Objective:To investigate the association between estimated cumulative low-density lipoprotein cholesterol (LDL-C) exposure and the severity of coronary artery disease and long-term adverse cardiovascular and cerebrovascular events (MACCE) in patients with acute coronary syndrome (ACS).Methods:The subjects were from the PROMISE study. This study was a prospective cohort study led by Fuwai Hospital, Chinese Academy of Medical Sciences, with participation from eight regional tertiary hospitals as sub-centers, and enrolled 18 701 patients with confirmed coronary heart disease between January 2015 and May 2019. Among them, 8 429 patients with ACS were included in this study. The estimated cumulative LDL-C exposure was calculated by multiplying LDL-C by age. Participants were then divided into four groups based on quartiles. Baseline data and coronary angiography data were collected, and participants were followed for 2 years. The primary endpoint was MACCE, which was composed of all-cause death, cardiac death, myocardial infarction, revascularization, and stroke. Spearman correlation analysis was used to estimate the correlation between cumulative LDL-C exposure and the severity of coronary artery disease. The differences in MACCE among the four groups were compared, and multivariate Cox regression was used to divide the estimated cumulative exposure LDL-C into two groups, three groups, and four groups to analyze its relationship with MACCE.Results:The 8 429 ACS patients included in the study had an age of (60.9±11.4) years, with 1 951(23.1%) females. Spearman correlation analysis revealed that estimated cumulative LDL-C exposure was positively associated with the preoperative SYNTAX score, three-vessel lesions disease, left main disease, and the number of target lesions (correlation coefficients r=0.14, 0.10, 0.04 and 0.03, respectively, with all P<0.05). The 2-year follow-up results indicated that the incidence rates of MACCE, all-cause death, cardiac death, myocardial infarction, and stroke in ACS patients grouped by different levels of estimated cumulative LDL-C exposure were statistically significant (all P<0.05). The results of the Cox multivariate regression analysis showed that when the estimated cumulative LDL-C exposure was treated as a continuous variable and analyzed in two, three, and four groups, with the lowest group as the reference, the risk of MACCE occurrence in the high-value group increased by 21% (95% CI 1.08-1.37, P=0.002), 24% (95% CI 1.07-1.43, P=0.004), and 21% (95% CI 1.02-1.43, P=0.025) respectively. Conclusions:A positive correlation was found between estimated cumulative LDL-C exposure and severity of coronary artery disease. High estimated cumulative LDL-C exposure level is a risk factor for MACCE in ACS patients within 2 years.

Objective:To investigate the association between estimated cumulative low-density lipoprotein cholesterol (LDL-C) exposure and the severity of coronary artery disease and long-term adverse cardiovascular and cerebrovascular events (MACCE) in patients with acute coronary syndrome (ACS).Methods:The subjects were from the PROMISE study. This study was a prospective cohort study led by Fuwai Hospital, Chinese Academy of Medical Sciences, with participation from eight regional tertiary hospitals as sub-centers, and enrolled 18 701 patients with confirmed coronary heart disease between January 2015 and May 2019. Among them, 8 429 patients with ACS were included in this study. The estimated cumulative LDL-C exposure was calculated by multiplying LDL-C by age. Participants were then divided into four groups based on quartiles. Baseline data and coronary angiography data were collected, and participants were followed for 2 years. The primary endpoint was MACCE, which was composed of all-cause death, cardiac death, myocardial infarction, revascularization, and stroke. Spearman correlation analysis was used to estimate the correlation between cumulative LDL-C exposure and the severity of coronary artery disease. The differences in MACCE among the four groups were compared, and multivariate Cox regression was used to divide the estimated cumulative exposure LDL-C into two groups, three groups, and four groups to analyze its relationship with MACCE.Results:The 8 429 ACS patients included in the study had an age of (60.9±11.4) years, with 1 951(23.1%) females. Spearman correlation analysis revealed that estimated cumulative LDL-C exposure was positively associated with the preoperative SYNTAX score, three-vessel lesions disease, left main disease, and the number of target lesions (correlation coefficients r=0.14, 0.10, 0.04 and 0.03, respectively, with all P<0.05). The 2-year follow-up results indicated that the incidence rates of MACCE, all-cause death, cardiac death, myocardial infarction, and stroke in ACS patients grouped by different levels of estimated cumulative LDL-C exposure were statistically significant (all P<0.05). The results of the Cox multivariate regression analysis showed that when the estimated cumulative LDL-C exposure was treated as a continuous variable and analyzed in two, three, and four groups, with the lowest group as the reference, the risk of MACCE occurrence in the high-value group increased by 21% (95% CI 1.08-1.37, P=0.002), 24% (95% CI 1.07-1.43, P=0.004), and 21% (95% CI 1.02-1.43, P=0.025) respectively. Conclusions:A positive correlation was found between estimated cumulative LDL-C exposure and severity of coronary artery disease. High estimated cumulative LDL-C exposure level is a risk factor for MACCE in ACS patients within 2 years.

