Abstract:Objective To investigate the safety and efficacy of minimally invasive left atrial appendage closure(LAAC)combined with catheter ablation(CA)in one-stop treatment of non-valvular atrial fibrillation(NVAF).Methods From August 2022 to July 2023,patients with NVAF who underwent one-stop minimally invasive LAAC combined with CA(one-stop group,20 cases)and only CA(single ablation group,22 cases)in the Department of Cardiology,Maoming People's Hospital,Guangdong Province were retrospectively analyzed.The baseline data,surgical procedures,perioperative complications,postoperative medications and 12-month follow-up results were collected and analyzed.Results The proportion of ischemic stroke history,CHA2DS2-VASc score,HAS-BLED score,left atrial anteroposterior diameter in the one-stop group were higher than those in the single ablation group(all P＜0.05).In terms of perioperative complications,there was 1 case of pseudoaneurysm vascular complication and 2 cases of epistaxis in the one-stop group,and no pericardial effusion and stroke events occurred in the two groups.There was significant difference in the oral administration of single drug between the two groups(P=0.038).In the one-stop group,there were 3 cases of recurrent atrial fibrillation,1 case of bleeding event,and no stroke.There were no recurrent atrial fibrillation,bleeding events and stroke in the single ablation group.Three patients had a residual shunt less than 3 mm at 3 months after surgery,and no patient had a residual shunt greater than 5 mm.Conclusions Minimally invasive LAAC combined with CA one-stop procedure is suitable for patients with high risk of thromboembolism and bleeding.One-stop procedure simplifies the procedure,reduces the risk,does not rely on transesophageal echocardiography,improves operability and safety,and is equivalent to simple CA surgery,and may be more effective in high-risk patients.

Abstract:Artificial intelligence is used to calculate the fractional flow reserve(CT-FFR)of coronary artery by coronary CT angiography(CCTA)data.This ability can be used to automatically detect and assess coronary stenosis,identify plaque components,and predict disease progression.It can also significantly improve the accuracy and efficiency of diagnosis.The application of artificial intelligence in CCTA also faces some challenges and problems,including the generalization ability of the algorithm,data standardization,and privacy protection.In order to further improve the practicability and efficiency of CT-FFR technology in clinical practice,in-depth research on these challenges and the development of more optimized solutions are needed.

Abstract:Lipids play a crucial role in the growth and metabolism of Mycobacterium tuberculosis(Mtb).During Mtb infection,foamy macrophages accumulate lipids in granulomas,such as triglycerides and cholesterol,which can promote the formation of drug-resistant Mtb,thereby reducing the effectiveness of anti-tuberculosis treatment.Therefore,it is critical to understand the changes in lipid metabolites in the host and Mtb.The slow growth and drug resistance of Mtb results in prolonged treatment with associated risks of side effects and drug resistance.In order to improve the efficacy of anti-tuberculosis drugs,it is necessary to understand the mechanism of action of anti-tuberculosis drugs on lipid metabolism of Mtb.This paper mainly discusses the impact of lipids reprogramming by host and Mtb during infection on the anti-tuberculosis response,and analyzes the interactions between lipids,antibiotics,and lipid metabolites.In addition,this paper discusses the influence of lipids on drug efficacy,in order to provide reference for effective control of Mtb infection.

