A domestically produced self-expanding transcatheter aortic valve controllable bending delivery system(VitaFlow? Ⅲcontrollable bending retrievable delivery system)was first used to perform transcatheter aortic valve replacement(TAVR)in a symptomatic severe aortic valve stenosis patient with severe heart failure and high risk of surgery in China on September 22,2023.The patient successfully completed TAVR under general anesthesia,with good valve position and function after the operation.Before discharge and at one month of follow-up,the patient's symptoms and degree of heart failure were significantly improved.The follow-up results of this case showed that the VitaFlow? Ⅲ controllable bending retrievable delivery system for TAVR is safe and feasible,and future prospective,multicenter clinical trials are expected to evaluate its efficacy.

Objective:To analyze potential roles of mechanical stress in the formation of plantar melanoma.Methods:A retrospective analysis was conducted on 129 cases of plantar melanoma in Xiangya Hospital, Central South University between 2014 and 2021, and the distribution and clinical characteristics of plantar melanoma were analyzed. The goodness-of-fit test was used to compare the distribution of plantar melanoma between weight-bearing areas (the toes, forefoot, lateral midfoot, heel) and non-weight-bearing areas of the foot (the arch) , while t test, Fisher′s exact test and Wilcoxon rank sum test were used to analyze differences in clinicopathological characteristics of plantar melanoma between weight-bearing areas and non-weight-bearing areas of the foot. Results:Among the 129 patients with plantar melanoma, 66 (51.2%) were males and 63 (48.8%) were females, and their age at onset was 60.6 ± 13.1 years. Plantar melanoma mostly occurred on the heel (65 lesions, 1.31 lesions per square centimeter) , followed by the forefoot (31 lesions, 0.41 lesions per square centimeter) , the bottom of the toes (15 lesions, 0.43 lesions per square centimeter) , lateral midfoot (11 lesions, 0.38 lesions per square centimeter) and the arch of foot (7 lesions, 0.16 lesions per square centimeter) . The goodness-of-fit test showed that melanoma was more prone to occur in the weight-bearing areas than in the non-weight-bearing areas ( χ2 = 66.59, P < 0.001) ; compared with the arch of foot, a higher incidence density was observed in the heel and forefoot ( χ2 = 38.29, 5.23, P < 0.001, = 0.022, respectively) . There were no significant differences in the gender ratio, age and occupation of patients, prevalence rates of left/right foot involvement, Breslow thickness, ulceration status, Clark grades, lymph node metastasis rate, and stages between melanomas in the weight-bearing areas and those in non-weight-bearing areas (all P > 0.05) . Conclusion:Plantar melanoma was more prone to occur in the weight-bearing areas than in the non-weight-bearing areas, suggesting that mechanical stress may be related to the occurrence and development of melanoma.

