Objective To systematically analyze the characteristics of the disease burden of hypertensive heart disease (HHD) in the elderly (≥60 years) globally and in China from 1990 to 2021, and to predict its future trends from 2022 to 2040, with the aim of providing data support for optimizing comprehensive prevention and control strategies for HHD. Methods Based on the Global Burden of Disease (GBD) 2021 database, the number of prevalent cases and disability-adjusted life years (DALYs) of HHD in the elderly were extracted for the world, China, and five regions categorized by sociodemographic index (SDI). Joinpoint regression was used to analyze the temporal trends of age-standardized prevalence rate and age-standardized DALYs rate of HHD in the elderly. A three-factor decomposition method was applied to evaluate the relative contributions of aging, population growth, and epidemiological changes to the variations in the elderly HHD burden. Additionally, a Bayesian age-period-cohort model was used to predict the elderly HHD burden from 2022 to 2040. Results In 2021, the number of prevalent elderly HHD cases reached 10 283 000 globally and 3 412 400 in China, representing increases of 179.20% and 159.20% respectively, compared with 1990. The DALYs of elderly HHD were 18 812 700 person-years globally and 4 731 400 person-years in China, rising by 76.08% and 29.45% respectively from 1990. Meanwhile, the growth rates of the number of prevalent cases and DALYs of elderly HHD varied across different SDI regions. From 1990 to 2021, the age-standardized prevalence rate of elderly HHD in China, as well as the age-standardized DALYs rate of elderly HHD both globally and in China, showed significant downward trends (all average annual percentage changes<0, all P<0.001). In 2021, the 70-74 years age group accounted for the highest proportion of prevalent cases and DALYs of elderly HHD, both globally and in China. Decomposition analysis revealed that population growth was the dominant factor driving the increase in the elderly HHD burden across all regions. The prediction model results indicated that the number of prevalent cases and DALYs of elderly HHD would continue to rise globally and in China from 2022 to 2040, with the growth rate of the elderly HHD burden in China between 2021 and 2040 expected to exceed the global average. Conclusion Over the past 32 years, although the age-standardized disease rates of elderly HHD have mainly shown a downward trend globally and in China, the absolute number of the disease burden has increased substantially. The projection model indicates a continued upward trajectory, with the growth rate in China higher than the global average. Therefore, there is an urgent need to implement precise prevention and control strategies to effectively mitigate the disease burden of elderly HHD.

ObjectiveTo explore the effect of cluster scalp acupuncture combined with Taijiquan training on depressive symptom, motor function, activities of daily living, serum markers, as well as brain functional connectivity (FC) and network topological properties in patients with post-stroke depression (PSD). MethodsA total of 40 PSD patients in the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from September, 2022 to September, 2023 were enrolled and randomly divided into control group (n = 20) and experimental group (n = 20). The control group received cluster scalp acupuncture alone, while the experimental group underwent Taijiquan training in addition, for four weeks. They were assessed with Hamilton Depression Scale-17 (HAMD-17), Fugl-Meyer Assessment (FMA) and Barthel Index (BI) before and after treatment, while the serum levels of dopamine (DA), 5-hydroxytryptamine (5-HT), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected with enzyme-linked immunosorbent assay. Resting-state functional magnetic resonance imaging (rs-fMRI) was applied to assess brain FC, as well as the global efficiency (Eg) and small-world property (σ) of brain networks. ResultsThe scores of HAMD-17, FMA and BI improved in both groups (t > 2.922, P < 0.01) after treatment, and improved more in the experimental group than in the control group (t > 2.517, P < 0.05). The serum levels of DA and 5-HT increased in both groups (t > 2.637, P < 0.05), and increased more in the experimental group (t > 2.192, P < 0.05). The serum levels of IL-6 and TNF-α decreased in the experimental group after treatment (t > 4.059, P < 0.001), and they were less than those in the control group (t > 2.154, P < 0.05). FC between left middle frontal gyrus and right anterior cingulate gyrus, as well as between left hippocampus and right precuneus were higher in the experimental group than in the control group after treatment (t > 3.867, P < 0.001), while Eg and σ increased in both groups (t > 2.828, P < 0.05), and they were higher in the experimental group (t > 2.675, P < 0.05). ConclusionCombination of Taijiquan training is more effective on depressive symptoms, motor function and activities of daily living in PSD patients, which may be related to up-regulation of serum DA and 5-HT, reduction of inflammatory factors, enhancement of prefrontal-limbic system functional connectivity and optimization of brain network topological properties.

