Objective To understand the epidemic characteristics of heart failure in Guangzhou, and to provide a basis for the prevention and control of heart failure. Methods The information of patients hospitalized for heart failure in Guangzhou from January 1, 2017 to December 31, 2021 was collected, and t test, rank sum test, and χ² test were used to analyze the differences of central tendency and composition ratio. Results From 2017 to 2021, there were 6 823 hospitalized patients with heart failure in Guangzhou, with 8,716 hospitalizations and 849 deaths. The average age of hospitalization was 78.50 ±10.48 years old. Male patients were younger than female patients (P<0.001), and females died 3.86 years later than males on average (P<0.001). The number of hospitalizations for males (4 251 person times, accounting for 48.77%) was less than that for females (4 465 person times, accounting for 51.23%), and the number of hospitalizations for urban registered residence (7 346 person times, accounting for 84.28%) was much more than that for rural registered residence (1 370 person times, accounting for 15.72%). The number of hospitalizations in the fourth quarter was the largest. The combined rates of coronary heart disease, hypertension, type 2 diabetes, chronic obstructive pulmonary disease and hyperlipidemia were 58.65%, 69.52%, 34.92%, 10.69% and 10.23% respectively. There were differences in age, registered residence, residential area and complications among patients with acute and chronic heart failure (P<0.05). Conclusion The mortality of patients with heart failure in Guangzhou is high, and the distribution characteristics of acute and chronic heart failure is different. Corresponding preventive measures should be taken for different groups to reduce the disease burden and improve the quality of life.

Objective: To evaluate the long-term healing rate of transsphincteric anal fistula treated with anal fistula plug procedure and the risk factors affecting the healing of anal fistula. Methods: A retrospective case-control study was conducted to analyze the clinical data of 207 patients with transsphincteric anal fistulas who received anal fistula plug procedure at the Department of General Surgery, Beijing Chaoyang Hospital of Capital Medical University from August 2008 to September 2012. Inclusion criteria: (1) consistent with the diagnosis of transsphincteric anal fistula: the anal fistula passed through the internal and external sphincter; (2) complete data; (3) initial treatment with anal fistula plug procedure. Exclusion criteria: (1) acute rectal or perianal infection or poorly controlled focal infection; (2) recent incision and drainage of perianal abscess or spontaneous rupture of abscess; (3) patients with malignant tumor; (4) patients with Crohn′s disease or ulcerative colitis; (5) patients with heart, liver, brain, lung or renal insufficiency; (6) cachexia due to various chronic wasting diseases; (7) patients could not tolerate surgery. Patients were followed up for anal fistula healing. The cumulative healing rate of patients with transsphincteric anal fistula was plotted using the Kaplan-Meier method, and the factors affecting anal fistula healing were explored by univariate and multivariate logistic regression analysis. Results: There were 186 males and 21 females with age of 15 to 69 (mean 38) years. The duration of anal fistula was 3-60 (mean 15) months. Three patients had a history of previous episodes of perianal abscess and underwent incision and drainage of perianal abscess (all more than 3 months). During follow-up ending on October 31, 2018, 72 patients (34.8%) were lost to follow-up. Among 135 patients who were successfully followed up, the average follow-up period was 96 (75-124) months. Seventy-five patients had anal fistula healing, with healing rate of 55.6%. Kaplan-Meier survival curve showed that the healing time of anal fistula was prolonged and finally stabilized at 55.6%. In the patients who failed initial treatment with anal fistula plug packing, there were 6 cases whose anal fistula healed spontaneously without other treatment. Among them, 3 cases healed spontaneously 2 years and 3 cases 3 years after operation without recurrence. From 2008 to 2012, the annual healing rates of anal fistula plug treatment were 3/6, 61.5% (24/39), 42.1% (24/57), 12/15 and 12/18, respectively. Multivariate logistic regression analysis showed that the duration of anal fistula≥6 months (OR=3.187, 95% CI: 1.361-7.466, P=0.008) was an independent risk factor for anal fistula healing after treatment with anal fistula plug. Conclusion The long-term efficacy of anal fistula plug procedure in the treatment of transsphincteric anal fistula is positive, and this procedure should be implemented as soon as possible.

