Standardizing the emergency assessment and management process for patients with implantable continuous-flow left ventricular assist device (LVAD) in emergency and intensive care settings is of great significance for reducing delays in diagnosis and treatment, lowering the mortality associated with LVAD-related emergencies, and improving overall prognosis and long-term survival. To this end, a multidisciplinary expert committee was convened to develop this consensus, integrating international evidence-based findings with clinical practice experience in China, with an emphasis on highlighting the characteristics of domestically manufactured devices. The aim is to establish an actionable standardized emergency management protocol to enhance clinical identification and response efficiency, reduce the risk of LVAD-related emergencies, and improve patient outcomes. Using a modified Delphi method, this consensus proposes a structured decision-making pathway that integrates an "ABC" rapid assessment with parallel device troubleshooting, prioritizing the use of point-of-care echocardiography for hemodynamic evaluation and complication assessment. Key emergency scenarios covered include low-flow alarms, pump thrombosis, right heart dysfunction, bleeding and anticoagulation imbalance, arrhythmias, and cardiac arrest. This consensus applies to implantable continuous-flow LVADs commonly used in China, including domestically manufactured devices such as Corheart 6, CH-VAD, EVAHEART, and HeartCon, as well as the imported device HeartMate 3.

Objective To explore the valve regurgitation status of left heart after the implantation of left ventricular assist device (LVAD) and its effect on prognosis of patients with LVAD implantation. Methods A total of 35 patients with cardiomyopathy who underwent magnetic levitation LVAD implantation at Zhongshan Hospital, Fudan University from February 2021 to July 2024 were retrospectively selected. Clinical data during hospitalization were collected, including preoperative basic data and postoperative valve regurgitation status. Telephone follow-ups were conducted to monitor patients’ survival status and transthoracic echocardiography was used to assess left valve function. Kaplan-Meier survival curves and log-rank test were employed to compare the survival rate of patients with different levels of valve regurgitation. Results The 35 patients had a mean age of (53.9±11.1) years, with 85.7% male, and 3 patients (8.6%) died during hospitalization. Preoperatively, 17 patients (48.6%) had moderate or greater mitral regurgitation, while all 35 patients had less than moderate aortic regurgitation. One month postoperatively, thirty patients were followed up, among which 24 patients (80%) had less than moderate mitral regurgitation, including 11 cases with alleviated regurgitation compared to pre-surgery; 6 patients (20%) had moderate or greater mitral regurgitation, including 4 cases with stable regurgitation and 2 cases with progression of regurgitation compared to pre-surgery; 2 patients (6.7%) had progression of aortic regurgitation to moderate or greater. The follow-up time was 1.2 (1.0, 2.1) years, with 1-year survival rate of 91.4% and 3-year survival rate of 71.1%. Survival analysis showed that the 3-year survival rate of patients with moderate or greater mitral regurgitation one month postoperatively was significantly lower than that of patients with less than moderate regurgitation (66.7% vs 83.3%, P＝0.046). Conclusions After the implantation of magnetic levitation LVAD, most patients showed improvement in mitral regurgitation, while aortic regurgitation remained unchanged. The degree of mitral regurgitation one month postoperatively is associated with prognosis.

