Objective To explore the role of CLEARstent Live(CSL),a real-time stent visualiza-tion tool,in guiding percutaneous coronary intervention(PCI)for patients with complex coronary artery disease(CAD)and its effect on the risk of restenosis of stented coronary arteries.Methods A total of 140 patients with complex CAD undergoing PCI in our hospital from September 2022 to October 2023 were enrolled,and randomly divided into routine group(conventional stent doc-king technique)and CSL group(PCI under CSL visualization),with 70 patients in each group.The quality of angiographic images,basic conditions of surgical treatment,cardiac function and inci-dence of in-stent restenosis were compared between the two groups.Results The effective radia-tion dose,developing time,and dose area product were significantly lower,and the image quality score was obviously higher in the CSL group than the conventional group(P＜0.01).There were no significant differences in success rate of stent implantation,operation time,stent length or stent number between the two groups(P＞0.05).The CSL group had notably shorter length of hospital stay(9.83±1.21 d vs 11.85±1.68 d,P=0.000)and higher treatment cost[(3.01±0.63)× 104 Yuan vs(2.79±0.52)×104 Yuan,P=0.026]when compared with the conventional group.In both group,surgical treatment resulted in significantly elevated cardiac index and decreased left ventricular end-diastolic diameter and left ventricular end-systolic diameter at 7 d after operation(P＜0.05).The incidence of in-stent restenosis was statistically lower in the CSL group than con-ventional group[4.29％(3 cases)vs 25.71％(18 cases),x2=12.605,P=0.000].Conclusion CSL visualization provides better image quality for patients with complex CAD undergoing PCI,thus reducing the risk of in-stent restenosis and improving the treatment efficacy.

Objective To explore the role of CLEARstent Live(CSL),a real-time stent visualiza-tion tool,in guiding percutaneous coronary intervention(PCI)for patients with complex coronary artery disease(CAD)and its effect on the risk of restenosis of stented coronary arteries.Methods A total of 140 patients with complex CAD undergoing PCI in our hospital from September 2022 to October 2023 were enrolled,and randomly divided into routine group(conventional stent doc-king technique)and CSL group(PCI under CSL visualization),with 70 patients in each group.The quality of angiographic images,basic conditions of surgical treatment,cardiac function and inci-dence of in-stent restenosis were compared between the two groups.Results The effective radia-tion dose,developing time,and dose area product were significantly lower,and the image quality score was obviously higher in the CSL group than the conventional group(P＜0.01).There were no significant differences in success rate of stent implantation,operation time,stent length or stent number between the two groups(P＞0.05).The CSL group had notably shorter length of hospital stay(9.83±1.21 d vs 11.85±1.68 d,P=0.000)and higher treatment cost[(3.01±0.63)× 104 Yuan vs(2.79±0.52)×104 Yuan,P=0.026]when compared with the conventional group.In both group,surgical treatment resulted in significantly elevated cardiac index and decreased left ventricular end-diastolic diameter and left ventricular end-systolic diameter at 7 d after operation(P＜0.05).The incidence of in-stent restenosis was statistically lower in the CSL group than con-ventional group[4.29％(3 cases)vs 25.71％(18 cases),x2=12.605,P=0.000].Conclusion CSL visualization provides better image quality for patients with complex CAD undergoing PCI,thus reducing the risk of in-stent restenosis and improving the treatment efficacy.

