Objective To analyze the current status and hotspots of surgical transmural ablation of atrial fibrillation using CiteSpace and VOSviewer. Methods The Web of Science Core Collection database was used as the data source. The CiteSpace 5.8.R3 and VOSviewer software were used to analyze the related studies on surgical transmural ablation of atrial fibrillation about the authors, countries/institutions, literature co-citation and keywords. Results A total of 109 articles were enrolled. Damiano RJ was the most prolific researcher, while Cox JL was the author with the highest number of citations. The United States was the leading country in this research field. The University of Washington was an important institution in the study of atrial fibrillation transmural ablation. The main hotpots were the effectiveness of surgical ablation, especially Cox-maze procedure, selection of the energy source of surgical ablation, combination of surgical and catheter ablations, and pulmonary vein isolation. Conclusion This study visualizes the current research status of surgical ablation of atrial fibrillation. How to improve the effectiveness and transmurality of surgical ablation is a hot research topic in the surgical treatment of atrial fibrillation. The combination of electrophysiology mapping and surgical ablation may be the development direction in the surgical treatment of atrial fibrillation.

Heart transplantation is the gold standard for treating advanced heart failure. As a key indicator of the prognosis of heart transplant recipients, health-related quality of life (HRQOL) is susceptible to physical, psychological, social and other factors. This article reviews the concept, evaluation tools, influencing factors, and intervention of HRQOL among heart transplant recipients, aiming to provide a reference for selecting appropriate evaluation tools, exploring effective intervention methods for improving HRQOL of heart transplant recipients, and developing a systematic intervention management plan in clinical practice.

Objective:To search and analyze the relevant evidence of exercise rehabilitation in heart transplant patients and summarize the best evidence.Methods:The best practice information book, evidence summary, guidelines, expert consensus and systematic review of exercise rehabilitation for heart transplant patients in CNKI, Wanfang, CBM, PubMed, Embase, Cochrane Library, UpToDate, BMJ Best Practjce, National Institute for Health and Clinical Excellence (NICE), International Guidelines Network (GIN), Scottish Intercollegiate Guidelines Network (SIGN), New England Medicine (NEJM), Joanna Briggs Institute (JBI) Evidence-based Health Care Center in Australia, American Health Care Policy Research Institute (AHRQ), American Heart Association (AHA), American College of Cardiology (ACC), American Association for Cardiopulmonary Rehabilitation (AACVPR), European Society of Cardiology (ESC), International Society for Heart and Lung Transplantation (ISHLT) were searched by computer.Results:A total of 10 articles were included, including 1 clinical decision, 2 guidelines, 1 expert consensus and 6 systematic reviews; after evaluation, a total of 21 best evidences in 7 aspects: exercise effectiveness, exercise timing, exercise assessment, exercise modality, exercise duration, pre-habilitation, exercise compliance were summarized.Conclusions:This study summarizes the best evidence of exercise rehabilitation in patients undergoing heart transplantation and provides a reference for medical staff to develop exercise rehabilitation programs for patients after heart transplantation.

Objective:To explore the factors affecting bone mineral density (BMD) in adult males with low-to-moderate fluoride exposure in Henan Province.Methods:Adult male villagers from low-to-moderate fluoride exposure areas in Tongxu County, Kaifeng City, Henan Province were recruited from April to May 2017 based on cluster random sampling. Questionnaire survey, physical measurements and urinary samples collection were conducted respectively. Urinary fluoride (UF) was determined by fluoride ion-selective electrode. Ultrasound bone densitometer was used to measure BMD (T-score). Partial correlation analysis and multiple linear regression were used to analyze the influence factors of BMD.Results:A total of 439 adult males were included in this study. Age, body mass index (BMI), UF content, and T-score of the participants were (47.99 ± 8.49) years, (25.77 ± 3.23) kg/m 2, (1.34 ± 0.74) mg/L, and-1.79 ± 0.79, respectively. Partial correlation analysis showed a significantly positive correlation between BMI and T-score after age adjustment ( r = 0.194, P < 0.05). Multiple linear regression showed that T-score decreased by 0.015 (95% CI:-0.024 -- 0.005, P < 0.05) for each 1-year increase in age and T-score increased by 0.034 (95% CI: 0.009-0.059, P < 0.05) for each 1.0 kg/m 2 increase in BMI. Interaction analysis showed that T-score was closely related to the interaction between overweight (≥24.0 kg/m 2), non-smoking, tea drinking and UF [ β (95% CI): 0.134 (0.001-0.269), 0.163 (- 0.015-0.337), 0.215 (- 0.006-0.436), P < 0.10]. Conclusions:Our findings reveal a negative correlation between age and BMD, and a positive correlation between BMI and BMD in adult males with low-to-moderate fluoride exposure in Henan Province. In addition, low-to-moderate fluoride exposure is more likely to damage the BMD of smokers.

