Percutaneous coronary intervention(PCI) has been a mainstay in the management of coronary artery disease since its introduction in the late 1970s.Bare-metal stents and,more recently,first-generation drug-eluting stents(DES),such as sirolimus-eluting(Cypher) and paclitaxel-eluting stents(Taxus),have further improved results of percutaneous coronary intervention by improving early results and reducing the risk of restenosis.There are currently debates on the safety of these first-generation DES,given the potential for late stent thrombosis which is a first-generation drug-eluting stent of the largest security issue,especially after discontinuation of dual antiplatelet therapy.Next-generation DES such as everolimus-eluting stents(Xience V) holds the promise of superior anti-restenosis efficacy as well as long-term safety.This review makes a presentation of the evidence-based clinical research according to everolimus-eluting stents(Xience Ⅴ).

Objective To study the application value of the combined detection of serum HE4 ,CAl25 ,CA72‐4 and IL‐6 in the di‐agnosis of ovarian malignant tumor .Methods The serum levels of CA125 and CA72‐4 were determined by ECLI ,and the serum levels of HE4 and IL‐6 were determined by ELISA in 32 patients with ovarian cancer ,56 patients with benign ovarian disease and 40 healthy controls .The detection results were performed the statistical analysis .Results The serum levels of HE4 ,CAl25 ,CA72‐4 and IL‐6 in the ovarian cancer group were significantly higher than those in the other two groups with statistically significant differ‐ences(P< 0 .01) ;the sensitivity of CA125 detection in the single index detections was highest(75 .0% ) ,the specificity of HE4 was highest(83 .9% ) ,the highest diagnostic efficiency of single index detection was 79 .5% .The sensitivity ,specificity and efficiency of the combined detection for diagnosis were 96 .9% ,71 .4% and 80 .7% .Except the specificity ,the sensitivity and diagnostic efficien‐cy of the combined detection were higher than those of any one of single index detection .Conclusion The combined detection of se‐rum HE4 ,CAl25 ,CA72‐4 and IL‐6 could increase the diagnostic efficiency of ovarian cancer and conduces to the diagnosis and help to the diagnosis and differential diagnosis of ovarian malignancies .

Objective To investigate the preoperative management and the clinical effeciency of Lichtenstein tension-free hernioplasty in adult patients with inguinal incarcerated hernia.Methods Clinical data of 86 patients with inguinal incarcerated hernia were analyzed retrospectively.Hernia was repaired with Lichtenstein tension free after reposition.Results There were 59 male patients and 27 female patients with median age of (63 ± 18) years.There were 8 patients with liver cirrhosis.The operation was performed successfully in all patients.Segmental bowel resection with end-to-end anastomosis was performed in 38 emergency cases.Operative time was 20-120 min,with an average time of 54 min.The postoperative hospitalization was 5-17 d,with an average of 8 d.There were 7 cases of skin ecchymosis at the scrotum,there were no intestinal perforation,hepatic encephalopathy and upper gastrointestinal hemorrhage after operation.In early series of 24 cases without drainage tube left in place,there were 10 cases of fat liquefaction,10 cases of hydrops of hernial sac,6 cases of seroma and 3 cases of wound infection after operation.After 12 to 48 months of follow-up,there was no mortality after 2 years,no hernia recurrence.Conclusions Tension free repair in the treatment of incarcerated inguinal hernia is safe and feasible.

Objective : To investigate the HIV-1 molecular transmission network among school students with newly confirmed HIV/AIDS in Hangzhou City from 2020 to 2021, so as to provide insights into AIDS control in school. Methods : School students with newly confirmed HIV/AIDS in Hangzhou City from 2020 to 2021 were sampled, and participants' demographics and epidemiological survey data were retrieved from the HIV/AIDS Control Information System of Chinese Disease Prevention and Control Information System. The HIV-1 pol gene was amplified in participants' blood samples using reverse transcription (RT) and nested PCR assays, and the HIV subtypes were characterized through multiple sequence alignments. The gene sequences were aligned among newly confirmed HIV/AIDS patients in Hangzhou City during the same study period. The genetic distance was estimated using the software MEGA 11, and the molecular transmission network was created using the software Cytoscape 3.9.1 to analyze the characteristics of clustered cases in the network. Results: A total of 99 school students were newly confirmed with HIV/AIDS in Hangzhou City from 2020 to 2021, including 98 men (98.98%), and 94 men who had sex with men (94.94%). The HIV-1 pol gene sequence was successfully amplified from 87 cases, and four HIV-1 subtypes were characterized, including CRF07_BC (49 cases, 56.32%), CRF01_AE (27 cases, 31.03%), CRF55_01B (6 cases, 6.90%) and CRF67_01B (5 cases, 5.75%). There were 30 molecular clusters in 50 MSM, with 2 to 16 cases in each cluster, and 27 molecular clusters associated with non-student cases, and clustered cases were all MSM. Infection route, location of schools and current address of non-student cases were identified as factors affecting case clustering, and the residence of schools was an important area of activity among clustered HIV/AIDS cases. Conclusions CRF07_BC and CRF01_AE were predominant HIV-1 subtypes among school students with newly confirmed HIV/AIDS in Hangzhou City from 2020 to 2021, and the transmission of HIV/AIDS strongly correlated with non-student cases, with men-men sexual behaviors as the predominant transmission route. The interventions for of MSM is recommended to be reinforced to block the transmission of HIV/AIDS from community to schools.

