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Background The treatment of coronary microvascular disease (CMVD) has always been the focus of non-coronary obstructive ischemic heart disease. Adenosine injection and adenosine disodium triphosphate (ATP) injection, which are common clinical loading drugs to determine coronary flow reserve (CFR) and evaluate CMVD, are related but significantly different. ATP is the precursor of adenosine, with low price and similar vasodilatory mechanism to adenosine, and is often substituted for adenosine in clinical practice, but its potential adverse effects are ignored. Objective To compare the incidence of adverse reactions in the assessment of coronary microvascular disease by adenosine load and adenosine disodium triphosphate load. Methods A total of 170 patients who visited the Department of Cardiology of Shaanxi Provincial People's Hospital for typical angina pectoris and underwent coronarography/Coronary CT angiography (CTA) to determine the residual stenosis diameter of each branch coronary artery 0.05) . Conclusion Compared with ATP loading, adenosine loading has a lower incidence of adverse reactions determine CFR.

Spinal cord injury (SCI) is a serious disabling injury, and the main factors causing SCI in patients include car accidents, falls from heights, as well as heavy blows and falls. These factors can all cause spinal cord compression or even complete rupture. After SCI, problems with the movement, balance, and walking ability of the lower limbs are most common, and SCI can cause abnormalities in patient’s movement, sensation, and other aspects. Therefore, in the treatment of SCI, it is necessary to strengthen the rehabilitation training (RT) of patients based on data science to improve their motor ability and play a positive role in the recovery of their walking ability. This article used lower limb rehabilitation robot (LLRR) to improve the walking ability of SCI patients and applied them to SCI rehabilitation. The purpose is to improve the limb movement function of patients by imitating and assisting their limb movements, thereby achieving pain relief and muscle strength enhancement and promoting rehabilitation. The experimental results showed that the functional ambulation category (FAC) scale scores of Group A and Group B were 0.79 and 0.81, respectively, in the first 10 weeks of the experiment. After 10 weeks of the experiment, the FAC scores of Group A and Group B were 2.42 and 4.36, respectively. After the experiment, the FAC score of Group B was much higher than that of Group A, indicating that Group B was more effective in improving patients’ walking ability compared to Group A. This also indicated that LLRR rehabilitation training can enhance the walking ability of SCI patients.

Background Percutaneous coronary intervention (PCI) is an effective treatment for coronary heart disease in cardiology. A variety of complex lesions are faced during PCI, among which coronary artery calcification (CAC) increases the difficulty of PCI, immediate postoperative risk, short-term and long-term postoperative risk of adverse cardiovascular events. Early identification and assessment of CAC is important to improve surgical success rate, reduce postoperative complications and adverse cardiovascular events risks and improve prognosis. Objective To explore the influencing factors of CAC in patients with coronary heart disease, so as to provide evidence for early prevention, diagnosis and PCI of CAC. Methods From January to December 2021, 353 patients with coronary heart disease admitted to the Department of Cardiology of Shaanxi Provincial People's Hospital for chest pain or chest tightness and diagnosed with coronary artery disease by coronary angiography (CAG) . A total of 196 patients who met the inclusion criteria were selected and received intravascular ultrasound (IVUS) . The included patients were divided into 73 patients in the non-calcification group (median calcification index = 0) , 62 patients in the low-calcification index group (0.000 1≤median calcification index≤0.216 6) , 61 patients in the high-calcification index group (median calcification index > 0.216 6) . Spearman rank correlation and multivariate Logistic regression analysis were used to explore the influencing factors of the severity and incidence of CAC. Results There were significant differences in age, sex composition ratio, history of smoking, hypertension, diabetes mellitus and thyroid disease, total protein, alkaline phosphatase, glutamyl transferase, albumin-to-globulin ratio, triglyceride-glucose index, triglyceride, phosphorus and glycated hemoglobin among the non-calcification group, low-calcification index group and high-calcification index group (P

