Abstract:Objective To investigate the occurrence of new-onset postoperative atrial fibrillation (POAF) in intensive care unit (ICU) patients after non-cardiac surgery, and to analyze its risk factors and impact on short-time outcomes. Methods A retrospective nested case-control study was conducted among the 2586 cases who underwent non-cardiac procedures and then admitted into ICU in the period from January 2011 to December 2013. Those with new-onset POAF during hospitalization were screened out. Control patients who were matched in age, gender and location of surgery were selected at a 1∶[KG-*2]2 ratio. SPSS statistics 21.0 was used to perform the statistical analysis. Risk factors were screened with multivariate logistic regression analysis. Early postoperative outcomes were compared between the 2 groups. Results Among the subjects, 2.7%(71/2586) developed new-onset POAF. The incidence was quite higher in those very old (≥75 years old) and in those after intra-thoracic surgery. In the patients who developed new-onset POAF, 77.5%(55/71) occurred within 3 d postoperatively, and only 33.8%(24/71) complained of discomfort. Sepsis (OR=11.81, 95%CI 1.72-81.00, P=0.012), hypokalemia (OR=19.48,5%CI 2.31-164.09, P=0.006), postoperative acute congestive heart failure (OR=9.91, 95%CI 1.92-51.22, P=0.006), and new-onset non-atrial fibrillation arrhythmias (OR=20.32,5%CI 3.51-117.55,P=0.001) were independent risk factors for new-onset POAF in the matched patients. Higher in-hospital mortality was associated with longer mechanical ventilation and ICU stay in these patients. Conclusion The incidence of new-onset POAF is 2.7% in the patients admitted to ICU after non-cardiac surgery. The condition is more common in the very elderly (≥75 years old) and those after intra-thoracic surgery. Sepsis, acute congestive heart failure, hypokalemia and new-onset non-AF arrhythmias are independent risk factors of POAF in the matched patients. New-onset POAF is deteriorated with worse outcomes.

Abstract:Objective To explore the relationship of blood pressure variability and cognitive impairment in the very elderly patients with hypertension. Methods A total of 177 hypertensive patients (80-91 years old) admitted in our department from March to December 2017 were recruited in this study. According to the results of Montreal cognitive assessment (MoCA), the patients were divided into mild cognitive impairment group (MCI group, n=114) and normal cognitive group (control group, n=63). The general conditions, laboratory examination results, mean blood pressure, variable coefficient and circadian rhythms of blood pressure, and morning surge in blood pressure were compared between the 2 groups. SPSS statistics 17.0 was used to perform the statistical analysis. Student＇s test or Chi-square was employed for comparison between two groups. Results There were no significant differences in general conditions between the 2 groups (P>0.05). The patients from MCI group had obviously higher variable coefficient of systolic blood pressure [(0.11±0.02)% vs (0.08±0.03)%, P<0.05] and diastolic blood pressure [(0.12±0.02)% vs (0.11±0.03)%, P<0.05] than those in the control group. No significant differences were seen in declined rate of systolic blood pressure and diastolic blood pressure and morning diastolic blood pressure surge between the 2 groups (P＞0.05). The morning systolic blood pressure surge was also significantly higher in the MCI group than the control group [(17.37±5.36) vs (13.60±3.57) mmHg, P<0.05]. No significant differences were seen in the ratios of patients presenting non-dipper type, dipper type, reverse dipper type and over dipper type of blood pressure between the 2 groups(P＞0.05). Conclusion Controlling blood pressure variability and morning systolic blood pressure surge is helpful to the improvement of cognitive function in very elderly hypertensive patients.

