Objective:To evaluate the effectiveness,safety and economics of absorbable drug-eluting coronary stent systems using rapid health technology assessment tools,and to provide evidence-based basis for rational use for clinicians use and expert evaluation.Methods:A computer search was performed on PubMed,CNKI,Wanfang,VIP and other databases from 1 January 2014 to 1 January 2023 for relevant literature on patients with coronary artery disease who were treated with coronary artery stent interventional surgery.The 210 collected literatures were screened and extracted according to the inclusion and exclusion criteria,and the literature quality evaluation was carried out.The extracted data related to the intravascular thrombosis rate,myocardial infarction rate,cardiac mortality rate,all-cause mortality rate,target lesion revascularization rate and intravascular adverse event incidence of absorbable drug-eluting coronary stents and drug-eluting coronary stents were meta-analyzed by Revman5.4 software.Results:7 studies were ultimately included in the comparative study of absorbable drug-eluting coronary stents and drug-eluting coronary stents.The thrombosis rate,all-cause mortality rate and intravascular adverse event rate of absorbable drug-eluting coronary stents were lower than those of drug-eluting coronary stents,and the difference was statistically significant(Z=2.16,1.89,2.22,P＜0.05).There were no statistically significant difference in the myocardial infarction rate,cardiac mortality rate and target lesion revascularization rate between absorbable drug-eluting coronary stents and drug-eluting coronary stents(P＞0.05).Conclusion:There was no significant difference in safety and efficacy between absorbable drug-eluting coronary stents and drug-eluting coronary stents.In terms of economy,the cost of absorbable drug-eluting coronary stents is significantly higher than that of drug-eluting coronary stents,and patients can choose stents according to their own economic conditions and other actual conditions.

Objective:To summarize the clinical, pathological and molecular characteristics of various types of pediatric glioma, and to explore the differences in the morphology and clinical significance among various types of pediatric glioma.Methods:Based on the fifth edition of the World Health Organization classification of central nervous system tumors, this study classified or reclassified 111 pediatric gliomas that were diagnosed at Guangzhou Medical University Affiliated Women and Children′s Medical Center from January 2020 to June 2023. The clinical manifestations, imaging findings, histopathology, and molecular characteristics of these tumors were analyzed. Relevant literature was also reviewed.Results:The 111 patients with pediatric glioma included 56 males and 55 females, with the age ranging from 10 days to 13 years (average age, 5.5 years). Clinically, manifestations presented from 5 days to 8 years before the diagnosis, including epilepsy in 16 cases, increased intracranial pressure in 48 cases and neurological impairment in 66 cases. MRI examinations revealed tumor locations as supratentorial in 43 cases, infratentorial in 65 cases, and spinal cord in 3 cases. There were 73 cases presented with a solid mass and 38 cases with cystic-solid lesions. The largest tumor diameter ranged from 1.4 to 10.6 cm. Among the 111 pediatric gliomas, there were 6 cases of pediatric diffuse low-grade glioma (pDLGG), 63 cases of circumscribed astrocytoma glioma (CAG), and 42 cases of pediatric diffuse high-grade glioma (pDHGG). Patients with pDLGG and CAG were younger than those with pDHGG. The incidence of pDLGG and CAG was significantly lower in the midline of the infratentorial region compared to that of pDHGG. They were more likely to be completely resected surgically. The pDLGG and CAG group included 4 cases of pleomorphic xanthoastrocytoma, showing histological features of high-grade gliomas. Among the high-grade gliomas, 13 cases were diffuse midline gliomas and also showed histological features of low-grade glioma. Immunohistochemical studies of H3K27M, H3K27ME3, p53, ATRX, BRAF V600E, and Ki-67 showed significant differences between the pDLGG and CAG group versus the pDHGG group ( P<0.01). Molecular testing revealed that common molecular variations in the pDLGG and CAG group were KIAA1549-BRAF fusion and BRAF V600E mutation, while the pDHGG group frequently exhibited mutations in HIST1H3B and H3F3A genes, 1q amplification, and TP53 gene mutations. With integrated molecular testing, 2 pathological diagnoses were revised, and the pathological subtypes of 35.3% (12/34) of the pediatric gliomas that could not be reliably classified by histology were successfully classified. Conclusions:There are significant differences in clinical manifestations, pathological characteristics, molecular variations, and prognosis between the pDLGG, CAG and pDHGG groups. The integrated diagnosis combining histology and molecular features is of great importance for the accurate diagnosis and treatment of pediatric gliomas.

