Objective To compare the safety and efficacy of directional atherectomy with anti-restenosis therapy(DAART,drug-coated balloon)versus conventional balloon angioplasty(bare-metal stent,BMS)in elderly patients with femoropopliteal artery disease.Methods A retrospec-tive cohort study was conducted on 116 elderly patients undergoing endovascular intervention due to femoropopliteal artery disease in our hospital between May 2016 and September 2019,divided into DAART group(57 cases)and BMS group(59 cases).Results No statistical differences were observed between the DAART and BMS groups in terms of age,risk factors,distribution of Ruth-erford classification,lesion length,lesion type,lesion location,Global Limb Anatomic Staging Sys-tem grade,infra-popliteal runoff status,or preoperative ankle-brachial index(P＞0.05).However,the BMS group had significantly larger proportion of chronic limb-threatening ischemia than the other group(P＜0.05).Both groups achieved a 100％success rate of surgery.The DAART group obtained obviously higher primary patency rates at 1 and 2 years than the BMS group(90.4％vs 75.0％,76.3％vs 57.3％;P＜0.045).There were no significant differences in the rate of freedom from target lesion revascularization at 1 and 2 years between the two group(96.1％vs 88.8％,91.6％vs 77.7％;P＞0.05).In 2 years of follow-up,the incidence of major adverse events was 10.0％(5 cases)in the DAART group and 20.8％(12 cases)in the BMS group,but no obvious difference(P＞0.05).Conclusion DAART demonstrates superior mid-term efficacy than BMS in treating femoropopliteal artery disease in elderly patients.However,comprehensive preoperative assessment is essential to optimize individualized treatment strategies for this population.

Objective To compare the safety and efficacy of directional atherectomy with anti-restenosis therapy(DAART,drug-coated balloon)versus conventional balloon angioplasty(bare-metal stent,BMS)in elderly patients with femoropopliteal artery disease.Methods A retrospec-tive cohort study was conducted on 116 elderly patients undergoing endovascular intervention due to femoropopliteal artery disease in our hospital between May 2016 and September 2019,divided into DAART group(57 cases)and BMS group(59 cases).Results No statistical differences were observed between the DAART and BMS groups in terms of age,risk factors,distribution of Ruth-erford classification,lesion length,lesion type,lesion location,Global Limb Anatomic Staging Sys-tem grade,infra-popliteal runoff status,or preoperative ankle-brachial index(P＞0.05).However,the BMS group had significantly larger proportion of chronic limb-threatening ischemia than the other group(P＜0.05).Both groups achieved a 100％success rate of surgery.The DAART group obtained obviously higher primary patency rates at 1 and 2 years than the BMS group(90.4％vs 75.0％,76.3％vs 57.3％;P＜0.045).There were no significant differences in the rate of freedom from target lesion revascularization at 1 and 2 years between the two group(96.1％vs 88.8％,91.6％vs 77.7％;P＞0.05).In 2 years of follow-up,the incidence of major adverse events was 10.0％(5 cases)in the DAART group and 20.8％(12 cases)in the BMS group,but no obvious difference(P＞0.05).Conclusion DAART demonstrates superior mid-term efficacy than BMS in treating femoropopliteal artery disease in elderly patients.However,comprehensive preoperative assessment is essential to optimize individualized treatment strategies for this population.

Objective To explore the effects of cognitive behavioral therapy based on 5G internet of things(IOT)on rehabilitation and kinesiophobia in elderly patients after percutaneous coronary intervention(PCI)for coronary artery disease.Methods Sixty elderly postoperative PCI patients with coronary artery disease admitted from June to December 2023 were selected as study subjects and randomly divided into the control group and the 5G group,with 30 cases in each group.The control groupreceived conventional nursing intervention,while the 5G group receivedcognitive behavioral therapy based on 5G IOT in addition to traditional nursing.Left ventricular ejection fraction(LVEF),6-minute walking distance(6MWD),the Tampa Scale for kinesiophobia Heart(TSK-SV Heart)scores,the Seattle Angina Questionnaire(SAQ)scores,and rehabilitation compliance were compared between the two groups.Results 12 weeks afterintervention,LVEF and 6MWD in the 5G groupwere significantly improved as compared with those in the control group(P＜0.05).The TSK-SV Heart scores in the 5G group werelower than those in the control group(P＜0.05),but the SAQ scores were higher(P＜0.05).And the rate of better rehabilitation compliance in the 5G group was significantly higher than thatin the control group(P＜0.05).Conclusions Cognitive behavioral therapy based on 5G IOT helps to improve the rehabilitation effect in elderly patients with coronary artery disease after PCI,reduce kinesiophobia,improve quality of life,and enhance reha-bilitationcompliance,thus promoting the rehabilitation process of the patients.

