Objective To explore the effect of stress hyperglycemia (SHG) on new-onset atrial fibrillation (NOAF) in patients with acute myocardial infarction (AMI). Methods A total of 1 321 patients with non-diabetic AMI who were admitted to the hospital from February 2024 to February 2025 were retrospectively selected. The occurrence of SHG was assessed according to the blood glucose level at admission. All patients received standard treatment after admission. The occurrence of NOAF during hospitalization was recorded. According to the presence or absence of NOAF occurrence, the patients were classified into NOAF group (n=118) and no-NOAF group (n=1,203). The clinical data of the two groups were collected and compared. Multivariate logistic regression analysis was applied to analyze the factors influencing the occurrence of NOAF in AMI patients. Results Among the 1 321 patients, 369 cases (27.93%) had SHG according to their blood glucose test at admission. After the completion of hospitalization, 118 of the 1321 patients developed NOAF, with an incidence rate of 8.93%. Multivariate logistic regression analysis revealed that SHG (OR=2.776, 95%CI: 1.384-5.567), smoking history (OR=2.680, 95%CI: 1.457-4.931), Killip grading at admission (OR=2.779, 95%CI: 1.361-5.671), Gensini score (OR=1.119, 95%CI: 1.038-1.205), time from onset to revascularization (OR=1.114, 95%CI: 0.973-1.275), and NT-proBNP (OR=1.123, 95%CI: 1.049-1.203) were independent influencing factors of NOAF in patients with AMI (P<0.05). Conclusion SHG, smoking history, Killip grading at admission, Gensini score, NT-proBNP, and time from onset to revascularization may influence the occurrence of NOAF in AMI patients during hospitalization, which should be given high attention.

Objective To analyze the application characteristics of acupuncture and moxibustion in the treatment of postherpetic neuralgia(PHN)using complex networks;To provide clinical acupuncture and moxibustion treatment with application basis for acupoint selection,acupuncture and moxibustion,and treatment ideas.Methods The clinical research literature on acupuncture and moxibustion treatment for PHN was retrieved from CNKI,Wanfang Data,VIP,PubMed and Web of Science.The literature was screened according to the inclusion and exclusion criteria,and Excel 2019 was used to establish an acupuncture and moxibustion treatment PHN database.SPSS Modeler 18.0 software was used for modeling and association rule analysis,and Gephi 0.10.1 software was used for complex network analysis.Results Totally 237 articles were included,and 262 acupuncture and moxibustion prescriptions data were extracted,involving a total of 115 acupoints,with a total use frequency of 1 432 times.The top 10 most frequently used acupoints were Ashi acupoint(214 times)and Jiaji acupoint(198 times),Zusanli(74 times),Taichong(74 times),Sanyinjiao(66 times),Hegu(65 times),Yanglingquan(62 times),Xuehai(60 times),Zhigou(53 times),and Quchi(52 times).The association rule analysis showed that the acupoint combination with the highest correlation was Ashi acupoint-Jiaji acupoint.K-core hierarchical analysis and community analysis on the complex network of the acupoint prescriptions obtained two core acupoint groups.Therapy analysis showed that filiform needle acupuncture was the most commonly used intervention for acupuncture treatment of PHN;syndrome type-acupoint analysis showed that the syndrome types with the highest frequency of PHN were liver meridian heat stagnation,blood stasis and collaterals obstruction,and spleen meridian damp-heat;tonic and diarrhea-acupoint analysis showed that the main operating techniques were neutral-tonifying and neutral-discharging.Conclusion Acupuncture and moxibustion treatment for PHN mainly selects local acupoints,Ashi acupoint and Jiaji acupoint are often selected,and focusing on the cooperation with distal acupoints.The external and internal meridians are mostly selected according to different syndrome types.The operation is performed using neutral-tonifying and neutral-discharging techniques.Commonly used filiform acupuncture combined with electro-acupuncture,pricking,cupping and other therapies.The application characteristics can provide clinical reference for the treatment of PHN.

In cardiac ablation procedures,the accuracy of catheter positioning determines the authenticity of the cardiac model and the accuracy of the ablation target.This article reviews the literature on catheter positioning in electrophysiology and summarizes the key technologies for catheter positioning,such as magnetic-electric fusion and interference suppression.Addressing the limitations of electric and magnetic positioning individually,the paper elaborates on the rationale for catheter positioning technology based on magnetic-electric fusion.It also outlines the framework of a complex catheter positioning system.Specifically,the magnetoelectric conversion matrix is established first,followed by the optimization of the catheter shape.The interference factors such as magnetic field interference,body movement,respiration,and heartbeat in catheter positioning and their suppression methods are analyzed and discussed in detail.Finally,the development trend of three-dimensional electrophysiology catheter positioning technology is prospected,offering feasible insights for the research on catheter positioning technology based on magnetic-electric fusion.