ObjectiveTo investigate the mechanism of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis extract （ASH） in treating Parkinson's disease （PD） in mice by Data-Independent Acquisition （DIA） proteomics. MethodsThe α-Synuclein （α-Syn） transgenic PD mice were selected as suitable models for PD， and they were randomly assigned into PD， ASH （61.25 mg·kg^-1）， and Madopar （97.5 mg·kg^-1） groups. Male C57BL/6 mice of the same age were selected as the control group， with eight mice in each group. Mice were administrated with corresponding drugs by gavage once a day for 20 days. The pole climbing time and the number of autonomic activities were recorded to evaluate the exercise ability of mice. Hematoxylin-eosin staining was employed to observe neuronal changes in the substantia nigra of PD mice. Immunohistochemistry （IHC） was employed to measure the tyrosine hydroxylase （TH） activity in the substantia nigra and assess the areal density of α-Syn in the striatum. DIA proteomics was used to compare protein expression in the substantia nigra between groups. IHC was utilized to validate key differentially expressed proteins， including Lactotransferrin， Notch2， Ndrg2， and TMEM 166. The cell counting kit-8 （CCK-8） method was used to investigate the effect of ASH on the viability of PD cells with overexpression of α-Syn. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were employed to determine the protein and mRNA levels of Lactotransferrin， Notch2， Ndrg2， and TMEM 166 in PD cells. ResultsCompared with the control group， the model group showed prolonged pole climbing time， diminished coordination ability， reduced autonomic activities （P<0.01）， and reduced swelling neurons. Compared with the model group， ASH and Madopar reduced the climbing time， increased autonomic activities （P<0.01）， and ameliorated neuronal damage. Compared with the control group， the model group showed a decrease in TH activity in the substantia nigra and an increase in α-Syn accumulation in the striatum （P<0.01）. Compared with the model group， the ASH group showed an increase in TH activity and a reduction in α-Syn accumulation （P<0.05）. DIA proteomics revealed a total of 464 differentially expressed proteins in the model group compared with the control group， with 323 proteins being up-regulated and 141 down-regulated. A total of 262 differentially expressed proteins were screened in the ASH group compared with the model group， including 85 proteins being up-regulated and 177 down-regulated. Kyoto encylopedia of genes and genomes （KEGG） pathway analysis indicated that ASH primarily regulated the Notch signaling pathway. The model group showed up-regulation in protein levels of Notch2， Ndrg2， and TMEM 166 and down-regulation in the protein level of Lactotransferrin compared with the control group （P<0.01）. Compared with the model group， ASH down-regulated the protein levels of Notch2， Ndrg2， and TMEM 166 （P<0.05） while up-regulating the protein level of Lactotransferrin （P<0.01）. The IHC results corroborated the proteomics findings. The cell experiment results showed that compared with the control group， the modeling up-regulated the mRNA and protein levels of Notch2， Ndrg2， and TMEM 166 （P<0.01）， while down-regulating the mRNA and protein levels of Lactotransferrin （P<0.01）. Compared with the model group， ASH reduced the mRNA and protein levels of Notch2， Ndrg2， and TMEM 166 （P<0.01）， while increasing the mRNA and protein levels of Lactotransferrin （P<0.05， P<0.01）. ConclusionASH may Synergistically inhibit the Notch signaling pathway and mitigate neuronal damage by down-regulating the expression of Notch2 and Ndrg2. Additionally， by up-regulating the expression of Lactotransferrin and down-regulating the expression of TMEM166， ASH can address brain iron accumulation， intervene in ferroptosis， inhibit mitophagy， and mitigate reactive oxygen species damage， thereby protecting nerve cells and contributing to the treatment of PD.

AIM: To investigate the impact of corneal fluorescein sodium(NaF)staining on the examination results of iTrace visual function analyzer(iTrace).METHODS: Prospective cohort study. Totally 100 patients(100 eyes)with ametropia who visited the outpatient department of Anhui Eye Hospital from April to November 2024 were recruited. They were divided into an experimental group and a control group, with 50 patients(50 eyes, and only the right eyes were selected for inclusion)in each group. In the experimental group, corneal staining was performed using fluorescein sodium staining test strips, while in the control group, 1 drop of 0.9% normal saline was instilled into the eyes. The iTrace examination was conducted before the intervention and at 5, 10, and 20 min after the intervention. The total corneal higher-order aberrations, spherical aberration, coma aberration, trefoil aberration, best sphere value(RO value), asphericity factor(Q value), and corneal vertical refractive power difference(IS value)at each time of examination were recorded and compared.RESULTS: There was no statistically significant difference in the baseline levels between the two groups(all P>0.05). Intra-group comparison revealed that the total higher-order aberrations, spherical aberration, coma aberration, and trefoil aberration measured 5 min after NaF staining in the experimental group were significantly increased compared with those before staining(all P<0.05). Inter-group comparison showed that the changes(differences from the baseline)in the total corneal higher-order aberrations, spherical aberration, coma aberration, and trefoil aberration measured by iTrace 5 min after the intervention in the experimental group were significantly greater than those in the control group(all P<0.05). There was no statistically significant difference in the changes(differences from the baseline)of various iTrace parameters measured at 10 and 20 min after the intervention between the two groups(all P>0.05). There was no statistical significance in the RO value, Q value, and IS value in the two groups(all P>0.05).CONCLUSION: Corneal NaF staining can cause a short-term increase in the wavefront aberration values(total corneal higher-order aberrations, spherical aberration, coma aberration, trefoil aberration)measured by iTrace, and it gradually disappears with the passage of time. However, it has no impact on the measurement of corneal topography parameters(RO value, Q value, IS value).

