With the aging of the population,the disease burden of heart valve disease in China has significantly increased.In recent years,the interventional treatment for heart valve disease has flourished,among which transcatheter aortic valve replacement(TAVR)has become the first-line treatment for elderly patients with aortic valve stenosis.China started relatively late in the field of interventional treatment for heart valve disease.The construction of heart valve centers helps to standardize the diagnosis and interventional treatment of heart valve disease in China and improve the management of prognosis for patients.Up to December 2024,a total of 453 centers have participated in the construction of heart valve centers,including 100 construction centers and 40 certification centers.The National Transcatheter Valve Therapeutics Registry(NTCVR)database has reported a total of 28 594 cases,with approximately 50％of Chinese TAVR cases recorded in NTCVR database.The construction of the heart valve centers has shown initial results,significantly optimizing the process of diagnosis and treatment of heart valve disease and improving the prognosis.At present,there are still many shortcomings in the construction of heart valve centers.For example,the follow-up rate of patients after discharge is low,and long-term management after discharge needs to be further improved.There is still a gap in some indicators between construction centers and certification centers,and the promotion of high-quality management of interventional treatment of heart valve disease in China is still a long way to go.

Objective:To compare the efficacy and safety of the gastrointestinal endoscopic super minimally invasive surgery (eSMIS) and the laparoscopic minimally invasive procedure (LS) for the treatment of gastric glomus tumors(GGT).Methods:This study retrospectively included 15 patients with GGT who underwent eSMIS at the First Medical Center of Chinese PLA General Hospital from May 2014 to May 2024. Data on demographic characteristics, surgical indexes, efficacy evaluation indexes, postoperative medical disposition, health economics indexes and postoperative laboratory indexes were collected and analyzed, the patients were followed up for survival outcomes and the postoperative quality of life, efficacy and safety of the two groups were compared.Results:The amount of bleeding in the eSMIS group was lower than that in the LS group: 1.25 (0, 3.75) ml vs. 41.56 (10.00, 50.00) ml, and the surgical cost in the eSMIS group was lower than that in the LS group: 10 792.87 (8 424.90, 12 730.30) yuan vs. 21 773.06 (19 940.60, 24 843.10) yuan, there were statistical differences ( P<0.05). The surgical efficacy, postoperative laboratory indicators and medical treatment convenience between the two groups had no statistical differences ( P>0.05). Conclusions:In the choice of surgical procedures for the treatment of GGT, eSMIS is superior to LS in terms of bleeding and surgical cost, and not inferior to LS in other indicators. This suggested that the treatment of GGT with eSMIS is feasible, safe and effective.

Iron is one of the essential trace elements for the human body,which is crucial for the growth and development of newborns,especially premature infants.It participates in the generation of hemoglobin,affects the activity of various enzymes,and subsequently affects neurometabolism,neurochemistry,neuroanatomy,and gene/protein composition,thereby having a lasting impact on the development of the central nervous system.This article reviews the research progress on the relationship between iron metabolism and neurodevelopment in premature infants in recent years,aiming to provide scientific basis for clinical management and preventive intervention of premature infants.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective:To compare the efficacy and safety of the gastrointestinal endoscopic super minimally invasive surgery (eSMIS) and the laparoscopic minimally invasive procedure (LS) for the treatment of gastric glomus tumors(GGT).Methods:This study retrospectively included 15 patients with GGT who underwent eSMIS at the First Medical Center of Chinese PLA General Hospital from May 2014 to May 2024. Data on demographic characteristics, surgical indexes, efficacy evaluation indexes, postoperative medical disposition, health economics indexes and postoperative laboratory indexes were collected and analyzed, the patients were followed up for survival outcomes and the postoperative quality of life, efficacy and safety of the two groups were compared.Results:The amount of bleeding in the eSMIS group was lower than that in the LS group: 1.25 (0, 3.75) ml vs. 41.56 (10.00, 50.00) ml, and the surgical cost in the eSMIS group was lower than that in the LS group: 10 792.87 (8 424.90, 12 730.30) yuan vs. 21 773.06 (19 940.60, 24 843.10) yuan, there were statistical differences ( P<0.05). The surgical efficacy, postoperative laboratory indicators and medical treatment convenience between the two groups had no statistical differences ( P>0.05). Conclusions:In the choice of surgical procedures for the treatment of GGT, eSMIS is superior to LS in terms of bleeding and surgical cost, and not inferior to LS in other indicators. This suggested that the treatment of GGT with eSMIS is feasible, safe and effective.

