Objective:Exploring the effect of radiofrequency ablation treatment to restore sinus rhythm on the improvement of functional mitral regurgitation (FMR) and cardiac structure in patients with atrial fibrillation combined with moderate or severe FMR, compared with drug therapy alone.Methods:This retrospective cohort study consecutively enrolled patients diagnosed with persistent atrial fibrillation and moderate or severe FMR who were admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2021. Forty-eight patients who were treated with radiofrequency ablation and maintained sinus rhythm were enrolled in the ablation group, and 63 patients who were treated with medication alone during the same period were in the medicine group. Patients in the ablation group and medicine group were matched in a 1∶1 ratio using a propensity score, and 41 patients were finally included in each of the 2 groups. All patients reexamined echocardiography after 3-month of treatment. The proportion of patients with FMR improvement and the differences in changes of cardiac structural and functional parameters were compared between groups.Results:After propensity score matching, the ablation group was aged (69.3±7.1) years with 21 males (51.2%) and the medicine group was aged (71.3±9.4) years with 21 males (51.2%). The echocardiography after 3-month of treatment showed the rate of FMR improvement was significantly higher in the ablation group than in the medicine group (19 (46.3%) vs. 33 (80.5%), P<0.001), and patients in the ablation group showed a significant decrease in FMR extent (Δmitral regurgitation area: (-1.30±2.64) cm 2 vs. (-3.55±2.50) cm 2, P<0.001), left atrial size (Δleft atrial diameter: (-0.17±3.78) mm vs. (-2.46±4.01) mm, P=0.009) and E/e′ (ΔE/e′:-2.54±7.34 vs.-6.34±7.08, P=0.021) compared with the medicine group. There was also a significant decrease in left ventricular size (Δleft ventricular end diastolic diameter: (-3.12±6.62) mm vs. (-0.73±3.62) mm, P=0.046) and significant increase in left ventricular ejection fraction (Δleft ventricular ejection fraction: (2.73±9.69) % vs. (-0.93±5.41) %, P=0.038) in ablation group. Conclusion:Performing radiofrequency ablation to restore sinus rhythm can effectively reduce the severity of mitral regurgitation and improve left atrial and left ventricular remodeling and cardiac function in patients with atrial fibrillation and FMR.

Objective:To investigate the effects of gestational diabetes mellitus (GDM) on neonatal metabolites.Methods:This retrospective cohort study recruited 580 singleton newborns who were born to women with GDM from January 2018 to December 2018 in Foshan Maternal and Child Health Care Hospital as the GDM group. Another 580 counterparts born to non-GDM singleton mothers with matching age were selected as the non-GDM group with an allocation ratio of 1 to 1. Neonatal genetic metabolic disease screening was performed within 3-7 days after birth. Two independent sample t-test, and multiple linear regression model were used for statistical analysis. Results:There were significant differences in seven amino acids and 10 fatty acids levels between the GDM and non-GDM group. The serum levels of six amino acids and eight fatty acids were increased in the GDM group, while the levels of piperamide [(140.79±32.60) vs (150.26±35.46) μmol/L, t=－4.733, P<0.001], palmitoyl carnitine [(2.59±0.81) vs (2.73±0.82) μmol/L, t=－2.940, P=0.003], and carbamate [(0.066±0.022) vs (0.069±0.022) μmol/L, t=－1.937, P=0.042] were decreased compared with the non-GDM group. After adjusting for maternal gravidity, parity, neonatal birth weight, and gender, multivariate linear regression analysis showed that GDM was positively correlated with three amino acids levels, which were cysteine ( ?=0.012), homocysteine ( ?=0.263) and leucine ( ?=4.225); and was negatively correlated with glycine ( ?=－6.271) and piperamide level ( ?=－9.885). With regard to the fatty acids, GDM was positively correlated with the neonatal propionyl carnitine ( ?=0.214), butyryl carnitine ( ?=0.014), 3-hydroxybutyryl carnitine ( ?=0.006), isovaleryl carnitine ( ?=0.009), 3-hydroxyisovaleryl carnitine ( ?=0.024), hexadecanoyl carnitine ( ?=0.001), decadienoyl carnitine ( ?=0.045), octadecadienyl carnitine level ( ?=0.128), but was negatively correlated with palmitoyl carnitine ( ?=－0.119), and carbamate ( ?=－0.002) (all P<0.05). Conclusions:Correlations between maternal GDM and the levels of amino acids and fatty acids in neonates was noted in this study, suggesting that maternal GDM may affect the metabolism of amino acids and fatty acids in offspring at early stage of life.

Objective:To investigate the epidemiological characteristics and transmission chain of COVID-19 in two families, and to provide scientific evidence for effective prevention and control measures.Methods:Field epidemiological investigation was conducted for the COVID-19 cases occurred in two families and the close contacts in a county of Baotou city in Inner Mongolia Autonomous Region. Descriptive statistical analysis on epidemiological data was conducted.Results:The infection source of the COVID-19 cases in the two families was a man who had living history in Wuhan. After his return, his parents were infected by him. A few days later, the members of a neighbor family were found to be infected, and relatives of this family were also infected after dining together repeatedly. Finally, ten confirmed cases and three suspected cases of COVID-19 were detected in the two families.Conclusions:Human-to-human transmission of COVID-19 can occur not only in a family but also in neighborhoods. The cases in two families had close relationship, indicating the necessity to strengthen the health education about COVID-19 prevention and control and the management of groups at high risk to reduce the incidence of COVID-19 in families and neighborhoods.

