In recent years, with the continuous development and increasing maturity of interventional techniques, interventional treatment for congenital heart disease (CHD) has been progressively disseminated to county- and city-level hospitals in China. Concurrently, the standardized management of adult CHD (particularly patent foramen ovale) and the lifelong management of complex CHD are gaining increasing clinical attention, while the emergence of new techniques and products continuously advances the discipline. This article aims to review the new progress made in the field of interventional treatment for congenital heart disease in China during 2024. It specifically reviews and analyzes the following key aspects: (1) annual statistics on interventional closure procedures for CHD; (2) recent insights into patent foramen ovale closure; (3) advances in transcatheter pulmonary valve replacement; (4) interventional treatment and lifelong management strategies for complex CHD; (5) new interventional techniques for acquired heart disease; and (6) the application of artificial intelligence in CHD management. Through the synthesis and discussion of these topics, this article seeks to provide a detailed analysis of the current landscape of interventional treatment for CHD in China and project its future development trends.

Objectives:To investigate the impacts of American College of Cardiology/American Heart Association (ACC/AHA) coronary artery classification on the progression of coronary non-target lesions and revascularization in patients with coronary heart disease.Methods:From January 2010 to September 2014,1255 patients who underwent two consecutive coronary angiographies at Fuwai Hospital and had coronary non-target lesions were retrospectively analyzed.Lesion characteristics of all coronary non-target lesions were recorded at both procedures.All non-target lesions were divided into A,B1,B2 and C lesion group according to ACC/AHA coronary artery classification.Patients were divided into non-B2/C lesion group (noncomplex lesion group) and B2/C lesion group (complex lesion group) according to whether the non-target lesion had B2/C lesion The characteristics of all non-target coronary artery lesions and quantitative coronary angiography results were recorded.Lesion progression and revascularization were compared between different groups.Results:There were 1003 (79.9％) male patients,mean age was (58.0±9.7) years old,and 853 patients had B2/C lesions.There were 1670 non-target lesions,including 619 A/B1 lesions (214 A lesions and 405 B1 lesions) and 1051 B2/C lesions (796 B2 lesions and 255 C lesions).Follow-up time was (14.8±4.5) months.Compared with the patients in noncomplex lesion group,patients in complex lesion group were older,had lower proportion of family history of coronary heart disease and stroke (all P<0.05).The baseline levels of leukocytes,C-reactive protein,erythrocyte sedimentation rate (ESR),triglyceride and HbA1c were higher in complex lesion group than those in noncomplex lesion group.Complex lesion group had higher risk of lesion progression (21.8％ vs.13.2％,P<0.001) compared with noncomplex lesion group,similar results were observed in revascularization (16.5％ vs.11.2％,P=0.013),and there was no statistically difference in non-target lesion related myocardial infarction (P>0.05).At the lesion level,compared with A/B1 lesion,B2/C lesion was associated with a higher rate of lesion progression (17.4％ vs.11.0％,P<0.001),and a higher rate of revascularization (13.0％ vs.9.2％,P=0.018).Multivariate Cox regression analysis showed that lesion classification (B2/C) was an independent risk factor for non-target lesion progression (HR=1.732,95％CI:1.275-2.351,P<0.001) and non-target lesion revascularization (HR=1.477,95％CI:1.053-2.070,P=0.024).Conclusions:The risk of non-target lesion progression and revascularization is higher in complex groups compared with noncomplex groups according to ACC/AHA classification.So patients with complex lesions should receive more strict medical care to control related risk factors and improve their outcome.

