In recent years, the prevalence of obstructive coronary artery disease has continued to rise. Despite the widespread application of strategies such as intensive pharmacotherapy, coronary artery bypass grafting, or percutaneous coronary intervention, a subset of patients still experience recurrent angina symptoms, which severely impacts their quality of life. For such cases of refractory angina (RA), researchers domestically and internationally have explored therapeutic approaches such as spinal cord stimulation, transmyocardial laser revascularization, and sympathectomy. However, existing studies are largely limited to small-scale clinical trials, and their clinical translation still faces challenges due to insufficient validation of safety and efficacy. Injectable hydrogels, as functional materials with hydrophilic three-dimensional network structures, demonstrate unique advantages in the treatment of RA. They can not only provide mechanical support but also serve as controlled-release carriers for drugs and proteins, and synergize with gene therapy and stem cell therapy to promotemyocardial tissue repair. This article systematically reviews the application prospects of injectable hydrogels in the treatment of RA, aiming to provide insights for future therapeutic strategies.

Objectives:To investigate the factors affecting the formation of coronary collateral circulation(CCC)in patients with chronic total occlusion(CTO)lesion of coronary artery.Methods:A total of 305 consecutive patients who were hospitalized in the department of cardiology of the First Hospital of Lanzhou University from December 2022 to December 2023 and CTO lesions were confirmed by coronary angiography in at least one major coronary artery were included.The clinical data were collected,and the patients were divided into poor CCC group(Rentrop grade 0-1,n=109)and good CCC group(Rentrop grade 2-3,n=196)according to Rentrop criteria.Univariate logistic regression and multivariate logistic regression analysis were used to investigate the risk factors of poor CCC formation in CTO lesion patients.Results:There were 109 patients with poor CCC formation and 196 patients with good CCC formation in this cohort.The levels of white blood cell count,neutrophil count,platelet count,platelet to lymphocyte ratio,neutrophil to lymphocyte ratio,systemic immunoinflammatory index(SII),lipoprotein a and fibringen(Fib)were significantly higher,lymphocyte count and mean platelet volume were significantly lower in patients with poor CCC formation than in patients with good CCC formation(all P<0.05).Multivariate logistic regression analysis showed that higher SII(OR=1.004,95%CI:1.003-1.006,P<0.001),Fib(OR=1.546,95%CI:1.038-2.301,P=0.032)levels were independent predictors of poor CCC formation in CTO lesion patients.Conclusions:Higher levels of SII and Fib are independently correlated with poor CCC formation,which may be used as clinical predictor of poor CCC formation in CTO lesion patients.

Objectives:To investigate the factors affecting the formation of coronary collateral circulation(CCC)in patients with chronic total occlusion(CTO)lesion of coronary artery.Methods:A total of 305 consecutive patients who were hospitalized in the department of cardiology of the First Hospital of Lanzhou University from December 2022 to December 2023 and CTO lesions were confirmed by coronary angiography in at least one major coronary artery were included.The clinical data were collected,and the patients were divided into poor CCC group(Rentrop grade 0-1,n=109)and good CCC group(Rentrop grade 2-3,n=196)according to Rentrop criteria.Univariate logistic regression and multivariate logistic regression analysis were used to investigate the risk factors of poor CCC formation in CTO lesion patients.Results:There were 109 patients with poor CCC formation and 196 patients with good CCC formation in this cohort.The levels of white blood cell count,neutrophil count,platelet count,platelet to lymphocyte ratio,neutrophil to lymphocyte ratio,systemic immunoinflammatory index(SII),lipoprotein a and fibringen(Fib)were significantly higher,lymphocyte count and mean platelet volume were significantly lower in patients with poor CCC formation than in patients with good CCC formation(all P<0.05).Multivariate logistic regression analysis showed that higher SII(OR=1.004,95%CI:1.003-1.006,P<0.001),Fib(OR=1.546,95%CI:1.038-2.301,P=0.032)levels were independent predictors of poor CCC formation in CTO lesion patients.Conclusions:Higher levels of SII and Fib are independently correlated with poor CCC formation,which may be used as clinical predictor of poor CCC formation in CTO lesion patients.

