Objective To investigate the safety and efficacy of the radial artery hemostatic device in trans-brachial coronary intervention,and assess its effectiveness.Methods A retrospective analysis was conducted on patients who underwent trans-brachial coronary intervention at Peking University International Hospital from January 1,2018 to December 31,2023.The patients were divided into the radial artery hemostatic device group(170 cases)and the conventional compression group(100 cases)based on the postoperative hemostasis method,and the incidence of complications and clinical characteristics were compared between the two groups.Results A total of 270 patients underwent trans-brachial coronary intervention,with 18 complications occurring.Among them,17 cases were hemorrhage around the puncture site(16 cases were mild and 1 case was severe)and 1 was transient median nerve injury.The overall complication rate was 6.7％,and the incidence of hemorrhage around the puncture site was 6.3％.The hemorrhage rate in the radial artery hemostatic device group was 5.9％,while that in the conventional compression group was 7.0％,with no statistically significant difference between the two groups(P=0.715).Multivariate regression analysis indicated that female was an independent risk factor for hemorrhage around the puncture site(OR 4.57,95％CI 1.40-14.96,P=0.012).With the accumulation of technology,the application of trans-brachial access and radial artery hemostatic devices increased year by year(both P＜0.010).Conclusions The radial artery hemostatic device effectively controls bleeding in trans-brachial coronary interventions and demonstrates satisfactory safety.Its simplicity and efficacy provide a new strategy for hemostatic management in percutaneous trans-brachial access,which may gradually become the new standard in the future.

Aim To explore the mechanism of Jiawei Shaofu Zhuyu decoction in antagonizing endometriosis fibrosis by regulating mitophagy.Methods After the animal model was constructed,the syndrome was evalu-ated by general condition,organ water content and ther-mal imaging.The curative effect was evaluated by the weight of ectopic focus and the degree of adhesion.The pathological changes were compared using HE stai-ning,transmission electron microscopy,Masson and Sir-ius red staining.The expression of PINK1 and Parkin was detected by immunohistochemistry.The expression of mRNA and protein was determined by qPCR and Western blot,and the level of serum ROS was detected by ELISA.Results The autonomic activity of model mice was weakened,the water content of organs rose,and the temperature of limbs and lower abdomen was reduced by thermal imaging.HE staining showed obvi-ous hyperplasia of ectopic epithelium and glands.Transmission electron microscopy showed mitochondrial and endoplasmic reticulum structure damage,and nor-mal autophagy structure disappeared.Masson and Siri-us red staining showed increased collagen deposition;immunohistochemistry showed decreased expression of PINK1 and Parkin in ectopic foci.qPCR and Western blot showed that the expression of PINK1,Parkin,Bec-lin1,LC3 mRNA and protein in ectopic foci of model mice decreased,the expression of p62 mRNA and pro-tein increased,and serum ROS increased.The syn-drome performance of model mice was improved after the intervention of Jiawei Shaofu Zhuyu decoction;the inflammatory infiltration of ectopic foci was relieved,the morphology of mitochondria and endoplasmic retic-ulum was restored,and normal autophagy structure ap-peared.The degree of collagen deposition and fibrosis was reduced;the mRNA and protein expression of PINK1,Parkin,Beclin1 and LC3 increased.The ex-pression of p62 mRNA and protein decreased,and the level of ROS decreased.Conclusions Jiawei Shaofu Zhuyu decoction can improve the fibrosis of ectopic le-sions in mice with endometriosis of cold-dampness sta-sis syndrome,which may be related to the regulation of mitophagy.

