Objective:Committee of Minimally Invasive Cardiovascular Surgery(CMICS) conducts an annual summary of minimally invasive cardiovascular surgery procedures performed throughout the country, which includes a comprehensive survey of the total number of minimally invasive procedures by region and the distribution of minimally invasive procedures by hospital. Since CMICS first published the 2018-2019 China Minimally Invasive Cardiovascular Surgery Data White Paper in 2020, the report has received great attention from peers within and outside the industry. In this statistical report, CMICS will focus on publishing the data related to minimally invasive cardiovascular surgery in China from 2021 to 2023 for reference and use by industry peers.

Objective:To investigate the correlation of serum interleukin-6 (IL-6) and homocysteine (Hcy) levels, monocyte-to-lymphocyte ratio (MLR), and serum lipid levels [triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels] with ulcerative colitis.Methods:The clinical data of 98 patients with ulcerative colitis admitted to Bayannur Hospital from November 2021 to November 2023 (observation group) were retrospectively analyzed. Forty-nine healthy individuals who were selected at a 2:1 ratio during the same period were included in the control group. Serum IL-6 and Hcy levels, MLR, and lipid levels were compared between the two groups. The diagnostic efficacy of serum IL-6, Hcy, MLR, and lipid levels for ulcerative colitis was assessed using receiver operating characteristic (ROC) curves. Additionally, Pearson correlation analysis was conducted to analyze correlation of serum IL-6 and Hcy levels, MLR, and lipid levels with ulcerative colitis.Results:In the observation group, serum IL-6 and Hcy levels and MLR were (39.87 ± 12.36) pg/mL, (13.01 ± 3.52) μmol/L, and (0.38 ± 0.12), respectively, all of which were significantly higher than those in the control group [(22.3 ± 3.26) pg/mL, (10.05 ± 3.26) μmol/L, (0.29 ± 0.08), t = 9.77, 4.92, 4.78, all P < 0.05]. In the observation group, serum levels of TG, TC, LDL-C, and HDL-C levels were (1.16 ± 0.32) mmol/L, (4.12 ± 1.15) mmol/L, (2.60 ± 0.75) mmol/L, and (1.02 ± 0.17) mmol/L, respectively, all of which were significantly lower than those in the control group [(1.45 ± 0.41) mmol/L, (4.91 ± 0.99) mmol/L, (3.20 ± 0.71) mmol/L, (1.13 ± 0.16) mmol/L, t = 4.71, 4.11, 4.65, 3.77, all P < 0.05]. ROC curve analysis indicated that the areas under the curve (AUC) for diagnosing ulcerative colitis based on serum levels of IL-6, Hcy, MLR, TG, TC, LDL-C, and HDL-C were 0.957, 0.749, 0.746, 0.732, 0.678, 0.722, and 0.681, respectively. Pearson correlation analysis showed that serum levels of IL-6, Hcy, MLR, TG, TC, LDL-C, and HDL-C were all correlated with the severity of ulcerative colitis in patients ( r = 0.501, 0.615, 0.605, -0.577, -0.542, -0.548, -0.646, all P < 0.05). Additionally, serum levels of IL-6, Hcy, and MLR were negatively correlated with lipid levels ( r = -0.806, -0.801, -0.791, -0.649, -0.728, -0.671, -0.720, -0.655, -0.857, -0.877, -0.889, -0.583, all P < 0.05). Conclusions:In patients with ulcerative colitis, serum levels of IL-6, Hcy, and MLR are elevated, while lipid levels are decreased. Additionally, serum levels of IL-6, Hcy, MLR, and lipid levels are associated with the severity of the disease. There is also a correlation between serum levels of IL-6, Hcy, MLR, and lipid levels.