Objective To study the efficacy of performing transvaginal Prosima mesh with high uterosacral ligament suspension (HUS) in treatment of severe pelvic organ prolapse (POP).Methods From July 2010 to February 2011,70 patients with severe POP underwent transvaginal prosima mesh with HUS in First Affiliated Hospital,General Hospital of People's Liberation Army.Clinical parameters of perioperation were collected.After 1 month and 2 - 3 months,perineal two-dimensional ultrasound examination was performed to measure mesh length in midsagittal plane.Validated prolapse quality of life questionnaires,pelvic floor distress inventsry short form 20 (PFDI-20) and pelvic floor impact questionnaire short form 7 (PFIQ-7) were used to evaluate the therapeutic effect.The mean results of pre-operative PFIQ-7 and PFDI-20 was 54 and 51,respectively.Results Median operation time was ( 195 ± 47 ) min and median blood loss was (160 ±64) ml.All the patients were followed for a mean time of 13 months (2 - 19 months).Seven cases were found with mesh exposure with less than 1 cm2.The objective cure rate was 100％.The mean score of post-operative PFIQ-7 and PFDI-20 were both 19,which were significantly lower than those of preoperation ( P ＜ 0.05 ).Anterior Prosima mesh was 3.5 cm at 1 month by ultrasound examination,and the second result of ultrasound scans was 2.8 cm at 2 - 3 month,which were both shortened 2.5 cm and 3.2 cm when compared with that of original size.Conclusions Transvaginal Prosima mesh placement with HUS is a safe and efficient surgery with less complication.Although mesh became shorter after 2 - 3 month,it did not affect surgery efficacy.

To investigate the genetic character and origin of the first imported infection case of middle East respiratory syndrome coronavirus (named as MERS-CoV_China GD01), RNA was extracted from swabs of this patient followed by RT-PCR amplification. All coding gene of structural (S, E, M, E) and accessory (ORF3, ORF4a, ORF4b, ORF5, ORF8b) proteins were sequenced and analyzed. Phylogenetic analyses of structural protein coding genes of MERS-CoV_ China GD01 indicates that several substitutes exists in S coding gene and its origin belong group 5 of MERS-CoV, which were recent circulated in Saudi Arabia area, while other three structural genes (N, E, M) were very conserved. Phylogenetic analyses of accessory protein coding genes of MERS-CoV China GD01 indicates that several substitutes exists among ORF3, ORF4a, ORF4b and ORF5, while ORF8b was conserved. In conclusion, genome of MERS-CoV_ China GD01 was general conserved although several genetic variations were found among structural and accessory protein coding genes. This is the first report on sequencing and phylogenetic analyses of the first imported MERS case in China, which may pay the way for prevention and control of imported MERS-CoV infection.
China ; Conserved Sequence ; Coronavirus Infections ; transmission ; virology ; Evolution, Molecular ; Genomics ; Humans ; Middle East Respiratory Syndrome Coronavirus ; genetics ; physiology ; Phylogeny ; Sequence Analysis ; Viral Proteins ; genetics

Objective To establish an inactivated viral particle-based ELISA for the detection of antibodies against Middle East respiratory syndrome coronavirus (MERS-CoV) in serum samples collected from a MERS-CoV associated case. Methods Serum samples were collected from 10 newborns and 40 healthy adults. A viral particle-based ELISA was established by using the inactivated MERS-CoV virions as antigen. The levels of IgM and IgG antibodies in the serum samples were detected by the established ELISA and the cut-off values for positive detection were determined. Then the inactivated MERS-CoV virion-based ELISA was used to detect the antibodies against MERS-CoV in 5 serum samples collected from the first im-ported MERS case in China. Results The cut-off values of IgM and IgG antibodies in serum samples for ELISA were determined to be A450 readings of 0. 32 and 0. 42, respectively. The titers of IgM and IgG anti-bodies in serum samples collected at early admission to hospital from the first imported MERS case in China were both 1 ︰ 40. Seroconversion occurred 2 weeks after his admission to hospital with the titers of IgM and IgG reaching to 1 ︰ 320. Conclusion The inactivated MERS-CoV virion-based ELISA was established successfully and could be used for the detection of serum antibodies (IgG and IgM) in MERS associated cases.

