Objective:To compare the influence of dronedarone and amiodarone on the bleeding risk of patients with atrial fibrillation treated with rivaroxaban anticoagulation.Methods:Clinical data of 81 patients with atrial fibrillation treated with rivaroxaban anticoagulation at Xi'an International Medical Center Hospital from January 2020 to July 2023, including 36 patients treated with dronedarone and 45 patients treated with amiodarone, were retrospectively analyzed. The effects of dronedarone and amiodarone on the anticoagulation of rivaroxaban were compared using the incidence of bleeding events, thrombosis events, and adverse reactions as outcome measures.Results:The total bleeding in the dronedarone group [22.22% (8/36)] was significantly higher than that in the amiodarone group [6.67% (3/45)] ( χ2 = 4.12, P < 0.05). The total bleeding of conventional-dose rivaroxaban in the dronedarone group was 30.00% (6/20), while the total bleeding of low-dose rivaroxaban was 12.50% (2/16), with no statistical significance ( χ2 = 1.58, P > 0.05). No thrombotic events or adverse reactions to dronedarone or amiodarone were observed in all patients. Conclusion:Compared with amiodarone, dronedarone significantly increases the bleeding risk of rivaroxaban anticoagulation in patients with non-valvular atrial fibrillation, and reducing the dose of rivaroxaban in patients using dronedarone does not reduce the bleeding risk.

Objective:To investigate the influences of Pinocembrin on inflammatory injury in rats with acute myocardial in-farction(AMI)by regulating TLR4/NF-κB/NLRP3 signaling pathway.Methods:The AMI model was established by coronary liga-tion,and the rats were grouped into Sham group,AMI group,Pinocembrin group(5 mg/kg tail vein injection),TLR4 inhibitor group(TAK-242 group,2.0 mg/kg tail vein injection),the levels of cardiac function indexes(LVEF,LVEDD,LVESD,FS)and serum LDH,cTnⅠ,IL-6,IL-β and TNF-α were detected in rats,TTC staining,HE staining and Masson staining were applied to observe myocardial infarction and myocardial histopathological changes in rats,cardiomyocyte apoptosis was detected by TUNEL method,im-munohistochemistry and Western blot were applied to detect TLR4/NF-κB/NLRP3 pathway-related proteins in rat myocardial tissue.Results:Compared with Sham group,the myocardial infarction area increased,the number of myocardial cells decreased,some myo-cardial fibers were broken,inflammatory cells infiltrated,collagen fibers increased,and the apoptosis rate was obviously increased in AMI group(P<0.05),LVEDD,LVESD,serum LDH,cTnⅠ,IL-6,IL-β,TNF-α levels,myocardial tissue TLR4,MyD88,p-NF-κB p65,NLRP3,Caspase-1 expression levels were obviously increased(P<0.05),while LVEF and FS were obviously decreased(P<0.05);compared with AMI group,the myocardial infarction area of the Pinocembrin group and the TAK-242 group were reduced,the cell damage and inflammatory infiltration were reduced,the necrotic cells were obviously reduced,and the apoptosis rate was obvious-ly reduced(P<0.05),LVEDD,LVESD,serum LDH,cTnⅠ,IL-6,IL-β,TNF-α levels,myocardial tissue TLR4,MyD88,p-NF-κB p65,NLRP3,Caspase-1 expression levels were decreased(P<0.05),LVEF and FS were obviously increased(P<0.05);there was no obvious difference in each index between Pinocembrin group and TAK-242 group(P>0.05).Conclusion:Pinocembrin may at-tenuate myocardial inflammatory injury caused by AMI by inhibiting TLR4/NF-κB/NLRP3 signaling pathway.

AIM：To establish a project management tool to measure the working ability of research coordinators and the workload of clinical trial projects, and optimize medical institutions or clinical trial site management organization (SMO) allocation basis of clinical trial items by collecting the work stress and personal ability values of clinical coordinators. METHODS: Different words in the five major databases were searched and information on the work capacity and workload in the Subei People' s Hospital was collected. In addition, the paper analyzes the characteristics of coordinators working pressure source by SPSS26.0 statistical software and stability coefficient method. RESULTS: The study established the clinical research coordinator's personal ability - assessment tool (CRCPA-AT) and clinical trial project workload - assessment tool (CTPW-AT) to assess the coordinator's working ability and clinical trial workload. The two tools in this study were tested retrospectively in 61 coordinators and 144 clinical trials, 39 (66.1%) coordinators' projects were reasonably allocated, 18 (30.5%) coordinators were in the state of theoretical pressure and 12 (20.3%) coordinators had high actual pressure, which matched with the theoretical pressure. CONCLUSION: In this study, two scoring scales were established to quantify the working ability of the coordinators and the workload of clinical trial projects. Through the verification of the 61 coordinators and its management projects, the Likert5 point scoring method was used to analyze, more than 86.4% of the actual pressure of coordinators was consistent with the theoretical pressure quantified by the tool.

