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

AIM: To investigate the association between HOXA1 and FOXF2 gene variants and genetic susceptibility in multigenerational families with exotropia, and to elucidate the molecular genetic etiological mechanisms of exotropia.METHODS:A total of 10 multigenerational families with a definitive history of exotropia were recruited from September 2023 to February 2025, comprising 165 members(87 exotropia patients and 78 normal controls). Detailed ophthalmological examinations were performed, family pedigrees were constructed, peripheral blood samples were collected, genomic DNA was extracted, and PCR amplification followed by Sanger sequencing were used to detect exons and flanking sequences of the HOXA1 and FOXF2 genes. Identified variants were subjected to pathogenicity classification and association analyses.RESULTS:Among the 10 families, 5 variant sites in HOXA1(c.218G>A, c.385C>T, c.496A>G, c.652T>C, c.874C>T)and 4 in FOXF2(c.102C>T, c.344G>A, c.576T>C, c.892A>G)were identified. The HOXA1 c.496A>G variant showed statistically significant differences between carrier and noncarrier in exotropia angle, exotropia type, stereoscopic vision, and parallax(all P<0.05). The age of onset of FOXF2 gene c.344G>A mutation carrier group was younger than that of the non-carrier group(t=3.55, P=0.004).CONCLUSION:HOXA1 and FOXF2 gene variants are significantly associated with genetic susceptibility to exotropia, particularly influencing age of onset and deviation angle, offering novel targets for molecular diagnosis and precision treatment of exotropia.

Objective: To find a viable alternative to reduce the number of doses required for the patients with post-traumatic stress disorder (PTSD), and to improve efficacy and patient compliance. Methods: In this study, we used ginger oil, a phytochemical with potential therapeutic properties, to prepare ginger oil patches. High-performance liquid chromatography (HPLC) was used to quantify the main active component of ginger oil, 6-gingerol. Transdermal absorption experiments were conducted to optimize the various pressure-sensitive adhesives and permeation enhancers, including their type and concentration. Subsequently, the ginger oil patches were optimized and subjected to content determination and property evaluations. A PTSD mouse model was established using the foot-shock method. The therapeutic effect of ginger oil patches on PTSD was assessed through pathological sections, behavioral tests, and the evaluation of biomarkers such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), brain-derived neurotrophic factor (BDNF), and melatonin (MT). Results: The results demonstrated that ginger oil patches exerted therapeutic effects against PTSD by inhibiting inflammatory responses and modulating MT and BDNF levels. Pharmacokinetic experiments revealed that ginger oil patches maintained a stable blood drug concentration for at least one day, addressing the rapid metabolism drawback of 6-gingerol and enhancing its therapeutic efficacy. Conclusions Ginger oil can be prepared as a transdermal drug patch that meets these requirements, and the bioavailability of the prepared patch is better than that of oral administration. It can improve PTSD with good patient compliance and ease of administration. Therefore, it is a promising therapeutic formulation for the treatment of PTSD.

Objective:To explore the clinical epidemiological characteristics of respiratory syncytial virus in children in Hubei Province from 2020 to 2023.Method:A single-center and cross-sectional study was used to analyze the clinical data of 3 271 children with respiratory syncytial virus infection in Wuhan Children′s Hospital affiliated to Huazhong University of Science and Technology from July 1, 2020 to June 30, 2023. Nonparametric rank sum test and χ2 test were used for comparative analysis. Results:From July 1, 2020 to June 30, 2023, a total of 25 583 children were included in the analysis, of which 3 271(12.8%) children infected RSV. The detection rate was 16.3% in 2020-2021, 14.7% in 2021-2022 and 9.1% in 2022-2023. The detection rate decreased year by year ( χ2=222.054, P<0.05). From 2020 to 2023, there was an anti-seasonal epidemic of RSV in spring and autumn. The detection rate of RSV in infants under 1 year old was the highest, but the median ages of RSV positive children increased ( H=140.575, P<0.05). Pneumonia was the main clinical manifestation of RSV respiratory tract infection. Conclusion:The epidemiological characteristics of RSV in children in Hubei Province were different from those before. From 2020 to 2023, the detection rate of RSV decreased year by year. Besides winter, the prevalence of RSV could also be seen in spring and autumn. The median age of children infected with RSV increased after the epidemic. Pneumonia was the main clinical manifestation after RSV infection.