Objective To explore the effect of KIAA0753 on glucose and energy metabolism in mouse embryonic osteoblast precursor cell line MC3T3-E1.Methods The GSE182286 datasets of patients with Joubert syndrome acquired from the Gene Expression Comprehensive database were analyzed for the levels of gene expression.After the cells with KIAA0753 overexpression were constructed and the experiment were divided into the control group,the high glucose group and the high glucose+overexpression KIAA0753 group,Western blotting was used to determine the effect of KIAA0753 on MC3T3-E1 cells under high glucose condition by detecting the expression of the glucose metabolism-related proteins,such as glycogen synthase 1 (GYS1 ),glycogen phosphorylase L (PYGL ),glucose transporter type 4 (GluT4 ),phosphofructokinase muscle (PFKM),pyruvate dehydrogenase phosphatase 1 (PDP1 ),and acetyl-CoA carboxylase α(ACACA ),as well as the mitochondria function-associated proteins,including peroxisome proliferator-activated receptor-γcoactivator-1α(PGC-1α),nuclear respiratory factor 1 (NRF1 ),and mitochondrial transcription factor A (TFAM).The effect of KIAA0753 on the intermediates of glucose metabolism was analyzed by determining the contents of glycogen,glucose and lactic acid in the cell culture medium.Cellular immunofluorescence assay and adenosine triphosphate (ATP ) assay were employed to measure the mitochondrial activity and function impacted by KIAA0753 in the cells under high glucose condition.The effect of KIAA0753 on the proliferation of MC3T3-E1 cells under high glucose was detected by EdU staining. Results The expression of KIAA0753 protein was downregulated in patients with Joubert syndrome and in MC3T3-E1 cells under high glucose conditions (P<0.05).High glucose resulted in inhibited protein expression of GYS1,ACACA,PFKM,GluT4,PGC-1α,TFAM and NRF1,enhanced protein levels of PDP1 and PYGL,reduced glycogen generation and consumption of extracellular glucose,and promoted production of lactic acid (P<0.05 ).While,overexpression of KIAA0753 could attenuate the effect of high glucose,that is,up-regulating the protein expression levels of GYS1,ACACA,PFKM,GluT4,PGC-1α,TFAM and NRF1,suppressing those of PDP1 and PYGL,enhancing glycogen generation and consumption of extracellular glucose,and inhibiting production of lactic acid (P<0.05 ). What's more,the overexpression also could elevate the activity and membrane potential of mitochondria,and promote the ATP synthesis (P<0.05 )and cell proliferation (P<0.05)in MC3T3-E1 cells under high glucose.Conclusion KIAA0753 can promote glucose metabolism and improve mitochondrial activity and function in osteoblasts,consequently providing more energy to the body.

Objectives:To investigate the impacts of American College of Cardiology/American Heart Association (ACC/AHA) coronary artery classification on the progression of coronary non-target lesions and revascularization in patients with coronary heart disease.Methods:From January 2010 to September 2014,1255 patients who underwent two consecutive coronary angiographies at Fuwai Hospital and had coronary non-target lesions were retrospectively analyzed.Lesion characteristics of all coronary non-target lesions were recorded at both procedures.All non-target lesions were divided into A,B1,B2 and C lesion group according to ACC/AHA coronary artery classification.Patients were divided into non-B2/C lesion group (noncomplex lesion group) and B2/C lesion group (complex lesion group) according to whether the non-target lesion had B2/C lesion The characteristics of all non-target coronary artery lesions and quantitative coronary angiography results were recorded.Lesion progression and revascularization were compared between different groups.Results:There were 1003 (79.9％) male patients,mean age was (58.0±9.7) years old,and 853 patients had B2/C lesions.There were 1670 non-target lesions,including 619 A/B1 lesions (214 A lesions and 405 B1 lesions) and 1051 B2/C lesions (796 B2 lesions and 255 C lesions).Follow-up time was (14.8±4.5) months.Compared with the patients in noncomplex lesion group,patients in complex lesion group were older,had lower proportion of family history of coronary heart disease and stroke (all P<0.05).The baseline levels of leukocytes,C-reactive protein,erythrocyte sedimentation rate (ESR),triglyceride and HbA1c were higher in complex lesion group than those in noncomplex lesion group.Complex lesion group had higher risk of lesion progression (21.8％ vs.13.2％,P<0.001) compared with noncomplex lesion group,similar results were observed in revascularization (16.5％ vs.11.2％,P=0.013),and there was no statistically difference in non-target lesion related myocardial infarction (P>0.05).At the lesion level,compared with A/B1 lesion,B2/C lesion was associated with a higher rate of lesion progression (17.4％ vs.11.0％,P<0.001),and a higher rate of revascularization (13.0％ vs.9.2％,P=0.018).Multivariate Cox regression analysis showed that lesion classification (B2/C) was an independent risk factor for non-target lesion progression (HR=1.732,95％CI:1.275-2.351,P<0.001) and non-target lesion revascularization (HR=1.477,95％CI:1.053-2.070,P=0.024).Conclusions:The risk of non-target lesion progression and revascularization is higher in complex groups compared with noncomplex groups according to ACC/AHA classification.So patients with complex lesions should receive more strict medical care to control related risk factors and improve their outcome.

