Objective:To investigate the effect of "four-staff co-management" follow-up mode on risk factor control and medium-term prognosis improvement in patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:This was a intervention study. Patients with coronary heart disease who were admitted to the Xiamen Cardiovascular Hospital of Xiamen University from June 2021 to January 2022 and successfully discharged after PCI were included. According to the different types of follow-up after discharge, patients were divided into the traditional follow-up group and the "four-staff co-management" follow-up group. The "four-staff co-management" follow-up mode means that specialists, specialist managers in third-level A hospitals and general practitioners and health managers in basic hospitals were jointly responsible for post-discharge follow-up of PCI patients. Baseline clinical data were collected. The primary endpoints were the rate of compliance of coronary heart disease risk factor control at 12 months after surgery, the rate of secondary surgery, and the incidence of mid-term major adverse cardiovascular and cerebrovascular events (MACCE). Unplanned secondary PCI included symptom-driven secondary PCI and asymptomatic secondary PCI. MACCE includes myocardial infarction, hospitalization for heart failure, stroke, major bleeding, all-cause death, and composite endpoints including these events.Results:A total of 2 181 patients were enrolled, including 1 097 patients in the traditional follow-up group and 1 084 patients in the "four-staff co-management" follow-up group. At baseline, there were no statistically significant differences in gender, age, discharge diagnosis, co-existing diseases, echocardiographic indexes, and coronary artery lesions between the two groups (all P>0.05). There were no significant differences between the two groups in total PCI stent length, maximum internal diameter of stent, proportion of patients using drug balloon, proportion of patients with a planned second surgery during hospitalization, and discharge with drugs (all P>0.05). Twelve months after PCI, the reduction in HbA1c and low-density lipoprotein cholesterol was greater in the "four-staff co-management " follow-up group than that in the traditional follow-up group (all P<0.05), and the rate of reaching the standard for low-density lipoprotein cholesterol was higher than that in the traditional follow-up group ( P=0.001), but there was no statistical significance between the two groups for blood pressure and blood glucose (all P>0.05). During the follow-up period, the proportion of symptom-driven second operation patients was lower in the "four-staff co-management" follow-up group than that in the traditional follow-up group ( P<0.001), and there was no significant difference in the proportion of asymptomatic second operation patients between the two groups ( P=0.191). The proportion of hospitalized patients with heart failure in the "four-staff co-management" follow-up group was lower than that in the traditional follow-up group ( P=0.029), and there was no significant difference in the proportion of myocardial infarction, cerebral infarction, cerebral hemorrhage, massive hemorrhage, death and complex endpoint events between the two groups (all P>0.05). Conclusion:The "four-staff co-management" follow-up mode can effectively improve the control of risk factors and medium-term prognosis in patients with coronary heart disease after PCI.

Proprotein convertase subtilisin/KEXIN type 9(PCSK9)is the ninth member of the pro pro-tein convertase family and released into the blood-stream.It reduces the availability of low-density li-poprotein receptors and leads to the accumulation of low-density lipoprotein cholesterol in plasma,thereby promoting the development of atheroscle-rotic plaques and thrombotic events.In addition to its classical pathway,recent studies have demon-strated multiple non-classical pathways by which PCSK9 influences the development of atherosclero-sis-related diseases,including participation in in-flammatory responses,regulation of autophagy and cell apoptosis,promotion of platelet activation and thrombus formation,etc.This article provides an overview of the latest progress in the molecular mechanism by which PCSK9 affects atherosclerotic diseases through non-lipid-dependent pathways.

Proprotein convertase subtilisin/KEXIN type 9(PCSK9)is the ninth member of the pro pro-tein convertase family and released into the blood-stream.It reduces the availability of low-density li-poprotein receptors and leads to the accumulation of low-density lipoprotein cholesterol in plasma,thereby promoting the development of atheroscle-rotic plaques and thrombotic events.In addition to its classical pathway,recent studies have demon-strated multiple non-classical pathways by which PCSK9 influences the development of atherosclero-sis-related diseases,including participation in in-flammatory responses,regulation of autophagy and cell apoptosis,promotion of platelet activation and thrombus formation,etc.This article provides an overview of the latest progress in the molecular mechanism by which PCSK9 affects atherosclerotic diseases through non-lipid-dependent pathways.