Objective:To explore the cumulative delivery rate and related factors of infertile women with anti-Müllerian hormone (AMH) no more than 1 μg/L during in vitro fertilization and embryo transfer (IVF-ET) treatment. Methods:In this retrospective cohort study, we analyzed 793 infertile women with AMH no more than 1 μg/L and underwent their first IVF-ET treatment in Henan Provincial People's Hospital between July 2016 and February 2018. All the patients were categorized into two groups according to cumulative delivery with at least one live baby or not. Baseline data and outcomes were compared between the two groups. The regression analysis was conducted to identify the independent factors of cumulative delivery rate and clinical outcomes of different age groups were compared.Results:1) The total cumulative delivery rate per start cycle was 23.83% (189/793). There were significant differences in age [33(30,37) years vs. 39(34,43) years], AMH [0.67(0.46,0.87) μg/L vs. 0.51(0.22,0.74) μg/L], antral follicle count (AFC) [6(4,8) vs. 4(2,6)], basal follicle-stimulating hormone (bFSH) [9.11(6.98,11.03) IU/L vs. 11.06(7.75,13.13) IU/L], starting dosage of gonadotropin (Gn) used [225.0(187.5,225.0) IU vs. 225.0(225.0,300.0) IU], total dosage of Gn used [2 475.0(1 800.0,3 137.5) IU vs. 2 100.0(1 575.0,2 850.0) IU], duration of Gn stimulation [10(8,12) d vs. 9(6,11) d], number of oocytes retrieved [5.0(3.0,7.5) vs. 2.5(1.0,4.0)], number of M II oocytes [4(3,6) vs. 2(1,3)] and number of available cleavage embryos [3.0(2.0,4.5) vs.1.0(0,2.0)] between the two groups (all P<0.001). 2) Multivariate logistic regression analysis suggested that age ( OR=0.878, 95% CI=0.846-0.911, P<0.001) was the vital factor of cumulative delivery rate. The cumulative pregnancy rate and the cumulative delivery rate were significantly decreased with age increasing (all P<0.001). And the cancelation rate of group with age more than 40 years was much higher ( P<0.001). Conclusion:Age was the independent influencing factor of cumulative delivery rate. The cumulative delivery rate decreased significantly with age increasing.

Objective:To explore the cumulative delivery rate and related factors of infertile women with anti-Müllerian hormone (AMH) no more than 1 μg/L during in vitro fertilization and embryo transfer (IVF-ET) treatment. Methods:In this retrospective cohort study, we analyzed 793 infertile women with AMH no more than 1 μg/L and underwent their first IVF-ET treatment in Henan Provincial People's Hospital between July 2016 and February 2018. All the patients were categorized into two groups according to cumulative delivery with at least one live baby or not. Baseline data and outcomes were compared between the two groups. The regression analysis was conducted to identify the independent factors of cumulative delivery rate and clinical outcomes of different age groups were compared.Results:1) The total cumulative delivery rate per start cycle was 23.83% (189/793). There were significant differences in age [33(30,37) years vs. 39(34,43) years], AMH [0.67(0.46,0.87) μg/L vs. 0.51(0.22,0.74) μg/L], antral follicle count (AFC) [6(4,8) vs. 4(2,6)], basal follicle-stimulating hormone (bFSH) [9.11(6.98,11.03) IU/L vs. 11.06(7.75,13.13) IU/L], starting dosage of gonadotropin (Gn) used [225.0(187.5,225.0) IU vs. 225.0(225.0,300.0) IU], total dosage of Gn used [2 475.0(1 800.0,3 137.5) IU vs. 2 100.0(1 575.0,2 850.0) IU], duration of Gn stimulation [10(8,12) d vs. 9(6,11) d], number of oocytes retrieved [5.0(3.0,7.5) vs. 2.5(1.0,4.0)], number of M II oocytes [4(3,6) vs. 2(1,3)] and number of available cleavage embryos [3.0(2.0,4.5) vs.1.0(0,2.0)] between the two groups (all P<0.001). 2) Multivariate logistic regression analysis suggested that age ( OR=0.878, 95% CI=0.846-0.911, P<0.001) was the vital factor of cumulative delivery rate. The cumulative pregnancy rate and the cumulative delivery rate were significantly decreased with age increasing (all P<0.001). And the cancelation rate of group with age more than 40 years was much higher ( P<0.001). Conclusion:Age was the independent influencing factor of cumulative delivery rate. The cumulative delivery rate decreased significantly with age increasing.

Objective To observe if subclinical lesion exists during and after tibia lengthening and investigate the repair mechanism of the nerve. MethodsTwenty-three cases(with 42 tibia) were lengthened by traction with the velocity of 1mm/d. The somatosensory evoked potentials (SEP) induced by stimulation of tibial nerve were recorded before operation and 2,3 months and 2 years after operation. The tibia was lengthened for a total of 4～10cm. ResultsAll cases had no significant symptoms except for 1 case with mild symptoms of nerve lesion when his tibia was lengthened for 9.5cm. However, the subclinical lesion was found by SEP record in all the cases, and this lesion could be repaired mostly in 3 months and completely recovered in 2 years. ConclusionThe peripheral nerves have good adaptability to tibia lengthening with a velocity of 1mm/d and the tibia could be lengthened to a great extend as long as there were no clinical symptoms manifestated.

Objective To study the optimal laparoscopic procedure and its indication for remove of common bile duct stone. Methods Analysis was made on the clmical data of 124 cases of laparoscopic choledocholithotomy and T tube drainage in our center.Results 82 patients underwent the improved laparoscopic procedure, alternation to open operation in 4 cases (4.9%),and the mean operating time was (80?30) min. While 42 patients were operated with traditional laparoscopic method,changing to open operation in 6 cases (14.3%),and the mean operating time was (170?40) min . The improved method could shorten the operation time and reduce the open operation rate significantly than traditional method did (P