Myelodysplastic syndrome (MDS) is a malignant hematologic tumor, which is currently difficult to cure. The theory of Xuanfu was proposed by Liu Wansu, which is unique in the clinical evidence of Chinese medicine and is less frequently applied to hematological diseases. The application of Xuanfu theory in myelodysplastic syndrome provides new ideas for the treatment of the disease. The abnormal flow of Qi, blood and fluids caused by the occlusion of the Xuanfu is the cause of toxic stasis obstruction, which is the pathogenesis of toxic stasis obstruction. Thus, the method of dispersion of Bone from Xuanfu, the external treatment of Xuanfu, and regulation of liver qi and Xuanfu help to return to normal of opening and closing function of Xuanfu, and release toxic stasis. In this paper, we analyzed the evidence of toxin-stasis obstruction in myelodysplastic syndrome from the theory of Xuanfu, aiming to provide a feasible theoretical basis for clinical treatment of the disease.

Objective To explore the effect of Endoanal advancement flap(ERAF)and transanal opening of interphincteric space(TROPIS)in the treatment of complex anal fistula and their impact on anorectal pressure,so as to provide a reference for clinical selection of surgical methods.Methods Eighty-four patients with complex anal fistula admitted from October 2018 to October 2022 were divided into group E received ERAF treatment(n=48)and group T received TROPIS treatment(n=36).The clinical efficacy,operation,wound surface and anorectal pressure of the two groups were compared.Results The effective rate of treatment in Group T was 97.22％,which was higher than that in Group E(87.50％),with no statistically significant difference(P＞0.05).The surgical time[(31.53 ±7.29)minutes],intraoperative bleeding volume[(29.56±7.37)ml],and wound area[(10.03± 0.96)cm2,(8.76±0.87)cm2,(6.20±0.77)cm2]on the day of surgery,7 and 14 days after surgery in Group T were all smaller than those in Group E[(35.36±8.54)min,(36.86±8.04)ml,(12.09± 1.23)cm2,(10.52±1.09)cm2 and(7.36±0.85)cm2](P＜0.05).After surgery,the VAS score and Wexner incontinence score of Group T were(1.38±0.27)and(0.21±0.08),respectively.Group E was(1.56±0.29)and(0.33±0.09),respectively.In group T,the anorectal systolic pressure at 20 mm and 30 mm and the anorectal resting pressure at 20 mm and 30 mm were(138.18±29.58)mmHg,(136.22±35.41)mmHg,(35.47±6.58)mmHg,and(32.97±8.01)mmHg,respectively.In Group E,the data was(152.78±31.53)mmHg,(156.29±32.74)mmHg,(38.29±7.62)mmHg and(36.41±7.63)mmHg,respectively.Both groups showed a decrease in score and anorectal pressure,and group T was lower than group E(P＜0.05).The incidence of adverse reactions in Group E was 20.83％,which was higher than that in Group T(11.11％),but the difference was not statistically significant(P＞0.05).Conclusion TROPIS has a better effect in the treatment of complex anal fistula,which can shorten the operation time,reduce intraoperative bleeding,reduce postoperative pain,and protect anal function.

