ObjectiveTo discuss the importance of early identification and effective management of puncture-associated complications after trans-radial percutaneous coronary procedures. MethodsA total of 698 patients undergoing trans-radial percutaneous coronary procedures from June to December 2012 were included and followed up. The puncture associated complications and their clinical managements were summarized in the present study. ResultsWe found that trans-radial approach was safe. The main puncture-associated complications included access-site pain, tension blisters and hemorrhagic complication. Complications with severe clinical consequence were rare. Most of the complications could be successfully treated with conservative management including access-site nursing and psychological nursing. ConclusionTrans-radial approach is safe for percutaneous coronary procedures, but close clinical monitoring and nursing are essential.
Facial filling injection is one of the technologies to achieve facial rejuvenation in a non-surgical way. With the application of emerging cosmetic filler preparations and the development of new technologies, there are more and more options to achieve facial rejuvenation. Complications may result from the use of new materials whose safety has not been proven in studies. This article describes common facial filler choices, facial risk areas and vascular complications, and discusses how to improve the safety of facial injections. The purpose is to enable operators to fully understand the facial risk area, select the appropriate filling injection, and be able to identify the symptoms of vascular complications as early as possible, thereby improving the safety of facial filling injection.
ObjectiveTo establish a rat model of diabetic microangiopathopathy and simulate the biochemical and pathological changes of diabetic retinal and renal microangiopathopathy. MethodsForty healthy male Sprague-Dawley rats were randomly divided into blank group and model group (10 and 30 rats, respectively). After the rats in blank group and model group were fed ordinary diet and high-fat and high-sugar diet for 5 weeks, respectively, the rats in model group were injected with 1% streptozotocin (STZ) through the abdominal cavity at the dose of 35 mg/kg to establish a type 2 diabetes model. After modeling, the rats were continuously fed until the 10th week (4 weeks after modeling), the general conditions of the rats were observed, and samples were collected for follow-up experiments. Serum creatinine (CREA), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), microalbuminuria, urinary creatinine (UCr) and urine sugar were detected. Calculate the kidney index and microalbumin/urinary creatinine ratio (UACR). Optical coherence tomography angiography (OCTA) was used to observe the vascular changes and non-perfusion area of retinal superficial capillary plexus. The morphological and structural changes of kidney and retina were observed by hematoxylin-eosin and periodate Scheff staining. The expression of nerve fibers and nucleus of Müller cells in rat retina was observed by immunofluorescence staining. Ultrastructural results of retina were observed by transmission electron microscope. Independent sample t test was used for comparison between groups. ResultsFour weeks after modeling, compared with blank group, the body weight of rats in model group was significantly decreased, and random glucose was significantly increased, with statistical significance (t=5.755, －51.291; P＜0.05). Renal index, urinary glucose and UACR were significantly increased, while UCr was significantly decreased, with statistical significance (t=10.878, 137.273, 3.482, －6.110; P＜0.05). CREA decreased, TG, TC, HDL-C, LDL-C increased, and the differences were statistically significant (t=－28.012, 33.018, 118.018, 13.585, 16.480; P＜0.05). OCTA examination showed that there was no perfusion area of shallow retinal capillaries. The optical microscope showed that the inner boundary membrane of retina in model group was swollen and thickened, the surface was uneven, the inner and outer nuclear layer cells were disordered and the density decreased. Glomerular congestion was accompanied by cortical tubular epithelial swelling, widening of the mesangial area, and thickening of the basement membrane. The results of immunostaining showed that the inner and outer plexiform layers of the retina showed lamellar strong green fluorescence expression, and the inner and outer nuclear layers showed scattered dot green fluorescence expression. Transmission electron microscopy showed that the basal membrane of retinal microvessels in model group was slightly thickened, vascular endothelial cells edema, endothelial nucleus and perinucleus contraction, nuclear membrane contraction, mild mitochondrial swelling, vacuolation. ConclusionHigh-glucose and high-fat feeding plus a single intraperitoneal injection of STZ 35 mg/kg can successfully establish a microangiopathic model of type 2 diabetes.
[Abstract]Objective: To explore the predictive value of four risk scoring systems for cardiovascular complications during pregnancy in patients with congenital heart disease (CHD).Methods: Computer searches were conducted in PubMed, EMbase, CENTRAL, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, and China Biology Medicine disc (CBM). Relevant studies on risk scoring systems for cardiovascular complications during pregnancy in CHD patients at home and abroad were comprehensively collected. The retrieval period was from the establishment of the databases to January 1, 2025, and the retrieval was updated on March 26, 2025. After two reviewers independently screened the literature and extracted the data, the quality assessment was carried out, and Meta-analysis was performed using MedCalc software.Results: A total of 11 studies were included, with a total of 4 987 patients. The incidence of cardiovascular complications during pregnancy in CHD patients ranged from 6.72% to 28.84%. The QUADAS-2 scoring tool results showed that two studies had a risk of bias, and nine studies were determined to have a high risk of bias.The results of the Meta-analysis showed that the CARPREGⅠ score [AUC=0.709, 95%CI (0.672, 0.745), P<0.001], CARPREGⅡ score [AUC=0.757, 95%CI (0.720, 0.794), P<0.001], ZAHARA score [AUC=0.732, 95%CI (0.674, 0.790), P<0.001], and mWHO classification system [AUC=0.681, 95%CI (0.617, 0.745), P<0.001] could independently predict cardiovascular complications during pregnancy in CHD patients.Conclusion: The existing evidence indicates that all four scoring systems can be used to predict cardiovascular complications during pregnancy in CHD patients. Although the CARPREGⅡ score has the highest accuracy, the number of included studies is small. It is recommended to give priority to using the ZAHARA score for risk stratification and pregnancy management of women with CHD before pregnancy. In view of the limitations of the quality of the included studies, this study needs to be further confirmed by high-quality studies.