Objective:To explore the clinical epidemiological characteristics of respiratory syncytial virus in children in Hubei Province from 2020 to 2023.Method:A single-center and cross-sectional study was used to analyze the clinical data of 3 271 children with respiratory syncytial virus infection in Wuhan Children′s Hospital affiliated to Huazhong University of Science and Technology from July 1, 2020 to June 30, 2023. Nonparametric rank sum test and χ2 test were used for comparative analysis. Results:From July 1, 2020 to June 30, 2023, a total of 25 583 children were included in the analysis, of which 3 271(12.8%) children infected RSV. The detection rate was 16.3% in 2020-2021, 14.7% in 2021-2022 and 9.1% in 2022-2023. The detection rate decreased year by year ( χ2=222.054, P<0.05). From 2020 to 2023, there was an anti-seasonal epidemic of RSV in spring and autumn. The detection rate of RSV in infants under 1 year old was the highest, but the median ages of RSV positive children increased ( H=140.575, P<0.05). Pneumonia was the main clinical manifestation of RSV respiratory tract infection. Conclusion:The epidemiological characteristics of RSV in children in Hubei Province were different from those before. From 2020 to 2023, the detection rate of RSV decreased year by year. Besides winter, the prevalence of RSV could also be seen in spring and autumn. The median age of children infected with RSV increased after the epidemic. Pneumonia was the main clinical manifestation after RSV infection.

Objective To evaluate the efficacy of Schroth PSSE combined with 3D printing braces in the treatment of adolescent idiopathic scoliosis.Method Forty patients were included and divided into a support group(3D printing support group)and a support+exercise therapy group(3D printing support+Schroth PSSE group).Excluding outliers and lost follow-up data,32 patients were ultimately included,with 16 patients in each group.Wearing time≥18 h for both groups of 3D printing supports.The intervention period of Schroth PSSE is 12 weeks,and exercise is maintained after 12 weeks until the end of follow-up.The longest follow-up time for the brace group was 25 months,with an average follow-up time of(15.00±1.29)months.The longest follow-up time for the brace+exercise therapy group was 24 months,with an average follow-up time of(16.59±1.01)months.Relevant indicators were evaluated after follow-up.Results The support and exercise therapy group showed better improvement in Cobb angle and trunk rotation angle(ATR)than the support group,with statistically significant differences(P<0.05);The distance between the midpoint of the C7 vertebral body and the midline of the sacrum(C7-CSVL)in the support and exercise therapy group showed a statistically significant difference before and after treatment(P<0.05),while there was a significant difference before and after Apical Vertebral Translation(AVT)treatment(P<0.01).There was no statistically significant difference compared to the support group(P<0.05);In terms of SRS-22 score,the brace+exercise therapy group can comprehensively improve the SRS-22 score.Conclusion The combination of Schroth PSSE and 3D printing braces has a better effect on improving Cobb angle and torso rotation angle,improving coronary imbalance,increasing patient satisfaction,and improving quality of life compared to using 3D printing braces alone.

Objective:To explore the correlation between self-efficacy and depression in patients with hematologic malignancy, and analyze the mediating role of social support and the moderating effect of resilience.Methods:From February to June 2017, a total of 284 patients with hematologic malignancy in Jining Medical University Affiliated Hospital completed Connor-Davidson resilience scale (CD-RISC), social support rate scale (SSRS), general self-efficacy scale (GSES), self-rating depression scale (SDS). SPSS 21.0 software was used for statistical analysis, and the correlation was obtained by Pearson correlation analysis, and PROCESS v3.4 macro program was used to test the mediating and moderating effects.Results:Self-efficacy played a significant negatively predictive effect on depression in patients with hematologic malignancy( β=-0.35, t=-6.16, P<0.01). Social support partially mediated the correlation between self-efficacy and depression(the mediating effect was -0.05, accounted for 14.29%(-0.05/-0.35) of the total effect). Resilience moderated the mediating effect of social support on the correlation between self-efficacy and depression.The self-efficacy had no predictive effect on social support when the level of resilience was low and it had a significant negatively predictive effect on social support when the level of resilience was high (simple slope=-0.28, P<0.01, 95% CI=-0.39- -0.18). Conclusion:Self-efficacy has a moderating effect on depression in patients with hematologic malignancy.Self-efficacy affects depression through social support, and resilience regulates the mediating role of social support in the relationship between self-efficacy and depression.

