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Background and Objectives: Use of drug-coated balloon (DCB)-only strategy for revascularization of native large coronary artery lesions is on the rise. The long-term efficacy of this approach for bifurcation and non-bifurcation lesions remains unknown. We aim to assess the long-term clinical outcomes of DCB-only strategy for the treatment of de novo bifurcation and non-bifurcation lesions in large coronary arteries. Methods: This multicenter, prospective, observational study enrolled 119 patients with de novo coronary lesions in vessels ≥2.75 mm. The primary end point was the rate of clinically driven target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization (TLR). Patients were followed up for a median of 2 years. Results: Of 119 patients with 138 lesions, 66 patients (75 lesions) had bifurcation and 53 patients (63 lesions) had non-bifurcation lesions. Average reference vessel diameter was 3.1 ± 0.3 mm, and there was no difference in bifurcation and non-bifurcation group (3.0 ± 0.3 vs. 3.1 ± 0.3mm; p = 0.27). At 2-year follow-up, the TLF occurred in five (4.2%), TLR in four (3.4%), and target vessel revascularization (TVR) in five (4.2%) cases. The frequency of TLR and TVR was higher in the non-bifurcation group (p = 0.04 and 0.02, respectively), but there were no differences in TLF between the two groups (p = 0.17). The cumulative incidence of TLF (Kaplan-Meier estimates) was also not different in the two groups (log-rank p = 0.11). Conclusion: DCB-only strategy for de novo lesions in large coronary arteries appears to be safe and effective for both bifurcation and non-bifurcation lesions. Further randomized clinical trials are warranted to confirm the value of DCB-only strategy in de novo bifurcation lesions of large vessels.
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The paper categories the modern hospital management and finds that there is an important and in-ner-relationship between the paper documents on public hospital reform and the policies on modern hospital manage-ment system construction. Secondly, it seems to be appropriate to coordinate the relation between deepening health reform and social governance in the pathway of modern hospital management system. Hence,this paper puts forward a series of countermeasures to address the difficulties.(1) Scientifically balancing the issues on unification and legaliza-tion with the reform and the system are raised;(2) The introduction of rules and implementation measures are men-tioned;(3) Guideline should be specialized to different hospital properties; (4) Non-public medical sector need more exploration;(5) The adaption and capacity of governance and government transformation are required.
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There ass an urgent call for the dynamic medical service price-adjustment mechanism with the fully launched Zero Markup policy,however it was lacking of one unified coordination mechanism between departments.It analyzed the responsibilities and challenges of four departments(Health,Pricing,Health Insurance and Finance Department).Also,one theoretical model has been established for analyzing the impacts on the four departments by the scope of pricing-adjustment.By witnessed the evidences on the price-adjustment,it highly recommended that the strategy for price-adjustment should go with high frequency but in a minor change.Meanwhile,it also proposed that to build one well-coordinated mechanism,introduce third parties to involve,and establish one simulation system for price-adjustment to push forward the progress of dynamic price-adjustment mechanism.
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Aim To discuss the effect of Danhong in-jection(DHI) on hyperlipidemia in rats and its possible mechanism. Methods The hyperlipidemia model of rats were induced by high fat diet. The protein expres-sion of adenosine 5'-monophosphate-activated protein kinase(AMPK), p-AMPK, cholesterol-binding ele-ment binding protein (SREBP-1), adenylate-activated protein kinase carboxylasecetyl-CoA(ACC) and p-ACC in liver were detected using Western blot. Results The protein expression levels of AMPK, SREBP-1 and ACC significantly decreased (P<0.05), but the pro-tein expression levels of p-ACC and p-AMPK signifi-cantly increased (P<0.05). Conclusions Danhong injection can reduce the activity of SREBP-1 and ACC by enhancing the activation of AMPK, and effectively reduce the blood lipid level of hyperlipidemic rats by promoting fatty acid oxidation and reducing lipid depo-sition.