Objective: To investigate the prevalence and influencing factors of mild cognitive impairment (MCI) among middle-aged and elderly people in Xihu District, Hangzhou City, so as to provide insights into prevention and intervention of MCI among middle-aged and elderly people. Methods: People aged 55 years and above were sampled from Xihu District using the multi-stage random sampling method, and demographic information, lifestyle behaviors, and chronic disease were collected through questionnaire surveys. The prevalence of MCI was assessed using the Montreal Cognitive Assessment, and influencing factors for MCI were analyzed using a multivariable logistic regression model. Results: A total of 440 valid questionnaires were recovered, with an effective recovery rate of 97.78%. There were 190 males (43.18%) and 250 females (56.82%). There were 179 respondents at ages of 55 to <65 years, accounting for 40.68%. The prevalence of MCI was 18.64%. Multivariable logistic regression analysis showed that the risk of MCI was higher among the middle-aged and elderly people who were aged 65 to 95 years (55 to <65 years as the reference, 65 to <75 years, OR=4.156, 95%CI: 1.284-13.201; 75 to 95 years, OR=5.013, 95%CI: 1.752-14.126), were smokers (OR=4.768, 95%CI: 1.560-14.580), had higher daily cooking oil intake (OR=2.128, 95%CI: 1.062-4.199), had diabetes (OR=4.137, 95%CI: 1.144-4.958) and had hypertension (OR=8.093, 95%CI: 1.697-38.593); while the risk of MCI was lower among the middle-aged and elderly people who were engaged in mental labor (OR=0.074, 95%CI: 0.007-0.756) and had a monthly household income per capita of 4 000 yuan and above (4 000 to <8 000 yuan, OR=0.071, 95%CI: 0.014-0.358; 8 000 yuan and above, OR=0.009, 95%CI: 0.001-0.136). Conclusion MCI among middle-aged and elderly people in Xihu District is affected by age, occupation, monthly household income per capita, smoking, daily cooking oil intake, diabetes and hypertension.

Objective By using the computational fluid mechanic(CFD)method the tandem carotid artery stenosis(TCAS)was simulated on the model,and to compare the postoperative hemodynamic changes of different surgical procedures.Methods One patient with tandem stenosis of internal carotid artery(ICA)and common carotid artery(CCA)was selected.CFD technique was used to establish four three-dimensional(3-D)models of the carotid bifurcations,including one model of a real patient and three models of presumptive surgery.The hemodynamic analysis was performed with these models so as to explore the development mechanism of TCAS and to discuss the selection of suitable surgical plan.Results In tandem stenosis,the stenosis was preferentially formed in CCA and subsequently led to ICA stenosis.The local hemodynamic situation in TCAS was more complex and more risky than in single carotid artery stenosis.In tandem stenosis,the treatment of one stenosis site would affect the blood flow at the next stenosis site and cause restenosis or plaque rupture.Conclusion In treating patients with TCAS,CFD simulation examination should be performed when the surgical plan is formulated,which can help clinicians to predict the postoperative changes in blood flow and to choose the appropriate surgical plan.

