Objective:To investigate the effectiveness and safety of ultrasound-guided endovascular therapy for autogenous arteriovenous fistula (AVF) thrombosis.Methods:It was a single-center retrospective cohort study. Data of patients undergoing ultrasound-guided intravascular therapy due to AVF thrombosis in the First Hospital of Hebei Medical University from August 2018 to June 2021 were analyzed. According to different surgical procedures, the patients were divided into two groups. Patients treated with percutaneous transluminal angioplasty (PTA) + drilling thrombectomy were in group A, and patients treated with PTA only were in group B. After 1 year of follow-up, the surgical technique success rate, primary patency rate, secondary patency rate and complications were compared between the two groups.Results:A total of 152 patients were enrolled, including 74 in group A and 78 in group B. There were no significant differences in gender, age, proportion of patients with diabetes and hypertension, and thrombosis time of AVF between the two groups (all P>0.05). Compared with group B, the diameter and length of thrombus in group A were larger [13.0(9.0, 16.0) mm vs. 6.0(5.0, 6.5) mm, Z=-9.362, P<0.001; 12(8, 15) cm vs. 3(3, 4) cm, Z=-10.061, P<0.001], and the establishment time of AVF was longer [5(2, 7) years vs. 2(1, 5) years, Z=-2.698, P=0.007]. Among the overall patients, the success rate of surgery was 96.7% (147/152), and the success rate of surgery was 95.9% (71/74) in group A and 97.4% (76/78) in group B respectively, with no statistical difference ( χ2=0.004, P=0.952). Kaplan-Meier survival analysis showed that, overall, the primary patency rate at 3rd, 6th and 12th month after operation was 87.1%, 71.4% and 56.6%, and the secondary patency rate was 97.1%, 96.4% and 94.1%, respectively. The primary patency rate of group A at 3rd, 6th and 12th month was 82.4%, 66.7% and 53.6%, and the secondary patency rate was 95.7%, 94.2% and 89.7%, respectively. The primary patency rate of group B at 3rd, 6th and 12th month was 91.5%, 73.2% and 59.7%, and the secondary patency rate was 98.6%, 98.6% and 98.5%, respectively. There was no significant difference in the primary and secondary patency rate between group A and group B at 3rd, 6th and 12th month (all P>0.05). The duration of operation in group A was longer than that in group B [2.0(1.9, 2.0) h vs. 2.0(1.0, 2.0) h, Z=-5.181, P<0.001], but no serious complications occurred in both groups. Conclusion:The two surgical methods are effective, safe and reliable in the treatment of AVF thrombosis, and have high clinical application value.

Objective: To study the survival time and its risk factors of patients with occupational pneumoconiosis. Methods: A total of 11 011 newly diagnosed occupational pneumoconiosis patients in Guangdong Province from 1980 to 2019 were selected as study subjects. The life table method was used for survival analysis. The influencing factors of survival time of occupational pneumoconiosis patients were analyzed using the WilCoxon (Gehan) test and Cox proportional hazards regression model. Results: The median survival time of pneumoconiosis patients was 26.0 years. The median survival period of stage Ⅰpatients was 3.5 years longer than that of stage Ⅱ patients and 10.1 years longer than that of stage Ⅲ patients. The median survival time of patients with an initial diagnosis age under 40.0 years old was 34.8 years longer than that of patients with an initial diagnosis age over 60.0 years old. The median survival time of patients with dust exposure duration under 25.0 years old was 13.6 years longer than patients with dust exposure duration age over 45.0 years old. The results of the Cox proportional hazards regression model showed that the initial diagnosis stage, initial diagnosis age, dust exposure duration, and medical insurance were risk factors of the survival time of occupational pneumoconiosis patients (all P<0.01). The risk of reduced survival time for patients with stage Ⅱ and stage Ⅲ as the initial diagnosis stage was 1.15 and 2.04 times higher, respectively, compared with stage Ⅰ patients (both P<0.01). The risk of reduced survival time for patients without medical insurance was 60.22 times higher than those with medical insurance (P<0.01). Conclusion: The risk factors of the survival time of occupational pneumoconiosis patients in Guangdong Province are initial diagnosis stage, initial diagnosis age, the dust exposure age, and medical insurance. Earlier detection, earlier diagnosis, and improvement of medical insurance coverage for patients can effectively improve the survival time of occupational pneumoconiosis patients.

Objective:To evaluate the clinical effect of Guanxin Tongmai plaster combined with conventional western medicine in the treatment of phlegm and blood stasis syndrome of coronary heart disease and angina pectoris.Methods:A total of 60 patients in the Department of Cardiology of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine (TCM) from February to August 2020 who met the inclusion criteria were randomly divided into two groups with 30 in each group. Both groups were treated with conventional western medicine. On this basis, Guanxin Tongmai plaster was applied at the acupoints in the treatment group and placebo plaster was applied in the control group. TCM syndrome score was performed before and after treatment, angina score was evaluated from three aspects of angina attack frequency, duration and pain degree, and blood lipid TG, TC, LDL-C and HDL-C were detected by enzyme quantitative method. The blood homocysteine (Hcy) was detected by enzyme circulation method, the ECG and the nitroglycerin reduction rate were recorded, and the safety index was detected according to the ECG changes.Results:In the treatment period, 2 patients in the treatment group fell off, 3 in the control group. A total of 28 patients in the treatment group and 27 in the control group were analyzed. The total effective rate of ECG efficacy in the treatment group was 67.9% (19/28) and the control group was 48.1% (13/27). There was significant difference between the two groups ( χ2=4.46, P=0.040). After treatment, the TCM syndrome score and angina score in the treatment group were significantly lower than those in the control group ( t values were 9.12 and 4.45, P values were 0.004 and 0.042, respectively). The reduction rate of nitroglycerin in the treatment group was 82.1% (23/28) and 55.6% (15/27) in the control group. There was significant difference between the two groups ( χ 2=4.72, P=0.030). After treatment, the plasma TG, TC, LDL-C in the treatment group were significantly lower than those in the control group ( t values were 4.17, 6.57 and 6.52, P<0.05 or P<0.01), the level of HDL-C was significantly higher than that of the control group ( t=7.07, P=0.010), and the level of plasma Hcy was significantly lower than that in the control group ( t=6.70, P=0.012). There was no significant difference in liver, kidney and coagulation function between the two groups. Conclusion:Guanxin Tongmai plaster combined with conventional western medicine can improve the clinical symptoms of patients with coronary heart disease and angina pectoris, reduce the level of blood lipid and Hcy, and improve the clinical curative effect.

