Objectives:Quantitative flow ratio(QFR)is a coronary angiography-derived functional test without the need of guidewire use.Fractional flow reserve(FFR)is used as the reference standard to verify the diagnostic value of QFR in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)with coronary critical lesion(40%-70%stenosis)and functional stenosis. Methods:This retrospective analysis included patients with NSTE-ACS who were admitted to Fuwai Central China Cardiovascular Hospital from June 1,2018 to February 1,2023 and underwent coronary FFR examination.QFR values of target vessels were analyzed offline by AngioPlus(Shanghai Pulsation Medical Imaging Technology Co.,LTD.),the second-generation QFR detector,and anatomical parameters of the diseased vessels were recorded as follows:minimal luminal diameter(MLD),percent diameter stenosis(DS%),minimal luminal area(MLA),percent area stenosis(AS%).Functional coronary artery stenosis is defined as FFR≤0.80. Results:Using FFR as the gold standard,the AUC values of contrast-flow QFR(cQFR)and fixed-flow QFR(fQFR)for identifying functional coronary artery stenosis in NSTE-ACS patients were 0.829(95%CI:0.773-0.885,P<0.001)and 0.821(95%CI:0.766-0.875,P<0.001),respectively.The diagnostic accuracy,sensitivity and specificity of cQFR and fQFR were 81.30%,56.00%,98.63%and 76.83%,59.00%,99.04%,respectively.DeLong test showed that diagnostic performance of cQFR was significantly better than fQFR in diagnosing functional stenosis of coronary critical lesions in patients with NSTE-ACS. Conclusions:With FFR as the gold standard,QFR(especially cQFR)has certain diagnostic value in patients with NSTE-ACS with functional stenosis of coronary critical lesions.

Objective To analyze the quality of 22 batches of Fritillariae thunbergii bulbus Formula Granules from 12 different manufacturers by using water-extraction reference substance of Fritillariae thunbergii bulbus(ZBM ERS ST)and water-extraction reference substance of Fritillariae hupehensis bulbus(HBBM ERS ST)as references.Methods Ethyl acetate-methanol-triethylamine-water(17∶1∶1∶0.5)was used as the developing solvent for high-performance thin-layer chromatography(HPTLC)fingerprint analysis.The high-performance liquid chromatography(HPLC)fingerprint analysis was performed on a Agilent Eclipse XDB-C18 column(4.6 mm×250 mm,5 μm)with the gradient mobile phase consisted of acetonitrile-0.03%diethylamine solution.The column temperature was set at 25℃and evaporative light-scattering detector was used.The determination was conducted according to standard test method for measurement of Fritillariae thunbergii bulbus Formula Granules(Guangdong PFKL00117).Results The results of HPTLC and HPLC analysis showed that there are significant differences among the 22 batches of Fritillariae thunbergii bulbus Formula Granules.There were 4 batches of Fritillariae thunbergii bulbus Formula Granules from 3 manufacturers among them showed fingerprint characteristics of Fritillariae hupehensis bulbus.The total amount of peimine and peiminine in the remaining 18 batches of Fritillariae thunbergii bulbus Formula Granules was 0.291-3.179 mg·g-1,which were quite different.Conclusion Currently,the quality of Fritillariae thunbergii bulbus Formula Granules on the market varies greatly.Standardized water-extract reference substance has better applicability for the analysis of the quality of Fritillariae thunbergii bulbus Formula Granules than the control medicinal materials.

