OBJECTIVES: To analyze the early clinical outcomes of the Xcor^TM transcatheter aortic valve replacement (TAVR) system in treating severe aortic stenosis. This study has been registered at Chinese Clinical Trial Registry (ChiCTR2200065593). METHODS: This single-arm, prospective clinical trial enrolled patients with severe aortic stenosis treated with the Xcor^TM TAVR system at the Section of Heart Valve & Coronary Artery Surgery, Guangdong Provincial People's Hospital. Perioperative and follow-up parameters were compared to evaluate differences in hemodynamic outcomes. All-cause mortality, aortic regurgitation, paravalvular leakage, cerebrovascular events, and reoperation were analyzed. RESULTS: Thirty-two patients with severe aortic stenosis were included (20 males, 12 females), with (70.9±4.3) years old and a Society of Thoracic Surgeons (STS) score of 6.45% (6.07%, 7.28%). Notably, 87.5% of patients had New York Heart Association (NYHA) class≥Ⅲ. All patients underwent successful Xcor^TM bioprosthesis implantation, achieving an immediate technical success rate of 100.0% and device success rate of 96.9%. Mean aortic valve gradient decreased from (55.21±23.17) mmHg (1 mmHg=0.133 kPa) to (8.45±5.30) mmHg, peak aortic jet velocity decreased from (4.66±0.85) m/s to (1.99±0.48) m/s, aortic valve area increased from (0.66±0.21) cm² to (2.09±0.67) cm² (all P<0.01). Intraoperative ventricular fibrillation occurred in one patient, while one case exhibited moderate prosthetic valve regurgitation and paravalvular leakage post-procedure. At 12-month follow-up, sustained improvements were observed in cardiac function, left ventricular ejection fraction, hemodynamic parameters, and SF-12 quality-of-life scores (all P<0.01). All-cause mortality was 12.5% (4/32), with 13.8% (4/29) developing moderate paravalvular leakage. CONCLUSIONS The Xcor^TM TAVR system demonstrated favorable early outcomes in severe aortic stenosis patients, significantly improving symptoms and hemodynamics while exhibiting excellent performance in preventing malignant arrhythmias and coronary obstruction.
Humans ; Male ; Female ; Aortic Valve Stenosis/surgery* ; Transcatheter Aortic Valve Replacement/methods* ; Aged ; Follow-Up Studies ; Prospective Studies ; Treatment Outcome ; Aged, 80 and over ; Heart Valve Prosthesis ; Middle Aged

OBJECTIVES: Renal cell carcinoma (RCC) is a malignant renal tumor that poses a significant threat to patient health. Accurate preoperative pathological grading plays a crucial role in determining the appropriate treatment for this disease. Currently, deep learning technology has become an important method for pathological grading of RCC. However, existing methods primarily rely on single-phase computed tomography (CT) imaging for analysis and prediction, which has limitations such as missing small lesions, one-sided evaluation, and local focusing issues. Therefore, this study proposes a multi-modal deep learning algorithm that integrates multi-phase enhanced CT images with clinical variable data, aiming to provide a basis for predicting the pathological grading of RCC. METHODS: First, the algorithm took four-phase enhanced CT images from the plain scan, arterial phase, venous phase, and delayed phase, along with clinical variables, as inputs. Then, an embedding encoding module was used to extract heterogeneous information from the clinical variables, and a 3-dimensional (3D) ResNet50 model was employed to capture spatial information from the multi-phase enhanced CT image data. Finally, a Fusion module deeply integrated the feature information from clinical variables and each phase's CT image features, further utilizing a cross-self-attention mechanism to achieve multi-phase feature fusion. This approach comprehensively captures the deep semantic information from the patient data, fully leveraging the complementary advantages of multi-modal and multi-phase data. To validate the effectiveness of the proposed method, a total of 1 229 RCC patients were approved by ethics review were included to train the model. RESULTS: Experimental results demonstrated superior performance compared to traditional radiomics and state-of-the-art deep learning methods, achieving an accuracy of 83.87%, a recall rate of 95.04%, and an F1-score of 82.23%. CONCLUSIONS The proposed algorithm exhibits strong stability and sensitivity, significantly enhancing the predictive performance of RCC pathological grading. It offers a novel approach for accurate RCC diagnosis and personalized treatment planning.
Humans ; Carcinoma, Renal Cell/pathology* ; Deep Learning ; Kidney Neoplasms/diagnostic imaging* ; Tomography, X-Ray Computed/methods* ; Algorithms ; Neoplasm Grading ; Male ; Female ; Middle Aged

