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 explore the effect of humanistic care combined with Morita therapy on anxiety state of hemodialysis patients.Methods:A self-controlled study was conducted on 54 patients with end-stage renal disease and anxiety who received maintenance hemodialysis in China-Japan Friendship Hospital from August 2020 to August 2022. All patients were treated with humanistic care nursing and Morita therapy for one month. The Self Rating Anxiety Scale (SAS) scores of the patients before and after the intervention were compaired. The comparison of quantitative data was conducted by paired t-test, and the comparison of qualitative data was conducted by χ2 test. The correlation between different factors and anxiety was analyzed by Spearman correlation analysis. Results:Among the 54 patients, there were 26 males and 28 females, aged (61.8±16.3) years (ranging from 29 to 88 years). The SAS score after the intervention (44.0±11.1) was lower than that before the intervention (51.9±8.5) ( t=5.395, P<0.001). The anxiety of patients was related to their age ( r=0.305), employment status ( r=0.270) and marital status ( r=0.397) (all P<0.05). The satisfaction of patients with care measures and nursing before and after the intervention was 45.6% and 87.7%, respectively ( χ2=5.720, P<0.05). Conclusion:After receiving combined humanistic care nursing and Morita therapy, patients in a state of anxiety could experience significant psychological improvement, which is conducive to the successful completion of hemodialysis treatment and enhances the quality of life for patients.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.

Background and purpose:BRCA1/2 plays an important role in maintaining the genome stability.Whether BRCA1/2 germline mutation could increase the tumor sensitivity to radiotherapy,thereby inducing secondary primary cancer after radiotherapy is unclear.This study aimed to investigate whether postoperative radiotherapy is a risk factor for the development of second primary cancer in triple-negative breast cancer(TNBC)patients with BRCA1/2 germline mutation.Methods:This research was based on a previously reported retrospective cohort,i.e.,the Fudan University Shanghai Cancer Center TNBC cohort.Between January 1,2007 and December 31,2014,a total of 292 female TNBC patients with BRCA1/2 mutation were enrolled.We performed logistic regression analysis in patients without BRCA1/2 germline mutation(n=261)and BRCA1/2 germline mutation patients(n=31),respectively,to assess the risk factors affecting the incidence of second primary cancer.We then performed interactive analysis on the above two analyses to evaluate the interactive effect between BRCA1/2 germline mutation and postoperative radiotherapy.P<0.05 indicates a statistically significant difference.The research was approved by Fudan University Shanghai Cancer Center TNBC Ethics Committee(050432-4-2108),and each patient provided written informed consent.Results:Logistic regression analysis in patients with BRCA1/2 germline mutations showed that postoperative radiotherapy significantly increased the risk of secondary primary disease compared to non-radiotherapy[odds ratio(OR)=2.475,95%confidence interval(CI):1.933-3.167,P<0.001].In patients without BRCA1/2 germline mutation,the effect of radiotherapy on the incidence of second primary tumor was not significant.There was a significant interaction between BRCA1/2 germline mutation and postoperative radiotherapy for the incidence of secondary primary cancer(OR=9.710,95%CI:0.320-295.250,P=0.193).Conclusion:Although statistical analysis results show that patients with BRCA1/2 germline mutations have an increased risk of developing a second primary tumor after postoperative radiotherapy compared to patients who have not received radiotherapy,there is no significant correlation between BRCA1/2 germline mutations and radiotherapy for the development of a second primary tumor.Therefore,patients with BRCA1/2 germline mutations who receive radiotherapy after surgery may not increase the risk of developing a second primary tumor.

Background and Aims:The success of thyroid surgery largely depends on an accurate understanding and proper handling of cervical anatomical structures. As a key anatomical landmark,the middle cervical fascia plays a critical role in thyroid lobe resection and precise identification of the recurrent laryngeal nerve (RLN) during thyroid surgery. However,existing anatomical literature provides limited descriptions of the middle cervical fascia and surrounding spaces. This study was performed to explore the anatomical characteristics of the middle cervical fascia and its adjacent spaces in detail,providing more accurate anatomical evidence and practical guidance to improve the safety and efficacy of thyroid surgery.Methods:First,systematic anatomical studies were conducted on formalin-fixed cadaveric specimens. During the dissections,the structural features of the middle cervical fascia and its surrounding spaces were meticulously recorded,with special attention to its relationships with the thyroid gland,common carotid artery,and infrahyoid muscles. Second,real-time observations and records were made during thyroid surgery on patients with thyroid cancer. The appearance of the middle cervical fascia and changes in related anatomical structures were documented during surgery. Results:Both cadaveric dissections and intraoperative observations revealed that the middle cervical fascia is closely attached to the thyroid gland medially,while laterally it extends across the surface of the common carotid artery to the infrahyoid muscles. When the fascial plane was incised,important structures such as adipose tissue,lymph nodes,RLN,middle thyroid vein,inferior thyroid artery,and inferior thyroid vein were clearly observed. Additionally,it was found that the RLN is enveloped by a thin layer of fascia and adipose tissue. Intraoperative findings showed that RLN exposure techniques based on the middle cervical fascia significantly facilitated RLN identification and improved surgical efficacy. Conclusion:The middle cervical fascia is a key supportive structure on the thyroid surface and an independent fascial plane critical for tissue dissection and precise RLN exposure during thyroid surgery. A deeper understanding of the anatomy of the middle cervical fascia and its surrounding spaces is essential for ensuring the safety and effectiveness of thyroid surgery.

