Objectives:To investigate the relationship between locations of ventricular septal perforation and 30-day prognosis in patients with acute myocardial infarction complicated by ventricular septal perforation.Methods:Clinical data of 150 acute myocardial infarction patients with ventricular septal perforation admitted to Fuwai Hospital of Chinese Academy of Medical Sciences and People's Hospital of Xinjiang Uygur Autonomous Region from January 2009 to October 2023 were retrospectively analyzed.Kaplan-Meier method was used to compare the difference in 30-day survival rate among patients with different sites of ventricular septal perforation.The impact of locations of ventricular septal perforation on 30-day prognosis of acute myocardial infarction patients was evaluated by multivariate Cox regression analysis(forward stepwise).Results:In acute myocardial infarction patients,the occurrence of anterior ventricular septal perforation was higher than that of posterior ventricular septal perforation(79.5%vs.20.5%,P<0.001).In the anterior ventricular septal perforation patients,females were more common(50.0%vs.22.6%,P=0.006),the blood glucose level was higher([10.51±5.99]mmol/L vs.[8.02±2.81]mmol/L,P=0.026),the left ventricular end-diastolic diameter was smaller([50.7±6.1]mm vs.[55.1±5.0]mm,P<0.001),the ventricular septal aperture was also smaller([9.8±4.6]mm vs.[12.6±5.4]mm,P=0.004),30-day mortality was higher(55.8%vs.35.5%,P=0.043)compared with posterior ventricular septal perforation patients.Multivariate Cox regression analysis(forward stepwise)showed that no transthoracic surgery or transcatheter closure(HR=26.344,95%CI:8.261-84.009,P<0.001)and anterior ventricular septal perforation(HR=2.432,95%CI:1.281-4.619,P=0.007)were associated with increased risk of 30-day all-cause mortality in patients with acute myocardial infarction complicated by ventricular septal perforation.Conclusions:In patients with acute myocardial infarction complicated by ventricular septal perforation,the incidence of anterior ventricular septal perforation is higher than posterior ventricular septal perforation and the 30-day all-cause mortality of anterior ventricular septal perforation patients is also higher.No transthoracic surgery or transcatheter closure and anterior ventricular septal perforation are the independent influential factors of 30-day all-cause mortality in patients with acute myocardial infarction and ventricular septal perforation.

Objectives:To investigate the relationship between locations of ventricular septal perforation and 30-day prognosis in patients with acute myocardial infarction complicated by ventricular septal perforation.Methods:Clinical data of 150 acute myocardial infarction patients with ventricular septal perforation admitted to Fuwai Hospital of Chinese Academy of Medical Sciences and People's Hospital of Xinjiang Uygur Autonomous Region from January 2009 to October 2023 were retrospectively analyzed.Kaplan-Meier method was used to compare the difference in 30-day survival rate among patients with different sites of ventricular septal perforation.The impact of locations of ventricular septal perforation on 30-day prognosis of acute myocardial infarction patients was evaluated by multivariate Cox regression analysis(forward stepwise).Results:In acute myocardial infarction patients,the occurrence of anterior ventricular septal perforation was higher than that of posterior ventricular septal perforation(79.5%vs.20.5%,P<0.001).In the anterior ventricular septal perforation patients,females were more common(50.0%vs.22.6%,P=0.006),the blood glucose level was higher([10.51±5.99]mmol/L vs.[8.02±2.81]mmol/L,P=0.026),the left ventricular end-diastolic diameter was smaller([50.7±6.1]mm vs.[55.1±5.0]mm,P<0.001),the ventricular septal aperture was also smaller([9.8±4.6]mm vs.[12.6±5.4]mm,P=0.004),30-day mortality was higher(55.8%vs.35.5%,P=0.043)compared with posterior ventricular septal perforation patients.Multivariate Cox regression analysis(forward stepwise)showed that no transthoracic surgery or transcatheter closure(HR=26.344,95%CI:8.261-84.009,P<0.001)and anterior ventricular septal perforation(HR=2.432,95%CI:1.281-4.619,P=0.007)were associated with increased risk of 30-day all-cause mortality in patients with acute myocardial infarction complicated by ventricular septal perforation.Conclusions:In patients with acute myocardial infarction complicated by ventricular septal perforation,the incidence of anterior ventricular septal perforation is higher than posterior ventricular septal perforation and the 30-day all-cause mortality of anterior ventricular septal perforation patients is also higher.No transthoracic surgery or transcatheter closure and anterior ventricular septal perforation are the independent influential factors of 30-day all-cause mortality in patients with acute myocardial infarction and ventricular septal perforation.

