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

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To explore the correlation between the diameter of patients'autologous tendon and the prognosis of anterior cruciate ligament(ACL)reconstruction surgery.Methods From October 2018 to October 2023,82 patients who underwent anterior cruciate ligament reconstruction surgery at Wuxi No.904 Hospital were selected.Based on whether complications occurred after the anterior cruciate ligament reconstruction surgery,they were divided into a group with good prognosis(n=64)and a group with poor prognosis(n=18).Performing univariate analysis on the prognosis of anterior cruciate ligament reconstruction surgery.Pearson correlation analysis was used to analyze the relationship between tendon diameter and prognosis.A multifactorial Logistic regression model was applied to analyze the factors influencing the prognosis of ACL reconstruction and construct a nomogram.The diagnostic efficacy of tendon diameter on the prognosis of ACL reconstruction was analyzed using the receiver operating characteristic(ROC)curve.Results The results of the univariate analysis showed that there were statistically significant differences in gender and age between the two groups(P＜0.05).The tendon diameter and cross-sectional area in the group with a good prognosis were higher than those in the group with a poor prognosis(P＜0.05).Post-treatment,the Lysholm,Tegner,and IKDC scores in the group with a good prognosis were higher than those in the group with a poor prognosis(P＜0.05).Pearson correlation analysis showed a significant positive correlation between the patient's tendon diameter and Lysholm,Tegner,and IKDC scores(r=0.417,0.411、0.446,P＜0.05).Logistic analysis indicated that gender,age,tendon diameter,and tendon cross-sectional area are factors affecting the prognosis of ACL reconstruction(P＜0.05).The ROC curve results showed that the combined diagnostic effect of gender,age,tendon diameter,and cross-sectional area is significantly better than any single factor alone.Conclusion There is a significant correlation between the patient's autologous tendon diameter and the prognosis of ACL reconstruction surgery.An increase in autologous tendon diameter enhances knee joint function and improves patient prognosis.

Objective To explore the correlation between the diameter of patients'autologous tendon and the prognosis of anterior cruciate ligament(ACL)reconstruction surgery.Methods From October 2018 to October 2023,82 patients who underwent anterior cruciate ligament reconstruction surgery at Wuxi No.904 Hospital were selected.Based on whether complications occurred after the anterior cruciate ligament reconstruction surgery,they were divided into a group with good prognosis(n=64)and a group with poor prognosis(n=18).Performing univariate analysis on the prognosis of anterior cruciate ligament reconstruction surgery.Pearson correlation analysis was used to analyze the relationship between tendon diameter and prognosis.A multifactorial Logistic regression model was applied to analyze the factors influencing the prognosis of ACL reconstruction and construct a nomogram.The diagnostic efficacy of tendon diameter on the prognosis of ACL reconstruction was analyzed using the receiver operating characteristic(ROC)curve.Results The results of the univariate analysis showed that there were statistically significant differences in gender and age between the two groups(P＜0.05).The tendon diameter and cross-sectional area in the group with a good prognosis were higher than those in the group with a poor prognosis(P＜0.05).Post-treatment,the Lysholm,Tegner,and IKDC scores in the group with a good prognosis were higher than those in the group with a poor prognosis(P＜0.05).Pearson correlation analysis showed a significant positive correlation between the patient's tendon diameter and Lysholm,Tegner,and IKDC scores(r=0.417,0.411、0.446,P＜0.05).Logistic analysis indicated that gender,age,tendon diameter,and tendon cross-sectional area are factors affecting the prognosis of ACL reconstruction(P＜0.05).The ROC curve results showed that the combined diagnostic effect of gender,age,tendon diameter,and cross-sectional area is significantly better than any single factor alone.Conclusion There is a significant correlation between the patient's autologous tendon diameter and the prognosis of ACL reconstruction surgery.An increase in autologous tendon diameter enhances knee joint function and improves patient prognosis.

Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.
Male ; Female ; Humans ; Aged ; Natriuretic Peptide, Brain ; Simendan/therapeutic use* ; Non-ST Elevated Myocardial Infarction ; Heart Failure/drug therapy* ; Peptide Fragments ; Arrhythmias, Cardiac ; Biomarkers ; Prognosis

Objective To discuss the effect of Anemarrhenae Rhizoma with different proportions on the dissolution of 6 inorganic elements(K,Ti,Sr,Ba,Ca,Mg)in Gypsum Fibrosum under different compatibility based on grey correlation analysis and technique for order preference by similarity to an ideal solution(TOPSIS)method and to provide reference for clinical application.Methods Inductively coupled plasma mass spectrometry(ICP-MS)was established for simultaneous analysis of inorganic elements K,Ti,Sr,Ba,Ca,Mg in Gypsum Fibrosum-Anemarrhenae Rhizoma.The gray correlation ananlysis and TOPSIS method were used to comprehensively analyze the changes of six inorganic elements in Gypsum Fibrosum under different compatibility.Results The findings of the ICP-MS determination of inorganic elements in Gypsum Fibrosum-Anemarrhenae Rhizoma were good in terms of linearity,precision,repeatability and stability.The average recovery was 81.78％-104.13％,and the RSD was 2.10％-4.62％(n=6).The dissolution of six inorganic elements in Gypsum Fibrosum after compatibility with different proportions of Anemarrhena Rhizoma was significantly higher than that of Gypsum Fibrosum single decoction(P＜0.05).The dissolution scores of six inorganic elements in Gypsum Fibrosum were the highest when the compatibility proportion of Gypsum Fibrosum-Anemarrhenae Rhizoma was 30∶9.Conclusion ICP-MS is a sensitive and accurate method for determining K,Ti,Sr,Ba,Ca and Mg in Gypsum Fibrosum-Anemarrhenae Rhizoma.The best compatibility ratio of Gypsum Fibrosum-Anemarrhenae Rhizoma is 30:9,which can effectively improve the dissolution of six inorganic elements in Gypsum Fibrosum,and provide the basis for the further compatibility study of Gypsum Fibrosum and Anemarrhenae Rhizoma.