Objective To determine the effect of thrombus aspiration combined with intracoronary injection of recombinant human TNK tissue type plasminogen activator(rhTNK-tPA)on micro-circulation and cardiac function during primary PCI in elderly patients with acute myocardial in-farction(AMI).Methods A retrospective study was conducted on 90 elderly patients with STEMI undergoing primary PCI in Tianjin Third Central Hospital from January 2021 to October 2023.According to their treatment strategies,they were divided into simple suction group(n=46)and combination group(n=44).The suction group received a suction catheter for thrombus aspiration within the coronary artery,while the combined group got a suction catheter for thrombus aspira-tion within the infarct related blood vessels,and then received a local injection of rhTNK-tPA into the lesion through the suction catheter.Their general data,proportion of ST segment resolution(STR)≥70％at 90 min after surgery,postoperative TIMI blood flow grade,postoperative TIMI myocardial perfusion grade(TMPG),corrected TIMI frame count(CTFC)and cardiac ultrasound indicators as well as the incidence of adverse cardiac events during hospitalization were compared between the two groups.Results Larger proportions of postoperative STR ≥70％,postoperative TIMI blood flow grade 3 and TMPG grade 3,and lower CTFC were observed in the combination group than the suction group(P＜0.05).In 1 week after surgery,the simple suction group had lower left ventricular ejection fraction[LVEF,(52.5±6.2)％vs(58.3±6.4)％,P＜0.05],but larger left ventricular diameter(LVD,44.1±3.9 mm vs 51.9±2.5 mm,P＜0.05)than the com-bined group.The incidence of MACE during hospitalization was obviously lower in the combined group than the suction group(20.5％vs 37.0％,P＜0.05).Conclusion Combined intracoronary injection of rhTNK-tPA based on thrombotic aspiration can effectively reduce the coronary thrombus burden,improve myocardial microcirculation perfusion,reduce the incidence of MACE during hospitalization,and not increase the risk of bleeding in elderly STEMI patients.

Objective:To analyze the current situation and influencing factors of work-related musculoskeletal disorders (WMSDs) among scientific researchers in a computer workstation of a high-tech aerospace enterprise, and to provide data support for the improvement of occupational health management policies in this type of enterprise.Methods:From March to April 2023, using convenient sampling method, 1398 scientific researchers using computer workstations in an aerospace high-tech enterprise in Beijing were selected as the research subjects. The incidence of WMSDs in various parts of the body was investigated by using the Musculoskeletal Disorders Questionnaire, and the influencing factors of WMSDs in neck, lower back, shoulder and upper back were analyzed by logistic regression.Results:The total incidence of WMSDs was 55.4% (774/1398) in the scientific researchers who used computer workstations. The top 4 body parts in WMSDs incidence were neck (24.3%, 340/1398), lower back (20.4%, 285/1398), shoulder (18.7%, 262/1398), upper back (12.7%, 177/1398). The results of multivariate logistic regression analysis showed that feeling slightly tired and tired after work, setting a rest/break time of 10 to 15 min before the next continuous job, and operating computer for 2 to 4 hours and >4 hours were the influencing factors for the occurrence of neck WMSDs ( OR=3.08, 1.90, 0.60, 2.00, 1.49, P<0.05). Female, 5-<10 years of working experience, feeling slightly tired, tired and very tired after work, operating computer for 6-<8 hours and 8-10 hours a day were all the influencing factors for the occurrence of WMSDs in the lower back ( OR=1.82, 0.64, 2.95, 1.80, 1.61, 1.82, 1.73, P<0.05). Female, feeling slightly tired and tired after work were the influencing factors of shoulder WMSDs occurrence ( OR=2.42, 2.09, 2.00, P<0.05). Female, 5-<10 years, 10-15 years of working age, 1-3 times of physical exercise/quarter, feeling slightly tired, tired and very tired after work were the influencing factors for the occurrence of upper back WMSDs ( OR=2.76, 2.19, 2.78, 0.48, 4.20, 2.66, 2.19, P<0.05) . Conclusion:The incidence of WMSDs among scientific researchers in computer workstations of aerospace high-tech enterprises is high, which is closely related to individual characteristics and workstation usage characteristics. Measures should be taken to prevent and improve the WMSDs status of scientific researchers.

[Objective] To review the clinical information, imaging features, pathological manifestations and prognosis of low-grade oncocytic tumor (LOT), so as to improve the clinical understanding of the disease. [Methods] The imaging, clinicopathological and postoperative follow-up data of 3 LOT cases treated in Peking University Third Hospital during Feb.2020 and Sep.2022 were retrospectively collected. [Results] All patients were male, aged 51—70 years.All tumors were single, with the maximum diameter of 14—21 mm. None of the patients had any specific clinical manifestations.The mass showed a circular isodense shadow on CT.All patients underwent nephron-sparing tumor resection.Postoperative pathology showed that the incision surface of the tumors was brownish-yellow or brown, and the tumors were solid or partially cystic.HE staining showed that the cells were uniformly eosinophilic; the nucleus was round or oval, with slight local perinuclear halo.Immunohistochemistry showed positive CK7 but negative CD117.Genetic testing in case 2 showed 1 potentially clinically significant somatic mutation TSC2.During the follow-up of 12-23 months, no recurrence occurred. [Conclusion] There were no obvious clinical symptoms and imaging features of LOT, which morphologically showed heterozygous or borderline characteristics with renal eosinophilia and renal chromophobe cell carcinoma, and the biological behavior was indolent.Nephron-sparing tumor resection promised good prognosis.

