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 elucidate the experience of treating radial nerve injury with external treatment based on"treatment for flaccid paralysis aiming at Yangming meridian".[Methods]Based on the symptoms and manifestations of radial nerve injury,the etiology and pathogenesis were analyzed,and the connotation of"treatment for flaccid paralysis aiming at Yangming meridian"was deeply analyzed.The strategies of treating radial nerve injury with external treatment were expounded with the guidance of classical articles,and a typical medical case was presented for demonstration.[Results]The causes of radial nerve injury are nothing more than deficiency and excess.The deficiency symptoms are deficiency of the spleen and stomach,deficiency of the liver and kidney,and the excess symptoms include dampness,heat,blood stasis,phlegm turbidity block,and it is easy to be mixed with deficiency and excess."Treatment for flaccid paralysis aiming at Yangming meridian"not only focuses on the spleen and stomach,but also not blindly tonifying the spleen and stomach,but paying attention to regulating the spleen and stomach as the core,distinguishing deficiency and excess,taking into account the five viscera,and clearing and tonifying Qi and blood as the fundamental.The external treatment strategy under the guidance of"treatment for flaccid paralysis aiming at Yangming meridian"can be summarized as"use acupuncture treatment,and focus on selecting Yangming""use acupressure to promote Qi and blood""external use of traditional Chinese medicine to promote blood circulation and remove meridian obstruction""rehabilitation exercise,supplemented by physiotherapy"and"combining Chinese and western,and get results quickly",clinical flexible cooperation of many means can harvest significant results.In the medical case cited,the patient suffered from the radial nerve injury due to a car accident,and identified as the flaccidity syndrome of blood stasis block.The treatment was based on the principle of promoting blood circulation and removing blood stasis,clearing the channels and relieving pain,and the comprehensive use of acupuncture,massage and traditional Chinese medicine fumigation and washing was used to treat the patient's wrist freely for one month,with remarkable results.[Conclusion]"Treatment for flaccid paralysis aiming at Yangming meridian"is not only tonifying the deficiency of the spleen and stomach,but focusing on dredging Yangming Qi and blood,and producing normally.The theory guides the thinking of treating radial nerve injury from the angle of promoting blood circulation and removing blood stasis,attaches importance to the advantages of acupuncture,massage and traditional Chinese medicine fumigation and washing.

Dracaena marginata is a widely cultivated horticultural plant in the world, which has high ornamental and medicinal value. In this study, the whole genome of leaves from D. marginata was sequenced by Illumina HiSeq 4000 platform. The chloroplast genome were assembled for functional annotation, sequence characteristics and phylogenetic analysis. The results showed that the chloroplast genome of D. marginata composed of four regions with a size of 154 926 bp, which was the smallest chloroplast genome reported for Dracaena species to date. A total of 132 genes were identified, including 86 coding genes, 38 tRNA genes and 8 rRNA genes. Codon bias analysis found that the codon usage bias was weak and there was a bias for using A/U base endings. 46 simple sequence repeat and 54 repeats loci were detected in the chloroplast genome, with the maximum detection rate in the large single copy region and inverted repeat region, respectively. The inverted repeats boundaries of D. marginata and Dracaena were highly conserved, whereas gene location differences occurred. Phylogenetic analysis revealed that D. serrulata and D. cinnabari form a monophyletic clade, which was the closest relationship and conformed to the morphological classification characteristics. The analysis of the chloroplast genome of D. marginata provides important data basis for species identification, genetic diversity and chloroplast genome engineering of Dracaena.
Phylogeny ; Dracaena ; Genome, Chloroplast/genetics* ; Base Sequence ; Genes, Plant

Objective: To deliver macro understanding of the latest research progress on clinical trials and approved products of cancer drugs in China in 2019. Methods: The number of clinical trials and related investigational products by domestic and foreign enterprises in 2019 were acquired in the China Food and Drug Administration Registration and Information Disclosure Platform for Drug Clinical Studies, while listed drugs were obtained in the China Food and Drug Administration Query System for Domestic and Imported Drug. Characteristics on stage, scope, indication of those trials, classification and mechanism of involved products, as well as listed anticancer drugs were summarized and depicted. Results: There were 474 cancer drug trials registered in China in 2019, accounting for 21.8% of the total, and 397 (83.8%) were initiated by domestic pharmaceutical enterprises. Overall, international multicenter trials accounted for 13.1%, and phase I trials accounted for 47.3%. Compared with global enterprises, the proportion of international multi-center trials initiated by domestic companies is lower (4.8% vs. 55.8%, P<0.001), and the proportion of phase I clinical trials and bioequivalence trials is higher (51.9% vs. 23.4%, 19.4% vs. 1.3%, P<0.001). An accumulative of 27 cancer types were involved for all the cancer drug trials, and lung cancer, solid tumor, and breast cancer were the most common cancer types, with 103, 95 and 49 trials, respectively. For the three cancer types unique to Chinese population, gastric, liver and esophageal cancer, the total number of initiated trials was 47. For all those trials, there were 335 cancer drug varieties, with 86.0% developed by domestic pharmaceutical enterprises, including 300 therapeutic drugs, 30 adjunctive drugs and 5 preventive drugs. In terms of mechanism, targeted drugs and immune drugs were the most popular, accounting for 74.6% and 20.3%, respectively. In addition, 17 anticancer drugs targeting on 11 cancer types were approved in China in 2019. Conclusions Clinical trials on cancer drugs in China have ushered a booming era, with large number of innovative agents represented by targeted drugs and immune drugs under clinical development or putting into clinical practice. Those local enterprises are playing more and more critical roles. Strengthening clinical research and development on Chinese unique cancer types is the key direction of future work.