Objective:To explore the effect of peripheral blood T lymphocyte subsets on locally advanced rectal cancer after neoadjuvant chemoradiotherapy.Methods:108 patients were included at the Department of General Surgery of Beijing Chaoyang Hospital from Jun 2016 to Jun 2017. Peripheral blood was collected within one week before neoadjuvant therapy and one week before rectal surgery. Flow cytometry was applied to detect the CD3 + 、CD4 + 、CD8 + 、CD45RA + 、CD45RO + expression. Receiver operating characteristic (ROC) curve analysis was performed to determine the best cut-off value of the ratio of lymphocytes. A logistic regression model was obtained in multivariate analysis. Results:The values of CD3 + , CD4 + and CD8 + T lymphocytes in peripheral blood of the patients decreased compared with that before neoadjuvant treatment (all P<0.05). There was no significant decrease in the proportion of CD4 + , CD8 + , CD45RA + T and CD45RO + lymphocytes in patients′ peripheral blood (all P>0.05). The CD45RO in peripheral blood decreases during neoadjuvant therapy for locally advanced rectal cancer, and it is associated with better tumor regression( P<0.05). The best cut-off value for the ratio changes of CD45RO was 1.07. The ratio changes of CD45RO were the only significant factor for tumor regression in multivariate analysis ( P=0.005, OR=26.867, 95% CI: 1.530-471.635). Conclusion:The percentage of peripheral blood CD45RO may predict the sensitivity of neoadjuvant therapy in rectal cancer patients.

Objective:To evaluate the long-term effects of anal fistula plug treatment on postoperative anal function in patients with trans-sphincteric perianal fistula, and identify risk factors associated with anal function.Methods:A case-control study was conducted. Clinical and follow-up data of 123 patients with trans-sphincteric perianal fistula receiving anal fistula plug treatment in Beijing Chaoyang Hospital from August 2008 to September 2012 were retrospectively analyzed. The follow-up deadline was April 30, 2020. The Wexner score for incontinence was used to evaluate pre-and postoperative anal function (range from 0 to 20, with higher score representing worse function). The potential risk factors affecting postoperative anal function, including gender, age, fasting blood glucose, diabetes, smoking, alcoholism, location of external opening of anal fistula, surgeon expertise and operation time, were statistically analyzed.Results:Among the 123 patients, 114 were male and 9 were female, the median age was 39 (15-69) years, body mass index (BMI) was (26.2±3.9) kg/m 2, and the median distance between the external opening of anal fistula and the anal verge was 2.6 (1.0-5.0) cm. The median operation time was 30.4 (15.0-60.0) minutes. The median follow-up time was 120 (93-141) months. Sixty-nine patients (56.5%) were healed. The assessment of anal function by Wexner incontinence score showed that 33 (26.8%) patients had anal functional decline after surgery, and the postoperative median Wexner score was 1.34 (0-8), which was significantly higher than preoperative score of 0.17 (0-4) ( Z=-5.057, P<0.001). Compared with preoperative levers, postoperative subscores of flatus incontinence, liquid incontinence, solid incontinence and alteration in lifestyle were increased significantly (all P<0.05). Subgroup analysis showed that both in the healed and unhealed groups, the postoperative Wexner scores were higher than those before surgery [healed group: 1.22 (0-8) vs. 0.17 (0-1), Z=-3.796, P<0.001; unhealed group: 1.5 (0-8) vs.0.17 (0-3), Z=-3.422, P=0.001]. Univariate analysis revealed that 33 patients with postoperative anal functional decline had higher BMI, higher fasting blood glucose, higher proportion of alcoholism, longer distance between external opening of anal fistula and the anal verge, and longer operation time (all P<0.05). Multivariate logistic regression analysis testified that higher BMI (OR=1.485, 95% CI: 1.220-1.807, P<0.001) and longer distance between external opening and anal verge (OR=2.207, 95% CI: 1.276-3.220, P=0.003) were independent risk factors for postoperative anal functional decline. Conclusions:The treatment for trans-sphincteric anal fistula with anal fistula plug leads to long-term postoperative anal function decline. For patients with obesity and longer distance between external opening of anal fistula and the anal verge, this procedure should be performed with particular caution, and the anal sphincter should be preserved as much as possible during the operation.

