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

ObjectiveTo explore the effect of Babaodan （BBD） on the NOD-like receptor pyrin domain containing 3/cysteine aspartate-specific protease-3 （NLRP3/Caspase-1） pathway proteins in mice with acetaminophen （APAP）-induced acute liver injury. MethodC57BL/6 mice were randomly grouped， and BBD （75， 150， 300 mg·kg^-1， ig） was administered twice a day for three days. After 2 hours of the last administration， the mice were treated with APAP （400 mg·kg^-1， ip）， and the eyeballs were removed to collect blood after 14 hours. Then they were sacrificed by cervical dislocation for sample collection. Hematoxylin-eosin （HE） staining was used to observe the morphological changes of liver tissue cells， and biochemical methods were used to detect the activities of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， superoxide dismutase （SOD）， malondialdehyde （MDA） and myeloperoxidase （MPO） in serum of mice in each group. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was performed to determine the mRNA expression of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β） and IL-6， and Western blot was performed to determine the protein expression of cyclooxygenase-2 （COX-2）， inducible nitric oxide synthase （iNOS）， NLRP3， Caspase-1 and IL-18 in the liver of mice. ResultCompared with the conditions in normal group， the hepatic lobule structure of mice in the model group was partially destroyed， and the hepatic sinusoids were dilated. And the expression levels of ALT and AST in serum， the protein levels of NLRP3， Caspase-1， iNOS， IL-18 and COX-2 and the mRNA levels of IL-1β， IL-6 and TNF-α were increased （P<0.05， P<0.01）. Compared with the model group， the administration groups had improvement in liver cell rupture and hepatic sinusoidal compression， and a dose-dependent decrease in the levels of ALT and AST in serum as well as the protein levels of NLRP3， Caspase-1， iNOS， IL-18 and COX-2 and the the mRNA levels of IL-1β， IL-6 and TNF-α in liver tissue （P<0.05， P<0.01）. ConclusionBBD can reduce APAP-induced acute liver injury in mice. The mechanism may be related to anti-oxidative stress， inhibition of NLRP3/Caspase-1 pathway， and decreased expression levels of IL-1β， IL-18， TNF-α and IL-6.

Objective:To construct a recombinant plasmid DNA carrying the decorin( DCN) gene and study its therapeutic effect on hypertrophic scars of rabbit ears. Methods:The human decorin gene fragment amplified by PCR was cloned into plasmid vector pUDK to construct the recombinant plasmid pDCN, which was identified by enzyme digestion and sequencing. pDCN was transfected into 293T cells, and the expression of DCN and TGF-β1 was detected. The therapeutic effect of pDCN on rabbit ear hypertrophic scar model was observed by hypertrophy index, pathological examination and immunohistochemical staining. Results:The decorin gene was successfully inserted into pUDK, which was examined by enzyme digestion and sequencing. The expression level of mRNA and protein of DCN was up-regulated in 293T cells post pDCN transfection, and the expression of TGF-β1 was suppressed. Then the rabbit ear hypertrophic scars were treated with different doses of pDCN, and the results showed that the hypertrophy index of the medium dose (200 μg/cm 2) pDCN group was significantly lower than that of the PBS group ( P<0.05), while there was no significant difference in the hypertrophy index of the low dose and high dose pDCN group compared with the PBS group. The expression of DCN in ears skin in the medium dose pDCN group was significantly higher than that in the PBS group ( P<0.05). The pathological examination showed that inflammatory cell infiltration and fibrous deposition in scar tissue were significantly reduced. These results indicated that the medium-dose pDCN could effectively inhibit the hyperplasia of hypertrophic scar in rabbit ears. Conclusions:pDCN, the plasmid carrying decorin gene, has therapeutic effects on hypertrophic scars of rabbit ears by inhibiting TGF-β1 expression.

Objective:To construct a recombinant plasmid DNA carrying the decorin( DCN) gene and study its therapeutic effect on hypertrophic scars of rabbit ears. Methods:The human decorin gene fragment amplified by PCR was cloned into plasmid vector pUDK to construct the recombinant plasmid pDCN, which was identified by enzyme digestion and sequencing. pDCN was transfected into 293T cells, and the expression of DCN and TGF-β1 was detected. The therapeutic effect of pDCN on rabbit ear hypertrophic scar model was observed by hypertrophy index, pathological examination and immunohistochemical staining. Results:The decorin gene was successfully inserted into pUDK, which was examined by enzyme digestion and sequencing. The expression level of mRNA and protein of DCN was up-regulated in 293T cells post pDCN transfection, and the expression of TGF-β1 was suppressed. Then the rabbit ear hypertrophic scars were treated with different doses of pDCN, and the results showed that the hypertrophy index of the medium dose (200 μg/cm 2) pDCN group was significantly lower than that of the PBS group ( P<0.05), while there was no significant difference in the hypertrophy index of the low dose and high dose pDCN group compared with the PBS group. The expression of DCN in ears skin in the medium dose pDCN group was significantly higher than that in the PBS group ( P<0.05). The pathological examination showed that inflammatory cell infiltration and fibrous deposition in scar tissue were significantly reduced. These results indicated that the medium-dose pDCN could effectively inhibit the hyperplasia of hypertrophic scar in rabbit ears. Conclusions:pDCN, the plasmid carrying decorin gene, has therapeutic effects on hypertrophic scars of rabbit ears by inhibiting TGF-β1 expression.