Abstract:Objective To determine the therapeutic effect of intermediate care (IC) mode on rehabilitation of the elderly patients with moderate or severe chronic obstructive pulmonary diseases (COPD). Methods A total of 124 elderly patients with whole clinical data, suffering from acute exacerbation of COPD and then gotten improved after hospitalization in Beijing Geriatric Hospital during January 2015 and June 2017 were recruited in this study. They were randomly divided into IC group and control group(n=62 for each group). The patients of the IC group adopted IC mode on the basis of general clinical treatment, while those of the control group was treated only with general internal medicine. Their BODE index [body mass index (BMI), measure of airflow obstruction, dyspnea score and exercise capacity], health related quality of life (HRQL), results of blood gas analysis were compared before and in 15,0 and 60 d after the treatment.The fall scores, times of acute exacerbation of COPD, and re-hospitalization were recorded. SPSS statistics 20.0 was used for data analysis. The measurement data were expressed as mean±standard deviation, and Student′s t test was employed for the comparison between groups. Enumeration data were expressed as percentage, and inter-group comparison was carried out with Chi-square test. Results There were no statistical differences in all indicators between the 2 groups before treatment (P>0.05). Compared with the following indicators before treatment, no obvious differences were seen between the 2 groups in 15 d after the treatment, including forced expiratory volume in one second/forced vital capacity (FEV1/FVC, FEV1%), 6-minute walking test (6MWT), BMI, Saint George′s Respiratory Questionnaire (SGRQ), modified British Medical Research Committee respiratory distress scale (mMRC) score, BODE score, partial pressure of oxygen (PaO₂), partial pressure of carbon dioxide (PaCO₂), and fall score (P>0.05). But the above indicators were significantly improved in 30 and 60 d after treatment (P<0.05). After treatment, the improvement of FEV1%, 6MWT, BMI, SGRQ, PaO₂ and PaCO₂ in the IC group was significant in 30 and 60 d (P<0.05), and the decrease of mMRC score was not obvious (P>0.05). There was no notable difference in BODE index between the 2 groups in 15 d (P>0.05), but the differences were significant in 30 and 60 d after treatment (P<0.05). After 30 days′ treatment, there was no significant improvement in the risk score, times of acute exacerbation and re-hospitalization in the 2 groups (P>0.05), but the 3 indicators were significantly reduced after 60 days′ treatment (P<0.05). Conclusion IC mode can significantly reduce the BODE index, improve PaO₂ and decrease PaCO₂, lower the incidence of falls, times of acute exacerbation and re-hospitalization in the elderly patients with moderate and severe COPD.

Abstract:Objective To determine the effect of comprehensive rehabilitation treatment on emotion, nutritional status, and quality of life in elderly patients with head and neck cancer after radiotherapy. Methods A total of 62 elderly patients with head and neck cancer completing radiotherapy in our hospital from June 2015 to June 2017 were enrolled in this study. They were randomly divided into rehabilitation group (n=31) and control group (n=31). The patients from the both groups were given routine healthy counseling and follow-up, while those of the former group were additionally provided with comprehensive rehabilitation treatment, including psychological counseling, physical exercise, swallowing training and nutrition intervention. They were assessed with geriatric depression scale (GDS), mini-nutritional assessment short-form (MNA-SF), quality of life questionnaire-core 30 (QLQ-C 30) immediately after radiotherapy and 6 months after radiotherapy. SPSS statistics 19.0 was used for data analysis. The measurement data were expressed as mean±standard deviation, and Student′s t test was employed for the comparison between groups. Results There were no statistical differences in scores of GDS, MNA-SF and QLQ-C 30 immediately after radiotherapy. At 6 months after radiotherapy, the scores of GDS[(7.35±1.75) vs (10.20±1.94)], MNA-SF[(10.85±3.23) vs (9.56±4.21)] and QLQ-C 30[(57.84±9.57) vs (49.73±10.01)] in the rehabilitation group were all significantly better than those in control group (P＜0.05). The score of MNA-SF in the control group was significantly better than that immediately after radiotherapy[(9.56±4.21) vs (8.24±4.05), P＜0.05]. Conclusion Comprehensive rehabilitation treatment can more significantly improve the depressive status, nutritional status and quality of life in the elderly patients with head and neck cancer after radiotherapy.