Objective:To study the effect of insulin intraperitoneal administration combined with dietary intervention on glycemic regulation in in KKAy mice with spontaneous type 2 diabetes.Methods:An animal model of type 2 diabetes was established, and healthy C57BL/6J mice were selected as the normal control group and healthy KKAy mice as the non-disease group. The successfully modeled KKAy mice were randomly divided into the subcutaneous group, the intraperitoneal group, and the untreated group. The non-disease group was given a maintenance diet, and all other groups were fed a high-fat, high-sugar diet. The daily feeding time was from 08:00 to 20:00, with one feeding at a 4-hour interval, for a total of four times. The subcutaneous and intraperitoneal groups were given subcutaneous and intraperitoneal insulin injections before feeding, and recombinant glargine insulin injection (subcutaneous group: 0.125 IU/g; intraperitoneal group: 0.250 IU/g) was injected before the first feeding, and biosynthetic human insulin injection (subcutaneous group: 0.075 IU/g; intraperitoneal group: 0.125 IU/g) was injected after a 0.5 h interval; the rest 3 times before feeding, the biosynthetic human insulin injection (subcutaneous group: 0.075 IU/g; intraperitoneal group: 0.125 IU/g) was injected for 4 weeks. The dietary intake, body mass, fasting blood glucose, and 1 and 2 h postprandial blood glucose of mice in each group were tested regularly, and an oral glucose tolerance test was performed.Results:The total dietary intake of mice in the intraperitoneal group was lower than that in the subcutaneous group. Compared with the initial body mass, the body mass of the mice in the subcutaneous and intraperitoneal groups decreased by 5.05 and 3.59 g at week 4, respectively. The changes of fasting blood glucose in the subcutaneous and intraperitoneal groups ranged from 5.4 to 9.4 and 5.4 to 6.4 mmol/L, respectively, and the changes of 1 h postprandial blood glucose ranged from 4.6 to 12.3 and 5.7 to 8.9 mmol/L, respectively, and the changes of 2 h postprandial blood glucose ranged from 2.5 to 9.8 and 3.8 to 7.1 mmol/L, respectively. For the glucose tolerance index, the intraperitoneal group showed improvement at all time points, and the subcutaneous group showed a decrease at all time points except for 0 and 60 min.Conclusions:In combination with dietary intervention, insulin intraperitoneal injection was more effective in controlling blood glucose in KKAy mice with spontaneous type 2 diabetes compared with subcutaneous insulin injection, and had a significant improvement in glucose tolerance.

Objective:To investigate the effects of pre-pregnancy health examination combined with standardized health care during pregnancy on the pregnancy outcome at advanced maternal age.Methods:A total of 300 pregnant women who visited the Perinatal Clinic of the First Affiliated Hospital, School of Medicine, Shihezi University, China who received treatment between September 2018 and September 2019 were included in this study. They were divided into three groups according to pre-pregnancy health examination and heath care during pregnancy. In the observation group ( n = 78), pregnant women received pre-pregnancy health examination and health care during pregnancy on time and regularly. In the control group 1 ( n = 110): pregnant women did not receive pre-pregnancy health examination or regular health care during pregnancy. In the control group 2 ( n = 112), pregnant women received pre-pregnancy health examination or regular heath care during pregnancy. The pregnancy outcome was compared among three groups. The pre-pregnancy health examination and regular health care during pregnancy in women at advanced maternal age were correlated with gestational hypertension, gestational diabetes mellitus, premature delivery and other pregnancy risks. Results:There were significant differences in premature delivery (20.5%, 9.8%, 2.7%), gestational hypertension (23.1%, 12.5%, 3.6%), gestational diabetes mellitus (19.2%, 8.9%, 2.7%), premature rupture of membrane (17.9%, 10.7%, 3.6%), postpartum hemorrhage (12.8%, 8.0%, 1.8%), gestational anemia (19.2%, 8.0%, 2.7%) and placental abruption (7.7%, 8.0%, 0.9%) among control group 1, control group 2, and observation group ( χ2 = 16.047, 16.376, 14.724, 10.489, 8.781, 15.380, 6.744, all P < 0.05). The rate of cesarean section rate in the control group 1, control group 2, and observation group was statistically significant (70.5%, 44.6% and 27.3%, χ2 = 34.468, P < 0.05). There were significant differences in the incidence rates of macrosomia (15.4%, 8.9%, 2.7%), low birth weight infants (11.5%, 5.4%, 0.0%), stillbirth or late-term abortion (10.3%, 4.7%, 0.9%), neonatal asphyxia (16.7%, 7.1%, 1.8%) among the control group 1, control group 2 and observation group ( χ2 = 9.654, 12.840, 8.979, 14.284, all P < 0.05). Conclusion:The risk of adverse pregnancy outcomes is increased at advanced maternal age. Pre-pregnancy health examination combined with standardized health care during pregnancy can improve the pregnancy outcomes at advanced maternal age.