OBJECTIVE To compare the effectiveness，safety and economy of bovine pulmonary surfactant （PS） and porcine PS in the treatment of preterm neonates with respiratory distress syndrome （RDS）. METHODS Retrieved from PubMed，Embase， Cochrane Library，CNKI，SinoMed，Wanfang and health technology assessment （HTA） organization websites and relevant database， HTA report，systematic review/meta-analysis and pharmacoeconomic study about bovine PS versus porcine PS in the treatment of preterm neonates with RDS were included from the inception to Feb 2022. Data extraction and quality evaluation were carried out for the included literature，and then research results were summarized and analyzed descriptively. RESULTS A total of 1 HTA report，6 systematic reviews/meta-analyses，and 6 pharmacoeconomic studies were included. There appeared to be no significant differences between bovine PS and porcine PS in terms of time staying in neonatal intensive care unit and extra-pulmonary outcomes. In terms of PS re-treatment，blood gas index，total effective rate and the incidence of patent ductus arteriosus，porcine PS was superior to bovine PS. Results from other indicators，such as mortality， the incidence of bronchopulmonary dysplasia，air leakage syndrome，pulmonary hemorrhage，were still controversial. In terms of economy，there was no statistical difference in average hospital charges and administration cost per dose between two groups （P＞0.05）； compared with porcine PS，mean wastage cost per dose of bovine PS was higher （P＜0.001），and 24 h treatment cost of bovine PS was lower （P＜0.05）； the results of average medication cost were controversial. CONCLUSIONS The effectiveness， safety and economy of bovine PS are found to be similar or inferior to porcine PS. It is not certain whether the inferiority has clinical significance.

Lateral ankle avulsion fracture is a common sports injury that can lead to chronic lateral ankle instability and substantial deterioration of the joint function. Currently, problems such as misdiagnosis, inappropriate treatment, disparate outcomes and lack of standardization are usually met in the diagnosis and treatment of lateral ankle avulsion fracture. The Foot and Ankle Committee of Chinese Association of Sports Medicine Physicians thus organized a working group of experts in the field of sports medicine and ankle surgery from China to develop "An evidence-based clinical guideline for the diagnosis and treatment of lateral ankle avulsion fractures (2022 version)" in accordance with the principle of evidence-based medicine and scientificity and practicability. The guideline covered the topics of imaging diagnosis, indications and methods of non-operative and operative treatment as well as postoperative rehabilitation, in order to provide guidance for the diagnosis and treatment of lateral ankle avulsion fracture.

Objective To investigate the status of radiological protection in Baoji City. Methods Using the questionnaire survey method, the survey forms were sent to the radiology clinics and other relevant units in the counties and districts of the city to investigate the basic situation of radiology and treatment of medical and health institutions, basic information of radiology and treatment equipment, personal information of radiation workers, and health monitoring of radiation workers. Results There is 1.13 X-ray diagnostic equipment per 10, 000 people, 0.015 radiotherapy equipment per 10, 000 people in Baoji City, and One million people own 11.4 CTs. There are 1, 102 radiation workers in Baoji City, and 2.92 per 10, 000 people. The occupational health check rate of medical radiation personnel was 87.7% within 2 years, the personal dose monitoring rate was 90.4%, the radiation worker training rate was 73.6% within 2 years, about the holding rate of "Radiation Staff Certificate" in Baoji City was 73.0%, and the occupational health file rate was 89.2%. The evaluation indexes of various health monitoring were lower, especially in township hospitals (35.7%～50.8%). Conclusion On the whole, the number of radiological diagnosis and treatment equipment is small, and Class A large equipment is almost blank. The city is stronger than the county in health monitoring. The status of health monitoring is very different from urban to rural areas.

Objective To investigate the variations and clinical significance of mean platelet volume (MPV),platelet distribution width (PDW) and red cell distribution width (RDW) in type 2 diabetic patients with lower extremity atherosclerotic disease (LEAD).Methods In this study,330 patients (168 male and 162 female ones) diagnosed with type 2 diabetes mellitus were recruited.According to the ankle brachial index (ABI),all the patients were divided into three groups:patients without LEAD (Group A),patients with mild to moderate LEDA (group B),and severe LEAD (group C).And 100 healthy subjects served as control group.Blood routine,fasting plasma glucose (FPG),Hemoglobulin Alc (HbAlc),blood pressure,high-sensitivity C-reactive protein (hs-CRP),blood lipids,serum creatinine and uric acid were all measured in the patients.Results MPV,PDW,RDW in all the patients with type 2 diabetes mellitus were significantly higher than those in the control group (P ＜ 0.05).Compared with the group without LEAD,MPV,PDW and RDW in the group with LEAD were significantly higher,with significant statistically difference (P ＜ 0.05).Pearson correlation analysis showed that MPV,PDW,RDW were positively correlated with the index of blood glucose and lipids.Logistic regression analyses indicated that the levels of MPV,PDW,RDW,hsCRP,HbAlc and low-density lipoprotein cholesterol (LDL-C) were significantly associated with lower extremity arterial disease in type 2 diabetes mellitus.Conclusions Patients with higher MPV,PDW and RDW levels were more likely to develop LEAD than those with lower levels.MPV,PDW and RDW were important risk factors for lower extremity atherosclerotic disease in patients with type 2 diabetes mellitus.

