Objective:The aim of this study was to assess the frailty status of patients with heart failure undergoing CRT-D and then explore the predictive value of frailty for all-cause mortality and heart failure-related readmissions in these patients.Methods:We retrospectively included 374 patients with chronic heart failure who underwent CRT-D treatment at the First Affiliated Hospital of Xinjiang Medical University between June 2020 and June 2024. Based on the Tilburg Debilitation Assessment Scale, 175 patients (46.8%) were classified as frail while 199 (53.2%) were classified as non-frail. The baseline data between the two groups was compared using Cox regression analysis and Kaplan-Meier curves were used for survival analysis. P-values of <0.05 indicated statistically significant differences. Results:A total of 374 patients aged 25-93 (68±11) years were enrolled in this study, 101 (27.0%) of which were female. Among these, 175 (46.8%) were categorized as frail, and 199 (53.2%) were classified as non-frail. Over a median follow-up time of 23 (5, 45) months, 35 (9.4%) patients experienced all-cause mortality, with 30 (17.1%) deaths occurring in the frail group and 5 (2.5%) in the non-frail group; meanwhile, readmission events due to heart failure occurred in a total of 174 (46.5%) patients, including 122 (70.1%) in the frail group, and 52 (29.9%) in the non-frail group. Cox analysis showed that frailty was a significant determinant of all-cause mortality ( HR=21.25, 95% CI 3.99-113.30, P<0.001) and readmission among heart failure patients receiving CRT-D ( HR=2.52, 95% CI 1.73-3.68, P<0.001). Log-rank tests showed that the survival rate of patients in the frail group was significantly lower than that of patients in the non-frail group ( HR=7.22, 95% CI 2.80-18.60, P<0.001) and the risk of readmission events due to heart failure was significantly higher among patients in the frail group than among those in the non-frail group ( HR=2.75, 95% CI 1.98-3.81, P<0.001). Conclusions:Frailty is an independent predictor of postoperative all-cause mortality and the occurrence of heart failure-related readmissions in patients with heart failure treated receiving CRT-D.

Objective:The aim of this study was to assess the frailty status of patients with heart failure undergoing CRT-D and then explore the predictive value of frailty for all-cause mortality and heart failure-related readmissions in these patients.Methods:We retrospectively included 374 patients with chronic heart failure who underwent CRT-D treatment at the First Affiliated Hospital of Xinjiang Medical University between June 2020 and June 2024. Based on the Tilburg Debilitation Assessment Scale, 175 patients (46.8%) were classified as frail while 199 (53.2%) were classified as non-frail. The baseline data between the two groups was compared using Cox regression analysis and Kaplan-Meier curves were used for survival analysis. P-values of <0.05 indicated statistically significant differences. Results:A total of 374 patients aged 25-93 (68±11) years were enrolled in this study, 101 (27.0%) of which were female. Among these, 175 (46.8%) were categorized as frail, and 199 (53.2%) were classified as non-frail. Over a median follow-up time of 23 (5, 45) months, 35 (9.4%) patients experienced all-cause mortality, with 30 (17.1%) deaths occurring in the frail group and 5 (2.5%) in the non-frail group; meanwhile, readmission events due to heart failure occurred in a total of 174 (46.5%) patients, including 122 (70.1%) in the frail group, and 52 (29.9%) in the non-frail group. Cox analysis showed that frailty was a significant determinant of all-cause mortality ( HR=21.25, 95% CI 3.99-113.30, P<0.001) and readmission among heart failure patients receiving CRT-D ( HR=2.52, 95% CI 1.73-3.68, P<0.001). Log-rank tests showed that the survival rate of patients in the frail group was significantly lower than that of patients in the non-frail group ( HR=7.22, 95% CI 2.80-18.60, P<0.001) and the risk of readmission events due to heart failure was significantly higher among patients in the frail group than among those in the non-frail group ( HR=2.75, 95% CI 1.98-3.81, P<0.001). Conclusions:Frailty is an independent predictor of postoperative all-cause mortality and the occurrence of heart failure-related readmissions in patients with heart failure treated receiving CRT-D.

