OBJECTIVES: To analyze the early clinical outcomes of the Xcor^TM transcatheter aortic valve replacement (TAVR) system in treating severe aortic stenosis. This study has been registered at Chinese Clinical Trial Registry (ChiCTR2200065593). METHODS: This single-arm, prospective clinical trial enrolled patients with severe aortic stenosis treated with the Xcor^TM TAVR system at the Section of Heart Valve & Coronary Artery Surgery, Guangdong Provincial People's Hospital. Perioperative and follow-up parameters were compared to evaluate differences in hemodynamic outcomes. All-cause mortality, aortic regurgitation, paravalvular leakage, cerebrovascular events, and reoperation were analyzed. RESULTS: Thirty-two patients with severe aortic stenosis were included (20 males, 12 females), with (70.9±4.3) years old and a Society of Thoracic Surgeons (STS) score of 6.45% (6.07%, 7.28%). Notably, 87.5% of patients had New York Heart Association (NYHA) class≥Ⅲ. All patients underwent successful Xcor^TM bioprosthesis implantation, achieving an immediate technical success rate of 100.0% and device success rate of 96.9%. Mean aortic valve gradient decreased from (55.21±23.17) mmHg (1 mmHg=0.133 kPa) to (8.45±5.30) mmHg, peak aortic jet velocity decreased from (4.66±0.85) m/s to (1.99±0.48) m/s, aortic valve area increased from (0.66±0.21) cm² to (2.09±0.67) cm² (all P<0.01). Intraoperative ventricular fibrillation occurred in one patient, while one case exhibited moderate prosthetic valve regurgitation and paravalvular leakage post-procedure. At 12-month follow-up, sustained improvements were observed in cardiac function, left ventricular ejection fraction, hemodynamic parameters, and SF-12 quality-of-life scores (all P<0.01). All-cause mortality was 12.5% (4/32), with 13.8% (4/29) developing moderate paravalvular leakage. CONCLUSIONS The Xcor^TM TAVR system demonstrated favorable early outcomes in severe aortic stenosis patients, significantly improving symptoms and hemodynamics while exhibiting excellent performance in preventing malignant arrhythmias and coronary obstruction.
Humans ; Male ; Female ; Aortic Valve Stenosis/surgery* ; Transcatheter Aortic Valve Replacement/methods* ; Aged ; Follow-Up Studies ; Prospective Studies ; Treatment Outcome ; Aged, 80 and over ; Heart Valve Prosthesis ; Middle Aged

【Objective】 To investigate the predictive value of visceral fat area （VFA） in patients with gastric cancer after radical gastrectomy. 【Methods】 A retrospective analysis was performed on 195 patients who underwent radical gastrectomy in the Department of General Surgery， The First Affiliated Hospital of Xi’an Jiaotong University from January 2014 to December 2017. CT image data and clinicopathological data within 1 week before surgery were collected. VFA was calculated by software， and the patients were divided into VFA-H group （n=96） and VFA-L group （n=99）. The relationship between VFA in different groups and long-term prognosis was compared. 【Results】 CT examination results showed that VFA value was （111±62） cm²， and BMI was positively correlated with VFA value （r=0.640， P<0.001）. ROC curve showed that VFA was more valuable in predicting the prognosis of gastric cancer （AUC=0.703， P<0.001） and better than BMI. Cox regression analysis of prognostic factors in gastric cancer patients： Univariate analysis showed that age， tumor length， TNM stage and VFA were the influencing factors for prognosis， while multivariate analysis showed that TNM stage III and VFA-L were independent risk factors for prognosis of gastric cancer patients. 【Conclusion】 VFA has a good predictive ability and can be used to evaluate the prognosis of gastric cancer patients after operation.

Objective: To determine the first dengue fever case in Taizhou and trace probable transmission sources. Methods: Collected serum of three patients for antigen, antibody and nucleic acid detection. Dengue viruses were isolated and cultured in C6/36 cell. The whole length of E gene was amplified by reverse transcriptase-polymerase chain reaction(RT-PCR) and then sequenced. The phylogenetic tree was drawn. Results: Three cases were positive in nucleic acid detection. Two cases were IgM positive. One case was NSI antigen postive. Three strains of type I dengue virus were isolated from samples. The phylogenetic trees shown that the three strains were on the same branch. The identities of nucleotide were 99.87%. The identities of amino acid were 99.6%-99.8%. Conclusions The dengue virus strains isolated in Taizhou was imported from Guangdong or Southeast Asia and caused location infection.

