Objective To investigate the predictive value of PCSK9 gene rs562556 polymorphism for major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with type 2 diabetes mellitus(T2DM)complicated by acute myocardial infarction(AMI).Methods A total of 97 patients were involved in this study with T2DM complicated by AMI,who underwent PCI at The Third Affiliated Hospital of Qiqihar Medical University between January 2019 and December 2021.Based on MACE occurrence during a 2-year follow-up period,patients were divided into non-MACE group and MACE group(n=57 and 40,respectively).Clinical biochemical parameters,including blood glucose and lipid levels,were recorded.Plasma PCSK9 levels were assessed using enzyme-linked immunosorbent assay.Plasma PCSK9 gene rs562556 polymorphism was detected through sequencing.Kaplan-Meier curve analysis was performed to assess how rs562556 polymorphism impacts MACE incidence post-PCI.Multivariate logistic regression was applied to identify independent MACE-associated risk factors.ROC curve analysis was performed to evaluate the predictive value of rs562556 poly-morphism and key clinical variables for MACE occurrence post-PCI.Results Compared to the non-MACE group,patients in the MACE group exhibited significantly higher age,heart rate,creatinine,NT-proBNP,LDL-C,and plasma PCSK9 levels,along with higher hyper-tension and coronary atherosclerotic heart disease prevalence,and lower diastolic blood pressure(all P＜0.05).In patients with T2DM and AMI,the rs562556 genotype AA of the PCSK9 gene positively correlated with plasma PSCK9 levels(r=0.61,P＜0.000 1).The frequen-cies of the rs562556 genotype AA and allele A were significantly higher in the MACE compared to the non-MACE group(P＜0.05).The AA genotype of the PCSK9 gene rs562556 was associated with an increased risk of MACE during follow-up in patients with T2DM and AMI(P＜0.05).After adjusting for other confounding variables,advanced age,increased NT-proBNP and PCSK9 levels,and the rs562556 AA genotype were identified as independent risk factors for MACE post-PCI in this patient population.Combined analysis of these factors demonstrated superior predictive value for MACE occurrence compared to individual markers.Conclusion The PCSK9 gene rs562556 genotype AA is associated with a significantly increased risk of MACE within two years post-PCI in patients with T2DM and AMI,sug-gesting that it could serve as a promising predictive biomarker for post-PCI MACE in the given population.

Objective To investigate the predictive value of PCSK9 gene rs562556 polymorphism for major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with type 2 diabetes mellitus(T2DM)complicated by acute myocardial infarction(AMI).Methods A total of 97 patients were involved in this study with T2DM complicated by AMI,who underwent PCI at The Third Affiliated Hospital of Qiqihar Medical University between January 2019 and December 2021.Based on MACE occurrence during a 2-year follow-up period,patients were divided into non-MACE group and MACE group(n=57 and 40,respectively).Clinical biochemical parameters,including blood glucose and lipid levels,were recorded.Plasma PCSK9 levels were assessed using enzyme-linked immunosorbent assay.Plasma PCSK9 gene rs562556 polymorphism was detected through sequencing.Kaplan-Meier curve analysis was performed to assess how rs562556 polymorphism impacts MACE incidence post-PCI.Multivariate logistic regression was applied to identify independent MACE-associated risk factors.ROC curve analysis was performed to evaluate the predictive value of rs562556 poly-morphism and key clinical variables for MACE occurrence post-PCI.Results Compared to the non-MACE group,patients in the MACE group exhibited significantly higher age,heart rate,creatinine,NT-proBNP,LDL-C,and plasma PCSK9 levels,along with higher hyper-tension and coronary atherosclerotic heart disease prevalence,and lower diastolic blood pressure(all P＜0.05).In patients with T2DM and AMI,the rs562556 genotype AA of the PCSK9 gene positively correlated with plasma PSCK9 levels(r=0.61,P＜0.000 1).The frequen-cies of the rs562556 genotype AA and allele A were significantly higher in the MACE compared to the non-MACE group(P＜0.05).The AA genotype of the PCSK9 gene rs562556 was associated with an increased risk of MACE during follow-up in patients with T2DM and AMI(P＜0.05).After adjusting for other confounding variables,advanced age,increased NT-proBNP and PCSK9 levels,and the rs562556 AA genotype were identified as independent risk factors for MACE post-PCI in this patient population.Combined analysis of these factors demonstrated superior predictive value for MACE occurrence compared to individual markers.Conclusion The PCSK9 gene rs562556 genotype AA is associated with a significantly increased risk of MACE within two years post-PCI in patients with T2DM and AMI,sug-gesting that it could serve as a promising predictive biomarker for post-PCI MACE in the given population.

