Objective To evaluate the safety and efficacy of transcatheter mitral valve-in-valve replacement(ViV-TMVR)in the treatment of bioprosthetic mitral valve failure.Methods Seventeen patients with bioprosthetic mitral valve failure who required ViV-TMVR were selected.Preoperative data including age,gender,body mass index(BMI),usage time of bioprosthetic mitral valve,comorbidities(hypertension,coronary heart disease,old cerebral infarction,atrial fibrillation and diabetes)and New York Heart Association(NYHA)functional class were recorded,and left ventricular end-diastolic diameter(LVEDD),right atrial diameter(RA),pulmonary artery systolic pressure(PASP),left ventricular ejection fraction(LVEF),type of bioprosthetic mitral valve failure,degree of bioprosthetic mitral valve regurgitation and stenosis,peak velocity and mean transvalvular pressure gradient of the bioprosthetic mitral valve,and Society of Thoracic Surgeons(STS)score were also collected.Intraoperative data included puncture route,valve type,intraoperative complications,operation time and immediate postoperative transesophageal echocardiography(TEE)assessment(peak velocity and mean transvalvular pressure gradient of the valve-in-valve,valve-in-valve regurgitation or paravalvular regurgitation)were collected.Postoperative data included time in the intensive care unit(ICU)/cardiovascular intensive care unit(CCU),total postoperative hospital stay and 30-day postoperative echocardiographic results and NYHA functional class were recorded.Patients were divided into the domestic NewMed valve group(10 cases)and the imported Edwards valve group(7 cases)based on the type of valve used.The safety and efficacy of ViV-TMVR were analyzed,and the efficacy of domestic valves and imported valves was compared.Results All 17 patients successfully underwent ViV-TMVR via the transseptal approach without serious complications,and the 30-day readmission rate was 0%.There were no significant differences in operation time of domestic valves and imported valves,mild paravalvular regurgitation of the valve-in-valve,peak velocity and mean transvalvular pressure gradient of the valve-in-valve immediately after surgery and at 30-day postoperatively,time in ICU/CCU,total postoperative hospital stay and the proportion of patients with NYHA functional class Ⅲ-Ⅳ at 30-day postoperatively between the domestic valve group and the imported valve group.During the 30-day follow-up,one patient died of cerebral hemorrhage,and one patient had major adverse cardiovascular events(MACE,cerebral hemorrhage).Compared with before the operation,the peak velocity and mean transvalvular pressure gradient of the valve-in-valve,LVEF,and PASP decreased immediately after surgery and at 30 days after surgery.Compared with immediately after surgery,the peak velocity and mean transvalvular pressure gradient of the valve-in-valve increased at 30 days postoperatively(P＜0.01),while there were no significant differences in LVEF and PASP.Conclusion Transseptal ViV-TMVR is safe and effective in the short term for patients with bioprosthetic mitral valve failure who are at high risk of re-thoracotomy,and the efficacy of domestic valves is comparable to that of imported valves.

