Objective To discuss the causes of abnormal arterial pressure waveforms occurring during coronary angiography(CAG)and percutaneous coronary intervention(PCI).Methods A total of 760 patients,who received CAG and PCI at Nanjing Municipal First Hospital of China from September 2023 to March 2024,were enrolled in this study.The abnormal arterial pressure waveforms were collected,and their morphological features and causes were analyzed.Results A total of 848 abnormal waveforms were recorded,and based on the morphology these abnormal waveforms were classified into 8 types.Three most commonly-seen abnormal waveforms were nested waveform(22.76％,n=193),atypical waveform(21.11％,n=179)and attenuated waveform(15.57％,n=132).The causes of the abnormal waveforms could be classified into 5 categories.The top three reasons were technical operation factors(n=445,52.49％),vascular factors(n=214,25.23％),and individual factors of the patient(n=101,11.91％).In the specific abnormal reasons,the ostial lesions and spasm of the coronary arteries accounted for the largest proportion(n=183,21.57％).Conclusion Accurate identification of abnormal waveforms is essential for the prevention of complications in performing CAG and PCI procedure.The technical operation factors are the main causes for the occurrence of abnormal waveform.

Allogeneic hematopoietic stem cell transplantation is an effective method for treating various hematological diseases. Membranous nephropathy is the second leading cause of novo glomerular disease after transplantation. Protocadherin FAT1 is a target antigen for diagnosing membranous nephropathy, primarily related to hematopoietic stem cell transplantation. Here we report a rare case of membranous nephropathy after hematopoietic stem cell transplantation. The target antigen of membranous nephropathy was confirmed to be FAT1 by pathology combined with mass spectrometry analysis. The nephrotic syndrome achieved partial remission after corticosteroid combined with cyclosporine treatment, and the patient's condition was stable during follow-up.

Objective:To investigate the risk factors for bleeding and thrombosis during extracorporeal membrane oxygenation (ECMO) therapy in critically ill patients and determine the best predictors of coagulation-related complications.Methods:A retrospective analysis was performed on patients who received ECMO for respiratory or circulatory failure at Xiangya Hospital of Central South University from January 2020 to December 2022. The outcome was whether bleeding or thrombosis occurred from 24 h after ECMO insertion to before weaning. The differences in demographic characteristics, weaning conditions, prognosis, routine blood tests, organ function, coagulation and blood product transfusion of each group were compared. Logistic regression analysis was used to evaluate the risk factors for bleeding and thrombosis, and ROC curve evaluation was used to assess their capacity to predict complications.Results:A total of 61 patients with ECMO were enrolled, with 21 cases of bleeding and 14 cases of thrombosis during ECMO. Compared with the nonbleeding group, the activated partial thromboplastin time, thromboplastin time (TT), and transfusions of frozen plasma and red blood cells were higher in the bleeding group (all P<0.05). Compared with the nonthrombotic group, the increase in body weight, D-dimer (DD), fibrinogen degradation product (FDP), and improvement of arterial oxygen partial pressure (ΔPO 2) within 24 h were significantly higher in the thrombotic group (all P<0.05). Logistic regression analysis revealed that TT ( OR=1.039, 95% CI: 1.006~1.072, P=0.018) and frozen plasma transfusion volume ( OR=1.046, 95% CI: 1.010-1.083, P=0.012) were risk factors for bleeding events. FDP ( OR=1.030, 95% CI: 1.009-1.051, P=0.005), DD ( OR=1.181, 95% CI: 1.044-1.336, P=0.008), and ΔPO 2 ( OR=1.007, 95% CI: 1.002-1.012, P=0.006) were risk factors for thrombosis. According to ROC curve analysis, the AUCs of TT, frozen plasma transfusion, and combined indexes for predicting bleeding were 0.712, 0.690, and 0.816, respectively. The combined indices had a cut-off value of 0.273, a sensitivity of 75.61%, and a specificity of 80.00%. The AUCs of FDP, DD, ΔPO 2, and combined FDP with ΔPO 2 for predicting thrombosis were 0.778, 0.748, 0.786, and 0.868, respectively. The cut-off value of the combined index was 0.157, the sensitivity was 68.09%, and the specificity was 92.86%. Conclusions:TT combined with frozen plasma transfusion volume predicted bleeding optimally, while FDP plus ΔPO 2 predicted thrombotic events better during ECMO treatment in critically ill patients.

Cholecystolithiasis with choledocholithiasis (CCL) is a common disease.The removal of common bile stone is a challenge for the surgery.This paper discussed the clinical application of three stone removal techniques including direct stone removal,irrigation and stone extraction by basket under cholangioscopy in order to take the stones effectively and safely,shorten the procedure time,avoid the injuries of common bile duct wall caused by the repetition of a single method such as biliary endoscopic stone extraction,reduce the difficulty of taking stone and enhance recovery of patients.

Objective To investigate infection situation and knowledge of high‐risk human papilloma virus(HPV)among women working in entertainment places in Gaoqiao area ,and provide theory evidences for making health education measures related to high‐risk HPV .Methods According to the systematic random sampling method ,entertainment female in Gaoqiao area were extracted , and normal women who participated in community gynecology census were extracted as control group .Then questionnaire investiga‐tion and laboratory testing were carried out .Results The infection rate of high‐risk HPV in entertainment female was 35 .18% , while in normal woman was 15 .84% ,there was significant differences of infection rate between the two groups (P<0 .05) .There were were only 16 women(14 .81% )and 17 women(16 .83% )had heard of information about HPV in two groups respectively ,and there was no statistically significant difference(P>0 .05) .The cognitive situation of whether a person with family history of cervi‐cal cancer should be regularly attend screening among the two groups of women was different ,and had significant difference(P<0 .05) .Conclusion Women who worked in entertainment places had higher infection rate of high‐risk HPV ,both of the two groups had poor knowledge of HPV .So the propaganda and screening of HPV should be strengthen in order to raise consciousness in pre‐venting cervical cancer .

Objective To explore new method to improve the teaching effects of complete denture prosthetics.Methods Totally 49 students were divided into 6 groups randomly.Lecture-based learning (LBL) combined with problem-based learning (PBL) methods were tried in complete denture prosthetics teaching.LBL teaching was made up of 18 class hours,in which teachers' teaching in the form of lecture was given priority to and introduction to basic theory of complete denture was focused on.PBL teaching was made up of 6 class hours in the form of small class ； the teaching plan ' new dentures of uncle Wang' compiled by the teaching and research section was taken as the blueprint；students searched for the references and discussed on the upcoming problems,relevant reasons and processing methods for wearing new dentures ； students made the final report.The effects were estimated by denture prosthodontics examination and PBL teaching feedback form.Data were described by percentage.Results 93.88％ students passed the exam,67.35％ students got good results.Feedback showed that 77.55％ students hold a positive attitude to PBL teaching.Conclusion Combining LBL with PBL in complete denture prosthetics teaching can achieve satisfactory results.