Objective:To test the feasibility, efficacy and safety of percutaneous patent foramen ovale(PFO) closure utilizing the Pansy biodegradable occluder(PBO) at 1-, 3-, 6-, 12-, 24-, and 36-month follow-up.Methods:In this single-center prospective clinical study, we enrolled 15 patients with PFO eligible for closure, all treated with the PBO, with device sizes ranging 24-34 mm. All clinical data were recorded in a 36-month follow-up period. Patients were summoned to the hospital in the 1, 3, 6, 12, 24, and 36 months after closure for transthoracic echocardiography(TTE), or transesophageal echocardiography(TEE), contrast transcranial doppler(cTCD) or contrast transthoracic echocardiography(cTTE), and a routine fasting blood sample.Results:The mean age was 27-68(44.0±16.4) years old. Indications for closure were cryptogenic stroke in 6 patients and migraine in 9 patients. Procedures were technically successful in 100%(15/15), in which course TTE showed that the position and shape of occluders were satisfactory. Small residual shunt was found by TTE in 2 patients with ASA in 1 month and 6 months after closure, respectively. 1 patient with cryptogenic stroke had another recurrent stroke 8 months after closure. At 12-month follow-up, 11 cases were closure. At 36-month follow-up, 13 cases were closure. 12 patients without atrial septal aneurysm(ASA) were closure. 1 patients with ASA was complete closure. No device-related complications occurred during the follow-up.Conclusion:PBO has good biocompatibility and suitable degradation time. A high technical success rate and closure rate can be achieved in those patients without ASA. Percutaneous closure of PFO using PBO is feasible, effective, and safe.

Objective Based on the bidirectional fluid-structure coupling model of the intermittent pneumatic compression device acting on lower extremities established by the research group at the early stage,the study adopts viscoelastic properties for human tissues to better conform to human biomechanical characteristics.Methods The bidirectional fluid-structure coupling model of the intermittent pneumatic compression device acting on lower extremities was constructed with Ansys Workbench.In the simulation model,fat,muscles and venous walls were endowed with viscoelastic properties,and the change of lower extremity venous blood volume during inflation-holding-deflation operation of the intermittent pneumatic compression device was obtained.A self-developed intermittent pneumatic compression device was used to apply the same working conditions as in the simulation to the calf of the healthy subject,and the blood volume of the great saphenous vein was monitored using an infrared detection sensor based on photoplethysmography.Results The simulation and measurement results were consistent.With the intermittent pneumatic compression device acting on lower extremities,the blood volume in the lower extremity veins decreased in the inflation stage,and blood was discharged;in the holding stage,the blood volume also decreased;in the deflation stage,the blood volume increased,and the veins were refilled with blood,with the refilling time longer than the deflation duration.Conclusion The change of blood volume measured with the infrared detection sensor is consistent with the simulation results,verifying the accuracy and reliability of the proposed model of viscoelastic materials.

【Objective】 To explore the clinical features, treatment and prognosis of paraganglioma of the urinary bladder (PUB). 【Methods】 The clinical data of 41 PUB patients treated at our hospital during Sep.2012 and Sep.2022 were collected. The clinical features, surgical records, pathological reports and follow-up records were retrospectively analyzed. Patients’ survival was estimated with Kaplan-Meier estimator. The differences among groups were compared with Log-rank test. 【Results】 Among the 41 patients, 20 were male and 21 were female, with a median age of 52 years. All patients were treated with surgery, including transurethral resection of bladder tumor (TURBT) in 16 cases, partial cystectomy (PC) in 23 cases, and radical cystectomy (RC) in 2 cases. All patients were followed up for 4.0 to 125.0 months, with a median of 59.0 months. Local recurrence occurred in 5 patients, and distant metastasis occurred in 5 patients. Survival analysis showed that the 5-year overall survival (OS) rate and 5-year relapse-free survival (RFS) rate were 95.7% and 84.8%, respectively. Further analysis showed statistically significant differences in OS and RFS among groups with different maximum tumor diameters, growth patterns, and Ki-67 expressions (P<0.05). For patients with a maximum tumor diameter ≤2.8 cm, there was no significant difference in OS and RFS among different surgical groups. 【Conclusion】 PUB is rare, and a definitive diagnosis is based on pathology. In addition, the main treatment is surgery and the prognosis is good.