Objective To evaluate the safety and efficacy of transcatheter mitral valve-in-valve replacement(ViV-TMVR)in the treatment of bioprosthetic mitral valve failure.Methods Seventeen patients with bioprosthetic mitral valve failure who required ViV-TMVR were selected.Preoperative data including age,gender,body mass index(BMI),usage time of bioprosthetic mitral valve,comorbidities(hypertension,coronary heart disease,old cerebral infarction,atrial fibrillation and diabetes)and New York Heart Association(NYHA)functional class were recorded,and left ventricular end-diastolic diameter(LVEDD),right atrial diameter(RA),pulmonary artery systolic pressure(PASP),left ventricular ejection fraction(LVEF),type of bioprosthetic mitral valve failure,degree of bioprosthetic mitral valve regurgitation and stenosis,peak velocity and mean transvalvular pressure gradient of the bioprosthetic mitral valve,and Society of Thoracic Surgeons(STS)score were also collected.Intraoperative data included puncture route,valve type,intraoperative complications,operation time and immediate postoperative transesophageal echocardiography(TEE)assessment(peak velocity and mean transvalvular pressure gradient of the valve-in-valve,valve-in-valve regurgitation or paravalvular regurgitation)were collected.Postoperative data included time in the intensive care unit(ICU)/cardiovascular intensive care unit(CCU),total postoperative hospital stay and 30-day postoperative echocardiographic results and NYHA functional class were recorded.Patients were divided into the domestic NewMed valve group(10 cases)and the imported Edwards valve group(7 cases)based on the type of valve used.The safety and efficacy of ViV-TMVR were analyzed,and the efficacy of domestic valves and imported valves was compared.Results All 17 patients successfully underwent ViV-TMVR via the transseptal approach without serious complications,and the 30-day readmission rate was 0%.There were no significant differences in operation time of domestic valves and imported valves,mild paravalvular regurgitation of the valve-in-valve,peak velocity and mean transvalvular pressure gradient of the valve-in-valve immediately after surgery and at 30-day postoperatively,time in ICU/CCU,total postoperative hospital stay and the proportion of patients with NYHA functional class Ⅲ-Ⅳ at 30-day postoperatively between the domestic valve group and the imported valve group.During the 30-day follow-up,one patient died of cerebral hemorrhage,and one patient had major adverse cardiovascular events(MACE,cerebral hemorrhage).Compared with before the operation,the peak velocity and mean transvalvular pressure gradient of the valve-in-valve,LVEF,and PASP decreased immediately after surgery and at 30 days after surgery.Compared with immediately after surgery,the peak velocity and mean transvalvular pressure gradient of the valve-in-valve increased at 30 days postoperatively(P＜0.01),while there were no significant differences in LVEF and PASP.Conclusion Transseptal ViV-TMVR is safe and effective in the short term for patients with bioprosthetic mitral valve failure who are at high risk of re-thoracotomy,and the efficacy of domestic valves is comparable to that of imported valves.

Objective To evaluate the effect of modulating gut microbiota for improving brain injury in rats with post-stroke depression.Methods Adult SD rats were randomized into normal control,middle cerebral artery occlusion(MCAO),post-stroke depression(PSD),PSD with fecal transplantation,PSD with antibiotics(rifaximin),PSD with probiotics(lactobacilli),and PSD with fluoxetine treatment groups(n=9).Neurological function scores of the rats were determined,and the changes in sugar water preference and immobility time in forced swimming test were observed;plasma levels of trimethylamine N-oxide(TMAO)and hydrogen sulfide(H2S)were detected with ELISA,Occludin,and the expressions of occludin,caudin-5 and IgG proteins I the brain tissues were determined using Western blotting.Results Compared with those in the control group,the rats in MCAO and PSD groups had significantly increased neurological function scores,TMAO level,the ratio of TMAO/H2S,and immobility time in forced swimming test with a lowered level of H2S(P<0.05).These changes were more obvious in PSD rats,which also exhibited a reduced sugar water preference with increased IgG protein and decreased occluding and caudin-5 expressions in the brain tissue(P<0.05).TMAO/H2S ratio in PSD rats was positively correlated with neurological function score(R2=0.3235,P=0.0269)and immobility time in swimming(R2=0.6290,P=0.0004)and negatively with sugar water preference(R2=-0.4534,P=0.0059).Treatment with fecal transplantation,antibiotics,probiotics and fluoxetine all significantly reduced neurological function scores,immobility time in forced swimming,TMAO/H2S ratio,and IgG protein expression and increased sugar water preference and brain occludin and caudin-5 expressions of the PSD rats(P<0.05).Conclusion In PSD rats,TMAO/H2S ratio is correlated with neurological function score,immobility time in forced swimming and sugar water preference,and modulating intestinal flora can improve neurological function and depressive symptoms and improve the integrity of the blood-brain barrier.