Objective    To analyze the early and mid-term safety and effectiveness of concomitant cryosurgical Cox-Maze Ⅳ procedure in minimally invasive mitral valve surgery. Methods    We retrospectively reviewed the clinical data of 68 patients (28 males and 40 females with a mean age of 38.7±9.3 years) who underwent concomitant cryosurgical Cox-Maze Ⅳ procedure in minimally invasive mitral valve and tricuspid surgery in the Department of Cardiovascular Surgery of the Second Xiangya Hospital from August 2013 to October 2017. The heart rhythm of the patients after surgery was supervised by 24 hour holter monitoring eletrocardiogram. Results    No death occurred during operation and follow-up. One patient underwent reexploration for bleeding. The rate of sinus rhythm restored at the time of discharge was 95.8%. The rate of sinus rhythm restored at 6 months, 12 months, 24 months, 36 months after surgery was 93.5%, 91.6%, 90.3% and 89.5% respectively. Conclusion    Concomitant cryosurgical Cox-Maze Ⅳ procedure in minimally invasive mitral valve surgery is quite safe and effective in treatment of rheumatic mitral valve disease and atrial fibrillation in the early and mid-term follow-up.

Objective To evaluation of abnormality of intrarenal veins in the patients of diabetic nephropathy (DN) and the correlation between the intrarenal venous impedance index (VII) and renal function with color Doppler ultrasonography. Methods Sixty-four subjects with type 2 diabetic nephropathy from December 2016 to October 2017 were enrolled and divided into three groups according to glomerular filtration rate(GFR) level: GFR≥90 ml/(min·1.73 m2) as group B (25 cases), 60 ml/(min·1.73 m2)≤GFR＜90 ml/(min·1.73 m2) as group C (21 cases), GFR＜60 ml/(min·1.73 m2) as group D(18 cases), and 25 healthy volunteers were recruited as group A. Color Doppler ultrasonography was used to obtain the intrarenal VII. Results There were significant differences among A, B, C, D group of right renal segmental vein (0.41 ± 0.04, 0.36 ± 0.09, 0.29 ± 0.05, 0.19 ± 0.05; F＝81.85), right renal interlobular vein (0.41 ± 0.03, 0.35 ± 0.04, 0.29 ± 0.04, 0.22 ± 0.11; F＝96.42), left renal segmental vein (0.42 ± 0.08, 0.36 ± 0.05, 0.30 ± 0.08, 0.20 ± 0.04; F＝101.38) and left renal interlobular vein (0.40 ± 0.15, 0.36 ± 0.04, 0.30 ± 0.04, 0.20 ± 0.07; F＝95.71), all P＜0.05. The VII of group B, C and D was significantly lower than that of group A (P＜0.05). The VII of group D was lower than that of group B and C (P＜0.05), and the VII of group C was lower than that of group D(P＜0.05). There were no significant differences of the VII between the left and right kidneys (F＝0.001, P＞0.05). The VII was positively correlative with GFR (r＝0.85, P＜0.05). Conclusions The VII of the patients of DN can be obtained by color Doppler ultrasonography conveniently and non-invasively, which can reflex the renal function changes and provide a new diagnostic index for the patients of DN in diagnosis and treatment.