Objective:Committee of Minimally Invasive Cardiovascular Surgery(CMICS) conducts an annual summary of minimally invasive cardiovascular surgery procedures performed throughout the country, which includes a comprehensive survey of the total number of minimally invasive procedures by region and the distribution of minimally invasive procedures by hospital. Since CMICS first published the 2018-2019 China Minimally Invasive Cardiovascular Surgery Data White Paper in 2020, the report has received great attention from peers within and outside the industry. In this statistical report, CMICS will focus on publishing the data related to minimally invasive cardiovascular surgery in China from 2021 to 2023 for reference and use by industry peers.

Objective:To compare the impact of preoperative pulmonary vascular resistance(PVR) levels on the prognosis of patients undergoing left ventricular assist device(LVAD)implantation.Methods:A retrospective analysis was conducted on the clinical data of 33 patients among September 2021 and June 2024, who underwent LVAD implantation at Zhongshan Hospital, Fudan University. 29 males and 4 females, with a mean age of(53.61±9.65)years old. The cohort included 30 cases of dilated cardiomyopathy, 2 cases of ischemic cardiomyopathy, and 1 case of noncompaction cardiomyopathy. Patients were grouped based on a preoperative PVR threshold of 3 WU, Preoperative data from Swan-Ganz catheterization, liver and renal function indicators, as well as other relevant clinical parameters were recorded. Patients were followed up to assess differences in survival outcomes.Results:Preoperative PVR was elevated in 18 cases(60%)of the patients, with a mean preoperative PVR of(3.16±1.71)WU. Immediate postoperative right heart catheterization was performed in 20 patients, showing a significant reduction in PVR from(3.85±1.72)WU preoperatively to(1.80±1.38)WU postoperatively( P<0.05). The cardiac index improved significantly from(1.95±0.63)L·min -1·m -2 preoperatively to(4.25±1.26)L·min -1·m -2 postoperatively( P<0.001). The mean follow-up duration was(14.78±12.06)months, no significant difference in postoperative survival was observed between the two groups(100% vs. 80%, P=0.667). Conclusion:Increased pulmonary resistance is often secondary to left heart dysfunction. After the implantation of a LVAD, pulmonary resistance can be improved. For patients with relatively normal right heart function before surgery, elevated pulmonary resistance does not affect the short-term outcomes of the implantation.

Neuromyelitis optica spectrum disorders (NMOSD) refer to a group of autoimmune-mediated central nervous system inflammatory demyelinating diseases that primarily affect the optic nerve and spinal cord. Most patients have anti-aquaporin 4 (AQP4) autoantibodies. The activation of the complement system plays a crucial role in the pathogenesis of AQP4 IgG seropositive NMOSD. In recent years, complement inhibitors, such as eculizumab, have demonstrated promising efficacy and development prospects in AQP4 IgG seropositive NMOSD patients. This review article focuses on the advancements made in the utilization of complement inhibitors for the management of NMOSD.