Objective To evaluate the effect of modulating gut microbiota for improving brain injury in rats with post-stroke depression.Methods Adult SD rats were randomized into normal control,middle cerebral artery occlusion(MCAO),post-stroke depression(PSD),PSD with fecal transplantation,PSD with antibiotics(rifaximin),PSD with probiotics(lactobacilli),and PSD with fluoxetine treatment groups(n=9).Neurological function scores of the rats were determined,and the changes in sugar water preference and immobility time in forced swimming test were observed;plasma levels of trimethylamine N-oxide(TMAO)and hydrogen sulfide(H2S)were detected with ELISA,Occludin,and the expressions of occludin,caudin-5 and IgG proteins I the brain tissues were determined using Western blotting.Results Compared with those in the control group,the rats in MCAO and PSD groups had significantly increased neurological function scores,TMAO level,the ratio of TMAO/H2S,and immobility time in forced swimming test with a lowered level of H2S(P<0.05).These changes were more obvious in PSD rats,which also exhibited a reduced sugar water preference with increased IgG protein and decreased occluding and caudin-5 expressions in the brain tissue(P<0.05).TMAO/H2S ratio in PSD rats was positively correlated with neurological function score(R2=0.3235,P=0.0269)and immobility time in swimming(R2=0.6290,P=0.0004)and negatively with sugar water preference(R2=-0.4534,P=0.0059).Treatment with fecal transplantation,antibiotics,probiotics and fluoxetine all significantly reduced neurological function scores,immobility time in forced swimming,TMAO/H2S ratio,and IgG protein expression and increased sugar water preference and brain occludin and caudin-5 expressions of the PSD rats(P<0.05).Conclusion In PSD rats,TMAO/H2S ratio is correlated with neurological function score,immobility time in forced swimming and sugar water preference,and modulating intestinal flora can improve neurological function and depressive symptoms and improve the integrity of the blood-brain barrier.

ObjectiveTo analyze the prevalence of HCV antibody positive and associated factors among drug users in Dehong Prefecture， Yunnan， and to provide scientific evidence for HCV prevention. MethodsQuestionnaire surveys and serological testing were conducted among 400 drug users continuously selected from four national AIDS sentinel surveillance in Dehong Prefecture between January and July during 2014‒2021. Results11 683 drug users were included. The prevalence of HCV antibody positive was 20.2% overall， and 14.9%， 20.1%， 22.4%， 19.8%， 22.5%， 20.6%， 24.5%， 19.0% from 2014 to 2021， respectively （trend Z=-3.78， P<0.001）. Multivariable analysis indicated the following were independently associated with HCV antibody positive： that older age （OR=1.02， 95%CI： 1.02‒1.03）， male （OR=1.70， 95%CI： 1.19‒2.42）， unmarried （OR=1.64， 95%CI： 1.44‒1.87）， divorced or widowed （OR=1.73， 95%CI： 1.48‒2.02）， Jingpo ethnicity （OR=1.39， 95%CI： 1.19‒1.63）， injection drug use （OR=15.46， 95%CI： 13.13‒18.12）， and HIV infection（OR=4.96， 95%CI：4.12‒5.99）. ConclusionThe prevalence of HCV antibody positive among drug users in Dehong Prefecture is high and increases with some fluctuations during 2014 to 2021， which highlights the need to develop interventions targeting this population.