Aim To explore the mechanism of Jiawei Shaofu Zhuyu decoction in antagonizing endometriosis fibrosis by regulating mitophagy.Methods After the animal model was constructed,the syndrome was evalu-ated by general condition,organ water content and ther-mal imaging.The curative effect was evaluated by the weight of ectopic focus and the degree of adhesion.The pathological changes were compared using HE stai-ning,transmission electron microscopy,Masson and Sir-ius red staining.The expression of PINK1 and Parkin was detected by immunohistochemistry.The expression of mRNA and protein was determined by qPCR and Western blot,and the level of serum ROS was detected by ELISA.Results The autonomic activity of model mice was weakened,the water content of organs rose,and the temperature of limbs and lower abdomen was reduced by thermal imaging.HE staining showed obvi-ous hyperplasia of ectopic epithelium and glands.Transmission electron microscopy showed mitochondrial and endoplasmic reticulum structure damage,and nor-mal autophagy structure disappeared.Masson and Siri-us red staining showed increased collagen deposition;immunohistochemistry showed decreased expression of PINK1 and Parkin in ectopic foci.qPCR and Western blot showed that the expression of PINK1,Parkin,Bec-lin1,LC3 mRNA and protein in ectopic foci of model mice decreased,the expression of p62 mRNA and pro-tein increased,and serum ROS increased.The syn-drome performance of model mice was improved after the intervention of Jiawei Shaofu Zhuyu decoction;the inflammatory infiltration of ectopic foci was relieved,the morphology of mitochondria and endoplasmic retic-ulum was restored,and normal autophagy structure ap-peared.The degree of collagen deposition and fibrosis was reduced;the mRNA and protein expression of PINK1,Parkin,Beclin1 and LC3 increased.The ex-pression of p62 mRNA and protein decreased,and the level of ROS decreased.Conclusions Jiawei Shaofu Zhuyu decoction can improve the fibrosis of ectopic le-sions in mice with endometriosis of cold-dampness sta-sis syndrome,which may be related to the regulation of mitophagy.

Aim To study the effect of p-benzoyl sali-droside(pOBz)on angiogenesis after ischemic stroke and to explore the underlying mechanism.Methods The MCAO model was prepared by suture method.Rats were divided into four groups:sham,MCAO,pOBz administration,and edaravone positive control,treated for seven days.The mNSS was used to assess the neurological impairment.Western blotting was em-ployed to detect CD31,NICD,and Hes-1 protein ex-pression,while immunofluorescence staining was ap-plies to quantify CD31-positive cells in ischemic brain tissue.In vitro an OGD/R model was established in HUVECs.Following treatment with varying pOBz con-centrations(0.01,0.1,1 μmol·L-1),the CCK-8 as-say was uses to measure cell viability,and in vitro tube formation assay was utilized to evaluate angiogenesis.Western blotting was employed again to assess CD31,NICD and Hes-1 protein levels.To further elucidate the mechanism,HUVEC were treated with the Notch inhibitor DAPT prior to grouping and pOBz administra-tion,and the same parameters were evaluated.Results pOBz significantly reduced the mNSS score of MCAO rats,increased CD31-positive cell counts,and upregu-lated CD31,NICD,and Hes-1 protein expression(P＜0.01).In vitro results further showed that pOBz could dose-dependently increase the survival rate and angio-genesis ability of HUVEC induced by OGD/R,and promote CD31,NICD and Hes-1 proteins(P＜0.01),and Notch inhibitor DAPT could reverse the above effects of pOBz.Conclusion pOBz promotes angio-genesis in HUVEC,and its mechanism involves activa-tion of the Notch signaling pathway.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Nocardia is an emerging worldwide distributed zoonotic pathogen,and the common infected population is immu-nocompromised.This article reports a case of non-immunodeficient infected with Nocardia brevicatena/paucivorans complex,combined with literature analysis,aiming to improve scientific reference for clinical diagnosis,treatment and prevention of No-cardia.The patient was a 54-year-old male with no chronic diseases,hospitalized due to repeated low back pain and fever dis-comfort,MRI showed lumbar soft tissue and abdominal abscess.The examination of the immune function aspect was normal,conventional pathogen culture was negative.mNGS showed Nocardia brevicatena/paucivorans complex infection.The anti-in-fection regimen of SMZ was safe and effective,and no recurrence was observed after 1 year of follow-up.Although Nocardia is an opportunistic pathogen,immunocompetent people are still at risk of infection and often present with skin and soft tissue le-sions.