Objective To investigate the feasibility and accuracy of an ultrasound-based transfer learning artificial intelligence model in predicting the malignancy probability of partially cystic thyroid nodules(PCTN).Methods A retrospective analysis was conducted on 246 patients with PCTN who had definitive pathological results and were admitted to Weihai Municipal Hospital,Cheeloo College of Medicine,Shandong University from January 2021 to December 2023.Patients were randomly divided into training and test cohorts at a ratio of 7:3.Ultrasonic image features of PCTN were evaluated,and independent risk factors were identified using multivariate logistic regression analysis,with the area under the curve(AUC)subsequently calculated.Additionally,five different pre-trained models-Inception_v3,EfficientNet,VGG19,ResNet50,and DenseNet121-were selected for transfer learning after data preprocessing using the PyTorch framework in Python.The AUC values of these models were calculated and compared.Results Solid portion greater than 50%,eccentric acute angle,ill-defined margin,spiculated or microlobulated margin,rim calcification,and microcalcification exhibited statistically significant differences(P<0.05)in distinguishing between benign and malignant PCTN.The AUC value derived from these independent risk factors was 0.843.Furthermore,among the five transfer learning models evaluated,the ResNet50 model demonstrated the highest diagnostic efficiency,achieving an AUC value of 0.903 2.Conclusion The ultrasound-based transfer learning artificial intelligence model demonstrated superior performance compared to traditional ultrasound image evaluation methods,enabling accurate prediction of the nature of PCTN and thereby reducing unnecessary ultrasound-guided fine needle biopsies.

Objective To investigate the feasibility and accuracy of an ultrasound-based transfer learning artificial intelligence model in predicting the malignancy probability of partially cystic thyroid nodules(PCTN).Methods A retrospective analysis was conducted on 246 patients with PCTN who had definitive pathological results and were admitted to Weihai Municipal Hospital,Cheeloo College of Medicine,Shandong University from January 2021 to December 2023.Patients were randomly divided into training and test cohorts at a ratio of 7:3.Ultrasonic image features of PCTN were evaluated,and independent risk factors were identified using multivariate logistic regression analysis,with the area under the curve(AUC)subsequently calculated.Additionally,five different pre-trained models-Inception_v3,EfficientNet,VGG19,ResNet50,and DenseNet121-were selected for transfer learning after data preprocessing using the PyTorch framework in Python.The AUC values of these models were calculated and compared.Results Solid portion greater than 50%,eccentric acute angle,ill-defined margin,spiculated or microlobulated margin,rim calcification,and microcalcification exhibited statistically significant differences(P<0.05)in distinguishing between benign and malignant PCTN.The AUC value derived from these independent risk factors was 0.843.Furthermore,among the five transfer learning models evaluated,the ResNet50 model demonstrated the highest diagnostic efficiency,achieving an AUC value of 0.903 2.Conclusion The ultrasound-based transfer learning artificial intelligence model demonstrated superior performance compared to traditional ultrasound image evaluation methods,enabling accurate prediction of the nature of PCTN and thereby reducing unnecessary ultrasound-guided fine needle biopsies.

Objective:To analyze the association between the rs562556 polymorphism of the proprotein convertase subtilisin/kexin type 9(PCSK9)gene and the degree of coronary artery stenosis in the patients with acute myocardial infarction(AMI).Methods:A total of 200 patients diagnosed with AMI from January 2021 to December 2022 were selected as AMI group,and 200 healthy individuals during the same period were selected as control group.According to the Gensini scoring standard,the patients in AMI group were divided into low risk group(Gensini score≤40,n=78)and medium-high risk group(Gensini score>40,n=122).The levels of lipid metabolism indicators in serum of the patients in two groups were detected by fully automatic biochemical analyzer;enzyme linked immunosorbent assay(ELISA)method was used to detect the PCSK9 levels in serum of the patients in two groups;ultraviolet spectrophotometry was used to detect the single nucleotide polymorphism(SNP)of PCSK9 gene of the patients in two groups;Spearman correlation analysis was used to detect the correlation between the rs562556 polymorphism of the PCSK9 gene and the degree of the disease and the levels of lipid metabolism indicators in serum of the patients.Results:Compared with control group,the percentage of smokers of the patients in AMI group was significantly increased(P<0.01).Compared with control group,the levels of low-density lipoprotein cholesterol(LDL-c)and PCSK9 in serum of the patients in AMI group were significantly increased(P<0.05).Compared with low risk group,the levels of LDL-c and PCSK9 in serum of the patients in medium-high risk group were significantly increased(P<0.05).The distribution of PCSK9 gene rs1800487 genotype in both control and AMI groups conformed to the Hardy-Weinberg(H-W)equilibrium(χ2=0.677,P=0.713;χ2=0.970,P=0.831).Compared with control group,the distribution frequencies of PCSK9 gene rs562556 genotype AA and allele A of the patients in AMI group were significantly increased(P<0.05).In the AMI patients,the distribution of PCSK9 gene rs562556 genotype in both low risk and medium-high risk groups conformed to the H-W equilibrium(χ2=0.045,P=0.978;χ2=1.290,P=0.525).Compared with low risk group,the distribution frequencies of genotype AA and allele A of PCSK9 gene rs562556 of the patients in medium-high risk group were significantly increased(P<0.05).The PCSK9 gene rs562556 genotype AA was positively correlated with the degree of AMI(r=0.193,P=0.006)and LDL-c level(r=0.301,P<0.01).Allele A was positively correlated with the LDL-c level(r=0.168,P=0.017).Conclusion:The PCSK9 gene rs562556 genotype AA is positively correlated with the degree of coronary artery stenosis of the AMI patients,and its polymorphism may promote the development of AMI by upregulating the LDL-c level.

