BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Objective To propose a deep learning neural network approach for transforming megavoltage computed tomography(MVCT)images of cervical cancer into pseudo kilovoltage computed tomography(kVCT)images with high signal-to-noise ratio and contrast-to-noise ratio,thus providing three-dimensional anatomical images and localization information required for adaptive radiotherapy of cervical cancer,and guiding the accelerator to achieve precise treatment.Methods The MVCT and kVCT images of 54 patients treated with cervical cancer radiotherapy were collected,with 44 cases randomly selected as the training set,and the remaining 10 cases as the test set.A cyclic generative adversarial network with gating mechanism and multi-channel data input was used to synthesize pseudo-kVCT images from MVCT images.The network training results were evaluated with imaging quality evaluation parameters,such as mean absolute error(MAE),peak signal-to-noise ratio(PSNR),and structural similarity index(SSIM).Results The MAE,PSNR,and SSIM of MVCT imagesvspseudo-kVCT(5:5)images were(24.9±0.7)HUvs(17.8±0.3)HU,(29.8±0.2)dBvs(30.7±0.2)dB,and 0.841±0.007 vs 0.898±0.003,respectively.Conclusion The generated pseudo-kVCT images have advantages in noise reduction and contrast enhancement,and can reduce the need for additional MV-kVCT electron density calibration in dose calculations.The dose calculation ability of pseudo-kVCT is comparable to that of MVCT,providing a possibility for the application of pseudo-kVCT images in image-guided adaptive radiotherapy.

The treatment of acute Stanford type A aortic dissection has always been extremely challenging. Organ malperfusion syndrome is a common severe complication of acute aortic dissection, which can cause organ ischemia and internal environment disorder. Malperfusion increases early mortality, and impacts the long-term prognosis. In recent years, many scholars have done some studies on aortic dissection complicated with malperfusion. They explored the pathogenesis, proposed new classification, and innovated new treatment strategies. However, at present, the treatment strategies of acute Stanford type A aortic dissection complicated with organ malperfusion are different at different centers and consensus on its treatment is still lacking. Therefore, this review summarized the pathogenesis, classification, treatment strategy, and prognosis of acute Stanford type A aortic dissection complicated with malperfusion.

Objective: To investigate the effects of tanshinone ⅡA on atherosclerosis plaque formation and adventitial mast cells activation in high-fat-diet induced Apo E^-/- mice model. Methods: Sixteen 8-week-old Apo E^-/-male mice and eight 8-week-old C57BL/6 male mice were randomly allocated into following group: the control group (C57BL/6 + carboxymethyl cellulose per gavage), the atherogenic group (Apo E^-/-+carboxymethyl cellulose per gavage) and the tanshinoneⅡA intervention group (Apo E^-/-+30 mg/kg tanshinone ⅡA per gavage). All three groups were fed with high-fat-diet for 26 weeks. Tanshinone ⅡA/carboxymethyl cellulose was applied by the method of gavage administration 6 weeks before execution. After 26 weeks, tumor necrosis factor-α (TNF-α) andinterleukin (IL)-6 levels in serum were assessed by ELISA. Carotid artery was removed, fixed with paraformaldehyde, embedded with paraffin and sectioned. Percentage of stenosis was evaluated on HE stained sections. Plaque progression was assessed by Movat staining. Toluidine blue staining was used to evaluate mast cells infiltration and activation. Immunochemistry staining was used to assess 5-HT, TNF-α and IL-6 expression. mRNA expression of mast cell marker Fcer1a in adventitial tissue was detected by real time-PCR. Results: After high-fat-diet for 26 weeks, the mice in the atherogenic group showed advanced atherosclerosis, tanshinoneⅡA intervention reduced the percentage of carotid artery stenosis caused by atherosclerotic plaque formation ((58.48±8.07)% vs. (80.31±4.08)%, P<0.05). Compared with the atherogenic group, tanshinone ⅡA intervention group had lower level of TNF-α ((12.39±1.62)pg/ml vs. (17.44±1.42)pg/ml) and IL-6 ((116.24±12.16)pg/ml vs. (166.05±19.09)pg/ml) in serum, lower TNF-α ((20 145±1 556) vs. (25 288±1 671)) and IL-6 ((25 688±1 604) vs. (35 286±4 198)) expression in adventitia (all P<0.05). TanshinoneⅡA intervention also decreased the number of mast cells infiltration and activation, reduced 5-HT expression and mast cell marker Fcer1a mRNA relative expression in adventitia (all P<0.05). Conclusions Tanshinone ⅡA could attenuate induced by high-fat-diet carotid artery atherosclerosis in Apo E^-/- mice. The protective effect of tanshinoneⅡA is probably mediated through reducing the number and activation percentage of mast cells, decreasing the release of inflammatory cytokines and inflammation of carotid artery in adventitia.