Objective:To investigate the effect of "four-staff co-management" follow-up mode on risk factor control and medium-term prognosis improvement in patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:This was a intervention study. Patients with coronary heart disease who were admitted to the Xiamen Cardiovascular Hospital of Xiamen University from June 2021 to January 2022 and successfully discharged after PCI were included. According to the different types of follow-up after discharge, patients were divided into the traditional follow-up group and the "four-staff co-management" follow-up group. The "four-staff co-management" follow-up mode means that specialists, specialist managers in third-level A hospitals and general practitioners and health managers in basic hospitals were jointly responsible for post-discharge follow-up of PCI patients. Baseline clinical data were collected. The primary endpoints were the rate of compliance of coronary heart disease risk factor control at 12 months after surgery, the rate of secondary surgery, and the incidence of mid-term major adverse cardiovascular and cerebrovascular events (MACCE). Unplanned secondary PCI included symptom-driven secondary PCI and asymptomatic secondary PCI. MACCE includes myocardial infarction, hospitalization for heart failure, stroke, major bleeding, all-cause death, and composite endpoints including these events.Results:A total of 2 181 patients were enrolled, including 1 097 patients in the traditional follow-up group and 1 084 patients in the "four-staff co-management" follow-up group. At baseline, there were no statistically significant differences in gender, age, discharge diagnosis, co-existing diseases, echocardiographic indexes, and coronary artery lesions between the two groups (all P>0.05). There were no significant differences between the two groups in total PCI stent length, maximum internal diameter of stent, proportion of patients using drug balloon, proportion of patients with a planned second surgery during hospitalization, and discharge with drugs (all P>0.05). Twelve months after PCI, the reduction in HbA1c and low-density lipoprotein cholesterol was greater in the "four-staff co-management " follow-up group than that in the traditional follow-up group (all P<0.05), and the rate of reaching the standard for low-density lipoprotein cholesterol was higher than that in the traditional follow-up group ( P=0.001), but there was no statistical significance between the two groups for blood pressure and blood glucose (all P>0.05). During the follow-up period, the proportion of symptom-driven second operation patients was lower in the "four-staff co-management" follow-up group than that in the traditional follow-up group ( P<0.001), and there was no significant difference in the proportion of asymptomatic second operation patients between the two groups ( P=0.191). The proportion of hospitalized patients with heart failure in the "four-staff co-management" follow-up group was lower than that in the traditional follow-up group ( P=0.029), and there was no significant difference in the proportion of myocardial infarction, cerebral infarction, cerebral hemorrhage, massive hemorrhage, death and complex endpoint events between the two groups (all P>0.05). Conclusion:The "four-staff co-management" follow-up mode can effectively improve the control of risk factors and medium-term prognosis in patients with coronary heart disease after PCI.

OBJECTIVE To explore the effect of changing lifestyle diet in the treatment of laryngeal reflux disease(LRPD).METHODS A total of 92 patients with LRPD who received outpatient treatment in the Second Affiliated Hospital of Fujian Medical University from January 2022 to June 2023 were selected as the study control,divided into control group(46 cases)and treatment group(46 cases).The control group was treated with conventional acid suppression and gastric motogenic therapy.The treatment group was treated on the basis of the control group with giving guidance on lifestyle and diet.The changes of reflux symptom index scale(RSI)and reflux sign score scale(RFS)and the clinical efficacy of the two groups were compared 8 weeks and 12 weeks after treatment.RESULTS RSI total score was improved 8 weeks after treatment compared with before treatment in both RSI control group and treatment group(P＜0.05).The total RSI score of 12 weeks after treatment was improved compared with that of 8 weeks after treatment in both control and treatment groups(P＜0.05).The total RFS score at 8 weeks after treatment was improved in both control group and treatment group compared with before treatment(P＜0.05).Compared with 8 weeks after treatment,the total RFS score in both control group and treatment group was improved(P＜0.05).After 8 weeks of treatment,the total effective rate of the control group(60.9%)was compared with that of the treatment group(71.7%),and there was no significant difference between the two groups(χ2=1.335,P=0.513).After 12 weeks of treatment,the total effective rate of the control group(73.9%)was compared with the total effective rate of the treatment group(91.3%),and the difference between the two groups was statistically significant(χ2=6.226,P=0.044).CONCLUSION The change of lifestyle and diet should become an important part of the treatment of LRPD.By adjusting the unhealthy lifestyle and diet,the symptoms of patients can be significantly reduced and better clinical efficacy can be obtained.

Objective:This study aimed to explore the ″special″ review points and ethical strategies in the ethical review of medical research involving children, providing references for the medical research on this group.Methods:Combining the physical and mental characteristics of children, and comparing clinical research ethics review points, this study discussed the key aspects to be concerned about in the ethical review of medical research involving children, and proposed " special protection" strategies to be implemented.Results:Ethics committees should fully recognize the uniqueness of child development. The definition of minimal risk in the child population needs to be fully understood at the risk-benefit assessment stage, to develop ethical responses to the risk-benefit ratios in different situations, and to avoid special risks. Informed consent procedures should adhere to basic principles while respecting dissenting voices by designing multiple versions of informed consent for research, and developing informed consent countermeasures for vulnerable children groups.Conclusions:Medical research involving children should follow more rigorous and scientific procedures to protect rights, standardize clinical research in pediatric healthcare, and promote the healthy development of pediatric health endeavors.

