Objectives:To explore the feasibility of zero-ray radiofrequency catheter ablation for paroxymal atrial fibrillation under the guidance of transthoracic echocardiography combined with three-dimensional mapping system.Methods:This is a single-center prospective observational study.A total of 12 patients with paroxysmal atrial fibrillation who underwent radiofrequency catheter ablation in Fuwai Hospital,Chinese Academy of Medical Sciences from June 1,2024 to September 30,2024 were included.All patients underwent successful percutaneous puncture,atrial septal puncture under the guidance of transthoracic echocardiography,and all patients underwent left atrial modeling and discharge ablation under the guidance of transthoracic echocardiography combined with three-dimensional mapping system.The disappearance of pulmonary vein potential was confirmed after the ablation operation and as the ablation endpoint and successful ablation marker.The operation results and 1-month and 3-month follow-up results of the patients were observed.Results:There were 12 patients with paroxysmal atrial fibrillation,9 males and 3 females,aged(56.8±11.2)years,with a history of paroxysmal atrial fibrillation(4.2±2.3)years.The mean left atrial diameter was(36.5±2.5)mm,the left ventricular end-diastolic diameter was(47.8±4.1)mm,and the left ventricular ejection fraction was 55%-65%.The mean overall operation time was(102.25±14.51)min,the ultrasound operation time was(29.58±6.23)min,and the catheter operation time was(33.08±4.10)min.All patients completed circumferential pulmonary vein isolation without intraoperative complications.The hospitalization time was 2-6 days.At the 1-month follow-up after ablation,all patients showed sinus rhythm on 24-hour ambulatory electrocardiogram,and 2 patients had occasional atrial premature contractions without recurrence of atrial fibrillation.At the 3-month follow-up,two patients had occasional premature atrial contractions,and no recurrence of atrial fibrillation was recorded on the electrocardiogram of all patients.Conclusions:It is feasible to complete radiofrequency catheter ablation of paroxysmal atrial fibrillation under the guidance of transthoracic echocardiography combined with three-dimensional mapping system.

The superiority of magnetic resonance(MR)images in soft tissue imaging makes them indispensable for medical diagnosis and radiotherapy,but factors such as acquisition cost and contraindications limit their widespread application.In contrast,computed tomography(CT)scanning has the advantages of fast imaging speed and low cost.Herein,this review summarizes the research progress of generative deep learning models in the field of medical CT to MR image synthesis,and especially analyzes the technical characteristics,performance advantages,and challenges of various MR image synthesis methods from clinical scenarios such as spinal lesions,acute ischemic stroke,and tumor segmentation.Furthermore,the application value and future research prospects of medical image synthesis are discussed.

Objectives:To explore the feasibility of zero-ray radiofrequency catheter ablation for paroxymal atrial fibrillation under the guidance of transthoracic echocardiography combined with three-dimensional mapping system.Methods:This is a single-center prospective observational study.A total of 12 patients with paroxysmal atrial fibrillation who underwent radiofrequency catheter ablation in Fuwai Hospital,Chinese Academy of Medical Sciences from June 1,2024 to September 30,2024 were included.All patients underwent successful percutaneous puncture,atrial septal puncture under the guidance of transthoracic echocardiography,and all patients underwent left atrial modeling and discharge ablation under the guidance of transthoracic echocardiography combined with three-dimensional mapping system.The disappearance of pulmonary vein potential was confirmed after the ablation operation and as the ablation endpoint and successful ablation marker.The operation results and 1-month and 3-month follow-up results of the patients were observed.Results:There were 12 patients with paroxysmal atrial fibrillation,9 males and 3 females,aged(56.8±11.2)years,with a history of paroxysmal atrial fibrillation(4.2±2.3)years.The mean left atrial diameter was(36.5±2.5)mm,the left ventricular end-diastolic diameter was(47.8±4.1)mm,and the left ventricular ejection fraction was 55%-65%.The mean overall operation time was(102.25±14.51)min,the ultrasound operation time was(29.58±6.23)min,and the catheter operation time was(33.08±4.10)min.All patients completed circumferential pulmonary vein isolation without intraoperative complications.The hospitalization time was 2-6 days.At the 1-month follow-up after ablation,all patients showed sinus rhythm on 24-hour ambulatory electrocardiogram,and 2 patients had occasional atrial premature contractions without recurrence of atrial fibrillation.At the 3-month follow-up,two patients had occasional premature atrial contractions,and no recurrence of atrial fibrillation was recorded on the electrocardiogram of all patients.Conclusions:It is feasible to complete radiofrequency catheter ablation of paroxysmal atrial fibrillation under the guidance of transthoracic echocardiography combined with three-dimensional mapping system.

The superiority of magnetic resonance(MR)images in soft tissue imaging makes them indispensable for medical diagnosis and radiotherapy,but factors such as acquisition cost and contraindications limit their widespread application.In contrast,computed tomography(CT)scanning has the advantages of fast imaging speed and low cost.Herein,this review summarizes the research progress of generative deep learning models in the field of medical CT to MR image synthesis,and especially analyzes the technical characteristics,performance advantages,and challenges of various MR image synthesis methods from clinical scenarios such as spinal lesions,acute ischemic stroke,and tumor segmentation.Furthermore,the application value and future research prospects of medical image synthesis are discussed.

