By morpometric and immunohistochemical methods, it is observed that the volume density, the numerical density on area and the numerical density of specific granules in the perinuclear region of the atrial myocytes in the aging rats ars significantly less than that in the young groups (p

This paper designs a heart sound processing analog circuit, in which the amplification circuit, the filter circuit and the lifting of electrical level circuit are involved. It also gives a safety design problem analysis using an electret capacitor microphone to pick-up the heart sound signals. It is proved that the circuit is reliable and effective.

Objective To assess effects of stress dynamic CT myocardial perfusion imaging (CT-MPI) combined with coronary CT angiography (CCTA) on the diagnosis of myocardial perfusion defects in coronary artery disease (CAD). Methods Patients with CAD diagnosed by CCTA underwent ATP stress CT-MPI examination. Single-photon emission computed tomography (SPECT) myocardial perfusion imaging (SPECT-MPI) was performed within one week and set as the reference standard. CT-MPI results were qualitatively analyzed, and myocardial blood flow (MBF), myocardial blood volume (MBV) as well as time to peak (TTP) were quantified according to CT-MPI. Effects of CCTA, CT-MPI, and CT-MPI combined with CCTA on predicting myocardial perfusion defects were assessed in comparison with NMPI. Results Thirty patients [(54.8±8.4)years] were enrolled in our study, 20 were men (68%). MBF [(79.3±18.0) versus (135.1± 35.2) ml·100 ml-1·min-1] and MBV [(8.9±2.9) versus (13.8±8.9) ml/100 ml] were significantly decreased in hypoperfused segments compared with normal segments, while TTP was increased in hypoperfused segments [(13.9 ± 2.5)s] compared with normal segments [(9.1 ± 2.1)s] (t=0.302, 0.866 and 0.024 respectively, all P values<0.01). The sensitivity, specificity of CT-MPI for identifying segments with perfusion defects were 91.3%(147/161), 84.6%(281/332), respectively. On a per-vessel basis, the area under the receiver operating characteristic curve for predicting myocardial perfusion defects were 0.635(95%CI:0.517—0.753) for CCTA, 0.709(95%CI:0.599—0.819)for CT-MPI, and 0.837(95%CI:0.749—0.925)for CT-MPI combined with CCTA, respectively. Conclusions The performance of stress dynamic CT-MPI in the diagnosis of myocardial perfusion defects in CAD was good. One-stop examination of CT-MPI combined with CCTA improves the diagnostic accuracy for identifying flow-obstructing stenosis.

Objective To build a predictive model of depression with secondary mild cognitive impairment (MCI) in elderly patients based on current clinical diagnosis and treatment technology,and to analyze its application.Methods Elderly patients with depression hospitalized in three hospitals were consecutively included in our study from September 2013 to December 2015 for collecting relevant clinical data,and followed up for 18 months to confirm a prognosis.The follow-up results were used to predict influencing indices for secondary MCI risk,and to verify judgement effectiveness of the critical value of the relevant indices on the window of time of the secondary MCI.Results A total of 216 elderly patients with depression were included in this study,of whom 9 patients were lost to follow-up.Finally,27 patients had secondary MCI,and 180 patients had normal cognitive function during the follow-up period.Cox multiple regression analysis showed that the risk model of secondary MCI in elderly patients with depression was composed of age (HR:1.30,95 ％ CI:1.12-1.64,P =0.03),education years (HR:0.56,95 ％ CI:0.41-0.80,P =0.01),regular psychological treatment (HR:0.73,95％ CI:0.58-0.92,P=0.03),and BSSI scale (HR:1.24,95％ CI:1.08-1.56,P=0.03).Age and BSSI scale were risk factors,while education years and regular group psychotherapy were protective factors.For an elderly patient with depression who was characterized by age ≥ 72.3 years,education years ＜8.3 years,and BSSI scale ≥75.1,the window of time for secondary MCI was shorter,and these critical values of the independent factors had significant judgement effectiveness.Conclusions Age,education years,regular psychological treatment,and BSSI scale are independently influencing factors for secondary MCI in elderly patients receiving the treatment for depression.Furthermore,age ≥72.3 years,the education period ＜8.3 years,and BSSI scale ≥75.1 points are critical values of secondary MCI.

