Aortic stenosis is a valve disease characterized by dynamic and continuous changes in structure and function of left ventricle.Left ventricular remodeling,which embodies pathological changes in myocardial cellular and ventricular geometry,is an important prognostic factor of patients with aortic stenosis.Aortic valve replacement is the only effective treatment for severe aortic stenosis.Current guideline recommendations for interventions are based on symptoms and left ventricular ejection fraction.With the improvements of modern imaging technology,different patterns of remodeling,including hypertrophy and fibrosis,could be identified now.Studies also explored the close association between left ventricular remodeling and function in the setting of aortic stenosis.In this review,we aim to elucidate the characteristic imaging features and potential mechanisms of left ventricular remodeling,and further,we highlight the clinical value of specific imaging features and clinical application of modern imaging methods in the evaluation,risk stratification,and intervention decision-making for patients with aortic stenosis.

The healing process of skin wounds caused by severe mechanical trauma and chronic diseases(e.g.,diabetic foot ulcers)is often accompanied by tissue injury,microbial infection,intense inflammatory reactions,hypertrophic scars,and other complications.Microneedles have been widely used to facilitate wound healing in recent years.According to their different modes of action,microneedle formulation can be categorized into five types:solid microneedles,hollow microneedles,coated microneedles,soluble microneedles,and hydrogel microneedles.This paper reviews the preparation methods and characteristics of microneedles,and summarizes their roles in hemostasis,bacteriostasis,anti-inflammation,enhancement of collagen deposition,and angiogenesis,in the hope of providing some reference for future research and development.

Objective:To analyze the clinical features and immunotherapy responsiveness of patients with myelin oligodendrocyte glycoprotein immunoglobulin G-antibody associated disease (MOGAD) with epilepsy, and display the risk factors of epilepsy in MOGAD.Methods:Eighty-nine patients with MOGAD diagnosed at the First Affiliated Hospital of Zhengzhou University between October 2019 and May 2023 were enrolled and classified into 2 groups upon MOGAD with ( n=29) or without epilepsy ( n=60). The Expanded Disability Status Scale (EDSS) and Clinical Assessment Scale for Autoimmune Encephalitis (CASE) were used for evaluation of severity, and EDSS or CASE scores on the 30th day after first-line immunotherapy initiation lower than that on admission were defined as well treatment responsiveness. The differences of general data, clinical manifestations, cerebrospinal fluid (CSF) and peripheral blood biochemical examination results, and immunotherapy reactivity between the 2 groups were thoroughly explicated. In addition, the risk factors of epilepsy in MOGAD were analyzed by univariate and multivariate Logistic regression analysis. Results:Compared with patients with MOGAD without epilepsy, patients with MOGAD with epilepsy were characterized by lower age of onset [24.5(10.3, 34.0) years vs 11.0(6.5, 20.0) years, Z=-2.348, P=0.019], higher percentage of male patients [43.3%(26/60) vs 75.9%(22/29), χ 2=8.326, P=0.004], higher virus infection rate [28.3%(17/60) vs 51.7%(15/29), χ 2=4.645, P=0.031], higher incidence of prodromal symptoms [11.7%(7/60) vs 34.5%(10/29), χ 2=6.586, P=0.010], higher blood-brain barrier breakdown rate [35.0%(21/60) vs 58.6%(17/29), χ 2=4.458, P=0.035], higher percentage of CSF albumin level>450 mg/L [48.3%(29/60) vs 75.9%(22/29), χ 2=6.056, P=0.014] and higher creatine kinase level [45.50(28.50, 69.75) U/L vs 57.50(41.75, 97.25) U/L, Z=-2.349, P=0.019]; more epilepsy [0(0) vs 29/29 (100.0%), χ 2=89.000, P<0.001] and disturbance of consciousness [0(0) vs 6/29(20.7%), χ 2=10.224, P=0.001] as clinical manifestations, and more cerebral cortex lesions [30/60(50.0%) vs 25/29(86.2%), χ 2=10.856, P=0.001] on magnetic resonance imaging. Nevertheless, the patients with MOGAD without epilepsy were featured with more visual impairment [23/60(38.3%) vs 3/29(10.3%), χ 2=7.406, P=0.007], limb weakness [18/60(30.0%) vs 1/29(3.4%), χ 2=8.209, P=0.004], sensory disturbance [15/60(25.0%) vs 0(0), Fisher exact probability test, P=0.002] and more cervical cord lesions [22/60(36.7%) vs 4/29(13.8%), χ 2=4.946, P=0.026] on magnetic resonance imaging. Immunotherapy responsiveness was relatively poor in the MOGAD with epilepsy group [EDSS score lower than that on admission: 15/29(51.7%) vs 46/60(76.7%), χ 2=5.641, P=0.018; CASE score lower than that on admission: 16/29(55.2%) vs 47/60(78.3%), χ 2=5.072, P=0.024] compared with the MOGAD without epilepsy group. Male was the independent risk factor of epilepsy in MOGAD ( OR=7.078, 95% CI 1.709-29.326, P=0.007). Conclusions:Compared with patients with MOGAD without epilepsy, patients with MOGAD with epilepsy reported more male patients, lower age of onset and higher incidence of prodromal symptoms, blood-brain barrier dysfunction rate, virus infection rate, CSF albumin level and creatine kinase level; clinical phenotypes were mainly meningoencephalitis and more cerebral cortex lesions were shown on magnetic resonance imaging. MOGAD with epilepsy was closely related to poor immunotherapy responsiveness, and gender was found to be the independent risk factor for epilepsy in MOGAD.