Abstract:Objective To investigate the efficacy and safety of high-flow nasal cannula oxygen therapy(HFNCO)in emergency patients with acute exacerbation of chronic heart failure.Methods A total of 63 patients with acute exacerbation of chronic heart failure admitted to the Department of Emergency,the 980th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from January 1,2020 to December 31,2021 were selected and divided into HFNCO group and non-invasive ventilation(NIV)group according to the random number table method.The general condition,oxygenation index and cardiac function related index were observed and compared between the two groups when they entered and left the emergency department.Results Arterial partial pressure of carbon dioxide was significantly lower in the HFNCO group than in the NIV group at discharge from the emergency department[(38±4)mmHg vs(41±5)mmHg](P=0.015).Compared with those at the time of admission to the emergency department,the arterial oxygen partial pressure of patients in the HFNCO group and the NIV group was significantly improved at the time of leaving the emergency department[(74±8)mmHg vs(68±9)mmHg,(75±7)mmHg vs(69±12)mmHg](both P＜0.05).Cardiac index,stroke volume,and stroke volume index were significantly lower in the HFNCO group than in the NIV group at discharge from the emergency department(all P＜0.05).Cardiac output,cardiac index,stroke volume,and stroke volume index were significantly increased at the time of leaving the emergency department in both HFNCO and NIV groups compared with those at the time of admission(all P＜0.05).There were no statistically significant differences in the success rate of ventilation and emergency room stay time between the two groups(both P＞0.05).Conclusion HFNCO can improve oxygenation index and cardiac function in emergency patients with acute exacerbation of chronic heart failure.

Abstract:Objective To investigate the efficacy and safety of anticoagulation therapy with bivalirudin and heparin in adult patients receiving extracorporeal membrane oxygenation(ECMO)support after cardiac surgery.Methods The clinical data of 56 patients receiving ECMO support after adult cardiac surgery at the Department of Critical Care Medicine Center,the First Affiliated Hospital of Xinjiang Medical University from March 2018 to June 2024 were retrospectively analyzed.According to the application of anticoagulant drugs during ECMO support,patients were divided into heparin group(25 cases)and bivalirudin group(31 cases).The baseline data and outcome indicators of the two groups were collected,and the ECMO support time,platelet count,coagulation indicators,the rate of successful ECMO withdrawal,in-hospital mortality and survival at 90 d of follow-up were compared between the two groups.Results There were no significant differences in age,gender,body mass index,ECMO mode,platelet count,activated partial thromboplastin time(APTT)before ECMO,and acute physiology and chronic health evaluation Ⅱ score before ECMO between the two groups(all P＞0.05).In terms of outcome measures,there were no significant differences in the duration of ECMO support,mean hemoglobin value,APTT during ECMO support,coagulation time of activated whole blood during ECMO support,plasma transfusion volume,and the incidence of thrombosis,minor bleeding,and severe bleeding complications between the two groups(all P＞0.05).The lowest platelet count,platelet count,the lowest hemoglobin,and the rate of successful ECMO withdrawal in the bivalirudin group were higher than those in the heparin group,and the amount of red blood cell transfusion,platelet transfusion and in-hospital mortality in the heparin group were less than/lower than those in the heparin group(all P＜0.05).The results of cross-effect analysis showed that there was no interaction between group and before and after treatment,that is,the treatment effect of the two groups had the same trend on the effect of ACT(Fcross=0.509,P=0.799).A total of 25 patients(80.6％)in the bivalirudin group and 13 patients(52.0％)in the heparin group were alive at day 90,with a higher overall survival rate in the bivalirudin group than in the heparin group(Log-rank x2=6.174,P=0.013).Conclusion In adult patients receiving ECMO support after cardiac surgery,bivalirudin has the same anticoagulant effect as heparin,and can reduce blood product transfusion volume and in-hospital mortality,increase the probability of successful ECMO withdrawal,and improve the safety of anticoagulation therapy.

