Objective:To explore the long-term effects of intravascular ultrasound (IVUS) guidance on patients with acute coronary syndrome (ACS) undergoing drug-eluting stents (DES) implantation.Methods:Data used in this study derived from ULTIMATE trial, which was a prospective, multicenter, randomized study. A total of 1 448 all-comer patients were enrolled between 2014 August and 2017 May. Primary endpoint of this study was target vessel failure (TVF) at 3 years, including cardiac death, target-vessel-related myocardial infarction, and clinically-driven target vessel revascularization.Results:ACS was present in 1 136 (78.5%) patients, and 3-year clinical follow-up was available in 1 423 patients (98.3%). TVF in the ACS group was 9.6% (109/1 136), which was significantly higher than 4.5% (14/312) in the non-ACS group (log-rank P=0.005). There were 109 TVFs in the ACS patients, with 7.6% (43/569) TVFs in the IVUS group and 11.6% (66/567) TVFs in the angiography group (log-rank P=0.019). Moreover, patients with optimal IVUS guidance were associated with a lower risk of 3-year TVF compared to those with suboptimal IVUS results (5.4% (16/296) vs. 9.9% (27/273),log-rank P=0.041). Conclusions:This ULTIMATE-ACS subgroup analysis showed that ACS patients undergoing DES implantation were associated with a higher risk of 3-year TVF. More importantly, the risk of TVF could be significantly decreased through IVUS guidance in patients with ACS, especially in those who had an IVUS-defined optimal procedure.

Objective:In this study, the application value of a specific information platform in heart failure was explored.Methods:We constructed five modules of information platform based on clinical needs, including user interface, patient management interface, follow-up platform, data processing interface and system management. By making good use of the platform, a database of heart failure was established and quality-controlled to realize the management of chronic heart failure, and prepare database for possible clinical research.Results:More than 3 000 patients with heart failure had been registered in the heart failure special disease platform. Long-term out-of-hospital management of cerfain patients with heart failure was conducted through intelligent information means. High-quality heart failure data were obtained and translated into clinical results.Conclusions:Long-term out-of-hospital management of patients with chronic heart failure can be realized through the special disease information platform, and high-quality evidence-based medical data can be obtained. Besides, the platform provides theoretical basis and data support for evaluation system of prognosis of heart failure, provides theoretical basis and data support for improving medication and surgical treatment plans and comprehensive management system of patients with heart failure.

Objective:This article takes the practical experience of the construction of the cardiovascular disease clinical medicine research center in Nanjing First Hospital as an example to provide reference for institutions preparing to build a clinical research center.Methods:The center conducts top-level design based on clinical needs, and this study systematically elaborates the construction of the center from management mechanisms, research platforms, collaborative networks, team building and international cooperation.Results:The center has made remarkable progress in clinical research, scientific and technological innovation, transformation and promotion, standard formulation, and technology leading. On the basis of an international perspective, the level of regional diagnosis and treatment has been improved by optimizing the structure of subject talents, and focusing on the clinical needs of cardiovascular subspecialty.Conclusions:Taking the construction of the clinical medicine center as an opportunity, integrating superior resources, improving the level of disease diagnosis, treatment and service and enhancing international academic influence are effective measures to accelerate the development of health services and deepen medical reforms.

Talents constitute key resources for the development of healthcare sector, and studying abroad is an important and effective means for their training. Based on the analysis of the current status of China′s international talents training project of hospitals, this study summarized existing problems in such training. The authors covered such six aspects as lawful standardization of project management methods, selection of trainees by levels and by types, innovation of the process tracking management mechanisms and strengthened full-process assessment, all dimensional institutional support, consolidation of the responsibilities by individual disciplines in talent team building, and measures to cope with the impact of COVID-19. In accordance with the research results, the study analyzed the exploration and practice of the international training project under the " Elite Talents Cultivation Project" of the Affiliated Hospital of Qingdao University, and raised targeted recommendations on attention to the strategic and forward-looking planning, precise setup of training goal categories, classified evaluation of study results, and lawful management among others.

