Objective To explore the effect of aortic valve neo-cuspidization (AVNeo) for patients with severe aortic valve lesions simultaneously. Methods Patients who underwent AVNeo combined valve repair surgery for multiple valve diseases were included in Beijing Anzhen Hospital from May 2016 to September 2023. Results We included 11 patients with 7 males and 4 females at a median age of 38 (36, 49) years. Rheumatic heart disease was found in 5 (45.5%) patients and non-rheumatic heart disease in 6 (54.5%) patients. The median EuroSCORE Ⅱ score was 1.62 (1.18, 1.75) points. Eight patients underwent AVNeo plus mitral and tricuspid valve repair, and 3 patients underwent AVNeo plus mitral valve repair. The median operative time was 356 (315, 415) min, and the median cardiopulmonary bypass time and aortic clamping time were 203 (174, 231) min and 168 (131, 188) min, respectively. In the early stage, 2 patients underwent combined valve repair surgery, and 1 patient underwent in-hospital reoperation for aortic valve replacement because of severe aortic regurgitation. There were 9 patients in the mature stage of AVNeo, and no perioperative adverse events or moderate or above residual valvular disease occurred. All patients recovered and were discharged from the hospital. The follow-up period was 3-99 months, and no reoperation, severe valve disease, bleeding, cerebral infarction, or other adverse events occurred in all patients. Conclusion For non-elderly patients whose mitral and tricuspid valves can be repaired successfully with severe aortic valve lesions, AVNeo can be attempted after proficiency. But the operation time and cardiopulmonary bypass time will inevitably be prolonged, and the patient's basic situation should be carefully evaluated before surgery.

Objective To compare the perioperative renal function changes in patients undergoing heart transplantation (HT) and left ventricular assist device (LVAD) implantation. Methods Patients with end-stage heart failure who underwent surgical treatment at Beijing Anzhen Hospital, Capital Medical University from January 2019 to April 2024 were included. According to the surgical method, patients were divided into a HT group and a LVAD group, and the estimated glomerular filtration rate (eGFR) of patients before surgery and postoperative 1, 7, 30, 60 days was compared between the two groups. The patients with preoperative renal dysfunction were subdivided into subgroups for comparison of eGFR changes before surgery and 30 days after surgery between the two groups. Results A total of 112 patients were enrolled. There were 78 patients in the HT group, including 61 males and 17 females, aged (44.42±18.51) years. There were 34 patients in the LVAD group, including 30 males and 4 females, aged (54.94±11.37) years. Compared with the HT group, the average age of patients in the LVAD group was greater (P<0.001), body mass index was higher (P=0.008), preoperative eGFR was lower (P=0.009), and the proportions of smokers (P=0.017), alcohol drinkers (P=0.041), and diabetes mellitus (P=0.028) patients were higher. Among patients with preoperative renal dysfunction [eGFR<90 mL/(min·1.73 m2)], compared with the HT group, the postoperative eGFR of the LVAD group was significantly higher than that of the HT group, and it was significantly increased compared with that before surgery; the postoperative eGFR of the HT group was comparable to that before surgery, and more than half of the patients had a lower eGFR than before surgery. Among patients with preoperative renal dysfunction, 11 patients in the HT group received continuous renal replacement therapy, and 8 died early; 2 patients in the LVAD group received continuous renal replacement therapy, and 1 died early. Conclusion For end-stage heart failure patients with combined renal dysfunction, compared with HT, LVAD implantation enables patients to obtain better renal function benefits.

In China, more than half of heart failure patients are ischemic heart failure patients. And a large proportion of left ventricular assist device implantation patients are also ischemic heart failure patients. However, left ventricular assist device implantation in ischemic heart failure patients is facing with problems such as patient screening, coronary artery disease, small left ventricle, mitral insufficiency, and ventricular aneurysm. There are only a few retrospective studies with small sample sizes abroad trying to provide solutions to these problems. While there is a lack of systematic understanding of this issue in China. Therefore, we provide an overview of the application and progress of left ventricular assist devices in ischemic heart failure patients, aiming to help clinicians have a comprehensive understanding of this issue and provide some guidance.