Objective:To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the hippocampal lipidome in a rat model of chronic unpredictable stress(CUS).Methods:Twenty-four SD rats were randomly assigned to the following 3 groups ( n=8 for each group): sham group, CUS group and CUS+ rTMS group. The sham group received only sham stimulation and rats in the CUS and CUS+ rTMS group were subjected to CUS stimulation. Then, rats received 5 Hz rTMS (5 Hz, 1.26 Tesla) or sham rTMS for 7 days. After the last stimulation, all rats underwent sucrose preference test, open filed test and forced swimming test so as to observe the effect of rTMS on depressive behavior. Then, rats were sacrificed, and the levels of lipid composition in hippocampus were determined by high performance liquid chromatography mass spectrometry and analyzed by lipid search software version 4.1 and SIMCA-P 14.1.The software of SPSS 19.0 was used for statistical analysis. Univariate analysis of variance was used for comparison among groups, and Tukey test was used for multiple comparison. Results:(1)There were significant differences in open field test, sugar preference test and forced swimming test among the three groups( F=6.853-7.466, all P<0.05). In the open field experiment, the exploring time and percentage of movement distance in central area of rats in CUS group((50.72±6.38)s, (11.41±1.55)%) was significantly less than that of sham group ((86.06±7.31)s, (18.60±1.21)%) and CUS+ rTMS group((79.87±7.87)s, (16.74±1.27)%)(all P<0.05). The results of sucrose preference test showed that the percentage of sucrose intake of rats in CUS group ((37.63±6.06)%) was significantly lower than that in sham group ((68.30±6.39)%) and CUS+ rTMS group ((62.68±5.50)%)(both P<0.05) . In forced swimming test, the immobility time of rats in CUS group ((137.60±13.36)s) was significantly longer than that of sham group ((80.57±10.36)s)) and CUS+ rTMS group ((86.14±11.49)s) (both P<0.05). (2)The levels of lipid composition in hippocampus were significantly different in the three groups( F=3.826-15.440, all P<0.05). The contents of phosphatidylethanolamine (PE) ((20 850±956.56)×10 7, (24 133.33±1 242.04)×10 7), phosphatidylinositol (PI) ((788.78±136.11)×10 7, (953.65±131.26)×10 7), lysophosphatidylcholine (LPC) ((340.29±35.66)×10 7, (275.32±35.78)×10 7), creatine phosphate (CerP) ((239.65±18.14)×10 7, (293.82±38.28)×10 7), sphingosine (So) ((22.96±4.04)×10 7, (15.36±3.87)×10 7), diglyceride (DG) ((3.35±0.85)×10 7, (4.57±1.02)×10 7) and monoglyceride (MG) ((6.71±0.82)×10 7, (7.94±0.91)×10 7)in hippocampus of rats in CUS group were significantly higher than those of sham group(all P<0.05), while the phosphatidic acid(PA) ((424.52±33.38)×10 7, (509.22±42.09)×10 7) and acyl carnitine(AcCa) ((2.68±0.33)×10 7, (3.39±0.33)×10 7) decreased(both P<0.05). Compared with CUS group, the contents of PE(21 816.67±928.26)×10 7, PI(83.16±91.52)×10 7, LPC(323.59±33.91)×10 7, CerP(236.39±32.02)×10 7, So(23.35±4.46)×10 7, DG(3.16±0.85)×10 7 and MG(7.03±0.26)×10 7 in the hippocampus of CuS+ rTMS group decreased, while the contents of PA(421.55±44.28)×10 7 and ACCA(2.56±0.32)×10 7 in the hippocampus of CUS+ rTMS group increased (all P<0.05). Conclusion:The levels of glycerophospholipids, glyceroglycerides, sphingolipids, fatty acids and other lipids in the hippocampus of CUS model rats are abnormal. And the 5 Hz rTMS intervention can ameliorate the depression like behavior and the disturbances of lipid in hippocampus of CUS model rats.

Objective:To characterize limb traumatic osteomyelitis in a regional trauma center in South China.Methods:The case system at Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital was searched for the data of confirmed limb traumatic osteomyelitis from January 1, 2010 through September 1, 2019. The clinical items collected were gender, age of onset, cause of injury, injury nature (open or closed), infected site (single site or multiple sites), intraoperative culture of pathogenic microorganisms, number and type of pathogenic microorganisms, and amputation. The above data were sorted out and analyzed statistically.Results:A total of 674 patients suffered limb traumatic osteomyelitis in South China with a male to female ratio of 4.81∶ 1. The limb traumatic osteomyelitis resulted mainly from open injury (64.09%, 432/674). It was mainly caused by a traffic accident (39.51%, 211/534). It was featured by single-site infection (83.68%, 564/674). It affected mainly the lower limbs: the tibia (53.19%, 300/564), the femur (18.97%, 107/564), the calcaneus (11.70%, 66/564) and other foot bones (4.61%, 26/564). The positive rate of intraoperative microorganisms culture was 65.26% (355/544). In the majority of patients (74.65%, 265/355), the traumatic osteomyelitis was caused by infection of a single pathogenic microorganism. The most common single pathogenic microorganism was Staphylococcus aureus (38.11%, 101/265), followed by Pseudomonas aeruginosa (20.00%, 53/265). The rate of amputation related to traumatic osteomyelitis was 3.71% (25/674), and the overall disability rate was 4.45% (30/674).Conclusions:In South China, more males were prone to limb traumatic osteomyelitis. Most cases were secondary to an open fracture and caused by a traffic accident. Traumatic osteomyelitis usually occurred at a lower limb. The most common pathogenic microorganism was Staphylococcus aureus.