Abstract:Objective To investigate the relationship of serum miR-133b level with renal injury and prognosis in the elderly with diabetic nephropathy (DN). Methods A total of 182 elderly DN patients (DN group) admitted to our hospital from January 2016 to December 2017 were enrolled in this study, and another 80 matched healthy individuals taking physical examination during the same period served as control group. Real-time quantitative PCR (qRT-PCR) was used to detect serum miR-133b level, and the results were analyzed for the relationship with clinical indices in the elderly DN patients. Renal injury was evaluated by nephrotic grade, interstitial fibrosis and tubular atrophy (IFTA) score and interstitial inflammation, and the diversity of miR-133b level in different severity grades was analyzed. After the DN patients were divided into low- and high-expressed miR-133b groups, and the relationship of miR-133b level with pronostic in the two groups was also analyzed. SPSS statistics 19.0 was used to perform the statistical analysis. One-way analysis of variance, group t test, or Chi-square test was employed for intergroup comparison based on different data types. Pearson correlation analysis was performed for the correlations. Results The serum miR-133b level was significantly higher in the DN group than in the control group [(5.38±1.28) vs (1.06±0.25), P<0.01]. Significant differences were also seen in its serum level among the patients with different course of diabetes, proteinuria, serum creatinine (SCr), blood urea nitrogen (BUN) and estimated glomerularfiltration rate (eGFR) (P<0.05), and so were in those with different nephrotic grades, IFTA score and interstitial inflammation (P<0.05). What′s more, with the severity of renal pathological damage, the serum level was elevated (P<0.05). Pearson correlation analysis showed that the serum miR-133b level was positively correlated with proteinuria, SCr and BUN levels, nephrotic grade, IFTA score, and interstitial inflammation (r=0.492, 0.382,0.415,0.463,0.338,0.547, P<0.01), but negatively correlated with eGFR level (r=-0.625, P<0.01). Among the 182 elderly DN patients, 76 developed into end-stage renal disease (ESRD), with 65.9%(58/88) from the high miR-133b expression group while 19.1%(18/94) from the low expression group, indicating the former group having higher risk of ESRD (χ²=6.175, P=0.006). Conclusion Serum miR-133b level is significantly elevated, and associated with renal injury and poor prognosis in the elderly DN patients. The higher the level is, the severer the renal injury is and the poorer the prognosis is.

Abstract:Objective To compare the effects of ticagrelor versus double maintenance dose of clopidogrel in poor-metabolizing (PM) patients [with an abnormal variant of cytochrome P450 family 2 subfamily C member 19 (CYP2C19)] after percutaneous coronary intervention (PCI). Methods A total of 205 patients with verified PM by CYP gene test who underwent PCI in the cardiological department of Chinese PLA General Hospital from June 2014 to September 2016 were recruited in this study. They were randomly divided into clopidogrel group (n=103) and ticagrelor group (n=102). The patients of the clopidogrel group were given 150 mg/d clopidogre for 3 months and then 75 mg/d for the other 9 months. While those from the ticagrelor group were given a loading dosage of 180 mg ticagrelor, followed by a maintenance dosage of 90 mg, twice per day. All of the patients were given dual antiplatelet agents for 12 months, and the outcomes were analyzed after 12 months of follow-up. SPSS statistics 17.0 was used to perform the statistical analysis. Independent sample t test, rank-sum test, Chi-square test, or Fisher exact test was employed for comparison between groups. Results There were no significant differences between the 2 groups in age, sex, body mass index (BMI), platelet count, estimated glomerular filtration rate (eGFR), ratios of those suffering from ST segment elevation myocardial infarction (STEMI), non-ST segment elevation myocardial infarction (Non-STEMI), hypertension and hyperlipidemia, and previous intervention of PCI (P>0.05). But obvious differences were seen in balloon dilatation pressure [(12.3±2.8) vs (11.4±1.7)mmHg] and stent expansion pressure [(12.4±2.5) vs (11.5±2.2) mmHg] between the 2 groups (P<0.05). What′s more, the incidence rates of major adverse cardiovascular events (MACEs) was notably higher in the clopidogrel group than in the ticagrelor group [14.6%(15/103) vs 5.9%(6/102), P=0.040]. Conclusion Ticagrelor is superior to maintenance dose of 150 mg clopidogrel in clinical outcomes for the PM patients