Objective To observe the influence of functional ankle instability(FAI)on balance and lower limb explosive power. Methods A total of 26 male FAI participants,13 bilateral(bilateral group)and 13 left(left group),who regularly en-gaged in high-intensity exercise,were recruited at Harbin Sport University in May,2024.Meanwhile,13 unin-jured male participants who engaged in high-intensity exercise were recruited as control group.They were mea-sured the moving area of the left foot,right foot and body center of gravity standing on feet with the eyes opened and closed;as well as the sway angle,confidence ellipse diameter(maximum and minimum)to circle area ratio,sway ratio and confidence ellipse standing on single foot,with Gaitview plantar pressure analysis system.They were also tested with Y-balance test(YBT),and were measured flight time and center of gravity height during jumps single leg left/right drift,stiffness and counter movement jump using Opto-jump Optical Measurement of Motor Quality. Results There were significant differences among the groups in swing angle,confidence ellipse diameter(maximum and minimum)to circle area ratio,swing ratio and confidence ellipse as left-leg stance with eyes closed(F>3.300,P<0.05),which was the least in the control group(P<0.05).Swing angle,swing ratio and confidence ellipse were also different among the groups as right-leg stance with eyes closed(F>4.404,P<0.05),and they were less in the control group than in the bilateral group(P<0.05),and less in the left group than in the bilateral group(P<0.05),except swing angle.There was a significant difference in YBT results(F>3.649,P<0.05),which was the least in the bilateral group(P<0.05).There were significant differences in the flight time and center of gravity height during counter movement jump(F>7.458,P<0.01),which was the least in the bilateral group(P<0.05). Conclusion FAI may impair the static balance as single-leg stance with eyes closed,dynamic balance and lower limb ex-plosive power.

Objective:To investigate the protective effects of Huoxue Rongluo Decoction on hypoxic-ischemic brain damage (HIBD) rats; To clarify the expression of AMPK signaling pathway during HIBD injury and repair.Methods:On the basis of the hypoxia ischemia reperfusion model, an improved hypoxia bottle was used to establish a full-term HIBD rat model. Totally 60 successfully modeled mice were divided into model group and TCM group using a random number table method, with 30 mice in each group and 30 mice in a control group. Two hours before surgery, TCM group was orally administered with Huoxue Rongluo Decoction 1.17 g/100 g (equivalent dose). The control group and model group were orally administered with equal volume of physiological saline. Two hours after surgery, it was orally administered again, twice a day, for consecutive 5 d. Behavioral tests (convulsion assessment, Longa score, suspension test, water maze test) were used to evaluate the motor nerve function and long-term learning ability of young rats in different groups. HE staining and electron microscopy were used to observe the pathological changes of brain tissue and mitochondrial damage. Evans blue (EB) staining and brain water content measurement were used to detect blood-brain barrier permeability and brain edema. The expression of AMPK signaling pathway related genes in brain tissues of different groups of young rats was detected by PCR array technique.Results:Compared with the model group, the convulsions of the rats in the TCM group were improved, the Longa score was significantly reduced, the grip strength test score and suspension time were significantly improved, the escape latency was significantly shortened, and the number of crossing platforms significantly increased ( P<0.05); the degree of neuronal and mitochondrial damage in the TCM group was reduced, and cerebral vascular permeability and brain water content were significantly reduced ( P<0.01). The results of PCR array showed that compared with the control group, 2 genes were significantly up-regulated and 12 genes were significantly down-regulated in the brain tissue of the model group; compared with TCM group, 15 genes were relatively down-regulated in the model group. Conclusion:Huoxue Rongluo Decoction can significantly reduce the degree of brain injury after HIBD, improve the motor nerve function and long-term learning and cognitive ability of model rats, and its damage repair mechanism is related to the expression regulation of AMPK signaling pathway related genes.

Objective: To investigate the spatio-temporal distribution characteristics of pulmonary tuberculosis in Ningbo City from 2015 to 2020, so as to provide insights into tuberculosis control. Methods: The data of pulmonary tuberculosis cases in Ningbo City from 2015 to 2020 were collected from Tuberculosis Management Information System of China Disease Control and Prevention Information System, and were linked with the geographic information database of Ningbo Planning Design and Research Institute. The software SaTScan version 10.3 was employed for monthly spatio-temporal scanning and cluster analysis of reported pulmonary tuberculosis cases, populations, longitude and latitude in 153 townships of Ningbo City from 2015 to 2020. Results: There were one class Ⅰ cluster and two class Ⅱ clusters of pulmonary tuberculosis cases in Ningbo City from 2015 to 2020, and the class Ⅰ cluster was centered in Song'ao Township and covered 37 townships, with aggregation time from January 1, 2015 to December 31, 2017, while class Ⅱ clusters were covered 38 tounships which were centered in Sanqishi Township of Yuyao County, and one township in Hangzhou Bay New Town. The aggregation time was from January to June in 2015 and 2016, from March to August between 2017 and 2019 and between May and October, 2020. The overall reported incidence of pulmonary tuberculosis appeared a tendency towards a decline in each township of Ningbo City from 2015 to 2020; however, the incidence of pulmonary tuberculosis was more than 80 per 100 thousand in Fuming Township of Yinzhou District and Juexi Township of Xiangshan County in 2020. Conclusions There were significant spatio-temporal clustering characteristics of pulmonary tuberculosis incidence at a township level in Ningbo City from 2015 to 2020, and the clusters were mainly concentrated in the central and eastern Ningbo City. The reported incidence of pulmonary tuberculosis is high in Fuming Township of Yinzhou District and Juexi Township of Xiangshan County, where targeted regional tuberculosis control strategies should be implemented.