Abstract:Objective To investigate the pregnancy outcomes of pregnant women with arrhythmia without structural heart disease,and to analyze the corr-elation between adverse pregnancy outcomes and arrhythmia types.Methods A total of 283 pregnant women with arrhythmia without structural heart disease admitted to the Department of Obstetrics and Gynecology,Beijing Anzhen Hospital,Capital Medical University from June 2013 to June 2020 were collected.The patients were divided into the adverse pregnancy outcome group and the normal pregnancy outcome group according to the pregnancy outcome.The types of arrhythmia and their correlation with adverse pregnancy outcomes were analyzed.Results Among the 283 pregnant women with arrhythmia without structural heart disease,124(43.8％)had adverse pregnancy outcomes and 159(56.2％)had normal pregnancy outcomes.Among the 124 cases with adverse pregnancy outcomes,9 cases(7.3％)had abortion,22 cases(17.7％)had preterm birth,11 cases(8.9％)had small for gestational age,12 cases(9.7％)had macrosomia,27 cases(21.8％)had fetal distress,2 cases(1.6％)had stillbirth,32 cases(25.8％)had gestational diabetes mellitus,17 cases(13.7％)had gestational hypertension and 23 cases(18.5％)had postpartum hemorrhage.The proportions of premature atrial contraction and right bundle branch block in the adverse pregnancy outcome group were higher than those in the normal pregnancy outcome group(both P＜0.05).Conclusion There is a considerable proportion of the population of pregnant women with arrhythmia without structural heart disease may have adverse pregnancy outcomes such as gestational diabetes mellitus and fetal intrauterine distress.Premature atrial contraction and right bundle branch block are related to the occurrence of adverse pregnancy outcomes,which need to be paid attention to in clinical practice.

Abstract:Objective To investigate the predictive value of plasma eicosanoids in predicting adverse cardiovascular events in patients with acute coronary syndromes(ACS).Methods Totally 309 hospitalized patients with ACS were retrospective analyzed,admitted to Beijing Anzhen Hospital,Capital Medical University for revascularization treatment from June to December 2019,with a median follow-up time of 3.8(3.6,3.9)years.Patients were divided into event group(33 cases)and non-event group(276 cases)based on the occurrence of adverse cardiovascular events.High performance liquid chromatography tandem mass spectrometry was used to determine 74 types of patient's plasma eicosanoids levels,and patient's global registry of acute coronary events risk(GRACE)score was performed.Differential eicosanoids were screened out in the two groups,patients were divided into different groups according to the cut-off of plasma eicosanoids from receiver operating characteristic(ROC)curve analysis.The effects of eicosanoids on the prognosis of ACS patients were evaluated by multivariate Cox regression analysis and Kaplan-Meier plots,and the value of eicosanoids and GRACE score in predicting adverse cardiovascular events was analyzed by ROC curve.Results The plasma 15-hydroxyeicosatetraenoic acid(15-HETE),15-oxoeicosatetraenoic acid(15-oxo-ETE)and 14,15-dihydroxyeicosatrienoic acid(14,15-DHET)of patients in the event group were significantly higher than those in the non-event group(all P＜0.05).Cox regression analysis showed that after adjusting for multivariate factors,15-HETE≥0.84 μg/L and 14,15-DHET≥0.20 μg/L were independent risk factors for adverse cardiovascular events in ACS patients after revascularization(both P＜0.05).A Kaplan-Meier curve showed patients in 15-HETE≥0.84 μg/L and 14,15-DHET ≥0.20 μg/L,were more likely to experience adverse events(both Log-rank P＜0.01).The ROC curve analysis showed that the area under the curve predicted by GRACE score alone and 15-HETE,14,15-DHET and GRACE scores in combi-nation for adverse cardiovascular events in ACS patients after revascularization were 0.699 and 0.712 respectively.The area under the curve predicted by GRACE score combined with 15-HETE and 14,15-DHET was larger than that predicted by GRACE score alone(P＜0.05).Conclusions High levels of plasma 15-HETE and 14,15-DHET are independent risk factors for the risk of adverse cardiovascular events in patients with ACS after revascularization,and have certain predictive value for adverse cardiovascular events.