Abstract:Objective To analyze the characteristics of nonagenarian inpatients in internal medicine department and investigate the influencing factors associated with the in-hospital mortality. Methods Medical records of 141 over-90-year-old inpatients admitted in our department from January to December 2014 were collected and then retrospectively analyzed. According to their in-hospital outcome, the patients were divided into death group (n=29) and survival group (n=112). The general information, results of bio-chemical indices at admission, Barthel index (BI) activities of daily living (ADL) were compared between the 2 groups for influencing factors associated with the in-hospital mortality. SPSS statistics 16.0 was used to analyze the data. Student′s t test, Wilcoxon rank sum test or Chi-square test was employed for the comparison between groups. Multivariate logistic regression analysis was adopted to explore the factors affecting in-hospital mortality. Results Compared with the patients in the survival group, those from the death group had higher ratios of acute or old myocardial infarction, atrial fibrillation, anemia, hypoalbuminemia and cancer (P<0.05), lower BI [(37.93±25.27) vs (61.92±23.64)], and decreased levels of hemoglobin [(110.11±20.79) vs (120.59±16.83)g/L] and albumin [(35.42±4.67) vs (38.35±4.25)g/L], but larger white blood cell count [(8.89±4.75)×10⁹/L vs (6.95±2.26)×10⁹/L]and higher level of high sensitivity C-reactive protein [19.44(6.99,0.77) vs 5.18(1.27,3.48)mg/L] (all P<0.05). Logistic regression analysis indicated that severe and very severe disability(OR=5.055,5%CI 1.961-13.026,P=0.001), anemia (OR=4.796, 95%CI 1.795-12.813,P=0.002), and white blood cell count (OR=1.233,5%CI 1.046-1.455,P=0.013) were risk factors for in-hospital death in the cohort. Conclusion The inpatients aged 90 or above should actively improve their ability of daily living after admission, and the state of anemia should be corrected initiatively.

Abstract:Objective To explore the clinical efficacy and safety of ultra-early intravenous thrombolytic therapy in the treatment of acute cerebral infarction. Methods A retrospective study was performed on 260 patients with acute cerebral infarction in the Department of Neurosurgery from January 2014 to April 2017. Their clinical data were collected and analyzed. According to ultra-early thrombolysis or not, they were divided into thrombolytic group and control group, 130 cases in each group. Thrombolytic group was treated with recombinant human tissue plasminogen activator within a therapeutic window of 4.5 h, and the control group was given with conventional anticoagulation and antihypertensive therapy. National Institutes of Health Stroke Scale (NIHSS) score, Barthel index, long term prognosis and coagulation function, including activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and fibrinogen (FIB) at different time points after treatment were used to compare the efficacy of the 2 groups. SPSS statistics 16.0 was used for data processing. According to the data type, Students′t test or Chi-square test was used in the comparison between groups. Results After treatment for 24 h, the patients in the thrombolysis group had significantly longer APTT [(32.9±2.8) vs (30.1±3.0) s], PT [(13.7±1.6) vs (12.8±1.5) s] and TT [(17.3±1.0) vs (16.1±1.3) s] (all P<0.05), but obviously lower FIB level [(2.6±0.4) vs (2.9±0.6) g/L, P<0.05] when compared with those in the control group. Before treatment, there was no significant difference in NIHSS scores between the 2 groups (P>0.05), but the scores were notably lower in the thrombolysis group than the control group in 24 h, and 7,4 and 28 d after treatment (P<0.05). At 1,3, and 6 months after treatment, the Barthel index of patients in the thrombolysis group was significantly higher than that in the control group at the same time (P<0.05). After 6 months of treatment, the rate of good prognosis was significantly higher in the thrombolysis group than in the control group (76.15% vs 64.62%,P<0.05). In the thrombolysis group, there was 1 case of gingival bleeding, 2 cases of epistaxis, and 13 cases of subcu-taneous hemorrhage at the site of intravenous infusion, but no other serious adverse events occurred. Conclusion Ultra-early intravenous thrombolytic therapy can effectively improve the symptoms of neurological deficits in the patients with acute cerebral infarction, and is of great significance for long-term rehabilitation.

