The present case report described a patient with paroxysmal atrial fibrillation who received pulsed-filed ablation guided by intracardiac echocardiography and 3-dimentional mapping system.All four pulmonary veins were isolated in the procedure,good clinical results and acute safety profile were achieved.The present case reveals the safety and feasibility of the technique for the treatment of paroxysmal atrial fibrillation.

BACKGROUND: Evidence on the relations of the American Heart Association's ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps. METHODS: A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004-2018), Dongfeng-Tongji cohort (2008-2018), and Kailuan study (2006-2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis. RESULTS: During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10-14 vs. 0-6 were 0.52 (0.41-0.67), 0.44 (0.37-0.53), 0.54 (0.45-0.66), and 0.86 (0.64-1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed. CONCLUSIONS ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.
Adult ; Humans ; Cardiovascular Diseases/prevention & control* ; East Asian People ; Prospective Studies ; Risk Factors ; Smoking

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective To investigate whether the characteristics of pathogens mediated by Wolbachia can interfere with Japanese encephalitis virus (JEV) replication and explore the regulatory role of Wolbachia on JEV replication transmitted by Culex mosquitoes. Methods Real-time fluorescence quantitative PCR (qPCR) and RNA fluorescence in situ hybridization (RNA-FISH) were used to detect Wolbachia density in Aa23 (naturally infected with Wolbachia) Aedes albopictus cell and negative control Aa23T Aedes albopictus cells (Wolbachia infection was removed by tetracycline treatment). The plaque assay was conducted to measure the viral titers and cytopathic effect (CPE) in Aa23T and Aa23 cells on days 1 to 8 after JEV (P3 strain) infection. Results qPCR and RNA-FISH results consistently showed that the symbiosis of Wolbachia was negative in Aa23T cell. In Aa23 cells, the copy number of the WSP gene of Wolbachia and the fluorescence signal intensity targeting Wolbachia 16S rDNA increased with cell growth time. In response to JEV infection, Wolbachia prolonged the CPE in viral infected Aa23 cells, which compared to infected Aa23T cells. The plaque assay result has obviously showed that JEV titer in Aa23 cells (106 PFU/mL) was significantly lower than that in Aa23T control cells (108 PFU/mL). Conclusions Wolbachia significantly delays CPE of JEV on cells and inhibits JEV replication in A. albopictus cells. To the best of our knowledge, this is the first report that Wolbachia strongly inhibits JEV infection in mosquito cells. It revealed the role of Wolbachia on inhibition of the viruses that transmitted by Culex mosquitoes. In particular, it provides important experimental data and theoretical basis for application of Wolbachia-based mosquito control technology in prevention and control of JEV.

Objective:To observe the clinical effect of Traditional Chinese Medicine (TCM) collapsibility combined with pressure therapy in the treatment of eczema.Methods:From January 2021 to August 2021, 60 patients with lower extremity venous ulcers who were treated in Wangjing Hospital, China Academy of Chinese Medical Sciences were selected and randomly divided into the control group (30 patients) and observation group (30 patients). The control group was treated by the routine pressure therapy, and the observation group was by the TCM nursing intervention on the basis of the control group. Both groups were treated for 2 weeks. The visual analogy scale (VAS),chronic Venous Insufficiency Questionnaire (CIVIQ), Self-rating Anxiety Acale (SAS), and Self-rating Depression Scale (SDS) were measured and evaluated at baseline and after treatment.Results:The total response rate was 100.0% (30/30) in the observation group and 86.7% (26/30) in the control group, and the difference was statistically significant ( χ2=4.29, P=0.038). The VAS (2.47±0.68 vs. 2.97±0.14, t=3.95), SAS (40.31±11.93 vs. 55.87±4.53, t=4.73), SDS (44.30±5.38 vs. 47.61±5.33, t=2.39) scores were significantly lower than those in the control group ( P<0.05), CIVIQ score (86.63±2.74 vs. 84.67±3.23, t=2.54) was significantly higher than that of the control group ( P<0.05). Conclusion:TCM combined with pressure therapy can promote the healing of ulcers in patients with eczema, relieve pain, and improve the quality of life of patients.

Objective:To explore the clinical effects in repairing dorsal complex tissue defect of finger with the flap based on superficial palmar branch of radial artery (SPBRA) with palmaris longus tendon.Methods:From May, 2011 to October, 2017, dorsal complex tissue defects of 15 fingers and thumbs in 15 patients were treated by the flaps which were based on SPBRA with palmaris longus tendon. There were 10 males and 5 females, in an average of 35.8 (19-51) years. All the defects (3 thumbs, 5 index, 2 middle and 5 ring fingers) were dorsal complex tissue defects and all had extensor tendon defects. The areas of soft tissue defect measured 2.0 cm×1.5 cm to 4.0 cm×2.0 cm. The lengths of tendon defect measured 2.0-4.0 cm. All patients received emergency surgery. The time before the surgery was 1.5-3.0 hours. The surgery time was 3.0-4.5 hours, 3.6 hours in an average. Postoperative regular follow-up.Results:All of the wounds healed in stage I and all flaps survived. Texture of the flaps was soft with rosy color. No obvious swelling occurred. All the donor sites healed in stage I. The patients were followed-up for 4-18 months, 8 months in an average. The appearance and function of the repaired fingers and thumbs were satisfactory. The pain, temperature and touch sensations were good. The color of flaps was similar to the normal finger without swelling. The wear resistance of the flaps was good. Thin-line scars were in the wrist donor sites without contracture. The range of motion of active palmar flexion of the wrist was from 0° to 80° and active hyperextension was from 0° to 70°. No obvious limitation was found.Conclusion:It is able to achieve a satisfactory clinical effects by using the flap that is based on SPBRA with palmaris longus tendon in repairing the dorsal complex tissue defect of hand. The advantages of the technique are that the donor site is concealed. The wound is small, and the flap is easy to be harvested and anastomosed.