Objective To analyze the factors influencing hypercoagulable state in patients with benign prostatic hyperplasia(BPH)after surgery,so as to provide reference for preventing postoperative thrombosis in BPH.Methods A retrospective analysis was conducted on the clinical data of 307 BPH patients who underwent surgery in the Department of Urology at the First Affiliated Hospital of Xi'an Jiaotong University during Apr.2022 and Sep.2023.Patients were divided into the hypercoagulable state group and non-hypercoagulable state group based on the presence of abnormal postoperative coagulation parameters.Single factor and binary logistic regression analysis were used to screen risk factors affecting postoperative blood hypercoagulability in BPH patients.Results Among the 307 BPH patients,45(14.66％)developed a hypercoagulable state postoperatively.Univariate analysis revealed statistically significant differences between the hypercoagulable and non-hypercoagulable groups regarding patients'age,length of hospital stay,body mass index(BMI),history of hypertension,history of diabetes,and blood type(P＜0.05).Binary logistic regression analysis identified BMI(OR=1.135,95％CI:1.006-1.281,P=0.039),history of hypertension(OR=2.342,95％CI:1.103-4.927,P=0.027),and blood type(OR=2.270,95％CI:1.066-4.836,P=0.034)as independent risk factors for postoperative hypercoagulable state.Conclusion Non-O blood type,high BMI,and history of hypertension are independent risk factors for the occurrence of hypercoagulable state following surgery for BPH.

Objective To examine the impact of two DRG performance management approaches on the operations of neu-rology and neurosurgery departments.Methods DRG discharge case data were collected from a tertiary hospital in Laibin City between January 2022 and April 2024.The Interrupted Time Series(ITS)was used to analyze the impact of the two types of DRG performance management on financial performance,service capacity and efficiency,patient burden,and profitability of the neurology and neurosurgery departments.Heatmap clustering analysis was employed to compare the changes in disease surplus rates before and after the two management models,and non-parametric tests were conducted to analyze the impact of departmental transfers on hospitalization costs.Results The change in the ITS(Interrupted Time Series)slope coefficient for operational effi-ciency was significant in the neurology department but not in neurosurgery.The change rates of disease surplus in the two depart-ments were classified into five categories,with similar trends observed in diseases with closely related weights.Furthermore,hos-pitalization costs for certain diseases significantly increased following the transfer of patients from one department to the other(P＜0.05).Conclusion Significant differences exist in the impact of different DRG(Diagnosis-Related Group)performance management approaches in the same department,and the same DRG performance management approach has varying effects on dif-ferent departments.Departmental transfer is a key factor influencing hospitalization costs.

Objective To analyze the factors influencing hypercoagulable state in patients with benign prostatic hyperplasia(BPH)after surgery,so as to provide reference for preventing postoperative thrombosis in BPH.Methods A retrospective analysis was conducted on the clinical data of 307 BPH patients who underwent surgery in the Department of Urology at the First Affiliated Hospital of Xi'an Jiaotong University during Apr.2022 and Sep.2023.Patients were divided into the hypercoagulable state group and non-hypercoagulable state group based on the presence of abnormal postoperative coagulation parameters.Single factor and binary logistic regression analysis were used to screen risk factors affecting postoperative blood hypercoagulability in BPH patients.Results Among the 307 BPH patients,45(14.66％)developed a hypercoagulable state postoperatively.Univariate analysis revealed statistically significant differences between the hypercoagulable and non-hypercoagulable groups regarding patients'age,length of hospital stay,body mass index(BMI),history of hypertension,history of diabetes,and blood type(P＜0.05).Binary logistic regression analysis identified BMI(OR=1.135,95％CI:1.006-1.281,P=0.039),history of hypertension(OR=2.342,95％CI:1.103-4.927,P=0.027),and blood type(OR=2.270,95％CI:1.066-4.836,P=0.034)as independent risk factors for postoperative hypercoagulable state.Conclusion Non-O blood type,high BMI,and history of hypertension are independent risk factors for the occurrence of hypercoagulable state following surgery for BPH.