OBJECTIVETo investigate the characteristics of null allele for 17 Y-chromosomal short tandem repeats (Y-STR) loci in a group of infertile males.

METHODSTwo hundred thirty six infertile males featuring non-obstructive azoospermia and severe oligozoospermia were analyzed with an AmpFISTR ((R)) Yfiler (TM) kit. Deletions of azoospermia factor (AZF) fragments were confirmed with Y chromosome sequence-tagged sites (STSs) analysis using modified multiplex PCR.

RESULTSThe overall prevalence of AZF microdeletions was 16.95% (40/236). In the non-obstructive azoospermia group, 13 cases had AZFc deletion, 6 cases had AZFb+c deletion, 2 cases had AZFa deletion, 1 case had AZFb deletion. In the severe oligozoospermia group, 17 cases had AZFc deletion and 1 had AZFb deletion. No AZFa+b+c deletion was detected. Forty cases showed null alleles by scanning of the 17 STR loci. Deletions of DYS438, DYS439, DYS437, DYS389I and DYS389II were found in the 2 cases with AZFa deletion. In patients with AZFb deletion, DYS392 and DYS385a/b were found deleted. Deletions of DYS448 were detected in all of the 30 cases with AZFc deletion. Deletions of DYS392, DYS385a/b, and DYS448 were found in 6 cases with AZFb+c deletion.

CONCLUSIONDeletions of the Y chromosome AZF regions are associated with azoospermia and severe oligozoospermia. Null allele due to complete absence of AZFa, AZFb and AZFc regions may lead to misinterpretation in the sexual assault cases. Revealing the locus heterogeneity in male infertility population can enrich the Y-STR database and facilitate interpretation STR data in forensic DNA testing.

Objective We investigated urinary incontinence (UI) among patients of the Gynecological Department of Renmin Hospital of Wuhan University,to observe characteristics of women with UI in our province,and to analyze preliminary factors affecting their treatment.Methods We evaluated 15 300 patients treated for UI from August 2009 to April 2011,using site information and questionnaires.We also compared them to 66 825 other gynecology outpatients at our hospital over the same period.Results We found that the incidence of UI tended to increase with age,and was associated with body mass index,parturition,and surgery history.But 54.63％ (8358/15 300) of them refused surgical treatment.Of these 8358 patients,29.78％ (2489/8358) because of economic factors,25.83％ (2159/8358) because of mental stress,and 24.30％ (2031/8358) because of lack of faith in the efficacy of surgical treatment,20.09％ (1679/8358) did so because of knowing little of the disease.Conclusions UI is inconvenient to patients,and seriously affects their physical and mental health. Many patients refuse surgical treatment.Medical staff should attempt to educate patients better with regard to treatment,and to offer them help to improve the quality of their lives.

Objective To search the literature of randomized controlled trials on the treatment of anterior vaginal wall prolapse with adjuvant materials and compare the efficacy and safety of anterior vaginal wall prolapse repair with and without adjuvant materials.Methods Searches were made in the databases of Pubmed,Embase and Ovid for randomized controlled trials from 1980 to 2012 on the treatment of anterior vaginal wall prolapse with adjuvant materials.Comprehensive meta-analyses were conducted with Revman 5.1 analysis software to compare vaginal wall anatomy failure rate,operative duration,intraoperative bleeding volume,postoperative visceral injury,pelvic pain,urinary infection,material exposure,material erosion,de novo urinary incontinence and de novo dyspareunia in the adjuvant materials repair and repair without adjuvant materials groups.Results A total of 20 randomized controlled trials including 2313 participants were retrieved.The shortest average follow-up period was 3 months and the longest 36 months.Compared with repair without adjuvant materials,the application of adjuvant materials in anterior vaginal wall repair reduced vaginal front wall prolapse anatomy failure rate lower anatomy failure rate,had a longer operating duration,more peri-operative bleeding and lower urinary tract infection rate.The comprehensive effects were as follows:P＜0.01,RR =0.51,95％CI:0.41-0.64;P ＜0.01,weighted mean differenece (WMD) =16.25,95％ CI:8.07-24.43;P =0.01,WMD =35.00,95％ CI:6.90-63.11 ;P =0.03,RR =0.51,95％ CI:0.28-0.93,respectively,but the comparison of two groups around in visceral injury,postoperative pain,de novo stress urinary incontinence and de novo dyspareunia had no significant differences (P =0.07,0.58,0.54 and 0.67) and the average materiale exposure and rosion rate were 4.37％ (27/618) and 7.69％ (24/312) respectively.Conclusions The application of adjuvant materials in anterior vaginal wall repair can improve the postoperative recurrence.But no obvious differences exist in the incidence of complications in anterior repair with adjuvant materials and repair without adjuvant materials.

