Hypertrophic cardiomyopathy (HCM) is a major contributor to cardiovascular diseases (CVD), the leading cause of death globally. HCM can precipitate heart failure (HF) by causing the cardiac tissue to weaken and stretch, thereby impairing its pumping efficiency. Moreover, HCM increases the risk of atrial fibrillation, which in turn elevates the likelihood of thrombus formation and stroke. Given these significant clinical ramifications, research into the etiology and pathogenesis of HCM is intensifying at multiple levels. In this review, we discuss and synthesize the latest findings on HCM pathogenesis, drawing on key experimental studies conducted both in vitro and in vivo. We also offer our insights and perspectives on these mechanisms, while highlighting the limitations of current research. Advancing fundamental research in this area is essential for developing effective therapeutic interventions and enhancing the clinical management of HCM.
Cardiomyopathy, Hypertrophic/physiopathology* ; Humans ; Animals

Objective:To evaluate the safety and feasibility of Da Vinci robot-assisted proximal gastrectomy (PG) for proximal gastric cancer (PGC) and adenocarcinoma of the esophagogastric junction (AEG).Method:Twenty-five patients (PGC: n=7; AEG: n=18) undergoing Da Vinci-assisted PG at the First Affiliated Hospital of Dalian Medical University from Jan 2021 to Mar 2025 were divided into (indocyanine green ,ICG) ( n=9) and non-ICG ( n=16) groups based on whether intraoperative ICG navigation was used. Perioperative outcomes and pathological data were compared. Results:All operations were successfully completed without conversion to open surgery. The median proximal resection margin was 3.0 cm (2.5-3.0) cm, and the median distal resection margin was 4.0 cm (3.0-5.0) cm. Operative time in the ICG and non-ICG groups was (294.4±41.3) min and (354.4±67.4) min, respectively, with a statistically significant difference ( t=2.760， P< 0.05). The total number of lymph nodes harvested, as well as D 1 and D 2 LN stations, was (29.3±14.8) vs. (21.8±6.3), 17.0 (10.0-24.8) vs. 14.0 (11.0-22.5), and 10.0 (2.0-17.0) vs. 7.2 (2.0-7.5) in the ICG and non-ICG groups, respectively. Although the ICG group showed a trend toward higher LN yield, the difference was not statistically significant ( P>0.05). Conclusions:Da Vinci robotic assisted proximal gastrectomy is safe and feasible for treating PGC and AEG. ICG fluorescence imaging demonstrates promising clinical value.

Copy number variation encompassing SNP plays an important role in IVD and precision medi-cine.As the most commonly used method,FISH could not overcome the probe cross-reactivity which is common when to detect SNP.Here we developed a quantitative and qualitative method on copy number variation encompassing SNP.In this study,the rs76711854 was used as an example to establish a quanti-tative method by advantage of probe cross-reactivity.The fragment encompassing rs76711854 and its downstream to 9 514 bp were amplified by PCR.The allelic genotypes were verified by Sanger sequen-cing.Different probes with or without cross-reactivity to be used via quantitative real-time PCR and digit-al PCR.The different clusters(2D)and fluorescence intensity layers(1D)exist by adding probe with cross-reactivity.The A/G ratio measured by digital PCR is 2︰1,which is verified by probe targeting to the SNP.The copy-number variant exists in the 9kb-long fragment upstream to the SNP of prostate cancer cell line but not in human endometrial adenocarcinoma cell line Ishikawa.The data suggest that there is a multi-copy variation at this locus in DU145 cells.The method applied here is based on one single cross-reactivity probe via digital PCR.

BACKGROUND: Congenital heart disease (CHD) is a leading cause of birth defect-related mortality. However, more recent CHD mortality data for China are lacking. Additionally, limited studies have evaluated sex, rural-urban, and region-specific disparities of CHD mortality in China. METHODS: We designed a population-based study using data from the Dataset of National Mortality Surveillance in China between 2008 and 2021. We calculated age-adjusted CHD mortality using the sixth census data of China in 2010 as the standard population. We assessed the temporal trends in CHD mortality by age, sex, area, and region from 2008 to 2021 using the joinpoint regression model. RESULTS: From 2008 to 2021, 33,534 deaths were attributed to CHD. The period witnessed a two-fold decrease in the age-adjusted CHD mortality from 1.61 to 0.76 per 100,000 persons (average annual percent change [AAPC] = -5.90%). Females tended to have lower age-adjusted CHD mortality than males, but with a similar decline rate from 2008 to 2021 (females: AAPC = -6.15%; males: AAPC = -5.84%). Similar AAPC values were observed among people living in urban (AAPC = -6.64%) and rural (AAPC = -6.12%) areas. Eastern regions experienced a more pronounced decrease in the age-adjusted CHD mortality (AAPC = -7.86%) than central (AAPC = -5.83%) and western regions (AAPC = -3.71%) between 2008 and 2021. Approximately half of the deaths (46.19%) due to CHD occurred during infancy. The CHD mortality rates in 2021 were lower than those in 2008 for people aged 0-39 years, with the largest decrease observed among children aged 1-4 years (AAPC = -8.26%), followed by infants (AAPC = -7.01%). CONCLUSIONS CHD mortality in China has dramatically decreased from 2008 to 2021. The slower decrease in CHD mortality in the central and western regions than in the eastern regions suggested that public health policymakers should pay more attention to health resources and health education for central and western regions.
Humans ; Heart Defects, Congenital/mortality* ; Male ; Female ; China/epidemiology* ; Infant ; Child, Preschool ; Adult ; Child ; Adolescent ; Infant, Newborn ; Middle Aged ; Young Adult ; Aged ; Rural Population