Objective:To explore the distribution and determinants of abnormal blood lipid metabolism among flying personnel with lumbar disc herniation and with different flying hours and to provide data for targeted intervention strategies.Methods:The hospitalization data of 214 male flying personnel was retrospectively analyzed who were admitted to the Air Force Medical Center between September 2020 and September 2023, diagnosed with lumbar intervertebral disc protrusion, and underwent blood lipid testing within 24 h of admission. According to the hours of flying, they were divided into <1 000 h group (45 cases), 1 000-<3 000 h group (107 cases), and ≥3 000 h group (62 cases). The blood lipid biochemical indicators [total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C)], basic information and personal history of the flying personnel were collected. The detection rates of blood lipid metabolism disorders among flying personnel with different durations of flight were compared. The chi-square test for linear trend was used to find out whether there was a trend of linear changes in the detection rates of various blood lipid disorders. The multivariate Logistic regression analysis was conducted to analyze the determinants of abnormal blood lipid metabolism.Results:There were significant differences in age, levels of total cholesterol and low-density lipoprotein cholesterol, and non-HDL-C between flying personnel in different flying hours groups ( F=80.76, 4.67, 4.00, 6.35, P<0.001,=0.010, 0.020, 0.002). The levels of total cholesterol and low-density lipoprotein cholesterol, and non-HDL-C in the 1 000-<3 000 h group were higher than those in the <1 000 h group ( P=0.023, 0.029, 0.003). The total detection rate of elevated triglyceride was the highest (28.04%). There was a significant difference in the detection rate of elevated low-density lipoprotein cholesterol between the 3 groups ( χ2=6.50, P=0.039), which was lower in the 1 000-<3 000 h group than in the <1 000 h group ( P=0.010). The results of the chi-square analysis of linear association showed that with the increase of flight duration, there was a linear decrease in the detection rates of elevated total cholesterol and elevated non-HDL-C ( χ2=4.17, 4.16, P=0.041, 0.041). The univariate Logistic regression analysis showed that compared with the <1 000 h, the 1 000-<3 000 h was an influencing factor for elevated triglyceride ( OR=4.406, 95% CI: 1.604-12.103) and elevated non-HDL-C ( OR=6.217, 95% CI: 1.403-27.551) while body mass index was an influencing factor for elevated total cholesterol ( OR=1.237, 95% CI: 1.055-1.450) and elevated non-HDL-C ( OR=1.298, 95% CI: 1.087-1.548). Current smoking was an influencing factor for elevated triglyceride ( OR=3.214, 95% CI:1.700-6.078) and decreased high-density lipoprotein cholesterol ( OR=3.200, 95% CI: 1.724-5.941). The multivariate Logistic regression analysis showed that body mass index was a risk factor for elevated total cholesterol ( OR=1.245, 95% CI: 1.054-1.471) and elevated non-HDL-C ( OR=1.301, 95% CI: 1.082-1.564). Current smoking was a risk factor for elevated triglyceride ( OR=3.439, 95% CI: 1.550-7.631) and decreased high-density lipoprotein cholesterol ( OR=4.047, 95% CI: 1.901-8.729). Conclusions:Flying personnel with lumbar intervertebral disc protrusion and with different flying hours exhibit distinct features of phased blood lipid metabolism disorders. The triglyceride levels of those with 1 000-<3 000 h deserve more attention while the levels of low-density lipoprotein cholesterol should be brought under control for those with <1 000 h. It is recommended that hierarchical interventions be exercised according to flight stages, and that priority be given to controlling daily adjustable behavioral factors such as body mass index and smoking.