Umbilical cord inflammatory myofibroblastic tumor is rare. This article reports a case of a male patient admitted to the hospital due to “difficulty in urination for 1 month”. Physical examination revealed a soft abdomen without tenderness or rebound tenderness in the bladder area，and no abnormal masses were palpated. CT imaging showed a cord-like structure connecting to the mass and extending towards the umbilicus，leading to the anatomical localization diagnosis of an umbilical cord origin. The ring-like enhancement of the tumor capsule was its radiological feature. After completing preoperative preparations，the patient underwent laparoscopic umbilical cord tumor resection and transurethral bladder lesion resection under general anesthesia. During the operation，the bladder was filled with fluid，and a localized mucosal protrusion measuring 3.0 cm × 3.0 cm was observed at the bladder dome. The tumor margin was identified with the guidance of the cystoscope light beam. The bladder tissue was incised layer by layer from the outside to the inside under laparoscopy，and the bladder wall was incised 2 cm away from the tumor margin. After the bladder mucosa was exposed，the bladder was emptied，and the tumor was completely resected. This surgical approach ensured negative surgical margins while maximizing the preservation of bladder tissue. The postoperative pathology indicated inflammatory myofibroblastic tumor of the urachus，with no recurrence observed during a 4-month follow-up.

Umbilical cord inflammatory myofibroblastic tumor is rare. This article reports a case of a male patient admitted to the hospital due to “difficulty in urination for 1 month”. Physical examination revealed a soft abdomen without tenderness or rebound tenderness in the bladder area，and no abnormal masses were palpated. CT imaging showed a cord-like structure connecting to the mass and extending towards the umbilicus，leading to the anatomical localization diagnosis of an umbilical cord origin. The ring-like enhancement of the tumor capsule was its radiological feature. After completing preoperative preparations，the patient underwent laparoscopic umbilical cord tumor resection and transurethral bladder lesion resection under general anesthesia. During the operation，the bladder was filled with fluid，and a localized mucosal protrusion measuring 3.0 cm × 3.0 cm was observed at the bladder dome. The tumor margin was identified with the guidance of the cystoscope light beam. The bladder tissue was incised layer by layer from the outside to the inside under laparoscopy，and the bladder wall was incised 2 cm away from the tumor margin. After the bladder mucosa was exposed，the bladder was emptied，and the tumor was completely resected. This surgical approach ensured negative surgical margins while maximizing the preservation of bladder tissue. The postoperative pathology indicated inflammatory myofibroblastic tumor of the urachus，with no recurrence observed during a 4-month follow-up.

Objective    To study the relationship between preoperative heart rate variability (HRV) and postoperative atrial fibrillation (POAF) after off-pump coronary artery bypass grafting (OPCAB). Methods    A retrospective analysis was performed on the clinical data of 290 patients who were admitted to the Department of Cardiovascular Surgery, General Hospital of Northern Theater Command from May to September 2020 and received OPCAB. There were 217 males and 73 females aged 36-80 years. According to the incidence of POAF, the patients were divided into two groups: a non-atrial fibrillation group (208 patients) and an atrial fibrillation group (82 patients). The time domain and frequency domain factors of mean HRV 7 days before operation were calculated: standard deviation of all normal-to-normal intervals (SDNN), root mean square of successive differences, percentage difference between adjacent normal-to-normal intervals that were greater than 50 ms, low frequency power (LF), high frequency power (HF), LF/HF. Results    The HRV value of patients without POAF was significantly lower than that of patients with POAF (P<0.05). The median SDNN of the two groups were 78.90 ms and 91.55 ms, respectively. Age (OR=3.630, 95%CI 2.015-6.542, P<0.001), left atrial diameter (OR=1.074, 95%CI 1.000-1.155, P=0.046), and SDNN (OR=1.017, 95%CI 1.002-1.032, P=0.024) were independently associated with the risk of POPAF after OPCAB. Conclusion     SDNN may be an independent predictor of POAF after OPCAB.

Objective:To evaluate the long-term results of bipolar radiofrequency(BRF) ablation in restoring sinus rhythm in patients with permanent atrial fibrillation(AF) undergoing surgery for cardiac surgery.Methods:This retrospective study sample consisted of 268 patients with LSP-AF underwent cardiac operations concomitant BRF maze Ⅳ procedure. Data were collected prospectively on perioperative outcomes, rhythm status, survival, and clinical events.Results:15 patients died in the early postoperative period, perioperative mortality rate was 5.5%. The rate of stable sinus rhythm(sSR)was 86.6%, 75.4%, 67.7%, 57.8% in 1, 2, 5, 8 years after operation. Multivariate analysis proved the size of the left atrium( HR=1.073, P<0.001) and duration of AF( HR=1.070, P=0.025) to be an independent predictor of the radiofrequency ablation outcome. Conclusion:Bipolar radiofrequency maze procedure can effectively eliminate AF, maintain long-term of sinus rhythm. Bipolar radiofrequency maze procedure is a safe, easy and effective surgical option for the treatment of AF, with satisfactory long-term results, is worthy of promotion.