Objective To analyze the practice of position setting management in a public hospital and provide sugges-tions for optimizing the hospital's position setting management.Methods The position setting plans,number of positions set,and number of positions employed from 2010 to 2023 in the hospital were reviewed,and existing problems were analyzed.Results In 2023,the proportion of non-permanent staff accounted for 51.94％of the total number of in-service employees,the number of professional and technical positions accounted for 95.95％of the in-service employees,and the number of senior professional and technical positions employed accounted for 18.00％of the total number of professional and technical positions.The"rigidi-ty"of the position setting method restricts professional development.There are issues such as the need to adjust the structure of professional and technical positions,and vacancies in management and skilled worker positions.Conclusion It is suggested to facilitate the integration of non-permanent staff into the establishment management system,dynamically adjust position setting plans,and strengthen post-employment management.

Objective:To evaluate the safety and feasibility of Da Vinci robot-assisted proximal gastrectomy (PG) for proximal gastric cancer (PGC) and adenocarcinoma of the esophagogastric junction (AEG).Method:Twenty-five patients (PGC: n=7; AEG: n=18) undergoing Da Vinci-assisted PG at the First Affiliated Hospital of Dalian Medical University from Jan 2021 to Mar 2025 were divided into (indocyanine green ,ICG) ( n=9) and non-ICG ( n=16) groups based on whether intraoperative ICG navigation was used. Perioperative outcomes and pathological data were compared. Results:All operations were successfully completed without conversion to open surgery. The median proximal resection margin was 3.0 cm (2.5-3.0) cm, and the median distal resection margin was 4.0 cm (3.0-5.0) cm. Operative time in the ICG and non-ICG groups was (294.4±41.3) min and (354.4±67.4) min, respectively, with a statistically significant difference ( t=2.760， P< 0.05). The total number of lymph nodes harvested, as well as D 1 and D 2 LN stations, was (29.3±14.8) vs. (21.8±6.3), 17.0 (10.0-24.8) vs. 14.0 (11.0-22.5), and 10.0 (2.0-17.0) vs. 7.2 (2.0-7.5) in the ICG and non-ICG groups, respectively. Although the ICG group showed a trend toward higher LN yield, the difference was not statistically significant ( P>0.05). Conclusions:Da Vinci robotic assisted proximal gastrectomy is safe and feasible for treating PGC and AEG. ICG fluorescence imaging demonstrates promising clinical value.

Copy number variation encompassing SNP plays an important role in IVD and precision medi-cine.As the most commonly used method,FISH could not overcome the probe cross-reactivity which is common when to detect SNP.Here we developed a quantitative and qualitative method on copy number variation encompassing SNP.In this study,the rs76711854 was used as an example to establish a quanti-tative method by advantage of probe cross-reactivity.The fragment encompassing rs76711854 and its downstream to 9 514 bp were amplified by PCR.The allelic genotypes were verified by Sanger sequen-cing.Different probes with or without cross-reactivity to be used via quantitative real-time PCR and digit-al PCR.The different clusters(2D)and fluorescence intensity layers(1D)exist by adding probe with cross-reactivity.The A/G ratio measured by digital PCR is 2︰1,which is verified by probe targeting to the SNP.The copy-number variant exists in the 9kb-long fragment upstream to the SNP of prostate cancer cell line but not in human endometrial adenocarcinoma cell line Ishikawa.The data suggest that there is a multi-copy variation at this locus in DU145 cells.The method applied here is based on one single cross-reactivity probe via digital PCR.