Objective:To construct an effectiveness evaluation model of internal control of medical equipment in public hospitals based on fuzzy analytic network process(F-ANP),and to improve the level of internal control management of medical equipment in hospitals.Methods:Through literature research and analysis,based on the internal control theory system of The Committee of Sponsoring Organizations of the Treadway Commission(COSO),combined with the characteristics of medical equipment management in public hospitals,the effectiveness evaluation model of internal control of medical equipment in public hospitals was established by F-ANP,which was combining analytic network process(ANP)and fuzzy comprehensive evaluation.An empirical analysis was carried out on the internal control of medical equipment in Beijing Friendship Hospital,Capital Medical University.Results:The index system for model evaluation included 5 first-level indicators of control environment,risk evaluation,control activities,information exchange,and supervision mechanism,17 second-level indicators,and 50 third-level indicators.The model was used to evaluate the effectiveness of internal control of medical equipment in the hospital,its maximum membership value was 0.133 7,and the result was"relatively effective",indicating that the construction and implementation of internal control of medical equipment in the hospital were relatively perfect,while the management of scrapping of medical equipment,cost control and equipment informatization construction still need to be improved.Conclusion:The effectiveness evaluation model of internal control of medical equipment of public hospitals based on F-ANP can provide certain reference value for evaluation of the effectiveness of internal control of medical equipment in public hospitals,which is conducive to standardizing internal control of medical equipment,promoting the fine management of medical equipment and ensuring the safety of medical equipment assets.

Objective:To observe the rehabilitative effect of combining respiratory function training with balloon dilatation for persons with cricopharyngeal achalasia after radiotherapy for nasopharyngeal carcinoma.Methods:A total of 120 nasopharyngeal carcinoma patients with cricopharyngeal achalasia after radiotherapy were randomly divided into an observation group and a control group, each of 60. Both groups were treated with routine functional swallowing training and balloon dilatation, while the observation group was additionally provided with respiratory function training 5 days a week for 8 weeks. Before the treatment and after 4 and 8 weeks of treatment, the swallowing function of both groups was evaluated using video fluoroscopy (VFSS), a functional oral intake scale (FOIS), cricopharyngeal muscle functional status and the M. D. Anderson dysphagia inventory (MDADI).Results:After 4 weeks of treatment the average VFSS, FOIS and MDADI scores of both groups were significantly better than before the treatment, and significant improvement continued over the subsequent four weeks. After 8 weeks of treatment, the average VFSS, FOIS and MDADI scores of the observation group had again improved significantly. Physiology, functioning, and their emotional state were also adjudged to have improved compared with 4 weeks earlier and compared with the control group.Conclusion:Combining respiratory function training with balloon dilatation can improve swallowing and can significantly reduce or delay swallowing disorders among patients with cyclopharyngeal achalasia after radiotherapy.