Gastric cancer (GC) is characterized by high morbidity and mortality rates. Chinese agarwood comprises the resin-containing wood of Aquilaria sinensis (Lour.) Gilg., traditionally utilized for treating asthma, cardiac ischemia, and tumors. However, comprehensive research regarding its anti-GC effects and underlying mechanisms remains limited. In this study, Chinese agarwood petroleum ether extract (CAPEE) demonstrated potent cytotoxicity against human GC cells, with half maximal inhibitory concentration (IC₅₀) values for AGS, HGC27, and MGC803 cells of 2.89, 2.46, and 2.37 μg·mL^-1, respectively, at 48 h. CAPEE significantly induced apoptosis in these GC cells, with B-cell lymphoma-2 (BCL-2) associated X protein (BAX)/BCL-2 antagonist killer 1 (BAK) likely mediating CAPEE-induced apoptosis. Furthermore, CAPEE induced G₀/G₁ phase cell cycle arrest in human GC cells via activation of the deoxyribonucleic acid (DNA) damage-p21-cyclin D1/cyclin-dependent kinase 4 (CDK4) signaling axis, and increased Fe²⁺, lipid peroxides and reactive oxygen species (ROS) levels, thereby inducing ferroptosis. Ribonucleic acid (RNA) sequencing, real-time quantitative polymerase chain reaction (RT-qPCR), and Western blotting analyses revealed CAPEE-mediated upregulation of heme oxygenase-1 (HO-1) in human GC cells. RNA interference studies demonstrated that HO-1 knockdown reduced CAPEE sensitivity and inhibited CAPEE-induced ferroptosis in human GC cells. Additionally, CAPEE administration exhibited robust in vivo anti-GC activity without significant toxicity in nude mice while inhibiting tumor cell growth and promoting apoptosis in tumor tissues. These findings indicate that CAPEE suppresses human GC cell growth through upregulation of the DNA damage-p21-cyclin D1/CDK4 signaling axis and HO-1-mediated ferroptosis, suggesting its potential as a candidate drug for GC treatment.
Animals ; Humans ; Mice ; Antineoplastic Agents, Phytogenic ; Apoptosis/drug effects* ; Cell Line, Tumor ; Cyclin D1/genetics* ; Cyclin-Dependent Kinase 4/genetics* ; DNA Damage/drug effects* ; Drugs, Chinese Herbal/pharmacology* ; Ferroptosis/drug effects* ; G1 Phase Cell Cycle Checkpoints/drug effects* ; Heme Oxygenase-1/genetics* ; Mice, Inbred BALB C ; Mice, Nude ; Plant Extracts/pharmacology* ; Stomach Neoplasms/physiopathology* ; Thymelaeaceae/chemistry* ; Up-Regulation/drug effects*

Objective:To investigate the prognostic value and safety of thoracic radiotherapy in patients with synchronous oligometastatic, driver gene-negative non-small cell lung cancer (NSCLC) receiving immune checkpoint inhibitors (ICIs) as first-line treatment.Methods:Data were retrospectively collected from 55 patients diagnosed with synchronous oligometastatic, driver gene-negative NSCLC who received first-line ICIs from January 2017 to March 2022. These patients were categorized into two groups based on the administration of thoracic radiotherapy: the thoracic radiotherapy group ( n = 27) and the non-thoracic radiotherapy group ( n = 28). Comparative analyses were conducted to evaluate survival outcomes and safety profiles between the two groups. Results:Among the 55 patients, 27 (49.1%) received thoracic radiotherapy. The median follow-up time was 37.0 months (2.2-76.7 months). Patients in the thoracic radiotherapy group exhibited significantly improved median overall survival (OS: 53.4 vs. 21.3 months, P = 0.049) and median progression-free survival (PFS: 13.6 vs. 8.3 months, χ2=4.11, P = 0.043) compared to those in the non-thoracic radiotherapy group. Multivariate Cox regression analysis identified thoracic radiotherapy as an independent prognostic factor for OS ( HR = 0.39, 95% CI: 0.17-0.90, P = 0.027) and PFS ( HR = 0.53, 95% CI: 0.28-0.99, P = 0.046). The most common grade 3 or higher toxicity was bone marrow suppression, occurring in seven patients (12.7%). There was no significant difference between both groups in the incidence of grade 3 or higher treatment-related adverse events, including pneumonitis. Conclusion:In patients with driver gene-negative, synchronous oligometastatic NSCLC, first-line immunotherapy combined with thoracic radiotherapy may improve survival outcomes without increasing the incidence of severe treatment-related adverse events. Further large-scale, randomized prospective trials are needed to verify the findings of this study.