Abstract:Objective To explore the effect and adverse events of zanubrutinib first line treatment of elderly patients with previously untreated mantle cell lymphoma(MCL).Methods The clinical data of 13 elderly patients with previously untreated MCL treated with zanubrutinib from August 2020 to July 2022 in Gansu Provincial Cancer Hospital were retrospectively reviewed.Patients were given zanubrutinib for more than 4 cycles(1 month as a cycle),and the initial dose was 160 mg twice daily.The objective response rate(ORR),progression free survival(PFS),overall survival(OS),6-month and 12-month PFS rate and OS rate were recorded,and the effects of different factors on PFS and OS were analyzed.Results Follow-up until November 1,2022,among the 13 patients,7 cases achieved completely response(53.8％),2 cases achieved partially response(15.4％)and 4 cases achieved progressive disease(30.8％).The ORR was 69.2％(9/13).The median PFS was 8(4-28)months,and the median OS was 10(5-28)months.The 6-month PFS rate and the OS rate were 68.0％and 92.0％.The 12 month PFS rate and the OS rate were 23.0％and 31.0％.Univariate analysis showed that the Eastern Cooperative Oncology Group score,Ki-67 index and lactic dehydrogenase(LDH)were the probable effect factors for PFS,the age,Ki-67 index and LDH were the probable effect factors for OS(all P＜0.05).However,no statistically significant factors affecting PFS and OS were observed in the multivariate Cox regression analysis results(all P＞0.05).Among the 13 patients,one patient with hematological toxicity was mild,while four patients with non hematological toxicity included infection,secondary malignant tumors,joint pain,and nausea.All adverse reactions were safe and controllable after reduction,discontinuation of zanubrutinib,and symptomatic treatment,with no treatment-related deaths.Conclusions Zanubrutinib first line monotherapy had higher ORR,completely response rates and better tolerance in elderly patients with previously untreated MCL.Especially for patients with poor physical status can not tolerate chemotherapy and personal willingness to refuse chemotherapy.

Abstract:Objective To investigate the prognostic value of the product of reverse shock index and Glasgow coma scale(rSIG)index combined with serum D-dimer,fibrinogen and C-reactive protein in multiple trauma patients with multiple organ dysfunction syndrome(MODS).Methods A total of 194 patients with multiple trauma treated in the Emergency Treatment Room,North China University of Science and Technology Affiliated Hospital from January 2020 to January 2022 were selected as the research objects.According to the presence or absence of MODS during treatment,they were divided into non-MODS group(98 cases)and MODS group(96 cases).The MODS group was further divided into survival group(52 cases)and death group(44 cases)according to the survival situation of patients at 28 d after injury.The levels of serum D-dimer,fibrinogen,C-reactive protein and rSIG index were compared among the groups.Multivariate Logistic regression was used to analyze the influencing factors of the prognosis of multiple trauma patients with MODS.Receiver operating characteristic(ROC)curve was used to analyze the value of rSIG index combined with serum D-dimer,fibrinogen and C-reactive protein in predicting the prognosis of multiple trauma patients with MODS.Results The levels of serum D-dimer,fibrinogen and C-reactive protein in MODS group were higher than those in non-MODS group[(14±3)mg/L vs(9±3)mg/L,(4.5±1.0)g/L vs(3.0±1.0)g/L,(32±6)mg/L vs(21±6)mg/L](t=10.352,10.079,12.883;all P＜0.001).The levels of serum D-dimer,fibrinogen,and C-reactive protein in the death group were significantly higher than those in the survival group,and the rSIG index was significantly lower than that in the survival group(all P＜0.001).Multivariate Logistic regression analysis showed that D-dimer,fibrinogen,C-reactive protein and rSIG index were independent prognostic factors for multiple trauma patients with MODS(all P＜0.05).ROC curve analysis showed that the area under the curve of D-dimer,fibrinogen,C-reactive protein,and rSIG index combined detection to predict the prognosis of multiple trauma patients with MODS was 0.964,the sensitivity was 84.09％,and the specificity was 96.15％,which was better than that of each index alone(all P＜0.05).Conclusion The serum D-dimer,fibrinogen,and C-reactive protein of patients in the death group of multiple trauma combined with MODS increased significantly,and the rSIG index decreased significantly.The combination of the above indicators has a good predictive value for the prognosis of patients with multiple trauma combined with MODS.