Objective:To investigate the potential correlation between miR-223 level in leukocytes and platelet responses to clopidogrel in patients with coronary artery disease.Methods:A cohort of 188 outpatients,who conducted percutaneous coronary intervention (PCI) and received dual antiplatelet therapy,were recruited.The patient's electronic health data were collected,and their blood samples were obtained for measurement of adenosine diphosphate (ADP)-induced whole-blood platelet aggregation.Extreme cases ofplatelet responses to clopidogrel (ultra-vs.non-responder) were measured with miR-223-3p levels in leukocytes.Results:Both groups had similar miR-223-3p levels in leukocytes.There were no significant differences in other demographic and clinical data except for metrics of ADP-induced whole-blood platelet aggregation between the 2 group.Conclusion:MiR-223-3p in peripheral leukocytes is not associated with the altered platelet responses to clopidogrel in PCI outpatients.

Objective To investigate the status quo of knowledge-attitude-practice in preventing venous thromboembolism (VTE) among medical staff in Shandong Province and analyze the influencing factors, so as to provide guidance for the prevention and treatment of VTE. Methods In November 2017, 1 987 medical staff from 52 hospitals in Shandong Province were investigated by filling out an electronic questionnaire with a self-designed questionnaire on knowledge, attitude and behavior related to VTE prevention among medical staff. Results The knowledge score on VTE prevention of medical staff was (19.49±2.33), attitude score (21.82±2.55), practice score (64.87±9.54), respectively accounted for 88.59%, 87.28% and 81.09%. The total scores of knowledge, belief and practice of VTE prevention among medical staff in different hospital grades, occupations, educational background, professional titles and departments were statistically significant (F=9.419, 8.418, 2.823, 6.852, 6.375; P＜ 0.05). Conclusions Medical staff have a higher level of knowledge and attitude towards prevention of VTE, but lack of behavioral knowledge. The hospital should establish a standardized VTE prevention and management system to raise the level of VTE prevention and control.

Objective To analyze the genetic quality of 24 domestic inbred strains mice using microsatellite loci panel.Methods Previously selected 30 microsatellite loci of mouse with high polymorphism and more allele numbers were used to synthesize corresponding fluorescently-labeled primers.Then the genomic DNA samples of each mouse were amplified by PCR and the products were analyzed by STR scanning to genotype the inbred strains of mice.Results Out of the 24 inbred strains, 15 inbred strains showed the same genotype within one strain at 30 loci.Among different strains, microsatellite loci indicated polymorphism which could be used to distinguish different strains.However, the rest 9 strains demonstrated polymorphism within strains.Conclusions Our stuoly provides a useful microsatellite panel to detect genetic quality of inbred mice and distinguish different strains with the optimized microsatellite loci.