Madelung's disease is more common in male patients who drink alcohol. It can affect many parts of the body, but rarely affects scrotum. A case of Madelung's disease involving the scrotum was reported. The scrotum tumor was removed by operation and good results were obtained. No recurrence was found in the follow-up of 14 months. Surgical resection could be an effective treatment for this disease.

Brain decoding based on functional magnetic resonance imaging has recently enabled the identification of visual perception and mental states. However, due to the limitations of sample size and the lack of an effective reconstruction model, accurate reconstruction of natural images is still a major challenge. The current, rapid development of deep learning models provides the possibility of overcoming these obstacles. Here, we propose a deep learning-based framework that includes a latent feature extractor, a latent feature decoder, and a natural image generator, to achieve the accurate reconstruction of natural images from brain activity. The latent feature extractor is used to extract the latent features of natural images. The latent feature decoder predicts the latent features of natural images based on the response signals from the higher visual cortex. The natural image generator is applied to generate reconstructed images from the predicted latent features of natural images and the response signals from the visual cortex. Quantitative and qualitative evaluations were conducted with test images. The results showed that the reconstructed image achieved comparable, accurate reproduction of the presented image in both high-level semantic category information and low-level pixel information. The framework we propose shows promise for decoding the brain activity.

Objective To investigate the diagnostic value of prostate specific antigen density (PSAD),Gleason score and serum ferritin (SF) in bone metastases from prostate cancer.Methods 45 patients diagnosed with bone metastases from prostate cancer in our hospital from January 2015 to October 2017 were selected as metastasis group.90 cases without bone metastases in prostate cancer were selected as control group.The PSAD,SF and Gleason scores of the two groups were measured and compared.Receiver operating characteristic (ROC) curve was used to analyze the three indexes to predict the clinical value of bone metastases in patients with prostate cancer.Results The serum PSA,SF,prostate volume,PSAD levels in metastasis group were significantly higher than those in the control group,with statistically significant difference (P ＜ 0.05);the average Gleason scores metastasis group were significantly higher than the control group (P ＜ 0.05);The sensitivity and specificity of SF combined with PSAD and Gleason score diagnosis in patients with prostate cancer bone metastasis was 95.64％ and 91.30％ respectively,the area under the curve (AUC) value is 0.930.Conclusions Detection and analysis of PSAD,SF,and Gleason scores in patients with prostate cancer will help to evaluate whether or not the patients have bone metastases.

OBJECTIVE:To investigate the characteristics of pediatric drug-induced liver injury (DILI) in China,and to provide reference for reducing ADR.METHODS:Using"liver injury liver damage hepatotoxicity hepatitis liver disease""drug induced children" as keywords,related domestic literatures were retrieved from CNKI and Wanfang database during 2007-2016,clinical information of DILI children in literatures were recorded in detail and analyzed comprehensively.RESULTS:A total of 363 literatures were retrieved,including 13 effective literatures and 665 children in total.There were 424 boys (63.76％)and 241 girls (36.24％),with ratio of 1.76 ∶ 1.The youngest child was 1 month old,the oldest child was 14 years old;the average age was 7.87 years,337 children aged more then 7 years old,accounting for 50.68％.Top 3 primary diseases were respiratory tract infection (40 cases,31.50％),hematologic diseases (29 cases,22.83％) and tumor (14 cases,11.02％).Top 3 pediatric DILI-inducing drug types were antibiotics (245 cases,34.41％),TCM (143 cases,20.08％) and antipyretic analgesics (113 cases,15.87％).DILI usually happened within 4 weeks (332 cases,82.18％).The most common clinical classification was hepatocellular type (382 cases,65.30％).The severity of liver injury was mainly mild and moderate (505 cases,86.32％),and 80 cases were severe (13.68％),including 31 cases of hepatic failure (5.30％).Clinical symptoms mainly manifested as anorexia,jaundice,nausea,vomiting,hypodynamia and abdominal discomfort.After drug withdreawd and treatment,96.54％ of the patients were recovered or cured,and 4 cases died (0.60％).CONCLUSIONS:Under the premise of rational use of drugs,it is necessary to carry out medication education and supervision for antibiotics,TCM and antipyretic analgesics which mainly induce pediatric DILI,pay attention to allergic history and evaluate the progress of extrahepatic symptoms.When ADR occurred,the timely and drug withdrawal intervention are conducted to improve good prognosis.