Arecae Semen, as the first place among "Four South Medicines" in China, has great dual-use value of medicine and food. The research of Arecae Semen was mainly focused on the active ingredients and efficacy value, and its potential safety hazards were also concerned. Until now, there is still a lack of clear boundaries between medicine and food, resulting in its safety cannot be guaranteed. Therefore, it is of great significance to establish clear boundaries of medicine and food use and health risk assessment. In this paper, the differences of pretreatment and application methods of Arecae Semen were analyzed, and the research progress of Arecae Semen in chemical composition identification and toxicology research and safety evaluation were reviewed emphatically. Finally, the differences of quality control and safety evaluation of Arecae Semen in pharmacopoeias or standards were analyzed at home and abroad. It was expected to provide reference value for quality control, safety evaluation and international standardization research of Arecae Semen.
Areca ; China ; Drugs, Chinese Herbal/adverse effects* ; Seeds ; Semen

【Objective】 To explore the effect of prostate volume on outcomes of nerve sparing laparoscopic radical prostatectomy(nsLRP) and investigate its predictive value for postoperative continence recovery. 【Methods】 A retrospective study was conducted on 178 patients with low risk prostate cancer(PCa) who underwent nsLRP from January 2004 to June 2018. All the patients included had normal preoperative urinary function, a mean age of 66 years(range 46~88), a median PSA level of 6.9 μg/L(range 0.6~10.0) and a mean body mass index of(24±5) kg/m². The correlation of prostate volume with perioperative data was assessed by using Spearman correlation coefficient. Univariate and multivariate Cox regression analyses were employed to identify prognostic predictors for postoperative continence recovery. 【Results】 Increased prostate volume was significantly correlated with older age(rs=0.370, P<0.001), higher PSA level(rs=0.168, P=0.025), lower biopsy Gleason score(rs=-0.165, P=0.027), lower pathological T stage(rs=-0.152, P=0.042) and Gleason score(rs=-0.182, P=0.015), longer operative time(rs=0.239, P=0.001) and greater estimated blood loss(rs= 0.181, P=0.016). The continence rates in the 3rd, 6th, and 12th month after surgery were 64.0%(114/178), 88.2% (157/178), and 96.1%(171/178), respectively. Univariate and multivariate Cox analysis showed that patient age(RR= 0.528, 95% CI: 0.381~0.730) and prostate volume(RR=0.598, 95% CI: 0.412~0.869) were independent predictors of continence recovery. 【Conclusions】 Larger prostate volume was associated with older age, higher PSA level, lower tumor stage and grade, greater intraoperative blood loss and longer operative time in low risk PCa patients. Older age and increased prostate volume may independently predict poor continence recovery after nsLRP.

Objective: To understand the consistency of ALK Ventana-D5F3 immunohistochemistry (IHC) interpretation in Chinese lung adenocarcinoma among histopathologists from different hospitals, and to recommend solution for the problems found during the interpretation of ALK IHC in real world, with the aim of the precise selection of patients who can benefit from ALK targeted therapy. Methods: This was a multicenter and retrospective study. A total of 109 lung adenocarcinoma cases with ALK Ventana-D5F3 IHC staining were collected from 31 lung cancer centers in RATICAL research group from January to June in 2018. All cases were scanned into digital imaging with Ventana iSCANcoreo Digital Slide Scanning System and scored by 31 histopathologists from different centers according to ALK binary (positive or negative) interpretation based on its manufacturer′s protocol. The cases with high inconsistency rate were further analyzed using FISH/RT-PCR/NGS. Results: There were 49 ALK positive cases and 60 ALK negative cases, confirmed by re-evaluation by the specialist panel. Two cases (No. 2302 and No.2701) scored as positive by local hospitals were rescored as negative, and were confirmed to be negative by RT-PCR/FISH/NGS. The false interpretation rate of these two cases was 58.1% (18/31) and 48.4% (15/31), respectively. Six out of 31 (19.4%) pathologists got 100% accuracy. The minimum consistency between every two pathologists was 75.8%.At least one pathologist gave negative judgement (false negative) or positive judgement (false positive) in the 49 positive or 60 negative cases, accounted for 26.5% (13/49), 41.7% (25/60), respectively, with at least one uncertainty interpretation accounted for 31.2% (34/109). Conclusion There are certain heterogeneities and misclassifications in the real world interpretation of ALK-D5F3 IHC test, which need to be guided by the oncoming expert consensus based on the real world data.