Chronic coronary syndrome(CCS)is one of the most prevalent cardiovascular disease(CVD)in clinical practice.With the accelerating aging of the population and the increasing prevalence of cardiovascular risk factors,CVD has become the leading cause of death among Chinese residents.To optimize diagnosis and treatment strategies through integrated traditional Chinese and Western medicine approaches,and to further improve the clinical management of CCS,the expert group reviewed recent domestic and international guidelines on CCS diagnosis and treatment.Incorporating advances in traditional Chinese medicine(TCM)and leveraging the unique characteristics of Yunnan's local herbal medicine(Yunyao),this consensus document was developed.It aims to guide clinical practice and enhance the overall management of CCS patients in the province.

Objective:To explore the effectiveness of robotic implant technology in the postgraduate education of implant dentistry.Methods:The teaching method that combines of theory and model manipulation was used to teach 20 postgraduate students. After completing the theoretical course of implant dentistry, all students performed free hand, digital template, and dental implant robot implant surgery on the simulation jaw models. At the end of the course, an error analysis of the three and a feedback questionnaire distributed to the students were conducted in order to assess the effectiveness of the dental implant robot.Results:Compared to the freehand [2.45(1.1) mm,2.80(0.88) mm,4.95°(2.68°)] and digital template group [1.25(0.68) mm,2.00(0.90) mm, 3.35°(1.60°)], the dental robot implant group had smaller values for implant platform deviation, apical deviation and angular deviation [0.29(0.08) mm,0.26(0.20) mm,0.72°(0.13°)], and the difference was statistically significant ( P<0.001). The results of the questionnaire showed that dental implant robot helps to ensure the accuracy and safety of the implanting process and stimulates students′ interest in learning. Conclusions:At postgraduate level, the safety and accuracy of the implantation process was effectively improved and good teaching result achieved by introducing dental implant robot into the process of dental implant training.

Objective:To explore the effectiveness of robotic implant technology in the postgraduate education of implant dentistry.Methods:The teaching method that combines of theory and model manipulation was used to teach 20 postgraduate students. After completing the theoretical course of implant dentistry, all students performed free hand, digital template, and dental implant robot implant surgery on the simulation jaw models. At the end of the course, an error analysis of the three and a feedback questionnaire distributed to the students were conducted in order to assess the effectiveness of the dental implant robot.Results:Compared to the freehand [2.45(1.1) mm,2.80(0.88) mm,4.95°(2.68°)] and digital template group [1.25(0.68) mm,2.00(0.90) mm, 3.35°(1.60°)], the dental robot implant group had smaller values for implant platform deviation, apical deviation and angular deviation [0.29(0.08) mm,0.26(0.20) mm,0.72°(0.13°)], and the difference was statistically significant ( P<0.001). The results of the questionnaire showed that dental implant robot helps to ensure the accuracy and safety of the implanting process and stimulates students′ interest in learning. Conclusions:At postgraduate level, the safety and accuracy of the implantation process was effectively improved and good teaching result achieved by introducing dental implant robot into the process of dental implant training.

Objective To investigate the association between four single nucleotide polymorphisms(SNP)(rs9340 in MAPK1,rs14804 in NRAS,rs712 and rs7973450 in KRAS)in the 3'UTR of ERK1/2 signaling pathway-related genes and non-small cell lung cancer(NSCLC).Methods A total of 478 NSCLC patients and 480 healthy controls were enrolled in this study.Four SNPs were genotyped by using TaqMan assays.The association between the four SNPs and NSCLC was analyzed.Results The distribution frequency difference of the allele of rs9340 was statistically significant between the control group and the non-small cell squamous cell carcinoma(SCC)group(P = 0.009),suggesting that the G allele of rs9340 may be a protective factor for non-small cell lung squamous cell carcinoma(OR = 0.67,95%CI:0.50～0.91).In addition,in the<50 years age group,the distribution frequency difference of the allele of rs9340 was statistically significant between the control group and the NSCLC group(P = 5.07×10-4),indicating that the G allele of rs9340 may be a protective factor for NSCLC(OR = 0.46,95%CI:0.29～0.72).Conclusion The SNP rs9340 in MAPK1 may be associated with the risk of NSCLC.