Abstract:Objective To investigate the correlation of hypomagnesemia and 90-day poor prognosis in the elderly patients with acute heart failure (AHF). Methods A single center prospective trial was conducted on 150 elderly AHF patients admitted in the emergency department of Beijing Hospital between January 2013 and December 2016. According to the occurrence of endpoint events (all-cause mortality and re-hospitalization due to AHF) within 90 d after admission, they were divided into poor prognosis group (n=56) and non-poor prognosis group (n=94). SPSS statistics 19.0 was used to perform the statistical analysis. Student′s t test, Mann-Whitney U test or Chi-square test was employed for comparison between groups. Univariate and multivariate logistic regression analyses were adopted to screen the risk factors influencing the prognosis. Results The incidence rate of 90-day endpoint events were 37.3%(37/150), including 47 cases (31.3%) of re-hospitalization due to AHF and 9 cases (6.0%) of death. The serum magnesium level was significantly lower in the poor prognosis group than the non-poor prognosis group [(0.70±0.05) vs (0.80±0.09) μmol/L, P=0.000]. Multivariate logistic regression analysis indicated that lower magnesium level (OR=30.631,5%CI 5.943-157.881; P=0.000), rapider respiration rate (OR=1.354,5%CI 1.112-1.648; P=0.003), severer grade in bedside classification (OR=3.316, 95%CI 1.169-9.403; P=0.024) and elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) level (OR=3.960, 95%CI 1.318-11.892; P=0.014) were independent risk factors influencing 90-day prognosis of the AHF patients. Conclusion Hypomagnesemia is an independent risk factor for 90-day poor prognosis of elderly AFH patients, and clinicians should pay more attention to its value.

Abstract:Objective To evaluate the clinical effectiveness of Solitaire AB stent thrombectomy for acute ischemic stroke (AIS). Methods A retrospective study was carried out in 94 AIS patients admitted in our department from November 2014 to January 2016. According to the treatment they received, they were divided into group A (Solitaire AB stent thrombectomy, n=40) and group B (conventional microcatheter mechanical thrombectomy, n=54). All patients were followed up for 3 months. Their pre- and post-operative nerve function indices were compared between the 2 groups. The therapeutic effects were evaluated by thrombolysis in cerebral infarction (TICI) perfusion scale, National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (MRS). SPSS statistics 16.0 was used to perform the statistical analysis. Independent sample t test or Chi-square test was employed for intergroup comparison, while paired t test for intragroup comparison. Results There were no significant differences in the serum levels of neuron-specific enolase (NSE), central nerve specific protein (S100β), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) at the same time point between the 2 groups (P>0.05). In both groups, the serum levels of NSE, S100β, TNF-α and IL-6 were significantly elevated in 24 h post-operatively, and then decreased in 72 h than those before operation (P<0.05). In group A, there were 70.00%(28/40) patients of TICI grade Ⅲ, 17.50%(7/40) of TICI grade Ⅱ, 12.50%(5/40) of TICI grade 0-Ⅰ. And the percentages were 57.41%(31/54), 25.93%(14/54), and 16.67%(9/54) respectively in the patients of group B, without significantly diffe-rences when compared with those of group A (P＝0.238). Though no significant difference was seen in NIHSS scores between group A and group B at same time point (P>0.05), the scores were obviously decreased in 1 and 2 weeks postoperatively than those before operation (P<0.05). After 3 months, there was no significant difference in the ratio of better prognosis between the 2 groups (80.00% vs 70.37%, P>0.05). Conclusion Solitaire AB stent thrombectomy shows similar efficacy as conventional mechanical thrombolysis in the treatment of AIS patients, but the operation is relatively complicated and difficult. Clinicians should choose rational surgical approaches according to patient′s condition.

