Objective:To determine the safety and efficacy of the modified off-pump biatrial mini-maze procedure to treat isolated atrial fibrillation.Methods:This study retrospectively included isolated atrial fibrillation patients who underwent the modified off-pump biatrial mini-maze procedure at the Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University from January 2021 to December 2023. These patients underwent a mini-maze procedure using the Dallas lesion set protocol. A purse-string suture was then performed on the right atrium, and 4 ablation lesions were made to the superior vena cava, the inferior vena cava, the appendix of the right atrium and the tricuspid valve annulus from the purse-string suture point using the bipolar radiofrequency clamp. After the operation, the patients were followed up at 3, 6 and 12months and every year thereafter.Results:A total of 301 patients were followed up. There were no deaths or strokes. A follow-up at intervals of 3, 6, 12, 24 and 36 months showed that the cumulative success rate free from isolated atrial fibrillation was 96.0%、91.0%、85.9%、79.5% and 72.7%.Conclusion:The modified off-pump biatrial mini-maze procedure is safe and effective and can be considered as an off-pump ablation option for patients and cardiac surgeons.

Objective:To determine the safety and efficacy of the modified off-pump biatrial mini-maze procedure to treat isolated atrial fibrillation.Methods:This study retrospectively included isolated atrial fibrillation patients who underwent the modified off-pump biatrial mini-maze procedure at the Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University from January 2021 to December 2023. These patients underwent a mini-maze procedure using the Dallas lesion set protocol. A purse-string suture was then performed on the right atrium, and 4 ablation lesions were made to the superior vena cava, the inferior vena cava, the appendix of the right atrium and the tricuspid valve annulus from the purse-string suture point using the bipolar radiofrequency clamp. After the operation, the patients were followed up at 3, 6 and 12months and every year thereafter.Results:A total of 301 patients were followed up. There were no deaths or strokes. A follow-up at intervals of 3, 6, 12, 24 and 36 months showed that the cumulative success rate free from isolated atrial fibrillation was 96.0%、91.0%、85.9%、79.5% and 72.7%.Conclusion:The modified off-pump biatrial mini-maze procedure is safe and effective and can be considered as an off-pump ablation option for patients and cardiac surgeons.

Driven by multiple factors such as policy incentives,enhanced economic capacity of residents,aging popula-tion,and medical system reform,China's rehabilitation industry has been in a rapid development stage where opportunities and challenges coexist.Various rehabilitation hospitals urgently need new development thinking on how to seize the new opportunities for the development of rehabilitation medicine,give full play to the benefits of high-quality rehabilitation medical resources,and deal with the development of rehabilitation institutions under the new situation.Taking the tertiary rehabilitation hospital where the authors work as an example,this paper deeply analyzes the practical difficulties and challenges faced by the development of reha-bilitation hospital under the new circumstance,further explores the construction of a new working mode based on people-oriented and medical-rehabilitation integration.It also briefly summarizes the beneficial experiences and practices in the reform of rehabili-tation service models,and elaborates on the periodic achievement,so as to provide a meaningful reference for the majority of re-habilitation hospitals to plan and practice high-quality development and reform.

Objective:To investigate the facilitators and hindrances of smoking cessation in patients with chronic obstructive pulmonary disease (COPD), and to provide a basis for developing individualized smoking cessation intervention strategies for COPD patients.Methods:Based on the health ecology theory and using a phenomenological approach in qualitative research, purposive sampling was used to select 15 COPD patients with smoking history who were admitted to Tianjin Fourth Central Hospital from March to May 2023 and face-to-face semi-structured interviews were conducted. Colaizzi seven-step analysis was used to analyze the interview content.Results:A total of 15 COPD patients were interviewed, including 13 males and 2 females, aged 61-75 years old. The facilitators of smoking cessation in COPD patients included complications, sequelae of novel coronavirus infection, fear of death, smoking cessation counseling by medical staff, heavy family financial burden, and smoke-free environment. The hindrances of smoking cessation in COPD patients included milder disease symptoms of COPD, higher levels of nicotine dependence, false disease-related perceptions, family supervision and control, and occupational experience.Conclusions:Smoking cessation in COPD patients is influenced by five factors: personal characteristics, behavioral characteristics, interpersonal network, living and working conditions, and policy environment. Medical staff and relevant national institutions should formulate corresponding smoking cessation strategies according to address the facilitators and hindrances of smoking cessation in COPD patients, so as to further reduce the smoking prevalence of COPD patients, promote the health of patients and reduce the burden of disease.