Objective To investigate the impact of colpocleisis on body image in women with severe pelvic organ prolapse (POP). Methods From Oct. 2005 to Feb. 2010,60 POP patients with stage Ⅲ and Ⅳ by POP quantitation system underwent total or partial colpocleisis. Patients received body image evaluation before and 1 year after operation. Results One year after operation, 52 (87% , 52/60) patients completed body image evaluation. Before and 1 year after operation, the ratio of answer Not at all of questions such as Have you felt less physically attractive as a result of your vaginal prolapse? , Have you been feeling less feminine as a result of your vaginal prolapse? , Did you find it difficult to look at yourself naked? , Have you been feeling less sexually attractive as a result of your vaginal prolapse?, Have you felt dissatisfied with your body? were 25% and 96% ( P ＜ 0. 01 ) , 21% and 96% ( P ＜ 0. 01) , 37% and 67% (P = 0.018), 29% and 96% (P＜0.01), 12% and 83% (P＜0.01), respectively, indicating significant improvement on body image after operation for patients treated by colpocleisis. Conclusion Women underwent colpocleisis for severe POP could not decrease their body image as a result of the disability of vaginal intercourse.

Objective To assess the long-term effectiveness of the transvaginal high uterosacral ligament suspension (HUS) in women suffering from advanced pelvic organ prolapse (POP).Methods A retrospective review of records identified 118 women who underwent transvaginal HUS with or without additional concomitant anterior and (or) posterior repairs from June 2003 to August 2009 in the First Affiliated Hospital,General Hospital of People's Liberation Army.Of 118 women,104 women completed the follow-up during study period;these 104 women were analysed.Follow-up visits were performed 2,6 and 12 months after surgery and then annually.Anatomic results of POP was established by pelvic examination using pelvic organ prolapse quantitation system (POP-Q) staging.Funtional results were obtained by patient global impression of improvement (PGI-I),pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7).Surgical success required the fulfillment of all 3 criteria:(1) prolapse leading edge of 0 cm or less and apex of 1/2 total vaginal length or less;(2) the absence of pelvic organ prolapse symptoms as reported on the PFDI-20 question No.3 (Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?);and (3) no prolapse reoperations or pessary use during the study period.Results The mean follow-up time was (9.1 ± 1.5) years.The overall surgery success rate was 91.3％ (95/104) according to above all 3 criteria.Prolapse recurrence rates were isolated anterior 6.7％ (7/104),isolated apical 0,isolated posterior 2.9％ (3/104) and multiple compartments 1.0％ (1/104).Five women (4.8％,5/104) developed bothersome vaginal bulge symptoms.None of recurrent women underwent retreatment,including either surgery or use of a pessary at last follow-up.The subjective satisfaction rate was 90.4％ (94/104).PFDI-20 and PFIQ-7 scores showed a statistically significant improvement from preoperative 72 and 65 points to postoperative 17 and 9 points respectively (all P＜0.01).There was a 2.9％ (3/104) rate of intraoperative ureteral kinking and 3.8％ (4/104) rate of postoperative morbidity.Conclusions The transvaginal HUS for vault prolapse offers good long-term anatomical results with excellent vault suspension.With additional concomitant anterior and (or) posterior repairs,it will be a reconstructive surgery for the majority of advanced POP.It is minimal traumatic and appropriate for different type of POP,especially for the eldly patients.It is worthy of being popularized for clinical application.

Objective:To evaluate the indications, surgical skills and clinic outcomes of abdominal minimal incision sacrocolpopexy (AMISC) for treatment of advanced pelvic organ prolapse (POP).Methods:The retrospective study analyzed 30 women with advanced POP who underwent AMISC between June 2016 and October 2019, including 9 cases of recurrent prolapse and 10 cases of vault prolapse. AMISC was especially applicable to: (1) patients with several medical complications who was unable to tolerate general anesthesia or laparoscopic surgery, but able to tolerate combined spinal-epidural anesthesia and open surgery; (2) other abdominal procedures were indicated to perform with AMISC simultaneously, such as myomectomy, subtotal hysterectomy etc, the specimens were easy to get out of the abdominal cavity and morcellation was avoided; (3) surgeons preferring open surgery to laparoscopic surgery or skilled in open surgery; (4) patients with prior pelvic operations, presenting severe abdominal and pelvic adhesions. Objective outcomes were assessed by pelvic organ prolapse quantification (POP-Q) system. Subjective outcome were assessed by pelvic floor distress inventory-short form 20 (PFDI-20), pelvic floor impact questionnaire-short form (PFIQ-7) and patient global impression of improvement (PGI-I).Results:All patients with 1-3 medical complications were successfully performed with AMISC without stopping procedure, enlarging the incision or changing to other procedure, the operation duration was (110±19) minutes. The mean time of follow-up was (33.5±12.4) months (range: 8-49 months). The postoperative points of Aa, Ba, C, Ap, Bp reduced significantly and point C improved from (2.33±2.50) cm to (-7.54±1.18) cm after AMISC ( P<0.01). The objective cure rates were both 100% (30/30) in apex and posterior compartment, while 97% (29/30) in anterior compartment. Postoperative scores of PFDI-20 and PFIQ-7 were all significant decreased (all P<0.01). About PGI-I, 29 patients chose “significant improvement”, subjective satisfaction was 97% (29/30). Anterior sacral plexus hemorrhage occurred in 2 cases (7%, 2/30). There was no intestinal obstruction or injury of bladder, bowel and ureter intra- and postoperation. Two cases (7%, 2/30) had mesh exposure. Conclusion:AMISC is a safety, convenient, minimal traumatic and durable procedure for apical prolapse with short learning curve in the most of cases.