Objectives:To investigate the impact of the Micra AV leadless pacemaker on cardiac function.Methods:A total of 76 patients who received the implantation of Micra AV leadless pacemaker due to sick sinus syndrome or atrioventricular block at Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from September 2022 to April 2023 were included in this study.Among them,26 patients(34.2%)had sick sinus syndrome,and 50 patients(65.8%)had atrioventricular block.The patients were followed up for 1 year postoperatively.Cardiac function was evaluated by echocardiography,and the parameters of the pacemaker were collected through the outpatient clinic programming system.Results:After a follow-up of 120(87,181)days,compared with the preoperative state,the left ventricular ejection fraction(LVEF)decreased postoperatively([66.6±5.6]%vs.[63.8±5.2]%,P<0.001),and the cardiac output increased[(4.3±1.2)L/min vs.(5.3±1.5)L/min,P<0.001].There were no statistically significant differences in various cardiac function indexes of patients with sick sinus syndrome between the postoperative and preoperative states(all P>0.05).Compared with the preoperative state,in patients with atrioventricular block,the LVEF decreased postoperatively([67.0±5.1]%vs.[63.4±4.4]%,P<0.001),the cardiac output increased([4.2±1.1]L/min vs.[5.2±1.2]L/min,P<0.001),and the left ventricular end-diastolic diameter decreased[(49.9±5.4)mm vs.(48.6±5.0)mm,P=0.044].Firth's logistic regression analysis indicated that the preoperative LVEF(for every 1%increase,OR=1.56,95%CI:1.12-2.17,P=0.001),stroke volume(for every 1 ml increase,OR=1.15,95%CI:1.04-1.28,P=0.001),body mass index(for every 1 kg/m2 increase,OR=1.49,95%CI:1.02-2.17,P=0.020),and hypertension(OR=12.71,95%CI:1.11-145.13,P=0.039)were independent risk factors for the decrease in LVEF after surgery in patients with atrioventricular block.After the implantation of the MciraTM AV leadless pacemaker,the overall atrioventricular synchrony rate was 81.2%(68.8%,89.0%).The atrioventricular synchrony rates of patients with sick sinus syndrome and those with atrioventricular block were 70.6%(59.5%,83.4%)and 82.4%(74.2%,89.3%)respectively(P<0.05).Firth's logistic regression analysis indicated that sick sinus syndrome(OR=0.26,95%CI:0.07-0.89,P=0.029)and preoperative LVEF(for every 1%increase,OR=1.18,95%CI:1.03-1.35,P=0.015)were independent predictive factors for the atrioventricular synchrony rate>80%.Conclusions:There are differences in the impacts of the Micra AV leadless pacemaker on the LVEF and atrioventricular synchrony rate between patients with sick sinus syndrome and those with atrioventricular block.The preoperative LVEF,stroke volume,body mass index,and hypertension have independent predictive effects on the decrease in postoperative LVEF in patients with atrioventricular block.Sick sinus syndrome and preoperative LVEF are independent predictive factors for the atrioventricular synchrony rate>80%after surgery.