Objective To make clear the arsenic distribution in drinking water sources in Hubei Province, make provincial distribution map of high-arsenic water and provide scientific basis for formulating refined measures to prevent and control arsenic poisoning of drinking water type in Hubei Province. Methods In 103 counties of Hubei Province, residents were sampled according to different water supplies (centralized water supply, small centralized water supply in rural areas and decentralized water supply). One water sample was collected from source water and tap water in centralized water supply system and at least 3 samples were collected from decentralized water supply system in a village. Water iodine content was tested using atomic fluorescence spectrometry and a distribution map of high-arsenic water at county level was drawn using ArcGIS 10.2. Results Totally 38 292 water samples were collected. The water-arsenic-concentration median was less than 1.00 μg/L. The high-arsenic water detection rate in urban centralized water supply was 3.7%(80/2 176);which were all 0.1%(4/4 304,30/31 812) in small centralized water supply in rural areas and decentralized water supply. The high-arsenic water sources from centralized water supplies were distributed centrally in the south, the central and the east of Hubei Province and those from dispersed water supplies were distributed dispersedly in the south, the central and the east of Hubei Province.Conclusions There are still some dispersed water supplies with very high arsenic concentration in Hubei Province, which should be included to change the water area as soon as possible. Moreover, high arsenic water samples are found from centralized water supplies, which means the water treatment process should be upgraded or water resources should be changed.

Objective To make clear the fluorine content distribution in drinking water of residents in Hubei Province,draw a provincial distribution map of high-fluorine water and provide scientific basis for formulating refined prevention and control measures of drinking water type fluorosis in Hubei Province.Methods In 116 counties of Hubei Province,including development zones,scenic zones and farmlands,drinking water of residents was sampled according to different water supplies (centralized water supply,small centralized water supply in rual areas and decentralized water supply) from 2013 to 2015.For a centralized water supply,one sample was collected from the source water and the tap water each and at least 3 samples were collected for decentralized water supply in a village.Selective electrode method was used to detect the water fluorine content and ArcGIS 10.2 was used to draw distribution map of high-fluorine water at county level.Results A total of 38 284 water samples were collected,the median of fluorine content was 0.21 mg/L.The highest detective rate of all types of water supply with high fluorine content was pressure water well (64/100,64.0％) and high-fluorine water sample was not found in the reservoir.The high-fluorine water sources from centralized water supplies were distributed dispersedly in the north-west and the east of Hubei Province and those from decentralized water supplies were distributed dispersedly in the middle-north and the east of Hubei Province.Conclusions Fluorine concentration in drinking water is generally low.However,there are still some high-fluorine water supplies which should be reported to Hubei Provincial Water Resources Department as soon as possible.Moreover,there is a phenomenon of fluorine rebounce in the water reduction project,and managements of those projects should be strengthened.

Objective? To evaluate the effects of Peplau's interpersonal relationship model among patients with rhegmatogenous retinal detachment (RRD). Methods? From October 2017 to February 2018, a total of 96 patients with RRD in the Ophthalmology Department of He'nan Provincial People's Hospital were selected by convenience sampling method. The patients were divided into intervention group and control group, with 48 cases in each group. Nursing intervention guided by Peplau's interpersonal relationship theory was adopted in the experimental group, while routine nursing measures were adopted in the control group. Hospital Anxiety and Depression Scale (HADS) and Hospitalized Patients Satisfaction Questionnaire were used to compare the effect of intervention; the hospitalization time of the two groups was compared. Results? The total scores of HADS, anxiety and depression of RRD patients in the intervention group were lower than those in the control group, and the differences were statistically significant (P＜ 0.01). The satisfaction score of RRD patients in the intervention group was higher than that in the control group, and the difference was statistically significant (P＜ 0.01). There was no significant difference in hospitalization time between two groups of RRD patients (P＞ 0.05). Conclusions? The nursing care based on the Peplau's interpersonal relationship for the patients with RRD can effectively alleviate patients' anxiety and depression, and improve the level of satisfaction.

