Based on Sun Yat-Sen University Cancer Hospital’s practice of applying big data for prevention of registration traffickers,the paper analyzes the behavioral characteristics of technology-based registration traffickers'malicious occupation from the aspects of abnormal registration,abnormal withdrawal,abnormal grab and abnormal user binding,makes the corresponding technical plans and countermeasures,so as to limit the malicious registration of registration traffickers using the reservation system and guarantee the medical resources can be distributed to patients fairly and impartially.

OBJECTIVETo investigate whether myocardial bridging (MB) is an independent risk factor for coronary atherosclerosis proximal to the bridge site in the left anterior descending coronary artery (LAD) in diabetic patients.

METHODSFrom March 2011 to December 2012, 9862 patients with suspected coronary disease underwent coronary computed tomography angiography (CCTA) using a dual-source CT scanner. The baseline clinical characteristics (age, gender, smoking history, presence of hypertension, dyslipidemia, diabetes mellitus, family history of heart attack and body mass index) and the results of CCTA were reviewed. Two radiologists evaluated the MB and coronary atherosclerosis stenosis (CAS) over 50% in the LAD and made a diagnosis by consensus. Significant independent risk factors for CAS were investigated by logistic regression analysis.

RESULTSOf the 2345 patients identified to have diabetes mellitus, 1373 had MB, among whom 827 had coronary atherosclerosis proximal to the bridge site; 972 of the diabetic patients were free of MB, among whom 254 had coronary atherosclerosis at the equivalent site. None of the patients had CAS in the tunneled segment. After adjusted for clinical data, logistic regression analysis showed that MB in the LAD was significantly correlated with coronary atherosclerosis in the proximal LAD in diabetic patient (OR=3.91) and non-diabetic patients (OR=2.69) (P<0.05).

CONCLUSIONIn diabetic patients, atherosclerosis occurred frequently in the segment proximal to MB in the LAD, and MB in the mid-LAD is an independent risk factor for CAS in the proximal LAD.

Angiography ; Atherosclerosis ; Coronary Artery Disease ; Coronary Stenosis ; Diabetes Mellitus ; Humans ; Myocardial Bridging ; Myocardium ; pathology ; Risk Factors

Objective:To compare the effect and safety of continuous veno-venous hemofiltration (CVVH)+double plasma molecular absorption (DPMA)+hemoperfusion (HP), CVVH+HP, and CVVH+plasma exchange (PE) in treatment of patient with severe wasp stings injury.Methods:Multicenter, historical cohort study and superiority test were used. From July 2020 to October 2022, patients with wasp sting injury and multiple organ damage admitted to the intensive care units (ICU) of five hospitals were consecutively screened and recruited into the CVVH+DPMA+HP group (intervention group). Propensity score matching was used to establish historical cohorts. Patients with severe wasp sting injury who hospitalized from January 2016 to June 2020 in each ICU were collected and matched 1∶1 with the intervention group, and divided into CVVH+HP group and CVVH+PE group according to their actual hemopurification protocols (historical control groups). The primary outcome was the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score on days 3 and 7 after initiation of treatment. Secondary outcomes included complications, length of ICU and hospital stays, and all-cause mortality. Multivariate Cox proportional risk regression was used to analyze the prognosis of patients.Results:After propensity score matching, 56 patients in intervention group and each of the two historical control groups were matched successfully. There were no significant differences in age, gender, comorbidities, biochemical test indices and critical illness scores among the groups. After treatment, APACHE Ⅱ score markedly declined in all groups, and the decrease was faster in the intervention group; treatment with DPMA [hazard ratio ( HR) = 1.04, 95% confidence interval (95% CI) was 1.02-1.08, P = 0.00], the decreased levels of body temperature ( HR = 1.02, 95% CI was 1.00-1.03, P = 0.02), serum creatine kinase (CK; HR = 0.98, 95% CI was 0.96-1.00, P = 0.05) and myoglobin (MYO; HR = 2.88, 95% CI was 1.24-6.69, P = 0.01) were independent risk factors for APACHE Ⅱ score decline to the target value (15 scores). There were no significant differences in the incidence of bleeding complications, filter or perfusion thrombosis, blood pressure reduction, catheter-related infection and anaphylaxis among the groups. Conclusion:CVVH+DPMA+HP regimen can significantly reduce the APACHE Ⅱ score of patients with severe wasp sting injury, and the efficacy is superior to CVVH+HP and CVVH+PE regimens, with safety.