Objectives:To investigate the impact of the Micra AV leadless pacemaker on cardiac function.Methods:A total of 76 patients who received the implantation of Micra AV leadless pacemaker due to sick sinus syndrome or atrioventricular block at Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from September 2022 to April 2023 were included in this study.Among them,26 patients(34.2%)had sick sinus syndrome,and 50 patients(65.8%)had atrioventricular block.The patients were followed up for 1 year postoperatively.Cardiac function was evaluated by echocardiography,and the parameters of the pacemaker were collected through the outpatient clinic programming system.Results:After a follow-up of 120(87,181)days,compared with the preoperative state,the left ventricular ejection fraction(LVEF)decreased postoperatively([66.6±5.6]%vs.[63.8±5.2]%,P<0.001),and the cardiac output increased[(4.3±1.2)L/min vs.(5.3±1.5)L/min,P<0.001].There were no statistically significant differences in various cardiac function indexes of patients with sick sinus syndrome between the postoperative and preoperative states(all P>0.05).Compared with the preoperative state,in patients with atrioventricular block,the LVEF decreased postoperatively([67.0±5.1]%vs.[63.4±4.4]%,P<0.001),the cardiac output increased([4.2±1.1]L/min vs.[5.2±1.2]L/min,P<0.001),and the left ventricular end-diastolic diameter decreased[(49.9±5.4)mm vs.(48.6±5.0)mm,P=0.044].Firth's logistic regression analysis indicated that the preoperative LVEF(for every 1%increase,OR=1.56,95%CI:1.12-2.17,P=0.001),stroke volume(for every 1 ml increase,OR=1.15,95%CI:1.04-1.28,P=0.001),body mass index(for every 1 kg/m2 increase,OR=1.49,95%CI:1.02-2.17,P=0.020),and hypertension(OR=12.71,95%CI:1.11-145.13,P=0.039)were independent risk factors for the decrease in LVEF after surgery in patients with atrioventricular block.After the implantation of the MciraTM AV leadless pacemaker,the overall atrioventricular synchrony rate was 81.2%(68.8%,89.0%).The atrioventricular synchrony rates of patients with sick sinus syndrome and those with atrioventricular block were 70.6%(59.5%,83.4%)and 82.4%(74.2%,89.3%)respectively(P<0.05).Firth's logistic regression analysis indicated that sick sinus syndrome(OR=0.26,95%CI:0.07-0.89,P=0.029)and preoperative LVEF(for every 1%increase,OR=1.18,95%CI:1.03-1.35,P=0.015)were independent predictive factors for the atrioventricular synchrony rate>80%.Conclusions:There are differences in the impacts of the Micra AV leadless pacemaker on the LVEF and atrioventricular synchrony rate between patients with sick sinus syndrome and those with atrioventricular block.The preoperative LVEF,stroke volume,body mass index,and hypertension have independent predictive effects on the decrease in postoperative LVEF in patients with atrioventricular block.Sick sinus syndrome and preoperative LVEF are independent predictive factors for the atrioventricular synchrony rate>80%after surgery.

Bacteria have posed a threat to human health,and the emergence of super bacteria has made it more difficult to cure bacterial infections in clinical practice.Currently,vaccines are one of the effective means of preventing bacterial infections.With the rapid development of cutting-edge technologies in recent years in such disciplines as biology,medicine,and materials science,various innovative strategies have been provided for vaccine research and preparation.This article summarizes the status quo and prospects of innovative vaccines for treating bacterial infections in recent years,including subunit vaccines,mRNA vaccines and attenuated live vaccine in the hopes of providing data for subsequent development and research of bacterial vaccines.

Objective:To evaluate the short-term precision and accuracy of bone mineral density (BMD) measured with quantitative CT (QCT) and dual-energy X-ray absorptiometry (DXA) in multi-centre clinical research with a European spine phantom (ESP).Methods:From January 2016 to April 2020, totally 40 CT scanners (12 Siemens from Germany, 12 Philips from Netherlands, 9 GE from US, 5 Toshiba from Japan, 2 United Imaging from China) and 53 DXA instruments (34 GE Lunar from US, 14 Hologic from US, 5 Medlink from France) used in multi-centre in China were enrolled. The CT equipment came from 31 centers and DXA equipment from 32 centers.Using Mindways QCT software, the ESP was scanned 10 times on each instrument with repositioning using standardized spine protocols with QCT and DXA. The BMD value of the three lumbar vertebrae with low, medium, high density and the mean BMD value were measured. Accuracy was assessed by comparing BMD values measured on each device with the actual value of the phantom. Short-term precision was calculated as the root-mean-square standard deviation (RMS-SD) and root-mean-square standard deviation coefficient of variation (RMS-%CV) for the repeated measurements. The repeated measures variance analysis was used to compare the differences in BMD between different devices.Results:The differences in BMD values were statistically significant among different CT and DXA devices.The ranges of the accuracy measured by different QCT devices were 1.20% to 7.60% for Siemens, -1.83% to 0.20% for Philips, 1.18% to 13.20% for GE, -0.12% to 3.55% for Toshiba, -1.65% to 6.32% for United Imaging, 6.59% to 21.34% for GE Lunar, -6.65% to 5.45% for Hologic, and -6.97% to -0.68% for Medlink, respectively. The RMS-%CV of all vertebral BMD values measured by QCT and DXA ranged from 0.38% to 3.85%. The RMS-SD of QCT was 0.54 to 2.45 mg/cm 3, of DXA was 0.009 to 0.037 g/cm 2. The RMS-%CV values of each vertebral body measured by different QCT and DXA devices decreased with the increase of BMD, while the RMS-SD values showed the opposite tendency. Conclusions:Based on ESP, the QCT and DXA devices have significant differences in lumbar spine BMD measurement. Comparing the measurement results among different devices requires cross-calibration. Overall, the accuracy and short-term precision are within a reasonable range, which can be used for clinical follow-up observation. The short-term precision error and accuracy error range of QCT in evaluating the density of ESP were slightly smaller than those of DXA.