Objective:To understand the development trend of scientific research in major medical institutions in China from 2019 to 2021.Methods:The PubMedplus database was searched, and the distribution of papers, published journals and its′ influencing factors (IF) of top 30 domestic medical institutions from 2019 to 2021 were statistically analyzed.Results:From 2019 to 2021, 84 405 PubMed papers were published by the top 30 medical institutions, including 79 459 papers in English, accounted for 94.14%, and 4 946 papers in Chinese, accounted for 5.86%. Of them, 22 447, 29 540 and 32 430 papers were published in 2019, 2020 and 2021. 75 240 papers in English were indexed by SCI database (89.14% of total English papers). 17 729 papers (accounted for 21.00%) were published by the top 27 journals, Frontier in Oncology ranks first. 4 400 papers (5.85% of total) were published by the journals of impact factors greater than 10. The biggest portion of the papers, 26 550 papers (35.29% of total) were published by the journals of impactor factor from 3 to 5. Conclusions:The quantity and quality of papers published by major medical institutions in China have been greatly improved each year. The progress level of medical institutions is different, and their advantageous disciplines of medical institutions have been well reflected.

Objective To analyze the basic characteristics and variation trend of death causes of permanent residents in Enshi City during 2013-2018, to assess the burden of different diseases, and to provide a scientific basis for formulating disease prevention and control strategies. Methods The death monitoring data of permanent residents in Enshi City, Hubei Province from 2013 to 2018 was collected. The crude mortality, standardized mortality, life expectancy, potential years of life loss (PYLL), standard potential years of life loss (SPYLL), average years of life lost (AYLL), and annual percentage change (APC) were calculated to describe the distribution and trend of death causes. Results The average annual crude death rate and standardized death rate of residents in Enshi City from 2013 to 2018 were 679.43 per 100 000 and 615.02 per 100 000, respectively. The top 5 causes of death were circulatory system diseases, respiratory system diseases, malignant tumors, injuries, and digestive system diseases, accounting for 91.2% of the total deaths. Analysis of life expectancy found that the average life expectancy of local residents from 2013 to 2018 was 78.02 years, and the value in the male group (75.57 years) was lower than that in the female group (80.78 years). Life loss analysis revealed that PYLL caused by various diseases was 171 620 person-years, SPYLL was 171 284.62 person-years, and AYLL was 15.03 years/person in Enshi City from 2013 to 2018. Among all the death causes, the top five in terms of life loss were injuries, malignant tumors, circulatory diseases, respiratory diseases and digestive diseases. Conclusion From 2013 to 2018, the death rate of residents in Enshi City was relatively higher compared with those in other cities in China, the average annual crude death rate was on the rise, and the average annual standardized death rate was on the decline, indicating a highly ageing region. Chronic diseases such as circulatory system diseases, malignant tumors, and respiratory diseases, as well as injuries were the main death causes and caused a heavy burden of diseases, which should be the focus of future prevention and control work. Considering the higher levels of death and life loss indicators of male residents than those of women, targeted prevention and control measures should be taken to narrow the gap between men and women and improve the overall life quality of the whole population.

Coronary disease is one of the highest mortality diseases in the world,and interventional therapy has been the best treatment choice for its low risks,high efficiency,less wound and rapid recovery after the operation.Thrombus aspiration catheter is one of the most important equipment in the interventional therapy instrument of coronary disease.This paper is based on the demand of clinical and market,designed and manufactured aspirated catheter for the treatment of coronary thrombosis.Through the performance comparison of the material,confirmed the main material quality of thrombus aspiration catheter and its organization.We also made the appraisement for the function of the material and the main performance of the thrombus aspiration catheter.The experiment turned out that our catheter performance is stable and also with highly reliable,which is absolutely fit for the using requirements of the clinical.
Catheters ; Coronary Angiography ; Coronary Thrombosis ; therapy ; Humans ; Suction ; Thrombectomy ; instrumentation ; Treatment Outcome

AIM:To investigate the molecular mechanism of inhibition of miR-421 expression promoting radiosensitivity in the cervical cancer cells.METHODS:Cervical cancer lines HeLa, SiHa, C33A and CaSki were transfected with miR-421 inhibitor or negative control nucleotide using Lipofectamine 2000 kit, and the levels of miR-421 expression in the cervical cancer lines and endometrial epithelium cell line ESC were detected by real-time PCR.These cells with transfection were exposed to various doses of X-ray (0, 2, 4, 6 and 8 Gy).After 48 h, the cell viability, LDH leakage rate and apoptotic rate were measured respectively by MTT assay, ELISA and flow cytometry with Annexin V-FITC/PI staining.The protein levels of cleaved caspase-9, caspase-9, cleaved PARP, PARP, Bcl-2 and Bax were monitored by Western blot.RESULTS:Low miR-421 levels was found in the ESC cells, while high miR-421 levels were observed in the HeLa, SiHa, C33A and CaSki cells.The level of miR-421 in the cells transfected with miR-421 inhibitor was significantly lower than that in negative control group (P<0.05).The viability and LDH leakage rate of the cervical cancer cells with low miR-421 expression were notablely lower than those in negative control group, and the apoptotic rate at 72 h was remarkablely increased (P<0.05) under the same conditions.The results of Western blot indicated that, after exposure to ionizing radiation, the protein levels of cleaved caspase-9, cleaved PARP and Bcl-2 were significantly increased, while the protein level of Bax was significantly decreased in the cervical cancer cells with low miR-421 expression compared with negative control group (P<0.05).CONCLUSION:miR-421 is lowly expressed in the normal endometrial epithelial cells, but highly expressed in the cervical cancer cells.Down-regulation of miR-421 expression significantly inhibits the growth and enhances the radiosensitivity of cervical cancer cells at least partly via activating caspase-9 apoptosis pathway, thus promoting Bcl-2 and inhibiting Bax expression.