Objective To observe the relationship between the expression of human matricellular protein 3(MATN3)and the pathological features,drug resistance,and prognosis of gastric cancer based on immunohistochemical method.Methods A total of 100 gastric cancer patients treated at the First Affiliated Hospital of Bengbu Medical College from January 2022 to December 2022 were included.MATN3 expression in gastric cancer tissues and paracancerous tissues was assessed by immunohistochemistry.The expression of MATN3 was compared across pathological features.Patients were divided into sensitive and resistant groups based on chemotherapy resistance,and MATN3 expression was compared between these groups.The relationship between MATN3 and recurrence-free survival(RFS)and overall survival(OS)of gastric cancer patients was analyzed using Kaplan-Meier survival curves.Univariate and multifactorial Cox regression analyses were used to analyze the factors affecting the prognosis of gastric cancer patients.Human gastric cancer cells MGC803 were transfected with MATN3.The cells were divided into a high expression group(LV-MATN3 group)and its control group(LV-NC group)and a low expression group(sh-MATN3 group)and its control group(sh-NC group).Cell proliferation was assessed using the CCK8 assay,cell migration and invasion were assessed using the Transwell assay,and MATN3 mRNA expression levels were measured using RT-qPCR.A nude mouse xenograft model was constructed by hypodermic injection of MGC-803 cells transfected with MATN3,and MATN3 mRNA expression levels in tumor tissues were measured using RT-qPCR.Results Immunohistochemical results showed a significantly higher rate of high MATN3 expression in gastric cancer tissues(64.00%,64/100)compared to adjacent non-cancerous tissues(31.00%,31/100)(P＜0.05).High MATN3 expression was associated with age≥60 years old,tumor location in the gastric body,tumor size≥5 cm,lymph node metastasis(N1-N3),histological differentiation(moderate to high),tumor invasion depth(T3-T4),TNM stage(Ⅲ-Ⅳ),distant organ metastasis,recurrence,and mortality(P＜0.05).Among patients with chemotherapy resistance,the high MATN3 expression rate was 79.49%(31/39)in the resistant group compared to 54.10%(33/61)in the sensitive group(P＜0.05).Follow-up duration ranged from 11 to 22 months,with a 97.00%follow-up rate and 3 cases lost to follow-up.Kaplan-Meier survival curve analysis showed that patients with high MATN3 expression had significantly lower RFS and OS compared to those with low MATN3 expression(RFS:log-rank=17.291,P＜0.001;OS:log-rank=21.719,P＜0.001).Multivariate Cox analysis identified high MATN3 expression(hazard ratio[HR]=2.291,95%confidence interval[CI]:1.268-5.392),tumor location in the gastric body(HR=2.057,95%CI:1.441-5.666),lymph node metastasis(N1-N3)(HR=2.011,95%CI:1.010-2.274),tumor invasion depth(T3-T4)(H=2.977,95%CI:1.032-7.853),TNM stage Ⅲ-Ⅳ(HR=2.008,95%CI:1.049-3.902),and distant organ metastasis(HR=2.505,95%CI:1.529-5.000)as independent risk factors affecting RFS and OS(P＜0.05).Cell and animal experiments demonstrated that compared to the LV-NC group,the LV-MATN3 group exhibited significantly higher cell proliferation,migration,and invasion(P＜0.05),as well as increased tumor volume and MATN3 mRNA expression in tumor tissues(P＜0.05).Conversely,the sh-MATN3 group showed significantly reduced cell proliferation,migration,and invasion,along with decreased tumor volume and MATN3 mRNA levels compared to the sh-NC group(P＜0.05).Conclusion MATN3 is highly expressed in gastric cancer tissues and is associated with various pathological features,drug resistance and poor prognosis.MATN3 holds potential as a diagnostic marker for poor prognosis and may play a role in the malignant behaviors of gastric cancer cells,including proliferation,migration,and invasion.