Abstract:Objective To investigate the prognostic value of stress hyperglycemia ratio(SHR)in patients with peripartum cardiomyopathy(PPCM).Methods The clinical data of 78 patients diagnosed with PPCM in Beijing Anzhen Hospital,Capital Medical University from January 2007 to March 2023 were collected and retrospectively analyzed.According to the improvement of cardiac function,the patients were divided into non-improvement group(37 cases)and improvement group(41 cases).The receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of SHR for poor prognosis of patients,and Logistic regression analysis was used to evaluate the influencing factors of no improvement of cardiac function.Results The age,proportion of multipara,proportion of PPCM history,left ventricular end diastolic diameter,serum creatinine,blood glucose,B-type natriuretic peptide and SHR in the non-improvement group were larger/higher than those in the improvement group,while systolic blood pressure and left ventricular ejection fraction(LVEF)were lower than those in the improvement group(all P＜0.05).The ROC curve analysis results showed that the optimal cut-off value of SHR for predicting poor prognosis in patients with PPCM was 1.079,the sensitivity was 81.1％,the specificity was 90.2％,and the area under the curve was 0.880(95％confidence interval:0.800-0.961)(P=0.041).Multivariate Logistic regression analysis results showed that SHR≥1.079,serum creatinine and LVEF＜35％were independent risk factors for poor prognosis in patients with PPCM(all P＜0.05).Conclusion SHR ≥ 1.079 is a risk factor for poor prognosis in PPCM patients,and the use of SHR can assist in identifying high-risk populations for PPCM.

Abstract:Objective To investigate the effect of Fuyanjing capsules combined with ceftriaxone sodium in the treatment of chronic pelvic inflammatory disease.Methods A total of 90 patients with chronic pelvic inflammatory disease admitted to Bozhou Hospital Affiliated to Anhui Medical University from October 2020 to September 2023 were selected and divided into observation group(45 cases)and control group(45 cases)by random number table method.The control group was treated with ceftriaxone sodium,and the observation group was treated with Fuyanjing capsules on the basis of ceftriaxone sodium.Both groups were treated for 7 d.The clinical efficacy,improvement time of clinical symptoms,hemorheological indexes and serum inflammatory indexes before and after treatment were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[91.1％(41/45)vs 75.6％(34/45)],and the improvement time of leucorrhea,lower abdominal pain and lumbosacral pain were shorter than those of the control group(all P＜0.05).After treatment,the levels of plasma viscosity,whole blood high shear viscosity,erythrocyte sedimentation rate,C-reactive protein,monocyte chemotactic protein and interleukin-6 in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).There were no obvious adverse reactions in the two groups during treatment.Conclusion Ceftriaxone sodium combined with Fuyanjing capsules in the treatment of chronic pelvic inflammatory disease can achieve good effect,and can effectively improve the state of hemorheology disorders,reduce the inflammation in patients with good safety.

Abstract:Objective To explore the correlation between glucose and lipid metabolism and traditional Chinese medicine(TCM)syndrome elements in obese patients before and after metabolic surgery.Methods The obese patients who underwent metabolic surgery in China-Japan Friendship Hospital from February 2023 to March 2024 and followed-up in outpatient clinic 1 and 3 months after operation were selected.The blood biochemical indexes and TCM syndrome factors were collected before operation,1 and 3 months after operation,and the correlation between them was analyzed.Results A total of 95 obese patients were included,85 patients were reexamined 1 month after operation,and 60 patients were reexamined 3 months after operation.The body mass,body mass index and waist circumference of male and female at 1 and 3 months after operation were lower than those before operation(all P＜0.05).At 1 and 3 months after operation,the percentage of overall body mass reduction was higher in the severely obese group than in the mildly and moderately obese group(all P＜0.001).The levels of fasting blood glucose,glycosylated hemoglobin,fasting insulin and homeostasis model assessment of insulin resistance index(HOMA-IR)in obese patients at 1 and 3 months after operation were lower than those before operation.The levels of fasting insulin and HOMA-IR in the heat syndrome group were higher than those in the non-heat syndrome group in obese patients with diabetes mellitus[37.4(17.0,55.4)mIU/L vs 19.8(14.4,32.6)mIU/L,12.3(11.0,21.8)vs 6.6(5.6,11.2)](all P＜0.05).Heat syndrome factor was positively correlated with fasting insulin and HOMA-IR levels,respectively(Hazard ratio=0.371,P=0.030)and(Hazard ratio=0.415,P=0.026).Conclusions Metabolic surgery can quickly and effectively reduce the body mass of obese patients and improve glucose and lipid metabolism in obese patients.The more obvious the heat syndrome factor before operation,the higher the fasting insulin and HOMA-IR levels in patients with obesity combined with diabetes mellitus.