To know about the cesarean section rate and the changes of the indications for cesarean section in Changsha from 2008 to 2017, and to provide scientific basis for decreasing the cesarean section rate.
 Methods: We collected the clinical data of deliveries in a general hospital in Changsha from January 2008 to December 2017, and analyzed the cesarean section rate, the changes of the indications for cesarean section and the influential factors. 
 Results: The cesarean section rate in this hospital was 50.0% from 2008 to 2017, and the cesarean section due to social factors showed a decreasing trend year by year. Multiple-factor analysis of the cesarean section shows that advanced age, multi-parous pregnancy, gravida (≥4 times), abnormal fetal position and heavy fetus weight were dangerous factors, and the multipara was a protective factor.
 Conclusion: The cesarean section rate in a general hospital in Changsha is at a high level, and there are many factors affecting cesarean section. It is necessary to optimize the strategies and measures to reduce the cesarean section rate, and to control the cesarean section rate in a reasonable range.
Cesarean Section ; Delivery, Obstetric ; Female ; Hospitals, General ; Humans ; Pregnancy ; Retrospective Studies

Objective:To investigate the correlation between basal ganglia (BG) enlarged perivascular space (EPVS; BG-EPVS) and cognitive and motor longitudinal changes in patients with newly diagnosed Parkinson′s disease and its different motor subtypes [tremor dominant (TD), postural instability and gait disorder (PIGD)].Methods:A total of 131 Parkinson′s disease patients from the Parkinson Progression Markers Initiative (PPMI) database were screened and their clinical data were collected at baseline, 1 year and 2 years of follow-up. The number of EPVS in different brain regions was assessed on axial T 2-weighted images by cranial imaging data, and they were divided into two groups according to the degree of EPVS: BG-EPVS- and BG-EPVS+. Parkinson′s disease patients were divided into TD and PIGD groups by Movement Disorder Society Unified Parkinson′s Disease Rating Scale (MDS-UPDRS) score, and the number and clinical data of EPVS were compared between the two groups, and the correlation between the number and degree of BG-EPVS at baseline and longitudinal changes in clinical outcome measures of Parkinson′s disease and its different motor subtypes (TD, PIGD) was analyzed. Results:BG-EPVS was positively correlated with age ( r=0.32, P<0.01), Hoehn & Yahr stage ( r=0.21, P<0.05), serum neurofilament light chain ( r=0.18, P<0.05) and Epworth Sleepiness Scale score ( r=0.20, P<0.05) in all Parkinson′s disease patients. At baseline and 2 years, the number of BG-EPVS was more in the PIGD group than in the TD group (11.0±4.2 vs 9.0±3.8, t=2.18, P=0.03; 16.3±6.7 vs 12.6±4.6 , t=2.71 , P=0.007;after correction).At baseline, more BG-EPVS in patients with Parkinson′s disease and its motor subtypes (TD, PIGD) was significantly associated with baseline motor outcomes ( β=0.66, P=0.01; β=0.64, P=0.008; β=0.91, P=0.009), but not with cognitive outcomes. By linear mixed effects model analysis, BG-EPVS numbers and moderate to severe BG-EPVS were positively correlated with motor outcomes over time in patients with Parkinson′s disease and its motor subtypes (TD, PIGD) ( β=0.51, P=0.008; β=0.59, P=0.025; β=0.80, P=0.038). After dividing BG-EPVS in Parkinson′s disease patients into different degrees, moderate to severe BG-EPVS was positively correlated with motor outcomes over time ( β=3.30, P=0.031). Conclusion:In this longitudinal study, bigger baseline BG-EPVS numbers were found to be positively associated with longitudinal changes in dyskinesia severity in Parkinson′s disease patients, not with cognitive changes, and be able to predict decline in motor function over a 2-year follow-up period.

Objective To explore the application of dual-source CT derived fractional flow reserve(FFR)for percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods A retrospective study was conducted on 68 coronary heart disease patients admitted from January 2022 to June 2022.Whether PCI was carried out was dependent on coronary angiography in control group(n=34)and dual-source CT derived FFR in research group(n=34).The two groups were compared for general data,length of diseased blood vessels,number of stents,hospitalization expenses and incidence of adverse reactions.Results The differences in age,smoking history,diabetes,hypercholesterolemia and angina pectoris between two groups were trivial(P＞0.05).After treatment,research group had less number of stents,lower hospitalization costs,and shorter diseased blood vessels than control group(P＜0.05).The 6-month follow-up showed that the total incidences of adverse reactions in research group and control group were 17.65％and 58.82％(P＜0.05).Conclusion Using dual-source CT derived FFR to guide PCI can reduce the number of stents and hospitalization costs,and lower the incidence of cardiovascular adverse reactions.