Objective:To investigate the correlation between early recurrence and late recurrence within 48 hours after catheter ablation of atrial fibrillation.Methods:A retrospective analysis was conducted on atrial fibrillation patients who underwent catheter ablation at the Heart Center of the First Affiliated Hospital of Xinjiang Medical University from April 2020 to November 2021. Preoperative examinations and baseline data of patients were collected. After surgery, the patient was given continuous electrocardiogram monitoring for 48 hours to observe whether there was early recurrence of atrial fibrillation. Follow up visits were conducted at 3, 6, 9, and 12 months after surgery to observe whether there were atrial fibrillation events. The impact of extremely early recurrence on late recurrence free atrial fibrillation was analyzed using Kaplan Meier curves, and the predictive value of extremely early recurrence and other indicators for late atrial fibrillation recurrence was evaluated using Cox proportional hazards models and receiver operating characteristic (ROC) curves.Results:A total of 96 patients who underwent catheter ablation for atrial fibrillation for the first time were included in this study, with an age of (60.2±12.6)years. Among them, 46 patients (47.92%) experienced very early recurrence within 48 hours after surgery. During the 1-year follow-up, 16 patients in the very early recurrence group experienced late recurrence, which was statistically significant compared to the very early non recurrence group ( P=0.003). The proportion of persistent atrial fibrillation was higher in patients with very early recurrence (32.6% vs 8.0%, P=0.006), and more patients with late recurrence (34.8% vs 8.0%, P=0.003). The left atrial diameter was larger [(40.28±4.72)mm vs (37.10±4.35)mm, P=0.001]. The Kaplan Meier curve showed that compared with the very early non recurrence group, the late recurrence rate of patients in the very early recurrence group was significantly higher (Long rank P=0.001 6). Cox single factor regression analysis showed that very early recurrence, age increase, increased left atrial diameter, hypertension and diabetes were risk factors for late recurrence (all P<0.2). Multivariate regression analysis suggested that extremely early recurrence was an independent risk factor for late recurrence ( HR=3.99, 95% CI: 1.22-13.06, P=0.021). The area under the ROC curve for predicting late recurrence after catheter ablation of atrial fibrillation with extremely early recurrence was 0.703, and the negative predictive value was 0.920. Conclusions:Early recurrence within 48 hours after catheter ablation of atrial fibrillation is an independent risk factor for late recurrence and has good predictive value.

Hypertrophic obstructive cardiomyopathy (HOCM) is the most common type of hypertrophic cardiomyopathy, which is prone to left ventricular outflow obstruction and causes various adverse effects. It is also the main cause of sudden death in adolescents and athletes. Timely intervention is crucial for the prognosis of patients. Radiofrequency ablation has been widely used in the treatment of various arrhythmias, but it is still a new treatment method in HOCM. This article mainly reviews the clinical application progress of radiofrequency ablation in the treatment of HOCM patients.