Objective To summarize and analyze the preliminary clinical outcomes of the KokaclipTM transcatheter edge-to-edge mitral valve repair system for severe degenerative mitral regurgitation (DMR). Methods This study was a single-arm, prospective, single-group target value clinical trial that enrolled patients who underwent the KokaclipTM transcatheter edge-to-edge repair (TEER) system for DMR in the Department of Heart Surgery of Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute from June 2022 to January 2023. Differences in the grade of mitral regurgitation (MR) during the perioperative and follow-up periods were compared, and the incidences of adverse events such as all-cause death, thoracotomy conversion, reoperation, and severe recurrence of MR during the study period were investigated. Results The enrolled patient population consisted of 14 (50.0%) females with a mean age of 70.9±5.4 years. Twenty-eight (100.0%) patients were preoperatively diagnosed with typeⅡ DMR, with a prolapse width of 12.5 (11.0, 16.1) mm, a degree of regurgitation 4+ leading to pulmonary venous reflux, and a New York Heart Association cardiac function class≥Ⅲ. All patients completed the TEER procedure successfully, with immediate postoperative improvement of MR to 0, 1+, and 2+ grade in 2 (7.1%), 21 (75.0%), and 5 (17.9%) patients, respectively. Mitral valve gradient was 2.5 (2.0, 3.0) mm Hg. Deaths, thoracotomy conversion, or device complications such as unileaflet clamping, clip dislodgement, or leaflet injury were negative. Twenty-eight (100.0%) patients completed at least 3-month postoperative follow-up with a median follow-up time of 5.9 (3.6, 6.8) months, during which patients had a mean MR grade of 1.0+ (1.0+, 2.0+) grade and a significant improvement from preoperative values (P<0.001). There was no recurrence of ≥3+ regurgitation, pulmonary venous reflux, reoperation, new-onset mitral stenosis, or major adverse cardiovascular events. Twenty-two (78.6%) patients’ cardiac function improved to classⅠorⅡ. Conclusion The domestic KokaclipTM TEER system has shown excellent preliminary clinical results in selected DMR patients with a high safety profile and significant improvement in MR. Additional large sample volume, prospective, multicenter studies, and long-term follow-up are expected to validate the effectiveness of this system in the future.

Objective     To evaluate the early clinical outcomes of the Renatus® balloon-expandable valve in the treatment of severe aortic stenosis. Methods    From November 2021 to April 2022, a total of 38 patients who received Renatus® balloon-expandable valve for severe aortic stenosis in Guangdong Provincial People's Hospital were included. There were 22 males and 16 females, with an average age of 73.7±5.3 years. Mean aortic gradient and peak aortic jet velocity at baseline, post-procedure, and follow-up were compared. Clinical outcomes including all-cause mortality, perivalvular leakage, serious adverse cardiovascular events and the occurrence of permanent pacemaker implantation were assessed. Results    All patients completed the procedure successfully without conversion to thoracotomy or perioperative death. The post-implant mean aortic pressure gradient was decreased from 41.5 (27.8, 58.8) mm Hg to 6.0 (3.0, 8.0) mm Hg, and the peak aortic jet velocity was also decreased from 4.1±0.9 m/s to 1.7±0.4 m/s (P<0.001). Pacemakers were required in 2 (5.3%) patients. The median follow-up time was 27.5 (23.0, 87.5) d, with a follow-up rate of 100.0%. The mean aortic gradient was 8.0 (7.0, 10.8) mm Hg and peak aortic jet velocity was 2.0±0.3 m/s, showing significant improvement compared with those in the preoperative period (P<0.001). No severe aortic regurgitation or paravalvular leak was observed. There was no serious cardiovascular adverse event or reoperative event during the study period. Conclusion    Transcatheter aortic valve replacement with the domestic Renatus® balloon-expandable valve system is a safe and effective procedure for selected patients with severe aortic stenosis who are at high risk or not candidates for surgical aortic valve replacement.

OBJECTIVE: To explore the effect of 1,2-dichloroethane(1,2-DCE) induced apoptosis on the expression of related proteins in human neuroblastoma cells(SH-SY5 Y cells). METHODS: SH-SY5 Y cells were cultured in complete medium with 1,2-DCE at final concentrations of 0,10,20,30,40,50,60,70 and 80 mmol/L. After being cultured for24 hours,the apoptosis of SH-SY5 Y cells was tested by flow cytometry using annexin Ⅴ-fluorescein isothiocyanate and propidium iodide. Western blot was used to detect the protein expression of P53,B cell lymphoma/leukmia-2(BCL-2)and BCL-2 associated X protein(BAX). RESULTS: At 1,2-DCE concentrations of 0-80 mmol/L,the total apoptosis rate of SH-SY5 Y cells increased with 1,2-DCE concentrations in a dose-dependent manner(P < 0. 01). At 1,2-DCE concentrations of 30-80 mmol/L,the early apoptosis rate and total apoptosis rate of SH-SY5 Y cells increased significantly than the control group(P < 0. 05). Compared with the other groups,the protein expression of P53 was the lowest when the1,2-DCE concentration was 20 mmol/L(P < 0. 05),and the protein expression of BCL-2 and the BCL-2/BAX ratio were the lowest when the 1,2-DCE concentration was 70 mmol/L(P < 0. 05). There is no dose-response relationship in the1,2-DCE concentrations and the protein expression levels of P53,BCL-2 and BAX,and BCL-2/BAX ratio. Linear multiple regression analysis revealed that the total apoptosis rate of SH-SY5 Y cells treated with 1,2-DCE was associated with the protein expression of P53 and BCL-2,and BCL-2/BAX ratio(P < 0. 05). CONCLUSION: 1,2-DCE could inhibit the apoptosis of SH-SY5 Y cells. The mechanisms may be related to the changes of P53 and BCL-2 protein expression,and BCL-2/BAX relative amount.

