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 compare the gut fungal composition between gout patients and healthy individuals through high-throughput sequencing of ribosomal DNA internal transcribed spacer 1(ITS1).Methods Gout patients and healthy volunteers who visited our hospital from January 2023 to December 2024 were enrolled in this study.Then based on established medical guidelines,the gout patients were categorized into 3 groups:Group H(asymptomatic hyperuricemia,n=14),Group G(acute gouty arthritis,n=14),and Group I(intercritical period of gouty arthritis,n=15),and the healthy individuals were assigned into Group N(n=9).Fecal samples were collected from all the participants to undergo ITS1 sequencing analysis.The differences in diversity and composition of gut mycobiome,and FunGuild-derived fungal functions and nutritional status were compared among the 4 groups,and the correlation between the gut mycobiome and clinical indicators was analyzed.Results There were no significant differences in baseline features such as gender,age,glomerular filtration rate(GFR),and levels of serum creatinine(SCr)and serum urea among Group N and other gout groups,but obvious differences were observed in body mass index(BMI),erythrocyte sedimentation rate,and levels of C-reactive protein(CRP),serum uric acid(SUA),and IL-1β and IL-6(P<0.05).In terms of gut fungal diversity,ITS1 analysis showed there were no statistical differences in α-diversity or the principal coordinate analysis(PCoA)of β-diversity among the groups.However,as gout progressed,significant changes were observed in β-diversity indices,indicating a shift in the gut fungal community composition with disease advancement(P<0.05).The phyla Ascomycota,Basidiomycota,and Mucoromycotina were the dominant fungal phyla in all groups.Compared with the other 3 gout groups,the abundance of Pichia was significantly increased in Group N(P<0.05),that of Saccharomyces was in Group H(P<0.05),and that of Starmerella was in Group G(P<0.05).Correlation analysis between the gut mycobiome and clinical indices indicated that the relative abundance of Starmerella was significantly positively correlated with IL-1β(P<0.01)and IL-6(P<0.05).The relative abundance of Pichia was significantly positively correlated with IL-1β and IL-6 levels(P<0.05),and negatively correlated with serum urea level(P<0.05),and the relative abundance of Saccharomyces was negatively correlated with IL-1β and IL-6 levels(P<0.05).Conclusion There exist significant alterations in both the diversity and composition of gut fungi among patients with gout at various stages.Notably,the fluctuations in the relative abundance of Starmerella,Pichia and Saccharomyces appear to correlate with key clinical indicators.

Objective To investigate the effect of oral fish oil on wound healing and related indexes in patients with diabetic foot ulcer(DFU).Methods A randomized,double-blind,placebo-controlled design was used to recruit 68 patients with DFU aged 18-80 years old in the hospital,and the baseline clinical data of the patients were collected.The patients were randomly divided into experimental group(32 cases,fish oil soft capsule,3 g/d)and control group(33 cases,corn oil soft capsule,3 g/d)by random number generated by Ex-cel,and the intervention lasted for 12 weeks.The primary endpoints included the proportion of complete wound healing and healing area≥50%.The secondary endpoints included wound area,healing time,inflamma-tion index,glucose metabolism index,nutrition related index and wound reinfection.Additionally,the influen-cing factors of wound healing were analyzed.Results After intervention,the proportion of complete wound healing and healing area≥50%in the experimental group was significantly higher than that in the control group(P=0.007,0.039).In the subjects with complete wound healing,the mean healing time in the experi-mental group was shorter than that in the control group,but the difference was not statistically significant(P=0.132).The reduction area of wound area in the experimental group was significantly larger than that in the control group(P=0.045).The decrease of interleukin(IL)-6 and IL-8 in the experimental group was significantly higher than that in the control group(P<0.05).There was no significant difference in the reduc-tion of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),neutrophil-to-lymphocyte ratio(NLR),glycated hemoglobin A1c(HbA1c)and platelet-to-lymphocyte ratio(PLR)between the two groups(P>0.05).The improvement of prealbumin(PA)in the experimental group was higher than that in the control group,but the difference was not statistically significant(P>0.05).Multivariate logistic regression analysis showed that oral fish oil intervention(OR=6.771,95%CI:1.787-25.652),HbA1c(OR=4.149,95%CI:1.026-16.770)and ulcer type(OR=4.319,95%CI:1.026-18.173)were the influencing factors of wound healing(P<0.05).Conclusion Oral fish oil promotes wound healing in patients with DFU,which may be re-lated to improving the level of chronic inflammation in the body.

Objective The characteristics of the time-scheduled appointment late arrival of outpatients in thoracic surgery at West China Hospital Sichuan University were analyzed.Methods A total of 9 378 cases of thoracic surgery patients were extracted from the HIS system of West China Hospital of Sichuan University in 2019.The normal patients were used as the control group,and the late patients were analyzed by SPSS 24.0 software.Results Age,gender,place of origin,type of consultation,consultation time,appointment method,expert level,and consultation time were the influencing factors of lateness,and the differences were statistically significant(P＜0.05).The lateness rate of patients is highest on Monday,reaching 34.6%,the lateness rate is highest between＞08:30-09:00 every morning,reaching 78.1%,and the lateness rate is highest between＞13:00-13:30 in the afternoon,reaching 65.7%.Conclusion Patients who are late for medical appointments have certain characteristics.Therefore,solutions need to be proposed based on relevant characteristics to improve patients'compliance with medical appointments within the appointment time period.

