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 predictive value of the neutrophil-to-lymphocyte ratio (NLR) and soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) for the risk of severe community-acquired pneumonia (CAP) in elderly patients.Methods:A total of 109 elderly CAP patients admitted to Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from November 2023 to May 2024 were included. The patients were classified into severe group and non-severe group according to the severity of the disease. Inflammatory markers including NLR, sTREM-1, platelet-to-lymphocyte ratio (PLR), procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) were compared between severe group and non-severe group. Levels of NLR, sTREM-1, and PLR on days one, four and seven after admission in 27 elderly patients with severe CAP were dynamically monitored. Statistical analyses were performed using two independent sample t-test and Mann-Whitney U test. The predictive factors for severe CAP in elderly patients were analyzed by multivariate logistic regression analysis, and receiver operating characteristic (ROC) curve was used to evaluate the efficacy of each indicator for predicting severe CAP in elderly patients. Results:There were 36 cases in severe group, and 73 cases in non-severe group. The levels of NLR, sTREM-1, PLR, PCT, CRP and IL-6 were significantly higher in the severe group than those in the non-severe group ( Z=-5.77, -3.48, -2.84, -3.94, -3.36 and -3.25, respectively; all P<0.01). Multivariate logistic regression analysis revealed that NLR and sTREM-1 were independent predictive factors for severe CAP in elderly patients (odds ratio ( OR) =1.112, 95% confidence interval ( CI) 1.000 to 1.235, P=0.049; OR=1.006, 95% CI 1.000 to 1.012, P=0.034). The ROC curve showed that the optimal cut-off value was 5.679 for NLR, and the area under the curve (AUC) was 0.841, with the sensitivity and specificity of 0.833 and 0.753, respectively. The optimal cut-off value of sTREM-1 was 151.275 ng/L (AUC was 0.731), with the sensitivity and specificity of 0.639 and 0.639, respectively. The AUC of the combined detection of NLR and sTREM-1 was 0.839, with the sensitivity and specificity of 0.944 and 0.630, respectively. The levels of sTREM-1 ((121.84±75.04) ng/L vs (179.06±85.44) ng/L), NLR (6.74±4.40 vs 11.87±7.78), and PLR (210.07±129.93 vs 294.91±187.61) on the 7th day of admission in 27 elderly patients with severe CAP were significantly lower than those on the 1st day ( t=-3.396, -3.492 and -3.396, respectively, P=0.005, 0.004 and 0.005, respectively). Conclusions:NLR and sTREM-1 have certain predictive value for the risk of severe CAP in elderly patients.

Objective:To explore the predictive value of the neutrophil-to-lymphocyte ratio (NLR) and soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) for the risk of severe community-acquired pneumonia (CAP) in elderly patients.Methods:A total of 109 elderly CAP patients admitted to Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from November 2023 to May 2024 were included. The patients were classified into severe group and non-severe group according to the severity of the disease. Inflammatory markers including NLR, sTREM-1, platelet-to-lymphocyte ratio (PLR), procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) were compared between severe group and non-severe group. Levels of NLR, sTREM-1, and PLR on days one, four and seven after admission in 27 elderly patients with severe CAP were dynamically monitored. Statistical analyses were performed using two independent sample t-test and Mann-Whitney U test. The predictive factors for severe CAP in elderly patients were analyzed by multivariate logistic regression analysis, and receiver operating characteristic (ROC) curve was used to evaluate the efficacy of each indicator for predicting severe CAP in elderly patients. Results:There were 36 cases in severe group, and 73 cases in non-severe group. The levels of NLR, sTREM-1, PLR, PCT, CRP and IL-6 were significantly higher in the severe group than those in the non-severe group ( Z=-5.77, -3.48, -2.84, -3.94, -3.36 and -3.25, respectively; all P<0.01). Multivariate logistic regression analysis revealed that NLR and sTREM-1 were independent predictive factors for severe CAP in elderly patients (odds ratio ( OR) =1.112, 95% confidence interval ( CI) 1.000 to 1.235, P=0.049; OR=1.006, 95% CI 1.000 to 1.012, P=0.034). The ROC curve showed that the optimal cut-off value was 5.679 for NLR, and the area under the curve (AUC) was 0.841, with the sensitivity and specificity of 0.833 and 0.753, respectively. The optimal cut-off value of sTREM-1 was 151.275 ng/L (AUC was 0.731), with the sensitivity and specificity of 0.639 and 0.639, respectively. The AUC of the combined detection of NLR and sTREM-1 was 0.839, with the sensitivity and specificity of 0.944 and 0.630, respectively. The levels of sTREM-1 ((121.84±75.04) ng/L vs (179.06±85.44) ng/L), NLR (6.74±4.40 vs 11.87±7.78), and PLR (210.07±129.93 vs 294.91±187.61) on the 7th day of admission in 27 elderly patients with severe CAP were significantly lower than those on the 1st day ( t=-3.396, -3.492 and -3.396, respectively, P=0.005, 0.004 and 0.005, respectively). Conclusions:NLR and sTREM-1 have certain predictive value for the risk of severe CAP in elderly patients.