Objective:To systematically evaluate the relationship between thiazide diuretics and the risk of hip fracture in the elderly patients.Methods:The relevant databases at home and abroad were searched up to December 31, 2023 and case-control studies and cohort studies on the relationship between thiazide diuretics and the risk of hip fractures in the elderly patients were collected. Quality of the enrolled studies was evaluated by bias risk assessment tool of Newcastle-Ottawa Scale (NOS). RevMan 5.4 software was used for meta-analysis on related outcome indicators, and the effect sizes were odds ratio ( OR) and the 95% confidence interval ( CI). Funnel plots, Egger′s method and Begg′s method were performed using Stata 15.1 software to analyze the inclusion literature for publication bias. Results:A total of 18 studies were enrolled in the study, including 7 case-control studies and 11 cohort studies and involving 175 200 patients in the trial group (thiazide diuretics) and 1 574 989 in the control group (placebo or other medications). All 18 studies scored ≥5 on the NOS (15 articles of high quality and 3 articles of medium quality). The meta-analysis results indicated that the risk of hip fractures in the trial group was lower than that in the control group ( OR=0.82, 95% CI: 0.75-0.89, P<0.001). Subgroup analyses by study type and gender both revealed that thiazide diuretics were associated with a reduced risk of hip fractures in the elderly (adjusted OR in case-control studies was 0.78, 95% CI: 0.72-0.84, P<0.001; adjusted OR in cohort studies was 0.83, 95% CI: 0.74-0.93, P=0.002; adjusted OR in female was 0.78, 95% CI: 0.72-0.85, P<0.001; adjusted OR in male was 0.73, 95% CI: 0.68-0.80, P<0.001). The subgroup analysis of 11 large-sample studies (≥2 000 cases) indicated that thiazide diuretics were associated with a reduced risk of hip fractures in the elderly (adjusted OR=0.79, 95% CI: 0.72-0.87, P<0.001). However, 6 small-sample studies did not find the similar correlation. A combined analysis of studies that rigorously controlled for confounding factors revealed that thiazide diuretics were associated with a lower risk of hip fractures in the elderly ( OR=0.79, 95% CI: 0.74-0.84, P<0.001), and the combined results showed no heterogeneity ( P=0.72, I2=0%). Conclusions:Thiazide diuretics were associated with a reduced risk of hip fractures in the elderly patients. Based on a comprehensive assessment of the risks and benefits of medication for elderly patients, clinicians may prioritize thiazide diuretics as a component of combination therapy for eligible patients, which may be beneficial in reducing their risk of hip fractures.

Objective:To systematically evaluate the relationship between thiazide diuretics and the risk of hip fracture in the elderly patients.Methods:The relevant databases at home and abroad were searched up to December 31, 2023 and case-control studies and cohort studies on the relationship between thiazide diuretics and the risk of hip fractures in the elderly patients were collected. Quality of the enrolled studies was evaluated by bias risk assessment tool of Newcastle-Ottawa Scale (NOS). RevMan 5.4 software was used for meta-analysis on related outcome indicators, and the effect sizes were odds ratio ( OR) and the 95% confidence interval ( CI). Funnel plots, Egger′s method and Begg′s method were performed using Stata 15.1 software to analyze the inclusion literature for publication bias. Results:A total of 18 studies were enrolled in the study, including 7 case-control studies and 11 cohort studies and involving 175 200 patients in the trial group (thiazide diuretics) and 1 574 989 in the control group (placebo or other medications). All 18 studies scored ≥5 on the NOS (15 articles of high quality and 3 articles of medium quality). The meta-analysis results indicated that the risk of hip fractures in the trial group was lower than that in the control group ( OR=0.82, 95% CI: 0.75-0.89, P<0.001). Subgroup analyses by study type and gender both revealed that thiazide diuretics were associated with a reduced risk of hip fractures in the elderly (adjusted OR in case-control studies was 0.78, 95% CI: 0.72-0.84, P<0.001; adjusted OR in cohort studies was 0.83, 95% CI: 0.74-0.93, P=0.002; adjusted OR in female was 0.78, 95% CI: 0.72-0.85, P<0.001; adjusted OR in male was 0.73, 95% CI: 0.68-0.80, P<0.001). The subgroup analysis of 11 large-sample studies (≥2 000 cases) indicated that thiazide diuretics were associated with a reduced risk of hip fractures in the elderly (adjusted OR=0.79, 95% CI: 0.72-0.87, P<0.001). However, 6 small-sample studies did not find the similar correlation. A combined analysis of studies that rigorously controlled for confounding factors revealed that thiazide diuretics were associated with a lower risk of hip fractures in the elderly ( OR=0.79, 95% CI: 0.74-0.84, P<0.001), and the combined results showed no heterogeneity ( P=0.72, I2=0%). Conclusions:Thiazide diuretics were associated with a reduced risk of hip fractures in the elderly patients. Based on a comprehensive assessment of the risks and benefits of medication for elderly patients, clinicians may prioritize thiazide diuretics as a component of combination therapy for eligible patients, which may be beneficial in reducing their risk of hip fractures.