The process of embryo implantation is a multifaceted and intricate dynamic event that includes the development of endometrial receptivity, embryo localization, adhesion, and invasion. Adhesion molecules, acting as crucial mediators of communication between cells or between cells and the extracellular matrix, are essential for the maintenance of endometrial receptivity and the regulation of embryo localization, adhesion, and invasion. However, the mechanisms by which adhesion molecules of maternal and embryo are organized to regulate key events in the peri-implantation period have yet to be fully explored. Based on recent research findings, this review provides a summary of the functions of different adhesion molecules at the maternal-fetal interface and their potential regulatory mechanisms according to the key progress of embryo implantation. In particular, we discussed the interactions between decidual immune cells and other cells mediated by adhesion molecules during the invasion process, which will provide novel perspectives into the role of adhesion molecule dysfunction in contributing to implantation failure.

The process of embryo implantation is a multifaceted and intricate dynamic event that includes the development of endometrial receptivity, embryo localization, adhesion, and invasion. Adhesion molecules, acting as crucial mediators of communication between cells or between cells and the extracellular matrix, are essential for the maintenance of endometrial receptivity and the regulation of embryo localization, adhesion, and invasion. However, the mechanisms by which adhesion molecules of maternal and embryo are organized to regulate key events in the peri-implantation period have yet to be fully explored. Based on recent research findings, this review provides a summary of the functions of different adhesion molecules at the maternal-fetal interface and their potential regulatory mechanisms according to the key progress of embryo implantation. In particular, we discussed the interactions between decidual immune cells and other cells mediated by adhesion molecules during the invasion process, which will provide novel perspectives into the role of adhesion molecule dysfunction in contributing to implantation failure.

Background and Aims:The success of thyroid surgery largely depends on an accurate understanding and proper handling of cervical anatomical structures. As a key anatomical landmark,the middle cervical fascia plays a critical role in thyroid lobe resection and precise identification of the recurrent laryngeal nerve (RLN) during thyroid surgery. However,existing anatomical literature provides limited descriptions of the middle cervical fascia and surrounding spaces. This study was performed to explore the anatomical characteristics of the middle cervical fascia and its adjacent spaces in detail,providing more accurate anatomical evidence and practical guidance to improve the safety and efficacy of thyroid surgery.Methods:First,systematic anatomical studies were conducted on formalin-fixed cadaveric specimens. During the dissections,the structural features of the middle cervical fascia and its surrounding spaces were meticulously recorded,with special attention to its relationships with the thyroid gland,common carotid artery,and infrahyoid muscles. Second,real-time observations and records were made during thyroid surgery on patients with thyroid cancer. The appearance of the middle cervical fascia and changes in related anatomical structures were documented during surgery. Results:Both cadaveric dissections and intraoperative observations revealed that the middle cervical fascia is closely attached to the thyroid gland medially,while laterally it extends across the surface of the common carotid artery to the infrahyoid muscles. When the fascial plane was incised,important structures such as adipose tissue,lymph nodes,RLN,middle thyroid vein,inferior thyroid artery,and inferior thyroid vein were clearly observed. Additionally,it was found that the RLN is enveloped by a thin layer of fascia and adipose tissue. Intraoperative findings showed that RLN exposure techniques based on the middle cervical fascia significantly facilitated RLN identification and improved surgical efficacy. Conclusion:The middle cervical fascia is a key supportive structure on the thyroid surface and an independent fascial plane critical for tissue dissection and precise RLN exposure during thyroid surgery. A deeper understanding of the anatomy of the middle cervical fascia and its surrounding spaces is essential for ensuring the safety and effectiveness of thyroid surgery.