OBJECTIVE: To analyze the clinical phenotype and genetic characteristics of a patient with Alport syndrome. METHODS: A patient with Alport syndrome who had visited the First Affiliated Hospital of Zhengzhou University in November 2020 was selected as the study subject. Clinical data of the patient were collected. High-throughput sequencing was carried out to detect potential variant of the COL4A3, COL4A4 and COL4A5 genes, and Sanger sequencing was carried out for verification of candidate variants in the family. RESULTS: The main clinical manifestations of the patient included hematuria, proteinuria, and impaired hearing. Audiometric testing suggested symmetrical cochlear sensory neural hearing loss on both sides. Renal biopsy revealed mild mesangial proliferative glomerulonephritis. Genetic testing revealed that the patient has harbored compound heterozygous variants of the COL4A4 gene, namely c.940G>A (p.Gly314Ser) and c.3773G>A (p.Gly1258Asp), which were respectively inherited from her father and mother. Neither variant has been reported before, and were predicted to be pathogenic based on the guidelines from the American College of Medical Genetics and Genomics. CONCLUSION The c.940G>A (p.Gly314Ser) and c.3773G>A (p.Gly1258Asp) compound heterozygous variants of the COL4A4 gene probably underlay the Alport syndrome in this patient. Above finding has enriched the mutational spectrum of the COL4A4 gene.
Female ; Humans ; Nephritis, Hereditary/genetics* ; Hematuria ; Genetic Testing ; Genomics ; Hearing ; Collagen Type IV/genetics*

Subcortical vascular mild cognitive impairment (svMCI) is a common prodromal stage of vascular dementia. Although mounting evidence has suggested abnormalities in several single brain network metrics, few studies have explored the consistency between functional and structural connectivity networks in svMCI. Here, we constructed such networks using resting-state fMRI for functional connectivity and diffusion tensor imaging for structural connectivity in 30 patients with svMCI and 30 normal controls. The functional networks were then parcellated into topological modules, corresponding to several well-defined functional domains. The coupling between the functional and structural networks was finally estimated and compared at the multiscale network level (whole brain and modular level). We found no significant intergroup differences in the functional–structural coupling within the whole brain; however, there was significantly increased functional–structural coupling within the dorsal attention module and decreased functional–structural coupling within the ventral attention module in the svMCI group. In addition, the svMCI patients demonstrated decreased intramodular connectivity strength in the visual, somatomotor, and dorsal attention modules as well as decreased intermodular connectivity strength between several modules in the functional network, mainly linking the visual, somatomotor, dorsal attention, ventral attention, and frontoparietal control modules. There was no significant correlation between the altered module-level functional–structural coupling and cognitive performance in patients with svMCI. These findings demonstrate for the first time that svMCI is reflected in a selective aberrant topological organization in multiscale brain networks and may improve our understanding of the pathophysiological mechanisms underlying svMCI.

Objective To investigate the effects of hemodialysis combined with hemopurification and comprehensive nursing intervention on the levels of interleukin -6 (IL-6), C-reactive protein (CRP) and β2- microglobulin (β2- MG) in patients with diabetic nephropathy (DN). Methods A total of 68 patients with DN were selected in our hospital, and were treated with hemodialysis combined with hemopurification. The control group was treated with routine nursing intervention, and the observation group was given comprehensive nursing intervention, with 34 cases in each group. The differences in the levels of IL- 6, CRP and β2- MG before and after treatment were compared between the two groups. Results In the control group, the level of IL-6 before treatment [(121.85±34.95) pg/ml] and 1 month after treatment [(120.53 ± 24.95) pg/ml] and 3 months [(119.05 ± 25.73) pg/ml] showed no significant difference (P>0.05). The level of IL-6 in the observation group for 1 month after treatment [(98.90±20.52) pg/ml] and 3 months [(70.32 ± 10.43) pg/ml] was significantly lower than that before treatment, and significantly lower than those in the control group (P<0.05). There was no significant difference in the level of CRPbetween the control group before treatment [(12.64 ± 3.08) mg/L] and 1 month after treatment (12.64±3.15) mg/L] and 3 months [12.89±4.02] mg/L] (P>0.05); the level of CRP at 1 month after treatment [(9.24 ± 3.24)mg/L] and 3 months after treatment [(7.04 ± 2.54)mg/L] in the observation group was significantly lower than that before the treatment, and significantly lower than those in the control group (P<0.05).The level of β2-MG in the control group at 1 month [(10.24±1.79) mg/L] and 3 months after treatment [(9.01 ± 1.47) mg/L] were significantly lower than before the treatment (12.53 ± 3.45) mg/L];thelevel of β2-MG at 1 month [(9.03±1.68) mg/L] and 3 months after treatment [(6.73±1.73)mg/L] in the observation group was also significantly lower thanthat before the treatment, and significantly lower than those in the control group (P<0.05). Conclusions Hemodialysis combined with hemopurification and comprehensive nursing intervention can effectively inhibit the release of inflammatory factors and reduce the inflammatory state, so it has good clinical application value.