Objective:To explore the clinical and electrophysiological characteristics of flail arm syndrome (FAS).Methods:Clinical and electrophysiological data were collected on 13 FAS patients and 31 persons with upper limb onset amyotropic lateral sclerosis (UL-ALS), including the amplitude of compound muscle action potential (CMAP) related to median nerve, ulnar nerve, and axillary nerve motor conduction. A split-hand index (SI) was calculated by dividing the CMAP amplitude of abductor pollicis brevis by that of the abductor digiti minimi. Clinical features, the CMAP amplitudes and SIs were compared between the FAS and UL-ALS patients.Results:Compared with UL-ALS patients, the age at onset among the FAS patients was older (averaging 60.9 years). The development to the second stage was longer (24±6 months). The upper limb reflexes of 15% of the FAS patients had disappeared and those of 77% were weakened, while the lower limb reflexes of 54% of the FAS patients were active and 38% were weakened, significantly different from the UL-ALS patients. However, there were no significant differences in the CMAP amplitudes of the median and ulnar nerves, nor in SI between the FAS and UL-ALS patients. The SIs of the FAS patients with upper motor neuron signs were significantly lower than those of FAS patients without such signs. Among the FAS patients, the average CMAP amplitude of the ulnar nerve was the highest, followed by those of the median and axillary nerves. Among the UL-ALS patients, however, the average CMAP amplitude of the ulnar nerve was not significantly different from that of the axillary nerve.Conclusions:FAS patients with upper motor neuron signs are more likely to have slip hand. The CMAP amplitude of their axillary nerve tends to be lower than that of their median and ulnar nerves. FAS seems to be a special type of ALS.

Objective:To investigate the effect of anterior or posterior debridement on infections of the lumbar vertebral fusion with cage and pedical screw system.Methods:A total of 10 cases (3 males and 7 females, age 49.80±13.29 years) with infections in the lumbar fusion device were admitted from January 2013 to December 2019. The cases were diagnosed with deep infections after the preview surgery at 10.80±13.24 months, including 10 cases with 12 cages infections and 8 cases with screw system infections. 7 cases were done with debridement and removal of the cages via the anterior approach. And another 3 cases underwent posterior debridement and removal of lumbar fusion cages. The changes in laboratory examination such as WBC count, ESR, CRP, visual analogue scale (VAS) and Oswestry Disability Index (ODI) score were compared preoperatively, 2 months and 6 months postoperatively.Results:No patients were lost in the follow-up. The average follow-up time periods is 16.30±5.10 months (range 9-24 months). There was no significant difference in WBC count between 2 and 6 months after surgery compared with preoperation ( F=0.855, P=0.436). The ESR, CRP, VAS and ODI scores decreased in 2 months and 6 months after sugery, which has significant differences compared preoperation ( P<0.05). The abnormal signals in the lambar vertebral showed a gradual fading trend in the postoperative MRI. The completely fading time was 5.00±1.33 months (range 3-7 months). One-stage bone grafting was performed in 6 cases with 8 spaces via anterior approach, 5 cases with 7 spaces showed the intervertebral fusion after postoperative with 6.80±2.28 months (range 4-10 months), 1 case wirh 1 space was not fused. One-stage bone grafting was performed in 2 cases via posterior approach: 1 case was fused after postoperative and the other patient was not, which due to bone graft area infection. Postoperative bone graft displacement occurred with 1 case and 1 case with L 5 nerve root pulling injury during the operation. Conclusion:The fusion cage can be removed by debridement via posterior approach, but it is difficult to done the completely debridement, which the main reason is the obstruction of the posterior nerve and bone structure. Posterior approach also have risks of infection recurrence and nerve root injury. Cage removal via anterior approach was relatively easy and debridement was thoroughly, which has the risk of injury of important adjacent vessels.