AIM:To investigate the role and mechanism of cell death-inducing DNA fragmentation factor al-pha(DFFA)-like effector B(Cideb)in promoting palmitic acid(PA)-induced lipid deposition in human hepatoblastoma HepG2 cells.METHODS:The HepG2 cells were divided into control group,model group,negative control silencing(siR-NC)group and Cideb silencing(siR-Cideb)group.The cells were treated with PA to establish a cellular model of lipid deposition.Specific siRNAs were used to silence the expression of Cideb,and the intracellular lipid content was mea-sured.Lipid deposition was observed by oil red O staining.RT-qPCR and Western blot were used to detect the expression levels of Cideb,sterol regulatory element-binding protein 1c(SREBP1c),acetyl-CoA carboxylase 1(ACC1),fatty acid synthase(FAS),stearoyl-CoA desaturase 1(SCD1)and AMP-activated protein kinase α(AMPKα)in the cells.The ef-fects of Cideb overexpression on HepG2 cells were observed by transfection with a Cideb eukaryotic expression plasmid.RESULTS:Compared with control group,the cells in PA model group presented lipid deposition,significantly increased triglyceride(TG)and total cholesterol(TC)content,elevated expression levels of Cideb,SREBP1c,ACC,FAS and SCD1,and decreased expression of AMPKα(P＜0.05).Compared with siR-NC group,the cells in siR-Cideb group pre-sented decreased lipid deposition,reduced intracellular TG and TC content,decreased SREBP1c,ACC,FAS and SCD1 expression levels,and increased AMPKα expression(P＜0.05).The overexpression of Cideb increased the lipid deposi-tion,TG and TC content,and the expression levels of SREBP1c,ACC,FAS and SCD1 in HepG2 cells,but decreased the expression of AMPKα(P＜0.05).CONCLUSION:Reduction of Cideb alleviates PA-induced lipid deposition in HepG2 cells by down-regulating the SREBP1c/ACC/FAS/SCD1 pathway and up-regulating the AMPKα pathway.

Objective:To explore the distribution and determinants of abnormal blood lipid metabolism among flying personnel with lumbar disc herniation and with different flying hours and to provide data for targeted intervention strategies.Methods:The hospitalization data of 214 male flying personnel was retrospectively analyzed who were admitted to the Air Force Medical Center between September 2020 and September 2023, diagnosed with lumbar intervertebral disc protrusion, and underwent blood lipid testing within 24 h of admission. According to the hours of flying, they were divided into <1 000 h group (45 cases), 1 000-<3 000 h group (107 cases), and ≥3 000 h group (62 cases). The blood lipid biochemical indicators [total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C)], basic information and personal history of the flying personnel were collected. The detection rates of blood lipid metabolism disorders among flying personnel with different durations of flight were compared. The chi-square test for linear trend was used to find out whether there was a trend of linear changes in the detection rates of various blood lipid disorders. The multivariate Logistic regression analysis was conducted to analyze the determinants of abnormal blood lipid metabolism.Results:There were significant differences in age, levels of total cholesterol and low-density lipoprotein cholesterol, and non-HDL-C between flying personnel in different flying hours groups ( F=80.76, 4.67, 4.00, 6.35, P<0.001,=0.010, 0.020, 0.002). The levels of total cholesterol and low-density lipoprotein cholesterol, and non-HDL-C in the 1 000-<3 000 h group were higher than those in the <1 000 h group ( P=0.023, 0.029, 0.003). The total detection rate of elevated triglyceride was the highest (28.04%). There was a significant difference in the detection rate of elevated low-density lipoprotein cholesterol between the 3 groups ( χ2=6.50, P=0.039), which was lower in the 1 000-<3 000 h group