ICIs-AKI when appearing extrarenal irAEs. Distinguishing ICIs-AKI from AKI caused by other causes will present a frequent challenge to clinical practitioners.

From the perspective of technical evaluation, this article introduces the focus of clinical evaluation of dental implants (systems) in comparison with the comparable devices and discusses the clinical evaluation of such products，combined with the clinical evaluation review of dental implants (systems) products in recent years, in order to provide reference for the registration of these products.
Dental Implants