Objective To investigate correlation between genetic polymorphisms of CDHR3 (rs6967330),GSDMB (rs2305480),IL-33 (rs928413),RAD50 (rs6871536) and IL1RL1 (rs1558641) and occurrence and severity of allergic asthma in Han population.Methods Genotype and allele frequencies were compared between 516 patients and 552 controls by Chi-square test.Correlation between genotype and FEV1,total IgE was analyzed.Results Compared with the controls,the allergic patients had significantly higher allergic G of rs928413 and allergic C of rs6871536 (P ＜0.001).Besides,allergic patients were found to have significantly lower frequency of allergic A of rs1558641 (P =0.007).Compared with other genotypes,patients with rs928413 genotype GG and rs1558641 genotype GG were significantly correlated with low FEV1％ and high level of serum total IgE.Conclusion Gene IL-33,IL1R1,and RAD50 are correlated with the risk of asthma in Han population.

Objective To investigate correlation between genetic polymorphisms of CDHR3 (rs6967330),GSDMB (rs2305480),IL-33 (rs928413),RAD50 (rs6871536) and IL1RL1 (rs1558641) and occurrence and severity of allergic asthma in Han population.Methods Genotype and allele frequencies were compared between 516 patients and 552 controls by Chi-square test.Correlation between genotype and FEV1,total IgE was analyzed.Results Compared with the controls,the allergic patients had significantly higher allergic G of rs928413 and allergic C of rs6871536 (P ＜0.001).Besides,allergic patients were found to have significantly lower frequency of allergic A of rs1558641 (P =0.007).Compared with other genotypes,patients with rs928413 genotype GG and rs1558641 genotype GG were significantly correlated with low FEV1％ and high level of serum total IgE.Conclusion Gene IL-33,IL1R1,and RAD50 are correlated with the risk of asthma in Han population.

Objective To compare the effect and safety of enteral and parenteral nutritional support for gastric cancer patients undergoing laparoscopic radical gastrectomy(LRG). Methods Sixty gastric cancer patients received nutritional support after LRG at The Third Affiliated Hospital of Sun Yat-sen University from December 2007 to April 2010. All patients were randomly divided into the enteral nutrition(EN) group (n = 30)and parenteral nutrition (PN) group (n = 30) according to the random number table. Anthropometry, nutritional indexes, complications and expenses of the two groups were compared after treatment. All data were analysed by using the t test and chi-square test. Results Body mass index, triceps skin fold, mid-upper arm muscle circumference, hemoglobin levels, transferrin levels, and albumin levels were ( 16.9 ± 2.4) kg/m2, ( 10.6 ± 2.5 ) mm,(24.2 ±2.5) cm, (106 ± 15) g/L, (2.2 ±0.4) g/L and (39 ±3) g/Lin the EN group, and they were (16.6 ±2.1) kg/m2, (9.2 ± 1.3) mm, (24.0 ±3.4) cm, (102 ± 18) g/L, (2.0 ±0.4) g/L and (38 ±3) g/L in the PN group, respectively, with no significant differences between the two groups (t =0. 52, 1.72, 0.05, 0.93, 1.94,1.29, P ＞ 0.05). Prealbumin levels, nitrogen balance, time of first flatus, and daily expenses in the EN group were (0.30 ±0.10) g/L,0.8 ±0.3, (29 ± 10) hours and (210 ±30) yuan, while they were (0.25 ±0.09) g/L,0. 4 ± 0.2, (38±6) hours and ( 700 ± 50) yuan in the PN group, respectively, with a significant difference between the two groups ( t = 2. 03, 6. 08, 2. 25, 10. 38, P ＜ 0.05 ). One patient had dysbacteriosis, two were glycometabolic and two had a hepatic disorder in the EN group, while the corresponding numbers in the PN group were 9, 12 and 15 patients, respectively, with a significant difference between the two groups ( x2 =7.68, 9.32,13.87, P ＜ 0.05). Conclusions Nutritional support can promote the recovery of gastric cancer patients undergoing LRG. The efficacy of EN is superior to that of PN, and EN is the method of choice for nutritional support.