Objective: To analyze the results of colorectal cancer screening among residents in Baoshan District, Shanghai Municipality from 2013 to 2021, so as to provide the basis for promoting colorectal cancer screening and prevention. Methods: Permanent residents aged 50 to 74 years in Baoshan District from 2013 to 2021 were selected as the screening population. The initial screening was conducted using a risk assessment form and fecal occult blood test. Positive results on either the risk assessment form or fecal occult blood test were considered positive for the initial screening. Participants with positive initial screening results were invited to undergo colonoscopy. The positive rate of the initial screening, colonoscopy compliance rate, and colonoscopy results were analyzed. Results: A total of 264 907 individuals underwent the initial colorectal cancer screening in Baoshan District from 2013 to 2021, with 65 333 individuals (24.66%) testing positive. Among them, the positive rate of the risk assessment form was 12.16%, and the positive rate of fecal occult blood test was 14.64%. A total of 14 473 individuals completed colonoscopy, with a compliance rate of 22.15%. A total of 1 284 precancerous lesions were detected, with a detection rate of 8.87%, and 386 cases of colorectal cancer were identified, with a detection rate of 2.67%. The positive rate of the initial screening, colonoscopy compliance rate, precancerous lesion detection rate, and colorectal cancer detection rate were higher in males than in females (25.55% vs. 24.06%, 23.12% vs. 21.45%, 11.60% vs. 6.74%, 3.62% vs. 1.93%, all P<0.05). With increasing age, the positive rate of the initial screening increased, the colonoscopy compliance rate decreased, the precancerous lesion detection rate and colorectal cancer detection rate increased (all P<0.05). From 2013 to 2021, the positive rate of the initial screening among residents showed a downward trend, while the colonoscopy compliance rate showed an upward trend (both P<0.05). Conclusions The detection rate of precancerous lesions in colorectal cancer was 8.87%, and the detection rate of colorectal cancer was 2.67% in Baoshan District from 2013 to 2021. Male and older individuals were the key populations for screening, and the colonoscopy compliance among residents needs to be improved.

Objective:To understand the current status of gastroscopy in diagnosing gastric lesions in general population, and to recommend the optimal age for the first gastroscopy and intervals for repeated gastroscopy.Methods:The gastroscopy records of residents aged 18-80 years in Yinzhou District of Ningbo, Zhejiang Province, between April 2010 and December 2021 were analyzed retrospectively. The detections of gastric lesions across different years, age and genders were described. Goodness of fit tests were applied to compare the differences in detection rates of different lesions in first-time endoscopy in different age groups and different populations. Generalized additive models were used to fit the trend of age specific gastric lesion detection rate explore the optimal age for gastroscopy. The appropriate gastroscopy intervals were determined according to the progress of the gastric lesions detected in repeated gastroscopy.Results:A total of 237 751 participants with 344 398 gastroscopy records were included in analyses. A total of 5 597 cases of chronic atrophic gastritis (CAG), 9 796 cases of intestinal metaplasia (IM), 165 cases of low-grade intraepithelial neoplasia (LGIN), 52 cases of high-grade intraepithelial neoplasia (HGIN) and 435 cases of gastric cancer were detected by the first gastroscopy. The overall detection rate of gastric lesions increased significantly in age group 45-70 years, and remained stable after 70 years old, with LGIN and HGIN showing notable increases at 50 and 55 years old, respectively. Repeated gastroscopy detected CAG, IM, LGIN, and HGIN at a higher rate compared with the first gastroscopy. Normal/superficial gastritis progressed in 3-5 years, whereas CAG or more severe lesions progressed in 1-6 years.Conclusion:Gastroscopy is recommended for general population aged 45 years and above. Furthermore, gastroscopy can be performed every 3-5 years for individuals with normal endoscopy results and once a year for patients with CAG or more severe gastric lesions.

This study was designed to investigate the effet of phillyrin(PHI)on sciatic nerve injury in diabetic peripheral neuropathy(DPN)rats based on the high mobility group protein box-1(HMGB1)/advanced glycation end product receptor(RAGE)signal pathway.DPN rat model was established by high fat and high sugar diet combined with injection of streptozotocin(STZ)solution,and the rats were randomly grouped into model group,phillyrin low dose(PHI-L,50 mg/kg)group,phillyrin medium dose(PHI-M,100 mg/kg)group,phillyrin high dose(PHI-H,200 mg/kg)group,and positive drug(mecobalamin,250 μg/kg)group,while another rats with normal diet were treated as the control group.Each group consisted of 10 rats.The conduction velocity of sciatic nerve was measured by BL-420S biological function experiment system;fasting blood glucose(FBG)level was detected by blood glucose meter;the levels of serum HbAlc,IL-6 and TNF-α were measured with ELISA kits;the ultrastructure of sciatic nerve was observed with electron microscope;the levels of ROS,SOD,MDA and MBP in sciatic nerve were detected with commercial kits;the mRNA and protein levels of HMGB1 and RAGE in sciatic nerve were detected by RT-qPCR and Westem blotting.Compared with model group,pathological injury of rats in PHI-M group,PHI-H group and positive drug group was significantly alleviated,the sciatic nerve conduction velocity and MBP/SOD levels were significantly recovered,the levels of FBG,HbAlc,IL-6,TNF-α,and the mRNA and protein levels of ROS,MDA,HMGB1 and RAGE were decreased significantly(P＜0.05).In conclusion,PHI can reduce the inflammatory reaction,reduce DPN in rats,thus plays a therapeutic role,and the mechanism may be related to the inhibition of HMGB1/RAGE signal pathway.