Objective:To investigate the relationship between the expression of hepatocyte nuclear factor-1 α (HNF-1α) and the occurrence and development of liver inflammation and fibrosis in liver tissues of patients with chronic hepatitis B.Methods:Sixty-four patients with chronic hepatitis B who were diagnosed and treated in our hospital from 2011 to 2018 were selected. All patients underwent ultrasound-guided aspiration liver biopsy. The pathological results of liver biopsy were collected for inflammation grading and fibrosis staging. The liver puncture biopsies was collected by paraffin sectioning. The expression of HNF1α in the liver tissue was detected by immunohistochemical staining. Mantel-Haenszel χ2 test was used for bidirectional ordered grouping data, and Spearman’s rank-correlation test was used for rank correlation analysis. Results:There were varying degrees of inflammatory necrosis and fibrosis in the liver tissues of patients with chronic hepatitis B. There was a linear relationship between the expression of HNF1α and the level of inflammation in liver tissues ( χ2MH = 40.70, P < 0.05). The expression of HNF1α in liver tissues of patients with chronic hepatitis B was decreased with the increase of liver inflammation. The expression intensity of HNF1α was negatively correlated with the inflammation grade ( rs = -0.815, P < 0.05). There was a linear relationship between the expressions of HNF1α and the degree and stage of liver fibrosis ( χ2MH = 31.95, P < 0.05). The expression level of HNF1α in liver tissue was gradually decreased with the aggravation of liver fibrosis. The expression intensity of HNF1α was negatively correlated with fibrosis stage ( rs = -0.713, P < 0.05). Conclusion:HNF1α is closely related to the occurrence and development of liver tissue inflammation and fibrosis, and is expected to be a sensitive indicator for evaluating the level of liver tissue inflammation and fibrosis in patients with chronic hepatitis B. In addition, its down-regulation may be involved in the process of occurrence and development of liver inflammation and liver fibrosis, and may become a new target for the treatment of chronic hepatitis B.

This review summarizes the basic situation and characteristics of nuclear technology utilization and radiation safety supervision in Sichuan Province, analyzed the main problems of radiation safety supervision, put forward the corresponding countermeasures and suggestions, and provided reference for improving the radiation safety supervision ability of the whole province.

Liver fibrosis is a chronic liver injury caused by various etiologies and a complex pathological change with the activation of hepatic stellate cells as the central link, and various signaling pathways are involved in the regulation of such complex lesions. It has the dual nature of repair and damage and may eventually progress to liver cirrhosis, liver failure, and even liver cancer. In recent years, rapid progress has been made in the basic research on the cell signal transduction pathways associated with liver fibrosis, and some achievements have been made in the research on the treatment strategy of liver fibrosis. This article briefly reviews the cell signaling pathways associated with the development of liver fibrosis, including the JAK/STAT signaling pathway, the NF-κB signaling pathway, the MAPK signaling pathway, the TGF-signaling 1/Smad signaling pathway, the Wnt signaling pathway, the Hedgehog signaling pathway, and the Notch signaling pathway, and also introduces the potential therapeutic strategies for liver fibrosis at present.