Objective To investigate the possibility of neutrophil-to-lymphocyte ratio (NLR),platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) as biomarker for early atherosclerosis in patients with newly diagnosed type 2 diabetes.Methods 420 newly diagnosed type 2 diabetes were enrolled in the study.They were divided into three groups:patients with normal carotid artery were group A (n =152),patients with unilateral carotid plaque were group B (n =138),patients with bilateral carotid plaque were group C (n =130).Their neutrophil,lymphocyte,mean platelet volume,lipid and glucose,carotid intimal medial thickness (CIMT),ankle brachial index (ABI) were all performed in these individuals.Results Compared with group A,the age,systolic pressure,neutrophil count (NC),platelet count (PLT),NLR,PLR,low density lipoprotein-cholesterol (LDL-C),total cholesterol (TC),fasting blood glucose (FBG),hemoglobin A1c (HbA1c) and CIMT were higher while ABI were lower in group B and group C;Compared with group B,the age,systolic pressure,NC,PLT,NLR,PLR,LDL-C,TC,CIMT and were higher while ABI was lower in group C (P ＜ 0.05).CIMT was positively correlated to age,systolic pressure,NLR,PLR,LDL-C,TC,FBG and HbA1c (P ＜ 0.05) while ABI was negtively correlated to age,NLR,PLR,LDL-C,FBG and HbA1c (P ＜ 0.05).In multiple linear regression analyses,after adjustment for age,lipid,glucose and so on,NLR and PLR were also significantly correlated to CIMT and ABI.Conclusions NLR and PLR were significantly correlated with CIMT and ABI in newly diagnosed type 2 diabetes.Therefore,NLR and PLR may have the potential to serve as biomarkers for early arteriosclerosis in type 2 diabetic patients.

Clinical data of 380 patients with type 2 diabetes mellitus (T2DM) admitted in the Second Hospital of Tianjin Medical University from October 2014 to June 2017 were retrospectively reviewed. Patients were divided into 3 groups according to the results of lower extremity arterial ultrasonography: 103 patients without lower extremity arterial disease (group A), 132 patients with mild arterial disease (group B), 145 patients with moderate to severe lower extremity arterial disease (group C);and 100 healthy subjects served as control group. Blood routine parameters and blood biochemistry were measured;the results showed that blood cell ratios in T2DM patients were significantly higher than those in control group (P<0.05), and blood cell ratios in group B and group C were higher than those in group A (P<0.05). Pearson correlation analyses indicated that neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), hs-CRP, HbA1c, LDL-C were significantly associated with lower extremity arterial disease in T2DM patients. Logistic analysis showed that NLR(OR=2.01,95％CI:1.15-3.63,P<0.05)and PLR(OR=1.75,95％CI:1.04-3.28,P<0.05)were risk factors for lower extremity arterial disease in patients with type 2 diabetes mellitus.