Objective To analyze the practice of position setting management in a public hospital and provide sugges-tions for optimizing the hospital's position setting management.Methods The position setting plans,number of positions set,and number of positions employed from 2010 to 2023 in the hospital were reviewed,and existing problems were analyzed.Results In 2023,the proportion of non-permanent staff accounted for 51.94％of the total number of in-service employees,the number of professional and technical positions accounted for 95.95％of the in-service employees,and the number of senior professional and technical positions employed accounted for 18.00％of the total number of professional and technical positions.The"rigidi-ty"of the position setting method restricts professional development.There are issues such as the need to adjust the structure of professional and technical positions,and vacancies in management and skilled worker positions.Conclusion It is suggested to facilitate the integration of non-permanent staff into the establishment management system,dynamically adjust position setting plans,and strengthen post-employment management.

Background/Aims: Despite the high efficacy of direct-acting antivirals (DAAs), approximately 1–3% of hepatitis C virus (HCV) patients fail to achieve a sustained virological response. We conducted a nationwide study to investigate risk factors associated with DAA treatment failure. Machine-learning algorithms have been applied to discriminate subjects who may fail to respond to DAA therapy. Methods: We analyzed the Taiwan HCV Registry Program database to explore predictors of DAA failure in HCV patients. Fifty-five host and virological features were assessed using multivariate logistic regression, decision tree, random forest, eXtreme Gradient Boosting (XGBoost), and artificial neural network. The primary outcome was undetectable HCV RNA at 12 weeks after the end of treatment. Results: The training (n=23,955) and validation (n=10,346) datasets had similar baseline demographics, with an overall DAA failure rate of 1.6% (n=538). Multivariate logistic regression analysis revealed that liver cirrhosis, hepatocellular carcinoma, poor DAA adherence, and higher hemoglobin A1c were significantly associated with virological failure. XGBoost outperformed the other algorithms and logistic regression models, with an area under the receiver operating characteristic curve of 1.000 in the training dataset and 0.803 in the validation dataset. The top five predictors of treatment failure were HCV RNA, body mass index, α-fetoprotein, platelets, and FIB-4 index. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the XGBoost model (cutoff value=0.5) were 99.5%, 69.7%, 99.9%, 97.4%, and 99.5%, respectively, for the entire dataset. Conclusions Machine learning algorithms effectively provide risk stratification for DAA failure and additional information on the factors associated with DAA failure.

Objective:To compare and analyze the short-term efficacy of the Da Vinci Xi (fourth generation) robotic surgical system and laparoscopic-assisted radical gastrectomy for gastric cancer.Method:In this retrospective cohort study, clinical pathological data of 190 patients with gastric cancer were collected from the clinical database of the First Affiliated Hospital of Dalian Medical University from 2020 Dec to 2023 May. The cohort comprised 136 men and 54 women aged 65 (30–85) years. Ninety of these patients had undergone robot assisted radical resection of gastric cancer and reconstruction of the digestive tract and were assigned to the robot-assisted group. The remaining 100 patients had undergone laparoscopic- assisted radical resection of gastric cancer and reconstruction of the digestive tract and were assigned to the laparoscopic control group. Variables investigated included surgical and postoperative factors and postoperative complications.Result:The procedure was successfully completed without the need to transition to open surgery in every patient in both groups. The median duration of surgery was 315 (270, 360) minutes and 240 (202, 280) minutes, median intraoperative blood loss 20 (10, 30) mL and 30 (10, 50) mL, median incision length 12.0 (10.8,13.0) cm and 10.0 (8.0, 10.8) cm, median time to first postoperative passage of flatus 4 (3, 5) days and 4 (4, 5) days, median time to first postoperative fluid intake 6 (4, 7) days and 8 (6, 9) days, time to gastric tube removal 4 (3, 7) days and 6 (5, 8) days, median time to drainage tube removal 8 (7, 10) days and 10 (9, 12) days, median duration of postoperative hospitalization 8 (7, 11) days and 12 (10, 14) days, and cost of surgery (7.6±1.2)×10 4 yuan and (4.0±0.6)×10 4 yuan in the robot-assisted and laparoscopic control groups, respectively. All the differences in the above indicators between the two groups of patients were statistically significant (all P<0.05). There were also significantly fewer complications in the robot-assisted than the laparoscopic control group (28.9% [26/90] vs. 44.0% [44/100], χ 2=0.31, P=0.031). Further subgroup analysis showed that the following factors were associated with greater improvement in the robot-assisted than laparoscopic control group: male sex (OR=0.41, 95%CI: 0.20–0.83, P=0.015), body mass index Conclusion:The Da Vinci robotic surgical system is safe and feasible for gastrectomy achieving a shorter recover period and fewer preoperative comorbidities.