Objective:To investigate the deep venous thrombosis (DVT) cognition and its influencing factors in patients with lower extremity DVT first time diagnosed so as to provide a basis for DVT management.Methods:From December 2018 to September 2019, we selected patients with lower extremity DVT first time diagnosed at Peking Union Medical College Hospital by convenience sampling. The cross-sectional investigation was carried out with the self-designed questionnaire including the general information, disease data, DVT knowledge. This study analyzed the influencing factors of DVT cognition of patients.Results:A total of 100 questionnaires were sent out and 99 valid questionnaires were collected. The standardized score of DVT knowledge was (45.76±28.05) . Single factor analysis showed that there were statistical differences in the scores of DVT knowledge among patients with different ages, education levels, types of thrombosis, diagnosis time of DVT, swelling, affecting life and work, awareness of intervention ( P<0.05) . Multiple linear regression analysis showed that the influencing factors of disease cognition of patients with lower extremity DVT first time diagnosed including the education levels and awareness of intervention with statistical differences ( P<0.05) . Conclusions:Patients with DVT first time diagnosed have the low level of disease cognition. Nurses should provide individualized health education and guide based on patients' personal and disease characteristics to improve patients' cognition on DVT, and DVT prevention to improve patients' long-term prognosis.

Objective:To explore the application effect of family-centered health education on parents of patients with adolescent idiopathic scoliosis.Methods:From September 2015 to December 2018, parents of patients who were diagnosed with adolescent idiopathic scoliosis in the Department of Orthopedics of a Class Ⅲ Grade A hospital in Beijing were selected as the research objects by convenience sampling method. According to the order of admission time, they were divided into the control group with 71 cases and the observation group with 67 cases. Parents in the control group were given routine health education while parents in the observation group were given family-centered health education on basis of the control group. The Chinese version of the State-Trait Anxiety Inventory and the Family Management Measure Scale were used to assess anxiety status and disease management abilities of parents, respectively.Results:There was no statistically significant difference in anxiety level of parents between the two groups ( P> 0.05) . At 3 and 6 months after discharge, the scores of parental disease management ability in the observation group were (45.89±4.18) and (41.84±3.02) , which were higher than (42.43±5.28) and (40.25±4.20) in the control group. The differences were statistically significant ( P<0.05) . The scores of parental disease management difficulties in the observation group were (28.20±4.71) and (32.98±6.16) , which were lower than (33.75±6.42) and (36.97±5.60) of the control group. The differences were statistically significant ( P<0.05) . Conclusions:Family-centered health education can improve parental disease management abilities of patients with adolescent idiopathic scoliosis after discharge, which is worthy of clinical reference and application.

Objective:To explore the effects of family-centered educational intervention on disease cognition and quality of life in patients undergoing surgery for adolescent idiopathic scoliosis (AIS) .Methods:A total of 122 patients diagnosed with AIS at the Ward Department of Orthopedics in a ClassⅢ Garde A hospital in Beijing from September 2015 to December 2018 were selected by convenient sampling, and divided into the control group ( n=62) and the observation group ( n=60) according to the admission time. Patients in the control group received routine health education, while patients in the observation group received family-centered educational intervention on this basis. The self-designed disease knowledge questionnaire and the Chinese version of Scoliosis Research Society Outcomes Questionnaire (SRS-22) were used to evaluate the disease knowledge and quality of life in the two groups of patients upon admission, 3 months and 6 months after discharge. Results:There was no statistically significant difference in the scores of disease knowledge between the two groups upon admission, 3 months and 6 months after discharge ( P>0.05) . Repeated measures analysis of variance showed no statistically significant difference in the interaction effect and between-group effect of the two groups' scores at 3 the time points ( P>0.05) , whereas the difference in the time effect was statistically significant ( P<0.05) . Three months after discharge, the total score of SRS-22 in the control group was (4.14±0.36) , while that in the observation group was (4.32±0.30) , and the difference was statistically significant ( t=2.964; P<0.05) . Conclusions:Family-centered educational intervention can appropriately improve the quality of life in patients with AIS and help them recover from illness.