Objective:To evaluate the long-term effects of anal fistula plug treatment on postoperative anal function in patients with trans-sphincteric perianal fistula, and identify risk factors associated with anal function.Methods:A case-control study was conducted. Clinical and follow-up data of 123 patients with trans-sphincteric perianal fistula receiving anal fistula plug treatment in Beijing Chaoyang Hospital from August 2008 to September 2012 were retrospectively analyzed. The follow-up deadline was April 30, 2020. The Wexner score for incontinence was used to evaluate pre-and postoperative anal function (range from 0 to 20, with higher score representing worse function). The potential risk factors affecting postoperative anal function, including gender, age, fasting blood glucose, diabetes, smoking, alcoholism, location of external opening of anal fistula, surgeon expertise and operation time, were statistically analyzed.Results:Among the 123 patients, 114 were male and 9 were female, the median age was 39 (15-69) years, body mass index (BMI) was (26.2±3.9) kg/m 2, and the median distance between the external opening of anal fistula and the anal verge was 2.6 (1.0-5.0) cm. The median operation time was 30.4 (15.0-60.0) minutes. The median follow-up time was 120 (93-141) months. Sixty-nine patients (56.5%) were healed. The assessment of anal function by Wexner incontinence score showed that 33 (26.8%) patients had anal functional decline after surgery, and the postoperative median Wexner score was 1.34 (0-8), which was significantly higher than preoperative score of 0.17 (0-4) ( Z=-5.057, P<0.001). Compared with preoperative levers, postoperative subscores of flatus incontinence, liquid incontinence, solid incontinence and alteration in lifestyle were increased significantly (all P<0.05). Subgroup analysis showed that both in the healed and unhealed groups, the postoperative Wexner scores were higher than those before surgery [healed group: 1.22 (0-8) vs. 0.17 (0-1), Z=-3.796, P<0.001; unhealed group: 1.5 (0-8) vs.0.17 (0-3), Z=-3.422, P=0.001]. Univariate analysis revealed that 33 patients with postoperative anal functional decline had higher BMI, higher fasting blood glucose, higher proportion of alcoholism, longer distance between external opening of anal fistula and the anal verge, and longer operation time (all P<0.05). Multivariate logistic regression analysis testified that higher BMI (OR=1.485, 95% CI: 1.220-1.807, P<0.001) and longer distance between external opening and anal verge (OR=2.207, 95% CI: 1.276-3.220, P=0.003) were independent risk factors for postoperative anal functional decline. Conclusions:The treatment for trans-sphincteric anal fistula with anal fistula plug leads to long-term postoperative anal function decline. For patients with obesity and longer distance between external opening of anal fistula and the anal verge, this procedure should be performed with particular caution, and the anal sphincter should be preserved as much as possible during the operation.

The establishment and development of the intestinal microbiota in early life is critical to the development of intestinal immune system, digestive function, metabolic function, and central nervous system function in infants.The first 1000 days of life is a critical period for the establishment of intestinal microbiota, which is susceptible to many factors.The disorder of intestinal microbiota in this period will increase the risk of some diseases in the long-term life.In this review, we will describe the main physiological functions of the early-life microbiota and its role in programming future health of infants.We also will describe the establishment and development of the intestinal microbiota in early life and its main drivers.