Objective To investigate the changes in tumor necrosis factor-α(TNF-α) and plasminogen activator inhibitor(PAI) in the presence of obstructive sleep apnea syndrome(OSAS) in patients with type 2 diabetes mellitus,and to investigate if that 2 inflammatory factors is associated with hypoxemia during sleep.Methods Fiftyfour patients with type 2 diabetes mellitus hospitalized for glycemic control were subgrouped into 27 patients with OSAS (group O) and 27 patients without OSAS (group N).26 people without diabetes and OSAS were selected from a health check-up program to serve as control group (group C).Serum TNF-α and PAI levels were measured by commercial ELISA kits.Apnea hypopnea index (AHI),the lowest pulse oxygen saturation (LSpO2) at night were detected by portable sleep monitor.The relativity regarding TNF-α,PAI,homeostasis model assessment for insulin resistance (HOMA-IR),fasting blood glucose(FBG),AHI,LSpO2,and age was discussed.TNF-α and PAI were regard as dependent variables,and FBG,HOMA-IR,AHI,LSpO2,and age as independent variables in multivariate stepwise linear analysis.Results The levels of HOMA-IR,TNF-α,PAI in group O [2.69 ± 1.53,(1.97 ±0.13) ng/ml,and (2.27 ± 0.85) ng/ml] were higher than the those in other 2 groups,and those in group N [1.70 ± 0.88,(1.09 ±0.29) ng/ml,and (1.59 ± 0.13) ng/ml] were higher than group C [1.15 ± 0.67,(0.73 ± 0.19) ng/ml,and (0.89 ±0.25) ng/ml].The levels of FBG in the 2 diabetic groups were higher than those in group C.The level of AHI in group O was higher than that in group N and group C,while LSpO2 in group O was lower than that in group N and group C.Spearman univariate analysis showed that TNF-α and PAl both were associated positively with HOMA-IR,FBG,and AHI,while negatively with LSpO2.Multivariate stepwise linear analysis denoted that TNF-α was independently associated with AHI,FBG,while PAI was independently associated with AHI and HOMA-IR.Conclusions Patients with diabetes and OSAS manifest raised level of chronic inflammatory activity,and therefore,OSAS might be implicated in the pathogenesis of chronic complication of patients with type 2 diabetes.

Objective To investigate the neuroprotective effect of granulocyte colony stimulating factor (G-CSF) combined with behavior training on the learning and memory abilities of cerebral ischemic injury in rats. Methods 96 Wistar rats, 2 months old, were divided as sham group (group A), model group (group B), G-CSF group (group C) and G-CSF+training group (group D). Modified middle cerebral artery occlusion (MCAO) was used to establish a ischemia 2 h/reperfusion 24 h model to all the rats, except sham group. 6 rats were selected in each group 1, 2, 4 and 8 weeks after successfully modeled, respectively. The abilities of learning and memory were detected with the latency of shuttle test video analysis system. The pathology of the hippocampus and the expression of nerve growth factor (NGF) and G-CSF were observed with HE and immunohistochemistry staining, respectively. Results The expression of NGF and G-CSF increased in group B transiently, and increased more and longer in the group C and D, especially in group D, as the time passed (P<0.05). The latency of shuttle test increased in group B, C and D, and gently decreased as the time passed, and the decrease more to less were group D, C and B (P<0.05).Conclusion The neuroprotective effects of G-CSF combined with behavior training are strengthened and long term beneficial than G-CSF alone.

ObjectiveTo explore the prevalence of thyroid nodules and metabolic syndrome,and to analyze the correlation between thyroid nodules and the components of metabolic syndrome.MethodsThis cross-sectional study included 8 217 people in our hospital health check-up center.Height,body weight,blood pressure,blood glucose,lipid profile,and liver function were measured and ultrasonic scanning of thyroid was performed.Metabolic syndrome was diagnosed according to criteria of CDS/2004.Results ( 1 ) The prevalence of thyroid nodules was 42.1％.The prevalence in women (49.6％) was significantly higher than that in men( 38.4％,P＜0.01.),and it was progressively increased with aging in both sexes.(2) The overall prevalence of metabolic syndrome was 21.7％.The prevalence in men( 28.5％ ) was significantly higher than that in women( 12.8％,P＜0.01 ),and was increased with age until 70 years old.( 3 ) Body mass index,systolic pressure,diastolic pressure,blood glucose,triglyceride in subject with thyroid nodules (TN) were higher than those in subjects without ( non-TN,P＜0.05 ).No difference in the levels of HDL-C was found between cases with TN and non-TN ( P＞0.05 ).(4) Logistic regression analysis revealed that the existence of thyroid nodules was significantly associated with overweight/obesity ( OR =1.263,95 ％ CI 1.134-1.407 ) after adjusting age and sex.Conclusion( 1 ) The prevalences of thyroid nodules and metabolic syndrome are high,and both prevalence increase with advancing age.(2) Obesity or overweight might be a risk factor for the development of thyroid nodules.