Abstract:Objective To investigate the predictive values of serum thymidine kinase 1 (TK1), carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) in postoperative recurrence and metastasis of colon cancer. Methods Totally 140 cases of colon cancer treated surgically in our 2 hospitals from March 2011 to December 2015 were enrolled in this study. The patients were divided into non-recurrence or -metastasis group (n=94) and recurrence and metastasis group (n=46) according to whether recurrence or metastasis occurred during follow-up. Their clinical data, and preoperative serum levels of TK1, CEA and CA199 were compared between the 2 groups. SPSS statistics 19.0 was used for data processing. The values of TK1, CEA and CA199 to predict the recurrence and metastasis of colonic cancer were analyzed by using the receiver operating characteristic (ROC) curve. The correlation of serum TK1, CEA and CA199 in patients with recurrent and metastatic colon cancer was analyzed by Pearson correlation. Results The positivity rates of TK1 (76.1% vs 51.1%), CEA (91.3% vs 64.9%) and CA199 (84.8% vs 58.5%) were significantly higher in the recurrence and metastasis group than the non-recurrence or -metastasis group (P<0.05). Similar results were found in the serum levels of TK1 [(3.70±1.62) vs (2.36±1.08) pmol/L], CEA [(28.63±9.14) vs (17.42±5.38)ng/ml] and CA199 [(75.26±17.30) vs (63.48±12.45) U/ml](all P<0.05). The ROC curve showed that the best cut-off values of serum TK1, CEA and CA199 for predicting the recurrence and metastasis of colon cancer were 2.96 pmol/L, 22.63 ng/ml and 69.24 U/ml,respectively. In the prediction for colon cancer, the area under ROC curve when the 3 molecules jointed together [95%CI,0.872(0.813-0.935)]was significant larger than they used solely [TK1:0.730(0.672-0.791), CEA:0.804(0.744-0.865), CA199:0.762(0.703-0.823)], with a sensitivity of 86.5% and a specificity of 82.4%. Pearson correlation analysis showed that serum TK1 level was positively correlated with those of CEA (r=0.760, P<0.01) and CA199 (r=0.702, P<0.01) in the patients with recurrent metastatic colon cancer, and that of CEA also had a positive correlation with that of CA199 (r=0.813, P<0.01). Conclusion The preoperative serum levels of TK1, CEA and CA199 are significantly higher in the patients doomed to recurrence and metastasis. And the joint test of the 3 molecules is of much higher value for predicting the recurrence and metastasis of colon cancer after operation.

Abstract:Objective To detect the level of adiponectin (APN) and liver expression of silent information regulator 1 (SIRT1) in rats in early stage of diabetic mellitus (DM) and investigate the role of SIRT1 in the regulation of APN. Methods A total of 42 Sprague-Dawley rats were randomly divided into normal control group (n=10), DM model group (n=10), DM+resveratrol (RES) group (n=11) and DM+niacin amide (NIA) group (n=11). Rat DM model was established by an injection of streptozocin after 5 weeks′ high fat diet. Basic metabolic indices, serological parameters, and pathological changes of liver tissues by HE staining were used to identify the model establishment. The plasma level of APN was detected by ELISA reagent kit. Western blotting and RT-PCR were employed to measure the expression of SIRT1 and APN receptor AdipoR2 at protein and mRNA levels in the liver tissues. SPSS statistics 19.0 was used to perform the statistical analysis. Chi-square test and Student′s t test were employed for intergroup comparison based on different data types. Results Compared with the DM group, the DM+RES group had significantly lower fasting blood glucose (FBG; P<0.05), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C; P<0.05), and triglycerides (TG; P<0.05), but obviously elevated high-density lipoprotein cholesterol (HDL-C; P<0.01), and slightly increased APN (P>0.05). The DM+NIA group had remarkable higher TC and LDL-C (P<0.05), and obviously decreased APN (P<0.05) when compared with the DM group. Pathological observation displayed that obvious infiltration of inflammatory cells and even degeneration in the liver tissues of the DM group, attenuated cell degeneration in the DM+RES group, and dispersed lipid droplets in the liver cells of the DM+NIA group. Western blotting showed the protein levels of AdipoR2 and SIRT1 were increased (both P<0.05) and that of WISP-1 was decreased in the DM+RES group (P<0.05), while the levels were reduced in the DM+NIA group. Similar trends were seen in the mRNA expression levels of the 2 molecules(P<0.05). Conclusion In the development of early liver damage in DM rats, the signaling molecules of SIRT1 may modulate the expression of AdipoR to regulate APN level, and then participate in the pathophysiological evolution of endocrine system after DM.

