As a new clinical trial mode,decentralized & digitalized clinical trial(DCT)is based on digital health equipment and uses internet and artificial intelligence technologies to complete the screening,registration,randomization,intervention,evaluation and follow-up of subjects,which is helpful to improve efficiency and reduce trial costs.The DCT mode has been applied to evaluate the treatment and management effects of cardiovascular diseases such as atrial fibrilla-tion,heart failure,coronary heart disease,and hypertension,showing broad development prospects and application space.This article will provide a brief introduction to representative DCT in the global cardiovascular disease field,and look for-ward to the application prospects of this model,providing reference and guidance for accelerating the development of cardio-vascular DCT in China.

Aim To explore the association between mental health status and post-ablation recurrence in elderly atrial fibrillation patients.Methods Consecutive patients aged≥60 years who underwent catheter ablation for atrial fi-brillation in Beijing Anzhen Hospital were enrolled,baseline clinical characteristics,comorbidities and treatment were col-lected.Five item mental health inventory(MHI-5)was used to evaluate the mental health status,and 76 points were taken as the cut-off value.Each patient was followed up at 3,6 and 12 months after ablation to assess atrial fibrillation recurrence,mental health status and other adverse events.Multivariate Logistic regression analysis was conducted to ex-amine the association between mental health status and the risk of atrial fibrillation recurrence.Results A total of 238 elderly patients with atrial fibrillation were enrolled,including 58 patients in the MHI-5≤76 points group and 180 patients in the MHI-5＞76 points group.During 12 months follow-up,73 patients(30.7％)developed atrial fibrillation recur-rence,and the recurrence rate in the MHI-5≤76 points group was significantly higher than that in the MHI-5＞76 points group[58.6％(34/58)vs.21.7％(39/180),P＜0.001].Multivariate Logistic analysis showed that after adjusting for demographic data and clinical factors,MHI-5≤76 points was significantly associated with a higher risk of atrial fibrillation recurrence after catheter ablation(OR=6.13,95％CI:3.08～12.24,P＜0.001).Conclusion Poor mental health status is significantly associated with higher post-ablation recurrence in elderly atrial fibrillation patients.

Aim To explore the association between mental health status and post-ablation recurrence in elderly atrial fibrillation patients.Methods Consecutive patients aged≥60 years who underwent catheter ablation for atrial fi-brillation in Beijing Anzhen Hospital were enrolled,baseline clinical characteristics,comorbidities and treatment were col-lected.Five item mental health inventory(MHI-5)was used to evaluate the mental health status,and 76 points were taken as the cut-off value.Each patient was followed up at 3,6 and 12 months after ablation to assess atrial fibrillation recurrence,mental health status and other adverse events.Multivariate Logistic regression analysis was conducted to ex-amine the association between mental health status and the risk of atrial fibrillation recurrence.Results A total of 238 elderly patients with atrial fibrillation were enrolled,including 58 patients in the MHI-5≤76 points group and 180 patients in the MHI-5＞76 points group.During 12 months follow-up,73 patients(30.7％)developed atrial fibrillation recur-rence,and the recurrence rate in the MHI-5≤76 points group was significantly higher than that in the MHI-5＞76 points group[58.6％(34/58)vs.21.7％(39/180),P＜0.001].Multivariate Logistic analysis showed that after adjusting for demographic data and clinical factors,MHI-5≤76 points was significantly associated with a higher risk of atrial fibrillation recurrence after catheter ablation(OR=6.13,95％CI:3.08～12.24,P＜0.001).Conclusion Poor mental health status is significantly associated with higher post-ablation recurrence in elderly atrial fibrillation patients.

