Objective To explore the feasibility,safety and efficacy of paclitaxel drug-coated balloon(DCB)in the treatment of atherosclerotic renal artery stenosis(ARAS).Methods A total of 28 patients with ARAS were selected.Balloon angioplasty was performed using a paclitaxel DCB at the site of renal artery stenosis(RAS)in these patients.Subsequently,a follow-up study was conducted to monitor various parameters of the patients,including vascular restenosis,blood pressure,the types of antihypertensive medications and renal function.The feasibility,efficacy and safety of balloon angioplasty using DCB in the treatment of ARAS were analyzed.Results Twenty-eight patients underwent 33 DCB balloon angioplasty.In one patient,there was no significant improve-ment in the degree of RAS,and thus further treatment with renal artery stenting was administered.The remaining patients all achieved both anatomical and hemodynamic success,with the degree of vascular stenosis at the lesion site decreasing from(79.74±5.13)％to(8.32±4.67)％,and the surgical success rate was 96.97％.The systolic/diastolic blood pressure of the patients was(179.16±30.65)mmHg/(108.26±20.93)mmHg(1 mmHg=0.133 kPa)at 24 hours postoperatively,(131.11±12.99)mmHg/(80.11±7.12)mmHg at 3 months postoperatively,(134.16±11.37)mmHg/(78.68±4.79)mmHg at 6 months postoperatively,and(133.37±12.71)mmHg/(80.11±4.84)mmHg at 12 months postoperatively.In comparison with the preoperative blood pressure of(184.63±27.64)mmHg/(109.11±22.26)mmHg,there was no significant decrease in blood pressure at 24 hours postoperatively,and the difference was not statistically significant.However,at 3,6,and 12 months postoperatively,the patients'blood pressure was signif-icantly lower than that before the operation,and all the differences were statistically significant.The glomerular filtration rate(GFR)was(36.19±18.32)mL/min at 24 hours postoperatively,(35.96±18.51)mL/min at 3 months postoperatively,(36.23±19.30)mL/min at 6 months postoperatively,and(35.59±18.26)mL//min at 12 months postoperatively,which all elevated compared with the preoperative GFR of(28.31±14.67)mL/min,and the differences were statistically significant(P＜0.05).At 3,6,and 12 months postoperatively,the vascular patency rate was 100％as indicated by multifunctional color Doppler ultrasound examination or renal artery computed tomography angiography(CTA).No relevant com-plications and postoperative adverse events,such as renal artery rupture or dissection,renal artery thrombosis and acute renal insuffi-ciency,occurred in all 28 patients.Conclusion The paclitaxel DCB is safe and reliable for the treatment of ARAS and has remarkable curative effects,and it can be used as an effective vascular treatment regimen for ARAS.

Objective To predict the risk of coronary atherosclerosis using cerebral small vessel disease and cerebral artery stenosis in order to assist early identification of coronary artery disease(CHD).Methods A retrospective analysis was conducted on 130 patients(aged≥65 years)who underwent cerebral MRI,magnetic resonance angiography(MRA),and coronary computed tomo-graphy angiography in the Chinese PLA General Hospital between January 2019 and December 2024.Based on coronary computed tomography angiography results,the patients were categorized into an asymptomatic CHD group(56 cases)and a non-CHD group(74 cases).Cerebral MRI and MRA were used to assess white matter hyperintensity,enlarged perivascular spaces,lacunar infarcts,cerebral microbleeds(CMB)scores,total score of cerebral small vessel disease and degree of cerebral artery stenosis.Multivariate logistic regression analysis was employed to identify the clinical and radiological indicators related to CHD.Then a predictive model was constructed,and then its performance in early predicting CHD was evaluated.Results Blood glucose,low-density lipoprotein cholesterol,CMB score≥ 1,and≥50％stenosis of the posterior cerebral artery were independent risk factors for CHD(P＜0.05).The combined predictive model integrating clinical indicators,cerebral small vessel disease,and cerebral artery stenosis demonstrated the best performance,with an AUC value of 0.867(95％CI:0.807-0.927),outperforming the clinical model and the clinical-cerebral small vessel disease model.Conclusion cerebral small vessel dis-ease and cerebral artery stenosis are closely related to coronary atherosclerosis.The predictive model integrating clinical features and cerebrovascular disease imaging markers provides impor-tant reference for early screening of CHD.