Objective To understand the prevalence of group sex in men who have sex with men (MSM) and related factors in Taizhou,Zhejiang province.Methods From March 2013 to September 2015,a cross-sectional survey was conducted among MSM recruited from gay bars or bath houses in Taizhou by using questionnaire to collect the information about their sexual behavior and HIV test.Results A total of 1 435 MSM were recruited,179 of them (12.5％) were HIV infected,231 (16.1％) reported group sex during the past year.Compared with MSM without group sex,more MSM with group sex had more than ten male sexual partners (53.7％ vs.19.0％,x2=125.527,P＜ 0.01),had both male and female sexual partners (86.6％ vs.68.2％,x2=31.935,P＜0.01),used no condom at sex with female partners during the past year (28.1％ vs.19.8％,x2=6.540,P＜0.05).After adjusted for educational level and occupation,group sex was associated with age [≥ 50 years old vs.≤ 24 years old,adjusted odds ratio (aOR)=2.25,P=0.027],marriage with female (divorced or widowed vs.unmarried,aOR=0.29,P=0.001),census registering (local resident vs.non-local resident,aOR=1.56,P=0.023),number of male seuxal partners (≥21 vs.2-5,aOR=8.06,P＜0.001;11-20 vs.2-5,aOR=3.25,P＜0.001) and number of female seuxal partners (≥6 vs.0,aOR=2.63,P=0.005;2-5 vs.0,aOR=2.58,P=0.001;1 vs.0,aOR=2.01,P=0.010).Conclusion The prcvalcncc of group sex in MSM was high in Taizhou,and their poor condom use and complex sex behaviors would result in higher HIV infection rate and risk of transmission.

UNLABELLEDObstract: To characterize and analyze risky sexual networks and genetic scales to potential HIV transmission for HIV seroconcordant couples in Taizhou municipality of Zhejiang Province.

METHODSHIV seroconcordant positive couples were invited as index cases to participate in an egocentric survey on HIV related risky behavior and behavioral network prior to HIV diagnosis during 2008-2011. Within-couple HIV transmission pairs were determined by the combination of both behavioral and phylogenetic analysis.

RESULTSTotally 27 HIV seroconcordant couples were enrolled in this study. Male spouses were more likely to report having two or more sexual partners in the past years prior to HIV diagnosis than female spouses (88.9% vs. 37.0%). Among 27 couples, 20 couples including 17 couples by male but not female spouses, 3 couples by female but not male spouses reported having two or more sexual partners (i.e., multiple sexual partners) prior to HIV diagnosis; and 7 couples by both spouses reported having multiple sexual partners. Twenty four of 27 sexual networks were determined to be HIV transmission pairs (20) or potential transmission pairs (4), 3 couples were subtyped with discordant HIV subtypes or large genetic distance and thus had different sources of HIV transmissions. In addition, among 27 concordant couples, HIV drug resistance (HIVDR) or primary HIVDR existed in 6 ART-naïve participants in 4 networks; among them, 2 networks were determined to be potential HIVDR transmission couple pairs.

CONCLUSIONSThe HIV strains isolated in HIV infected spouses characterized with diversity and CRF01_AE was the main strain subtype. One of the spouses with risky behavior infected HIV was the main route of transmission to other spouses through unprotected sexual contacts. HIVDR was isolated from some HIV infected individuals, suggesting the risk for HIVDR transmission in married couples. The results provide enhanced evidence for urgent development of tailored prevention strategies, such as couple-based HIV counseling and testing services to reduce HIV secondary transmission.

Objective To evaluate the clinical application of endoscopic thyroidectomy(ESTC) via the approach of areola of breast.Methods The clinical data of 46 cases of endoscopic thyroidectomy via the breast areola approach from October 2004 to November 2006 were retrospectively analyzed.Results The operation was successfulmy completed endoscopically in 44 cases,including 18 cases of unilateral partial thyroidectomy,26 cases of bilateral partial thyroidectomy,and 2 cases were converted to open operation for thyroid cancer neck dissection.The operation time of ESTC was 80~160minutes(mean 110min),and the intraoperative blood loss was 25~45ml,(mean,33?9.5ml).Pathological findings showed 25 cases of thyroid adenoma,16 cases of nodular goiter,and 3 cases of Graves disease.The length of postoperative hospital stay was 3~6day(mean4.5d).Complications occurred in 2 cases,including 1case of bleeding from left puncture tract,and 1 case of temporary hoarseness.Conclusions Endoscopic thyroidectomy via breast areola approach is a technically feasible and safe procedure,and has the advantage of minimal trauma,and with excellent cosmetic outcomes.