Objective To investigate the effects of tanshinoneⅡA on atherosclerosis plaque formation and adventitial mast cells activation in high?fat?diet induced Apo E?/?mice model. Methods Sixteen 8?week?old Apo E?/?male mice and eight 8?week?old C57BL/6 male mice were randomly allocated into following group: the control group (C57BL/6+carboxymethyl cellulose per gavage), the atherogenic group (Apo E?/?+carboxymethyl cellulose per gavage) and the tanshinoneⅡA intervention group (Apo E?/?+30 mg/kg tanshinoneⅡA per gavage). All three groups were fed with high?fat?diet for 26 weeks. TanshinoneⅡA/carboxymethyl cellulose was applied by the method of gavage administration 6 weeks before execution. After 26 weeks, tumor necrosis factor?α (TNF?α) andinterleukin (IL)?6 levels in serum were assessed by ELISA. Carotid artery was removed, fixed with paraformaldehyde, embedded with paraffin and sectioned. Percentage of stenosis was evaluated on HE stained sections. Plaque progression was assessed by Movat staining. Toluidine blue staining was used to evaluate mast cells infiltration and activation. Immunochemistry staining was used to assess 5?HT, TNF?α and IL?6 expression. mRNA expression of mast cell marker Fcer1a in adventitial tissue was detected by real time?PCR. Results After high?fat?diet for 26 weeks, the mice in the atherogenic group showed advanced atherosclerosis, tanshinoneⅡA intervention reduced the percentage of carotid artery stenosis caused by atherosclerotic plaque formation ((58.48±8.07)% vs. (80.31±4.08)%, P<0.05). Compared with the atherogenic group, tanshinoneⅡA intervention group had lower level of TNF?α ((12.39 ± 1.62)pg/ml vs. (17.44 ± 1.42)pg/ml) and IL?6 ((116.24 ± 12.16)pg/ml vs. (166.05 ± 19.09)pg/ml) in serum, lower TNF?α ((20 145±1 556) vs. (25 288±1 671)) and IL?6 ((25 688±1 604) vs. (35 286±4 198)) expression in adventitia (all P<0.05). TanshinoneⅡA intervention also decreased the number of mast cells infiltration and activation, reduced 5?HT expression and mast cell marker Fcer1a mRNA relative expression in adventitia (all P<0.05). Conclusions TanshinoneⅡA could attenuate induced by high?fat?diet carotid artery atherosclerosis in Apo E?/?mice. The protective effect of tanshinoneⅡA is probably mediated through reducing the number and activation percentage of mast cells, decreasing the release of inflammatory cytokines and inflammation of carotid artery in adventitia.

Objective: To establish the mouse aorta dissection (AD) model through drinking water containing β-aminopropionitrile (BAPN). Methods: Forty 3-week-old C57B1/6J male mice were divided into four groups according to randomized block design: control, 0.2, 0.4 and 0.8 g·kg^-1·d^-1 BAPN groups (dissolving respective dose of BAPN in the drinking water, n=10 each group). Arterial systolic blood pressure and heart rate were measured weekly in conscious, restrained mice using a noninvasive computerized tail-cuff system. Mice those died of rupture of aortic dissecting aneurysm during the study were autopsied and the aorta was examined. After 4 weeks, survived mice were sacrificed by an overdose of sodium pentobarbital and the whole aorta was harvested and analyzed. Results: The incidence of AD and the mortality of ruptured AD was 0 and 0 in control group, 30% (3/10) and 20% (2/10) in 0.2 g·kg^-1·d^-1 BAPN group, 50% (5/10) and 40% (4/10) in 0.4 g·kg^-1·d^-1 BAPN group, 90% (9/10) and 70% (7/10) in 0.8 g·kg^-1·d^-1 BAPN group (both P<0.05 vs. control group). The incidence of AD and the mortality of ruptured AD increased in proportion to BAPN concentration increase. In 0.8 g·kg^-1·d^-1 BAPN group, 7 mice died of dissecting aneurysm rupture during the experiment, among which 5 dissecting aneurysms were mainly located in the thoracic aorta and 2 dissecting aneurysms in abdominal aorta. The diameters of thoracic aorta and abdominal aorta were (1.38±0.19) and (1.23±0.13) mm in control group, (2.43±1.56) and (1.30±0.26) mm in 0.2 g·kg^-1·d^-1 BAPN group, (2.45±1.28) and (1.30±0.31) mm in 0.4 g·kg^-1·d^-1 BAPN group, (2.87±0.57) and (1.95±0.81) mm in 0.8 g·kg^-1·d^-1 BAPN group (both P<0.05 vs. control group). The diameters of thoracic aorta and abdominal aorta in mice also increased in proportion with BAPN concentration increase. Furthermore, blood-filled false lumen formation and elastic fibers fragmentation were evidenced in hematoxylin-eosin stained and Vitoria blue-Sirius red stained aortic cross-sections of mice in the 0.8 g·kg^-1·d^-1 BAPN group. Conclusion BAPN treatment induced aortic dissection model in C57Bl/6J mice can serve as a useful wild-type mouse model for the mechanism and pharmaceutical studies of AD.