Objective To establish biparameter MRI stepwiese discriminant models based on T2WI and diffusion-weighted imaging(DWI),and to observe their value for detecting clinically significant prostate cancer(CSPCa)in transitional zone.Methods Totally 224 patients with pathologically confirmed prostatic transitional zone lesions were retrospectively collected and divided into CSPCa group(n=81)and non-CSPCa group(n=143)according to pathological results and Gleason scores.Single factor and stepwise discriminant analysis were used to analyze T2WI and DWI manifestations of lesions in both groups,so as to screen the independent impact factors for distinguishing CSPCa from non-CSPCa.Discriminant functions models for CSPCa and non-CSPCa were established,respectively,and the diagnostic efficiency of models were verified using cross-verification method,while correct discriminant rate≥80％was considered as having differential diagnostic value.Results The maximum diameter,boundary,DWI signal of lesions,prostate capsule being complete or not,as well as the minimum apparent diffusion coefficient were all independent impact factors for distinguishing CSPCa from non-CSPCa,and the discriminant function models for CSPCa and non-CSPCa were established based on the above factors,respectively,with correct discrimination rates of discriminant function model for CSPCa and non-CSPCa of 90.11％and 88.81％,respectively,and the overall correct discrimination rate of 89.31％.Conclusion Biparameter MRI stepwise discriminant models could be used to detect CSPCa in transitional zone.

ObjectiveTo evaluate the efficacy and safety of Rongjin Tongbi decoction on sciatica caused by lumbar intervertebral disc herniation with liver and kidney deficiency type based on a randomized controlled study. MethodFrom January 2019 to July 2022， 90 patients in the department of Traditional Chinese medicine（TCM） of Beijing Jishuitan Hospital who met the inclusion criteria were selected and divided into two groups according to the random number table， with 45 patients in each group. During the study， 19 cases dropped out， with 41 cases included in the final observation group and 30 cases in the control group. The observation group was given Rongjin Tongbi decoction orally， and the control group was given Loxoprofen Sodium Tablets orally for 28 days. The differences in the visual analog scale （VAS） scores， the Japanese Orthopaedic Association （JOA） scores， activities of daily living （ADL） assessments， TCM clinical symptoms， subjective symptoms， and clinical signs scores between two groups before and after treatment were observed. Liver and kidney functions and gastrointestinal adverse reactions were detected for safety evaluation. ResultBefore treatment， there was no statistically significant difference in scores between the observation group and the control group. After treatment， the absolute values of the differences in VAS and ADL scores in the observation group were higher than those in the control group （P<0.05）. There was no statistically significant difference in the absolute value of the difference in JOA scores between two groups. The absolute value of the difference in TCM clinical symptom scores in the observation group was higher than that in the control group （P<0.01）. There was no statistically significant difference in the absolute values of the differences in subjective symptom and clinical sign scores between two groups. The levels of liver and kidney function indicators in both groups before and after the experiment were normal， and there was no significant difference in gastrointestinal reactions. ConclusionRongjin Tongbi decoction can significantly improve the symptoms of sciatica patients caused by lumbar intervertebral disc herniation with liver and kidney deficiency type. After treatment， the patients exhibited significant improvements in pain， activity and other aspects， and it is proven to be safe and reliable， which is conducive to the recovery of physical function.

Objective To establish biparameter MRI stepwiese discriminant models based on T2WI and diffusion-weighted imaging(DWI),and to observe their value for detecting clinically significant prostate cancer(CSPCa)in transitional zone.Methods Totally 224 patients with pathologically confirmed prostatic transitional zone lesions were retrospectively collected and divided into CSPCa group(n=81)and non-CSPCa group(n=143)according to pathological results and Gleason scores.Single factor and stepwise discriminant analysis were used to analyze T2WI and DWI manifestations of lesions in both groups,so as to screen the independent impact factors for distinguishing CSPCa from non-CSPCa.Discriminant functions models for CSPCa and non-CSPCa were established,respectively,and the diagnostic efficiency of models were verified using cross-verification method,while correct discriminant rate≥80％was considered as having differential diagnostic value.Results The maximum diameter,boundary,DWI signal of lesions,prostate capsule being complete or not,as well as the minimum apparent diffusion coefficient were all independent impact factors for distinguishing CSPCa from non-CSPCa,and the discriminant function models for CSPCa and non-CSPCa were established based on the above factors,respectively,with correct discrimination rates of discriminant function model for CSPCa and non-CSPCa of 90.11％and 88.81％,respectively,and the overall correct discrimination rate of 89.31％.Conclusion Biparameter MRI stepwise discriminant models could be used to detect CSPCa in transitional zone.