Abstract:This paper reviewed 1 case of chronic total occlusion of right coronay artery(RCA) undergoing the interventional treatment guided by real-time fusion technique of 3D-computed tomographic angiography(CTA) and coronary angiography(CAG) in our department. The patient was admitted to the hospital due to unstable angina pectoris. CAG showed that 95% stenosis in the middle part of the anterior descending branch,70% stenosis in the distal part of the anterior descending branch, 50%-90% stenosis in the pro-ximal middle segment of the circumflex branch, then most seriously, 85%, diffuse stenosis of the right proximal segment of RCA, and the middle segment of RCA totally occluded. CTA findings indicated RCA chronic total occlusion and predicted the severity of opening. At the same time, real-time fusion technique of 3D-CTA and CAG was used to guide the opening of chronic occlusion, and was helpful to identifying the position of the balloon and the stent. We also used contralateral contrast and micro-catheter to verify the effect of 3D-CTA and CAG fusion.

Abstract:Obstructive sleep apnea (OSA) during rapid eye movement (REM) sleep is defined as OSA occurring mainly in the REM sleep. Evidence shows that REM sleep is associated with abnormal higher sympathetic activity, so OSA in this period leads to even higher sympathetic activity, and thus cardiovascular instability. Recent studies have indicated that REM-OSA might be main reason for OSA induced hypertension, and this might also be the vital cause of negative or modest effect of continuous positive airway pressure (CPAP) therapy on such hypertension. In clinical practice, more attention should be paid to the diagnosis and treatment of REM-OSA, which is of great significance for the prevention and treatment of OSA related hypertension.

Abstract:Philadelphia chromosome-negative myeloproliferative neoplasms (Ph-MPN) mainly include 3 types, that is, primary myelofibrosis (PMF), polycythemia vera (PV), and primary thrombocythemia (PT). The Janus kinase1/2 (JAK1/2) inhibitor ruxolitinib has been at the heart of PMF treatment since 2011. Before this, allogeneic hematopoietic stem cell transplantation is the only possible treatment for PMF, but it is prohibitive for most patients because of lack of matching or expensive aspects. As the targeted drug for PMF, ruxolitinib aims at the pathogenesis of PMF, so as to fundamentally control the disease and improve the clinical symptoms of patients. In addition to treating PMF, it also plays a good role in PV or PT patients with hydroxyurea resistance or intolerance.

Abstract:In recent years, much evidence has shown that vitamin D not only plays important roles in bone diseases, but also plays more vital roles in non-bone diseases. Basic studies confirmed that vitamin D receptors are extensively expressed in various cells in the body. In clinical studies, vitamin D supplementation is essential in the prevention and treatment of tumors, metabolic syndrome, cardiovascular diseases, and autoimmune diseases. In this paper, we reviewed the progress in researches on vitamin D deficiency and above-mentioned diseases.

Abstract:Anterior cervical surgery has become a common surgical approach for cervical spine surgery. Although it is considered to be relatively safe and effective, the caused complications still bring great challenges to surgeons and patients. It is of importance to understand the types and treatment methods of these complications. In this review, we described the types, prevention and treatment of the complications.