Objective To establish a mouse model of aorta dissection (AD) by β-aminopropionitrile (BAPN) in drinking water + subcutaneously pumped angiotensin II (Ang II) infusion.Methods Forty 3-week-old C57B1/6J male mice were randomly divided into two groups.All animals received 0.1 g/kg/d BAPN in drinking water for 4 weeks.Then the BAPN drinking + saline infusion group and BAPN drinking + Ang II infusion group received continuous saline or Ang II (1,000 ng/kg/min) infusion, respectively, via subcutaneous osmotic minipump for 72 hour.The mice were restricted in a noninvasive computerized tail-cuff system and their arterial systolic blood pressure and heart rate were monitored.Autopsy was performed if a mouse died during the experiment.At the end of the experiment, mice were sacrificed by injection with an overdose of sodium pentobarbital and the aortas were harvested.The formation of aortic false lumen was observed by pathology using hematoxylin-eosin staining.Results The overall incidence of AD in the BAPN drinking administration +Ang II infusion group was 95%, whereas the incidence of AD in the BAPN drinking administration +saline infusion group was only 5%.The mortality from dissecting aneurysm rupture was 24% in the BAPN drinking administration +Ang II infusion group during the experiment.Pathological examination of the aortic cross-sections clearly showed the formation of blood-filled false lumens induced by Ang II.Conclusions A mouse model with high incidence of aortic dissection is successfully established.

Objective To evaluate the clinical effect of combination of acupuncture and medicine combined with auricular pointsfor the children of MT.Methods A total of 70 children with MT who met the inclusion criteria, were divided into the treatment group and control group according to random number table method (n=35); The treatment group was given acupuncture treatment and prescription ofZishen-Tiaogan and auricular points; and the control group was given Haloperidol tablets. Both groups were treated for 2 months. The severity of the children's convulsing symptoms and the clinical efficacy were assessed by the Yale Global Tie Severityb Scale (YGTSS).Results After 1 course of treatment, the total effective rate of the treatment group was 82.9% (29/35), while the control group was 57.1% (20/35), and the difference was statistically significant (Z=-2.276,P=0.023); after 2 courses of treatment, the total effective rate of the treatment group was 88.6% (31/35) and the control group was71.4% (25/35).The difference was statistically significant (Z=-2.346, P=0.019). After 1 course of treatment, YGTSS score was (14.6 ± 6.9vs. 17.3 ± 7.5,t=4.604), and after 2 course of treatment,YGTSS score was (8.0 ± 5.3vs. 10.3 ± 4.9,t=5.521) in the treatment group wwere significantly lower than the control group (P<0.05).Conclusions Combination of acupuncture and medicine combined with auricular points can alleviate the clinical symptoms of children with MT and improve the clinical effect.

Objective:To observe the effects of lactoferrin(LF)on the proliferation,migration and osteogenic differentiation of human periodontal ligament cells(HPDLCs)in vitro.Methods:HPDLCs were cultured and identified.The proliferation and migration of HP-DLCs cultured with 0,10 and 20 μg/ml lactoferrin respectively were tested by MTT assay,Transwell assay and scratch test.The os-teogenic differentiation of the cells was evaluated using alizarin red staining and real-time PCR.Results:Lactoferrin at 10 and 20μg/ml increased the proliferation(P <0.05),increased the quantities of mineralized nodules and the expression of alkaline phospha-tase(ALP),osteocalcin(OCN)and osteopontin(OPN)(P <0.05).Conclusion:Lactoferrin promotes the proliferation,migration and osteogenic differentiation of HPDLCs.

Objective To determine the ameliorative effects of Junzhi beverageⅠon neurobehavioral functions in subjects exposed to long-term sustained work.Methods Forty male students of a military institution were randomized into control group ( n=20 ) and the intervention group ( n=20 ) .All the subjects were exposed to 10-hours′high intensity mental work continuously (8∶00-18∶00).At 12∶50, the intervention group drunk a bottle of water with Junzhi beverageⅠ, but the control group drunk water of the same volume only.At 17∶00, neurobehavioral functions of all the subjects were tested by neurobehavioral core test battery (WHO-NCTB) and attention span test(AST).Results According to the results of WHO-NCBT, after 10-hours′continuous mental work,the profile of mood state in the intervention group was more stable than in the control group with lower scores in negative mood and higher scores in positive mood.Meanwhile, some of the neurobehavioral indexes were also found to be significantly improved, including shortened mean time of simple reaction and decreased error reaction rate, enhanced digit span backward, higher scores in Beton test , digit symbol test, Santa Ana practice hand and correct dot number (P<0.05).In addition, higher scores were obtained in the intervention group in AST(P<0.05).Conclusion Junzhi beverageⅠ can significantly improve the neurobehavioral function under sustained mental work conditions, which suggests that the beverage has the potential to postpone mental fatigue protect and enhance cognitive function.