Objective:To analyze the current situation and influencing factors of work-related musculoskeletal disorders (WMSDs) among scientific researchers in a computer workstation of a high-tech aerospace enterprise, and to provide data support for the improvement of occupational health management policies in this type of enterprise.Methods:From March to April 2023, using convenient sampling method, 1398 scientific researchers using computer workstations in an aerospace high-tech enterprise in Beijing were selected as the research subjects. The incidence of WMSDs in various parts of the body was investigated by using the Musculoskeletal Disorders Questionnaire, and the influencing factors of WMSDs in neck, lower back, shoulder and upper back were analyzed by logistic regression.Results:The total incidence of WMSDs was 55.4% (774/1398) in the scientific researchers who used computer workstations. The top 4 body parts in WMSDs incidence were neck (24.3%, 340/1398), lower back (20.4%, 285/1398), shoulder (18.7%, 262/1398), upper back (12.7%, 177/1398). The results of multivariate logistic regression analysis showed that feeling slightly tired and tired after work, setting a rest/break time of 10 to 15 min before the next continuous job, and operating computer for 2 to 4 hours and >4 hours were the influencing factors for the occurrence of neck WMSDs ( OR=3.08, 1.90, 0.60, 2.00, 1.49, P<0.05). Female, 5-<10 years of working experience, feeling slightly tired, tired and very tired after work, operating computer for 6-<8 hours and 8-10 hours a day were all the influencing factors for the occurrence of WMSDs in the lower back ( OR=1.82, 0.64, 2.95, 1.80, 1.61, 1.82, 1.73, P<0.05). Female, feeling slightly tired and tired after work were the influencing factors of shoulder WMSDs occurrence ( OR=2.42, 2.09, 2.00, P<0.05). Female, 5-<10 years, 10-15 years of working age, 1-3 times of physical exercise/quarter, feeling slightly tired, tired and very tired after work were the influencing factors for the occurrence of upper back WMSDs ( OR=2.76, 2.19, 2.78, 0.48, 4.20, 2.66, 2.19, P<0.05) . Conclusion:The incidence of WMSDs among scientific researchers in computer workstations of aerospace high-tech enterprises is high, which is closely related to individual characteristics and workstation usage characteristics. Measures should be taken to prevent and improve the WMSDs status of scientific researchers.