Objective To investigate the relationship between fasting blood glucose(FBG) with coronary arterial vulnerable plaque in civil airline pilots and its risk factors.Methods One hundred and twenty civil airline pilots with coronary heart disease were divided into the vulnerable plaque group and non-vulnerable plaque group based on the virtual histology intravascular ultrasound(VH-IVUS) results.Then the clinical data were collected.Logistic regression analysis was used to analyze the risk factors of vulnerable plaque.Results The FBG level in the vulnerable plaque group was much higher(P＜0.05);FBG,high-sensitivity C-reactive protein and low density lipoprotein were the risk factors for vulnerable plaque;FBG was positively correlated with the plaque necrosis core constituent ratio(r=0.44,P＜0.05).The area under curve of ROC curve efficiency for diagnosing vulnerable plaque was 0.72(95％CI:0.66-0.81),at FBG cut-off value of 6.39,the sensitivity was 71.35％ and specificity was 76.15％.Conclusion The FBG level is an independent risk factor of coronary arterial vulnerable plaque,which can assist in the identification of vulnerable plaque in civil airline pilots.

Objective To evaluate the effect of plastic surgery for scar contracture after hand burn.Methods Clinical treatment data of 56 patients with scar contracture after hand burn was collected from December 2011 to December 2016.Different surgery methods were adopted to treat the scar contracture after hand burn according to different degree,different sites and different range.Results All cases were operated successfully,and the appearance and function of the hands were almost recovered during the 6 months' follow-up,without contracture again.Conclusion Appropriate surgical programs should be used in scar contracture with different parts and degrees,and reasonable postoperative rehabilitation can improve the function and appearance of hands better,which can avoid secondum contracture.

Objective This study was to investigate the role of trimetazidine in the prevention of contrast-induced nephropathy (CIN) in renal dysfunction patients undergoing coronary angiography. Methods A total of 151 patients with renal dysfunction who underwent coronary angiography were enrolled in our study and randomly divided into control group (n=77) and trimetazidine group (n=74). Standard hydration was administered in all the patients. In trimetazidine group, patients were administered trimetazidine orally for 48 hours before and 7 days after coronary angiography. Adverse events were observed in 12 months. Results (1) For 24 h and 48 h after the procedure:levels of SCr and CysC in the control group were significantly increased compared with baseline levels; levels of SCr and CysC in trimetazidine group were not increased, compared with baseline levels;levels of SCr and CysC were lower in trimetazidine group than the control group. (2)The incidence of CIN was reduced in trimetazidine group compared with control group (22.1%vs 9.5%,P=0.034). (3) Kaplan-Meier analysis showed that the incidence of adverse events in trimetazidine group was lower compared with the control group (P = 0.003). Conclusions Trimetazidine in combination with standard hydration is more effective than isotonic saline alone in protecting renal function in patients with renal dysfunction who undergo coronary angiography.

Objective:To explore influence of preoperative tirofiban usage and using time on blood flow of infarct re-lated artery (IRA) in patients with acute ST elevation myocardial infarction (ASTEMI ) undergoing emergency di-rect percutaneous coronary intervention (PCI ) .Methods:A total of 266 ASTEMI patients undergoing direct PCI from Jan 2009 to Oct 2012 ,were randomly divided into tirofiban group (n=134 ,received preoperative tirofiban us-age for PCI) and routine treatment group (n=132 ,didn't receive tirofiban during PCI) .According to percutaneous using time of tirofiban tirofiban group was divided into <3h group (n= 63) and ≥3h group (n= 71) ;TIMI blood flow of IRA ,before and after PCI were compared among different groups .Results:Compared with routine treat-ment group before PCI ,there were significant rise in percentages of TIMI grade 3 (10.6% vs .20.9% ) in tirofiban group ,P=0.028 ;after PCI ,percentage of TIMI grade 3 in tirofiban group was more significantly rose than that of routine treatment group (78.8% vs .92.5% ,P=0.001);in tirofiban group ,blood flow of IRA before PCI in <3h group was significantly improved compared with ≥3h group (TIMI grade 2 + 3 ,63.5% vs .29.6% , P<0.01) . Conclusion:Early tirofiban usage can improve TIMI blood flow of IRA before and after PCI in ASTEMI patients , the earlier it′s used ,the more significant effect it has .

Objective To summarize the clinical experience about therapy for ear keloid by local injection of triamcinolone acetonide acetate combined with surgical resection to control the growth of keloid. Methods After 3~4 times injecting the triamcinolone acetonide ac-etate,the keloid was removed by surgery,some edge of keloid skin was kept and sutured without tension. Results The patients were followed up for 6~24 months,all of 31 ears were primary healing, 26 ears were cured, 4 ears were effective,only one ear was invalid,the effective cure rate was about 96. 8%. Conclusion Local injection with triamcinolone acetonide acetate combined with surgical resection can treat ear keloid.

Objective To improve the detail of the surgery for cicatricial ectropion,and the the effect was investigated. Methods Based on 46 patients withⅡ,Ⅲdegree cicatricial ectropion admitted to our department,choose the junction of normal skin and scar tissue as the incision line according to the degree of ectropion and local situation,and to reserve and recover the orbicularis oculi muscle as possible. The released areas exceeded separately the external canthus and reached the level of eye fissure,take advantage of full-thickness skin graft to correct the parallel lines and make fixation to the eyelid ectropion fusion skin graft on external canthal ligament. Results After followed up for 6 months to 2 years,46 cases of eyelid skin grafts survived completely and eyelids were in good reduction,with none case of incomplete eyelid closure. Conclusion Choose the surgical incision and the released areas in a proper way to reserve the structural integrity of orbicu-laris muscle and make skin graft fixation to inner and external canthal skin can prevent effectively the recurrence of ectropion and improve surgical progress.