Objective To explore the effect of lipid raft on cervical cancer cell growth and its mechanisms Methods HeLa cells in logarithmic phase were divided into three groups including control group, lipid raft interference agent group,and NADPH oxidase inhibitors group.Cells were treated with fre sh medium,3 μmol/L Apocynin and 1 mmol/L M-beta CD, respectively, for 24 h.Cell survival rate was detected using the MTT method, and the HIF-1α level was examined by Western-blot. Results Cell growths of the lipid raft interference agent group and NADPH oxidase inhibitors group were significantly slower than control group,(0.612±0.051 vs 0.984±0.034,0.591 ±0.074 vs 0.984±0.034,t=4.062,P＜0.05).HIF-1α expression in the lipid raft interference agent group and NADPH oxidase inhibitors group was also significantly reduced compared with control group (1.79±0.14 vs 2.56±0.22 and 1.54±0.12 vs 2.56±0.22) and the difference was significant (t=2.423,P＜0.05). Conclusion Lipid raft-NADPH oxidase pathway may activate HIF-1α and downstream protocarcinogenic gene expression to promote the growth of cervical cancer cells. The inhibitors of lipid raft and NADPH oxidase may become a new research direction for cervical cancer chemotherapy.

Forty nine patients with vesicovaginal fistula underwent transvaginal repair by the use of Foley catheter in our hospital.The clinical data were retrospectively analyzed.The success rate of primary operation was 98% (2/49), the mean operation time was (85±8)min, the mean postoperative hospital stay was( 13±2) d, the rate of postoperative urine leakage was 2%(1/49), the mean bladder capacity was (378±53)ml.Transvaginal repair of vesicovaginal fistula by the use of Foley catheter is an effective surgical modality with satisfactory results.

Objective To investigate the serological patterns of hepatitis B, understand the prevalence of hepatitis B infection in neonates, infants and preschool children based on hospital data in Zhejiang province and provide a basis for prevention and control of local pediatric hepatitis B infection. Methods Five serological markers were detected on electrochemiluminescence analyzer Roche E601. The results of all serological markers in children with hepatitis B from 2006 to 2010 were exported from laboratory information system and 24 892 (15 810 boys and 9 082 girls) cases were selected for further analysis according to the exclusion criterion including duplicate analysis, children older than 7 years and children living out of Zhejiang province. SPSS13.0 software and EXCEL 2003 were employed for statistical analysis in this study. Results Average HBV vaccination coverage rates among 15 413 boys and 8 840 girls were 99. 16%(98. 87% -99. 45%) and 99. 17% (98. 29% -99. 53%), respectively. Seventeen serological patterns of hepatitis B were observed, and "anti-HBs(+)alone"(64. 997%) was the dominant patterns followed by "negative" (18. 231%), "anti-HBc(+)anti-HBs(+)"(9.911%) and "anti-HBe(+)antiHBc(+) anti-HBs(+)"(4.395%), and the positive rates for other patters were 0. 004% -0. 992%. There were significant difference of detection rates for "anti-HBc(+)alone" and "anti-HBe(+)anti-HBs(+)"patterns between male and female (χ2=7.143,8.123, all P＜0.01), and there were no significant difference of detection rates for the other 15 patterns between male and female (all P ＞0.05). Ninety-four HBsAg positive cases were detected, accounting for 0.38%. Totally 19 899 anti-HBs positive cases were detected, accounting for 79.94%. Totally 16 187 cases were "anti-HBs(+) alone", accounting for 81.3%of the total anti-HBs(+) cases. The group of 1-2 years and 2 day-2 week had the highest and lowest rate for anti-HBs(+)alone respectively. The ratios in three groups with different anti-HBs levels (10-100 mIU/ml,100-1000 mIU/ml and ＞ 1000 mIU/ml) in 16 178 anti-HBs(+) children were 23. 64%, 27.66% and 13. 70%, respectively. Totally 3 904 cases with anti-HBc(+) were detected, accounting for 15.68%. The highest positivity rate and lowest positivity rate were in the group of 2-4 week and 3-4 week respectively. In total 1 565 cases with negative results, the lowest negativity rate and highest negativity rate were in the group of 9-12 month (3. 25%) and 6-7 age (36. 21%) respectively. Conclusions The dominant serological patterns of hepatitis B in local young children is "anti-HBs (+) alone" and most of the anti-HBs concentrations ranged from 100 to 1000 mIU/ml, followed by "negative". The total positive rate of HBsAg is mild. The rate of hepatitis B serological patterns in children is associated with ages but independent of gender. For interpretation of serological patterns of HBV in children below 12 months (especially in 3 months) the status of their mothers' HBV infection should also be taken into consideration.