Bladder cancer （BCa） is the most common malignant tumor of the urinary system， and its incidence is increasing year by year. At present， for all patients with resectable non-metastatic muscle-invasive BCa， radical cystectomy + bilateral pelvic lymph node dissection is strongly recommended， but they still face the risk of recurrence， metastasis and death. In recent years， the proportion of patients with advanced and metastatic BCa is increasing among patients with newly diagnosed BCa. Although current treatment models are diverse， they often struggle to achieve significant efficacy due to their low effectiveness and adverse effects， resulting in low survival rates for patients with advanced and metastatic BCa. Therefore， the treatment of BCa still faces great challenges， and there is an urgent need to discover an effective new antitumor drug. With the improvement of medical standards， traditional Chinese medicine has shown great advantages in the treatment of BCa. Traditional Chinese medicine is mild and easy to accept， and can inhibit tumor progression through a multi-pathway， multi-way and multi-target manner， so as to exert its anticancer effect. Taraxaci Herba is a medicinal and food homologous plant， which has many biological activities， such as antibacterial， anti-inflammatory， anti-oxidation， anti-tumor， protecting liver and gallbladder， reducing blood sugar and enhancing immunity， and it has shown a clear anticancer effect in breast cancer， liver cancer， gastric cancer， tongue cancer and lung cancer. By reviewing previous studies worldwide， this article summarizes the mechanism of Taraxaci Herba extract in inducing autophagy and apoptosis， inhibiting cell migration and invasion， regulating cell cycle and proliferation， regulating cell metabolism， inhibiting tumor angiogenesis， combining the effects of chemotherapeutic drugs， and regulating the transduction of related signal pathways. On this basis， this study systematically elaborates on the potential mechanism of Taraxaci Herba against BCa， in order to provide a theoretical basis for the research and treatment of BCa.

Objective To explore the mechanism of melatonin(Mel)alleviating cholestatic liver injury in a mouse cholestasis model induced by cholic acid(CA)feeding.Methods A total of 15 8-week-old male C57BL/6J mice were randomly divided into control group,1％CA group,and 1％CA+Mel group,with 5 animals in each group.The control group was fed with normal chow diet,and the other 2 groups were fed with a diet containing 1％CA for 14 d to construct a model of cholestasis,and intraperitoneal injection with 100 mg/kg Mel was given to the mice from the 1％CA+Mel group.Immunohistochemical assay of α-SMA was applied for the liver tissues in the 1％CA group and the 1％CA+Mel group.The mRNA expression levels of fibrosis-related indicators in mouse liver tissue were examined by RT-qPCR.Liquid chromatography tandem mass spectrometry(LC-MS/MS)and automated biochemical analyzer were used to detect the contents of bile acids in the liver tissues and the serum of mouse,respectively.Then real-time qPCR and Western blotting were applied to detect the expression of bile acid synthesis and liver detoxification enzymes related indicators at mRNA and protein levels,respectively,to further investigate the mechanism of bile acid metabolism.Results Compared with the 1％CA group,the mRNA levels of liver fibrosis indicators(such as Tgfβ1,Col Ⅰ a1,Col Ⅱa1 and α-SMA)were significantly reduced(P＜0.05),and activation of stellate cells was obviously weakened displayed by immunohistochemical staining in the 1％CA+Mel group.The 1％CA+Mel group had notably decreased contents of bile acids in the serum and liver tissues,especially taurocholic acid and reduced mRNA levels of cholesterol 7α-hydroxylase(Cyp7a1)and Cyp8b1,while enhanced mRNA levels of hepatic detoxification enzymes Cyp2b10 and udp-glucuronosyltransferase(Ugt1a1)as well as protein levels of Cyp2b10 and sulfotransferase family 2A member 1(Sult2a1/2)when compared with the 1％CA group(P＜0.05).Conclusion Mel exerts its therapeutic effect on cholestasis by decreasing bile acid synthesis and increasing hepatic detoxification enzymes.

Objective:To assess the clinical value of helium-free magnetocardiography(MCG) in the diagnosis of coronary artery disease(CAD).Methods:A total of 213 patients with suspected CAD undergoing MCG in Beijing Anzhen Hospital were enrolled in the study. All patients underwent coronary CT angiography/invasive coronary angiography(CCTA/ICA) within 48 hours after MCG scanning. The parameters of MCG, including magnetic field multipolarization, magnetic field unipolarization, T-wave flattened, change in magnetic field distribution at TT segment, abnormal T-peak amplitude ration of maximum to minimum, significant movement of poles, magnetic field angle deviation and abnormal distribution of positive pole were used for the evaluation of the stenosis of coronary arteries.Results:Among 213 patients, MCG scanning was completed in 193 cases(90.6%), while 20 cases were excluded for various reasons. The CCTA/ICA results were taken as gold standard, the total coincidence rate of MCG with the degree of stenosis was 88.60%(95% CI: 83.25%-92.72%), the sensitivity and specificity of MCG in the diagnosis of CAD was 89.63%(95% CI: 83.21%-94.21%) and 88.23%(95% CI:78.12%-94.78%), respectively; the positive and negative predictive value were 93.80%(95% CI:88.72%-96.68%) and 81.08%(95% CI:72.15%-87.64%), respectively. Conclusion:MCG is highly accurate in the diagnosis of CAD, it may be widely used clinically as an non-invasive method free of radiation or contrast agent.