Central medial thalamic nucleus (CM) is a nucleus located in the medullary plate of the midline thalamus. It belongs to the midline nucleus group of the thalamus and serves as a non-specific projection system. CM has extensive anatomical connections with other brain areas and acts as a relay and integration center for brain functions. Recent research has demonstrated that CM is involved in various behaviors such as general anesthesia and arousal, pain, itch, emotions, and cognition. This paper reviews the anatomical structure, morphology, fiber connection, electrophysiological characteristics, and other related functions of CM to provide references for future research.

The optimal protocol for neuromodulation by transcranial direct current stimulation (tDCS) remains unclear. Using the rotarod paradigm, we found that mouse motor learning was enhanced by anodal tDCS (3.2 mA/cm²) during but not before or after the performance of a task. Dual-task experiments showed that motor learning enhancement was specific to the task accompanied by anodal tDCS. Studies using a mouse model of stroke induced by middle cerebral artery occlusion showed that concurrent anodal tDCS restored motor learning capability in a task-specific manner. Transcranial in vivo Ca²⁺ imaging further showed that anodal tDCS elevated and cathodal tDCS suppressed neuronal activity in the primary motor cortex (M1). Anodal tDCS specifically promoted the activity of task-related M1 neurons during task performance, suggesting that elevated Hebbian synaptic potentiation in task-activated circuits accounts for the motor learning enhancement. Thus, application of tDCS concurrent with the targeted behavioral dysfunction could be an effective approach to treating brain disorders.
Transcranial Direct Current Stimulation/methods* ; Motor Cortex/physiology* ; Neurons ; Transcranial Magnetic Stimulation

Objective:To investigate the clinical efficacy and safety of anlotinib monotherapy in second-line treatment of extensive stage small cell lung cancer (ES-SCLC) with poor performance status (PS) score after treatment failure with first-line standard regimen.Methods:Thirty-three patients with ES-SCLC who failed to receive first-line standard treatment and had poor PS score were selected from Fuyang People's Hospital of Anhui Province from January 2021 to December 2022. All patients were given anrotinib 10 mg orally for second-line treatment, which was taken for 2 weeks and stopped for 1 week, with every 21 days being a cycle period, until the disease progressed or the patient became intolerable. Objective response rate (ORR), disease control rate (DCR) and adverse reactions were observed. Progression-free survival (PFS) was estimated by Kaplan-Meier method, and the influencing factors of PFS were analyzed by Cox regression model.Results:After at least 2 cycles of anlotinib monotherapy, there were no complete remission, 5 cases of partial remission, 17 cases of stable disease, 11 cases of progressive disease. ORR was 15.2% (5/33), DCR was 66.7% (22/33). The median PFS was 3.7 months (95% CI: 2.9-4.5 months). Univariate analysis showed that first-line recurrence time ( χ2=4.90, P=0.027), brain metastases ( χ2=12.42, P<0.001), liver metastases ( χ2=11.05, P=0.001) and controlling nutritional status (CONUT) score ( χ2=12.43, P<0.001) were the influential factors of PFS in ES-SCLC patients with poor PS score and first-line treatment failure of anlotinib monotherapy. Multivariate analysis showed that brain metastases ( HR=3.21, 95% CI: 1.24-8.29, P=0.016), liver metastases ( HR=2.80, 95% CI: 1.03-7.61, P=0.044) and CONUT score ( HR=2.72, 95% CI: 1.16-6.38, P=0.021) were independent influencing factors of PFS in ES-SCLC patients with first-line treatment failure of anlotinib monotherapy and poor PS score. Common adverse reactions were fatigue, hypertension, anorexia, etc. Most of the adverse reactions were grade 1-2, with the incidence of grade 3 adverse reactions being 9.1% (3/33), and no grade 4-5 adverse reactions occurred. Conclusion:The clinical efficacy of anlotinib monotherapy in second-line treatment of ES-SCLC with poor PS score and failure of first-line standard regimen is good, and the adverse reactions are controllable.