Objective:To investigate the association between abnormal left atrial appendage function and thrombotic events in patients with non-valvular atrial fibrillation, and the independent risk factors affecting left atrial appendage function.Methods:Patients with non-valvular atrial fibrillation, who visited the Atrial Fibrillation Center of the First Affiliated Hospital of Xinjiang Medical University from June 1, 2019 to June 1, 2021, were selected. According to left atrial appendage flow velocity (LAAFV), they were divided into normal left atrial appendage function group (297 patients with LAAFV ≥ 40 cm/s) and abnormal left atrial appendage function group (85 patients with LAAFV<40 cm/s). Baseline data and transesophageal echocardiography images were collected from all the patients. The occurrence of thrombotic events was recorded. Univariate and multivariate unconditional logistic regression analyses were conducted to investigate the correlation between abnormal left atrial appendage function and the occurrence of thrombotic events.Results:There were significant differences in gender, type of atrial fibrillation, CHA 2DS 2-VASc score, anticoagulant therapy, total cholesterol, low-density lipoprotein cholesterol, international normalized ratio (INR), left atrial diameter, proportion of patients with right atrial enlargement, left ventricular ejection fraction, inner diameter, sum of inner diameter, depth, and sum of depth of all angles of the left atrial appendage, and incidence of thrombotic events between the two groups (all P<0.05). After adjusting for confounders, multivariate unconditional logistic regression analyses showed that abnormal left atrial appendage function was closely associated with thrombotic events (β=1.168 P=0.002), and left atrial diameter ( OR=1.084, 95% CI 1.019-1.153, P=0.011) and persistent atrial fibrillation ( OR=2.323, 95% CI 1.226-4.403, P=0.010) were independent risk factors affecting left atrial appendage function. Conclusions:Abnormal left atrial appendage function is closely associated with thrombosis. The left atrial diameter and persistent atrial fibrillation were independent risk factors affecting left atrial appendage function.

OBJECTIVE:To optimize formulation matrix of processed Aconitum carmichaelii hydrogel patch,and to investigate its in vitro drug release.METHODS:The ratio of NP700,dihydroxyaluminum aminoacetate,tartaric acid and PVP K90 in processed A.carmichaelii hydrogel patch matrix was optimized by central composite design-response surface method (CCD-RSM) with initial adhesion,peel strength and sensory evaluation as evaluation indexes.The modified Franz diffusion cell method was used for in vitro drug release test processed A.carmichaelii hydrogel patch using accumulative release amount of six ester type alkaloids benzene [benzoyl mesaconine (BM),benzoyl aconitum (BA),benzoylhy paconine (BH),mesaconitine (MT),hypaconitine (HT) and aconitine (AT)] as evaluation indexes.RESULTS:The optimal matrix formulation was NP700-dihydroxyaluminum aminoacetate-tartaric acid-PVP K90 (1.72 ∶ 0.10 ∶ 0.02 ∶ 1.65,m/m/m/m).In validation test,the contents of six ester type alkaloids were 52.77,28.52,28.78,8.81,8.75,8.21 μg/g(RSD＜5％,n=3),comprehensive score was 118.67 ± 1.33 (RSD=4.62％,n=3).The release behavior of BM in vitro conformed to the Higuchi equation.The release behaviors of other 5 alkaloids were consistent with the Higuchi equation.12 h accumulative release amounts of BM,BA,BH,MT,HT and AT were 12.04,2.95,3.55,2.64,2.48,1.97 μg/cm2,respectively.CONCLUSIONS:The processed A.carmichaelii hydrogei patch prepared by matrix prescription is good in appearance,adhesion and in vitro release.The research can provide a basis for the development of new dosage form of processed A.carmichaelii.

Objective To investigate the effect of mitogen-activated protein kinases (MAPKs) activation on the heat stressinduced apoptosis of pulmonary microvascular endothelial cells (PMVECs).Methods A mouse model of severe heat stroke was made and TUNEL and immunohistochemistry were employed to detect lung tissue damage.MACS separation was used for isolation of neonatal PMVECs,and TUNEL was utilized to detect the apoptosis of PMVECs.Western blotting was used for determining the MAPKs activation during heat stress recovery (0,2,6h).The monolayer permeability of endothelial cells was detected in terms of transmembrane resistance (TEER) and horseradish peroxidase (HRP).Cells were pretreated with MAPKs activation inhibitors to examine the effect of heat stress on the monolayer cell permeability and apoptosis.Results In mice with severe heat stroke,extensive apoptosis of PMVECs was found in their pulmonary tissues.TUNEL revealed that the number of apoptotic cells increased over time during heat stress recovery period and heat stress could activate MAPKs in PMVECs.Compared with heat stress group,in the cells pretreated with p38 or ERK activation inhibitor PD98059 and SB203580,the monolayer permeability and apoptosis increased while in cells pretreated withJNK inhibitor SP600125,the cellular permeability and apoptosis decreased.Conclusion In mice with severe heat stoke,PMVECs might experience apoptosis and p38 and ERK could inhibit apoptosis while JNK could promote apoptosis.