Objective:To evaluate the effect of resveratrol on radiation-induced myocardial injury in mice.Methods:A total of 80 C57BL/6 mice were randomly divided into the control group, resveratrol (Res) group, radiation (RT) group and radiation+resveratrol (RT+Res) group. In the RT group, mice were given with heart radiation and mice in the Res group were given with resveratrol by gavage for 3 months. Cardiac ultrasound was used to evaluate cardiac function at 3 months after cardiac radiation. The hearts of mice were collected for HE staining, immunofluorescence, TUNEL staining, Masson staining and Western blot to evaluate the expression of silent information regulator 1 (SIRT1), the level of oxidative stress, inflammatory response, apoptosis and the degree of fibrosis in myocardial tissues. Experimental data were expressed as Mean ± SD. Continous data were statistically analyzed by t-test. Results:After 3 months of irradiation, compared with the control group, the ejection fraction (EF) and fractional shortening (FS) of cardiac function were decreased, and myocardial degeneration and disorder, reactive oxygen species (ROS) and inflammatory levels (interleukin-1β, interleukin-6, tumor necrosis factor-α), myocardial apoptosis (TUNEL positive cell rate) and fibrosis were increased in the RT group. In the RT+Res group, the cardiac function was improved, the expression of SIRT1 was increased, and the levels of oxidative stress, inflammation, myocardial apoptosis and fibrosis were decreased.Conclusions:Resveratrol can reduce oxidative stress, inflammatory infiltration, apoptosis and fibrosis of myocardium in mice with radiation-induced myocardial injury, thereby improving cardiac structural abnormalities and cardiac dysfunction. This protective effect can be mediated by upregulation of SIRT1 expression.

OBJECTIVE To explore the influence of Zingiber officinale and processed Z. officinale on pharmacodynamic indexes and intestinal flora on gastric ulcer rats with spleen -stomach deficiency and cold type before and after processing with sand . METHODS The SD rats were randomly divided into normal group ，model group ，positive control group （Compound tianqi weitong capsule 0.45 g/kg），Z. officinale high-dose（15.0 g/kg）and low -dose（7.5 g/kg）groups，processed Z. officinale high- dose（15.0 g/kg）and low -dose（7.5 g/kg）groups，with 10 rats in each group . The rat model of gastric ulcer with spleen -stomach deficiency and cold type was established by intragastric administration of vinegar （day 1-10）and absolute ethanol （day 11）. Administration groups were given relevant liquid intragastrically ，and normal group and model group were given water intragastrically（day 5-10）. One hour after intragastric administration of absolute ethanol ，blood was taken from the femoral artery of rats ，the serum contents of motilin （MTL），gastrin（GAS），epidermal growth factor （EGF）as well as 4 items of blood coagulation [activated partial thromboplastin time （APTT），prothrombin time （PT），thrombin time （TT），fibrinogen（FIB）] were detect. The ulcer index and inhibition rate of ulcer in gastric tissue were calculated . The pathological changes of gastric tissue were observed，and the number and area of erosions were recorded . The diversity of gut microbiota in fecal samples of rats was detected . RESULTS Compared with model group ，the contents of MTL （except for processed Z. officinale low-dose group ），GAS（except for processed Z. officinale low-dose group ），EGF（except forofficinale groups） and FIB （except for Z. officinale groups），inhibitory rate of ulcer （only positive control group ）were all increased significantly （P＜0.05）. APTT（except for Z. officinale groups），PT（only processed Z. officinale high- dose group ），TT（except for Z. officinale groups），ulcer index （except for Z. officinale groups），the number （except for Z. officinale groups）and area of erosions （except for Z. officinale groups）were shortened and decreased significantly （P＜0.05）； improvement effects of processed Z. officinale were better than those of the same dose of Z. officinale on EGF ，4 items of blood coagulation（except for PT ，TT，FIB of processed Z. officinale low-dose group ），ulcer index （except for processed Z. officinale low-dose group ）and inhibitory rate of ulcer （P＜0.05）. Compared with model group ，α diversity indexes as ACE ，Shannon and Simpson of intestinal microorganisms in rats were increased significantly in processed Z. officinale group；the relative abundance of Proteobacteria was decreased significantly in processed Z. officinale group，while that of Bacteroidetes was increased significantly （P＜0.05）； the relative abundance of Limosilactobacillus was decreased significantly in Z. officinale group （P＜0.05）. CONCLUSIONS Z. officinale and processed Z. officinale can improve the symptoms of spleen -stomach deficiency and cold ，and enhance gastrointestinal function by increasing the content of GAS and MTL . Processed Z. officinale can significantly inhibit gastric ulcer of spleen -stomach deficiency and cold type ，which is related to the promotion of mucosal protection and repair ，improvement of coagulation functionand adjustment of gut microbiotadisorder .