Objective:To explore the potential categories and associated factors of mild cognitive impairment (MCI) in community-dwelling older adults.Methods:A total of 393 community-dwelling older adults with MCI in Huzhou City were selected through multistage random sampling from January to July 2022.The survey was conducted by the general information questionnaire, Montreal cognitive assessment (MoCA), Pittsburgh sleep quality index (PSQI) and 15-item geriatric depression scale(GDS-15). Latent profile analysis (LAP) was applied to explore latent categories based on the characteristics of cognitive impairment, and Logistic regression analysis was performed to examine the factors associated with these MCI categories. The statistical software was SPSS 26.0.Results:The community-dwelling older adults with MCI was categorized into four subgroups: generalized mildly impaired subgroup, mixed impaired with visuospatial executive dysfunction subgroup, narrative memory dysfunction impaired subgroup, and high-risk severely impaired subgroup, with corresponding MoCA scores of (23.10±0.96), (21.87±0.92), (20.43±0.93), (19.00±0.00), PSQI scores of (6.00 (4.00)), (7.00 (6.00)), (7.00 (6.00)), (10.00 (3.00)), and GDS-15 scores of (4.00 (4.00)), (4.00(5.00)), (6.00(5.00)), (8.00 (3.00)), respectively. Logistic regression analysis revealed that compared to generalized mildly impaired subgroup, gender, age, exercise habits, sleep quality, depressive symptoms, chronic disease count, and medication count significantly affected other three subgroups, with female, older age, and never/irregular exercise as common risk factors. Poor sleep quality and depressive symptoms could positively predict mixed impaired with visuospatial executive dysfunction subgroup and narrative memory dysfunction impaired subgroup( B=0.82, OR=2.27, 95% CI=1.26-4.08; B=1.12, OR=3.06, 95% CI=1.36-6.91).Additionally, poor sleep quality, depressive symptoms, chronic disease and medication count could significantly predict high-risk severely impaired subgroup ( B=4.13, OR=62.32, 95% CI= 1.71->999.99; B=3.31, OR=27.49, 95% CI=1.37-549.99; B=1.20, OR=3.32, 95% CI= 1.06-10.41 and B=0.80, OR=2.22, 95% CI=1.04-4.71). Conclusion:Four latent MCI categories are identified among community-dwelling older adults, and each category was characterized by unique cognitive impairment features and factors. Healthcare professionals are advised to customize assessments and management strategies according to these specific characteristics to effectively slow cognitive decline.

Objective:To construct an analytic method aimed at the characteristics of the commonly method of supplementing and pouring of acupuncture based on the analysis and modeling of ultrasound images around acupoint region in the process of acupuncture.Methods:A total of 7 healthy subjects who underwent physical examination in Beijing Zhongguancun Hospital from June,2022 to June,2023 were selected,and their Kongzui acupoints were acupunctured by 10 acupuncturists with associate senior title as 4 kinds of acupuncture manipulations included reinforcing by twisting and rotating(RFTR),reducing by twisting and rotating(RDTR),reinforcing by lifting and thrusting(RFLT),and reducing by lifting and thrusting(RDLT).The B-ultrasound diagnostic device was used to collect the images of muscle and fascial tissue below the acupoint,so as to construct the model of images.The definition of virtual acupuncture point was adopted to study the regulation of perturbation of subcutaneous tissue that was caused after the skin was acupunctured by needle.The change regulation of the virtual acupuncture point of muscle bundle below skin at Zuikong acupoint of subjects was analyzed.Results:The difference value of average absolution value between peak and trough of the trajectory of virtual acupuncture point of twisting and rotating was 0.066±0.045,and the average value of amplitude of this method was less than that(0.428±0.276)of lifting and thrusting method,and the twisting and rotating method was uniform and symmetrical,and there was difference between two kinds of acupuncture methods.The characteristics of computer graphics was used to qualify the work effect of lifting and thrusting,and reinforcing and reducing,which showed the heavy insertion and light lifting of RFLT,and showed heavy lifting and light insertion of RDLT,thus distinguished the two methods[(RFLT)and(RDLT)].Conclusions:The ultrasound imaging and computer graphics can be used to analyze the regularity of the common"reinforcing and reducing"method of acupuncture and moxibustion.