than in the <1 000 h group ( P=0.010). The results of the chi-square analysis of linear association showed that with the increase of flight duration, there was a linear decrease in the detection rates of elevated total cholesterol and elevated non-HDL-C ( χ2=4.17, 4.16, P=0.041, 0.041). The univariate Logistic regression analysis showed that compared with the <1 000 h, the 1 000-<3 000 h was an influencing factor for elevated triglyceride ( OR=4.406, 95% CI: 1.604-12.103) and elevated non-HDL-C ( OR=6.217, 95% CI: 1.403-27.551) while body mass index was an influencing factor for elevated total cholesterol ( OR=1.237, 95% CI: 1.055-1.450) and elevated non-HDL-C ( OR=1.298, 95% CI: 1.087-1.548). Current smoking was an influencing factor for elevated triglyceride ( OR=3.214, 95% CI:1.700-6.078) and decreased high-density lipoprotein cholesterol ( OR=3.200, 95% CI: 1.724-5.941). The multivariate Logistic regression analysis showed that body mass index was a risk factor for elevated total cholesterol ( OR=1.245, 95% CI: 1.054-1.471) and elevated non-HDL-C ( OR=1.301, 95% CI: 1.082-1.564). Current smoking was a risk factor for elevated triglyceride ( OR=3.439, 95% CI: 1.550-7.631) and decreased high-density lipoprotein cholesterol ( OR=4.047, 95% CI: 1.901-8.729). Conclusions:Flying personnel with lumbar intervertebral disc protrusion and with different flying hours exhibit distinct features of phased blood lipid metabolism disorders. The triglyceride levels of those with 1 000-<3 000 h deserve more attention while the levels of low-density lipoprotein cholesterol should be brought under control for those with <1 000 h. It is recommended that hierarchical interventions be exercised according to flight stages, and that priority be given to controlling daily adjustable behavioral factors such as body mass index and smoking.

Objective:To examine the safety and effectiveness of a novel domestic transcatheter aortic valve system in addressing severe aortic valve stenosis.Methods:This prospective, multicenter, single-arm target-value clinical trial enrolled patients with severe aortic stenosis meeting inclusion criteria from 13 Chinese centers between July 2021 and April 2022. The primary endpoint was all-cause mortality at 1-year post-procedure. Secondary endpoints included safety outcomes (30-day all-cause mortality, 1-year major adverse cardiovascular events, device success) and efficacy parameters (transvalvular pressure gradient, paravalvular leak severity, New York Heart Association(NYHA)class improvement, and quality of life). Survival analysis was performed using the Kaplan-Meier analysis.Results:The study included 134 patients, 85 males and 49 females, with an age of (73.6±5.6)years (range: 65.1 to 91.8 years). Bicuspid aortic valve morphology was present in 59.7% (80/134). Device success rate was 99.3%, with one case converted to open surgery due to coronary obstruction. All-cause mortality was 0.8% (95% CI: 0.1% to 5.3%) at both 30-day and 1-year follow-up, significantly lower than the 25% target value ( P<0.01). Permanent pacemaker implantation rates remained 2.2% (3/134) at both timepoints. Stroke incidence was 0.7% (1/134) at 30 days and 1.5% (2/134) at 1 year. Myocardial infarction rates were 0.7% (1/134) at both intervals. The postoperative transvalvular pressure gradient of the aortic valve was (6.6±3.1) mmHg(1 mmHg=0.133 kPa) (range: 4 to 8 mmHg). Among the patients, 32 cases (23.9%) had mild paravalvular leakage, 4 cases (3.0%) had moderate paravalvular leakage, and no severe paravalvular leakage was observed. NYHA class Ⅰ and Ⅱ patients increased from 18.7% preoperatively to 99.3% postoperatively. Conclusion:The novel domestic transcatheter aortic valve system demonstrates satisfactory 1-year safety and efficacy outcomes in treating severe aortic stenosis.

