Objective The efficacy and safety of off-pump coronary artery bypass grafting (OPCAB) as comparing with conventional coronary artery bypass grafting(CCABG) remain inconclusive in randomized, controlled trials and retrospective studies. We tried to assess the incidence of myocardial infarction (MI) after OPCAB and CCABG. with a meta analysis based on published data in randomized ,controlled trials. Methods Relevant randomized controlled trials, published in English and Chinese before January 2009, were searched in Medline, the Science Citation Index Expanded, the Cochrane Central Register of Controlled Trials (CENTRAL) and CBMdisc. Manual searching of bibliographies were performed, with key words "oronary artery bypass graft", "off-pump" and "myocardial infarction". Two reviewers selected eligible trials independently, performed quality assessment and collected relevant data. Meta-analysis was performed with software RevMan 5. Results 22 trials were considered to be eligible for the meta analysis. The incidence of MI was 2.81% (42/1494) in the OPCAB group as compared with 3.57% (54/1512) in the CCABG group. No significant difference was present between the two groups (OR =0.80,95% CI =0.54 - 1.20, P =0.28). Conclusion Our meta analysis of current available randomized controlled trials involving OPCAB and CCABG in patients with coronary artery diseases suggests that the difference in the incidence of postoperative MI between CCABG and OPCAB groups is not significant.

Objective To investigate the effect of regulating peroxisome proliferator-activated receptor γγ (PPAR γ) on soluble endoglin (sEng) expression in first-trimester trophoblasts via an in vitro study.Methods Chorionic villus were collected from 20 samples of first-trimester artificial abortion in Peking University First Hospital from July 1 st to 31 st,2016.Primary culture of trophoblast cells was performed.Trophoblast cells from each sample were divided into three groups,which were PPAR γ antagonist group,PPAR γ antagonist and PPAR γ agonist group,and control group.Supematant sEng level was detected in each group by enzyme linked immunosorbent assay (ELISA).Paired-sample t test was used for statistical analysis.Results Compared with the control group,trophoblast cells in the PPAR γ antagonist group grew slower and were reduced in number.No significant difference in growth or morphology of trophoblast cells was observed between the PPAR γγ antagonist and PPAR γγ agonist group and the control group.Supernatant sEng level was elevated in the PPAR γ antagonist group,but was not significantly changed in the PPAR γ antagonist and PPAR γ agonist group as compared with that in the control group [(124.1 23.8) vs (94.0± 12.7) pg/ml,t=-4.31,P＜0.05;(87.1 ± 10.6) vs (94.0± 12.7) pg/ml,t=1.62,P=0.12).Conclusions Suppression of PPAR γ promotes sEng expression in trophoblast cells and that can be reversed by PPAR γ agonist.

Objective To investigate the clinical efficacy of angiotensin converting enzyme inhibitors(ACEI)or angiotensin Ⅱ receptor blockers(ARB)combined with glucocorticoid in treating IgA nephropathy patients.Methods A total of 125 IgA nephropathy patients admitted to Anyang District Hospital from October 2019 to October 2022 were selected as the research subjects.The patients were randomly divided into the control group(n=62)and the observation group(n=63).Patients in the control group were given ACEI or ARB treatment,while patients in the observation group were given ACEI or ARB combined with fluticasone propionate inhalation aerosol.All patients were treated continuously for 3 months.The treatment effect was compared between the two groups.The 24-hour urinary protein quantitation,serum creatinine(Scr),glomerular filtration rate(GFR),white blood cell(WBC)count,hemoglobin(HGB)level,and platelet(PLT)count of patients in the two groups were measured before and after treatment.The occurrence of adverse reactions during treatment in the two groups was recorded.Results The overall effective rates of patients in the control group and the observation group were 54.84％(34/62)and 84.13％(53/63),respectively;the overall effective rate of patients in the observation group was significantly higher than that in the control group(x2=12.669,P＜0.05).Before treatment,there was no significant difference in 24-hour urinary protein quantitation,Scr and GFR between the two groups(P＞0.05).There was no significant difference in 24-hour urinary protein quantitation of patients before and after treatment in the control group(P＞0.05),and the 24-hour urinary protein quantitation of patients after treatment in the observation group was significantly lower than that before treatment(P＜0.05).After treatment,Scr in the two groups was significantly lower than that before treatment,and GFR was significantly higher than that before treatment(P＜0.05).After treatment,24-hour urinary protein quantitation in the observation group was significantly lower than that in the control group(P＜0.05);and there was no significant difference in Scr and GFR between the two groups(P＞0.05).There was no significant difference in WBC,HGB and PLT of patients before and after treatment in the two groups(P＞0.05).No adverse reactions,such as abnormal glucose tolerance,steroid diabetes and elevated blood pressure,occurred in the two groups during treatment.Conclusion Fluticasone propionate inhalation aerosol combined with ACEI or ARB can re-duce the 24-hour urinary protein quantitation and improve the renal function of IgA nephropathy patients,without the risk of causing blood system damage.It is a safe approach with significant efficacy.