BACKGROUND: Erigeron, the inhibitor of protein kinase C, functions to decrease the death of neurocytes caused by cerebral ischemia reperfusion.OBJECTIVE: To study the effects of erigeron on hippocampus adenosine triphosphate (ATP) and adenosine triphosphatase (ATPase) of gerbils with cerebral ischemia reperfusion injury.DESIGN: A random controlled experiment.SETTING: Anesthesia Department of the Fourth Hospital of Suzhou University, Anesthesia Department of the Fourth People's Hospital of Wuxi City, and Anesthesia Department of the Affiliated Hospital of Xuzhou Medical College.MATERIALS: The experiment was done in the key laboratory of anesthesiology of Jiangsu Province from March 2002 to May 2003. The 90 Mongolian gerbils were divided into 9 groups: sham operated group, cerebral ischemia group, cerebral ischemia reperfusion 1 hour group, cerebral ischemia reperfusion 12 hours group, cerebral ischemia reperfusion 24 hours group, erigeron + cerebral ischemia group, erigeron + cerebral ischemia reperfusion 1 hour group, erigeron + cerebral ischemia reperfusion 12 hours group, and erigeron + cerebral ischemia reperfusion 24 hours group,with 10 gerbils in each. The erigeron injection with flavone 4.5 g/mL was made by the Biomedicine Factory of Yunnan Province and numbered 990103.METHODS: Apart from the sham operated group, all groups were established the ischemia reperfusion models. The erigeron groups were abdominally injected erigeron 10 mL/kg 30 minutes before the ischemia. Meanwhile, the other groups were injected the normal saline 10 mL/kg. The 6 gerbils of each group were taken blood for testing ATP content and ATPase activity and the rest 4 were only examined the pathological changes of neurocytes of hippocampus CA1 region. During the ischemia, the temperature of drum membrane (reflecting the brain temperature) was monitored and kept at (37±0.2)℃ in order to avoid the influence of temperature on the result. The comparison among groups was shown with the single factor analysis of variance.CA1 region.of ATP content and ATPase activity: Compared with the cerebral ischemia reperfusion 24 hours group, the ATP content of the erigeron 1, 12, 24 hours groups was obviously increased [(0.25 ±0.08), (0.81 ±0.12), (0.58 ±0.07),(0.43±0.09) mmol/kg, P ＜ 0.01], the Na+-K+-ATPase activity was obviously P ＜ 0.01], and the Ca2+-ATPase activity was also obviously promoted days after ischemia, the findings under the low power lens were: the pyramidal belt of the cerebral ischemia reperfusion groups became thinner and loose and even disappeared, but that of the erigeron groups became obviously wider and thicker; the findings under the high power lens were: most of the pyramidal cells of the cerebral ischemia reperfusion groups were in the state of coagulation necrosis, and those survived pyramidal cells with complete nuclear membrane and clear nucleole were very few, but the survived pyramidal cells of the erigeron groups were obviously more than those of the cerebral ischemia reperfusion groups.CONCLUSION: Erigeron increases obviously the ATP content after ischemia reperfusion, especially at the early stage of reperfusion, and at the same time, the ATPase activity is also in an improved tendency, relieving the ischemia reperfusion injury and protecting the neurocytes.

Objective To investigate the effect of hypothermia on cytokine expression in rats with lipopolysaccharide- induced acute respiratory distress syndrome (ARDS), and investigate whether or not hypothermia can inhibit inflammatory reaction and attenuated lung injuries, thereby preventing the development of ARDS. Methods A rat model of ARDS was established by intratracheal instillation of lipopolysaccharide (3 mg/ kg, 0.5 ml, LPS) at 16 h after LPS (1 mg/kg, 0.3 ml) intraperitoneal administration. Thirty-two male Sprague Dawley rats were randomly divided into four groups: ARDS + Normalthermia (AN) , ARDS + Hypothermia (AH) , NS+ Normalthermia (NN), and NS + Hypothermia (NH) groups. At 3 h after ARDS, rats were killed by hemorrhage from carotid artery. Lung lavage was performed, tumor necrosis factor ?(TNF-?) , interleukin-6 (IL-6) concentrations in BALF were measured using enzyme-linked immunosorbent assay (ELISA) .Results Within (2.3?1.6) h the ARDS model in AN group and AH group was successfully replicated. Compared with the NN group, the concentrations of TNF-? and IL-6 increased significantly in the AN group ( P 0.05). Conclusion Hypothermia has inhibitory effect on the expression and release of the pro-inflammatory cytokine (TNF-?, IL-6) in rats with ARDS. Hypothermia may inhibit inflammatory reaction, attenuated lung injuries and serve as a new measure to prevent and treat ARDS.