Objective:To investigate the clinicopathological features of gonadal neoplastic related lesions in children with disorders of sexual development (DsD).Methods:The clinical manifestations, chromosomal karyotype, histology and immunophenotype of 12 cases of neoplastic related lesions from Guangzhou Women and Children′s Medical Center, Guangzhou were analyzed during Jan 2015 to May 2020.Results:Twelve cases of neoplastic related lesions were screened in 205 cases of DsD, and 6 patients with gonadal germ cell neoplasia aged 3-13 years with an average age of 8.3 years. There were 2 males and 4 females. Clinical features showed malformation of external genitalia in 2 cases, short stature in 2 cases, clitoral enlargement in 1 case, lower abdominal pain and a huge pelvic mass in 1 case. Chromosomal karyotyping of peripheral blood showed 2 cases of 46XY and 4 cases of 45X/46XY. Fourteen gonadal specimens were examined. Microscopically, 1 case showed dysgerminoma in left ovary, and malignant mixed germ cell tumors in right ovary, as well as gonadoblastoma (GB) and undifferentiated gonadal tissue (UGT). The remaining 5 cases were all precursor lesions of germ cell tumor. Six specimens showed GB, 3 of UGT, and 3 specimens showed germ cell neoplasia in situ (GCNIS), one of which was accompanied by intratubular seminoma and 1 was GB with GCNIS. The other 6 patients with DsD were aged from 8 months to 2 years and 5 months, including 5 males and 1 females. Clinical manifestations showed 5 cases of hypospadias and 1 case of bilateral indirect inguinal hernia. Microscopically, 6 cases showed maturation delay of gonocytes in seminiferous tubules. Immunohistochemically, the primordial germ cells/gonocytes expressed OCT3/4, PLAP and c-KIT in the 12 cases.Conclusion:Gonadal neoplasia in children with DsD is mainly precursor lesions of germ cell tumor and improved understanding of these lesions is of great significance.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

Objective:To study the effect of insulin intraperitoneal injection on abnormal blood lipid intype 2 diabetic KKAy mice.Methods:Type 2 diabetic mice model was established by feeding high fat and high sugar diet. KKAy model mice were randomly divided into intraperitoneal injection group ( n=6), subcutaneous injection group ( n=6) and no-treatment group ( n=3). At the same time, healthy C57BL/6J mice were selected as normal group ( n=6), and healthy KKAy mice as disease-free group ( n=6). The treatment process was divided into two stages. The first stage consists of 6 weeks, in which the mice in the intraperitoneal and subcutaneous groups were treated with insulin intraperitoneally and subcutaneously respectively. The second stage consists of 4 weeks, in which the mice in intraperitoneal and subcutaneous groups were subcutaneously injected with insulin. The mice in the remaining 3 groups were not treated. The changes of related indicators were detected every two weeks, including body weight, fasting blood sugar, 2 hours after meal blood sugar, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C). Results:Changing the injection solution in the medium term of the treatment had no effect on the body mass and blood sugar of KKAy mice with type 2 diabetes. Under this condition, the effect of intraperitoneal injection of insulin on HDL-C and LDL-C is significantly better than that of subcutaneous injection. Besides, both injection solutions are effective in regulating TG, but the effect of reducing total cholesterol is not obvious.Conclusions:The intraperitoneal injection of insulin has a certain effect on the blood lipid abnormality of type 2 diabetic KKAy mice. It can promote the increase of HDL-C, the decrease of LDL-C, and the decrease of TG.