Objective To investigate the value of serum lipoprotein-associated phospholipase A2(Lp-PLA2)for predicting high-risk coronary plaques in elderly males.Methods A retrospective study was conducted on 46 elderly males aged ≥60 years undergoing health check-ups and coro-nary computed tomography angiography in our hospital between May and July 2024.Their general clinical data were collected.Artificial intelligence software was used to analyze coronary calcium scores and plaque characteristics.The participants were divided into a high-risk plaque group(n=15)and a non-high-risk plaque group(n=31).The differences were compared between the two groups.Multivariate logistic regression analysis was used to identify the influencing factors for high-risk coronary plaques.ROC curve was plotted to determine the predictive value of serum Lp-PLA2 for high-risk plaques,and its AUC value was calculated.Results The high-risk plaque group had significantly larger proportions of smoking history and hyperlipidemia,and higher level of homocysteine and Lp-PLA2 than the non-high-risk plaque group(P＜0.05,P＜0.01).Multiva-riate logistic regression analysis indicated that Lp-PLA2 was an independent risk factor for high-risk coronary plaques(HR=1.030,95％CI:1.008-1.053,P＜0.05).ROC curve analysis revealed that the AUC value of Lp-PLA2 in predicting high-risk coronary plaques was 0.833(95％CI:0.694-0.927,P＜0.01),with a sensitivity of 93.3％,a specificity of 71.0％,a positive predictive value of 62.5％,and a negative predictive value of 100％.Conclusion Serum Lp-PLA2 is of signif-icant value in predicting high-risk coronary plaques in elderly men.

Objective To explore the feasibility,safety and efficacy of paclitaxel drug-coated balloon(DCB)in the treatment of atherosclerotic renal artery stenosis(ARAS).Methods A total of 28 patients with ARAS were selected.Balloon angioplasty was performed using a paclitaxel DCB at the site of renal artery stenosis(RAS)in these patients.Subsequently,a follow-up study was conducted to monitor various parameters of the patients,including vascular restenosis,blood pressure,the types of antihypertensive medications and renal function.The feasibility,efficacy and safety of balloon angioplasty using DCB in the treatment of ARAS were analyzed.Results Twenty-eight patients underwent 33 DCB balloon angioplasty.In one patient,there was no significant improve-ment in the degree of RAS,and thus further treatment with renal artery stenting was administered.The remaining patients all achieved both anatomical and hemodynamic success,with the degree of vascular stenosis at the lesion site decreasing from(79.74±5.13)％to(8.32±4.67)％,and the surgical success rate was 96.97％.The systolic/diastolic blood pressure of the patients was(179.16±30.65)mmHg/(108.26±20.93)mmHg(1 mmHg=0.133 kPa)at 24 hours postoperatively,(131.11±12.99)mmHg/(80.11±7.12)mmHg at 3 months postoperatively,(134.16±11.37)mmHg/(78.68±4.79)mmHg at 6 months postoperatively,and(133.37±12.71)mmHg/(80.11±4.84)mmHg at 12 months postoperatively.In comparison with the preoperative blood pressure of(184.63±27.64)mmHg/(109.11±22.26)mmHg,there was no significant decrease in blood pressure at 24 hours postoperatively,and the difference was not statistically significant.However,at 3,6,and 12 months postoperatively,the patients'blood pressure was signif-icantly lower than that before the operation,and all the differences were statistically significant.The glomerular filtration rate(GFR)was(36.19±18.32)mL/min at 24 hours postoperatively,(35.96±18.51)mL/min at 3 months postoperatively,(36.23±19.30)mL/min at 6 months postoperatively,and(35.59±18.26)mL//min at 12 months postoperatively,which all elevated compared with the preoperative GFR of(28.31±14.67)mL/min,and the differences were statistically significant(P＜0.05).At 3,6,and 12 months postoperatively,the vascular patency rate was 100％as indicated by multifunctional color Doppler ultrasound examination or renal artery computed tomography angiography(CTA).No relevant com-plications and postoperative adverse events,such as renal artery rupture or dissection,renal artery thrombosis and acute renal insuffi-ciency,occurred in all 28 patients.Conclusion The paclitaxel DCB is safe and reliable for the treatment of ARAS and has remarkable curative effects,and it can be used as an effective vascular treatment regimen for ARAS.