Objective:To examine the effect of applying clinical pathway model in the cultivation of humanistic care ability of nursing college students in clinical practical teaching.Methods:The study collected 52 nursing students who practiced in the department of gynecology of a tertiary first-class hospital in Xi’an from July to October, 2017 as the control group, and 52 nursing students who practiced in the same unit from July to October, 2018 were selected as the experimental group. The control group adopted the teaching method of infiltrating humanistic care education into the training process of operational skills, while the experimental group adopted the teaching method of cultivating humanistic care ability of nursing college students through clinical pathway. The differences of humanistic care ability scores between the two groups were compared. SPSS 19.0 was used for t test. Results:Before the internship, there was no statistically significant difference in humanistic care scores between the two groups ( P>0.05). After the internship, the total scores of nursing students in the experimental group were significantly higher than those in the control group ( P<0.05). Conclusion:Applying the clinical pathway model to the cultivation of humanistic care ability of nursing students in clinical practice teaching is a new cultivation model of humanistic care ability, which is helpful to improve the humanistic care ability of nursing students.

Objective:To investigate the prevalence and influencing factors of mild visual impairment in type 2 diabetic patients aged ≥50 years living in Funing County, Jiangsu Province.Methods:A population-based cross-sectional study was adopted.Cluster sampling was conducted among diabetic patients aged ≥50 years registered in the Chronic Disease Information Center of Funing County Center for Disease Prevention and Control from March 7th to April 20th, 2019.General information of selected patients was collected.Visual and ocular examinations on site were performed by ophthalmologists and technicians.The International Council of Ophthalmology standard for mild visual impairment, 0.3≤best corrected visual acuity<0.8 was adopted.The influencing factors of mild visual impairment were analyzed by logistic regression.This study protocol was approved by the Ethics Committee of Affiliated Hospital of Nantong University (No.2014-071).Results:Among the included 2 067 patients, 1 909 cases completed the investigation, with a response rate of 92.4%.There were 1 146 patients with mild visual impairment in at least one eye, and the prevalence of mild visual impairment was 60.00%.Among the eyes examined, 1 832 eyes were with mild visual impairment, accounting for 47.98%.Cataract (896/1 632), refractive error (515/1 632) and diabetic retinopathy (166/1 632) were the main causes of mild visual impairment in diabetic patients, accounting for 54.90%, 31.61% and 10.19%, respectively.Aging, female gender, low educational attainment, oral hypoglycemic drugs or subcutaneous insulin injection were risk factors for mild visual impairment in both eyes.Higher educational attainment, more sunshine exposure and exercise were protective factors for mild visual impairment in both eyes.Conclusions:The prevalence of mild visual impairment is relatively high in type 2 diabetic patients.Cataract surgery, correction of refractive error may help to improve mild visual impairment.Strengthening blood glucose control, more physical exercise and outdoor activities may slow the progression of mild visual impairment and prevent it from moderate and severe visual impairment.

