OBJECTIVE To establish anticoagulation pharmaceutical service model based on the integrated theory of health behavior change （ITHBC）， and analyze its effects. METHODS Referring to relevant literature and soliciting opinions from 8 experts from departments such as pharmacy， respiratory medicine， and vascular surgery， a anticoagulation pharmaceutical service model based on ITHBC was ultimately formed. VTE inpatients were selected from The First Affiliated Hospital of Shihezi University from December 2023 to June 2024 as the research subjects. They were randomly assigned into intervention group （58 cases） and control group （60 cases） using a random number table method. The intervention group implemented pharmacist-led anticoagulant pharmaceutical service model based on ITHBC， while the control group adopted a conventional anticoagulant pharmaceutical service model. The anticoagulation-related outcomes of two groups were compared after 3 months： anticoagulation compliance rate， the incidence of adverse drug reactions， the score of medication adherence and compliance rate of anticoagulant prescription； economic evaluation was conducted. RESULTS After implementing ITHBC-based anticoagulant pharmaceutical services for 3 months， the intervention group had higher anticoagulation compliance rate， score of medication adherence， and compliance rate of anticoagulant prescription than the control group （P＜0.05）. There was no statistically significant difference in the total incidence of adverse drug reactions between the two groups （P＞0.05）. For every 1% point increase in anticoagulant compliance rate， the hospital needed to invest 4.35 yuan additionally in anticoagulant pharmaceutical service fees. Compared with China’s per capita gross domestic product （GDP， 89 358 yuan） in 2023， the incremental cost-effectiveness ratio value that increased the anticoagulation compliance rate by 50% is far less than one time of per capita GDP. CONCLUSIONS The pharmacist- led anticoagulant pharmaceutical service model based on ITHBC can effectively improve the outcomes of anticoagulant therapy for VTE patients， enhance medication compliance， improve patients’ awareness and recognition of adverse drug reactions to anticoagulants， and has certain economic and social benefits.

Patients who undergo sphincter-preserving surgery for rectal cancer may face intestinal dysfunction, psychological issues, and social problems. Patient self-management is of great significance for their recovery and quality of life. This paper mainly reviews the concept, evaluation tools, current situation, and intervention measures of self-management for patients after sphincter-preserving surgery for rectal cancer, in order to provide reference for clinical self-management education for those patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Purpose: Ankle pump exercises (APE) have been widely used in clinical practice. However, best practices for APE have not been established. Recognize the most effective frequency of APE for improving lower extremity hemodynamics and establish recommendations in clinical practice. Methods: Therefore, a systematic review and network meta-analysis (NMA) was performed according to PRISMA-NMA. Six English databases (Pubmed, Medline, CINAHL, Embase, the Cochrane library and ProQuest) and four Chinese databases (CNKI, Wanfang, VIP and Sinomed) were searched. Randomized controlled trials (RCTs) and quasi-experimental studies investigating the effects of different frequencies of APE on lower limb hemodynamics published before July 2022 were included. The reference list was also searched. Seven studies (one RCTs and six quasi-experimental studies) were included in the systematic review and five studies (one RCTs and four quasi-experimental studies) were included in the NMA. The risk of bias was assessed using the Cochrane and Joanna Briggs Institute tools. The NMA was performed using the R software (version 4.2.1) and OpenBUGS (version 3.2.3). Results: The results of the NMA showed that a frequency of every 3–4 s the most effective in improving lower extremity hemodynamics (P =.85), followed by every 1–2 s (P = .81), every 5–6 s (P=.32) and less than every 10 s (P =.02). Subgroup analysis failed to find a difference between healthy participants and those with unilateral total hip arthroplasty or fracture (MD = −0.23, 95% CI-5.92 to 4.61). Conclusions Consequencely, for adult patients, with or without lower extremity disease, a frequency of every 3–4 s can be recommended as the optimal frequency of APE in clinical care practice.Registered number on PROSPEROCRD42022349365. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=349365.