Objective:This paper is to evaluate the curative effect of Self-made Jishen prescription combined with conventional western medicine in the treatment of type 2 diabetic kidney disease (DKD) with both deficiency of both qi and yin and blood stasis.Methods:A total of 80 patients from February 2019 to July 2020 with the syndrome of deficiency of both Qi and Yin with blood stasis in the DKD Ⅲ stage of Ruzhou Jiren Diabetes Hospital were selected. Those patients who met the diagnostic criteria were randomly divided into 2 groups, the control group and the treatment group, according to registration orders, with 40 in each group. The control group was treated with conventional western medicine therapy, and the treatment group was treated with modified self-made Jishen prescription on the basis of the control group. The treatment of both groups lasted for 3 months. Traditional Chinese Medicine (TCM) symptoms were scored before and after the treatment; hexokinase method was used to detect FPG, sarcosine oxidase method was used to detect SCr and eGFR were calculated, latex enhanced turbidimetric inhibition immuno assay method was used to detect hypersensitive C-reactive protein (hs-CRP), the sandwich ELISA was used to detect transforming growth factor-β1 (TGF-β1), and HbA1c was detected by high performance liquid chromatography; 24 h urine was collected, and 24 hUTP was detected by pyrogallol red-molybdenum method; and the clinical efficacy was evaluated.Results:The total effective rate was 87.5% (35/40) in the treatment group and 67.5% (27/40) in the control group. The difference between the two groups was statistically significant ( Z=-2.72, P=0.006). After treatment, hs-CRP [(2.52±1.02) mg/L vs. (3.21±1.22) mg/L, t=2.74], TGF-β1 [(32.2±6.52) mg/L vs. (38.3±6.8) mg/L, t=-4.97], 24 hUTP [(120.91±38.84) mg vs. (144.84 ±49.69) mg, t=-5.94] in the treatment group were significantly lower than those in the control group ( P<0.05); eGFR [(66.23±4.91)ml?min -1?1.73m -2vs. (59.69 ±4.51) ml?min -1?1.73m -2, t=6.61] in the treatment group was significantly higher than that of the control group ( P<0.05). The TCM Symptom Score after treatment in the treatment group was significantly lower than that of the control group ( P<0.01). Conclusion:For the patients with T2DM kidney disease of Phase Ⅲ with Deficiency of both Qi and Yin and Blood Stasis, the treatment of self-made Jishen prescription combined with conventional western medicine can inhibit the inflammatory reaction and renal interstitial fibrosis, improve the glomerular filtration rate, and reduce the excretion of urine protein.

P450 fatty acid decarboxylase OleT from Staphylococcus aureus (OleTsA) is a novel cytochrome P450 enzyme that catalyzes the oxidative decarboxylation of fatty acids to yield primarily terminal alkenes and CO2 or minor α-and β-hydroxylated fatty acids as side-products.In this work,the interactions between a series of cycloalkyl phosphorus heterocycles (CPHs) and OleTsA were investigated in detail by fluores-cence titration experiment,ultraviolet-visible (UV-vis) and 31p NMR spectroscopies.Fluorescence titration experiment results clearly showed that a dynamic quenching occurred when CPH-6,a repre-sentative CPHs,interacted with OleTsA with a binding constant value of 15.2 × 104 M-1 at 293 K.The thermodynamic parameters (△H,△S and △G) showed that the hydrogen bond and van der Waals force played major roles in the interaction between OleTsA and CPHs.The UV-vis and 31p NMR studies indicated the penetration of CPH-6 into the interior environment of OleTsA,which greatly affects the enzymatic activity of OleTsA.Therefore,our study revealed an effective way to use phosphorus hetero-cyclic compounds to modulate the activity of cvtochrome P450 enzymes.

The organ system-based teaching model integrates the morphology and function of various organ and system of human body, breaks the boundaries of disciplines, and avoids the duplication and disjunction between disciplines. With this model general practitioners can effectively and efficiently learn basic knowledge and clinical skills in the training. This article introduces the organ system-based teaching model and its application in general practice job-transfer training in China.

Objective To investigate the correlation between serum proprotein convertase subtilisin/kexin 9 (PCSK9) level and the severity of angiographic coronary artery disease (CAD) in elderly patients with acute myocardial infarction (AMI) complicated with type 2 diabetes mellitus (T2DM). Methods The patients over the same period were divided into three groups:the elderly patients with AMI and T2DM (observation group, n=46), the elderly non diabetic patients with AMI (positive control group, n=34) and patients with chronic stable coronary heart disease (negative control group, n=33). The serum PCSK9 level was detected by enzyme-linked immunosorbent (ELISA) in three groups. The correlation between serum PCSK9 level and low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TG), total cholesterol (TC), glycosylated hemoglobin (HbA1c), high sensitive C reactive protein (Hs-CRP) and Gensini score were analyzed. Results The levels of PCSK9, HbA1c, Hs-CRP and Gensini score showed a gradually increased tendency in negative control group, positive control group and observation group. Multiple comparison differences between groups were statistically significant (P<0.05). The serum PCSK9 level was positively correlated with Hs-CRP and Gensini score in observation group (P<0.05), and showed no correlation with HbA1c, TG, TC, LDL-C and HDL-C (P>0.05). Conclusion The serum level of PCSK9 is positive correlated with the severity of CAD, which can be used to determine the severity of coronary artery lesions in elderly patients with AMI complicated with T2DM.