Objective To explore the effects of cognitive behavioral therapy based on 5G internet of things(IOT)on rehabilitation and kinesiophobia in elderly patients after percutaneous coronary intervention(PCI)for coronary artery disease.Methods Sixty elderly postoperative PCI patients with coronary artery disease admitted from June to December 2023 were selected as study subjects and randomly divided into the control group and the 5G group,with 30 cases in each group.The control groupreceived conventional nursing intervention,while the 5G group receivedcognitive behavioral therapy based on 5G IOT in addition to traditional nursing.Left ventricular ejection fraction(LVEF),6-minute walking distance(6MWD),the Tampa Scale for kinesiophobia Heart(TSK-SV Heart)scores,the Seattle Angina Questionnaire(SAQ)scores,and rehabilitation compliance were compared between the two groups.Results 12 weeks afterintervention,LVEF and 6MWD in the 5G groupwere significantly improved as compared with those in the control group(P＜0.05).The TSK-SV Heart scores in the 5G group werelower than those in the control group(P＜0.05),but the SAQ scores were higher(P＜0.05).And the rate of better rehabilitation compliance in the 5G group was significantly higher than thatin the control group(P＜0.05).Conclusions Cognitive behavioral therapy based on 5G IOT helps to improve the rehabilitation effect in elderly patients with coronary artery disease after PCI,reduce kinesiophobia,improve quality of life,and enhance reha-bilitationcompliance,thus promoting the rehabilitation process of the patients.

OBJECTIVE: To assess the clinical value of non-invasive prenatal testing (NIPT) for the screening of trisomy and copy number variations (CNVs) of chromosomes 21, 18 and 13. METHODS: From January 2015 to December 2019, 40 628 pregnant women underwent NIPT testing using high-throughput sequencing and bioinformatics analysis to test the cell-free fetal DNA in maternal plasma. High-risk pregnant women underwent invasive prenatal diagnosis, while low-risk ones were followed up by telephone. RESULTS: The three most common indications included intermediate risk of serological screening, high risk of serological screening and advanced maternal age. Among all pregnant women, 257 cases were detected as trisomy 21, 18 and 13 (170, 49 and 38 cases, respectively). 227 cases chose invasive prenatal diagnosis, with respectively 122, 28 and 10 cases confirmed. The positive predictive value (PPV) was 81.33% (122/150), 65.12% (28/43), 29.41% (10/34), respectively. Two false negative cases of trisomy 18 were found during follow-up. Meanwhile, NIPT has detected 46 cases (15, 16 and 15 cases, respectively) CNVs on chromosomes 21, 18 and 13, among which 37 cases underwent invasive prenatal diagnosis. There were 5, 3 and 5 positive cases, which yielded a PPV of 41.67% (5/12), 25%(3/12) and 33.33%(5/15), respectively. Two other chromosome CNVs were accidentally discovered among the false positive samples. CONCLUSION The incidence of chromosomal abnormalities in the serological screening high-risk group was 52.02%, which was significantly higher than other groups. NIPT has a high sensitivity and specificity for the screening of trisomies 21, 18 and 13, while its accuracy for detecting CNVs of chromosomes 21, 18 and 13 needs to be improved. As a screening method, NIPT has a great clinical value, though there are still limitations of false positive and false negative results.Comprehensive pre- and post-test genetic counseling should be provided to the patients.
Aneuploidy ; Chromosome Disorders/genetics* ; Chromosomes ; DNA Copy Number Variations ; Down Syndrome/genetics* ; Female ; Humans ; Pregnancy ; Prenatal Diagnosis ; Trisomy/genetics* ; Trisomy 18 Syndrome/genetics*

Objective To explore the clinical effectiveness and safety of selective usage of embolic protection device to prevent distal embolization during SilverHawk atherectomy for atherosclerotic femoropo-pliteal artery disease. Methods From Jan 2014 to December 2015, 45 femoropopliteal artery atherosclerot-ic patients were treated with SilverHawk atherectomy and selective embolic protection device (EPD). The indication for EPD was instent restenosis, highly calcified lesion, suspicious of thrombosis, ulcerated le-sion, and single below-the-knee runoff. All cases who met the indication were treated with atherectomy and EPD, and those who did not meet the indication were treated with or without EPD according to the patient's choice. The embolic related complications were analyzed. Results Twenty three out of 45 patients who met the EPD indication were all treated with SilverHawk atherectomy under EPD protection, filter captured deb-ris in 17 patients (73. 9％) of the patients. The other 22 patients who did not meet the indication were di-vided into 2 groups according to the patient's choice of EPD usage, 11 were treated by atherectomy with EPD and 11 without EPD. One case out of 11 unindicated patients without EPD suffered a tibioperoneal trunk embolization and restored with catheter aspiration. For 1/11 (9. 1％) unindicated cases with EPD protec-tion, the filter captured embolization. There was a significant difference of distal embolization rate between the indicated and unindicated patients (χ2 =19. 368,P =0. 000). All filters were retrieved successfully without any distal embolization and any complications except arterial spasm occurred in 2 patients and re-stored well with nitroglycerin. Conclusions It is safe and effective for selective usage of embolic protection device to prevent distal embolization during SilverHawk atherectomy for atherosclerotic femoropopliteal artery disease.