Objective To analyze the time and space aggregation of acute schistosome infections in marshland and lake areas in five provinces(Jiangsu,Anhui,Jiangxi,Hubei and Hunan province)from 2005 to 2012,so as to provide the evidence for es-tablishing control strategies and taking effective control measures. Methods The data of patients with acute schistosome infection in marshland and lake areas in five provinces from 2005 to 2012 were collected and analyzed with the concentration ratio and circu-lar distribution methods for the epidemic season features and time aggregation of the infection,and with the spatial autocorrelation analysis for the space aggregation of the infected cases. Results According to the concentration ratio,the occurrence of acute schistosome infection had strong seasonality,and the concentration ratio was 0.758;according to the circular distribution method, the peak day of acute schistosome infections was 10th,August. The spatial analysis suggested that the infected cases highly gath-ered around Poyang Lake,Dongting Lake and Yangtze River Basin in 23 counties of the five provinces,and the result of spatial au-tocorrelation analysis showed that the spatial autocorrelation index I was 0.16(P=0.01). Conclusion The occurrence of acute schistosome infections in lake regions of the 5 provinces shows strong seasonality and space aggregation,therefore we can bring the control mark forward,and take targeted prevention and control measures in high aggregation areas of acute schistosomiasis.

According to the requirement of the national assessment for achieving the infection control criteria, 42 villages (among them,25 villages belonged to the first stratum, and 17 villages belonged to the second stratum) in 14 counties from 5 provinces, including Hunnan, Hubei, Jiangxi, Anhui and Yunnan, were selected as sampling villages for the assessment.The results from the field assessment showed that 154 out of 9 067 people were found infected with Sckistosoma japonicum, with an average infection rate of 1.7% ranged from 0.31 % to 4.10% , and only Yongping Village from Weishan County and Tenglong Village from Eryuan County were not found any case. A total of 46 out of 3 323 head of cattle were infected with S. japonicum, with an average infection rate of 1.38% ranged from 0.26% to 3.79% , and no any infected individual detected in Nanling County. No outbreak occurred in those sampling villages. Therefore, it is indicated that the five sampling provinces have reached the national criteria on infection control of schistosomiasis.

This report overviewed the national endemic status of schistosomiasis in China in 2008. During the whole year of 2008, a total of 412 927 cases of schistosomiasis were estimated and 57 acute cases were reported, among which one acute case infected with Schistosoma mansoni was imported from overseas. The reduction rates of total cases and acute cases were 19.97% and 32.53% when comparing to those in 2007, respectively. A total of 21 222 advanced cases were treated in 2008 with an increase rate of 15.04% comparing with that in 2007. About 372 263. 11 hm~2 of areas infested with Oncomelania snails were found in 2008, and about 1 197. 89 hm~2 newly detected areas were found in non-infested areas with Oncomelania snails, in historical records. There were 1 468 669 head of the cattle with its infection rate of 1.34% in schistosomiasis transmission regions, with reduction rates of 1. 86% and 36.79% , respectively, comparing to those in 2007. However, cattle were still remaining as the main infectious source for the transmission of schistosomiasis. Six provinces including Jiangsu, Anhui, Jiangxi, Hubei, Hunan, and Yunnan reached the national criteria of infection control. Sichuan Province reached the national criteria of transmission control. The country achieved the mid-term goal of schistosomiasis control written in the document ofOutline of mid- and long-term national programme on control and prevention of schistosomiasis (2004 -2015).

Purpose: To observe the clinical efficacy on acupuncture treatment of functional dyspepsia. Methods: Major points including Zusanli (ST 36) were selected on the basis of meridian theory to treat functional dyspepsia with even reinforcing-reducing manipulations and electric stimulation. While commonly-used western medication domperidone was used in a control group. Results and conclusions: The total effective rate and the markedly effective rate were 93.8% and 63.3% respectively in the acupuncture group and 82.2% and 43.1% respectively in the medication group. The curative effect on nonspecific functional dyspepsia was better in the acupuncture group than in the medication group (P<0.05).Both treatments had marked effects on the dyskinetic type without a significant difference (P>0.05).