BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

OBJECTIVES: This study aimed to analyze the application value of a modified tragus edge incision and transmasseteric anteroparotid approach to condyle reconstruction. METHODS: Condyle reconstruction was performed in 16 patients (9 females and 7 males) with modified tragus edge incision and transmasseteric anteroparotid approach. After regular follow-up, the function of condyle reconstruction was evaluated by clinical indicators, such as parotid salivary fistula, facial nerve function, mouth opening, occlusal relationship, and facial scar. The morphology of rib graft rib cartilage was evaluated by imaging indicators, such as panoramic radiography, CT, and three-dimensional CT image reconstruction. RESULTS: At 6-36 months postoperative follow-up, all patients had good recovery of facial appearance, concealed incisional scar, no parotid salivary fistula, good mouth opening, and occlusion. One case had temporary facial paralysis and recovered after treatment. Radiographic evaluation further showed that costochondral graft survived in normal anatomic locations. CONCLUSIONS The modified tragus edge incision and transmasseteric anteroparotid approach can effectively reduce parotid salivary fistula and facial nerve injury in condylar reconstruction. The surgical field was clearly exposed, and the incision scar was concealed without increasing the incidence of other complications. Thus, this approach is worthy of clinical promotion.
Male ; Female ; Humans ; Mandibular Condyle/surgery* ; Cicatrix/surgery* ; Fracture Fixation, Internal/methods* ; Mandibular Fractures/surgery* ; Oral Surgical Procedures/methods* ; Treatment Outcome

Objective:To explore the application of games combined with speech training in rehabilitation care for language development retardation in high-risk children aged 2 to 5 years.Methods:Totally 190 high-risk children aged 2 to 5 years with language development retardation admitted from January 2016 to December 2018 in Luzhou People's Hospital were selected by convenient sampling, and divided into observation group ( n=95) and control group ( n=95) according to the random number table. Children in the control group received conventional speech training, while children in the observation group received speech training combined with games for 6 months. The effects of rehabilitation training were observed in the two groups, and the speech development quotient of the children was evaluated using the Gesell Developmental Schedules (GDS) . The satisfaction rate to rehabilitation of parents of two groups were compared. Results:After 6 months of training, the effective rates of rehabilitation training were 86.32% (82/95) in the observation group and 73.68% (70/95) in the control group, and the difference was statistically significant ( P<0.05) . The GDS scores were (60.36±8.25) in the observation group and (56.67 ± 7.84) in the control group, and the difference was statistically significant ( P<0.05) . The satisfaction rate of parents of children in the observation group on rehabilitation effect, service attitude, professional skills, and humane care were higher than those in the control group, and the differences between the two groups were statistically significant ( P<0.05) . Conclusions:In high-risk children aged 2 to 5 years with language development retardation, speech training combined with games can improve children's speech development quotient and promote their rehabilitation.

OBJECTIVEThe aim of this study was to investigate the value of free anterolateral thigh myocutaneous flap (ALTMF) and computed tomography angiography (CTA) for the reconstruction of mouth-floor defects after the resection of middle-late stage carcinoma of the mouth floor.

METHODSSixteen cases of middle-late stage carcinomas of the mouth floor underwent radical resection, and mouth-floor and tongue defects were reconstructed with ALTMF. CTA was applied to plan the lateral circumflex femoral artery (LCFA) and its perforating vessel, which was verified during the operation.

RESULTSThe position of the perforating vessel in the operation was fully consistent with that designed by the preoperative CTA. All 16 flaps completely survived. The appearance and function of all cases were both satisfactory. All donor sites were primarily closed and healed without functional morbidity. During the follow-up period of 6-36 months, 15 cases survived with acceptable aesthetic and functional results in mouth floor and tongue reconstruction, except for 1 case (T4N2M0) that died of metastasis carcinoma 10 months after operation.

CONCLUSIONCTA can accurately locate the LCFA and artery perforator. Preoperative perforator planning using CTA in ALTMF transplantation is a reliable and useful method thatresults in safe operation with optimal outcome. The ALTMF is an ideal choice for the reconstruction of soft tissue defects after the resection of middle-late staie carcinoma of the mouth floor

Angiography ; Carcinoma ; Free Tissue Flaps ; Humans ; Mouth Floor ; Myocutaneous Flap ; Patient Care Planning ; Reconstructive Surgical Procedures ; Thigh ; Tomography ; Tongue

Objective The?aim?of?this?study?was?to?investigate?the?value?of?free?anterolateral?thigh?myocutaneous?flap?(ALTMF)?and?computed?tomography?angiography?(CTA)?for?the?reconstruction?of?mouth-floor?defects?after?the?resection?of?middle-late?stage?carcinoma?of?the?mouth?floor.?Methods???Sixteen?cases?of?middle-late?stage?carcinomas?of?the?mouth?floor?underwent?radical?resection,?and?mouth-floor?and?tongue?defects?were?reconstructed?with?ALTMF.?CTA?was?applied?to?plan?the?lateral?circumflex?femoral?artery?(LCFA)?and?its?perforating?vessel,?which?was?verified?during?the?operation.?Results???The?position?of?the?perforating?vessel?in?the?operation?was?fully?consistent?with?that?designed?by?the?preoperative?CTA.?All?16?flaps?completely?survived.?The?appearance?and?function?of?all?cases?were?both?satisfactory.?All?donor?sites?were?primarily?closed?and?healed?without?functional?morbidity.?During?the?follow-up?period?of?6–36?months,?15?cases?survived?with?acceptable?aesthetic?and?functional?results?in?mouth?floor?and?tongue?reconstruction,?except?for?1?case?(T4N2M0)?that?died?of?metastasis?carcinoma?10?months?after?operation.?Conclusion???CTA?can?accurately?locate?the?LCFA?and?artery?perforator.?Preoperative?perforator?planning?using?CTA?in?ALTMF?transplantation?is?a?reliable?and?useful?method?thatresults?in?safe?operation?with?optimal?outcome.?The?ALTMF?is?an?ideal?choice?for?the?reconstruction?of?soft?tissue?defects?after?the?resection?of?middle-late?stage?carcinoma?of?the?mouth?floor.