Objective:To observe the therapeutic effect of intraocular lens (IOL) protected phacoemulsification (PHACO) in patients with hard nucleus cataract.Methods:A randomized controlled clinical study was conducted.A total of consecutive 120 patients (120 eyes) with hard nucleus cataract of Emery grade Ⅳ or Ⅴ were enrolled from January 2019 to May 2022.The patients were randomly divided into PHACO group receiving routine PHACO, IOL protected PHACO group receiving PHACO under IOL protection, and extracapsular cataract extraction (ECCE) group receiving ECCE, with 40 cases (40 eyes) in each group.Finally, 99 patients completed the follow-up, including 30 cases (30 eyes) in PHACO group, 35 cases (35 eyes) in IOL protected PHACO group, and 34 cases (34 eyes) in ECCE group.The total operation time, intraoperative PHACO time and cumulative energy release of each patient were recorded.The corneal endothelial cell density (ECD), coefficient of variation in endothelial cell area (CV), hexagonal endothelial cell ratio (6A), corneal astigmatism and the number of eyes with different grades of uncorrected visual acuity were measured and compared after 3-month follow-up.The intraoperative and postoperative complications were recorded.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Yanbian University Hospital (NO.2023002).Patients were informed of study content and purpose and signed a consent form before treatment.Results:There was no significant difference in ultrasonic energy and time between PHACO group and IOL protected PHACO group ( P=0.691, 0.982).The total operation time was (38.81±2.73) and (36.45±3.45) minutes in PHACO group and IOL protected PHACO group, significantly shorter than (69.60±4.35) minutes in ECCE group (both at P<0.001).There was no significant difference in age, sex, lens nucleus hardness and other baseline data among the three groups before operation (all at P>0.05).Three months after operation, the number of patients with higher uncorrected visual acuity in PHACO group and IOL protected PHACO group was larger than that in ECCE group ( P=0.006, 0.007).The ECD and 6A in IOL protected PHACO group were (2 155.57±177.88)/mm 2 and (41.31±5.18)%, respectively, which were significantly higher than (1 912.64±224.11)/mm 2 and (36.18±3.27)% in PHACO group, and the CV in IOL protected PHACO group was (50.34±5.90)%, which was lower than (55.67±3.30)% in PHACO group, showing statistically significant differences ( P=0.007, 0.003, 0.005).At 1 week and 3 months after the operation, the corneal astigmatism was significantly lower in IOL-protected PHACO group than in ECCE group, but higher than in PHACO group, and the difference were statistically significant (all at P<0.05). Conclusions:Compared with conventional PHACO, IOL-protected PHACO can effectively reduce the damage of corneal endothelium caused by ultrasonic energy, shorten the operation time and reduce postoperative inflammatory reaction compared with ECCE, and does not significantly increase postoperative corneal astigmatism.IOL-protected PHACO is an effective improved surgical method for patients with hard nucleus cataract.

Objective:To construct a user-centered intelligent interactive insulin pump information management system and verify its clinical application effects, providing more efficient and convenient blood glucose management support for medical staff.Methods:This study was divided into a retrospective cohort study and a cross-sectional survey study. Using purposive sampling, 152 patients using insulin pumps in the non-endocrinology department of Drum Tower Hospital Affiliated to Nanjing University Medical School from September to December 2021 were set as the control group, and 209 patients using insulin pumps in the same department from September to December 2022 were set as the experimental group. The control group was given insulin pump management based on the mode of the blood glucose management in hospital, while the experimental group, in addition to the insulin pump management based on the mode of blood glucose management in hospital, used a user-centered intelligent interactive insulin pump information management system. The incidence of adverse events related to insulin pumps in non-endocrinology department and the standardization rate of insulin pump documentation records were compared between the control group and the experimental group. In December 2022, 119 system users were surveyed using convenience sampling to evaluate the effectiveness of the insulin pump information system.Results:In the control group, there were 89 males,63 females, aged (58.15 ± 7.89) years.In the experimental group,there were 113 males,96 females, aged (58.72 ± 8.93)years. The incidence of adverse events related to insulin pumps was 1.48% (13/879) in the control group and 0.34%(4/1 182) in the experimental group, the difference was statistically significant ( χ2=8.02, P<0.05). The standardization rate of insulin pump paperwork in the experimental group was 90.1% (190/209), which was higher than that 48.02% (73/152) in the control group, the difference was statistically significant ( χ2=81.82, P<0.05). The average scores of each item in the system effectiveness evaluation questionnaire were all higher than the median of 2.5. Conclusions:The application of the user-centered intelligent interactive insulin pump information management system can reduce the incidence of adverse events related to insulin pumps, improve the standardization rate of insulin pump nursing documentation, and users are satisfied with the effectiveness evaluation of the system.