Objective:To compare the effects of different doses of ticagrelor on microcirculation, inflammatory factors and cardiac function in older adult patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:A total of 250 older adult patients with coronary heart disease who received PCI in The First People's Hospital of Wenling, China between March 2019 and March 2020 were included in this study. They were randomly assigned into group A and group B, with 125 patients per group. The group A was subjected to staged exercise and oral ticagrelor (45 mg once, twice a day). The group B was given staged exercise and oral ticagrelor (90 mg once, twice a day). Platelet function (maximum platelet aggregation rate, P2Y12 reaction unit), microcirculation (the index of microcirculatory resistance, circulatory flow reserve), inflammatory factor levels (high-sensitivity C-reactive protein, tumor necrosis factor alpha, interleukin-6), cardiac function recovery (left ventricular ejection fraction, 6-minute walk test, maximal oxygen consumption), cardiovascular adverse events, and bleeding events were compared between the two groups.Results:After treatment, maximum platelet aggregation rate and P2Y12 reaction unit in group B were (28.79 ± 3.52)% and (132.36 ± 12.16) U, respectively, which were significantly lower than those in group A [(33.45 ± 4.60)%, (146.79 ± 13.52) U, t = 8.99, 8.87, both P < 0.001]. After treatment, the index of microcirculatory resistance in group B was significantly lower than that in group A [(26.43 ± 4.51) vs. (29.68 ± 5.14), t = 5.31, P < 0.001]. Circulatory flow reserve in group B was significantly higher than that in group A [(2.16 ± 0.62) vs. (1.61 ± 0.50), t = 7.72, P < 0.001]. After treatment, tumor necrosis factor alpha, interleukin-6 and high-sensitivity C-reactive protein in group B were (39.54 ± 6.74) ng/L, (19.68 ± 4.06) ng/L, (5.98 ± 1.35) mg/L, respectively, which were significantly higher than those in group A [(28.26 ± 6.15) ng/L, (15.33 ± 3.87) ng/L, (4.83 ± 1.28) mg/L, t = 13.82, 8.67, 6.91, all P < 0.001]. After treatment, left ventricular ejection fraction, 6-minute walk test, maximal oxygen consumption in group B were (37.39 ± 5.10)%, (443.28 ± 29.64) m, (19.69 ± 3.57) L/min, respectively, which were significantly higher than those in group A [(34.64 ± 4.86)%, (410.45 ± 25.76) m, (17.33 ± 3.27) L/min, t = 4.36, 9.34, 5.45, all P < 0.001]. There was no significant difference in total incidence of cardiovascular events between the two groups (χ 2 = 0.05, P > 0.05). The incidence of bleeding events in group A was significantly lower than that in group B (4.80% vs. 13.60%, χ 2 = 5.79, P < 0.05). Conclusion:Compared with ticagrelor 90 mg/d, ticagrelor 180 mg/d can more greatly improve platelet function and microcirculation, reduce inflammatory reaction, promote the recovery of cardiac function, and reduce bleeding events in older adult patients with coronary heart disease after percutaneous coronary intervention.

Objective:To investigate the clinical characteristics and risk factors of lymph node metastasis of early gastric cance.Methods:The data of 176 early gastric cancer patients (EGC) undergoing radical gastrectomy were analyzed retrospectively.Results:Lymph node (LN) metastasis occurred in 24 patients. The average harvested LN in the negative group was 23±13, and that in the positive group was 30±16, ( t=0.327, P=0.015). Univariate analysis showed that there were significant differences in the depth of tumor invasion ( χ2=3.997, P=0.046), degree of pathological differentiation ( χ2=9.919, P=0.007), vascular invasion ( χ2=35.145, P=0.000) and nerve invasion ( χ2=13.343, P=0.000). Multivariate analysis showed that vascular infiltration ( OR=16.172, 95% CI: 4.781-55.875), nerve infiltration ( OR=1.365, 95% CI: 1.029-14.897), infiltration depth ( OR=1.859, 95% CI: 1.844-22.711) were independent risk factors for LN metastasis in early gastric cancer ( P<0.05). The overall 3-year survival rate was 96.6%, and the 5-year survival rate was 91.6%. Conclusion:The lymph node metastasis of early gastric cancer is related to the degree of differentiation, the depth of invasion, vascular invasion, nerve invasion and the number of lymph node dissected.

Optical coherency tomography (OCT) is one of the powerful optical imaging tools that allows cross-sectional tomography of the microstructure in living subjects with high resolution. With the rapid development of OCT and a wide range of preclinical and clinical tumor imaging, it provides profound insights into the complex physiological, cellular and molecular behaviors of tumors. Preclinical OCT has elucidated many inscrutable aspects of tumor biology, while clinical applications of OCT are revolutionizing diagnosis and therapies. As a new noninvasive optical imaging technique, OCT can realize the intraoperative imaging of tumor and provide meaningful image data, which will provide great help for the diagnosis, classification and boundary determination of tumor diseases in the future.