Objective : To analyze the screening results of Mycobacterium tuberculosis (MTB) and HIV co-infections in Ningbo City from 2012 to 2020, so as to provide insights into improving the tuberculosis control strategy. Methods : Data pertaining to HIV antibody testing among tuberculosis patients, MTB testing among HIV/AIDS patients, treatment of patients with MTB and HIV co-infections and prognosis of anti-tuberculosis therapy were collected from the annual working reports for the management of MTB and HIV co-infections in Ningbo City from 2012 to 2020, and the screening, treatment and prognosis of MTB and HIV co-infections were analyzed. Results : A total of 35 385 newly identified tuberculosis patients were reported in Ningbo City from 2012 to 2020, and there were 5 854 cases receiving HIV testing. The annual mean percentage of HIV screening was 17.57%, and the HIV screening rate appeared a tendency towards a rise in Ningbo City from 2012 to 2020 (χ2trend=4 926.309, P<0.001). Eleven patients were tested positive for HIV, with an annual mean HIV positive rate of 0.19%. A total of 26 043 HIV/AIDS patients received MTB screening, with an annual mean screening rate of 95.78%, and the annual screening rate of MTB appeared a tendency towards a rise in Ningbo City from 2012 to 2020 (χ2trend=79.077, P<0.001). A total of 81 tuberculosis patients were detected, with an annual mean detection rate of 0.31%. Among the 92 patients with MTB and HIV co-infections, there were 81 patients receiving anti-tuberculosis and antiviral therapy simultaneously (88.04%), 8 cases receiving anti-tuberculosis therapy alone (8.70%), 2 cases receiving antiviral therapy alone (2.17%) and 1 case without therapy (1.09%). Among the 89 MTB and HIV co-infected patients receiving anti-tuberculosis therapy, 27 cases were cured (30.34%), 53 cases completing the course of treatment (59.55%) and 7 cases died. Conclusions The MTB screening rate among HIV/AIDS patients and the percentage of MTB and HIV co-infected patients with successful anti-tuberculosis treatment were high in Ningbo City from 2012 to 2020; however, the HIV screening rate should be improved among tuberculosis patients.