OBJECTIVE: To perform morphometric analysis of bilateral cochleae in all subjects based on computed 3-dimensional reconstruction tomographic data and assist the surgeon in diagnosing the inner ear abnormality or surgical strategies. METHOD: Two hundred normal developed cochleae from 100 patients were divided into 5 groups according to age. Morphometric analysis of bilateral cochleae was performed in all subjects by 3D reconstructions and 2D multiplanar reformation. The length and width of the cochlear base, the length within the cochlear base, the height of the cochlea, the angle between the first and second turn of the cochlea, and the cochlear orientation within the cranial base were measured and compared in different age, sex and bilateral groups. RESULT: The length of the cochlear base was (8.56 +/- 0.52)mm, the width was (6.63 +/- 0.56)mm, the length within the cochlear base was (7.33 +/- 10.56)mm, the height of the cochlea was (3.76 +/- 0.28)mm, and the angle between the first and second turn of the cochlea was (15.82 +/- 2.78)degrees. All index above did not change significantly in different aging, sex or side (P > 0. 05). Variability in the angle between the first and second turn of the cochlea was considerable, and a smaller angle (from the midsagittal line) was showed in the older age groups than the younger groups (P < 0.05). CONCLUSION 3D and 2D volume rendering enables us to evaluate the features of cochlear morphology and orientation that may assist the surgeon in diagnosing the inner ear abnormality or surgical strategies.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cochlea ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; Infant ; Middle Aged ; Reference Values ; Tomography, X-Ray Computed ; methods ; Young Adult

Objective To improve EP9-A2 for Bias estimation among multiple quantitative detection systems within full range of AMR.Methods 40 patients specimens were determined twice for serum total cholesterol by four detection systems(A,B,C and D).With system A served as comparative method,Bias between A and the other three was evaluated according to CLSI EP9-A2 separately.Furthermore,DD(distance from deviation to tolerable error)and its average confidence intervals between every two sys-tem were calculated and compared with zero.The confidence interval of greater than zero was served as criteria for accepting bias between every two system.Results Bias between A and the other three meet the analytical quality specification according to EP9-A2,although that of D system was positive,and those of B and C system were negative.DD between every two system obeyed nor-mality distribution.All biases between every two system wes acceptable except that between B and D,causing of their interval con-taining zero.After correcting of results from system D,Biases between every two system were all acceptable.Plots of confidence in-terval could provide a full range bias assessment within AMR.Conclusion Comparability and Bias estimation in full range of AMR for results between every two system among 3 or more systems could be evaluated by confidence intervals.

ObjectiveTo establish a enzyme-linked immunosorbent assay (ELISA) method for detecting the β-amyloid peptide 42 ( Aβ42 ) and explore its clinical meaning for diagnosis and treatment in the early stages of the alzheimer disease ( AD).Methods Using the Aβ42 single chain variable fragment constructed by phage antibody library display system as coat antibody,associated with the Aβ42 polyclonal antibody acquired by Aβ42 immunized rabbit and HRP labeled goat anti rabbit IgG to establish ELISA method for detecting the Aβ42 in peripheral blood.The method was used it to test the Aβ42 in 120 vascular dementia VD) or cerebral vessel infarction patients and 120 AD patients and 120 controls.The methodology performance were evaluated.ResultsThe inter and intra coefficient of variable (CV) of this self-established ELISA method was 3.6％ and 3.5％,6.8％ and 7.1％ respectively.The recovery rate was 97.2％ -103.1％.The linear range was 0.050 - 2 μg,/L.Its reactivity decreased ＜ 12％ when it was put in both 37 ℃ for 6 days and 4 ℃ for 6 months.Compared with the Belgium INNOTEST reagent by testing 90 samples simultaneously,the results of self-established method was (0.207 ± 0.039 ) μg/L,the results of INNOTEST was (0.206± 0.038 ) μg/L; the regression equation was Y =1.011X - 0.003,R2 =0.979,P ＜0.01.The Aβ42 in blood of AD group was (0.247 ± 0.032 ) μg/L,VD or cerebral vessel infarction group was (0.173 ±0.028) μg/L,control group was (0.172 ±0.032) μg/L.The Aβ42 in AD group was higher than that in the VD or cerebral vessel infarction group and control group (q =18.867,18.907respectively,P ＜ 0.01 ).The cut off value was 0.212 μg/L decided by the receiver operating characteristic (ROC) curve.The reference interval was 0 -0.212 μg/L.The sensitivity of this ELISA method was 86.7％(104/120) and specificity was 90.8％ (218/240).ConclusionsThe ELISA method for detecting Aβ42 in peripheral blood established by the study is sensitive and specific and has good precision and stability.It could provide a new effective criterion and support for the early diagnosis and treatment of the AD patients.