OBJECTIVE To investigate the cellular uptake and in vivo imaging of paclitaxel(PTX)-loaded polyethylene glycol(PEG)-modified rhein conjugate micelles. METHODS (P4/P2+PTX)/CRmP micelles were prepared by co-loading environment-responsive fluorescent probes P4/P2 and PTX into CRmP micelles. Using MCF-7 cells as cell models, the uptake of the micelles by MCF-7 cells was analyzed by laser confocal microscopy and flow cytometry. The H22 subcutaneous transplanted tumor mice were used as animal models, and the distribution of the micelles in vivo and in vitro were analyzed by in vivo imaging system. RESULTS (P4+PTX)/CRmP micelles in the intact form were internalized by MCF-7 cells and distributed in the cytoplasm. (P2+PTX)/CRmP micelles were more accumulated in the liver and tumor sites in vivo, and gradually accumulated at the tumor sites during the experimental time. CONCLUSION The intact micelles can be taken up by tumor cells, and have liver and tumor targeting properties in vivo.

Objective:To explore the effect of postoperative delirium risk management in elderly patients with hip fragility fracture based on failure mode and effect analysis (FMEA) theory, and to provide a basis for reducing the incidence of postoperative delirium.Methods:A total of 50 patients admitted to the First Affiliated Hospital of Sun Yat-sen University due to hip fragility fractures from January to December 2019 were selected as the control group, and 50 patients admitted to the First Affiliated Hospital of Sun Yat-sen University for hip fragility fractures from January to December 2020 were selected as the observation group. The control group received routine care, and the observation group implemented risk control intervention measures based on FMEA theory on the basis of the control group. The risk priority number (RPN) value, incidence of delirium, duration of delirium, pain score, satisfaction, and average length of hospital stay were compared between the two groups of patients in each link of failure risk.Results:The RPN values of each link failure risk of the observation group were 100.80 ± 13.39, 103.96 ± 9.96, 103.76 ± 8.04, delirium duration was (36.33 ± 9.07) min, pain scores were 1.86 ± 0.76, 4.16 ± 1.17, average length of stay was (8.98 ± 4.64) days, and incidence of delirium was 6.0% (3/50), the RPN values of each link failure risk of the control group were 274.10 ± 8.48, 291.00 ± 10.10, 287.78 ± 11.64, delirium duration (78.70 ± 20.10) min, pain scores 2.26 ± 1.02, 4.74 ± 1.19, average length of stay was (11.50 ± 7.66) days, and incidence of delirium was 22.0% (11/50). The differences between two groups showed significant differences ( t values were 1.99-93.24, χ2=4.07, P<0.05). The patient satisfaction score of the observation group was 99.36 ± 1.01, which was higher than that of the control group 89.63 ± 2.62, and the difference was statistically significant ( t=24.50, P<0.05). Conclusions:The perioperative implementation of postoperative delirium risk management model based on FMEA theory in elderly patients with hip fractures can reduce the incidence of postoperative delirium, relieve pain, shorten hospital stay, and improve satisfaction degree. It is worthy of clinical promotion.