Objective: To investigate the epidemiological characteristics of pulmonary tuberculosis in Ningbo City from 2011 to 2020, so as to provide the evidence for developing the control measures of pulmonary tuberculosis. Methods: The data pertaining to pulmonary tuberculosis cases in Ningbo City from 2011 to 2020 were collected from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System. The temporal distribution, population distribution, regional distribution and case report by hospitals were descriptively analyzed. Results: Totally 38 305 pulmonary tuberculosis cases were reported in Ningbo City from 2011 to 2020, with an incidence rate of 48.71/105. The incidence of pulmonary tuberculosis appeared a tendency towards a decline ( P<0.05 ), with an annual reduction rate of 5.29%. There were 15 784 smear-positive cases ( 41.21% ), and the proportion of smear-positive cases appeared a tendency towards a reduction from 2011 to 2015 ( P<0.05 ), and a rise from 2016 to 2020 ( P<0.05 ). The number of reported pulmonary tuberculosis cases peaked from March to May (10 973 cases, 28.65%), and a higher incidence rate of pulmonary tuberculosis was found in men than in women ( 64.55/105 vs. 32.20/105, P<0.05 ). The highest incidence of pulmonary tuberculosis was found in cases at ages of 15 to 25 years ( 72.93/105 ), followed by in cases at ages of 65 years and greater ( 69.97/105 ), and farmers were the predominant occupation among the pulmonary tuberculosis patients ( 12 279 cases, 32.06% ). During the period from 2011 to 2020, pulmonary tuberculosis cases were reported across the 10 districts or counties of Ningbo City, and the top three high incidence of pulmonary tuberculosis were seen in Yinzhou District ( 59.91/105 ), Fenghua District ( 56.19/105 ) and Beilun District ( 56.01/105 ). The proportion of pulmonary tuberculosis cases reported by designated pulmonary tuberculosis hospitals increased from 72.16% in 2011 to 99.74% in 2020 in Ningbo City. Conclusions The incidence of pulmonary tuberculosis appeared a tendency towards a decline in Ningbo City from 2011 to 2020, and the annual decline rate meets the requirements of the WHO strategic goal of ending pulmonary tuberculosis; however, the control measures for pulmonary tuberculosis require to be intensified among men, youths, and farmers.

BACKGROUND: Ambient fine particle (PM METHODS: A time-stratified case-crossover design was used to analyze YLL from respiratory diseases in the elderly related to ambient PM RESULTS: Each 10 μg/m CONCLUSIONS Birth season which reflects the early-life PM
Aged ; Aged, 80 and over ; Air Pollutants/analysis* ; Cause of Death ; China/epidemiology* ; Cross-Over Studies ; Environmental Exposure/analysis* ; Humans ; Life Expectancy ; Particulate Matter/analysis* ; Respiration Disorders/mortality* ; Seasons

Objective:To examine the difference of long-term recurrence rate and survivals between the young patients and the old patients undergoing breast conserving therapy (BCT).Methods:Women with primary invasive breast cancer receiving BCT between December 1999 and December 2014 were selected retrospectively from the database of Breast Cancer Center, Peking University Cancer Hospital & Institute. The median age of all patients was 47 years (range: 21 to 91 years). The cases were categorized according to age at diagnosis into two subgroups: the ≤40 years group and the>40 years group. A total of 2 778 patients were included: 677 patients in the ≤40 years group and 2 101 patients in the >40 years group. Clinicopathological characteristics between two groups were compared. The recurrence rate and survival were calculated using the Kaplan-Meier method. The differences of outcomes were compared in different aged groups using the Log-rank test. Factors affecting local recurrence, distant disease-free survival (DDFS), disease-free survival (DFS), and breast cancer-specific survival (BCSS) were assessed by multivariable Cox proportional hazard models.Results:Proportions of T1 (301/677 vs. 1 160/2 101, χ2=37.660, P<0.01), involved lymph node (314/677 vs. 713/2 101, χ2=34.966, P<0.01) hormone receptor-negative (490/677 vs. 1 581/2 101, χ2=6.981, P=0.030) and neoadjuvant chemotherapy (413/677 vs. 1 010/2 101, χ 2=34.272, P<0.01)in the ≤40 years group were higher than that in the>40 years group. Median follow-up duration was 102 months. No significant difference in 10-year local recurrence was found between the two groups (2.5% vs. 1.6%, P=0.147). Ten-year DDFS rate in the ≤40 years group and in the>40 years group was 90.6% and 95.3%, respectively ( P<0.01). Ten-year DFS rate in the ≤40 years group and in the>40 years group was 86.5% and 91.1%, respectively ( P=0.001). Ten-year BCSS rate in the ≤40 years group and in the >40 years group was 91.0% and 93.7%, respectively ( P=0.105). Age was not the prognosis factor of local recurrence. Lymph node status (positive vs. negative: HR=2.73, 95%CI: 1.94 to 3.84, P<0.01), age (≤40 years vs.>40 years: HR=1.73, 95%CI: 1.24 to 2.42, P=0.001) and T stage (>2 cm vs. ≤2 cm: HR=1.61, 95%CI: 1.14 to 2.28, P=0.001) were the prognosis factors of DDFS, and also for DFS. Hormone receptor status (positive vs. negative: HR=0.54, 95%CI: 0.39 to 0.74, P<0.01), lymph node status (positive vs. negative: HR=2.94, 95%CI: 2.12 to 4.07, P<0.01) and T stage (>2 cm vs. ≤2 cm: HR=1.45, 95%CI: 1.05 to 2.01, P=0.025) were the prognosis factors of BCSS. Conclusions:The risk of local recurrence was similar between ≤40 years patient and >40 years patients receiving breast conserving therapy. Worse survivals in the ≤40 years group were found comparing to those in the >40 years group.