Abstract:In the field of immunology,pregnancy is equivalent to a successful semi-allograft phenomenon,and the maternal immune tolerance to the semi-allograft fetus is related to the outcome of pregnancy.Helper T cells 17(Th17)and regulatory T cell(Treg)are newly discovered subsets of CD4+T lymphocytes.The expression levels of related transcription factor retinoic acid-related orphan receptor γt and forkhead box transcription factor P3 are closely related to the balance between Th17/Treg.The Th17/Treg immune imbalance can lead to abnormal maternal attack on the fetus,resulting in maternal-fetal tolerance disorder,and is related to recurrent miscarriage,preeclampsia,gestational diabetes mellitus and other pathological pregnancy.

Abstract:Objective To explore whether psychological intervention can effectively reduce the incidence of postoperative depression in patients undergoing percutaneous coronary intervention(PCI)during the perioperative period.Methods A total of 266 patients with coronary atherosclerotic heart disease who underwent daytime PCI in Beijing Anzhen Hospital,Capital Medical University from September to October 2023 were enrolled.The patients were randomly divided into the psychological intervention group(136 cases)and the control group(130 cases).Patients in the control group were only given routine nursing during the perioperative period,while patients in the psychological intervention group were given perioperative psychological intervention in addition to routine nursing.The Hamilton Depression Rating Scale(HAMD)24-item version was used to assess patients'depressive mood postoperatively.Patients with HAMD score ≥21 were defined as having postoperative depression.Results The proportion of patients with HAMD score ≥ 21 at discharge in the psychological intervention group was lower than that in the control group[11.8％(16/136)vs 20.8％(27/130)](P＜0.05).The results of multivariate Logistic regression showed that after adjusting for potential confounding factors,psychological intervention was an independent influencing factor for the occurrence of postoperative depression in patients,and had a protective effect(odds ratio=0.41,95％confidence interval:0.20-0.85,P=0.017).Conclusion Perioperative psycho-logical intervention can reduce the incidence of postoperative depression in patients with daytime PCI.

Abstract:Objective To explore the correlation between grip strength and prognosis of patients with heart failure.Methods A total of 560 patients with heart failure in Tangshan Traditional Chinese Medicine Hospital,Hebei Province from June 2015 to June 2017 were selected.According to the tertile of grip strength,the patients were divided into three groups,group 1:grip strength＜18.9 kg(184 cases),group 2:18.9 kg≤ grip strength＜23.5 kg(188 cases),and group 3:grip strength≥23.5 kg(188 cases).The median follow-up time was 3 years.The main end points were all-cause death and heart failure rehospitalization.Kaplan-meier survival analysis was used to determine the relationship between grip strength level and endpoint events.Multivariate Cox regression was used to analyze the correlation between grip strength and prognosis of patients with heart failure.Subgroup analysis was used to explore the effect of grip strength on the outcomes of rehospitalization for heart failure in patients with different heart failure types.Locally weighted scatterplot smoothing(Lowess)curve was drawn to evaluate the relationship between grip strength and the risk of rehospitalization for heart failure.Results A total of 560 patients with heart failure were followed up for 3 years,and 28 cases(5.0％)died from any cause and 113 cases(20.2％)were rehospitalized for heart failure.There was no statistically significant difference in the incidence of all-cause death among the three groups(P=0.074),and the incidence of rehospitalization for heart failure was statistically different[25.0％(46/184),21.3％(40/188),and 14.4％(27/188)](P=0.034).Survival analysis result showed that with the increase of grip strength during follow-up,the incidence of rehospitalization for heart failure was significantly reduced(Log-rank P=0.034).Multivariate Cox regression analysis result showed that after more confounding factors were included,the risk of heart failure rehospitalization in patients with high grip strength was still significantly reduced(group 3 vs group 1,P=0.004).Subgroup analysis of different types of heart failure showed that patients with high grip strength had a significantly lower risk of heart failure rehospitalization in heart failure with reduced ejection fraction and heart failure with preserved ejection fraction(both P＜0.05).There were no significant interactions between heart failure type and grip strength group(interaction P=0.568).Lowess curve showed that grip strength,as a continuous variable,was inversely associated with the risk of heart failure rehospitalization.Conclusion In patients with heart failure,patients with high grip strength have a significantly lower risk of heart failure rehospitalization.

