Objective To compare the early result of endovascular repair and conventional open repair for abdominal aortic aneurysm. Methods We analyzed the clinical data of 34 patients with infrarenal AAA. Among them, 15 patients were treated with endovascular repair ( EVR group), 19 with conventional open repair ( COR group). Pre-operative status, intra-operative variables, post-operative outcomes and laboratory findings of the two groups were compared. Results Blood loss and blood transfusion in EVR group were significantly less than COR group (P =0.005, P =0.015). The median fasting period and post-operative hospital stay were shorter in EVR group (P

OBJECTIVE: To evaluate the safety and efficacy of FK506-based dual therapy and CsA-based triple therapy for immunosuppression after liver transplantation. METHODS: The literature about the randomized controlled trials (RCT) on FK506 and CsA for immunosuppression after liver transplantation was retrieved for analysis using RevMan 5.0 software. RESULTS: A total of 7 RCTs were included; 3 were considered as high quality of RCT, 4 as moderate quality. The results of Meta-analysis of FK506-based dual therapy indicated the patients’ survival rate (RR=1.06, 95%CI=0.77～1.45,P=0.72), grafts’ survival rate (RR=0.99, 95%CI=0.76～1.29,P=0.92), infection rate(RR=0.98, 95%CI=0.60～1.58,P=0.93)and incidence of neurotoxicity (RR=0.59, 95%CI=0.32～1.07,P=0.08)was not significantly different. The incidence of acute rejection in CsA group was lower than in FK506 group (RR=1.57, 95%CI=1.23～2.01,P=0.000 3). CONCLUSION: The curative efficacy of FK506 group is not different from that of CsA group in respect of rate of patient/graft, infection but increase the incidence of acute rejection. Because CsA can increase incidence of neurotoxicity, it is suggestion to treat patients of nervous systerm disease with FK506.

Objective To evaluate the feasibility of diffusion kurtosis imaging (DKI)in the diagnosis and aggressiveness assessment of prostate cancer.Methods The MR data with multi-b-value diffusion-weighted imaging (DWI)of 30 male patients with prostate cancer were retrospectively analyzed.D maps and K maps were generated from the DKI model and ADC maps were obtained using the conventional monoexponential model.Differences in the D,K and ADC values between prostate cancer and benign peripheral zone (PZ)tissues,among tumors with different Gleason scores were analyzed.P<0.05 was considered statistical significance.Results ADC and D values were significantly lower in the prostate cancers than in the benign PZs (P <0.001).K values were significantly greater in the prostate cancers than in the benign PZs (P <0.001).ADC,D and K values were different significantly among the tumors with Glea-son scores of 6,7 and ≥8 (P <0.001,P =0.01 5 and P <0.001,respectively).Conclusion The DKI model can better describe the signal intensity attenuation with b values increasing,which is helpful for diagnosing and grading prostate cancer.K value may be used to quantitatively evaluate the complicated microstructure of prostate cancer.

The burden of atrial fibrillation (AF) is projected to increase substantially over the next decade in parallel with the aging of the population. The increasing age, level of comorbidity, and polypharmacy will complicate the treatment of older adults with AF. For instance, advanced age and chronic kidney disease have been shown to increase the risk of both thromboembolism and bleeding in patients with AF. Frailty, recurrent falls and polypharmacy, while very common among elderly patients with AF, are often overlooked in the clinical decision making despite their significant interaction with oral anticoagulant (OAC) and profound impact on the patient's clinical outcomes. Such factors should be recognized, evaluated and considered in a comprehensive decision-making process. The introduction of non-vitamin K oral anticoagulants has radically changed the management of AF allowing for a more individualized selection of OAC. An understanding of the available data regarding the performance of each of the available OAC in a variety of at risk patient populations is paramount for the safe and effective management of this patient population. The aim of this review is to appraise the current evidence, point out the gaps in knowledge, and provide recommendations regarding stroke prevention in older adults with AF and comorbid conditions.
Accidental Falls ; Adult ; Aged ; Aging ; Anticoagulants ; Atrial Fibrillation ; Clinical Decision-Making ; Comorbidity ; Hemorrhage ; Humans ; Polypharmacy ; Renal Insufficiency, Chronic ; Stroke ; Thromboembolism ; Warfarin

The burden of atrial fibrillation (AF) is projected to increase substantially over the next decade in parallel with the aging of the population. The increasing age, level of comorbidity, and polypharmacy will complicate the treatment of older adults with AF. For instance, advanced age and chronic kidney disease have been shown to increase the risk of both thromboembolism and bleeding in patients with AF. Frailty, recurrent falls and polypharmacy, while very common among elderly patients with AF, are often overlooked in the clinical decision making despite their significant interaction with oral anticoagulant (OAC) and profound impact on the patient's clinical outcomes. Such factors should be recognized, evaluated and considered in a comprehensive decision-making process. The introduction of non-vitamin K oral anticoagulants has radically changed the management of AF allowing for a more individualized selection of OAC. An understanding of the available data regarding the performance of each of the available OAC in a variety of at risk patient populations is paramount for the safe and effective management of this patient population. The aim of this review is to appraise the current evidence, point out the gaps in knowledge, and provide recommendations regarding stroke prevention in older adults with AF and comorbid conditions.