Objective:To compare the adverse reactions of oxycodone hydrochloride prolonged-release tablets and fentanyl transdermal system in the treatment of moderate and severe cancer pain.Methods:The medical records of patients with moderate to severe cancer pain who used oxycodone hydrochloride prolonged-release tablets (oxycodone group) or fentanyl transdermal systems (fentanyl group) for more than 1 week during hospitalization in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2019 were collected. The occurrence of adverse reactions after analgesic treatments were retrospectively analyzed.Results:A total of 698 patients were enrolled in the analysis, including 535 in the oxycodone group and 163 in the fentanyl group. The incidence of adverse reactions in the oxycodone group was significantly higher than that in the fentanyl group [72.5% (388/535) vs. 51.5% (84/163), χ2=25.139, P<0.001]. The common adverse reactions (with incidence ≥5%) in the oxycodone group were constipation, nausea/vomiting, xerostomia, drowsiness, and dizziness, while those in the fentanyl group were constipation, nausea/vomiting, and dizziness. The incidence of constipation in the oxycodone group was significantly higher than that in the fentanyl group [60.9% (326/535) vs. 40.5% (66/163), χ2=21.209, P<0.001]. The differences in the incidence of other adverse reactions in the 2 groups were not statistically significant (all P>0.05). All adverse reactions were grade 1 or 2, which were improved after symptomatic treatments. No adverse reactions of grade 3 or more severe occurred. Conclusions:Both oxycodone hydrochloride prolonged-release tablets and fentanyl transdermal system are safe during the treatment for moderate to severe cancer pain, with mild adverse reactions, which can be relieved by symptomatic treatments. Oxycodone hydrochloride prolonged-release tablets are more likely to cause constipation than fentanyl transdermal system.

Objective:To compare the adverse reactions of oxycodone hydrochloride prolonged-release tablets and fentanyl transdermal system in the treatment of moderate and severe cancer pain.Methods:The medical records of patients with moderate to severe cancer pain who used oxycodone hydrochloride prolonged-release tablets (oxycodone group) or fentanyl transdermal systems (fentanyl group) for more than 1 week during hospitalization in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2019 were collected. The occurrence of adverse reactions after analgesic treatments were retrospectively analyzed.Results:A total of 698 patients were enrolled in the analysis, including 535 in the oxycodone group and 163 in the fentanyl group. The incidence of adverse reactions in the oxycodone group was significantly higher than that in the fentanyl group [72.5% (388/535) vs. 51.5% (84/163), χ2=25.139, P<0.001]. The common adverse reactions (with incidence ≥5%) in the oxycodone group were constipation, nausea/vomiting, xerostomia, drowsiness, and dizziness, while those in the fentanyl group were constipation, nausea/vomiting, and dizziness. The incidence of constipation in the oxycodone group was significantly higher than that in the fentanyl group [60.9% (326/535) vs. 40.5% (66/163), χ2=21.209, P<0.001]. The differences in the incidence of other adverse reactions in the 2 groups were not statistically significant (all P>0.05). All adverse reactions were grade 1 or 2, which were improved after symptomatic treatments. No adverse reactions of grade 3 or more severe occurred. Conclusions:Both oxycodone hydrochloride prolonged-release tablets and fentanyl transdermal system are safe during the treatment for moderate to severe cancer pain, with mild adverse reactions, which can be relieved by symptomatic treatments. Oxycodone hydrochloride prolonged-release tablets are more likely to cause constipation than fentanyl transdermal system.

