[Interpretation of 2020 edition of Japanese "Guidelines for the management of connective tissue disease/vasculitis-associated skin ulcers"].

Patients with connective tissue diseases and vasculitis often develop refractory skin ulcers in various parts of the body due to abnormal autoimmune reactions, and the skin ulcers caused by different types of diseases have strong heterogeneity. In 2020, The Journal of Dermatology published the Japanese "Guidelines for the management of connective tissue disease/vasculitis-associated skin ulcers", which is an updated version of its 2016 edition, to guide clinical management of related diseases in a more scientific and standard way. By interpreting the guidelines, this paper aims to help domestic clinicians clarify the diagnosis and treatment objectives of connective tissue disease and vasculitis-associated skin ulcers, accelerate skin wound healing, and improve healing quality.

[A comparison of the outcome of therapy between fractional flow reserve guided- versus coronary angiography guided-strategy in acute coronary syndrome patients with moderate coronary lesions].

OBJECTIVE: To compare the outcomes between coronary angiography (CAG ) guided- and fractional flow reserve (FFR) guided-strategy in acute coronary syndrome (ACS) patients with moderate lesions. METHODS: Totally, 249 ACS subjects with moderate lesions examined by CAG in Beijing Anzhen Hospital from July 1, 2014 to July 30, 2015 were included in the present analysis. Among them, 98 patients were further examined by FFR and 151 were not. All the patients were treated with medication either guided by CAG or by FFR. Subjects were followed up for an average of 10 months. The end points included death, nonfatal myocardial infarction (MI), target vessel revascularization (TVR), and hospitalization costs. Major adverse cardiac events (MACE) were defined as death, nonfatal MI, and TVR. RESULTS: At the end of follow-up, 29 patients had MACE with 6 cases (6.5%) in the FFR-guided group, and 23 cases (16.2%) in the CAG-guided group (P=0.036). Patients treated with FFR-guided strategy had significantly lower rate of TVR than those treated with CAG-guided strategy (5.4% vs 14.8%, P=0.045). No statistical difference was observed in nonfatal MI (2.2% vs 3.5%, P=0.242) between the two groups, and no cardiac death occurred in the two groups. However, the rate of patients treated with stains (P=0.033) and the hospitalization costs (P=0.001) were significantly increased in the FFR-guided group. CONCLUSIONS: FFR-guided strategy for patients with ACS results in lower TVR and MACE, but higher cost when compared with CAG-guided strategy.

[Preliminary analysis of influencing factors on source of snoring sound].

Objective:To investigate the main factors affecting the source of snoring sound of snoring patients.Method:Seventy-three patients with either simple snoring or obstructive sleep apnea-hypopnea syndrom(AHI≤40) underwent routine ENT examination,CT scanning(in awake condition) and drug-induced sleep endoscopy.The sources of snoring sound were observed.The neck circumference,body mass index and CT data were measured.Result:The sources of snoring sound of the 73 cases were divided into three types in general: palatal fluttering based group(Group Ⅰ),lateral wall vibration based group(Group Ⅱ) and palatal fluttering together with vibration of lateral wall based group(Group Ⅲ).The minimum lateral caliber of retropalatal region and retroglossal region,the ratio of minimum anteroposterior/ lateral caliber of the two regions,the thickness of pharyngeal lateral wall had statistical differences.The main influencing factors on the source of snoring sound between Group Ⅱ and Group Ⅰ were the ratio of minimum anteroposterior/lateral caliber of retropalatal region and the mean thickness of pharyngeal lateral wall.The influencing factor between Group Ⅲ and Group Ⅰ was the mean thickness of pharyngeal lateral wall.Conclusion:The ratio of minimum anteroposterior/lateral caliber of retropalatal region and the mean thickness of pharyngeal lateral wall are the main factors affecting the source of snoring sound of snoring patients.