Objective:To analyze the detection rate of hyperuricemia (HUA) and the distribution of serum uric acid (SUA) levels by multiple correlation analysis in middle-aged and elderly population receiving health examination.Methods:In this cross-sectional study, the study object were 25 587 middle-aged and elderly people who receiving health examination in Nanfang Hospital from January to December in 2014. According to the latest diagnostic criteria, the population was divided into HUA and non-HUA groups. Furthermore, the subjects were divided into 4 groups with the level of SUA (Q 1: SUA<313 μmol/L, Q 2:313 μmol/L≤SUA<375 μmol/L, Q 3:375 μmol/L≤SUA<440 μmol/L, Q 4: SUA≥440 μmol/L). According to the data types, two independent sample t test, Mann-Whitney U test, Chi-square test and multiple correspondence analysis were used for statistical analysis. Results:The mean age of the study subjects was (54.78±8.80) years with 16 570 males (64.8%) and 9 017 females (35.2%). The overall detection rate of HUA was 31.5%, and it was higher in men (43.1%) than in women (10.1%). The body mass index(BMI), systolic blood pressure, diastolic blood pressure, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and fasting blood glucose (FBG) in the HUA group were all higher than those in the non-HUA group (all P<0.001); and high-density lipoprotein cholesterol (HDL-C) was lower than that in the non-HUA group( P<0.001). In multiple correspondence analysis, Cronbach′s α coefficients of the first dimension and the second dimension was 0.608 and 0.237, respectively. Further analysis was performed stratified by gender, it indicated that 45-<55 years old male and overweight were closely associated with the Q 3 group, fatty liver and hyperlipidemia were closely associated with Q 4 group; the 55-<65 years old female, hyperlipidemia, fatty liver and obesity were closely associated with the Q 3 group, while hyperglycemia and hypertension were closely associated with the Q 4 group. Conclusion:The detection rate of HUA in middle-aged and elderly population receiving health examination was high, and the detection rate of HUA in male was higher than that in female. SUA levels are higher in middle-aged and elderly men who have fatty liver and hyperlipidemia. While SUA levels are higher in middle-aged and elderly women who have hyperglycemia and hypertension.

The performance appraisal of public hospitals is the most official and authoritative assessment and evaluation of tertiary public hospitals in China,and it is an important measure to guide hospitals to improve their internal management level and achieve high-quality development.In this study,a data monitoring management system based on the performance appraisal indicators of national tertiary public hospitals was developed and constructed through intelligent collection and reporting,report in-tegration,visual analysis,data drilling,etc.,which realized the one-stop dynamic management of indicators,optimized the data filling process of national examination indicators,improved the data quality and credibility,and promoted the integration of na-tional assessment and hospital assessment.the intelligent management level of the hospital has been improved,which provides strong support for the hospital's refined operation management and scientific decision-making.

This paper briefly expounds the present situation of medical equipment information management in military hospitals. From basic structure and main function of the software systems, it gives a detailed introduction of the probes and researches on medical equipment information management in recent years. It analyzes the existing problems and shortcomings, combined with the previous achievements and effects, and then it introduces the ideas and goals of the new medical equipment management information system, which now being developed. Then it discusses the key problems of the new system which need to be solved.

Objective:To investigate the clinical and imaging features of spontaneous convexal subarachnoid hemorrhage (cSAH) with acute cerebral infarction.Methods:Nine patients with cSAH complicated with acute cerebral infarction, admitted to our hospital from January 2018 to October 2021, were selected. The clinical data and efficacy of these patients were retrospectively analyzed.Results:The time from cSAH to the onset of acute cerebral infarction was 5-144 h, with median time of 2 d. The most common bleeding site of cSAH was the parietal lobe ( n=6); cSAH in the ipsilateral side of acute cerebral infarction was noted in 4 patients. Six patients had middle cerebral artery stenosis or occlusion, and 2 patients had anterior cerebral artery stenosis or occlusion. Hypertension ( n=7) was the most common primary disease; 7 patients were treated with antiplatelet drugs, anticoagulants and/or stents. The follow-up at 3 months after cSAH showed that 6 patients had good prognosis and one had poor prognosis. Conclusions:The cSAH often occurs 2 d after acute cerebral infarction; intracranial artery stenosis or occlusion may be the main cause of the disease. In patients complicated with cSAH, active antiplatelet, anticoagulation and/or stent therapy do not increase the risk of bleeding, and the prognosis is good.

Background::The risk for chronic kidney disease (CKD) is influenced by genetic predisposition, sex, and lifestyle. Previous research indicates that coffee is a potentially protective factor in CKD. The current study aims to investigate whether sex disparity exists in the coffee–CKD association, and whether genetic risk of CKD or genetic polymorphisms of caffeine metabolism affect this association.Methods::A total of 359,906 participants from the UK Biobank who were enrolled between 2006 and 2010 were included in this prospective cohort study, which aimed to estimate the hazard ratios for coffee intake and incident CKD using a Cox proportional hazard model. Allele scores of CKD and caffeine metabolism were additionally adjusted for in a subsample with qualified genetic data ( n = 255,343). Analyses stratified by genetic predisposition, comorbidities, and sex hormones were performed. Tests based on Bayesian model averaging were conducted to ascertain the robustness of the results. Results::Coffee was inversely associated with CKD in a dose-dependent manner. The effects of coffee did not differ across different strata of genetic risk for CKD, but were more evident among slower genetically predicted caffeine metabolizers. Significant sex disparity was observed ( P value for interaction = 0.013), in that coffee drinking was only associated with the risk reduction of CKD in females. Subgroup analysis revealed that testosterone and sex hormone-binding globulin (SHBG), but not estradiol, modified the coffee–CKD association. Conclusions::In addition to the overall inverse coffee–CKD association that was observed in the general population, we could also establish that a sex disparity existed, in that females were more likely to experience the benefit of the association. Testosterone and SHBG may partly account for the sex disparity.