Abstract:Infants with critical congenital heart disease face life-threatening conditions immediately after birth.Once the condition worsens,the prognosis is extremely poor.In view of the serious adverse consequences that may result from this critical condition after surgery,in the diagnosis and treatment of a pregnant woman with abnormal cardiac structure of infant admitted to Beijing Anzhen Hospital,Capital Medical University,we chose the multidisci-plinary treatment mode starting surgery immediately after delivery of neonate for the first time to avoid the high risk before surgery.The infant was diagnosed with total anomalous pulmonary venous connection during the mother's pregnancy.After delivering the fetus through cesarean section in our hospital,she was immediately transferred to the cardiac operating room to confirm the diagnosis,complete the necessary preoperative examination,start anesthesia,complete surgical correction,and the operation process and postoperative recovery were smooth.This treatment approach,involving early postnatal surgery,holds the promise of improving the prognosis of infants with critical congenital heart disease,reducing mortality,and enhancing long-term health outcomes.

Abstract:Objective To explore the effects of precise intervention in operating room and whole-course companionship on anxiety and depression in patients undergoing glioma resection in eloquent areas.Methods A total of 88 patients who underwent intraoperative awake functional area glioma resection in Beijing Tiantan Hospital,Capital Medical University from January 2020 to June 2021 were selected.The control group was given routine intervention of intraoperative wake-up surgery,and the observation group was given precise intervention and whole-process accompany on this basis.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to evaluate patients'anxiety and depression,satisfaction questionnaire was used to evaluate patients'satisfaction with operating room work,and the above indicators were compared between the two groups.Results The SAS and SDS scores of the two groups 3 d after operation were lower than those of the same group 1 d before operation,and the scores of the observation group were lower than those of the control group[between groups:(33.0±3.6)vs(37.8±1.5),(33.9±2.1)vs(35.5±2.2)](all P＜0.05).The total satisfaction of the observation group was higher than that of the control group[97.7％(43/44)vs 86.4％(38/44)](P＜0.001).Conclusion Operating room precise intervention and whole-course companishment can help to reduce the postoperative anxiety and depression of patients with glioma resection in functional area,and improve the satisfaction of patients with operating room related work.