Objective To investigate the efficacy and the course of desensitization treatment in bronchial asthma with positive specific IgE to dust mite in children. Methods A total of 105 children with bronchial asthma with positive specific IgE to dermatophagoides farinae allergens were randomized into the observation group and the control group. Children in the control group were treated to continue anti-asthma according to the routine of prevention and treatment children with asthma. Chinldren in the observation group were treated by dermatophagoides farinae drops in addition to the treatment of children in the control group. The recurrence of asthma was compared between two groups at 25 weeks post-treatment. At 25 weeks post-treatment , children in the observation group was randomly divided into the observation groupⅠand group Ⅱ. Children in the observation groupⅠreceived continuous treatment except for desensitization treatment. Children in the observation group II received the sublingual immunotherapy with dermatophagoides farinae drops (No.4) for 1 year in addition to the treatment in the observation groupⅠ. The recurrence of asthma was also compared between the two sub-groups. Results The rate and times of recurrence of asthma were lower in the observation group than those in the control group(P < 0.05), with no significant differences between the observation groupⅠand groupⅡ (P > 0.05). Conclusion The recurrent rate and frequency of asthma could be reduced by the sublingual immunotherapy with dermatophagoides farinae drops in children with asthma of positive specific IgE to dust mite. The course of treatment may be half year long.

Objective Through the dynamical monitoring of the water improvement projects operation,we intend to understand the prevalent trends of endemic fluorosis of children aged 8 to 12 in Hubei,to evaluate the effect of control measures and to provide the basis for making preventive measures.Methods In Hubei,ten surveillance counties were selected,and three epidemic villages were selected as fixed monitoring villages in each county from 2010 to 2014.In those villages,the operation situation of water improvement projects and the fluoride content in drinking water were detected,and the dental fluorosis of children aged 8 to 12 was diagnosed.Results From 2010 to 2014,the normal operation rate of water improvement projects was 75.61％-100.00％,the average of water fluorine content did not change,the differences were not statistically significant (F =2.00,P ＞ 0.05).The numbers of water improvement projects with water fluorine content in excessive amount was increased in the past five years which was only one project in 2010-2012 and was increased to two projects in 2013 and 2014.In 2010-2014,the dental fluorosis prevalence rate of whole children was 9.45％ (525/5 557),the dental fluorosis prevalence rate of exceeding-standard villages of water fluoride content was 42.40％ (92/217),the dental fluorosis prevalence rate of qualified villages was 8.11％ (433/5 340).The children's dental fluorosis prevalence rate of exceeding-standard villages of water fluoride content was higher than that in qualified villages;the differences were statistically significant (x2 =282.60,P ＜ 0.05).Conclusions The operation rate of water-improving projects is mostly higher than 90％,and so is the qualification rate of fluoride content in drinking water.The operation condition and water quality of the water-improving projects in Hubei need to be improved.The prevalence of children dental fluorosis of affected villages has dropped significantly after low fluoride water is provided continuously.

Aim Paclitaxel(PTX)has shown an effect against human cancer. However, serious drawbacks hamper PTX clinical use.Overcoming paclitaxel limi-tations is one of the best approaches to enhance water solubility.Methods In this study,water-soluble pa-clitaxel prodrug was prepared,folic acid-polyethylene glycol-glutamic-paclitaxel (FA-PEG-Glu-PTX ) com-posed of folic acid (FA,target),amino acids (Glu, linker),and polyethylene glycol(PEG)in order to im-prove the solubilization and stability. The chemical structure and physicochemical property of prodrug were measured by LC-MS,solubility,drug release rate to e-valuate the antitumor activity and cytotoxicity of FA-PEG-Glu-PTX.MTT assays were conducted on MDA-MB-231,MCF-7,A549 and HELF cell lines.FA-PEG-Glu-PTX prodrugs were labeled with 5 amino flu-orescence visible fluorescent dye (5 AF ) for fluores-cence microscopy.Results The successful conjugation of FA-PEG-Glu-PTX was confirmed by LC-MS,and had better water solubility,release rate curve.In vitro studies indicated that foliate receptor(FR-α)mediated uptake of PTX-conjugated multi-small molecules carri-ers induced highly targeting ability,and antitumor ac-tivity,as well as reduced side toxicity effects of PTX. Conclusion FA-PEG-Glu-PTX has a good antitumor activity.

Objective To observe the inhibitory effect of pyridoxine hydrochloride (PN) combined with common chemotherapeutics on mice hepatoma cells H22 in vitro. Methods MTT assay was used to determine the effects of PN in combination with 10 different antineoplastic agents on H22 cells, and immuno-histochemistry was used to observe the distribution of PN in H22 cells and morphologic changes of the cells before and after PN treatment. Results After 24 hours incubation with 5 mmol/L PN, the treated cells expanded apparently with nucleus chipping. PN entered the tumor cell and was mainly condensed in cytoplasma and H22 cells were sensitive to PN. When administered concomitantly with chemotherapic agents, most of the combinations showed antagonistic effects while a few of the combinations were additive. For instance, doxorubicin (ADM) used in combination with PN inhibited cell proliferation with an IR value (IR=0.63) much lower than ADM alone (IR=0.71, P<0.01), and the CI value was less than 0.9, which indicated an antagonistic effect. However, PN in combination with ifosfamide (ICTX) showed additive effect (CI>0.9), and the IR value (IR=0.60) in combined group was higher than that (IR=0.40) in ICTX group (P<0.05). Conclusion PN treatment could increase the intracellular PLP level and result in growth inhibition and cell death, and combined administration of PN and ICTX might be a potential method to improve efficacy and to reduce toxic effects while a co-administration of PN and ADM should be avoided.