OBJECTIVE： To study the effects of cimetidine on low dose rate irradiation-induced liver cell apoptosis in Beagle dogs. METHODS： Healthy male Beagle dogs were randomly divided into normal control group， model control group， positive drug group （lentinan， 21.33 mg/kg） and cimetidine low-dose， medium-dose and high-dose groups （5.33， 10.67， 21.33 mg/kg）， with 4 Beagle dogs each. Except for normal control group， other groups were given 60Co-γ accumulative irradiation （dosage rate： 0.040 8 mGy/min） for 23 d； the medication groups were given relevant medicine orally before irradiation， once a day. Twenty-four hours after stopping irradiation， TUNEL method was used to detect the apoptosis of liver cells in Beagle dogs. The percentage of apoptotic cells was calculated. The expression level of apoptosis-related proteins （Bax， Bcl-2， Caspase-3， p53） in liver tissue was detected by immunohistochemistry. RESULTS： Compared with normal control group， apoptotic cells and Bax， Caspase-3， p53 positive cells were increased significantly in liver tissue of Beagle dogs in model control group； the percentage of apoptotic cells， protein expression levels of Bax， Caspase-3 and p53 were increased significantly； Bcl-2 positive cells were decreased significantly， and its protein expression level was decreased significantly （P＜0.05 or P＜0.01）. Compared with model control group， above positive cells of liver tissue in Beagle dogs were changed to different extents in medication groups； the percentage of apoptotic cells and protein expression levels of p53 in medication groups， protein expression levels of Bax in positive drug group， cimetidine low-dose and high-dose groups as well as protein expression levels of Caspase-3 in cimetidine groups were decreased significantly； protein expression levels of Bcl-2 were increased significantly in cimetidine groups. The percentage of apoptotic cells in cimetidine medium-dose and high-dose groups as well as protein expression levels of Caspase-3 in cimetidine groups were all lower than positive control group. Protein expression level of p53 in cimetidine low-dose group was significantly higher than positive drug group （P＜0.05 or P＜0.01）. CONCLUSIONS： Cimetidine can inhibit the low dose rate irradiation-induced apoptosis of liver cells in Beagle dogs， and certainly protect liver cells against irradiation. The mechanism of it may be associated with up-regulating the protein expression of Bcl-2 and down-regulating the protein expression of Bax， Caspase-3 and p53 in liver cells.

Objects To study the protective effects of cimetidine against oxidative stress in rats induced by cumulative low-dose irradiation.Methods Sixty SD rats were randomly divided into 6 groups (10 each):normal control group,model control group,lentinan group [89mg/(kg.d)] and 3 dose groups of cimetidine.After oral administration,all the rats were exposed to γ-ray irradiation 8 hours/day for 12 days,and sacrificed on the 13th day.The activities of superoxide dismutase (SOD),glutathione peroxidase (GPx),catalase (CAT) and the content of malondialdehyde (MDA) in serum,liver,thymus and spleen were determined.By using the superoxide anion radical system,hydroxyl radical system,H2O2 radical system,oxidation system of linoleic acid induced by alkane radical system and diphenyl picryl hydrazinyl radical (DPPH) radical system,the antioxidation activities of cimetidine were detected.Results The activities of SOD in liver and thymus decreased significantly,the GPx activity in serum,liver and spleen decreased significantly and MDA level in serum,liver and spleen increased significantly after 0.3Gy cumulative ionizing radiation.Cimetidine enhanced the activities of antioxidant enzymes in serum and organs,and reduced the MDA level.In a certain concentration range,cimetidine had different scavenging effects onto these radical systems,and showed good performance in hydroxyl radical.Conclusion Cimetidine can effectively ameliorate the oxidative stress from low-dose cumulative irradiation by scavenging free radicals,increase the activity of antioxidant enzymes and reduce the content of lipid peroxidation products,thus presents a potential radio protective effect.

