Objectives:To analyze the safety of coronary artery stent rotational atherectomy due to stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment. Methods:A total of 19 patients with coronary artery disease who underwent coronary artery stent rotational atherectomy for the above reasons in 7 large heart centers in China from 2016 to 2022 were collected.Their baseline data,procedure process data,procedural complications,the occurrence of procedure-related adverse events(type 4a myocardial infarction,emergency coronary artery bypass grafting,and all-cause death)during hospitalization and major adverse cardiovascular events(MACE,including target vessel revascularization,stroke,all-cause death,and recurrent myocardial infarction)during post-discharge follow-up were retrospectively collected. Results:The mean age of the 19 patients was 70(64,73)years,and 13 patients were males.The mean left ventricular ejection fraction was(56.89±8.76)%.Radial artery approach was used in 13 patients,11 patients used 1 burr during the intervention period,6 patients used 2 burrs,and 2 patients used 3 burrs.The average times of burr passing through the lesion was(7.00±4.23)times.The surgical success rate was 100%,and the immediate lumen acquired area was(1.23±0.78)mm2.Drug-eluting stents were successfully implanted in all patients after spinning.Coronary slow blood flow occurred in 1 case after rotational grinding,which was improved after drug treatment.The burr was entrapmented in 3 cases and successfully pulled out after operation.No coronary artery perforation,coronary artery dissection,coronary artery spasm,emergency thoracotomy,or death occurred during the operation,and no procedure-related adverse events occurred during hospitalization.During 3 to 24 months of follow-up,1 patient underwent target vessel revascularization,and there were no MACE in other patients. Conclusions:Coronary artery stent rotational atherectomy in patients with stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment,is a feasible option,with a high surgical success rate and satisfactory safety.None of the patients experienced MACE during long-term follow-up.

Objective: To analyze the results of colorectal cancer screening among residents in Baoshan District, Shanghai Municipality from 2013 to 2021, so as to provide the basis for promoting colorectal cancer screening and prevention. Methods: Permanent residents aged 50 to 74 years in Baoshan District from 2013 to 2021 were selected as the screening population. The initial screening was conducted using a risk assessment form and fecal occult blood test. Positive results on either the risk assessment form or fecal occult blood test were considered positive for the initial screening. Participants with positive initial screening results were invited to undergo colonoscopy. The positive rate of the initial screening, colonoscopy compliance rate, and colonoscopy results were analyzed. Results: A total of 264 907 individuals underwent the initial colorectal cancer screening in Baoshan District from 2013 to 2021, with 65 333 individuals (24.66%) testing positive. Among them, the positive rate of the risk assessment form was 12.16%, and the positive rate of fecal occult blood test was 14.64%. A total of 14 473 individuals completed colonoscopy, with a compliance rate of 22.15%. A total of 1 284 precancerous lesions were detected, with a detection rate of 8.87%, and 386 cases of colorectal cancer were identified, with a detection rate of 2.67%. The positive rate of the initial screening, colonoscopy compliance rate, precancerous lesion detection rate, and colorectal cancer detection rate were higher in males than in females (25.55% vs. 24.06%, 23.12% vs. 21.45%, 11.60% vs. 6.74%, 3.62% vs. 1.93%, all P<0.05). With increasing age, the positive rate of the initial screening increased, the colonoscopy compliance rate decreased, the precancerous lesion detection rate and colorectal cancer detection rate increased (all P<0.05). From 2013 to 2021, the positive rate of the initial screening among residents showed a downward trend, while the colonoscopy compliance rate showed an upward trend (both P<0.05). Conclusions The detection rate of precancerous lesions in colorectal cancer was 8.87%, and the detection rate of colorectal cancer was 2.67% in Baoshan District from 2013 to 2021. Male and older individuals were the key populations for screening, and the colonoscopy compliance among residents needs to be improved.

