Objective:To investigate the circumstances of tobacco dependence diagnosis among smoking patients in 5 tertiary hospitals in Zhejiang Province and to assess the diagnostic awareness of the disease among specialists.Methods:A cross-sectional study was used to retrospectively collect data on outpatients and inpatients in a total of five tertiary hospitals, namely, the First Affiliated Hospital of Zhejiang University School of Medicine, the Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, the Fourth Hospital Affiliated to the Medical College of Zhejiang University, the Zhejiang Provincial Tongde Hospital, and the Lishui People′s Hospital of Zhejiang Province, from January 1, 2018 to December 31, 2022. Diagnoses were obtained through an outpatient or inpatient electronic medical record system, diagnostic data on tobacco dependence were analyzed, and a web-based questionnaire was further used to investigate the diagnostic awareness of physicians of various specialties in 1 of the hospitals.Results:A total of 340 tobacco dependence diagnoses were queried, including 5 inpatient diagnoses and 335 outpatient diagnoses. A total of 278 cases of tobacco dependence diagnosis in the First Affiliated Hospital of Zhejiang University School of Medicine.Of the 273 cases in the hospital′s internal medicine clinic, 268 (98.2%) were in respiratory medicine and 5 (1.8%) in cardiology; 234 (87.3%) were diagnosed by physicians trained in smoking cessation. Of the 170 clinicians surveyed at the First Affiliated Hospital of Zhejiang University School of Medicine, 7 were smokers, with a smoking rate of 4.1%. Regarding clinicians′ knowledge of tobacco dependence, 40 (23.5%) said"I know a lot about it", 96 (56.5%) said "I′ve heard of it but don′t know much about it", and 34 (20.0%) said "I have not heard of it". Of the 170 clinicians, 132 (77.6%) always or frequently asked patients about their smoking status, and 38 (22.4%) rarely or never asked. 145 (85.3%) clinicians always or frequently advised patients to quit smoking when they knew they smoked and 25 (14.7%) rarely or never advised.Conclusions:The diagnosis rate of tobacco dependence remains low in some comprehensive tertiary hospitals in Zhejiang, and clinicians in these tertiary hospitals in the region are not sufficiently aware of tobacco dependence and its diagnosis.

Objective:To investigate the circumstances of tobacco dependence diagnosis among smoking patients in 5 tertiary hospitals in Zhejiang Province and to assess the diagnostic awareness of the disease among specialists.Methods:A cross-sectional study was used to retrospectively collect data on outpatients and inpatients in a total of five tertiary hospitals, namely, the First Affiliated Hospital of Zhejiang University School of Medicine, the Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, the Fourth Hospital Affiliated to the Medical College of Zhejiang University, the Zhejiang Provincial Tongde Hospital, and the Lishui People′s Hospital of Zhejiang Province, from January 1, 2018 to December 31, 2022. Diagnoses were obtained through an outpatient or inpatient electronic medical record system, diagnostic data on tobacco dependence were analyzed, and a web-based questionnaire was further used to investigate the diagnostic awareness of physicians of various specialties in 1 of the hospitals.Results:A total of 340 tobacco dependence diagnoses were queried, including 5 inpatient diagnoses and 335 outpatient diagnoses. A total of 278 cases of tobacco dependence diagnosis in the First Affiliated Hospital of Zhejiang University School of Medicine.Of the 273 cases in the hospital′s internal medicine clinic, 268 (98.2%) were in respiratory medicine and 5 (1.8%) in cardiology; 234 (87.3%) were diagnosed by physicians trained in smoking cessation. Of the 170 clinicians surveyed at the First Affiliated Hospital of Zhejiang University School of Medicine, 7 were smokers, with a smoking rate of 4.1%. Regarding clinicians′ knowledge of tobacco dependence, 40 (23.5%) said"I know a lot about it", 96 (56.5%) said "I′ve heard of it but don′t know much about it", and 34 (20.0%) said "I have not heard of it". Of the 170 clinicians, 132 (77.6%) always or frequently asked patients about their smoking status, and 38 (22.4%) rarely or never asked. 145 (85.3%) clinicians always or frequently advised patients to quit smoking when they knew they smoked and 25 (14.7%) rarely or never advised.Conclusions:The diagnosis rate of tobacco dependence remains low in some comprehensive tertiary hospitals in Zhejiang, and clinicians in these tertiary hospitals in the region are not sufficiently aware of tobacco dependence and its diagnosis.

Objective:To evaluate the effectiveness and prognosis of emergent transcatheter aortic valve replacement (TAVR) and to provide standardized procedural suggestion for the development of emergent TAVR in China.Methods:From January 2020 to April 2021, 12 patients who underwent emergent or salvage TAVR in the Second Affiliated Hospital Zhejiang University School of Medicine were retrospectively enrolled from the TORCH registry (Transcatheter Aortic Valve Replacement Single Center Registry in Chinese Population, a prospective cohort study; NCT02803294). Baseline, periprocedural and 30-day follow up data were collected. Post-operative data were compared with pre-operative data using Paired-Samples test.Results:Patients’ median Society of Thoracic Surgeons score (STS score) was 15.432%. There was a significant decrease of mean gradient after emergent TAVR procedure (1.69 m/s vs. 4.90 m/s, P<0.01). During the 30-day follow up, there were 1 patient (8.3%) died and 2 patients received permanent pacemaker implantation. No disabling stroke, acute kidney injury, major vascular complication occurred during the first month after emergent TAVR. Among the survival patients, there was a significant releasing of heart failure symptoms to New York Heart Association function stage Ⅰ/Ⅱ in 81.8% patients at 30-day follow up. Left ventricular ejection fraction also improved significantly from (47.4±9.5)% to 58.8±8.0% ( P= 0.026). The mean gradient were (1.57±0.30) cm 2 and no patients had a moderate or severe paravalvular leakage. Besides, a significant decrease of pro-B-type natriuretic peptide (1 089.9 pg/mL vs. 12 215.5 pg/mL , P=0.001) and troponin T (0.020 ng/mL vs. 0.337 ng/mL, P=0.003) were found at 30 days after emergent TAVR. Conclusions:For patients with severe aortic stenosis and acute cardiac decompensated, emergent TAVR is a safe and effective rescue treatment.

Abstract-Eleven mouse monoclonal antibodies (McAbS)specific for human alpha-fetopr-otein(AFP) have been produced by the hybridoma technique. Immunodiffusion was us-ed for determining the immunoglobulin class and subclass of the McAbS. Seven of them are IgG; two are IgM. At least 4 different antigenic determinants on human AFPcan be recognized by using the McAbS and cross-two-site sandwich solid radioimmun-oassay. One of the McAbS can specially react with one of the fragments of AFP dig-ested by pepsin. In addition, the cross-reactivity among the AFPs of different mam-malian species was also tested by using the McAbS.