Objective The characteristics of the time-scheduled appointment late arrival of outpatients in thoracic surgery at West China Hospital Sichuan University were analyzed.Methods A total of 9 378 cases of thoracic surgery patients were extracted from the HIS system of West China Hospital of Sichuan University in 2019.The normal patients were used as the control group,and the late patients were analyzed by SPSS 24.0 software.Results Age,gender,place of origin,type of consultation,consultation time,appointment method,expert level,and consultation time were the influencing factors of lateness,and the differences were statistically significant(P＜0.05).The lateness rate of patients is highest on Monday,reaching 34.6%,the lateness rate is highest between＞08:30-09:00 every morning,reaching 78.1%,and the lateness rate is highest between＞13:00-13:30 in the afternoon,reaching 65.7%.Conclusion Patients who are late for medical appointments have certain characteristics.Therefore,solutions need to be proposed based on relevant characteristics to improve patients'compliance with medical appointments within the appointment time period.

Objective The characteristics of the time-scheduled appointment late arrival of outpatients in thoracic surgery at West China Hospital Sichuan University were analyzed.Methods A total of 9 378 cases of thoracic surgery patients were extracted from the HIS system of West China Hospital of Sichuan University in 2019.The normal patients were used as the control group,and the late patients were analyzed by SPSS 24.0 software.Results Age,gender,place of origin,type of consultation,consultation time,appointment method,expert level,and consultation time were the influencing factors of lateness,and the differences were statistically significant(P＜0.05).The lateness rate of patients is highest on Monday,reaching 34.6%,the lateness rate is highest between＞08:30-09:00 every morning,reaching 78.1%,and the lateness rate is highest between＞13:00-13:30 in the afternoon,reaching 65.7%.Conclusion Patients who are late for medical appointments have certain characteristics.Therefore,solutions need to be proposed based on relevant characteristics to improve patients'compliance with medical appointments within the appointment time period.

Objective The characteristics of the time-scheduled appointment late arrival of outpatients in thoracic surgery at West China Hospital Sichuan University were analyzed.Methods A total of 9 378 cases of thoracic surgery patients were extracted from the HIS system of West China Hospital of Sichuan University in 2019.The normal patients were used as the control group,and the late patients were analyzed by SPSS 24.0 software.Results Age,gender,place of origin,type of consultation,consultation time,appointment method,expert level,and consultation time were the influencing factors of lateness,and the differences were statistically significant(P＜0.05).The lateness rate of patients is highest on Monday,reaching 34.6%,the lateness rate is highest between＞08:30-09:00 every morning,reaching 78.1%,and the lateness rate is highest between＞13:00-13:30 in the afternoon,reaching 65.7%.Conclusion Patients who are late for medical appointments have certain characteristics.Therefore,solutions need to be proposed based on relevant characteristics to improve patients'compliance with medical appointments within the appointment time period.

Objective The characteristics of the time-scheduled appointment late arrival of outpatients in thoracic surgery at West China Hospital Sichuan University were analyzed.Methods A total of 9 378 cases of thoracic surgery patients were extracted from the HIS system of West China Hospital of Sichuan University in 2019.The normal patients were used as the control group,and the late patients were analyzed by SPSS 24.0 software.Results Age,gender,place of origin,type of consultation,consultation time,appointment method,expert level,and consultation time were the influencing factors of lateness,and the differences were statistically significant(P＜0.05).The lateness rate of patients is highest on Monday,reaching 34.6%,the lateness rate is highest between＞08:30-09:00 every morning,reaching 78.1%,and the lateness rate is highest between＞13:00-13:30 in the afternoon,reaching 65.7%.Conclusion Patients who are late for medical appointments have certain characteristics.Therefore,solutions need to be proposed based on relevant characteristics to improve patients'compliance with medical appointments within the appointment time period.

Objective The characteristics of the time-scheduled appointment late arrival of outpatients in thoracic surgery at West China Hospital Sichuan University were analyzed.Methods A total of 9 378 cases of thoracic surgery patients were extracted from the HIS system of West China Hospital of Sichuan University in 2019.The normal patients were used as the control group,and the late patients were analyzed by SPSS 24.0 software.Results Age,gender,place of origin,type of consultation,consultation time,appointment method,expert level,and consultation time were the influencing factors of lateness,and the differences were statistically significant(P＜0.05).The lateness rate of patients is highest on Monday,reaching 34.6%,the lateness rate is highest between＞08:30-09:00 every morning,reaching 78.1%,and the lateness rate is highest between＞13:00-13:30 in the afternoon,reaching 65.7%.Conclusion Patients who are late for medical appointments have certain characteristics.Therefore,solutions need to be proposed based on relevant characteristics to improve patients'compliance with medical appointments within the appointment time period.

Objective The characteristics of the time-scheduled appointment late arrival of outpatients in thoracic surgery at West China Hospital Sichuan University were analyzed.Methods A total of 9 378 cases of thoracic surgery patients were extracted from the HIS system of West China Hospital of Sichuan University in 2019.The normal patients were used as the control group,and the late patients were analyzed by SPSS 24.0 software.Results Age,gender,place of origin,type of consultation,consultation time,appointment method,expert level,and consultation time were the influencing factors of lateness,and the differences were statistically significant(P＜0.05).The lateness rate of patients is highest on Monday,reaching 34.6%,the lateness rate is highest between＞08:30-09:00 every morning,reaching 78.1%,and the lateness rate is highest between＞13:00-13:30 in the afternoon,reaching 65.7%.Conclusion Patients who are late for medical appointments have certain characteristics.Therefore,solutions need to be proposed based on relevant characteristics to improve patients'compliance with medical appointments within the appointment time period.