Objective : In the present study，the changes of left atrial matrix characteristics and the effect of cathe- ter ablation on cardiac function in elderly patients with persistent atrial fibrillation were observed．Furthermore，the application of two catheter ablation methods including circular pulmonary vein isolation combined with left atrial ma- trix modification or left atrial posterior wall isolation were compared by researchers in order to explore effectiveness and safety of the two methods in elderly persistent atrial fibrillation patients． Methods : A total of 86 elderly pa- tients with persistent atrial fibrillation were selected and divided into two groups using randomization principle ; the pulmonary vein isolation combined with left atrial matrix modified catheter ablation method was named matrix modi- fied group (43 cases) ; the pulmonary vein isolation combined with left atrial posterior wall isolation catheter abla- tion method was named posterior wall isolation group (43 cases) ．During ablation left atrial electro matrix mapping were analyzed by multipole catheter for all patients．After ablation all patients were follow-up in 12 months by car- diac color doppler ultrasound examination，ECG and Holter．The incidence of arrhythmia ，serious adverse event and complications were compared between two groups． Successful rate of single ablation and blank period recur- rence after ablation were observed in 12 months follow-up time. Results : Through electrogram mapping of left atri- um low-voltage areas or scar areas were founded in 72 cases among the 86 cases after ablation，After a 12-month follow-up，the incidence of arrhythmia in the blank period between the two groups was 41．9% ( matrix modified group) and 23. 3% (posterior wall isolation group) ，independently，P＜0. 01，successful rates of single ablation in the two groups were 83. 7% (matrix modified group) ，60. 5% (posterior wall isolation group) ，independently， P ＜0. 01 ．No adverse event occurred in the two groups．After AF ablation LVEF increased，LVEDD and LVAD significantly decreased in all of the cases．There was no significant difference between the two groups in patients ’ characters ablation time and complications rate． Conclusion Circular pulmonary vein isolation combined with left atrial matrix modification is as safe as left atrial posterior wall isolation，and it is a simplified，personalized，and more effective ablation strategy in elderly patients with persistent atrial fibrillation.

【Objective】 To statistically analyze the relationship between homologous recombination repair deficiency (HRD) score and clinicopathological characteristics, genomic mutations in patients with high-risk and metastatic hormone-sensitive prostate cancer (mHSPC) and the prognostic predictive value in mHSPC. 【Methods】 A total of 127 patients diagnosed with high-risk prostate cancer and mHSPC, treated at the Department of Urology of Chinese PLA General Hospital during Dec.2021 and Nov.2023 were enrolled.Homologous recombination repair (HRR) gene sequencing was performed, and the genomic scar score (GSS) algorithm were conducted to calculate the HRD score.The relationship between HRD scores and clinicopathological features, genomic alterations, and prognosis were analyzed. 【Results】 The median HRD score was 1.6(0.8, 5.2), 30(23.6%) patients’ HRD scores ≥10, and 11(8.7%) patients’ HRD scores ≥20.Clinicopathological features, including ISUP classification ≥4 (P=0.044) and metastatic status (P=0.008) were associated with high HRD score.Patients with mutations in the BRCA, TP53 and MYC systems had significantly higher HRD score than those with wild-type genes (P<0.05).In mHSPC, the risk of biochemical recurrence was 12.836 times higher in patients with HRD score ≥20 than in those with <20 [OR:12.836 (1.332-124.623), P=0.028]. 【Conclusion】 Baseline HRD score was lower in patients with high-risk prostate cancer and mHSPC.Patients with high HRD score may have higher histological grading (ISUP≥4) and later clinical stage.Further investigation is needed to determine the threshold of HRD scores as biochemical markers suggestive of a poor prognosis.

Objective : To investigate the effect and mechanism of endothelin-1 (ET-1) on atrial fibrosis in Atrial fibrillation (AF) rats . Methods : Fourteen adult male SD rats were randomly divided into normal control ( NC) group and Atrial fibrillation (AF) group . The rat model of Atrial fibrillation was established by inj ecting 0.1 ml/ 100g CaCl2 Ach mixture into the tail vein once a day for one week . The control group was inj ected with the same dose of normal saline . An electrocardiogram of normal or atrial fibrillation was recorded on the first day and the eighth day in each group , and echocardiography was used to monitor atrial size and cardiac function . The fibrosis of atrial was ob served using Masson and HE staining. The expression of endothelin-1 ( ET-1) , collagen-I ( Col-I) , transforming growth factor-β(TGF-β) and the store operated calcium channel (SOCC) protein Orai1 , stromal in teraction molecule 1 (STIM1) in atrial tissue were detected by Western blot. HL-1 cells were cultured and treated with gradient concentration of ET-1 for 24 hours . Western blot was used to ob serve changes in the expression of TGF-β, Orai1 and STIM1 proteins in ET-1 /SOCC/TGF βsignaling pathway of HL-1 cells . Small interfering RNA ( siRNA) transfection method was used to knock down the expression of Orai1 in HL-1 cells , then the cells were treated with appropriate concentrations of ET-1 for 24 hours , and the expression of TGF-β protein in HL-1 cells was detected by Western blot. Results : Compared with the control group , echocardiography showed a significant in crease in left atrial diameter (LAD) of the heart in atrial fibrillation rats (P < 0.05) . The HE and Masson staining results showed significant fibrosis in the myocardial tissue of AF group rats (P < 0.05) , and the Western blot re sults indicated the expression of ET-1 , Orai1 , STIM1 , TGF-β and COL-Ⅰ in the myocardial tissue of AF group significantly increased compared to the NC group (P < 0.05) . After ET 1 treatment of HL-1 cells , the protein ex pression of Orai1 , STIM1 and TGF βincreased (P < 0.05) , while knocking down Orai1 in HL-1 cells , ET-1 treat ment no longer caused the expression of TGF-β a significant upregulation . Conclusion AF caused by atrial fibril lation results in a significant increase in ET-1 expression in atrial tissue , and ET-1 /SOCC/TGF-β signal pathway promotes atrial fibrillation and fibrosis .