In recent years, monoclonal antibodies (mAbs) have been developing rapidly and widely used in fields of tumor, immunity, blood and other systemic diseases. Global share of mAbs in prescription drug market had reached up to $ 140 billion, 15.3% by 2019. As macromolecule proteins, with special structures and physiological properties, mAbs have great differences in absorption, distribution, metabolism and excretion in vivo compared with small molecule drugs, including characteristics of relatively large molecular mass, high specificity and selectivity in target combination, non-linear pharmacokinetics, time dependence, long half-life and so on. Fully understanding of these special pharmacokinetic characteristics shall effectively guide analysis of mAbs. Meanwhile, the particularity and complexity of disposal mechanism in organisms greatly increase the difficulty of biological detection. As a result, it is necessary to establish exclusive, sensitive, accurate and repeatable quantification methods in biological samples. This article focuses on pharmacokinetic characteristics, main analytical methods, and methodology validation of quantification for mAbs in biological samples, expounding with comparisons of small molecular drugs, so as to prompt development of pharmacokinetic study of this kind of drugs.

Objective To assess the influences of early implementation of patient-controlled epidural analgesia (PCEA) in labor on uterine myoelectrical activity and delivery outcomes. Methods A prospective study was conducted on 240 singleton cephalic primiparae with spontaneous labor at Guangzhou Women and Children's Medical Center from January 2015 to October 2018. Those women, who were ready to accept PCEA, were randomly assigned to early- or late-PCEA group based on cervical dilation of 0-3 cm or 3-6 cm at the time of commencing PCEA, while those who refused PCEA in labor were classified as non-PCEA group. Uterine electromyographic activity and visual analogue score (VAS)were recorded before and 1 h and 2 h after PCEA. Patient satisfaction with labor, duration of the first stage of labor, volume of postpartum bleeding within 2 h after delivery and neonatal Apgar score were compared between different groups using multivariate analysis of variance, repeated measures analysis of variance, LSD-t test or Chi-square test. Results The VAS values 1 h after PCEA in the early- and late-PCEA group were both lower than that in the non-PCEA group (2.08±1.34 and 2.00±1.28 vs 7.65±1.04, LSD-t were － 27.713 and － 27.663, P<0.001) and those before PCEA (7.65±0.91 and 7.62±0.86, LSD-t were －32.879 and －33.349, P<0.001). The VAS values 2 h after PCEA in the early- and late-PCEA group were both lower than that in the non-PCEA group (1.63±1.53 and 1.41±1.56 vs 7.66±0.87, LSD-t were －27.018 and －27.823, P<0.001) and those before PCEA (LSD-t were －31.379 and －32.718, P<0.001).The patient satisfaction rate with labor was higher in the early-PCEA group comparing to the late-PCEA group [80.0% (72/90) vs 61.1% (55/90), P<0.001], and the two figures above were both higher than that of the non-PCEA group [20.0% (12/60), both P<0.001]. There was no significant difference in the duration of the first stage of labor, the volume of postpartum blood loss 2 h after delivery, oxytocin usage rate, the rate of convertion to cesarean section, neonatal birth weight or Apgar score at 1 or 5 min among the three groups (all P>0.05). There was also no significant difference in uterine electromyographic parameters among the three groups before or 2 h after PCEA (all P>0.05). The number and duration of burst, power density spectrum peak frequency, root mean square and total power 1 h after PCEA in the early- and later-PCEA group were all lower than those in the non-PCEA group [4.80±2.49 and 5.54±3.04 vs 9.67±2.44; (34.41±1.21) and (36.94±1.18) vs (41.68±1.53) s; (0.36±0.08) and (0.36±0.07) vs (0.48±0.05) Hz ; (0.05±0.04) and (0.05±0.05) vs (0.07±0.05) mV; (4.33±0.51) and (5.36 ±0.59) vs (9.90±1.43) pV2; all P<0.05]. Conclusions The effect of PCEA on uterine myoelectrical activity has no association with the commencing time. While early PCEA could alleviate the labor pain as soon as possible, which enable us to improve the efficacy of labor analgesia, patient satisfaction and maternal and neonatal safety without increasing cesarean section rate.