Iron is one of the essential trace elements for the human body,which is crucial for the growth and development of newborns,especially premature infants.It participates in the generation of hemoglobin,affects the activity of various enzymes,and subsequently affects neurometabolism,neurochemistry,neuroanatomy,and gene/protein composition,thereby having a lasting impact on the development of the central nervous system.This article reviews the research progress on the relationship between iron metabolism and neurodevelopment in premature infants in recent years,aiming to provide scientific basis for clinical management and preventive intervention of premature infants.

Prescription sequence symmetry analysis (PSSA) is one of the important methods for post-marketing pharmacovigilance based on the real-world medical prescription databases. It can be used to detect prescription cascades and mine adverse drug reaction (ADR) signals, which has been verified by many studies. PSSA shows high specificity and medium sensitivity in identifying ADR. It can quantify the correlation or risks of ADR. It is easy to use and simple in algorithm, and it has good robustness to some non time-dependent confounding factors. However, the results may be affected by some human confounding factors and data quality. This paper reviews the principle, calculation method, application scope, and precaution of PSSA by reviewing related literature on PSSA domestically and abroad, in order to provide reference for pharmacovigilance in China.

Objective:To understand the application situation and role of prescription sequence symmetry analysis (PSSA) in pharmacovigilance.Methods:The relevant databases at home and abroad were searched (up to April 30, 2024), and the original articles using PSSA as the research method were collected. The basic information of the literature (first author, publication year, country, etc.), the purpose and main content of the study, the index drugs as well as the marker drugs or medical diagnoses involved in the adverse drug reactions (ADRs) were extracted. Descriptive statistical analysis was carried out.Results:A total of 66 articles were included in the analysis. The first article was published in 1996, the number of articles published in recent years has increased significantly, and those published after 2016 accounted for 68.2% (45/66). The top 3 countries in terms of published literature quantity were the United States, Denmark, and Japan. The index drugs most commonly studied were those for the cardiovascular system and the neuropsychiatric system, in 18 and 14 articles respectively. The drugs studied in 3 or more papers were hypolipidemic drugs, antihypertensive drugs, antipsychotics, antiepileptics, proton pump inhibitors, hypoglycemic drugs and anticoagulants. The targeted ADRs/diseases most studied were those about the neuropsychiatric system (in 13 studies), followed by those about the endocrine and metabolic system (in 12 studies). The research objective in 47 articles was to explore the association between index drugs and ADRs/diseases through PSSA. Finally, the associations between 21 ADRs and index drugs were identified in 24 articles, of which 9 were new ADRs not recorded in drug instructions; benefits or potential preventive and therapeutic effects of index drugs on certain diseases were found in 7 studies. Ten studies were conducted to explore ADR information of specific drugs or detect suspicious drugs that cause specific ADRs, and some correlation signals between drugs and ADRs that previously unknown were detected. Nine studies evaluated the prescribing cascades, including the use of antitussive drugs after ACEI, the prescribing cascades related to drug-induced lower urinary tract symptoms and edema, the prescription cascades of statins, and the prescribing cascade relic.Conclusion:PSSA is a useful method for identifying potential prescribing cascades and mining ADR signals using medical prescription databases, especially suitable for the safety monitoring of long-term medication for chronic diseases and the signal detection of ADR that causal relationships are difficult to determine.