Objective:To explore the risk factors of ischemic stroke after coronary artery bypass grafting(CABG) in elderly(≥75 years old)patients, establish a risk prediction model and evaluate it.Methods:From January 2015 to September 2021, a total of 1 553 elderly patients with coronary artery disease who were admitted to Beijing Anzhen Hospital for coronary artery bypass grafting were included retrospectively. Among which 1 121(72%) cases were males, with a median age of 77( IQR 75, 78) years. Clinical data were collected and univariate analysis and multiple logistic regression analysis were used to explore the risk factors of ischemic stroke after CABG in elderly patients. After the establishment of risk prediction model, we constructed the nomogram, and tested the discrimination and calibration of the model. Results:All patients underwent CABG, there were 35 patients with ischemic stroke after operation, with an incidence of 2.25%(35/1 553). Multivariate logistic regression analysis showed that diabetes( OR=2.61, 95% CI: 1.31-5.32), old myocardial infarction( OR=3.62, 95% CI: 1.61-7.63), systolic blood pressure( OR=1.03, 95% CI: 1.01-1.04) and vertebral artery stenosis( OR=1.01, 95% CI: 1.00-1.02) were independent risk factors for postoperative cerebral infarction in patients undergoing CABG. The model was presented by a nomogram, and the model discrimination was evaluated by ROC curve. The area under the curve( AUC) was 0.757, indicating a optimal discrimination. Hosmer- Lemeshow test of goodness of fit was performed to evaluate the model calibration( χ2=6.209, P=0.624). Conclusion:Diabetes mellitus, old myocardial infarction, systolic blood pressure and vertebral artery stenosis are independent risk factors for ischemic stroke in elderly patients after CABG. The established risk prediction model has optimal discrimination and calibration.

We report a fetus presented with complex cardiac malformations, pulmonary atresia with ventricular septal defect, detected by fetal echocardiography at 17 +4 weeks. The pregnancy was terminated after routine counseling and genetic tests were performed on umbilical cord of the induced fetus and peripheral blood samples of the parents. Whole-exome sequencing identified a novel maternally-inherited and likely pathogenic variation hemizygous nonsense variant, c.1651C>T (p.Gln551*) in the OTUD5 gene (NM_017602.3), which was confirmed by subsequent Sanger sequencing. The fetus was finally diagnosed as X-linked multiple congenital anomalies-neurodevelopmental syndrome.

The end of the COVID-19 infection peak in 2022 prompts a backlog of cardiovascular surgical patients to gradually return to the hospital, resulting in a surge in cardiovascular surgeries. However, against the backdrop of the COVID-19 pandemic, the clinical practice of cardiovascular surgery faces many problems. Therefore, organized by Beijing Anzhen Hospital, experts in cardiovascular surgery and related fields have formulated hospital expert experience on perioperative treatment principles of cardiovascular surgery for patients infected with COVID-19. This article summarizes the clinical decision-making of patients requiring cardiovascular surgery after COVID-19 infection, and advises on the corresponding recommendations according to the existing evidence-based medical evidence as well as the actual clinical practice experience of relevant experts. The main content of the article includes special requirements for cardiovascular surgical treatment indications in patients with COVID-19 infection, selection of surgical timing, special requirements of preoperative, intraoperative and postoperative management, etc., which aims to provide COVID-19-infected patients with guidance on rational decision-making when receiving cardiovascular surgery.

As a global disease, heart failure affects at least 26 million people, and its prevalence is still rising. Besides, the mortality rate and readmission rate remain high. Advanced heart failure is the terminal stage of various heart diseases, and often requires some treatments other than drug intervention, such as heart transplantation which is the gold standard for treatment of heart failure. However, limited by the number of donors, the number of heart transplants in the world has reached a bottleneck. There is a huge gap between the number of patients who need heart transplants and patients who get hearts for survival successfully in reality. With the exploration and development of mechanical circulation support devices for more than half a century, they have become a wonderful treatment for patients with advanced heart failure. This article will introduce the latest progress of mechanical circulatory support devices at home and abroad from the aspects of temporary and long-term devices.