Objective: To explore the effect of post-abortion care service based on Wechat follow-up on contraceptive compliance of multiple induced abortion patients, and to evaluate the satisfaction with PAC service. Methods: A quasi-experimental method was adopted. A total of 300 cases of induced abortion were selected in Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University from March 2018 to March 2019, with 150 cases from eastern branch in the experimental group and 150 cases from western branch in the control group. The control group received routine nursing care and post-abortion care service based on telephone follow-up, while the experimental group received routine nursing care and post-abortion care service based on Wechat follow-up. The missing rate of follow-up, the contraceptive method and the occurrence of unexpected pregnancy within one year after operation were collected in the two groups. Patients′ follow-up compliance and nursing satisfaction were evaluated. Results: The awareness of the risk of induced abortion in the experimental group was 90.4% (120/135) higher than that in the control group 77.5% (88/111), and the difference was statistically significant (χ² value was 9.128, P=0.010). The contraceptive consciousness of the two groups was 99.3% (134/135) and 94.6% (105/135), respectively, and the difference was not statistically significant (χ² value was 3.256, P=0.071). There was a statistically significant difference in the missing rate of follow-up between the two groups in January, March, June, and December (χ² value was 13.664, P=0.003). Compared with 19.8% (22/111) in the control group, 73.3% (99/135) patients in the study group chose high-efficiency contraception, the difference was statistically significant (χ² value was 69.795, P<0.01).There were no recurring pregnancies in the experimental group within one year, compared with 6.3% (7/111) in the control group, the difference was statistically significant (χ² value was 6.630, P=0.003). In the experimental group, the participation rate of the follow-up were (95.37±12.29)%, which were higher than that in the control group (90.77±16.49)%. The difference was statistically significant (t value was 2.438, P<0.05). The overall satisfaction score of the experimental group was 26.55 ± 2.80, which was higher than that of the control group (23.66 ± 3.32). The difference was statistically significant (t value was 7.285, P <0.01). Conclusion Post-abortion care service based on Wechat follow-up could enhance patients′ compliance and satisfaction, guide patients to choose the right contraceptive methods, reduce the rate of repeated abortion and promote female reproductive health.

Objective: To compare the long-term outcomes in ST-elevation myocardial infarction (STEMI) patients who underwent early or late delayed percutaneous coronary intervention (PCI) using drug-eluting stents (DES). Methods: This study was a retrospective, observational and single-center study. Consecutive STEMI patients (n=977), who admitted to Fuwai Hospital in 2013 and underwent successful selective PCI using drug-eluting stents (DES) within 3 to 35 days after symptom onset were enrolled and divided into the early delayed PCI (3-14 d) group (n=495) and the late delayed PCI (15-35 d) group (n=482). General clinical data of the patients and related data of coronary angiography and interventional therapy were collected, and the endpoint events were followed up. The primary endpoint was 2-year major adverse cardiac and cerebrovascular events (MACCE) including cardiac death, recurrent myocardial infarction, definite or probable stent thrombosis and ischemic stroke. The secondary endpoint was 2-year ischemia-driven target vessel revascularization. The incidence of endpoint events of the two groups was compared, and it was compared again after the primary baseline characteristics such as age and gender were matched by the propensity scoring method at a 1∶1 ratio. Results: A total of 910 (93.1%) patients who underwent delayed PCI were transferred from other hospitals, and 292 (29.9%) patients received thrombolysis before PCI. The time interval before PCI was 14 (10, 20) days. The incidence of 2-year MACCE (3.0%(15/495) vs. 2.3%(11/482), P=0.468) and ischemia-driven target vessel revascularization (3.8%(19/495) vs. 5.0%(24/482), P=0.385) were similar between the two groups. The incidence of 2-year MACCE (3.3%(15/453 vs. 2.4%(11/453), P=0.426) and ischemia-driven target vessel revascularization (4.2% (19/453) vs. 4.9%(22/453), P=0.632) were also similar between the two groups after matching propensity score. Conclusion The long-term clinical outcomes after early delayed PCI using DES is statistically equivalent to those of late delayed PCI using DES for STEMI patients who missed the time window for emergency PCI.