Emerging adult patients with Type 1 diabetes mellitus (T1DM) appear to have a reduced opportunities on learning and exercise, a decreased skill in learning and work, a lower degree of social support due to fear and avoidance of social interaction. This study aimed to assess the level of social avoidance and distress in emerging adults with T1DM, and to explore the correlation between social avoidance and distress and self-management or glycemic control. : A total of 342 T1DM patients aged 18-30 years old were recruited from 8 tertiary hospitals in Hunan Province from September 2014 to February 2019. The questionnaire included general information questionnaire, the Social Avoidance and Distress Scale (SAD), and Self-management Scale of Type 1 Diabetes for Chinese Adults (SMOD-CA). The total scores of SAD in emerging adult patients with T1DM were compared with those of norm. Correlation between glycated hemoglobin (HbA1c) and social avoidance and distress of emerging adult patients with T1DM was analyzed. : The total score of SAD (11.13±6.18) in emerging adults with T1DM was significantly higher than that in healthy adults (=77.06, <0.01). Pearson correlation analysis showed that the scores of SAD, social avoidance subscale, and social distress subscale were negatively correlated with the scores of SMOD-CA (all <0.01), and they were positively correlated with HbA1c (all <0.01). Multivariate linear regression analysis showed that social avoidance and distress, self-management, gender, and educational level were independent influential factors for HbA1c in emerging adults with T1DM. : The degree of social avoidance and distress of emerging adult patients with T1DM is higher than that of healthy people. The higher the degree of social avoidance and distress, the lower the level of self-management and the worse the control of blood sugar. Attention should be paid to social avoidance and distress in emerging adults with T1DM, and targeted interventions should be formulated.
Adolescent ; Adult ; Blood Glucose ; Cross-Sectional Studies ; Diabetes Mellitus, Type 1 ; Glycated Hemoglobin A ; analysis ; Humans ; Self-Management ; Surveys and Questionnaires ; Young Adult

Objective To analysis changes in species distribution of pathogenic dermatophytes from patients with tinea capitis in the Hangzhou Third Hospital between 2015 and 2017.Methods Demographic and mycological data were collected from 321 patients with confirmed tinea capitis in the Hangzhou Third Hospital between 2015 and 2017,and analyzed retrospectively.Results Of the 321 patients with tinea capitis,180 were males,and 141 were females.Their age of onset ranged from 1 month to 70 years.There were 154 (47.9％) preschool children and 13 (4.0％) adults.A total of 321 fungal strains were isolated,including 159 (49.5％) strains of Microsporum canis,110 (34.3％) strains of Trichophyton mentagrophytes,38 (11.8％) strains of Trichophyton violaceum,8 (2.5％) strains of Trichophyton tonsurans,4 (1.2％) strains of Microsporum gypseum,and 2 (0.6％) strains of Trichophyton rubrum.There was no significant difference in the distribution of fungal species (x2 =9.09,P ＞ 0.05) or the proportion of anthropophilic and non-anthropophilic dermatophytes among different age groups (x2 =1.85,P ＞ 0.05).The proportion of non-anthropophilic dermatophytes significantly differed among 2015,2016 and 2017 (x2 =23.82,P ＜ 0.01).From 2015 to 2017,the proportions of Microsporum canis were 32.5％,47.6％ and 59.6％ respectively,and the proportions of Trichophyton mentagrophytes were 53.0％,35.4％ and 23.7％ respectively.Conclusions During 2015-2017,the main population with tinea capitis in Hangzhou Third Hospital was preschool children.Moreover,the main pathogenic dermatophyte was Microsporum canis,whose proportion gradually increased year by year,followed by Trichophyton mentagrophytes,whose proportion gradually decreased year by year.

Objective To determine the important functional units of medical endoscopes and provide a theoretical basis for improving the maintenance and repair of hospital medical equipment.Methods The units of medical endoscopes were analyzed by the failure mode effects and criticality analysis (FMECA) method to determine the important functional unit.The maintenance methods of the important functional units were proposed and compared with those obtained by a medical equipment repair company.Results According to the risk priority number (RPN) score＞ 36,the important functional units of the medical endoscope were determined as electrical interface,water bottle interface,suction interface,housing,chain,pliers pipeline,water gas pipeline,jacket,charge coupled device (CCD) glass,guided beam glass and nozzles.These units require clinical operators to focus on and perform regular maintenances.Compared with the results obtained by the company,human factors were considered as a greater impact on the reliability of medical endoscopes.Conclusions For clinical operators,the operation training of medical endoscopes should be strengthened to avoid human-induced failures.