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

Objective To observe the value of contrast-enhanced ultrasound(CEUS)for evaluating DeBakey Ⅰ aortic dissection involved renal artery.Methods Totally 137 patients with DeBakey Ⅰ aortic dissection involved renal artery were retrospectively enrolled,including 132 cases involved unilateral and 5 cases involved bilateral renal arteries.The opening of totally 274 renal arteries in bilateral kidneys were observed.Taken CT angiography(CTA)as reference standard,the renal artery opened in true lumen was considered as unaffected,while opened in false lumen or true-false lumen were both considered as affected.Relative CEUS manifestations were observed,and their value for evaluating involved renal artery or not were analyzed.Results CTA showed that 132 renal arteries opened in true lumens,90 opened in false lumens and 52 opened in true-false lumens.CEUS diagnosed 131 renal arteries opened in true lumens,111 opened in false lumens and 32 opened in true-false lumens,and the sensitivity for diagnosing DeBakey Ⅰ aortic dissection involved renal artery was 90.84％,81.08％and 90.63％,respectively.The consistency between CEUS and CTA for evaluating renal artery opened in true lumen or false lumen was good(Kappa=0.786).Logistic regression analysis showed that the time to peak(TTP)and peak intensity(PI)of time intensity curve(TIC)were both impact factors for differentiating renal artery opened in true lumen or false lumen,as well as true lumen or true-false lumen(both P＜0.05),while the area under the curve(AUC)of TIC was impact factor for differentiating renal artery opened in true lumen or false lumen(P＜0.05).The AUC of receiver operating characteristic curve of the combination of TTP,PI and AUC of TIC for differentiating renal artery opened in true lumen or false lumen,true lumen or true-false lumen and false lumen or true-false lumen was 0.703,0.686 and 0.493,respectively.Conclusion CEUS was helpful for evaluating DeBakey Ⅰ aortic dissection involved renal artery.

Objective To observe the value of contrast-enhanced ultrasound(CEUS)for evaluating DeBakey Ⅰ aortic dissection involved renal artery.Methods Totally 137 patients with DeBakey Ⅰ aortic dissection involved renal artery were retrospectively enrolled,including 132 cases involved unilateral and 5 cases involved bilateral renal arteries.The opening of totally 274 renal arteries in bilateral kidneys were observed.Taken CT angiography(CTA)as reference standard,the renal artery opened in true lumen was considered as unaffected,while opened in false lumen or true-false lumen were both considered as affected.Relative CEUS manifestations were observed,and their value for evaluating involved renal artery or not were analyzed.Results CTA showed that 132 renal arteries opened in true lumens,90 opened in false lumens and 52 opened in true-false lumens.CEUS diagnosed 131 renal arteries opened in true lumens,111 opened in false lumens and 32 opened in true-false lumens,and the sensitivity for diagnosing DeBakey Ⅰ aortic dissection involved renal artery was 90.84％,81.08％and 90.63％,respectively.The consistency between CEUS and CTA for evaluating renal artery opened in true lumen or false lumen was good(Kappa=0.786).Logistic regression analysis showed that the time to peak(TTP)and peak intensity(PI)of time intensity curve(TIC)were both impact factors for differentiating renal artery opened in true lumen or false lumen,as well as true lumen or true-false lumen(both P＜0.05),while the area under the curve(AUC)of TIC was impact factor for differentiating renal artery opened in true lumen or false lumen(P＜0.05).The AUC of receiver operating characteristic curve of the combination of TTP,PI and AUC of TIC for differentiating renal artery opened in true lumen or false lumen,true lumen or true-false lumen and false lumen or true-false lumen was 0.703,0.686 and 0.493,respectively.Conclusion CEUS was helpful for evaluating DeBakey Ⅰ aortic dissection involved renal artery.