Authors of the paper analyzed the motivation of building the healthy town,and interrelated the scientific aspects of such a town. It was found that this town of diversified resources and advantages had become small but beautiful,special and strong clustering and convergent by means of collecting high-end factors, selecting of essential health businesses and constructing an ecosystem of health industry clusters. Based on a definition of the government role,the paper described the innovation of health policy in view of policy supply.

Described in the paper is the reform made at public hospitals in Zhejiang province,with analysis of its problems and causes. Based on such,the authors proposed the following actions:to accelerate the reform of public hospitals centering on health promotion, and encourage such hospitals to shoulder the health care responsibility on behalf of the government; to proceed with hierarchical medical system and contract-based service focusing on capacity building of general practitioners; to attract private capital into building the healthcare system; and to motivate non-governmental organizations to cater to diversified healthcare needs of the people.

Objective To explore the clinical effects and safety of edaravone and ozagrel in treatment of acute ischemic stroke. Methods60 patients with a cute ischemic stroke were divided into two groups randomly,each group 30 patients.The treatment group was treated by edaravone and ozagrel,and the control group was treated by ligustrazine injection.Before and 14 days after treatment,the neurologic impairment and clinical curative effect of the two groups were evaluated respectively. ResultsThe effective rate in the treatment group was 86.6%,and that in the control group was 63.3%.The difference between the two groups was statistically significant(P＜0.05). ConclusionEdaravone and ozagrel in the treatment of acute ischemic stroke was effective and worthy of being widely used.

AIM: To evaluate the growth-inhibitory effects of NS-398, a selective cyclooxygenase-2 inhibitor, in human colon cancer HT-29 cells and its possible mechanisms. METHODS: MTT assay was applied to detect the cell proliferation. Flow cytometry was performed to detect apoptosis rate and cell cycle. RT-PCR was used to detect the expression of bcl-2 mRNA and bax mRNA. Alteration of cytoskeleton component F-actin was observed by confocal laser scanning microscope. RESULTS: NS-398 could inhibit growth of HT-29 cells in dose-and time-dependent manners. Flow cytometry revealed that NS-398 could induce apoptosis and cause G0/G1 arrest of HT-29 cells in a dose-dependent manner. After 72 h incubation with NS-398 at different concentrations, the expression level of bcl-2 mRNA was lowered and the ratio of bcl-2 to bax was decreased in HT-29 cells. F-actin was mainly distributed around nuclei forming annular structure in HT-29 cells. After exposure to NS-398, the annular structure around nuclei disappeared and fluorescence intensity of F-actin decreased obviously. CONCLUSION: NS-398 can inhibit the growth effectively and induce apoptosis in HT-29 cells in vitro, which is associated with the down-regulation of bcl-2 to bax ratio and the disruption of cytoskeleton.

AIM: To investigate the alteration of serum free fatty acids in the carbon tetrachloride-induced fatty liver. METHODS: Drug-induced fatty liver rat models were built by injection 40% CCl_4. Serum free fatty acids were analyzed by gas chromatography. RESULTS: In the composition of serun free fatty acids, polyunsaturated fatty acids [oleic acid C18∶1,(28.672?7.332 ?/mg?L~(-1) vs 41.373?2.180 ?/mg?L~(-1)), linoleic acid C18∶2(16.739?0.871 ?/mg?L~(-1) vs 24.959?5.325 ?/mg?L~(-1)), arachidonic acid C20∶4(6.105?2.656 ?/mg?L~(-1) vs 9.802?0.779 ?/mg?L~(-1)),P

AIM: To study the anti-invasive effect of NS-398 on colon cancer cell line HT-29 in vitro an its regulation by CD44v6 and nm23-H1 genes. METHODS: Flow cytometry was used to detect the expression of COX-2 and CD44v6 in HT-29 cells. MTT was used for cell survival rate tests. The modified Boyden chamber model was used for quantitative invasion assay. RT-PCR was used to detect the expression of nm23-H1 mRNA. RESULTS: Flow cytometry analysis showed that COX-2 was positive in HT-29 cells. NS-398 had significant inhibitory effects on invasion of HT-29 cells, which had no relation with its cytotoxicity. NS-398 down-regulated the expression of CD44v6 and up-regulated the expression of nm23-H1 mRNA. CONCLUSION: NS-398 has an anti-invasive effect on HT-29 cells in vitro. Down-regulation of CD44v6 and up-regulation of nm23-H1 may be its underlying mechanisms.