Objective To investigate the risk factors of perioperative heart failure in the elderly patients with femoral neck fracture treated with hip joint replacement so as to provide relevant clinical reference.Methods A retrospective case control study was conducted to analyze the clinical data of 155 elderly patients with femoral neck fractures who underwent total hip or hemiarthroplasty in Wenzhou Traditional Chinese and Western Medicine Hospital from May 2012 to August 2016.There were 62 males and 93 females,aged (75.6 ± 7.4)years.The patients were divided into heart failure group (26 patients)and non heart failure group (129 patients).Heart failure group included 10 males and 16 females,aged (78.3 ± 8.2)years.There were 52 males and 77 females in the non heart failure group,aged (74.5 ±6.7) years.Information including age,gender,history of hypertension,history of heart diseases,American Society of Anesthesiologists (ASA) physical status classification,duration from injury to surgery,preoperative renal function,perioperative fluid balance,operation method,operation time,postoperative pain score,perioperative blood loss,and constipation were collected.Univariate analysis was firstly performed on the above data,and multivariate logistic regression analysis was conducted on the significant factors generated by the univariate analysis so as to identify independent risk factors for perioperative heart failure.Results According to the univariate analysis,age,history of heart diseases,preoperative renal function,and perioperative fluid balance were statistically different between the two groups (P ＜ 0.05).Multivariate analysis results showed that the independent risk factors of perioperative heart failure included age (OR =5.351,95％ CI 1.459-19.623,P ＜ 0.01),history of heart diseases (OR =5.717,95 ％ CI 2.399-13.624,P ＜ 0.01),preoperative renal function (OR =2.670,95％ CI 1.125-6.336,P ＜ 0.05),perioperative fluid balance (OR =2.980,95％ CI 1.287-6.899,P ＜0.01).Conclusions Age,history of heart diseases,preoperative renal function,and perioperative fluid balance are the risk factors of perioperative heart failure in elderly patients with femoral neck fracture.Therefore,more attention should be paid to these risk factors and corresponding preventative measures should be taken to reduce the incidence of perioperative heart failure.

It is of great clinical significance in the differential diagnosis of primary central nervous system lymphoma (PCNSL) and glioblastoma (GBM) because there are enormous differences between them in terms of therapeutic regimens. In this paper, we propose a system based on sparse representation for automatic classification of PCNSL and GBM. The proposed system distinguishes the two tumors by using of the different texture detail information of the two tumors on T1 contrast magnetic resonance imaging (MRI) images. First, inspired by the process of radiomics, we designed a dictionary learning and sparse representation-based method to extract texture information, and with this approach, the tumors with different volume and shape were transformed into 968 quantitative texture features. Next, aiming at the problem of the redundancy in the extracted features, feature selection based on iterative sparse representation was set up to select some key texture features with high stability and discrimination. Finally, the selected key features are used for differentiation based on sparse representation classification (SRC) method. By using ten-fold cross-validation method, the differentiation based on the proposed approach presents accuracy of 96.36%, sensitivity 96.30%, and specificity 96.43%. Experimental results show that our approach not only effectively distinguish the two tumors but also has strong robustness in practical application since it avoids the process of parameter extraction on advanced MRI images.

BACKGROUND:Positioning of the distal locking screws of a tibial intramedulary nail is often chalenging and time consuming. The traditional free-hand technique under fluoroscopic control involves considerable radiation exposure.OBJECTIVE: To evaluate the results of a new electromagnetic navigation system (TRIGEN-SURESHOT navigation system) for distal locking of tibial intramedullary nail in tibial diaphyseal fracture and to compare the effects with the free-hand method.METHODS: Forty-five cases of tibial diaphyseal fracture in the Second Hospital of Anhui Medical University from May 2014 to August 2015 were analyzed retrospectively, and were divided into two groups. Patients in navigation group (n=23) were treated with intramedullary nail using the TRIGEN-SURESHOT navigation system for distal locking, and the remainings in free-hand group (n=22) were given the free-hand method.RESULTS AND CONCLUSION: All cases were followed up for 17-32 months. The one-time success rate of distal locking nail operation was 100％ in the navigation group, which was significantly higher than that in the free-hand group (P < 0.05). The locking nail time in the navigation group was significantly less than that in the free-hand group (P < 0.05).No significant differences were found in the incidence of adverse events and fracture healing time between two groups (P > 0.05). To conclude, the effect of the TRIGEN-SURESHOT navigation system for distal locking of tibial intramedullary nail is satisfactory, exhibiting the advantages of short operation time, high success rate, and no radiation.

Objective To explore the association between ACTN3 gene R577X polymorphism and serum lipid levels in an elderly Chinese Han population.Methods This study was based on the ageing arm of The Rugao Longevity and Ageing Study (RtLAS).Genotyping was performed by Taqman MGB method.Lipids includedtotal cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C).Cut points of dyslipidemia were based on that reported in the NCEP ATPIII.We explored the associations between R577X polymorphism loci and dyslipidemia by using analysis of covariance and logistic regression analysis.Results Overall 1 618 samples was included (741 males and 877 females) in this study.Covariance analysis found that TC level of RR,XX and RX genotype in the general population were 1.34,1.37,1.43 mmol/L with an increasing trend (P =0.024);TC and LDL-C levels of RR,XX and RX genotype (TC:5.13,5.29,5.43 mmol/L,P =0.004;LDL-C:2.76,2.88,3.00 mmol/L,P =0.004) were significantly different in females.Logistic regression analysis showed that the increased copies of X allele were significantly associated with increased TC and LDL-C levels in the general population and females.For the general population,TC:OR=1.184,95％CI:1.030-1.361,P =0.018;LDL-C:OR =1.334,95％CI:1.101-1.588,P=0.003;For females,TC:OR=1.332,95％ CI:1.102-1.616,P =0.003;LDL-C:OR =1.549,95 ％CI:1.208-1.986,P =0.001.After adjusting for other covariates,the above associations remained significant.Conclusions ACTN3 gcnc R577X polymorphism is associated with plasma TC and LDL-C levels in elderly woman of Han populations in Rugao,China.