Objective:To investigate the therapeutic effect of carbon dioxide laser tonsillectomy.Method:In this prospective,randomized study, One hundred and two patients were divided into laser group or control group. Patients of laser group were cured with carbon dioxide laser tonsillectom,and the control group was cured with routine method. All operations are executed by one person. Observation index included operation time, hemorrhage in operation, ache after operation, inflammatory reaction of raw surface, repair time of raw surface, rehaemorrhagia and scar.Result:Laser group had advantages of less operation time, less hemorrhage, less ache and less inflammatory reaction of raw surface. Laser group have hemorrhage in operation (7.2±2.1)ml, while control group have hemorrhage in operation (92.0±35.0)ml. Laser group have pseudomembrane early but desquamate late.Conclusion:Carbon dioxide laser tonsillectomy is effective to relieve pain, inflammatory reaction and with less time ,it's an safe , efficient and mini-trauma operation.

OBJECTIVE: To investigate the therapeutic effect of carbon dioxide laser tonsillectomy. METHOD: In this prospective, randomized study, One hundred and two patients were divided into laser group or control group. Patients of laser group were cured with carbon dioxide laser tonsillectomy, and the control group was cured with routine method. All operations are executed by one person. Observation index included operation time, hemorrhage in operation, ache after operation, inflammatory reaction of raw surface, repair time of raw surface, rehaemorrhagia and scar. RESULT: Laser group had advantages of less operation time, less hemorrhage, less ache and less inflammatory reaction of raw surface. Laser group have hemorrhage in operation (7.2 +/- 2.1) ml, while control group have hemorrhage in operation (92.0 +/- 35.0) ml. Laser group have pseudomembrane early but desquamate late. CONCLUSION Carbon dioxide laser tonsillectomy is effective to relieve pain, inflammatory reaction and with less time, it's a safe, efficient and mini-trauma operation.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Lasers, Gas ; Male ; Middle Aged ; Prospective Studies ; Tonsillectomy ; methods ; Treatment Outcome ; Young Adult

OBJECTIVE To investigate the epidemic features of allergic rhinitis at out-patient in western area of China(Chengdu in Sichuan province, Chongqing, Urumchi in Xinjiang province, Nanning in Guangxi province). METHODS A questionnaire survey on AR, rhinology examination and skin prick test were carried out among 2267 AR patients at out-patient, from Mar. 2005 to Dec. 2006. RESULTS The incidence rate of sneezing、runny nose、stuffy nose、itchy nose were 88%, 89.19%, 85.58%, 83.58% respectively. 43.80% of AR patients had inherent predisposition that 25.50% had hereditary AR and 13.45% had hereditary asthma. 46.98% of AR patients had other allergic diseases, among them 10.50% combined with asthma. According to the classification criteria of Haikou in 1997 and ARIA in 2001, there were mainly seasonal AR and mild intermittent AR in Urumchi area, while perennial AR and moderate-severe persistent AR in other areas. There was a significant impairment in Quality of life that 50% were always upset and 40% didn't sleep well and more than 10% had emotional affections. CONCLUSION We had got epidemic data such as characteristics of clinical presentation of AR at out-patient in western of China. Strategy of prevention and treatment of AR should be worked out according to the epidemic feature of AR.