Objective:To examine the difference of long-term recurrence rate and survivals between the young patients and the old patients undergoing breast conserving therapy (BCT).Methods:Women with primary invasive breast cancer receiving BCT between December 1999 and December 2014 were selected retrospectively from the database of Breast Cancer Center, Peking University Cancer Hospital & Institute. The median age of all patients was 47 years (range: 21 to 91 years). The cases were categorized according to age at diagnosis into two subgroups: the ≤40 years group and the>40 years group. A total of 2 778 patients were included: 677 patients in the ≤40 years group and 2 101 patients in the >40 years group. Clinicopathological characteristics between two groups were compared. The recurrence rate and survival were calculated using the Kaplan-Meier method. The differences of outcomes were compared in different aged groups using the Log-rank test. Factors affecting local recurrence, distant disease-free survival (DDFS), disease-free survival (DFS), and breast cancer-specific survival (BCSS) were assessed by multivariable Cox proportional hazard models.Results:Proportions of T1 (301/677 vs. 1 160/2 101, χ2=37.660, P<0.01), involved lymph node (314/677 vs. 713/2 101, χ2=34.966, P<0.01) hormone receptor-negative (490/677 vs. 1 581/2 101, χ2=6.981, P=0.030) and neoadjuvant chemotherapy (413/677 vs. 1 010/2 101, χ 2=34.272, P<0.01)in the ≤40 years group were higher than that in the>40 years group. Median follow-up duration was 102 months. No significant difference in 10-year local recurrence was found between the two groups (2.5% vs. 1.6%, P=0.147). Ten-year DDFS rate in the ≤40 years group and in the>40 years group was 90.6% and 95.3%, respectively ( P<0.01). Ten-year DFS rate in the ≤40 years group and in the>40 years group was 86.5% and 91.1%, respectively ( P=0.001). Ten-year BCSS rate in the ≤40 years group and in the >40 years group was 91.0% and 93.7%, respectively ( P=0.105). Age was not the prognosis factor of local recurrence. Lymph node status (positive vs. negative: HR=2.73, 95%CI: 1.94 to 3.84, P<0.01), age (≤40 years vs.>40 years: HR=1.73, 95%CI: 1.24 to 2.42, P=0.001) and T stage (>2 cm vs. ≤2 cm: HR=1.61, 95%CI: 1.14 to 2.28, P=0.001) were the prognosis factors of DDFS, and also for DFS. Hormone receptor status (positive vs. negative: HR=0.54, 95%CI: 0.39 to 0.74, P<0.01), lymph node status (positive vs. negative: HR=2.94, 95%CI: 2.12 to 4.07, P<0.01) and T stage (>2 cm vs. ≤2 cm: HR=1.45, 95%CI: 1.05 to 2.01, P=0.025) were the prognosis factors of BCSS. Conclusions:The risk of local recurrence was similar between ≤40 years patient and >40 years patients receiving breast conserving therapy. Worse survivals in the ≤40 years group were found comparing to those in the >40 years group.