Objective To investigate the association of the Cx37 polymorphism of connexin gene with essential hyper?tension (EHT) in Xinjiang Han and Kazak population. Methods In Xinjiang region, 500 EHT patients (EHT group) were in?cluded in this study including Kazak 250 cases and Han 250 cases. Five hundred healthy volunteers (NT) were used as NT group including Kazak 250 cases and Han 250 cases. The values of age, body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP), and other general clinical features were compared between two groups. The poly?morphism of Cx37 gene rs1630310, rs697372 and rs705193 SNP were compared between EHT and NT groups in the two eth?nic groups. Hardy-Weinberg equilibrium was used to detect the representation, and differences of genotype frequencies and gene frequency were calculated in two groups of Kazak and Han groups. Results There were significant differences in BMI, SBP, DBP, apolipoprotein ratios and homocysteine between EHT group and NT group in Kazak and Han groups (P<0.05). There were no significant differences in genotype frequencies and gene frequencies of rs705193 between EHT and NT groups (P>0.05). The differences of Kazak rs1630310 genotype and gene frequency were statistically significant (P<0.01). The frequency of Kazak rs697372 locus genotype was not significantly different (P>0.05), but the difference of gene frequen?cy was statistically significant (P<0.05). There were no significant differences in rs1630310 and rs697372 locus genotype and gene frequency in two groups of Han group. Conclusion Cx37 gene polymorphism is associated with the occurrence of EHT in Xinjiang Kazak population, which may be related with the rs1630310 and rs697372 polymorphism.

Objective To investigate the trunk stability control of spastic cerebral palsy patients,and to analyze their visual compensation and the resulting symmetrical balance of the trunk.Methods Twenty children with spastic cerebral palsy and 20 healthy children formed the experimental and control groups respectively.Their balance was tested using the PK 254P rehabilitation system.Trunk stability and symmetry parameters were measured in standardized silent sitting for 30s with the eyes open and closed.The anterior-posterior (AP) and mediolateral deviations of the center of pressure (COP),the average speed of COP excursions in each direction,the COP perimeter,and the ellipse area of the COP were quantified.Results The two groups showed statistically significant differences in the average values of all the variables measured.The differences in the trunk stability control parameters of the experimental group between the eyes-open and eyes-closed conditions were significantly greater than those of the control group.The offset of the medial-lateral COP in the spastic cerebral palsy subjects was nearly symmetrical (the average position of the COP on the X axis was close to zero),while the anterior-posterior offset tended to the anterior direction (the average position of the COP on the Y axis was significantly positive).The medial-lateral and anterior-posterior offsets of the health subjects were nearly symmetrical (both close to zero).Conclusion Children with spastic cerebral palsy have less trunk stability control than healthy children.They rely more on visual cues in compensation.Their medial-lateral COP control is nearly symmetrical,but their anteriorposterior posture tends to the anterior.

Objective To analyze clinical and radiological characteristics of intracranial hemorrhage in hematological diseases to improve the recognition of them. Methods Thirty-one clinical data of intracranial hemorrhage cases with hematological diseases were reviewed. The basic diseases, clinical and radiological manifestations, and risk factors of mortality were analyzed. Results Intracranial hemorrhage usually occurred in patients with acute myeloid leukemia (AML) or idiopathic thrombocytopenic purpura (ITP),and 13 and 6 cases, respectively, in this group. Most patients presented with headache, restlessness, nausea,vomiting, conscious disturbance and no localization sign by physical examination. CT or MRI images often revealed focus of errlysis. Compared with CT scan, a higher detection rate of ICH could be realized by MRI scan. The total mortality in this group of ICH patients was 71% (22/31). Fever, white blood cell ＞5×109/L,platelet ＜50×109/L, hyperimmunoglobulinemia and disturbance of blood coagulation were risk factors for ICH of this group of patients. The mortality was higher in patients with no less than 2 risk factors[86.4 % (19/22)vs 33.3 % (3/9)] (x2 = 8.718, P = 0.003). Conclusion ICH is a serious complication for hematological patients. MRI scan is good at improving the diagnosis of ICH. It is of high risk of death in patients with no less than 2 risk factors such as fever, white blood cell higher than 5×109/L, platelet less than 50×109/L,hyperimmunoglobulinemia and disturbance of blood coagulation.