Risk analysis of gastrointestinal bleeding in hospital patients with acute myocardial infarction undergoing primary PCI

Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is the cornerstone of acute myocardial infarction(AMI)management,both invasive and conservative.[1,2]This dual strategy improved ischemic outcomes but was offset by an increased bleeding risk.The prognostic importance of bleeding events has been well established over the past decades,as several studies have shown a strong association between bleeding and mortality.[3]The CRUSADE score is superior to other scores in predicting in-hospital major bleeding events.In this regard,in its non-ST elevation acute coronary syndromes(NSTE-ACS)guidelines,the European Society of Cardiology(ESC)stated that the CRUSADE score could be considered for bleeding risk quantification of coronary angiography in NSTE-ACS patients(class IIb,level B evidence).[4]However,the most common site of spontaneous.

Dent disease:classification,heterogeneity and diagnosis

Background Dent disease is a rare tubulopathy characterized by manifestations of proximal tubular dysfunction,which occurs almost exclusively in males.It mainly presents symptoms in early childhood and may progress to end-stage renal failure between the 3rd and 5th decades of human life.According to its various genetic basis and to clinical signs and symp-toms,researchers define two forms of Dent disease(Dent diseases 1 and 2)and suggest that these forms are produced by mutations in the CLCN5 and OCRL genes,respectively.Dent diseases 1 and 2 account for 60% and 15% of all Dent disease cases,and their genetic cause is generally understood.However,the genetic cause of the remaining 25% of Dent disease cases remains unidentified.Data sources All relevant peer-reviewed original articles published thus far have been screened out from PubMed and have been referenced.Results Genetic testing has been used greatly to identify mutation types of CLCN5 and OCRL gene,and next-generation sequencing also has been used to identify an increasing number of unknown genotypes.Gene therapy may bring new hope to the treatment of Dent disease.The abuse of hormones and immunosuppressive agents for the treatment of Dent disease should be avoided to prevent unnecessary harm to children.Conclusions The current research progress in classification,genetic heterogeneity,diagnosis,and treatment of Dent disease reviewed in this paper enables doctors and researchers to better understand Dent disease and provides a basis for improved prevention and treatment.

The status quo and challenges of genetic diagnosis in children with steroid-resistant nephrotic syndrome

Introduction Idiopathic nephrotic syndrome(INS)is one of the most common renal diseases in the pediatric population,which is characterized by massive proteinuria,hypoalbuminemia,edema,and hyperlipidemia[1].

Evaluation of a new frequency-volume chart for children with primary monosymptomatic nocturnal enuresis:a prospective,comparative study

Introduction To improve compliance with voiding diaries in children with primary monosymptomatic nocturnal enuresis(PMNE),a new modified 3-day weekend frequency-volume chart(FVC)was designed,and the compliance and validity of this modified FVC was evaluated by comparing with the International Children's Continence Society(ICCS)recommended voiding diary.Methods A total of 1200 patients with PMNE were enrolled in the study from 13 centers in China and were randomly assigned to record this modified FVC or the ICCS-recommended voiding diary.The primary outcome measure was the compliance,assessed by comparing the completing index and the quality score of diaries between two groups.The secondary outcome measure was the validity,evaluated by comparing the constituent of subtypes,micturition parameters and response rate to desmopressin.Results Among the 1200 participants enrolled in the study,447 patients completed the ICCS-recommended voiding diary and 469 completed the modified diary.The diurnal completing index and the quality score of the modified FVC group were better than those of the ICCS group.In addition,there was no significant difference between these two groups in the subtype classification,or in the response rate to desmopressin.Conclusions The modified FVC could be applied to obtain the voiding characteristics of children with PMNE as the ICCS-recommended voiding diary does and offers a reasonable and better choice for children with PMNE from the unselected population in the future.

Effect of Ticagrelor on Coronary Blood Flow and Prognosis in Patients with Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention in Real World

To the Editor： Current treatment guidelines for patients with acute coronary syndrome （ACS） undergoing percutaneous coronary intervention （PCI） recommend dual antiplatelet therapy, a combination of aspirin and a P2YI2 inhibitor （i.e., clopidogrel, prasugrel, and ticagrelor） for a minimum of 12 months. Ticagrelor, an oral reversibly binding platelet P2Y 12 receptor inhibitor, generates a greater and more consistent inhibitory effect with rapid onset of action as compared to clopidogrel.