ObjectiveTo determine the characteristics and influencing factors of hepatitis C virus （HCV） co-infection among HIV concordant couples in Dehong Prefecture. MethodsUsing the data of newly reported HIV concordant couples in Dehong Prefecture from 2016 to 2019， we collected the demographic characteristics， exposure history， and HCV infection to determine the characteristics of HCV co-infection among HIV concordant couples. ResultsAmong the 160 HIV concordant couples included in the study， 46 （28.8%） males and 14 （8.8%） females were co-infected with HCV. The prevalence of HIV-HCV co-infection was higher among the male spouses who were diagnosed less than 40， Jingpo ethnic， Burmese， illiteracy， farmers， and intravenous drug users. In contrast， the prevalence of HIV-HCV co-infection was higher among the female spouses who were diagnosed less than 40， Jingpo ethnic， and Burmese. Logistic regression analysis among male spouses showed that the Jingpo ethnic and intravenous drug users had higher risk of HCV co-infection. ConclusionHIV concordant couples in Dehong Prefecture have high prevalence of HIV-HCV co-infection. Effective intervention strategies should be developed based on ethnic-specific factors and exposure characteristics among male and female spouses of HIV concordant couples.

Objective: To study the prevalence and correlates of diabetes among HIV/AIDS who were on antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefectures (Dehong), Yunnan province. Methods: The database of HIV/AIDS receiving ART in Dehong was downloaded by using the basic information system of AIDS prevention and control in China. In this cross-sectional study, HIV/AIDS patients who were currently on ART and aged 18 years or above, were consecutively recruited, between July 2017 and June 2018, in Dehong. All the subjects underwent hemoglobin A1c (HbA1c) testing. Patient with diabetes was defined as meeting any of these indicators (HbA1c ≥6.5%, baseline FPG ≥7.0 mmol/L, FPG ≥7.0 mmol/L in the most recent visit). Both univariate and multivariate logistic regression analysis were carried on to evaluate the correlates of diabetes among the HIV/AIDS patients. Results: In total of 4 376 HIV/AIDS patients were included for analysis, with the average age as (43.7±10.1) years, proportion of males as 53.8% (2 356/4 376) and the HCV positive rate as 24.1% (1 055/4 376). The mean years was (8.9±3.8) years after the HIV diagnosis was made, and the mean duration on treatment was (6.8±2.9) years. The prevalence of diabetes was 11.4% (500/4 376). Through multivariate logistic regression analysis, data showed that the risk factors of diabetes of HIV/AIDS on ART were: aged 40 years or above, being male, HCV positive, baseline body mass index ≥24.0 kg/m², elevated TG ≥1.70 mmol/L in the most recent visit and baseline antiretroviral regimens under Efavirenz (EFV). Conclusions Prevalence rate of diabetes appeared higher in HIV/AIDS patients who were on ART in Dehong. Prevention and control measures should be targeted on HIV/AIDS patients who were with risk factors of diabetes as being elderly, male, HCV positive, overweight and higher TG. Further esearch is needed to evaluate the association between the use of EFV and diabetes.

Aim Todiscusstheapplicationoftissue spontaneous fluorescence in myocardial ischemia injury of rats based on specific fluorescence detection technol-ogy.Methods Thechangeofspontaneousfluores-cence was compared between the myocardial tissue of normal rats and those of rats with myocardial ischemia injury and an quantitative analysis was then made.Re-sult Theresultsshowedthatspontaneousfluorescence of myocardial tissue for myocardial ischemia injury changed significantly.Spontaneous fluorescence signal of injury considerably was enhanced.The fluorescence signal which was quantified by FX Pro had statistical significance compared with normal myocardial tissue,P<0.01orP<0.05.Conclusion Ourresearchshows that spontaneous fluorescence of myocardial tissue can be enhanced obviously after myocardial ischemia inju-ry.Our research provides a method for the research and evaluation of myocardial ischemia injury model in rats which can be used in positioning,qualitative and quan-titative comparative study and in pathological,physio-logical,pharmacological and mechanism study.

Garlic is a bulb from generalized liliaceous plant Alli-um sativum, it plays an essential role in the prevention and treat-ment of cardiovascular diseases, tumors and pathogenic microor-ganisms. Through consulting domestic and foreign references, the main active ingredients of garlic and their pharmacological
effects are reviewed, the problems and achievement in Chinese research are also discussed. It can provide a certain reference for the further study of garlic and new drug development.