Objective:To evaluate the effect of inhaled medication compliance intervention in elderly patients with chronic obstructive pulmonary disease (COPD) based on integrated theory of health behavior change.Methods:A total of 117 elderly COPD patients who visited Respiratory Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University from July to December 2021 were selected by the convenient sampling method. According to the random number table method, they were divided into the experimental group and the control group. 7 cases fell off during follow-up, and a total of 110 cases were finally included in the study, of which 55 cases were in the experimental group and 55 cases in the control group. The control group adopted the conventional health education method, while the experimental group adopted the intervention plan of inhalation medication compliance of elderly COPD patients based on the integrated theory of health behavior change. The accuracy of inhalation device use, inhalant medication compliance, forced expiratory volume in the first second (FEV 1) and Chronic Obstructive Pulmonary Diseases Assessment Test (CAT) scores were compared between the two groups before intervention and 3 months after intervention. Results:After 3 months of intervention, the inhalation device use accuracy, inhalation medication compliance in experimental group were higher than those in the control group, the score of CAT in experimental group was lower than that in the control group, the differences were statistically significant ( P<0.05). There was no statistically significant difference in FEV 1 between two groups ( P>0.05) . Conclusions:The intervention plan for inhalation medication compliance in elderly patients with chronic obstructive pulmonary disease based on the integrated theory of health behavior changes can improve their inhalation medication compliance and improve their quality of life.

Objective:To investigate the significance of clinical factors combined with transvaginal ultrasound and contrast-enhanced ultrasound(CEUS) in guiding the choice of treatment plan for cesarean scar pregnancy(CSP).Methods:The clinical and transvaginal ultrasound and CEUS data of 120 patients with CSP from January 2016 to June 2021 in the First People′s Hospital of Foshan were retrospectively analyzed, and they were divided into ultrasound-guided curettage/ hysteroscopic group (Group A, 91 cases) and laparoscopic group (Group B, 29 cases) according to treatment option, and the differences in clinical and ultrasound factors between the two groups were compared, and to determine the relevant clinical and ultrasound indicators for the choice of treatment option.Results:There were statistical differences between the 2 groups in comparison of whether the gestational sac/mass protruded toward the plasma membrane, gestational sac/mass diameter, the main blood supply site of the gestational sac/mass, the site of the chorion/early placenta and scar thickness (all P<0.05). Logistic regression analysis indicated that CEUS showing major blood supply site of the gestational sac/mass ( OR=6.029, P=0.003) and uterine scar thickness ( OR=12.998, P=0.002) were independent risk factors for minimally invasive surgery for CSP. Conclusions:Ultrasound combined with clinical factors have a certain value in the selection of treatment options for CPS, and the thickness of the uterine scar and the main blood supply site of the gestational sac/mass showed in CEUS may be key factors affecting the minimally invasive surgical treatment of CSP.

Background::The study aimed to describe the aortic valve morphology in Chinese patients underwent transcatheter aortic valve replacement (TAVR) for symptomatic severe aortic stenosis (AS), and the impact of sizing strategies and related procedural outcomes.Methods::Patients with severe AS who underwent TAVR were consecutively enrolled from 2012 to 2019. The anatomy and morphology of the aortic root were assessed. "Downsize" strategy was preformed when patients had complex morphology. The clinical outcomes of patients who performed downsize strategy were compared with those received annular sizing strategy. The primary outcome was device success rate, and secondary outcomes included Valve Academic Research Consortium-3 clinical outcomes variables based on 1-year follow-up.Results::A total of 293 patients were enrolled. Among them, 95 patients (32.4%) had bicuspid aortic valve. The calcium volume (Hounsfield Unit-850) of aortic root was 449.90 (243.15-782.15) mm 3. Calcium is distributed mostly on the leaflet level. Downsize strategy was performed in 204 patients (69.6%). Compared with the patients who performed annular sizing strategy, those received downsize strategy achieved a similar device success rate (82.0% [73] vs. 83.3% [170], P= 0.79). Aortic valve gradients (downsize strategy group vs. annular sizing group, 11.28 mmHg vs. 11.88 mmHg, P = 0.64) and percentages of patients with moderate or severe paravalvular regurgitation 2.0% (4/204) vs. 4.5% (4/89), P = 0.21) were similar in the two groups at 30 days after TAVR. These echocardiographic results were sustainable for one year. Conclusions::Chinese TAVR patients have more prevalent bicuspid morphology and large calcium volume of aortic root. Calcium is distributed mostly on the leaflet level. Compare with annular sizing strategy, downsize strategy provided a non-inferior device success rate and transcatheter heart valve hemodynamic performance in self-expanding TAVR procedure.

The stability of deoxyribonucleoside triphosphate (dNTP) pool is essential for the normal synthesis of nuclear and mitochondrial DNA. The lack or excess of any dNTP may cause DNA damage and genomic instability, and increase mutation rate. Present studies have confirmed that the instability of dNTP pool is closely related to a variety of tumorigenesis. In addition, dNTP pool is involved in the development of tumor via multiple pathways, while the mechanisms of tumors caused by the instability of dNTP are complicated. This paper discusses the relationship between the stability of dNTP pool and DNA damage repair to provide a theoretical basis for early diagnosis and targeted treatment of tumors.