Objective: To explore the relationship between sleep quality with depression and anxiety symptoms among college students in Tibet plateau areas, and to provide scientific basis for sleep quality promotion, as well as depression and anxiety allevation in high-altitude areas. Methods: The stratified cluster sampling method was used to investigate 1 288 second and third year college students in Tibet University from October to November 2019. The Chinese Version of Pittsburgh Sleep Quality Index(PSQI), Self rating Depression Scale (SDS) and Self rating Anxiety Scale (SAS) were used in this survey, and the survey results were tested by t-test, variance analysis and Logistics regression analysis. Results: The mean sleep quality index was(5.32±2.94), and 20.5% (n=264) of participants reported poor sleep quality. The detection rates of depression and anxiety symptoms were 46.0% (n=592) and 24.4%(n=314), respectively. And 20.4% (n=263) had the worst sleep quality with the coexistence of depression and anxiety symptoms. College students who are female, Tibetan, smoking, drinking and poor sleep quality have a higher risk of depression(OR=1.55,1.80,1.51，1.67，5.60), while Tibetan, drinking and poor sleep quality college students have a higher risk of anxiety(OR=1.52,1.91，10.22)(P<0.05). Conclusion There is a close relationship between the sleep quality of college students in Tibet Plateau areas with depression and anxiety symptoms. Mental health education department in colleges should attach great importance to the sleep quality of students, especially for individuals with sleep disorders, so as to reduce the incidence of depression and anxiety symptoms among college students.

This article reports the clinical data, diagnosis and treatment plan and prognosis of 3 patients with breast cancer under 20 years old. The clinical pathological features, treatment and prognosis were discussed in the literature, and compared with the biological characteristics of young (under 35 years old) breast cancer patients, providing a reference for the clinical individualized treatment of the disease.

Objective To investigate the feasibility and prospects of nested real-time PCR(NR-PCR)technique for Treponema palladium(Tp)detection in various samples of different stages of syphilis from patients preliminarily diagnosed as syphilis. Methods Targeting the Tp polA gene, NR-PCR was performed to detect Tp DNA in various samples from the patients with various stages of syphilis at the first clinic visit, including skin tissue fluid swabs, serum, whole blood, cerebrospinal fluid(CSF)and earlobe blood. Data were analyzed with SPSS software version 13. Results A total of 368 clinical samples were collected from 200 patients with syphilis. With a detection limit of 2 Tp/ml, NR-PCR showed that the total positive rate for Tp DNA was 71.7%(264/368). The Tp DNA positive rate was highest in earlobe blood samples (92.0%, 23/25), followed by CSF samples(90.2%, 46/51), skin tissue fluid swabs(74.3%, 26/35), serum samples(66.9%, 99/148)and whole blood samples(64.2%, 70/109). There was good agreement between NR-PCR results and serologic test results, with a consistency rate of 76.0%(152/200). Furthermore, the Tp DNA positive rate did not differ between patients with primary(12/19)and secondary syphilis(14/16)in skin tissue fluid swabs(χ2 = 2.62, P > 0.05), and was slightly but insignificantly higher in patients with secondary syphilis than those with primary syphilis in the serum samples(χ2=3.6, P=0.06). The Tp DNA positive rate of whole blood samples was also higher in patients with secondary syphilis than those with any other types of syphilis. Among patients with neurosyphilis, no significant difference was observed in the Tp DNA positive rate between earlobe blood samples and CSF samples(P=0.06). Among patients with latent syphilis, the Tp DNA positive rate was significantly higher in serum samples with an RPR titer of ≥ 1:8 than those with an RPR titer of≤1:4. Conclusion NR-PCR is feasible for detecting Tp DNA in various kinds of samples, and the Tp DNA positive rate is influenced by stages of syphilis and types of samples, as well as RPR titers.

Objective:To explore characteristics and interventional treatment of the elderly patients with chronic total occlusion of coronary artery. Methods:According to the age,146 cases of coronary heart disease received interventional treatment of chronic total occlusion from Feb 2012 to Mar 2016 were divided into elderly group and youth group. Comparative analysis of characteristics and prognosis between the two groups was done. Results:The proportion of family history of coronary heart disease in elderly group was significantly lower than that in the young group (P<0.05), the incidence rate of occlusive vascular calcification or tortuosity and surgical intervention time were significantly higher than those in the young group (P<0.05) . After interventional treatment, LVEDD in elderly group was significantly lower than that in the young group (P<0.05),and LVEF,left ventricular aneurysm and wall motion abnormality rate had no significant differences (P>0.05) . Conclusions:Elderly patients with chronic total occlusion of coronary artery prone to calcification or tortuosity, interventional treatment takes a long time, success rate and adverse cardiovascular events had no difference compared with the young, postoperative cardiac function of elderly patients improved more obviously.

Surgical shunt is still an effective method in managing portal hypertension related gastrointestinal bleeding.To minimize the invasive trauma and adverse effect on transplantation remains to be the unsolved problem.Herein we present the use of a newly designed surgical shunt to cure massive refractory gastrointestinal tract hemorrhage in a patient,who was critically ill because of the extensive thrombus in portal venous system.The procedure is named gastrojugular shunt.For the sake of its simple operation and effective outcome,the procedure was performed on four other patients.All the patients were well treated and recovered uneventfully with good follow up results.