Objective To investigate the value of serum lipoprotein-associated phospholipase A2(Lp-PLA2)for predicting high-risk coronary plaques in elderly males.Methods A retrospective study was conducted on 46 elderly males aged ≥60 years undergoing health check-ups and coro-nary computed tomography angiography in our hospital between May and July 2024.Their general clinical data were collected.Artificial intelligence software was used to analyze coronary calcium scores and plaque characteristics.The participants were divided into a high-risk plaque group(n=15)and a non-high-risk plaque group(n=31).The differences were compared between the two groups.Multivariate logistic regression analysis was used to identify the influencing factors for high-risk coronary plaques.ROC curve was plotted to determine the predictive value of serum Lp-PLA2 for high-risk plaques,and its AUC value was calculated.Results The high-risk plaque group had significantly larger proportions of smoking history and hyperlipidemia,and higher level of homocysteine and Lp-PLA2 than the non-high-risk plaque group(P＜0.05,P＜0.01).Multiva-riate logistic regression analysis indicated that Lp-PLA2 was an independent risk factor for high-risk coronary plaques(HR=1.030,95％CI:1.008-1.053,P＜0.05).ROC curve analysis revealed that the AUC value of Lp-PLA2 in predicting high-risk coronary plaques was 0.833(95％CI:0.694-0.927,P＜0.01),with a sensitivity of 93.3％,a specificity of 71.0％,a positive predictive value of 62.5％,and a negative predictive value of 100％.Conclusion Serum Lp-PLA2 is of signif-icant value in predicting high-risk coronary plaques in elderly men.

Objective To predict the risk of coronary atherosclerosis using cerebral small vessel disease and cerebral artery stenosis in order to assist early identification of coronary artery disease(CHD).Methods A retrospective analysis was conducted on 130 patients(aged≥65 years)who underwent cerebral MRI,magnetic resonance angiography(MRA),and coronary computed tomo-graphy angiography in the Chinese PLA General Hospital between January 2019 and December 2024.Based on coronary computed tomography angiography results,the patients were categorized into an asymptomatic CHD group(56 cases)and a non-CHD group(74 cases).Cerebral MRI and MRA were used to assess white matter hyperintensity,enlarged perivascular spaces,lacunar infarcts,cerebral microbleeds(CMB)scores,total score of cerebral small vessel disease and degree of cerebral artery stenosis.Multivariate logistic regression analysis was employed to identify the clinical and radiological indicators related to CHD.Then a predictive model was constructed,and then its performance in early predicting CHD was evaluated.Results Blood glucose,low-density lipoprotein cholesterol,CMB score≥ 1,and≥50％stenosis of the posterior cerebral artery were independent risk factors for CHD(P＜0.05).The combined predictive model integrating clinical indicators,cerebral small vessel disease,and cerebral artery stenosis demonstrated the best performance,with an AUC value of 0.867(95％CI:0.807-0.927),outperforming the clinical model and the clinical-cerebral small vessel disease model.Conclusion cerebral small vessel dis-ease and cerebral artery stenosis are closely related to coronary atherosclerosis.The predictive model integrating clinical features and cerebrovascular disease imaging markers provides impor-tant reference for early screening of CHD.