Objective:To construct a user-centered intelligent interactive insulin pump information management system and verify its clinical application effects, providing more efficient and convenient blood glucose management support for medical staff.Methods:This study was divided into a retrospective cohort study and a cross-sectional survey study. Using purposive sampling, 152 patients using insulin pumps in the non-endocrinology department of Drum Tower Hospital Affiliated to Nanjing University Medical School from September to December 2021 were set as the control group, and 209 patients using insulin pumps in the same department from September to December 2022 were set as the experimental group. The control group was given insulin pump management based on the mode of the blood glucose management in hospital, while the experimental group, in addition to the insulin pump management based on the mode of blood glucose management in hospital, used a user-centered intelligent interactive insulin pump information management system. The incidence of adverse events related to insulin pumps in non-endocrinology department and the standardization rate of insulin pump documentation records were compared between the control group and the experimental group. In December 2022, 119 system users were surveyed using convenience sampling to evaluate the effectiveness of the insulin pump information system.Results:In the control group, there were 89 males,63 females, aged (58.15 ± 7.89) years.In the experimental group,there were 113 males,96 females, aged (58.72 ± 8.93)years. The incidence of adverse events related to insulin pumps was 1.48% (13/879) in the control group and 0.34%(4/1 182) in the experimental group, the difference was statistically significant ( χ2=8.02, P<0.05). The standardization rate of insulin pump paperwork in the experimental group was 90.1% (190/209), which was higher than that 48.02% (73/152) in the control group, the difference was statistically significant ( χ2=81.82, P<0.05). The average scores of each item in the system effectiveness evaluation questionnaire were all higher than the median of 2.5. Conclusions:The application of the user-centered intelligent interactive insulin pump information management system can reduce the incidence of adverse events related to insulin pumps, improve the standardization rate of insulin pump nursing documentation, and users are satisfied with the effectiveness evaluation of the system.

BACKGROUND/OBJECTIVES: Benign prostatic hyperplasia (BPH) is the most common prostate disease and one of the most common chronic diseases caused by aging in men. On the other hand, there has been no research on BPH using Abeliophyllum distichum Nakai (A.distichum). Therefore, this study investigated the effects of A. distichum on BPH.MATERIALS/METHODS: A. distichum leaves were extracted with distilled water, 70% ethanol, and 95% hexane as solvents. Subsequently, the inhibitory effects of each A. distichum extract on androgen receptor (AR) signaling were evaluated in vitro. The testosterone-induced BPH model was then used to confirm the efficacy of A. distichum leaves in 70% ethanol extract (ADLE). RESULTS: ADLE had the strongest inhibitory effect on AR signaling. A comparison of the activity of ADLE by harvest time showed that the leaves of A. distichum harvested in autumn had a superior inhibitory effect on AR signaling to those harvested at other times. In the BPH rat model, the administration of ADLE reduced the prostate size and prostate epithelial cell thickness significantly and inhibited AR signaling. Subsequently, the administration of ADLE also reduced the expression of growth factors, thereby inactivating the PI3K/AKT pathway. CONCLUSIONS An analysis of the efficacy of ADLE to relieve BPH showed that the ethanol extract grown in autumn exhibited the highest inhibitory ability of the androgen-signaling related factors in vitro. ADLE also inhibited the expression of growth factors by inhibiting the expression of the androgen-signaling related factors in vivo. Overall, ADLE is proposed as a functional food that is effective in preventing BPH.