Objective To measure the number of lymphocytes, B lymphocytes, CD5+B lymphocytes and level of IL-10 in peripheral blood of patients with systemic lupus erythematosus (SLE), and analyze their effects in the disease. Methods In this study, 84 cases of patients with SLE were randomly selected and evaluated according to the activity index (SLEDAI). These cases were divided into low activity group (SLEDAI<9) and high activity group (SLEDAI≥9). Ten healthy individuals were selected as the control group at the same time. The number of peripheral blood lymphocytes, B lymphocytes, CD5 + B lymphocytes, erythrocyte sedimentation rate (ESR), C3, C4 and interleukin (IL)-10 levels in serum were measured respectively and the correlation between the above indexes and SLEDAI and complement levels were analyzed. Pair-wise comparison of means of groups was conducted with one-way ANOVA. Comparison between the two groups was conducted by LSD-t test. Correlations between variables were carried out using Spearman's rank correlation test. Results The total number of lymphocytes in SLE group was lower than that in normal control group ( F=7.216, P<0.001); The number of CD19+ B lymphocytes in SLE group was higher than that in normal control group (F=3.589, P=0.036). The number of CD5+B lymphocytes of peripheral blood [(2.5±0.6)%] in patients with systemic lupus erythematosus was significantly lower than that in the normal control group [(3.2 ±0.8)%], but the difference was not statistically significant (t=3.412, P=0.698). The number of CD5+B lymphocytes in the high activity group was significantly lower than that in the low activity group (t=7.365, P=0.027)and the normal control group (t=5.649, P=0.002). The number of CD5+ B lymphocytes was negatively correlated with SLEDAI score (r=-0.692, P=0.001) and positively associated with the level of complement 3 (r=0.305, P=0.038), but not with complement 4 and ESR (P>0.05). In addition, the level of serum IL-10 in whether the low activity group (t=1.935, P=0.031) or the high activity group (t=3.048, P=0.012) was all higher than the normal control group. The level of serum IL-10 in patients with systemic lupus erythematosus was positively associated with SLEDAI score (r=0.425, P=0.024) and ESR (r=0.479, P=0.008), but was negatively correlated with complement 4 (r=-0.359, P=0.031). Conclusion The total number of lymphocytes in patients with SLE decreases significantly, while B lymphocytes increases significantly. The number of CD5+ B lymphocytes and the serum IL-10 level are also changed. It maybe related to the patient's inflammatory environment, and the number of CD5+B lymphocytes and the serum IL-10 level may be associated with disease activity.

OBJECTIVE:To realize reasonable regression of Chinese medicinal material price to deal with Chinese medicinal material“nominal high price”. METHODS:From the perspective of whole industry chain management,reasons for Chinese medici-nal material“nominal high price”were discussed and feasibility analysis of whole industry chain management of Chinese medicinal material was carried out by using Macro-environment analysis(including politics environment,economic environment,social envi-ronment and technology environment). RESULTS & CONCLUSIONS:At present, Chinese medicinal material“nominal high price”mainly results from lack of core organization,supply deficiency,demand expansion,nonstandard storage and circulation and other factors. Relevant management departments and enterprises should set up whole industry chain management model of Chinese medicinal material from aspects of political environment,economic environment,social environment and technology environment, including to establish industry chain management organization core,to practice standardized production in the upstream industry chain,to appropriately extend industry chain for middle and downstream and to build up modernized logistics service system.

Objective To study the diagnosis and surgical treatment of primary sarcoma of liver in order to obtain a better understanding of this disease and to improve its clinical treatment.Methods The clinical data on the clinicopathological features,surgical treatments and prognosis of 17 patients with primary liver sarcoma who were treated from January 2001 to May 2016 were retrospectively analyzed.Results Of 17 patients with primary sarcoma of liver,elevation of preoperative serum AFP was detected in one patient (5.9％),HBsAg positivity in 3 patients (17.6％),elevation of CEA in 2 patients (11.8％) and abnormal liver function in 3 patients (17.6％).The main clinical symptoms included epigastric pain in 9 patients,epigastric distention in 7 patients,loss of appetite in 5 patients (including in one patient after resection of gastric carcinoma).Twelve of these 17 patients underwent resection (resection rate 64.7％).Five patients underwent laparotomy and biopsy.Among patients who were treated with surgical resection,10 patients had R0 resection and 2 patients had R1 resection.Postoperatively,5 of these patients underwent adjuvant selective hepatic arterial infusion chemotherapy (mitomycin + fluorouracil + epirubicin),and 4 patients were treated with adjuvant systemic chemotherapy (vincristin,cisplatin,cyclophosphamide and Doxorubicin).The postoperative 1,3 and 5-year overall survival rates for all the patients were 58.8％ (10/17),29.4％ (5/17) and 11.7％ (2/17),respectively.In patients with liver resection,the survival rates were 83.3％ (10/12),41.6％ (5/12) and 16.7％ (2/12),and for R0 resection,100.0％ (10/10),50.0％ (5/10) and 20.0％ (2/10),respectively.Condusions The diagnosis of primary sarcoma of liver was difficult before operation.High survival rate could be achieved by radical resection and adjuvant chemotherapy.