TCM, as a traditional medical science in China, has received strong support from the country in recent years. Although TCM services are on the rise under the promotion of the government, there is still the problem of unreasonable resource allocation. In this article, the entropy weight TOPSIS method, Theil Index and Moran Index were used to analyze the TCM resources from 2016 to 2021. It is believed that the comprehensive score of China's current TCM resource allocation is not high, and Sichuan, Beijing, Chongqing, Zhejiang, and Inner Mongolia rank relatively high; the TCM resources of were distributed spatially; the imbalance in resource allocation mainly comes from the differences between provinces (cities); it is suggested to intensify the scientific planning of TCM, comprehensively develop the TCM cause according to local conditions, and improve the efficiency of resource utilization.

This article reports that a patient with bilateral ureterocutaneous stoma after radical cystectomy developed intermittent hematuria 2 years after surgery, and there were no abnormalities on bilateral renal artery and abdominal aortic angiography. After removal of the double J stent, a left common iliac artery ureteral fistula was seen on abdominal aortic angiography, and the patient immediately developed hemorrhagic shock. Abdominal aortic balloon occlusion and left common iliac artery stent grafting were performed in the emergency department. After the stent was deployed and the balloon deflated, no bleeding was observed, and the patient's heart rate and blood pressure stabilized. Follow-up angiography showed complete resolution of the fistula. This condition is rare and dangerous, but interventional treatment can quickly control bleeding, offering minimal surgical trauma and fast recovery.

This article reports that a patient with bilateral ureterocutaneous stoma after radical cystectomy developed intermittent hematuria 2 years after surgery, and there were no abnormalities on bilateral renal artery and abdominal aortic angiography. After removal of the double J stent, a left common iliac artery ureteral fistula was seen on abdominal aortic angiography, and the patient immediately developed hemorrhagic shock. Abdominal aortic balloon occlusion and left common iliac artery stent grafting were performed in the emergency department. After the stent was deployed and the balloon deflated, no bleeding was observed, and the patient's heart rate and blood pressure stabilized. Follow-up angiography showed complete resolution of the fistula. This condition is rare and dangerous, but interventional treatment can quickly control bleeding, offering minimal surgical trauma and fast recovery.

Objective:To systematically evaluate the efficacy of different kinds of smoking cessation drugs by network Meta-analysis.Methods:Literature was retrieved from PubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI, VIP, Wan fang database, from the establishment of the database to November 2022, and randomized controlled trials (RCT) about bupropion, varenicline, nicotine replacement therapy (NRT) versus placebo in the treatment of smoking patients were collected. After data extraction from included literature which met inclusion criteria, and quality evaluation with Cochrane 5.1 risk bias evaluation tool, network Meta-analysis was performed by Stata15.1 software.Results:A total of 19 RCTs, involving 6106 patients and three interventions measures (bupropion, varenicline, NRT) and one control measure (placebo) were included. The results of network Meta-analysis showed that in terms of short-term abstinence rate, varenicline [ OR=4.21, 95% CI (2.32, 7.63)], bupropion [ OR=2.81, 95% CI(1.05, 7.54)] were better than placebo ( P<0.05). The surface under the cumulative ranking area (SUCRA): varenicline (90.2%)>bupropion (64.8%)>NRT (41.7%)>placebo (3.2%). In terms of the long-term abstinence rate, varenicline [ OR=3.06, 95% CI (1.59, 5.90)], NRT [ OR=3.39, 95% CI (2.20, 5.21)] were better than placebo ( P<0.05). SUCRA: varenicline (83.8%)>NRT (73.9%)>bupropion (37.2%)>placebo (5.2%). Conclusion:The existing evidence shows that compared with bupropion, NRT, varenicline has the best effect on quitting smoking, but more high-quality randomized trial evidence is needed for verification.