Objective:To investigate the role of RNA helicase DDX5 in renal interstitial fibrosis and its potential mechanism, and provide possible molecular target for the diagnosis and treatment of renal interstitial fibrosis.Methods:The animal and cell models of unilateral ureteral obstruction (UUO) and DDX5-pharmacological and genetic blocking were established. Twenty-four male mice aged 6-8 weeks and weighting about 18-22 g were divided into sham operation group, UUO group, sham operation+RX5902 group and UUO+RX5902 group by random number table method, with 6 mice in each group. Supinoxin (RX5902, a phosphorylated DDX5 inhibitor, 75 mg/kg) was administered by gavage in mice in the sham operation+RX5902 group and UUO+RX5902 group on day 0 and day 3 after the operation, respectively. The mice were sacrificed to collect kidney specimens one week after the surgery. The human renal tubular epithelial cell line (HK-2 cells) was routinely cultured and divided into control group, scramble siRNA group, DDX5 siRNA group, TGF-β1 group, scramble siRNA+TGF-β1 group and DDX5 siRNA +TGF-β1 group. The dosage of RX5902 was 20 nmol/L, and the dosage of transforming growth factor-β1 (TGF-β1) was 10 ng/ml. HE staining and Masson staining were used to evaluate renal tubule injury and collagen fiber deposition. Western blotting, immunofluorescence and immunohistochemistry were used to detect the protein expression levels of DDX5 and fibrosis-related indexes such as fibronectin and α-smooth muscle actin (α-SMA). The flow cytometry was used to detect the cell cycle. Results:In comparison to sham operation group, UUO group exhibited significantly elevated protein expression levels of fibronectin, α-SMA and DDX5 in kidney tissues (all P<0.05), accompanied by notable nuclear translocation of DDX5. TGF-β1 stimulation facilitated the upregulation of fibronectin, α-SMA, and DDX5 expression, as well as DDX5 nuclear translocation in HK-2 cells (all P<0.05). Pharmacological and genetic inhibition of DDX5 attenuated UUO or TGF-β1-induced elevated protein levels of fibronectin and α-SMA. Compared with scramble siRNA+TGF-β1 group, DDX5 siRNA+TGF-β1 group exhibited reduced protein expression levels of fibronectin, α-SMA and DDX5 in HK-2 cells (all P<0.05). Compared with UUO group, UUO+RX5902 group showed alleviation of renal epithelial cell exfoliation, renal tubule atrophy or lumen dilation and decreased scores of both tubular injury and interstitial collagen deposition, along with reduced protein expression levels of fibronectin, α-SMA and DDX5 (all P<0.05). Similarly, RX5902 inhibited TGF-β1-induced fibrotic responses in HK-2 cells (all P<0.05). Flow cytometry analysis results revealed that TGF-β1 stimulation resulted in a significant increase in the proportion of HK-2 cells in the G2/M phase. Conversely, silencing of DDX5 led to a significant reduction in the proportion of HK-2 cells in the G2/M phase (all P<0.05). Conclusions:DDX5 is significantly elevated in the renal tissues of UUO mice and TGF-β1-induced HK-2 cells. The pharmacological and genetic blockade of DDX5 can delay renal fibrosis by reducing cell cycle arrest and alleviating cell damage.

Objective:Committee of Minimally Invasive Cardiovascular Surgery(CMICS) conducts an annual summary of minimally invasive cardiovascular surgery procedures performed throughout the country, which includes a comprehensive survey of the total number of minimally invasive procedures by region and the distribution of minimally invasive procedures by hospital. Since CMICS first published the 2018-2019 China Minimally Invasive Cardiovascular Surgery Data White Paper in 2020, the report has received great attention from peers within and outside the industry. In this statistical report, CMICS will focus on publishing the data related to minimally invasive cardiovascular surgery in China from 2021 to 2023 for reference and use by industry peers.