Objective:To analyze the clinical characteristics and prognosis of coronavirus disease 2019 (COVID-19) patients complicated with pneumothorax.Methods:The clinical data of 7 COVID-19 patients complicated with pneumothorax admitted to Huanggang Central Hospital from January 3 to March 10, 2020 were retrospectively analyzed. The clinical features, diagnosis and treatment were summarized, and experience in the treatment of COVID-19 was shared.Results:① General information: among the 7 patients, 5 were males and 2 were females. Four of them had no underlying disease, and 1 had a history of diabetes and hypertension. One patient had only a history of hypertension. There were 6 cases of right pneumothorax and 1 case of bilateral pneumothorax. The 7 patients had a long hospital stay, all over 4 weeks, mostly complicated with multiple organ dysfunction. ② Imaging examination: 1 case evolved from the early stage to the advanced stage within 1 week and to the severe stage within 2 weeks. Pneumothorax occurred 4 weeks later, and was absorbed within 2 weeks. The remaining 6 patients presented progressive stage on admission, all of them advanced to severe stage within 1 to 2 weeks, and most of them presented diffused consolidation shadows, striation shadows and fibrosis of both lungs, obvious pleural adhesion, and extremely slow lesion absorption. ③ Treatment: 1 severe patient with pneumothorax 4 weeks after onset was given non-invasive mechanical ventilation. The remaining 6 critically ill patients were treated with endotracheal intubation and mechanical ventilation. Five patients were treated with mechanical ventilation within 3 days after the occurrence of pneumothorax, and 1 patient was treated with mechanical ventilation after 11 days. ④ Outcome: 1 patient without endotracheal intubation was continuously given nasal high-flow oxygen therapy, and the condition was stable. Four of the 6 patients complicated with pneumothorax after endotracheal intubation died, and the other 2 patients successfully removed the drainage tube within 2 weeks of closed thoracic drainage, and their condition gradually stabilized.Conclusion:COVID-19 complicated with pneumothorax is a dangerous disease with poor prognosis, and should be paid adequate attention.

Objective:To detect the levels of serum IgM and IgG antibodies against 2019-nCoV in 79 patients with COVID-19 for understanding their variation patterns in vivo. Methods:Chemiluminescence immunoassay was used to detect the levels of 2019-nCoV-specific IgM and IgG antibodies in 167 serum samples collected at different periods (≤10 d, 10<~20 d, 20<~30 d、>30 d) after disease onset from 79 clinically confirmed COVID-19 patients in Hangzhou Xixi Hospital. The results were statistically analyzed together with clinical data.Results:The average levels of IgM and IgG antibodies in severe and common cases were higher than those in mild cases [IgM: 21.77 (10.18-128.65) and 13.13 (6.08-35.14) vs 3.01(1.69-8.69), χ 2=27.442, P<0.01; IgG: (124.22±36.79) and (120.04±63.25) vs (52.31±53.68), F/χ 2=27.295, P<0.01]. The positive rates of IgM and IgG antibodies in severe and common cases were also higher than those in mild cases after recovery ( P<0.01). The levels of IgM and IgG antibodies were affected by the time of detection. The level of IgM antibody detected during 10<~20 d of the disease onset was significantly higher than that within 10 d of the disease onset ( P<0.05). The level of IgG antibody detected after 10 d of the disease onset was significantly higher than that within 10 d of the disease onset ( P<0.01). Conclusions:Higher levels of IgM and IgG antibodies were detected in patients with severe COVID-19. A significant correlation was found between the levels of IgM and IgG antibodies and the time of detection.

Objective To explore the value of OSCE system combined with intelligent network in-formation platform in clinical skills assessment of obstetrics and gynecology. Methods 112 clinical medi-cal students who participated in the practice of gynecology and obstetrics in Second Military Medical Uni-versity in 2017 were randomly divided into the experimental group (network information OSCE) and the control group (traditional OSCE). The teaching results were evaluated by the questionnaire survey of teachers and students and the examination results as well. The statistical analysis was made with the Chi-square test and the t test respectively. Results According to the questionnaire survey of two skills assessment methods, the satisfaction index of the experimental group was higher than that of the control group in both teachers and students, and the difference was statistically significant (P<0.05). The total time of examination in the experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05). The final total score and the results of case analysis and clinical operation examination of experi-mental group were all higher than those of the control group, but there was no statistical difference (P>0.05). Conclusion OSCE combined with the network information system has an unparalleled advantage in the assessment of the obstetrics and gynecology department. The system will promote clinical education of ob-stetrics and gynecology and the evaluation of the clinical ability of the medical students to a new height, which deserves popularization.