Background and purpose:Currently, subjective questionaire is the most frequently used methods to evaluate swallowing dysfunctions after radiotherapy in nasopharyngeal carcinoma patients, while lacking of effective objective examinations. This study aimed to explore effective methods to evaluate swallowing dysfunctions after radiotherapy in nasopharyngeal carcinoma patients, and gain knowledge of the incidence and severity of swallowing dysfunctions. Methods: From Oct. 2013 to Dec. 2013, 128 consecutive outpatients with previously treated nasopharyngeal carcinoma received esophageal barium lfuoroscopy examination at there regularly follow-ups to evaluate swallowing function. Among these patients, 89 were primary treated with intensity modulated radiation therapy (IMRT) and 39 with conventional radiotherapy (CRT). In this study, each patient received esophageal barium lfuoroscopy examination for 3 times with thin, thick and pasty barium and were dynamically observed using X-ray fluoroscopy from front and lateral direction. Swallowing dysfunctions were defined as follows:①The bolus could not be swallowed and blocked in the mouth;②The dilute barium diverted to the glottis or trachea;③Residual barium delayed in the pyriform sinus and vallecula;④The movement of the hyoid bone or epiglottis were restricted;⑤Bolus prolong through the pharynx;⑥Barium slowed down when went though the esophageal entrance. Results:Of the 128 patients, incidence of dysphagia was 60.2%for the entire cohort, 52.8%for IMRT group and 76.9%for CRT group. Incidence of dysphagia for IMRT group was signiifcantly lower than CRT group (P=0.018). Dysphagia incidence within 1 year, 1 to 2 years and more than 2 years after RT were 63.1%, 33.3%and 69.0%, respectively (P=0.019). Conclusion:There was a high incidence of swallowing dysfunction for the nasopharyngeal carcinoma patients treated with radiotherapy and dysphagia incidence decreased when treated with IMRT. Esophageal barium lfuoroscopy examination is objective method to evaluate the incidence and severity of the swallowing dysfunction.

Objective To evaluate the effectiveness and safety of minimal incision laparotomy assisted endoscopic resection for polyps in small intestine in patients with Peutz-Jeghers syndrome. Methods The clinical data of patients with Peutz-Jeghers syndrome, who underwent minimal incision laparotomy assisted endoscopic resection for polyps in small intestine, were retrospectively studied. The size and number of the endoscopically rosected polyps, and the procedure related complications were documented. Results A total of 812 polyps in small-bowel were resected in 8 patients, in which 384 were smaller than 10mm, 356 with diameter ranging from 11 mm to 30mm, and 72 were larger than 30mm in diameter. Procedure related complications included intestinal dysfunction in 1 patient and abdominal pain in another. No bleeding with a fall in Hb or other severe complications were observed. Conclusion Minimal incision laparotomy assisted endoscopic resectio is a safe and reliable procedure for the treatment of mid-small bowel polyps in patients with Peutz-Jeghers syndrome. It revolutionizes the therapeutic options for polyps in the region of the mid-small bowel and limits the indications for primary surgical management.

Objective To study the changes of serum vascular endothelial growth factor(VEGF)levels before and after interventional therapy of hepatocellular carcinoma(HCC),in order to find out a experimental proof that can start the anti-angiogenesis therapy.Methods Enzyme linked immunosorbentassay(ELISA)was used to detect serum levels of VEGF before transcathter arterial chemo-ebolization and in 24 hours,72 hours,7 days,14 days,30 days,after the operation,in 50 healthy individuals and 54 HCC pationts.Results Serum levels of VEGF in 54 patients with HCC were significantly higher than those in healthy individuals(P