It was a retrospective study. The propensity score matching was applied to divide the type 2 diabetes mellitus (T2DM) patients who have underwent percutaneous coronary intervention (PCI) into two groups: short-term (<4 weeks) sodium-glucose cotransporter 2 inhibitor (SGLT2i) group (213 patients) and control group (213 patients). The occurrence of contrast-induced acute kidney injury (CIAKI) after PCI was compared between the two groups. The results showed that the incidence of CIAKI in the SGLT2i group was not significantly different from the control group [10.8% (23/213) vs. 7.5% (16/213), χ2=1.383, P=0.313]. The incidence of CIAKI in patients with SGLT2i application time <1 week was higher than that in control patients, but the difference was not statistically significant [13.00% (16/123) vs. 7.5% (16/213), χ2=2.734, P=0.122]. Multivariate logistic regression analysis showed that short-term (<4 weeks) use of SGLT2i would not increase the risk of CIAKI after PCI in T2DM patients ( OR=0.507, 95% CI 0.238-1.077, P=0.077). Short-term application of SGLT2i before PCI may not increase the risk of CIAKI, but it is advisable to avoid initiating the application of SGLT2i before PCI as much as possible.

It was a retrospective study. The propensity score matching was applied to divide the type 2 diabetes mellitus (T2DM) patients who have underwent percutaneous coronary intervention (PCI) into two groups: short-term (<4 weeks) sodium-glucose cotransporter 2 inhibitor (SGLT2i) group (213 patients) and control group (213 patients). The occurrence of contrast-induced acute kidney injury (CIAKI) after PCI was compared between the two groups. The results showed that the incidence of CIAKI in the SGLT2i group was not significantly different from the control group [10.8% (23/213) vs. 7.5% (16/213), χ2=1.383, P=0.313]. The incidence of CIAKI in patients with SGLT2i application time <1 week was higher than that in control patients, but the difference was not statistically significant [13.00% (16/123) vs. 7.5% (16/213), χ2=2.734, P=0.122]. Multivariate logistic regression analysis showed that short-term (<4 weeks) use of SGLT2i would not increase the risk of CIAKI after PCI in T2DM patients ( OR=0.507, 95% CI 0.238-1.077, P=0.077). Short-term application of SGLT2i before PCI may not increase the risk of CIAKI, but it is advisable to avoid initiating the application of SGLT2i before PCI as much as possible.

OBJECTIVE To investigate the impact of dapagliflozin on contrast-induced acute kidney injury(CIAKI)and prognosis in patients with diabetes mellitus type 2(T2DM)and acute coronary syndrome(ACS)who underwent percutaneous coronary intervention(PCI).METHODS Retrospective selection of data on T2DM patients with ACS who underwent PCI treatment in the Cardiology Department of Tianjin Chest Hospital from January 1st 2021 to December 31st 2022.The patients were divided into dapagliflozin group(96 cases)and control group(148 cases)based on whether they received dapagliflozin or not.Renal function indicators were measured for all enrolled patients before PCI and at 48 h and 1 week after PCI,including blood urea nitrogen(BUN),serum creatinine(Scr),estimated glomerular filtration rate(eGFR),cystatin-C(Cys-C),kidney injury molecule-1(KIM-1)and β2-microglobulin(β2-MG).All patients were followed up for at least 1 year.The incidence of CIAKI and major adverse cardiac event(MACE)during follow-up were recorded for both groups.Logistic regression was used to analyze the impact of dapagliflozin on the occurrence of CIAKI,while the Log-rank test was applied to compare the incidence of MACE between the two groups.Cox regression was employed to analyze the impact of dapagliflozin on prognosis.RESULTS At 48 h and 1 week after PCI,serum levels of Cys-C,KIM-1 and β2-MG were significantly lower in the dapagliflozin group compared to the control group(P＜0.05).The incidence of CIAKI was lower in the dapagliflozin group compared to the control group(6.25%vs.14.86%,P=0.042).Logistic regression analysis revealed that dapagliflozin was an independent protective factor against CIAKI(OR=0.280,95%CI 0.101-0.780,P=0.015).During the follow-up period,the incidence of MACE was lower in the dapagliflozin group compared to the control group(7.29%vs.17.57%,P=0.049).Cox regression analysis indicated that dapagliflozin reduced the occurrence of MACE after PCI(HR=0.374,95%CI 0.161-0.866,P=0.022).CONCLUSIONS With adequate hydration,the use of dapagliflozin does not increase the risk of CIAKI following PCI in T2DM patients with ACS.