Objective:To explore the effect of structured interdisciplinary bedside rounds (SIBR) model on diarrhea and nutritional status in patients with stroke receiving enteral nutrition through nasogastric tube.Methods:From February to September 2021, 117 stroke patients with enteral nutrition through nasogastric tube admitted to Taiyuan Central Hospital were selected as the study subject by convenient sampling. The patients were divided into the control group (57 cases) and the intervention group (60 cases) according to the ward at the time of admission. The control group received routine enteral nutrition intervention, and the intervention group carried out enteral nutrition intervention based on SIBR model. The incidence of diarrhea and incontinence dermatitis during hospitalization, the nutritional indicators before treatment and on the seventh and fourteenth days of nutritional treatment, the incidence of complications during hospitalization and the length of hospitalization were compared between the two groups.Results:The incidence, duration, severity of diarrhea and the incidence of incontinence dermatitis in the intervention group were lower than those in the control group, and the incidence of constipation, gastric retention and pulmonary infection were lower than those in the control group, and the length of hospitalization was less than that in the control group, and the differences were statistically significant ( P<0.05) . After 14 days of nutritional treatment, the albumin, total protein and hemoglobin in the intervention group were better than those in the control group, with statistical differences ( P<0.05) . Conclusions:SIBR model integrates the content of ward round, shortens the time of ward round, increases the work efficiency, effectively reduces the incidence of diarrhea and incontinence dermatitis in patients with stroke receiving enteral nutrition through nasogastric tube, improves the nutritional status of patients, reduces the incidence of complications, and shortens the length of hospitalization.

Objective: To establish a risk assessment system for the prevention and control of infectious diseases in primary and secondary schools in Tianjin and reduce the risk of infectious disease prevention and control through risk assessment and control. Methods: Based on the failure modes and effect analysis method, a quantitative risk assessment of infectious disease prevention and control in 45 primary and secondary schools in Tianjin was carried out. Risk based supervisory process was assessed, while control effect was evaluated for contined improvement in the prevention and control of infectious diseases in the primary and secondary schools. Results: The top three risk aspects found in the infectious disease prevention and control system in primary and secondary schools in Tianjin included failure to provide sanitation professionals (82.22%) in accordance with regulations, no hand sanitizer or disinfectant (35.56%) in wash basins, and drinking water related products without approval (28.89%). The results of the risk assessment indicated that the three risk aspects with the highest risk priority number (RPN) included failure to provide health professionals( n = 144), no morning and afternoon inspection arrangement( n =126), and low quality of morning and afternoon inspections( n =126). After optimizing the supervision measures for the risk aspects with a detectable degree≥7 points, a quantitative risk assessment was carried out again, the RPN values of all risk points fell below 125, indicating reasonable control effect. Conclusion Based on the failure mode and effect analysis method, the establishment of a risk assessment system for the prevention and control of infectious diseases in primary and secondary schools and regular risk assessments can timely detect risk aspects in the infectious disease prevention and control, to promote effective prevention of infectious diseases in schools.

Post-traumatic stress disorder (PTSD) is a psychiatric disease that seriously affects brain function. Currently, selective serotonin reuptake inhibitors (SSRIs) are used to treat PTSD clinically but have decreased efficiency and increased side effects. In this study, nasal cannabidiol inclusion complex temperature-sensitive hydrogels (CBD TSGs) were prepared and evaluated to treat PTSD. Mice model of PTSD was established with conditional fear box. CBD TSGs could significantly improve the spontaneous behavior, exploratory spirit and alleviate tension in open field box, relieve anxiety and tension in elevated plus maze, and reduce the freezing time. Hematoxylin and eosin and c-FOS immunohistochemistry slides showed that the main injured brain areas in PTSD were the prefrontal cortex, amygdala, and hippocampus CA1. CBD TSGs could reduce the level of tumor necrosis factor-