Amisulpride,a kind of the second generation antipsychotics,was marketed in China in 2010.A series of clinical research and experience before and after listed,especially the data based on Chinese population,provided evidence for the generalization and application of amisulpride.In order to optimize the clinical application of amisulpride,and improve the prognosis of patients,Expert Advice on the Practical Use of Amisulpride in the Treatment of Schizophrenia is presented here.This advice is based on the recent evidence and clinical experience,for guiding the clinical medication of amisulpride.

OBJECTIVETo investigate the influence of ozonated water on physical and chemical properties of vacuum sealing drainage (VSD) materials.

METHODSVSD materials (foam and sealing membrane) were immersed in 10 µg/ml ozonated water for 1 h twice daily for 8 days. The foam appearance and microscopic structure of the materials were observed, and tensile tests and Raman spectrum scan were performed assess the effect of ozonated water. Simulated VSD devices were prepared and tested for leakproofness under negative pressure after ozonated water treatment.

RESULTSzonated water treatment for 8 days caused no obvious abnormal changes in the foam appearance or microscopic structure of the materials. The maximum tensile load of foam before and after ozonated water treatment was 4.25∓0.73 kgf and 2.44∓0.19 kgf (P=0.000), the momentary distance when the foam torn before and after intervention was 92.54∓12.83 mm and 64.44∓4.60 mm, respectively (P=0.000). The corresponding results for VSD sealing membrane were 0.70∓0.58 kgf and 0.71∓0.08 kgf (P=0.698), and 99.30∓10.27 mm and 100.95∓18.22 mm (P=0.966), respectively. Raman spectroscopy revealed changes in only several wave intensities and no new chemical groups appeared within the scan range of 400-4000 cm(-1). The VSD device was well hermetic after treatment with ozonated water.

CONCLUSIONExcept for a decreased stretch resistance property of the foam, VSD materials display no obvious changes in physical and chemical characteristics after treatment with ozonated water for 8 days.

Objective To explore the long-term effect of bronchial artery, embolization (BAE) in patients with massive hemoptysis and the factors associated with prognosis. Methods Ninety six patients underwent BAE from 2002 to 2008 for the management of mass hemoptysis were retrospectively analyzed. Of them, BAE was successfully performed in 94 patients (mean age 43 years, age range 21 to 80 years), including active or inactive tuberculosis (89 cases), bronchiectasis (2 cases) and pulmonary carcinoma (5 cases). Results BAE resulted in an immediate cessation of hemoptysis in 94 of the initial 96 patients (97.9%). The rate of hemoptysis controlling at 30 d, 90 d, 1 year and 2 year after the BAE was 93.6% (88/94), 86. 2% (81/94), 81.9% (77/94) and 78.7% (74/94) respectively. Haemoptysis recurred in 9 patients in 30 days after the BAE due to missing of target vessel or recanalization. Five patients had recurrence of haemoptysis after 30 days and 2 patients recurrent after 90 days due to development of systemic collateral, progress in primary lesions and secondary infection. Conclusion BAE is an effective technique in the emergency treatment of massive hemoptysis. Avoiding missing target vessel, selecting the appropriate embolic material, paying attention to treatment of the primary disease after BAE, and preventing infection would improve the effects of BAE for massive hemoptysis.