Objective To investigate the changes in the expression of cold-inducible RNA-binding protein (CIRBP) in a radiation-induced lung injury model. Methods Thirty male C57BL/6 mice were randomly divided by body weight into control group (no intervention) and model group (single chest X-ray irradiation with a dose of 20 Gy to build a radiation-induced lung injury model). The mice were dissected five weeks after irradiation. Hematoxylin-eosin staining and Masson staining were used to observe the pathological changes of the lung tissue and the deposition of collagen fibers. Immunohistochemistry was used to measure the expression of the inflammatory factors interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the lung tissue. qRT-PCR was used to measure the expression of CIRBP mRNA in the lung tissue. The expression of CIRBP protein in the lung tissue was determined by the immunofluorescence assay and Western blot. Results Compared with the control group, the model group showed significant pulmonary vascular congestion, significant inflammatory cell infiltration, significant thickening of some alveolar septa, significantly increased IL-6 expression [(129.41 ± 5.58) vs (187.22 ± 34.77), t = 3.179, P < 0.05], significantly increased TNF-α expression [(137.52 ± 23.53) vs (187.02 ± 19.16), t = 5.069, P < 0.05], significantly increased CIRBP mRNA expression [(1 ± 0.08) vs (1.97 ± 0.39), t = 3.45, P < 0.05], and significantly increased CIRBP protein expression [(9.32 ± 1.26) vs (14.76 ± 1.61), t = 3.751, P < 0.05], by the immunofluorescence assay; [(1.13 ± 0.17) vs (1.49 ± 0.14), t = 2.819, P < 0.05], by Western blot). Conclusion The expression of CIRBP is significantly increased in the radiation-induced lung injury model, which may be an important pro-inflammatory factor in radiation-induced lung injury.

Objective To investigate the effect of CD40/CD40 ligand on the genesis and development of coronary artery disease (CAD),and the inhibitory effect of cyclosporine A (CsA) on CD40/CD40 ligand. Methods A total of 71 patients were divided into four groups:acute myocardial infarction group (AMI, n=19), unstable angina pectoris group (UAP, n=18), stable angina pectoris group (SAP, n=17) and normal control group (N, n=17). Flow cytometry was used to detect the expres?sion of CD40 and CD40L in peripheral blood mononuclear cells (PBMCs) of four groups. The group in which CD40 and CD40L were produced at the highest level was chosen, and a series concentrations of CsA(H1:0 mg/L, H2:0.01 mg/L, H3:0.1 mg/L, H4:1 mg/L)were used to treat the cells. Then the expressions of CD40 and CD40L were measured by flow cytome?try. Results Compared with N group,the expression of CD40 was significant higher in other groups (P<0.05). The expres?sion of CD40 was significant higher in UAP group and AMI group than that of SAP group. There was no significant difference in the expression of CD40 between UAP group and AMI group (P>0.05). The expression of CD40L was elevated and fol?lowed by different severity of CAD. There was significant difference in the expression of CD40L between groups (P<0.05) . AMI group showed the highest expression of CD40 and CD40L. After being treated with CsA, the expression of CD40 was higher in H1 group than that of H3 group and H4 group (P<0.05). The expression of CD40L was significantly higher in H1 group than that of other three groups (P < 0.05). Conclusion CD40 and CD40L may be involved in the development of CAD. Moreover, it might be restrained by CsA via regulation of CD40/CD40L.

Objective To investigate the incidence of depression of coronary artery bypass grafting before and after surgery in patients with coronary heart disease and the impact of depression on patients undergoing coronary artery bypass grafting.Methods 345 patients treat with CABG were divided into depression and non depression groups based on Serf-rating depression scale(SDS).Compare the change of different degree of depression occurrence rate before and after surgery.All patients were followed up for 24 months after procedure for the occurrence major adverse cardiovascular events(MACE),then make the non MACE survival analysis and Cox regression.Results Baseline data of BMI(body mass index) and history of hypertension,cerebrovascular disease was statistically significant difference between groups.Depression in patients after CABG was significantly higher than that before procedure(40.9％ vs 24.3％,P ＜0.05).The MACE rate was significantly higher in patients with post-procedure depression than that in patients without depression(16.5％ vs 5.2％,P ＜0.01),and the incidences of myocardial infarction and target lesion revascularization were also significantly higher in depression patients than in non-depression patients(6.8％ vs 2.1％,6.6％ vs 1.6％,P ＜ 0.05).There was no significant difference on accumulative mortality between two groups(3.3％ vs 1.6％,P =0.315).The survival analysis curve of Kaplan-Meier show the incidences of non MACE survival rate was significantly lower in depression patients than in non-depression patients (P ＜0.001).There was no significant difference on death survival analysis(P =0.309).Depression,old myocardial infarction and LVEF(left ventricular ejection fraction)were independent risk factors for MACE.Conclusion The proportion was higher in patients with post-procedure and pre-procedure who have different degree of depression,the MACE rate was significantly higher in patients with postprocedure depression than in patients without depression.Depression is dangerous factors for prognosis of patients with coronary artery bypass grafting.