Objective: To explore the optimal and rapid imaging acquisition time and clinical applicability when using high- and low-dose one day rest/stress myocardial perfusion imaging (MPI) with cadmium-zinc-telluride heart dedicated SPECT (CZT-SPECT). Methods: The MPI data with high-dose rest/stress protocol in 51 patients (22 males, 29 females, age: (55.4±8.5) years) between November 2017 and December 2017 and those with low-dose protocol in 50 patients (27 males, 23 females, age: (59.1±12.8) years) between July 2018 and October 2018 were retrospectively analyzed. The MPI was performed with CZT-SPECT. Each patient received 296-370 MBq rest dose of ⁹⁹Tc^m-methoxyisobutylisonitrile (MIBI) for high-dose protocol, 111-222 MBq rest dose of ⁹⁹Tc^m-MIBI for low-dose protocol. Stress dose was 3 times of the corresponding rest dose. Rest and stress scans were acquired 6 min and 4 min for high-dose protocol, while 8 min and 6 min for low-dose protocol in total. All rest or stress imaging data were reconstructed from list-mode raw data to obtain scan durations of 1 min, 2 min, etc, up to the maximum of acquisition time. Image quality at different acquisition times were evaluated, and myocardial perfusion and function parameters were compared. Paired t test, Wilcoxon signed rank test, Pearson correlation and Bland-Altman analyses were used for data analysis. Results: The image quality was rated as excellent/good in all patients (100%, 51/51) when acquisition time ≥3 min and ≥2 min respectively for rest and stress imaging with high-dose protocol, the similar results was obtained (100%, 50/50) when acquisition time ≥4 min and ≥3 min respectively for rest and stress imaging with low-dose protocol. The quantitative perfusion parameters(summed rest scores, summed stress scores, total perfusion deficit) and left ventricle ejection fraction (LVEF) at shorter acquisition times (3 min/2 min, 4 min/3 min) were not significantly different from the results at the longer acquisition times (6 min/4 min, 8 min/6 min; t values: from -1.196 to 1.597, z values: from -1.963 to 1.945, all P>0.05). Those parameters at shorter and longer acquisition times showed strong correlations (all r>0.700, all P<0.001), and Bland-Altman analysis revealed good agreement between them. Conclusion The optimal acquisition time is 3 min/2 min for high-dose one-day rest/stress CZT-SPECT MPI, and 4 min/3 min for low-dose protocol, which can significantly shorten the MPI acquisition time, then reliable perfusion parameters and LVEF can be obtained under the premise of ensuring image quality, making it the better clinical applicability.

Objective: To examine the effects of ursodeoxycholic acid combined with Traditional Chinese Medicine on biochemical response in patients with primary biliary cholangitis. Methods: According to the method of receiving treatment, 197 patients with primary biliary cholangitis were divided into Traditional Chinese Medicine plus Western medicine group (93 cases, 47.2%) and Western medicine group (104 cases, 52.8%). From the baseline date, the combined group was treated with ursodeoxycholic acid plus traditional Chinese medicine decoction or Chinese patent medicine for at least one month and the Western medicine group simply took ursodeoxycholic acid . Additionally, Traditional Chinese medicine decoction prescriptions were mainly Xiaoyaosan and Yinchenhao. Chinese patent medicine were restricted to Biejia Ruangan tablets, Fuzheng Huayu capsules, Jiuweigantai capsules and Yinzhihuang capsules, which were used to treat liver fibrosis and cholestasis. The primary efficacy endpoint was defined as ALP level < 1.67 × ULN and ≥ 15% decrease in ALP with baseline level and TBIL≤ULN after 12 months of treatment. Results: The overall biochemical response rate of patients was 35.0% (69/197). The response rate of TCM+ Western medicine group was 43.0% (40/93), and that of Western medicine group was 27.9% (29/104). The difference between the two groups was statistically significant (χ² = 4.936, P < 0.05). Further analysis showed that the Chinese and Western medicine group was superior to the Western medicine group alone in reducing γ-glutamyltransferase (GGT) and TBiL [the median decline were GGT: 160.1 U/L and 111.3 U/L (Z = -2.474, P < 0.05), TBiL: 5.2 umol/l and 3.1 umol/l (Z = -2.125, P < 0.05)]. Conclusion UDCA combined with TCM therapy can remarkably improve the biochemical response rate in patients with PBC and distinctly decrease the TBIL and GGT levels than UDCA monotherapy.