Since the first successful transcatheter aortic valve replacement (TAVR) was performed globally in 2002, the TAVR technology has become increasingly mature. With more than a decade of development in China, its application experience, device research and development, procedural improvements, evidence-based medicine, and guideline updates have continuously progressed, leading to a significant increase in the number of procedures conducted. Compared to traditional surgical operations, TAVR has different postoperative monitoring points and principles for the prevention and management of complications, necessitating the formulation of corresponding monitoring and treatment protocols that align with the technical characteristics of the procedure. This guideline is based on clinical practice and incorporates both domestic and international literature as well as the experiences of Fuwai Hospital. It distills and organizes routine postoperative monitoring practices, process optimization, and complication management for TAVR, establishing a set of practical guidelines for postoperative monitoring in China. These guidelines have strong practical value for optimizing postoperative management strategies and preventing and managing complications, which is beneficial for early functional recovery of patients, shortening hospital stays, and reducing complication rates. They provide guidance and reference for domestic peers and support the standardized development and quality improvement of postoperative management for TAVR in China.

ObjectiveTo investigate the effects and mechanism of the combination of arsenic trioxide （ATO） and its dimethylarsinic acid （DMAV） metabolite on apoptosis of human acute promyelocytic leukemia NB4 cells by affecting the balance of metabolic reaction. MethodsThe rats were injected with the same amount of sterile normal saline， ATO（1.6 mg·kg^-1）， and DMAV（4， 8， 16， and 32 mg·kg^-1） combined with ATO（1.6 mg·kg^-1）， respectively， to obtain the corresponding drug-containing serum. The effect of drug-containing serum on the proliferation of NB4 cells was detected by the cell counting kit-8 （CCK-8 ）method. Apoptosis was detected by flow cytometry with Annexin-V-FITC/PI double staining. Intracellular reactive oxygen species （ROS） accumulation was detected by flow cytometry using fluorescent probe DCFH-DA. The changes of mitochondrial membrane potential （Δψm） were detected by the fluorescence probe JC-1. Western blot detected the expression of apoptosis-related proteins， namely B-cell lymphoma-2（Bcl-2）-associated X protein（Bax）/Bcl-2， Cytochrome C， cleaved Caspase-9， and cleaved Caspase-3， as well as c-Jun N-terminal kinase（JNK） phosphorylation levels. Results①The Combination of the two drugs had a higher proliferation inhibition rate and more apoptosis than ATO alone. ②The combination of two drugs can significantly increase the production of ROS compared with any single treatment group. ③The Δψm was significantly reduced in the two-drug combination group compared with any single treatment group. ④Compared with either group， the combination group significantly released Cytochrome C， significantly down-regulated the expression of Bcl-2， and up-regulated the expression of Bax， cleaved Caspase-3， and cleaved Caspase-9. ⑤The phosphorylation level of JNK was significantly up-regulated in the two-drug combination group compared with any single treatment group. ConclusionThe combination of DMAV and ATO may synergistically induce mitochondrial apoptosis through ROS-mediated oxidative stress， triggering Δψm dissipation and Cytochrome C release. By activating Caspase-9/Caspase-3 and the phosphorylation level of JNK， the Bcl-2 family protein （Bax/Bcl-2） was regulated to promote the apoptosis of NB4 cells.

This report describes a case of an elderly patient whose cardiac pacemaker lead had dislocated and whose battery had depleted.After evaluation,the patient required implantation of a leadless pacemaker.The procedure was successfully completed using solely transthoracic ultrasound guidance,marking the first leadless pacemaker implantation done with only ultrasound guidance,and achieved favorable clinical outcomes.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Nipah virus (NiV) is a highly contagious zoonotic pathogen, responsible for a relatively high mortality in human and posing a serious threat to human health. There are currently no licensed vaccines or antiviral drugs. Preclinical studies on NiV vaccines with different strategies are mainly based on NiV glycoprotein (G) and/or fusion protein (F). Internationally, three NiV vaccine candidates are currently in the Phase I clinical stage. The risk of Nipah virus transmitted to China is relatively high. In order to cope with potential future epidemics, China should develop NiV prevention and control strategies, and accelerate Nipah virus-related technology reserves and vaccine development. This article introduces NiV from the aspects of microbiology, epidemiology, clinical characteristics, and vaccine research, and puts forward prevention and control suggestions in light of the risk of NiV transmission to China and China′s national conditions, hoping to provide reference for NiV vaccine research and development.

Objective To compare the effects of using three different filling appliances,CompothixoTM resin filler,conventional resin filler,and SonicFill sonic handpiece,on marginal microleakage after auxiliary resin filling of class Ⅱ cavities.Methods A total of 40 permanent molars extracted from the Department of Stomatology,Affiliated Hospital of Shandong Second Medical University(Weifang Medical University Affiliated Hospital)from October 2020 to February 2021 were collected and randomly divided into four groups:A,B,C,and D.Standard class Ⅱ cavities were prepared in the proximal and distal middle of the isolated teeth,filled according to the standard filling requirements of the instruments in each grouping,dissected after temperature cycling and methylene blue staining,and the dye penetration depths of the dental tissues and restorative axial and gingival walls were observed and graded under the body-view microscope to calculate the microleakage degree scores.Results Microleakage occurred in four groups,and tested by the Mann-Whitney U test,the microleakage scores of group A was higher than those of the other three groups(P<0.05);There was no statistically significant difference between groups B and C(P>0.05);The scores of groups B and C were higher than those of group D(P<0.05).Group A had higher microleakage scores than group D(P<0.05),and there was no statistically significant difference between the remaining groups(P>0.05).Conclusion The use of the CompothixoTM resin filler is beneficial in reducing microleakage between the resin and the tooth tissue when compared to conventional filling appliances;Compare with the SonicFill handpiece,the use of the CompothixoTM resin filler is not conducive to the reduction of microleakage between the SonicFill ultrasonic resin and the tooth tissue.