Abstract:Objective To investigate the inhibitory effect of telmisartan(TEL)on the proliferation of scirrhous gastric cancer(SGC)cells and to explore its mechanism.Methods Routine culture of gastric cancer cells MKN1 and SGC cells HSC45,Cells Count Kit-8 experiment to detect the effect of TEL on the proliferation ability of MKN1 and HSC45 cells.Flow cytometry was used to detect the effects of TEL on apoptosis and cell cycle of HSC45 cells.Western blotting was used to detect the effects of TEL on autophagy and phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR)signaling pathway related protein expression in HSC45 cells.HSC45 cells were treated with the PI3K/AKT/mTOR signaling pathway activator SC79 and TEL.The effects of TEL on HSC45 cell proliferation,apoptosis,autophagy,and cell cycle were detected,respectively,after activating the PI3 K/AKT/mTOR signaling pathway.Results TEL inhibited the proliferation ability of MKN1 and HSC45 cells in a concentration and time dependent manner(both P＜0.001),and had a significant inhibitory effect on HSC45 cell proliferation(P＜0.05).Compared with the control group,apoptosis rat in HSC45 cells,LC3 Ⅱ/Ⅰ protein expression cell cycle arrest in G0/G1 phase rate in TEL group were higher[(26.2±2.6)％vs(1.3±0.4)％,(1.02±0.09)vs(0.29±0.04),(53.4±3.4)％vs(38.1±2.9)％],and phosphorylated PI3K,AKT and mTOR expressions in TEL group were lower(all P＜0.05).Compared with the control group,proliferation rate,apoptotic rate,LC3 Ⅱ/Ⅰ protein expression,and cell cycle arrest in G0/G1 phase rate in TEL group and TEL+SC79 group were higher,while those in the TEL+SC79 group were lower than the TEL group(all P＜0.05).Conclusion TEL downregulates the PI3K/AKT/mTOR signaling pathway,and promotes SGC cell apoptosis,autophagy,and cycle arrest,thereby inhibiting SGC cell proliferation ability.

Abstract:Objective To investigate the clinical significance of positive anti-nuclear antibody(ANA)in patients with Takayasu arteritis(TA)and its impact on the risk of coronary artery disease.Methods A total of 158 patients with TA and without other immune diseases who were hospitalized in Beijing Anzhen Hospital,Capital Medical University from January 2014 to February 2022 were enrolled.According to the results of ANA,the patients were divided into ANA positive group(46 cases)and ANA negative group(112 cases).The general data,laboratory examination and imaging data of the subjects were collected,and the correlation analysis between the groups was performed.Logistic regression method was used to analyze the related risk factors,and the prediction model was established.Receiver operating characteristic(ROC)curve was used to compare the area under the curve(AUC)of different prediction models,and the clinical significance of positive ANA in patients with TA was analyzed.Results The incidence of hyperlipidemia was higher in ANA positive group than in ANA negative group[23.9％(11/46)vs 7.1％(8/112)](P=0.003).The incidence of coronary artery lesions in ANA positive group was significantly higher than that in ANA negative group[50.0％(23/46)vs 22.3％(25/112)](P=0.001).Multivariate Logistic regression analysis showed that positive ANA and hyperlipidemia were independent risk factors for coronary artery lesions in patients with TA(both P＜0.05).The ROC curve analysis showed that the AUC of the model based on age of onset,gender,course of disease,body mass index,National Institutes of Health(NIH)score and hyperlipidemia history was 0.713(P=0.001),and the AUC of the prediction model increased to 0.761 when ANA was added as a risk factor(P＜0.001).For patients without a history of hyperlipidemia(139 cases),the prediction model was constructed based on multivariate Logistic regression analysis,including age,gender,course of disease,body mass index and NIH score,and the AUC of the baseline model was 0.645(P=0.046),and the AUC increased to 0.709 when positive ANA was added as a risk factor(P=0.004).Conclusion Coronary artery disease should be alert to patients with TA combined with positive ANA,especially in patients without hyperlipidemia.

Abstract:Acute lung injury often leads to the death of critically ill patients with acute respiratory distress syndrome(ARDS),and immune cell infiltration is regarded as an important sign of ARDS.Alveolar macrophages(AMs)are immune cells that play a role in the pathogenesis of ARDS.AMs participate in the development of diseases mainly by interacting with alveolar epithelial cells(AECs).AMs participate in the development of diseases mainly by interacting with alveolar epithelial cells(AECs).In the early stages of ARDS,activated AMs secrete proinflammatory cytokines to remove pathogens that may disrupt the cellular structure of AECs and cause cell death.In the late stage of ARDS,alternatively activated macrophages secrete anti-inflammatory cytokines that inhibit inflammatory responses and promote epithelial regeneration and alveolar structural remodeling.This article mainly reviews the functions and characteristics of AMs and AECs in ARDS,and describes the interaction between AMs and AECs.