Objective:To understanding tobacco dependence and its influencing factors among smokers aged 40 or older in China and provide scientific data for the implementation of smoking cessation intervention.Methods:The data of this study were collected from 125 surveillance sites in 31 provinces (autonomous regions and municipalities) of chronic obstructive pulmonary disease (COPD) surveillance in China (2014 and 2015). The relevant variables of smoking status and tobacco dependence among people aged 40 or older were collected by face-to-face interview. The weighted proportion of tobacco dependence and its 95% CI and influencing factors among current smokers and daily smokers aged 40 or older in China were estimated with complex sampling weights. Results:A total of 22 380 current smokers and 19 999 daily smokers were included in the analysis. The proportion of high tobacco dependence of current smokers aged 40 or older was 31.1% (29.3%-32.9%). The proportion of high tobacco dependence was higher in men than in women, and higher in rural smokers than urban smokers. The proportion was 33.3% (31.3%-35.2%) in 40 to 59 years old smokers, which was higher than older age group. The proportion of high tobacco dependence among daily smokers aged 40 or older was 35.0% (33.0%-37.0%), and was 35.8% (33.8%-37.8%) in men and 22.0% (16.8%-27.2%) in women. Among current smokers and daily smokers, with the decrease of education level, the proportion of high tobacco dependence increased. The proportion of high tobacco dependence of smokers who started smoking before 18 years old was significantly higher than those who started smoking after 18 years old. The ratio of high tobacco dependence of smokers with chronic respiratory symptoms was higher than that of asymptomatic smokers. There was no significant difference in the tobacco dependence between patients with chronic diseases or chronic respiratory diseases and non patients ( P>0.05). Smokers with diabetes, cardiovascular and cerebrovascular diseases and hypertension had a slightly lower proportion of high tobacco dependence than smokers without above diseases ( P<0.05). Multivariate logistic regression analysis showed that men, central and eastern regions, 40-59 age group, engaged in agriculture, forestry, animal husbandry, fishery industry, water conservancy, manufacture, transportation and commercial services occupation, low education level and smoking onset age less than 18 years old had a high risk of high tobacco dependence. Conclusions:The proportion of high tobacco dependence among current smokers aged 40 or older is high in China, so there is a huge demand for smoking cessation interventions. Effective measures should be taken to promote smoking cessation intervention in China.

Objective: To summarize the treatment options for congenital maxillary lateral incisor agenesis (MLIA). Methods : Review the literature, summarize the current treatment options and advantages and disadvantages of various methods of MLIA, and analyze cases. Results : When a patient′s occlusion and other conditions are suitable for space closure and canine substitution, closure of the gap is the recommended method, as it has good aesthetic results and leads to good periodontal health. However, when closure cannot be performed, a dental implant has a strong advantage compared with other restoration methods. When planning implants for MLIA patients, doctors should carefully select the correct surgery time and take care with the implant position to obtain good results. Conclusion In the choice of a treatment plan for MLIA, we need to use the concept of multidisciplinary combined treatment to obtain a more satisfactory treatment effect with regard to aesthetics and function.

Objective:To understand the rate of spirometry examination and its related factors among chronic obstructive pulmonary disease (COPD) patients aged ≥40 years in China from 2014 to 2015, and provide evidence for diagnosis, treatment and management of COPD patients normatively.Methods:Data were obtained from 2014-2015 COPD surveillance, China. The previous lung function examination status and other information of the subjects were collected by face-to-face survey. We defined COPD as a post-bronchodilator FEV 1: FVC less than 70%. A total of 9 130 COPD patients were included in the analysis of this study. The rate of spirometry examination and its 95% confidence interval ( CI) were estimated in COPD patients aged ≥40 years with complicated sampling weights. Meanwhile, the spirometry examination related factors were analyzed. Results:The estimated rate of spirometry examination among COPD patients was 5.9% (95% CI: 4.9%-6.9%), 6.1% (95% CI: 5.2%-7.1%) for men and 5.3% (95% CI: 4.0%-6.6%) for women. The rate was significantly higher in urban population than in rural ( P<0.001). With the increase of education level, the rate of spirometry examination among COPD patients increased gradually ( P<0.001). The rate of spirometry examination was 4.0% (95% CI: 3.1%-4.9%) among COPD patients in agricultural industry. The rate of spirometry examination among COPD patients with awareness of pulmonary function test was 32.3% (95% CI: 26.4%-38.1%). The rate of spirometry examination among COPD patients with previous chronic respiratory disease and respiratory symptoms were 13.7%(95% CI:11.5%-15.9%), 8.8%(95% CI:7.2%-10.4%), respectively. The rate of spirometry examination among COPD patients exposed to occupational dust and/or harmful gases was 5.7% (95% CI: 4.6%-6.9%). The rate of spirometry examination in former smokers among COPD patients was 10.2% (95% CI: 8.0%-12.4%), higher than those in current smokers (4.2%, 95% CI: 3.3%-5.1%) and non-smokers (6.3%, 95% CI: 5.1%-7.6%). Conclusion:The rate of spirometry examination is extremely low among COPD patients aged ≥40 in China, and the standardized diagnosis, treatment and management of COPD patients need to be improved urgently.