By analyzing the main problems existing in the current management of medical devices for clinical trials, this study proposes a feasible management model and specific requirements for acceptance, distribution, storage and recovery combining with the characteristics of medical consumable equipment and diagnostic reagent, which provides a favorable guarantee for the authenticity and reliability of clinical trials.
Clinical Trials as Topic ; Equipment and Supplies/standards* ; Indicators and Reagents/standards* ; Reproducibility of Results ; Research Design/standards*

Guidance and reference are provided for protocol designer. The classification of laser medical devices are introduced. The key points such as the selection of control group, evaluation indicators and method, criteria of inclusion and exclusion, and application of blinded, etc. are discussed, and the importance of management of defects in medical device is emphasized.
Clinical Trial Protocols as Topic ; Equipment and Supplies ; Lasers ; Research Design

Objective To investigate plasma NGF expression in adriamycin induced rat heart failure (HF) model .Methods Twenty‐five Wistar rats were randomly divided into the CHF group (n=15 ,adriamycin 4 mg/kg ,by intraperitoneal injection ,for 6 weeks) and normal control group (NC group ,n=10) ,after successful model construction ,the 6‐week observation was continuously conducted .The body mass and plasma NGF expression were detected once per 2 weeks .Results After 6 weeks later ,the body mass in the CHF group was significantly reduced ,the difference was statistically significant (P<0 .05) ,LVEDV and LVESV were sig‐nificantly increased ,while LVEF was declined obviously (P<0 .05) ,the NGF expression amount was significantly decreased com‐pared with the control group ,the differences were statistically significant (P<0 .05);the NGF expression amount was gradually re‐duced with the time extension of disease course(P<0 .05) .Conclusion Intraperitoneal injection of adriamycin can successfully in‐duce heart failure model in Wistar rats ,moreover NGF may be closely associated with HF .

Objective To explore the feasibility ,effectiveness ,recurrence rate and complications ,etc .of endoscopic retrograde stenting in treating acute appendicitis .Methods A retrospective analysis was conducted on seven patients with the clinical diagnosis of acute appendicitis ,complying with the following treatment steps :(1) normal saline for high cleansing enema in 2-3 times ;(2) en-doscopically douching ileocecal junction and observing the opening of appendix ;(3) placing the guide wire into the opening of appen-dix under the guidance of imaging tube ,and then conducting angiography imaging ;(4) repeatedly douching with metronidazole;(5) implant the appendix stent ,draining the inflammatory secretions out and then douching ;(6 ) observing postoperative abdominal pain ,fever ,bowel and other conditions;(7) reviewing with the enteroscopy and removing the stent 2 weeks later .At 2 before the surgery and 48 after it ,all patients were administrated with antibiotics for anti-infective treatment .The follow-up was made from 8-15 months after the surgery .Results Among these 7 patients ,4 patients had successful appendix stenting :the abdominal pain sig-nificantly alleviated after the surgery ;the proportional level of white blood cells(WBC)recovered during 24-48 after the surgery .15 after discharge ,two patients returned to hospital and their appendix stent removal was successful;during the operation ,smooth mu-cosa at the opening of appendix was observed .The stents of two patients spontaneously fell off ,and normal morphology of the ap-pendix opening was observed at review .During the postoperative follow-up of 8-15 months ,one patient relapsed and underwent sur-gical treatment in the general surgery department .The other three patients did not undergo appendix stenting due to the unsuccess-ful intubation .Conclusion The treatment of acute appendicitis with endoscopic stenting has the advantages of little trauma ,high safety and significant efficacy .However ,this method still requires large-scale and multicenter randomized controlled clinical trials to evaluate its feasibility and long-term efficacy .

Objective This study compares a dual-freeze protocol with a triple freeze protocol for hepatic cryoablation in the Tibetan pig model.Method Cryoablation with a dual-(10-5-10-5 min)and triple-freeze (5-5-5-5-10-5 min) protocol for the normal livers of 9 Tibet pigs was performed under exposed operation.Temperature changes of cryoprobes and diameter changes of iceballs were measured during the ablation,and seven days later the pathological changes of cryozones were reviewed and the surface and depth cryolesions were measured.Results Compared with cryoablation with two freeze-thaw cycles,there was a greater iceball diameter for cryoablation by three freeze-thaw cycles.Also,seven days after cryosurgery,there were similar surface and deep cryolesions in dual-and triple-freeze protocols.Pathologically,the triple freezing protocol was associated with a longer zone of complete necrosis.Conclusions With the same freezing time (20 min),the triple-freeze protocol may become a more powerful liver-ablation method in cryosurgical application.