Objective To discuss the safety and feasibility of percutaneous transhepatic biliary preset implantation of after-loading radiotherapy catheter in treating bile duct carcinoma of ampulla.Methods A total of 10 patients with carcinoma of ampulla were collected.After percutaneous transhepatic biliary stent implantation was accomplished,the after-loading radiotherapy catheter was inserted via the guide wire.Based on the lesion's location,the positioning of both the catheter tip and the simulation radioactive source implanted through catheter was conducted.Each time before irradiation,the positions of the catheter and the radioactive source were reset under CT or fluoroscopic guidance in order to ensure that the lesion could get adequate internal irradiation dose.Results Percutaneous transhepatic biliary implantation of after-loading radiotherapy catheter and the positioning of simulation radioactive source were successfully accomplished in all 10 patients,and the total internal irradiation dose was completed within 5-7 days after catheter implantation.No severe complications occurred during the whole therapeutic process.Conclusion The technology of percutaneous transhepatic biliary preset implantation of after-loading radiotherapy catheter is safe and feasible,it carries high success rate with less complications.This therapy can improve the patency rate of biliary stent,and,as a palliative treatment,it is suitable for patients with carcinoma of ampulla.This treatment is worthy of application and promotion.

To study the chemical constituents of Veratrum dahuricum (Turcz.) Loes. f., a new aurone glycoside named as (Z)-7, 4'-dimethoxy-6-hydroxyl-aurone-4-O-β-glucopyranoside was isolated from the 95% ethanol extracts of the rhizomes and roots of Veratrum dahuricum (Turcz.) Loes. f. by repeated column chromatography on silica gel and recrystallization. Its structure was established by extensive spectroscopic analyses, and its cytotoxicities against HepG-2, MCF7 and A549 cell lines were measured in vitro.

ObjectiveTo observe the level of transforming growth factor-β1 ( TGF-31 ) in lung tissue of mice with acute lung injury induced by bleomycin. MethodsSixty Kunming male mice were randomly (random number) divided into sham operation group, model group, curcumin high dose group,medium dose group and low dose group (n =12 in each group). The models of acute lung injury were made by intratracheal instillation of bleomycin for once in the mice of model group and curcumin treated groups,and equal volume of saline was used in mice of sham operation group instead of bleomycin. Curcumin was given in doses of 200 mg· kg-1 · d-1 , 100 mg· kg-1 · d-1and 50 mg · kg-1 · d-1 to the mice of high dose group, medium dose group and low dose group, respectively 24 hours after modeling until the day before sacrifice, and the mice of sham operation group and model group were fed with equal volume of saline instead. Six mice of each group were sacrificed on the 3rd and 7th day separately for detecting lung wet to dry ratio (W/D), pathological changes of lung tissue stained with HE, and level of the transforming growth factor-β1 in the lung tissues stained with immunohistochemistry in mice of each group. Data were analyzed to express as mean ± standard deviation. -PSS11.5 statistical package was used for analysis. The comparison of the mean diversity carried out by using single factor analysis of variance. Results Morphological changes in lung tissue observed under light microscope showed that obvious morphological abnormalities,alveolar edema fluid and inflammatory cells were not found in mice of sham operation group, and lung capillaries dilated, widened alveolar septum, edema fluid and inflammatory cells infiltration in the alveolar in lung tissue were seen in mice of model group, and different degrees of pathological changes were found in mice of three curcumin treated groups, but those changes were less severe than those in mice of model group. Lung wet to dry ratio (W/D) was significantly higher in mice of model group than that in mice of sham group ( P ＜ 0. 01 ), but that in mice of three curcumin treated groups was significantly lower than that in mice of model group ( P ＜ 0. 01 ). Immunohistochemistry showed low level of TGF-β1 in lung tissue of mice in sham operation group, and the level of TGF-β1 in lung tissue of mice in model group was significantly higher than that in sham operation group ( P ＜ 0. 01 ). The level of TGF-β1 in lung tissue of mice in three curcumin treated groups was significantly lower than that in mice of model group ( P ＜ 0. 01 ),but that was still higher than that in sham group ( P ＜ 0. 01 ). ConclusionsCurcumin can inhibit the TGF-β1 in lung tissue and play a protective effect on acute lung injury induced by bleomycin, reducing the degree of lung injury. The protective mechanism may be associated with the inhibition of TGF-β1 in lung tissue.