Objective:To evaluate the long-term results of combined ganglion plexus ablation(GPA) during radiofrequency ablation(RF) with long-standing persistent atrial fibrillation(LSP-AF).Methods:This retrospective study sample consisted of 268 patients with LSP-AF underwent valve operations concomitant RF maze Ⅳ procedure. Data were collected prospectively on perioperative outcomes, rhythm status, survival, and clinical events. Propensity score matching conducted by RF and RF+ GPA resulted in 102 patients per group.Results:Independent predictors for rhythm success at 1 year were combined GPA( OR=0.205, P=0.005), smaller left atrium size( OR=1.091, P=0.000); at 5-year and 8-year were a shorter history of AF( OR=1.069, P=0.023; OR=1.066, P=0.030), and smaller left atrium size( OR=1.091, P=0.000; OR=1.086, P=0.000). After matching, RF+ GPA group had significantly higher sinus rhythm(SR) without antiarrhythmic drugs(AADs) at 6 months(91.3% vs. 79.8%, P=0.026), 1-year(90.2% vs. 78.5%, P=0.028), but there were no difference between the two groups at 5-year(64.8% vs. 64.4%, P=0.956), and 8-year(53.3% vs. 50.6%, P=0.711). During the 6 postoperative months, fewer patients in the RF+ GPA group underwent follow-up cardioversions(2.0% vs. 8.8%, P=0.030). Actuarial survival curves did not differ significantly between the 2 groups( HR=1.327, 95% CI 0.4633-3.802, P=0.598). Conclusion:The combination of GPA can be effective at the early postoperative stage for SR restoration in Maze Ⅳ procedures for the treatment of LSP-AF in heart valve surgeries, particularly for lower AADs use and lower cardioversions. However, this effect will gradually diminish after one year.

Objective:To observe the effect of computerized cognitive remediation therapy(CCRT) in the patients with mild cognitive impairment (MCI).Methods:A randomized, single-blinded clinical study was carried out from the April to June in 2019. 46 patients who met MCI criteria were randomly allocated into a CCRT group ( n=24) and a control group ( n=22). In CCRT group, the CCRT was conducted five times a week (30 minutes each time) for a total of 8 weeks (40 times), while a natural observation was performed in the control group. All the subjects were assessed by the Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment(MoCA) before and after the treatment. The Wilcoxon test in the paired rank-sum test of two related samples was used to evaluate the effect of CCRT on MCI before and after the intervention, and the Mann-Whitney U test in the rank-sum test of two independent samples was used to compare the differences in MMSE and MoCA scores between the two groups. Results:Before treatment, there were no statistically significant differences in MMSE, MoCA total scores and each factor between the CCRT group and the control group ( P>0.05). A total of 21 patients in CCRT group completed CCRT treatment. After 8 weeks of treatment, the difference between two groups in the total score of MMSE ( Z=-2.83), attention and calculation( Z=-2.58), time orientation( Z=-2.00) and visual spatial function ( Z=-2.45) scores were higher than those before the treatment ( P<0.05); the difference between two groups in MoCA total score ( Z=-3.40), visual space and executive function( Z=-3.41), attention ( Z=-3.09) were higher than those before the treatment ( P<0.05). Conclusion:CCRT may improve the cognitive function of MCI patients, especially the attention and visuospatial functions.

Objective:To observe the effect of computerized cognitive remediation therapy(CCRT) in the patients with mild cognitive impairment (MCI).Methods:A randomized, single-blinded clinical study was carried out from the April to June in 2019. 46 patients who met MCI criteria were randomly allocated into a CCRT group ( n=24) and a control group ( n=22). In CCRT group, the CCRT was conducted five times a week (30 minutes each time) for a total of 8 weeks (40 times), while a natural observation was performed in the control group. All the subjects were assessed by the Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment(MoCA) before and after the treatment. The Wilcoxon test in the paired rank-sum test of two related samples was used to evaluate the effect of CCRT on MCI before and after the intervention, and the Mann-Whitney U test in the rank-sum test of two independent samples was used to compare the differences in MMSE and MoCA scores between the two groups. Results:Before treatment, there were no statistically significant differences in MMSE, MoCA total scores and each factor between the CCRT group and the control group ( P>0.05). A total of 21 patients in CCRT group completed CCRT treatment. After 8 weeks of treatment, the difference between two groups in the total score of MMSE ( Z=-2.83), attention and calculation( Z=-2.58), time orientation( Z=-2.00) and visual spatial function ( Z=-2.45) scores were higher than those before the treatment ( P<0.05); the difference between two groups in MoCA total score ( Z=-3.40), visual space and executive function( Z=-3.41), attention ( Z=-3.09) were higher than those before the treatment ( P<0.05). Conclusion:CCRT may improve the cognitive function of MCI patients, especially the attention and visuospatial functions.

Objective To investigate the mechanism via which artesunate regulates the invasion and metastasis of colon cancer cells and the expression of members of the TGF-β1/Smad4 signaling pathway. Methods The cell counting kit 8 (CCK8), nude mouse xenograft model, Transwell invasion assay, and flow cytometry were used to investigate the effect of artesunate on the invasion and metastasis of colon cancer cells. Western blotting and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) were used to detect the expression of TGF-β1 and Smad4 proteins and mRNA, respectively. Results Artesunate inhibited the growth of transplanted tumor, cell proliferation, and invasion and promoted apoptosis. It inhibited TGF-β1 expression and promoted Smad4 expression. TGF-β1 inhibitors reversed the inhibitory effect of artesunate. Conclusion Artesunate can inhibit the growth of xenograft tumor in nude mice and its mode of action may be related to the TGF-β1/Smad4 signaling pathway.