Integrated medical courses are one of the key models for the development and transformation of modern medical education. Modular-based integrated courses set higher standards for knowledge, skills and quality objectives. This article primarily discusses the specific practices of teaching reform in the integrated medical course of Frontiers of Infection and Immunity for eight-year program at Air Force Medical University. It covers the selection and integration of teaching content, innovative application of various teaching methods, diversified teaching evaluation and feedback, and the teaching team building. The course not only deepens students' knowledge and promotes their creative abilities but also enhances their comprehensive literacy and international perspective, thus effectively preparing high-quality medical talents for future challenges in the medical field.
Humans ; Education, Medical/methods* ; Teaching ; Curriculum ; Immunity ; Infections/immunology*

Zhejiang University School of Medicine's affiliated Sir Run Run Shaw Hospital has responded to innovative rehabilitation healthcare policy by implementing enhanced recovery after surgery(ERAS)wards based on healing concepts during the development of new wards in its multi-campus integration.By integrating 5G communication technology with the hospital's various information systems and leveraging the hospital's locational advantages,the hospital has upgraded its software and hardware configurations,promoting a multidisciplinary collaborative bedside management model in the context of new technologies.In terms of overall environment construction,the hospital uses best healing theories in physical design,organizational conditions,and interpersonal relationships to facilitate and support patients'healing experiences,effectively improving medical and nursing services.

Zhejiang University School of Medicine's affiliated Sir Run Run Shaw Hospital has responded to innovative rehabilitation healthcare policy by implementing enhanced recovery after surgery(ERAS)wards based on healing concepts during the development of new wards in its multi-campus integration.By integrating 5G communication technology with the hospital's various information systems and leveraging the hospital's locational advantages,the hospital has upgraded its software and hardware configurations,promoting a multidisciplinary collaborative bedside management model in the context of new technologies.In terms of overall environment construction,the hospital uses best healing theories in physical design,organizational conditions,and interpersonal relationships to facilitate and support patients'healing experiences,effectively improving medical and nursing services.

Zhejiang University School of Medicine's affiliated Sir Run Run Shaw Hospital has responded to innovative rehabilitation healthcare policy by implementing enhanced recovery after surgery(ERAS)wards based on healing concepts during the development of new wards in its multi-campus integration.By integrating 5G communication technology with the hospital's various information systems and leveraging the hospital's locational advantages,the hospital has upgraded its software and hardware configurations,promoting a multidisciplinary collaborative bedside management model in the context of new technologies.In terms of overall environment construction,the hospital uses best healing theories in physical design,organizational conditions,and interpersonal relationships to facilitate and support patients'healing experiences,effectively improving medical and nursing services.

Zhejiang University School of Medicine's affiliated Sir Run Run Shaw Hospital has responded to innovative rehabilitation healthcare policy by implementing enhanced recovery after surgery(ERAS)wards based on healing concepts during the development of new wards in its multi-campus integration.By integrating 5G communication technology with the hospital's various information systems and leveraging the hospital's locational advantages,the hospital has upgraded its software and hardware configurations,promoting a multidisciplinary collaborative bedside management model in the context of new technologies.In terms of overall environment construction,the hospital uses best healing theories in physical design,organizational conditions,and interpersonal relationships to facilitate and support patients'healing experiences,effectively improving medical and nursing services.

Zhejiang University School of Medicine's affiliated Sir Run Run Shaw Hospital has responded to innovative rehabilitation healthcare policy by implementing enhanced recovery after surgery(ERAS)wards based on healing concepts during the development of new wards in its multi-campus integration.By integrating 5G communication technology with the hospital's various information systems and leveraging the hospital's locational advantages,the hospital has upgraded its software and hardware configurations,promoting a multidisciplinary collaborative bedside management model in the context of new technologies.In terms of overall environment construction,the hospital uses best healing theories in physical design,organizational conditions,and interpersonal relationships to facilitate and support patients'healing experiences,effectively improving medical and nursing services.

Zhejiang University School of Medicine's affiliated Sir Run Run Shaw Hospital has responded to innovative rehabilitation healthcare policy by implementing enhanced recovery after surgery(ERAS)wards based on healing concepts during the development of new wards in its multi-campus integration.By integrating 5G communication technology with the hospital's various information systems and leveraging the hospital's locational advantages,the hospital has upgraded its software and hardware configurations,promoting a multidisciplinary collaborative bedside management model in the context of new technologies.In terms of overall environment construction,the hospital uses best healing theories in physical design,organizational conditions,and interpersonal relationships to facilitate and support patients'healing experiences,effectively improving medical and nursing services.