Arteriovenous fistula dysfunction (AVF) is a frequent and often unforeseeable complication in hemodialysis patients, and the most common cause is venous outflow stenosis resulting from neointimal hyperplasia and outward remodeling. Currently, there have been few effective prevention and treatment measures for AVF, therefore, this paper reviews the interventions and preventive measures of the AVF. [ABSTRACT FROM AUTHOR]

Objective To analyze the frailty of patients with long-term maintenance dialysis (MD) and its influencing factors, and to explore the correlation of different dialysis modalities with the re-infection of novel coronavirus infection (COVID-19) and frailty syndrome. Methods Patients with regular dialysis in Nephrology Department of the Second Affiliated Hospital of Kunming Medical University from February to June 2023 were selected. A cross-sectional survey was conducted to collect clinical data of the patients, including dialysis modality (i. e. maintenance hemodialysis, abbreviated as hemodialysis, and continuous ambulatory peritoneal dialysis, abbreviated as peritoneal dialysis), and whether with re-infection of COVID-19. Patients were divided into 3 groups using Fried' s frailty phenotype (FP) : non-frailty group, pre-or-intermediate frailty group, and frailty syndrome group. The clinical characteristics of the FP were compared among the three groups. The correlation of frailty with clinical data, dialysis modality, re-infection of COVID-19 in each group was compared. Multifactorial logistic regression was used to analyze the factors influencing the development of frailty syndrome in patients. Results A total of 246 dialysis patients were included in this study, with 77 (31.3%) in the non-frailty group, 83 (33.7%) in the pre-frailty group and 86 (35.0%) in the frailty syndrome group. The frailty syndrome group showed characteristics of advanced age, high pre-dialysis creatinine level, low serum albumin level and combined pleural effusion ( all P < 0.05 ) .There was no statistically significant difference in the comparison of frailty between the hemodialysis and peritoneal dialysis group (P = 0.960).COVID-19 re-positive patients had higher frailty score than non-re-positive patients. Multifactor logistic regression showed that age, COVID-19 re-infection of COVID-19, serum albumin, pre-dialysis creatinine, and pleural effusion were factors influencing the development of frailty syndrome in dialysis patients (P < 0.05). Conclusion There is high incidence of frailty syndrome in dialysis patients, and there is no correlation of frailty with dialysis modality. High serum albumin level is a protective factor for the development of frailty syndrome in patients, whereas re-infection of COVID-19, advanced age, high pre-dialysis blood creatinine level and pleural effusion are risk factors for the development of frailty syndrome. [ABSTRACT FROM AUTHOR]

Background: There are 2 general types of total ankle replacement (TAR) designs with respect to the polyethylene insert, mobile-bearing (MB) and fixed-bearing (FB) TARs. The aim of this study is to compare polyethylene-related adverse events (AEs), particularly revisions, reported for MB TARs and FB TARs using the US Food and Drug Administration's (FDA's) Manufacturer and User Facility Device Experience (MAUDE) database. Methods: A text mining method was applied to the medical device reporting (MDR) in the MAUDE database from 1991 to 2020, followed by manual reviews to identify, characterize, and describe all polyethylene-related AEs, including revisions, reported for MB and FB TARs. Results: We found 1841 MDRs for MB (STAR Ankle only) and 1273 MDRs for 40+ FB TARs approved/cleared by the FDA. For the MB design, 33% (606/1841) of the AEs reported related to the polyethylene component, compared to 24% (291/1273) of the AEs reported for FB designs. Polyethylene fractures were reported in 11.3% (208/1841) for the MB designs compared to 0.2% (2/1273) for the FB designs. Half of the polyethylene-related revisions occurred within an average of 4.1 years after implantation for the MB design compared within an average of 5.2 years for FB designs. Conclusion: Analysis of this database revealed a higher proportion of reported polyethylene fractures and greater need for earlier revisions for polyethylene-related issues with use of the primary MB design in the database as compared with FB TAR designs. Further study of device-related complications with more recent designs for both MB and FB ankle replacement components are needed to improve the outcomes of total ankle replacement. Level of Evidence: Level III, retrospective comparative study. [ABSTRACT FROM AUTHOR]