OBJECTIVE: To improve the production and inspection efficiency of medical device manufacturers, improve the quality system management level of manufacturers, and ensure the safety and effectiveness of medical devices. METHODS: Sort out the business process of the medical device manufacturer, connect the database of production and ERP system to inspection system, and build the operation software for the quality control department. RESULTS: The system has covered all the products of the manufacturer, and has realized the informatization and visualization of the inspection process. CONCLUSIONS The research and application of the system can improve the quality management traceability system of medical device manufacturers, and improve the efficiency and accuracy of medical device quality inspection.
Commerce ; Information Systems ; Quality Control ; Software

Objective:To evaluate the diagnostic value of targeted biopsy of secondary lesion (SL) in systematic biopsy (SB) combined targeted biopsy for clinically significant prostate cancer (CsPCa).Methods:A retrospective analysis was conducted on the data of patients who underwent systematic biopsy combined target biopsy at Nanjing Drum Tower Hospital from January 2021 to February 2023, and they had at least two Prostate Imaging-Reporting and Data System (PI-RADS) score ≥3 lesions on prostate magnetic resonance imaging. The study included patients with a median age of 70 (65, 76) years old, median prostate specific antigen (PSA) was 9.1 (5.96, 13.62) ng/ml, median prostate volume was 39.1 (29.27, 53.25) ml, and median PSAD was 0.2 (0.15, 0.38) ng/ml 2.The index lesion (IL) was defined as the one with the highest PI-RADS score and SL was defined as the one with the second-highest PI-RADS score. If the two lesions had the same PI-RADS score, the one with larger maximum diameter was IL and the other one was SL. The median maximum diameter of IL and SL were 1.3 (1.06, 1.66) cm and 0.9 (0.69, 1.20) cm, respectively. The median maximum diameter ratio of IL and SL was 1.48 (1.10, 1.91), and the median maximum diameter difference of IL and SL was 0.9 (0.20, 1.89) cm. The IL in peripheral zone was found in 238 patients (62.63%) and SL in peripheral zone was found in 255 patients (67.10%). There were 204 patients (53.68%) having both IL and SL on the same side of prostate. According to the combination of PI-RADS scores of IL and SL, patients were categorized into various groups: 96 patients (25.26%) with IL3 and SL3, 79 (20.78%) with IL4 and SL3, 98 (25.78%) with IL4 and SL4, 21 (5.52%) with IL5 and SL3, 76 (20.0%) with IL5 and SL4, and 10 (2.63%) with IL5 and SL5. Targeted biopsy was performed on at least two of the most significant lesions. Comparison was performed in the detection rate of CsPCa between SB+ IL+ SL and SB+ IL (SL was omitted). To explore the factors influencing the detection rate of CsPCa, a multivariate logistic regression analysis was used. Results:The detection rate of CsPCa in this study was 78.95% (300/380) based on SB+ IL+ SL. After omitting SL target biopsy, the detection rate of CsPCa was 78.16% (297/380, P>0.05) under the condition of SB+ IL. No significant differences were noted between the two groups. The multivariate logistic regression analysis showed that PSA ( OR=1.11, 95% CI 1.05-1.20, P<0.01), prostate volume ( OR=0.98, 95% CI 0.96-0.99, P<0.01), SL maximum diameter ( OR=0.19, 95% CI 0.08-0.50, P<0.01), ratio of IL and SL maximum diameter ( OR=0.34, 95% CI 0.16-0.68, P<0.01), difference of IL and SL maximum diameter ( OR=1.50, 95% CI 1.10-2.29, P<0.05), and PI-RADS score group of IL and SL (IL3 vs. SL3 as the reference, IL4 vs. SL3 OR=4.79, 95% CI 2.21-10.91, P<0.01, IL4 vs. SL4 OR=23.11 95% CI 8.09-85.28, P<0.01, IL5 vs. SL3/4/5 OR=15.28 95% CI 5.21-48.55, P<0.01) were the influencing factors for detection rate of CsPCa. Conclusions:For patients with at least two PI-RADS score≥3 lesions on prostate magnetic resonance imaging, omitting SL can almost maintain the same detection efficacy.

Proteases have a fundamental role in maintaining physiological homeostasis, but their dysregulation results in severe activity imbalance and pathological conditions, including cancer onset, progression, invasion, and metastasis. This striking importance plus superior biological recognition and catalytic performance of proteases, combining with the excellent physicochemical characteristics of nanomaterials, results in enzyme-activated nano-drug delivery systems (nanoDDS) that perform theranostic functions in highly specific response to the tumor phenotype stimulus. In the tutorial review, the key advances of protease-responsive nanoDDS in the specific diagnosis and targeted treatment for malignancies are emphatically classified according to the effector biomolecule types, on the premise of summarizing the structure and function of each protease. Subsequently, the incomplete matching and recognition between enzyme and substrate, structural design complexity, volume production, and toxicological issues related to the nanocomposites are highlighted to clarify the direction of efforts in nanotheranostics. This will facilitate the promotion of nanotechnology in the management of malignant tumors.