Objective To observe the uhrasenographical characters of liver and spleen of residents and their changes in endearic areas of schistosomiasis japonica in Poyang Lake region.Jiangxi Province and to explore the value of ultrasonography for assessment of the morbidity of the disease.Methods All permanent residents aged above 3 years old were examined by ultrasonography and Kato-Katz method.Results The schistosome positive rates of fecal examinations decreased obviously from 16.29%in 1995 to 8.54%in 2007(P<0.01).However,the rates of hepatomegaly and splenomegaly between 1995 and 2007 were not significantly changed(P>0.05),with the rates of 8.82% and 20.33% in 1995 and 8.54% and 21.34% in 2007,respectively.The abnormal rate of portal vein diameter decreased significantly.from 32.47%in 1995 to 6.50% in 2007.The abnormal rate of liver parenehyma increased remarkably(P<0.01),from 34.85% to 51.83%.The changes of liver parenchyma Grade I showed a bidirectional trend,29.90% of them chased into Grade 0(normal image on ultrasonngraphy),and 34.02% changed into Grade 2 and above.The abnormality of various indices of uhrasonography examinations were related to age,occupation and schistesome infection status.Conclusions Ultrasonography can show the damages of liver and spleen of patients infected with Schistosoma japonicum directly.but it is necessary to study further on the sensitive indices that reflecting early pathological changes and the best combination of the indices for the assessment of schistosomiasis-related morbidity.

Objectives To explore the correlation between the population characteristics of sero-reactivity with quantitative antibody based-IHA and the transmission parameters,such as epidemic situation,transmission status or infection trend in population.Methods The residents in one endemic administrative village were simultaneously examined by Kato-Katz technique for parasitological stool examination,as well as by immuno-diagnostic technique IHA for detection of IgG antibody against soluble egg antigen for two consecutive years.The results of examination were analyzed and compared on the diagnostic parameters of IHA,the correlation of the changes of positive rates and antibody levels of IHA with the changes of infection trend in population and the distribution of antibody levels between 'the true negative' and 'the true positive'.Results When Kato-Katz technique based on 2 stool samples,each read in 3 thick smears,was used as the reference,the overall sensitivity of IHA was high (from 77.27% to 85.48%) with a relatively poor specificity of lower than 60%,the negative predict value (NPV) was excellent of higher than 94%.The specificity of IHA decreased with the increase of the age in different age-groups of population,showing the highest among the younger less than 15 years old.The distribution trends of positive rates of antibody in different age groups by IHA showed similar to that of egg positive rate detected by Kato-Katz although the positive rates of IHA were higher than these by Kato-Katz,which showed that a higher false positive (from 41.90% to 44.56%) and a certain false negative (from 14.52% to 22.73%)existed in IHA.The positive rate of antibody decreased slowly among the individuals with S.japonicum infection,who received treatment.There was an overlap in the distribution of antibody levels between ' the true negative' and ' the true positive'.Conclusions Under the current schistosomiasis epidemic situation in China,IHA is valuable in the epidemiologic surveys.It should be of further deliberation applying IHA as the screening approaches for identification of target individuals for treatment or determination of the infection rate in community and IHA needs to be combined with the parasitological examination.

FANCD2 is involved in DNA damage repair and maintenance of chromosome stability. The purpose of this study was to investigate the expression of FANCD2 in sporadic breast cancer tissues and its association with clinicopathological features. A total of 162 Chinese women with invasive breast carcinoma who had no family history in first-degree relatives and 12 normal breast tissues were examined. The expression of FANCD2 was detected by immunohistochemical staining based on a tissue microarray technique. SAS system was used to analyze the data. Twenty-one out of the 162 invasive breast cancers (13%) were negative for FANCD2. The mean percentage of FANCD2 positive cells was significantly lower in breast cancers than in controls (P<0.05). FANCD2 expression was significantly inversely associated with histological grade and TNM stage (P<0.05), but not with axillary lymph node status or other conventional prognostic markers such as ER, PR, Her-2 and PCNA (P>0.05). It was suggested that FANCD2 may play a critical role in breast carcinogenesis. It may become a valuable and independent marker for identifying women with sporadic breast cancer and evaluating the prognosis.