OBJECTIVE: This work aimed to study and identify the influence and target gene of microRNA-29a-3p (miR-29a-3p) in the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in a high-fat environment in vitro and in vivo. METHODS: 1) In vitro: BMSCs were randomly allocated into two groups and were then induced to undergo osteogenic differentiation in a normal or high-fat environment. Next, a miR-29a-3p mimic/inhibitor was transfected into the two groups of cells. The mRNA expression levels of alkaline phosphatase (ALP), Runt related gene 2 (Runx2), and miR-29a-3p and the protein expression levels of ALP and Runx2 were detected before and after transfection through reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR) and Western blot analyses. Moreover, Frizzled (Fzd) 4 was predicted as the target gene of miR-29a-3p by using an online database (Target Scan, MiRNA.org). The interactive relationship between miR-29a-3p and Fzd4 was confirmed through dual-luciferase assays. 2) In vivo: Rats were randomly divided into two groups and fed with a standard or high-fat diet. Titanium implants were grown in rats. Then, the expression levels of miR-29a-3p, ALP, and Runx2 were detected in bone tissues surrounding implants. Moreover, hard tissue sections were subjected to methylene blue-acid magenta staining and observed under microscopy to study bone formation around implants. In addition, miR-29a-3p-overexpressing lentiviral vectors were transfected into rats, and the expression levels of ALP, Runx2, and miR-29a-3p in bone tissues surrounding implants were detected at 3 and 10 days after transfection. RESULTS: The expression levels of ALP, Runx2, and miR-29a-3p and the osteogenic differentiation of BMSCs were suppressed in high-fat groups in vitro and in vivo. CONCLUSIONS MiR-29a-3p plays a positive role in the regulation of BMSCs in a high-fat environment. It can increase ALP and Runx2 expression levels in bone tissues surrounding implants in hyperlipidemia models. This result implies that miR-29a-3p can promote implant osseointergration in a rat model of hyperlipidemia.
Animals ; Cell Differentiation ; Dental Implants ; Hyperlipidemias ; MicroRNAs ; Osseointegration ; Osteoblasts ; Osteogenesis ; Random Allocation ; Rats

Objcetive: To explore the treatment of long segment defect of tibia by using tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle iliac flap. Methods: From February 2012 to August 2017, The People′s Hospital of Zun Yi City Bo Zhou District treated 16 patients who had long segment defect of tibia.There were 11 males and 5 females, age from 22 to 58 years old, the average age was 42 years old. Iliac flap grafting with tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle was used to treat the defect of long segment of tibia. There were 4 cases with simple tibial defect and 12 cases with skin defect. The longest tibial defect was 5-8 cm. Results: In this study, four patients used iliac flaps with deep circumflex iliac pedicle, the area of flaps ranged from 2.5 cm×5.0 cm to 5.0 cm×10.0 cm, while the area of iliac flaps ranged from 5.0 cm×2.5 cm to 8.0 cm×4.0 cm. Twelve patients used grafting with tensor fascia lata combined with iliac flap, the area of flaps ranged from 5.0 cm×12.0 cm to 12.0 cm×23.0 cm, while the area of iliac flaps ranged from 7.0 cm×2.0 cm to 8.0 cm×4.0 cm. All 16 cases of bone flap were survived, fracture healing, without surgical complications. The average follow-up period was 1.5 years, the flaps had good appearance in 10 cases and was slightly bloated in 6 cases; the ankle had normal motion in 14 cases and had poor dorsal extension in 2 cases. X-ray films showed that the bone flap repaired the bone defects and reached bone healing. Conclusions Vascularized tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle iliac flap grafts increase local blood supply and accelerate the process of fracture healing.

Objective To evaluate the safety,feasibility of the application of "four-quadrant" tumor target-artery positioning in "zero-ischemia" retroperitoneal laparoscopic partial nephrectomy.Methods A retrospective study was conducted on 25 patients who underwent retroperitoneal laparoscopic partial nephrectomy from November 2016 to March 2017 by single surgeon.There were 15 males and 10 females with a mean age of (52.6 ± 11.9) years old.The mean diameter of the tumor was (3.8 ± 0.5) cm.The mean R.E.N.A.L.score was (9.0±1.3).The mean GFR of the operation side was (49.2±11.4) ml/(min · 1.73 m2) before the operation.All 25 patients underwent 3 Dimentional CT for the reconstruction of their renal models.The tumor target-artery was located in "four-quadrant" system,which based on the boundary between tumor and renal parenchyma.Perioperative outcomes including the estimated blood loss (EBL),operation time,complications and oncological outcomes were carefully collected and analyzed.Results Of all the 25 patients,21 patients underwent "zero-ischemia" retroperitoneal laparoscopic partial nephrectomy,the mean operation time was (106.1 ± 18.8) min,the mean EBL was (162.2 ±68.0) ml with no transfusion case.4 patients converted to conventional retroperitoneal laparoscopic partial nephrectomy,the operation time was 110-140 min,the EBL was 350-500 ml and the warm-ischemia time was 12-20 min respectively.The pathological outcome shows renal cell carcinoma in 24 patients and papillary renal cell carcinoma in 1 patient with all negative margins.The mean GFR of the operation side was (45.1 ± 10.2) ml/(min · 1.73 m2) after three months of the surgery and shows no statistical difference (P =0.268).Conclusion The application of the "four-quadrant" tumor target-artery positioning in " zeroischemia" retroperitoneal laparoscopic partial nephrectomy is a safety and feasible method in terms of accurate location of the target-artery,better postoperative renal function,low EBL and reasonable oncological outcomes.