OBJECTIVE: To explore the molecular basis for a Chinese family affected with neurofibromatosis type I. METHODS: Peripheral blood samples were collected from the proband and his parents. Potential mutations of NF1 gene were screened by PCR and Sanger sequencing. Pathogenicity of candidate mutations was analyzed using Polyphen-2 and Provean software. RESULTS: Two mutations of the NF1 gene, including c.702G>A (synonymous mutation) and c.1733T>G (missense mutation), were discovered in the proband. Neither mutation was found in his parents and 50 healthy controls. Bioinformatics analysis indicated that the c.1733T>G mutation (p.Leu578Arg) was probably damaging. The affected codon L578 is highly conserved across various species. CONCLUSION The c.1733T>C mutation of the NF1 gene probably underlies the neurofibromatosis type I in this family.
Asian Continental Ancestry Group ; Genes, Neurofibromatosis 1 ; Humans ; Mutation ; Neurofibromatosis 1 ; genetics ; Neurofibromin 1 ; genetics ; Pedigree

Objective To explore the predictive value of artificial intelligence(AI)plaque quantitative analysis combined with CT derived fractional flow reserve(CT-FFR)and pericoronary fat attenuation index(FAI)in coronary heart disease(CHD)in Qinghai.Methods A total of 118 suspected CHD patients were selected,and were divided into a stenosis group(n=76)and a non-stenosis group(n=42)based on whether their vascular stenosis rate was＞50％.The plaque volume,load,CT-FFR value,and pericoronary FAI of the two groups were measured and compared,and their predictive value in CHD was further analyzed.Results The plaque total volume,calcified and non-calcified plaque volume,lipid plaque volume,and corresponding volume load of the stenosis group were significantly higher than those of the non-stenosis group(P＜0.05),the percentage of napkin ring sign and pericoronary FAI were significantly higher than those of the non-stenosis group,and the CT-FFR was significantly lower than that of the non-stenosis group(P＜0.05).Logistic regression analysis found that the volume load of calcified and lipid plaques,napkin ring sign,CT-FFR,and pericoronary FAI were independent risk factors for CHD(P＜0.05).The combination of AI plaque quantitative analysis,CT-FFR,and pericoronary FAI had high sensitivity and specificity,with high value in CHD diagnosis.Conclusion The combination of AI plaque quantitative analysis,CT-FFR,and pericoronary FAI has high value in the diagnosis of CHD,and may be worthy of clinical promotion application.

Objective To investigate the results of ambulatory electrocardiographic(ECG)monitoring in a community-based homebound elderly population and to explore the applicability of wearable long-range ambulatory ECG monitor for them.Methods Elderly volunteers were recruited in Shuangbei Community,Shapingba District,Chongqing,from November 2021 to June 2023.A single-lead wearable ambulatory ECG recorder was applied to them to obtain ECG for 7 consecutive days.The adverse reactions,acceptability,monitoring duration,and arrhythmia detection rate during the wearing were described and recorded.Serious arrhythmic events included frequent atrial premature,atrial flutter,atrial fibrillation(AF),frequent ventricular premature,and RR intervals ≥5 s.Results There were 416 individuals enrolled,with a mean age of 71.2±6.6 years,and a male percentage of 36.1％(150 men).Finally,384(92.3％)participants completed the wearing of the ECG monitor for 7 d,with an average time of 159.2±29.4 h.There were 179 participants(48.5％)reporting no discomfort during wearing,and 175 ones(47.4％)feeling itchy at the wearing site.The monitoring results showed that the common arrhythmias were atrial premature contractions(97.1％),premature ventricular contractions(93.3％),atrial tachycardia(84.6％),bradycardia(46.6％),frequent atrial premature contractions(15.1％),ventricular tachycardia(13.2％),and long RR interval(11.8％).Among them,29.1％of the participants experienced serious arrhythmic events,and the detection rate of certain serious arrhythmic events was comparatively higher in the individuals≥70 years of age and those with history of previous cardiac disease.Conclusion The detection rate of common arrhythmias is quite high in the community-based homebound elderly population.A 7-day long-range ambulatory ECG monitoring may be appropriate.