Objective:To evaluate the techniques and short-term outcomes of pericardial autologous angioplasty for the reconstruction of mediastinal large vessels in the treatment of locally advanced malignant thymoma.Methods:We retrospectively analyzed the clinical data of 6 patients with locally advanced malignant thymoma who received autologous pericardial transplantation for mediastinal great vascular reconstruction in the same treatment group of Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University from April 2017 to October 2018.Results:The operative time of malignant thymoma patients receiving autologous pericardial vascular reconstruction was(192.3±32.5)min, intraoperative blood loss was(105.0±27.5)ml, thoracic drainage time was(4.5±1.5)days, and postoperative hospital stay was(5.3±2.5)days. The postoperative quality of life of the patients was satisfactory. Angiography showed that the reconstructed vessels of the left inus vein were occluded in 1 patient 10 months after the operation, and the reconstructed vessels were unobstructed in the other patients. The average follow-up time of the patients was 34.3 months after surgery. One patient developed chest wall metastasis 23 months after surgery, and his condition was stable after receiving local radiotherapy. The other 5 patients did not occur local recurrence or distant metastasis.Conclusion:The application of autologous pericardium for the reconstruction of mediastinal great vessels in the treatment of malignant thymoma is a safe and effective method, and its clinical application prospect is worth expecting.

Objective:To understand the cognition, willingness to test and influencing factors of hepatitis C (HCV) based on social software for men who have sex with men (MSM).Methods:An online questionnaire was used to investigate the target population of Blued platform users, including general demographic characteristics, sexual behavior, drug abuse behavior, cognition of hepatitis C prevention and treatment, past hepatitis C testing status and future testing willingness. There were 14 questions in the cognition part, and answering 10 or more questions were defined as "knowing" . Cognition rate, willingness to test and related influencing factors of hepatitis C were analyzed in different characteristics population. Data were analyzed by univariate and multivariate logistic regression.Results:A total of 1800 valid questionnaires were completed, of which 58.9% (1 061/1 800) had heard of hepatitis C, and the overall cognition rate of hepatitis C was 33.5% (603/1 800). The cognition rate of hepatitis C among those aged 30 years old, monthly income among RMB 5 000~10 000, high school education or above, and previous HIV testing [42.5% (371/873), 36.7% (191/520), 35.1% (584/1 663) and 37.4% (544/1453)] was considerably higher than those of the corresponding low-age, low-income, low-educated, not having HIV testing and not insisting on condom use, and the differences were statistically significant ( P < 0.05). The proportion of respondents who were willing to undergo hepatitis C testing in the next 3 months was 82.5% (851/1 031). The proportion of respondents who were tested for HIV in the past, had anal sex in the past 6 months and had high-risk behaviors [85.2% (766/899), 86.1% (609/707) and 86.6% (610/704)] was considerably higher than those who had not been tested for HIV, had no anal sex and had no high-risk behaviors in the past 6 months, and the differences were statistically significant ( P < 0.05). Conclusion:The survey respondents have a low cognition rate of hepatitis C, but have a higher willingness to test. Targeted publicity and education should be strengthened for this population, and convenient conditions should be provided to promote regular testing.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Objective: To investigate the effect of siRNA silencing α1 antitrypsin (α1-AT) gene on the biological behavior of rheumatoid arthritis fibroblast-like synoviocytes (RA-SFs). Methods: Primary culture of knee synovial tissue from 5 patients with rheumatoid arthritis (RA) was performed. The artificially synthesized silencing α1-AT siRNA specifically inhibits the expression of α1-AT in RA-SFs. After 24 and 36 hours of transient transfection, the inhibition efficiency was detected by Quantitative reverse transcription polymerase chain reaction (RT-qPCR), and the expression of related genes after α1-AT gene silencing was detected.Furthermore, ethyl thiazolyl tetrazolium (MTT) assay, Trans-well chamber, cell scratch and enzyme-linked immunosorbent assay (ELISA) were used to detect the effects of interfering α1-AT expression on cell proliferation, invasion and migration, and secretion of interleukin (IL)-17, Tumor necrosis factor (TNF)-α, IL-1α, IL-1β and other related inflammatory factors. At the same time, when the pathway inhibitor (ERK inhibitor, signal transducer and activator of transcription 3 (STAT3) inhibitor, NF-κB inhibitor) stimulated cells, the effect on α1-AT was changed. One-way analysis of variance was used for comparison between the two groups; further pairwise comparison using LSD-t test; The count data was checked by χ² test. Results: Compared with the negative control group, the siRNA α1-AT group was transfected for 24 hours, the α1-AT mRNA level was significantly inhibited (P<0.05), and the proliferation rate of RA-SFs was not affected (P>0.05), and the invasion and migration ability of cells decreased significantly (P<0.05). The secretion of IL-17 and IL-1β was slightly decreased (P>0.05), while TNF-α and IL-1α were not affected (P>0.05). In addition, the expression of α1-AT downstream genes Matrix metallop roteinases (MMP)-2 169, Hu-Bax1, MMP-9, Hu Bax and Hu Bcl-xl were significantly decreased (P<0.05). Moreover, the signaling pathway inhibitors ERK inhibitor (PD98059) and NF-κB inhibitor (PDTC) had significant effects on α1-AT (P<0.05). Conclusion The α1-AT gene silencing has potential effect on the biological behavior of RA SFs. Further study of this mechanism is helpful to provide evidence for the treatment of RA.