Objective To explore the efficacy of superior hypogastric nerve block(SHNB)for alleviating pain after uterine artery embolization(UAE).Methods Twenty-five patients with hysteromyoma who underwent UAE were retrospectively enrolled.The patients were divided into SHNB group(n=11)and non-SHNB group(n=14,receiving peripheral intravenous analgesia)according to analgesia methods.The technique success rate and complication of SHNB were recorded.The maximum score of numeric pain-rating scale(NRS),the total dose of opioid consumption after UAE and the interval time between UAE completed to the first additional use of opioid were compared between groups.Results No significant difference of patient's age,body mass nor the maximum diameter of hysteromyoma was found between groups(all P＞0.05).The technique success rate of SHNB was 100%(11/11).No complication such as lower limb radiating numbness,intravascular injection,intraperitoneal hemorrhage nor peritonitis occurred.The maximum score of NRS after UAE and the total dose of opioid consumption after UAE in SHNB group were both significantly lower,while the interval time between UAE completed to the first additional use of opioid in SHNB group was significantly longer than those in non-SHNB group(all P＜0.001).Conclusion SHNB was effective for alleviating pain and reducing required dosage of analgesic medications after UAE in patients with hysteromyoma.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Abstract: Objective To investigate the prevalence and influencing factors of depressive symptoms among primary and middle school students in Xihu District, Hangzhou City, so as to provide insights into depression control among primary and middle school students. Methods: Students were sampled from two primary schools, two junior high schools, two ordinary high schools and one vocational high school in Xihu District using a stratified cluster random sampling method from September to November, 2021. Participants' demographics, diet, exercise, sleep and campus bullying were collected using questionnaire surveys. The depressive symptoms were evaluated using the Chinese version of the Center for Epidemiologic Studies-Depression Scale (CES-D), and factors affecting the depressive symptoms were identified among primary and middle school students using a multivariable logistic regression model. Results: A total of 1 518 students were investigated, including 518 primary school students (34.12%), 363 junior high school students (23.91%), 463 ordinary high school students (30.50%) and 174 vocational high school students (11.46%). Of all participants, there were 805 males (53.03%). The prevalence of depressive symptoms was 38.87% among the participants, and was 36.10%, 42.42%, 42.33% and 30.46% among primary school, junior high school, ordinary high school and vocational high school students, respectively. The multivariable logistic regression analysis showed that gender (OR=1.601, 95%CI: 1.289-1.989), type of school (junior high school, OR=1.299, 95%CI: 0.974-1.734; ordinary high school, OR=1.351, 95%CI: 1.025-1.780; vocational high school, OR=0.862, 95%CI: 0.585-1.272), frequency of fresh vegetable intake (less than once daily, OR=0.454, 95%CI: 0.304-0.679; once and more daily, OR=0.359, 95%CI: 0.235-0.548), duration spent on the internet (0.5 to 1 h daily, OR=1.447, 95%CI: 1.044-2.006; 1 h and longer daily, OR=1.456, 95%CI: 1.072-1.978), sufficient sleep (OR=0.525, 95%CI: 0.371-0.744), suffering from campus bullying (OR=1.992, 95%CI: 1.491-2.661) were associated with the development of depressive symptoms. Conclusions The prevalence of depressive symptoms is high among primary and middle school students in Xihu District. Gender, type of school, dietary behaviors, sleep duration and campus bullying are factors affecting the development of depressive symptoms.