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

Purpose/Significance To analyze the characteristics and problems of the policy texts of hospital informatization in China,and to explore the methods of policy optimization.Method/Process Related policy documents of hospital informatization at the national level are re-trieved from March 17,2009 to August 31,2023,and the policy texts are coded and analyzed from two dimensions of policy tools and system theory.Result/Conclusion The policy of hospital informatization in China is mainly based on environment-oriented policy tools,and it is sug-gested to pay more attention to the use of demand-oriented and supply-oriented tools.In addition,it is necessary to scientifically optimize the internal structure of policy tools,strengthen the use of internal submodels,and improve the systematization of policy tools.

BACKGROUND: Type I collagen is a polymer material that has good biocompatibility and good cell affinity, and can degrade under certain conditions. It can also develop good mechanical properties after cross-linking, but it is less reported in the reconstruction of the injured median nerve of the forearm. OBJECTIVE: To explore the preparation method of type I collagen nerve conduit and its mechanism in the reconstruction following median nerve injury in the forearm. METHODS: A total of 40 Sprague-Dawley rats were selected from the Medical Animal Experimental Center, the Affiliated Hospital of Guizhou Medical University, 10 of which were randomly selected as sham surgery group. The remaining 30 rats were used to establish a rat model of median nerve injury in the forearm by laser-induced photochemical reaction. After successful modeling, the model rats were randomly divided into positive control group (n=10), type I collagen group (n=10) and autologous nerve group (n=10). The sham surgery group was routinely fed and did not participate in the modeling; the positive control group did not take special treatment after the successful modeling; the type I collagen group was subjected to bridging with type I collagen nerve conduit; and the autologous nerve group was subjected to bridging with autologous nerve. The repair effects were compared among groups. RESULTS AND CONCLUSION: (1) Under the inverted microscope, the type I collagen was loosely arranged before cross-linking, and it had honeycomb-shaped irregular pores with the pore size of 10-100 μm and the porosity of 20-200 μm, and the pore interstitial was relatively thin. After cross-linking, the type I collagen was densely arranged, the collagen fibers could form relatively regular pores with the pore size of 50-100 μm and the porosity of 20-200 μm, the interstitial mass was thickened, and the spatial structure changed significantly. (2) After 4, 8 and 12 weeks of repair, the scores on the Minnesota Manual Dexterity Test in the type I collagen and autologous nerve groups were significantly lower than those in the positive control group (P < 0.05) and higher than those in the sham surgery group (P < 0.05). (3) At 12 weeks after repair, there was no significant difference in amplitude and latency between the type I collagen group and the autologous nerve group (P> 0.05), but the amplitude and latency in both groups were significantly higher than those in the positive control group (P < 0.05). (4) At 12 weeks after repair, the nerve injury site surrounded by necrotic tissues was visible in the positive control group; no injury was found in the autologous nerve group, and the surrounding necrotic area decreased, indicating good recovery; no injury was shown by toluidine blue staining in the type II collagen group, indicating good recovery. Overall, the type I collagen nerve conduit can be successfully prepared by the self-made mold, and it can be used for the reconstruction following median nerve injury in the rat forearm, helping nerve repair.

wearable microfluidics have wide applications in medical, sports and military field. with the help of wearable microfluidics, through the direct physical contact between the chip and skin, the pH, glucose, lactate, sodium/potassium, calcium and heavy metal in the body fluid can be detected from sweat, tear and saliva without puncture for blood. And these information are of great importance for the monitoring of vital signs and disease diagnosis. This paper introduced the most recent development and applications of the wearable microfluidics in the body fluid testing and drug delivery. The up-to-date research development for the drug delivery using wearable microfluidics was also briefly introduced in this article. The forecast of the emerging trend for wearable microfluidics and discussion of potential technique barriers was also provided at the end of this article.

Digital polymerase chain reaction ( PCR) has been experiencing a rapid development during the past few years. Comparing with the traditional real-time quantitative PCR ( RT-qPCR) , using the same primer and probe, the accuracy for the absolute quantification of target gene is significantly improved. The development of digital PCR is directly related to the development of microfluidics. The integrated fluid circuit is an early combination of the microfluidics and digital PCR, which has a complicated fabrication process with high cost. Recently, researchers are trying to apply the droplet microfluidics in digital PCR, and the droplet microfluidic chip is able to generate millions of droplets within a short time. Each of these droplets containing no more than one target gene is a reaction chamber during the amplification process. After amplification, each droplet is tested to achieve the absolute quantification of the target gene. This paper reviews the recent progresses of droplet digital PCR, and the applications of droplet digital PCR in biological, medical and environmental fields.