Objective To explore the therapeutic effect of microsurgical vascular decompression(MVD)under complete neuroendoscopy combined with nerve combing surgery in the treatment of primary trigeminal neuralgia(TN),and its impacts on prognosis.Methods 108 primary TN patients from November 2021 to November 2023 were retrospectively selected and grouped into combined group and control group based on the surgical plan,with 54 cases in each group.The control group received MVD treatment under the microscope,while the combined group received complete neuroendoscopic MVD combined with nerve combing surgery.The total effective rate,pain degree,stress indicators,quality of life,and complications were compared between the two groups.Results The total effective rate of the combined group(96.30%)was greatly higher than that of the control group(83.33%),the difference was statistically significant(P<0.05).The visual analogue scale(VAS)scores of both groups after surgery were significantly lower than those before surgery,and the combined group was lower than the control group,the differences were statistically significant(P<0.05).After surgery,the levels of norepinephrine(NE),superoxide dismutase(SOD),and cortisol(Cor)increased in both groups compared with those before surgery,but the combined group was greatly lower than that of the control group,the differences were statistically significant(P<0.05).The generic quality of life inventory-74(GQOL-74)scores in both groups after surgery were significantly higher than those before surgery,and the combined group was higher than the control group,the differences were statistically significant(P<0.05).There was no difference of the total complication rate between the two groups(P>0.05).Conclusion MVD under complete neuroendoscopy combined with nerve combing surgery in the treatment of primary TN,can relieve pain,reduce stress response and improve the quality of life of patients.It is worthy of clinical promotion and application.

Objective To explore the therapeutic effect of microsurgical vascular decompression(MVD)under complete neuroendoscopy combined with nerve combing surgery in the treatment of primary trigeminal neuralgia(TN),and its impacts on prognosis.Methods 108 primary TN patients from November 2021 to November 2023 were retrospectively selected and grouped into combined group and control group based on the surgical plan,with 54 cases in each group.The control group received MVD treatment under the microscope,while the combined group received complete neuroendoscopic MVD combined with nerve combing surgery.The total effective rate,pain degree,stress indicators,quality of life,and complications were compared between the two groups.Results The total effective rate of the combined group(96.30%)was greatly higher than that of the control group(83.33%),the difference was statistically significant(P<0.05).The visual analogue scale(VAS)scores of both groups after surgery were significantly lower than those before surgery,and the combined group was lower than the control group,the differences were statistically significant(P<0.05).After surgery,the levels of norepinephrine(NE),superoxide dismutase(SOD),and cortisol(Cor)increased in both groups compared with those before surgery,but the combined group was greatly lower than that of the control group,the differences were statistically significant(P<0.05).The generic quality of life inventory-74(GQOL-74)scores in both groups after surgery were significantly higher than those before surgery,and the combined group was higher than the control group,the differences were statistically significant(P<0.05).There was no difference of the total complication rate between the two groups(P>0.05).Conclusion MVD under complete neuroendoscopy combined with nerve combing surgery in the treatment of primary TN,can relieve pain,reduce stress response and improve the quality of life of patients.It is worthy of clinical promotion and application.

Objective:To investigate the prognostic and immunotherapeutic significance of androgen receptor V1 (ARV1) in colorectal cancer (CRC) and to explore its mechanism in CRC progression.Methods:The relationship between ARV1 expression and CRC prognosis was analyzed using data from The Cancer Genome Atlas Program (TCGA). Gene ontology (GO) analysis was performed to identify potential mechanisms through which ARV1 regulates CRC progression. Multiple public databases were used to analyze the correlation between ARV1 and immune cell infiltration and to predict the sensitivity of ARV1 to immunotherapy and chemotherapeutic drugs. Immunohistochemical validation was conducted using postoperative specimens from 199 CRC patients, and clinical correlations were analyzed.Results:ARV1 expression was significantly lower in CRC tissues compared to normal tissues ( P<0.001). Patients with high ARV1 expression exhibited better overall survival than those with low expression ( P=0.016). Clinical analysis indicated that ARV1 serves as an independent prognostic factor in CRC, and its expression was associated with age and clinical stage (all P<0.01). GO analysis revealed that ARV1 influenced multiple pathways in CRC. Immune-related analysis demonstrated that ARV1 participated in regulating immune cell infiltration in CRC. Drug sensitivity analysis showed differences in responses to various chemotherapeutic agents between high and low ARV1 expression groups ( P<0.01). In immunotherapy, significant differences in Immunophenotype Score (IPS) were observed between high and low ARV1 expression groups in PD1-negative/CTLA4-negative patients ( P<0.05). Immunohistochemical results from 199 CRC patients confirmed that low ARV1 expression was associated with poorer prognosis ( P<0.001). Conclusions:ARV1 expression affects CRC prognosis and may serve as a potential novel biomarker for immunotherapy in CRC.