Objective:Numerous studies have shown that neuroplasticity plays an important role in the pathogenesis of depression. This study aimed to investigate the relationship between the brain derived neurotrophic factor (BDNF) (Val66Met, rs6265) genotype and gray matter volume (GMV) in the first episode and treatment-naive patients with major depressive disorder (MDD) and healthy subjects.Methods:This study included 41 first episode and treatment-naive MDD patients (MDD group) and 44 sex and age matched healthy controls (HC group). All participants were arranged to take magnetic resonance imaging (MRI) scan. Meanwhile, BDNF rs6265 polymorphism was detected. Voxel-based morphometry (VBM) method was then performed to test the impact of the diagnosis (MDD vs. HC) and BDNF genotype (Met allele vs. Val/Val homozygous) on GMV. Results:There was no statistically significant difference on BDNF rs 6265 sites alleles frequency and genotype between MDD and HC groups (MDD χ 2=0.004, P>0.05; HC χ2=0.048, P>0.05). Gray matter volume in the left precuneus ( F=3.702, P<0.001), right middle temporal gyrus ( F=4.020, P<0.001) and cerebellum vermis_4_5 ( F=3.836, P<0.001) was larger in MDD patients than in the control group. BDNF genotype had effects on left fusiform gyrus ( F=-4.152, P<0.001). BDNF genotype-diagnosis interaction was found to be associated with left anterior cingulate cortex ( F=-4.775, P<0.001) and right anterior cingulate ( F=-3.795, P<0.001). For participants with Val/Val homozygous, compared to HC group, the volume of left anterior cingulate was reduced in MDD patients ( F=-3.729, P<0.001). For participants with the Met allele, compared to healthy controls, MDD patients showed significantly increased GMV in the left middle frontal gyrus ( F=4.317, P<0.001), right inferior occipital gyrus ( F=4.744, P<0.001), right supramarginal gyrus ( F=3.838, P<0.001), and left median cingulate gyrus( F=4.041, P<0.001). Separately in MDD patients and the control group, the GMV did not differ between the Val/Val homozygous group and the Met allele group. Conclusion:BDNF rs6265 alleles could be related to brain structural abnormalities in MDD patients, and could further explain the pathological mechanism of MDD.

Objective:Numerous studies have shown that neuroplasticity plays an important role in the pathogenesis of depression. This study aimed to investigate the relationship between the brain derived neurotrophic factor (BDNF) (Val66Met, rs6265) genotype and gray matter volume (GMV) in the first episode and treatment-naive patients with major depressive disorder (MDD) and healthy subjects.Methods:This study included 41 first episode and treatment-naive MDD patients (MDD group) and 44 sex and age matched healthy controls (HC group). All participants were arranged to take magnetic resonance imaging (MRI) scan. Meanwhile, BDNF rs6265 polymorphism was detected. Voxel-based morphometry (VBM) method was then performed to test the impact of the diagnosis (MDD vs. HC) and BDNF genotype (Met allele vs. Val/Val homozygous) on GMV. Results:There was no statistically significant difference on BDNF rs 6265 sites alleles frequency and genotype between MDD and HC groups (MDD χ 2=0.004, P>0.05; HC χ2=0.048, P>0.05). Gray matter volume in the left precuneus ( F=3.702, P<0.001), right middle temporal gyrus ( F=4.020, P<0.001) and cerebellum vermis_4_5 ( F=3.836, P<0.001) was larger in MDD patients than in the control group. BDNF genotype had effects on left fusiform gyrus ( F=-4.152, P<0.001). BDNF genotype-diagnosis interaction was found to be associated with left anterior cingulate cortex ( F=-4.775, P<0.001) and right anterior cingulate ( F=-3.795, P<0.001). For participants with Val/Val homozygous, compared to HC group, the volume of left anterior cingulate was reduced in MDD patients ( F=-3.729, P<0.001). For participants with the Met allele, compared to healthy controls, MDD patients showed significantly increased GMV in the left middle frontal gyrus ( F=4.317, P<0.001), right inferior occipital gyrus ( F=4.744, P<0.001), right supramarginal gyrus ( F=3.838, P<0.001), and left median cingulate gyrus( F=4.041, P<0.001). Separately in MDD patients and the control group, the GMV did not differ between the Val/Val homozygous group and the Met allele group. Conclusion:BDNF rs6265 alleles could be related to brain structural abnormalities in MDD patients, and could further explain the pathological mechanism of MDD.

Objective:To analyze the characteristics of health financing at the provincial level according to the total health expenditure since China health system reform began in 2009 and provide evidence for improving health fi-nancing policy. Methods:20 provinces were chosen and vertical and horizontal Comparative approach was used to an-alyze the data. Results:Total health expenditure increased for all regions, of which the biggest rate was Anhui prov-ince, about 82. 97%, while the largest increasing for government health care expenditure was Ningxia province, a-bout 108 . 71%. In 2012 , the provinces with social health expenditure share of total above 40% were allocated in the east region, and the number of provinces with out-of pocket payment share of total above 40% reduces to 5. Conclu-sion:Total health expenditure grew in all regions, but there were differences in the degree that this spending matched the economic level;The financing structure was optimized, but the characteristic of regional financing was different. Some provinces were under huge pressure to reduce out-of pocket payments. Suggestions: Under the premise of im-proving the funding level, financing structure adjustment must be focused, and public funding should play a bigger role and out-of pocket payments should be reduced.