Objective: To explore the role and mechanism of long noncoding RNA(lncRNA) AC005062.1 in colorectal cancer(CRC) cell proliferation and apoptosis. Methods: The analysis of GSE84983 and GSE 104364 was used to indicate the expression level lncRNA AC005062.1 in CRC. The tumor tissues(tumor group) and adjacent tissues(control group) of patients undergoing CRC surgery in the hospital tumor surgery department were collected. Eight pairs of tissues were randomly selected, and qPCR was used to detect the expression of lncRNA AC005062.1 in CRC tissues and paired adjacent tissues in the two groups. After using siRNA to down-regulate the expression of lncRNA AC005062.1 in CRC cells, CCK-8 assay was used to detect cell proliferation in two groups, flow cytometry was used to detect cell cycle and apoptosis in two groups, wound scratch test was used to detect cell migration in two groups, and the lncRNA was determined. The database was used to compare the localization of lncRNA AC005062.1 and MACC1 genes on staining. The expression levels of MACC1 transcription and protein levels in the control group and tumor group were detected by qPCR and Western blot, respectively. The lncRNA AC005062.1 in CRC cells was down-regulated, and the expression levels of MACC1 transcription and protein levels in the two groups of cells were detected by qPCR and Western blot, respectively. Results: The database analysis of GSE84983 and GSE104364 and the detection results of the two groups indicated that the lncRNA AC005062.1 was highly expressed in CRC. After down-regulation of lncRNA AC005062.1, the results of CCK-8 experiments showed that the proliferation rate of HT29 cells in the down-regulation group decreased. Flow cytometry showed that the number of apoptosis of HT29 cells in the down-regulated group increased, the proportion of G1 phase increased, and the proportion of S phase and G2 phase decreased. Western blot experiments showed that the expressions of cleaved-caspase3 and Bax in the down-regulated HT29 cells increased, while the expression of Bcl-2 decreased. Wound scratch experiments showed that the migration rate of HT29 cells in the down-regulated group was lower than that in the control group. The analysis of UCSC to compare the location of lncRNA ac005062.1 and MACC1 on chromosomes showed that they were located very close together. MACC1 was highly expressed in CRC and down-regulated lncRNA AC005062.1 expression in HT29 cells could reduce the expression of MACC1. Conclusion lncRNA AC005062.1 can inhibit the proliferation, cycle and migration of HT29 cells, and promote its apoptosis by regulating the expression of MACC1 in CRC.

Phased national medical licensing examination requires clinical students to have the ability to apply basic medical knowledge to solve comprehensive clinical problems. But the traditional teaching patterns of Medical Microbiology experiments can no longer meet requirements of actual education effect. In order to accommodate new situation, we have integrated medical licensing examination with microbiology experimental teaching syllabus and contents. We have also comprehensively applied a variety of teaching methods and curriculum formative assessment in class. These reforming methods have efficiently improved classroom teaching effect and greatly inspired the enthusiasm of students, and effectively improved early clinical thinking ability and innovation ability of students.

OBJECTIVE: To analyze the biomechanics of cystic lesions in the mandibular body in a three-dimensional (3D) finite element model. METHODS: A 3D finite element model of cystic lesion of the mandibular body was constructed based on the CT images of the mandible of a healthy adult female volunteer with normal occlusion. The size of the cyst and the residual bone wall were analyzed when the lesion area approached the stress peak under certain constraints and loading conditions. RESULTS: When the size of the cyst reached 37.63 mm×11.32 mm×21.45 mm, the maximal von Mises stress in the lesion area reached 77.295 MPa, close to the yield strength of the mandible with a risk of pathological fracture. At this point, the remaining bone thickness of the buccal and lingual sides and the lower margin of the mandible in the lesion area was 1.52 mm, 0.76 mm and 1.04 mm, respectively. CONCLUSIONS Residual bone mass is an important factor to affect the risk of pathological fracture after curettage of cystic lesions. A thickness as low as 1 mm of the residual bone cortex in the cystic lesion area of the mandibular body can be used as the threshold for a clinical decision on one-stage windowing decompression combined with two- stage curettage.
Adult ; Biomechanical Phenomena ; Female ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Mandible ; Stress, Mechanical