Objective To investigate the clinical outcome of drug-coated balloon ( DCB) treated atherosclerosis obliterans ( ASO) in lower extremity. Methods Data of 28 patients were retrospectively an-alyzed to determine the effectiveness and characteristics of DCB treatment. Results All the 28 patients were successfully treated with endovascular intervention therapy. Lesions mainly located in the superficial femoral arteries were divided into Groups A, B, C, and D according to TransAtlantic InterSociety Consensus (TASC) Ⅱ classification. Follow-up at 6, 9, and 12 months showed 100％, 84. 6％ and 76. 9％ patency rate in treated artery. After 9 months of endovascular intervention therapy, the combined artery patency rates in Groups A and B was 92. 8％, which was significantly better than 66. 7％ in Groups C and D ( P <0. 05 ) . DCB angioplasty had an artery patency rate of 86. 7％, while DCB angioplasty plus stenting had the patency rate of 85. 7％ (P>0. 05). Artery patency rate of Simple DCB angioplasty in ten patients (Exclu-ding patients with in-stent restenosis ) was 80％ and of Atherectomy plus DCB angioplasty in 5 patients was 100％ (P<0. 05). Conclusions DCB angioplasty has superiority over conventional intervention therapy. Combined debulky and DCB angioplasty appear to be the best choice in current treatment of ASO in lower extremity.

Objective To investigate the relationship between LUTS and degree,type of prostate histological inflammation in patients with benign prostatic hyperplasia (BPH).Methods From October 2013 to June 2016, 150 patients with BPH(62 -82 years old)were treated with selective TURP.After operation,the pathology examina-tion was practised.According to the international prostatitis histological classification standard,the patients were divid-ed into group A(without inflammation,18 cases),group B(inflammation around gland,45 cases),group C(gland inflammation,33 cases)and group D(mixed inflammation group,54 cases).There were no statistically significant differences among the 4 groups in age,course of disease,number of urinary retention and prostate volume(all P >0.05).The IPSS score before and 2 months after operation and the correlation between the IPSS and degree,type of histological inflammation were observed.Results In group A and C,the preoperative IPSS score and IPSS score at 2 months after surgery were (17.20 ±11.14)points,(8.45 ±5.14)points and (18.05 ±13.11)points,(9.85 ± 5.25)points respectively,there were no statistically significant differences between the two groups(t =0.485,1.294, all P >0.05).There were no statistically significant differences between group B[(22.55 ±11.85)points,(13.24 ± 6.46)points]and group D[(21.45 ±10.35)points,(12.36 ±6.04)points](t =0.824,1.436,all P >0.05).The group B had statistically significant differences compared with group A and group C (t =2.689,5.016,3.642,4.382, all P <0.05).The group D also had statistically significant differences compared with group A and group C (t =2.786,4.672,6.415,5.106,all P <0.05 ).There was positive correlation between the IPSS score before and 2 months after operation and the degree of inflammation in group B,D(B:r =0.698,0.795,D:r =0.546,0.485,all P <0.05),but there was no correlation in group C between them(r =0.182,0.170,all P >0.05 ).Conclusion There is a close correlation between LUTS and inflammation around gland in patients with BPH,and the LUTS can aggravate with the increased inflammation around gland and do not relate with the gland inflammation.

Objective To evaluate the clinical efficacy of bladder gasification and stasis dispersion in BPH patients with histological prostatitis after TUEP about IPSS /Qol score.Methods 126 BPH patients with histological prostatitis after TURP were divided into group A,B and C of equal number,and received oral placebo,tamsulosin,and herbal decoction a week after operation,respectively,for a course of 4 weeks.IPSS and Qol score were evaluated. Results After 5 weeks,121 cases finished the follow -up,the unfinished were 2 cases in group A,2 cases in group B and 1 cases in group C.The differences of the IPSS total scores,irritative subscore,obstructive subscore,quality of life score in group C(7.16 ±3.37)points,(4.22 ±2.70)points,(2.94 ±2.06)points,(1.47 ±1.44)points were statis-tically significant than those in group A[(13.77 ±4.50)points,(7.48 ±3.50)points,(6.29 ±2.63)points,(2.83 ± 1.72)points]and group B [(12.77 ±5.24)points,(8.05 ±3.88)points,(4.72 ±3.24)points,(3.07 ± 1.67)points](t =2.692,3.544,3.296,2.698 and t =2.326,3.532,2.418,2.414;all P <0.05).There was only obstructive subscore in group B better than that in group A(t =2.572,P <0.05).Conclusion Bladder gasification and stasis dispersion is effective for the treatment of BPH patients with histological prostatitis after TUEP about IPSS and Qol score.The clinical effect is indeed and satisfactory.