Objective To evaluate the diagnostic value of uroflowmetry of specific bladder capacity in the detection of early diabetic cystopathy (DCP). Methods One hundred and nine patients with type 2 diabetes mellitus (DM) and 48 normal control subjects (control group) were completed the uroflowmetry in bladder capacity about 300 ml. The patients with DM were divided into DM course≥10 years group and DM course<10 years group, glycated hemoglobin (HbA1c)≥7%group and HbA1c<7%group according to the course and HbA1c. The volume leading to first bladder sensation, maximal flow rate (MFR) and average flow rate (AFR) of bladder capacity about 300 ml, and residual urine volume afteremptyingwere measured by uroflowmetry. Results Among the 109 patients with DM, 74 cases (DCP group) had residual urine, and the incidence of DCP was 67.89% (74/109). Thirty-five cases (no-DCP group) had no residual urine. In control group, 8 cases had residual urine. The MFR and AFR in DCP group and no-DCP group were significantly lower than those in control group: (14.44 ± 5.90) and (17.38 ± 5.93) ml/s vs. (23.73 ± 5.81) ml/s, (9.52 ± 4.97) and (10.38 ± 4.46) ml/s vs. (15.88 ± 4.95) ml/s, and the MFR and AFR in DCP group were significantly lower than those in no-DCP group;the residual urine volume in DCP group was significantly higher than that in no-DCP group and control group: 26 (15 - 40) ml vs. 0 and 0 (0 - 51) ml, and there were statistical differences (P<0.05). The MFR and AFR in DM course ≥ 10 years group (27 cases) and DM course < 10 years group (82 cases) were significantly lower than those in control group:(13.34 ± 5.48) and (16.07 ± 6.09) ml/s vs. (23.73 ± 5.81) ml/s, (8.62 ± 3.28) and (10.19 ± 4.96) ml/s vs. (15.88 ± 4.95) ml/s, and the residual urine volume was significantly higher than that in control group:18 (0-75) and 15 (0-30) ml vs. 0 (0-51) ml. The MFR in DM course ≥ 10 years group was significantly lower than that in DM course< 10 years group, and the residual urine volume was significantly higher than that in DM course < 10 years group. There were statistical differences (P<0.05). The MFR and AFR in HbA1c≥7%group (92 cases) and HbA1c<7% group (17 cases) were significantly lower than those in control group: (15.51 ± 5.98) and (15.53 ± 6.60) ml/s vs. (23.73 ± 5.81) ml/s, (9.92 ± 4.74) and (9.88 ± 4.72) ml/s vs. (15.88 ± 4.95) ml/s, and the residual urine volume was significantly higher than that in control group: 17 (0 - 35) and 0 (0 - 24) ml vs. 0 (0 - 51) ml. There were statistical differences (P<0.05). There were no statistical differences between HbA1c ≥ 7% group and HbA1c < 7% group (P>0.05). There were no statistical differences in volume leading to first bladder sensation (P>0.05). Conclusions MFR decrease detected with the technology of uroflowmetry specific bladder capacity may be widely used in screening early DCP.

Objective To conduct an investigation on diabetes nutrition knowledge, attitude and practice in outpatients with type 2 diabetes, understand the nutritional knowledge and dietary behaviors in patients with type 2 diabetes to guide individualized nutrition education. Methods The diabetes nutrition Knowledge, Attitude and Practice(KAP) questionnairewas designed based onChinese dietary guidelines (2007)andChinese diabetes medical nutrition therapy guidelines (2013). Data of out-patients with type 2 diabetes from January to March 2015 were collected. The method of investigation was face-to-face interview. Results Totally 915 patients were enrolled into this survey(male 495 and female 420). The mean BMI was (27.23 ± 3.18)kg/m2, glycosylated hemoglobin A1c (HBA1c) was (8.03 ± 2.17)%. Among the questions on knowledge, only on 4 questions the rate of awareness was over 80%, and there was a misunderstanding on diet, only 54.10%of diabetes patients believed that diabetes diet should be balanced and reasonable, rather than just limiting staple food and meat. Patients generally could realize the importance of diet for diabetes treatment. For questions on practice, the rate of reaching the standard generally was not over 80%. The rate of correct answers was not significantly different among different age groups, gender, and durations. There was a linear correlation between the rate of correct answers and glycosylated hemoglobin (P=0.043), the correlation coefficient was-0.258. The higher the rate of correct answers, the lower the level of glycosylated hemoglobin. Conclusion Outpatients with type 2 diabetes had good awareness level about diabetic nutritional knowledge and attitude but the awareness level of balanced diet needs to improve, the awareness rate on behavior was relatively low.