Objective To analyze the short-term clinical outcomes of emergency conversion to surgery during transcatheter aortic valve replacement (TAVR). Methods Clinical data of patients who underwent emergency surgical conversion from TAVR in the Department of Cardiovascular Surgery, the Second Hospital of Hebei Medical University, from 2018 to 2023 were collected. Postoperative follow-up results at 1 month were recorded. Results A total of 253 patients underwent TAVR, of whom 11 (4.3%) required emergency conversion to surgery. Among these 11 patients, 7 were male and 4 were female, with a mean age of (69.55±5.01) years. The primary cause for emergency surgical conversion was valve stent displacement (63.6%), followed by left ventricular perforation/rupture (18.2%) and significant perivalvular regurgitation persisting after a second valve implantation (18.2%). One (9.1%) patient died intraoperatively. Among the 10 surviving patients, postoperative complications included pulmonary infection in 8 patients, severe pneumonia in 7, pleural effusion in 3, liver dysfunction in 8, renal dysfunction in 3, upper gastrointestinal bleeding in 5, cerebrovascular complications in 1, atrial fibrillation in 1, ventricular premature contractions in 1, atrioventricular block in 1, and complete left bundle branch block in 3. At 1-month postoperative follow-up, one additional patient died, yielding a 30-day mortality rate of 18.2% after TAVR emergency surgical conversion. The quality of life improved significantly compared to preoperative status in 9 (81.8%) patients, and no patients were readmitted for cardiovascular diseases. Conclusion The incidence of emergency conversion to surgery during TAVR is low, but the rates of surgical complications and 30-day postoperative mortality are high. Nevertheless, when severe complications occur during TAVR, emergency conversion to surgery can still yield satisfactory short-term clinical outcomes for a majority of these patients.

BACKGROUND: The potential impact of pre-existing coronary artery stenosis (CAS) on right ventricular (RV) function during acute pulmonary embolism (PE) episodes remains underexplored. This study aimed to investigate the association between pre-existing CAS and RV dysfunction in patients with acute PE. METHODS: In this multicenter, case-control study, 89 cases and 176 controls matched for age were enrolled at three study centers (Peking Union Medical College Hospital, Fuwai Hospital, and the Second Affiliated Hospital of Harbin Medical University) from January 2016 to December 2020. The cases were patients with acute PE with CAS, and the controls were patients with acute PE without CAS. Coronary artery assessment was performed using coronary computed tomographic angiography. CAS was defined as ≥50% stenosis of the lumen diameter in any coronary vessel >2.0 mm in diameter. Conditional logistic regression analysis was used to evaluate the association between CAS and RV dysfunction. RESULTS: The percentages of RV dysfunction (19.1% [17/89] vs. 44.6% [78/176], P <0.001) and elevated systolic pulmonary artery pressure (sPAP) (19.3% [17/89] vs. 39.5% [68/176], P = 0.001) were significantly lower in the case group than those in the control group. In the multivariable logistic regression model, CAS was independently and negatively associated with RV dysfunction (adjusted odds ratio [OR]: 0.367; 95% confidence interval [CI]: 0.185-0.728; P = 0.004), and elevated sPAP (OR: 0.490; 95% CI: 0.252-0.980; P = 0.035), respectively. CONCLUSIONS Pre-existing CAS was significantly and negatively associated with RV dysfunction and elevated sPAP in patients with acute PE. This finding provides new insights into RV dysfunction in patients with acute PE with pre-existing CAS.
Humans ; Pulmonary Embolism/complications* ; Case-Control Studies ; Male ; Ventricular Dysfunction, Right/physiopathology* ; Female ; Middle Aged ; Aged ; Coronary Stenosis/complications* ; Logistic Models ; Adult

Objective To investigate the imaging manifestations of inflammatory bowel disease-associated spondyloarthritis(IBD-SpA).Methods A retrospective analysis was conducted on 85 patients with inflammatory bowel disease(IBD)who underwent abdominal CT and MRI examinations.Patients with pregnancy,lactation,psoriasis,tumors,and other conditions were excluded through medical record screening,all patients met the diagnostic criteria for IBD.The presence of spondyloarthritis(SpA)was confirmed through ima-ging findings,and the imaging characteristics of the location and bone changes of SpA were observed.Twenty patients who under-went abdominal CT examination during the same period were selected as the control group.Results A total of 85 patients with IBD under-went CT and MRI examinations,the detection rate of MRI(37.6％)was significantly higher than that of CT(30.6％)(P＜0.05).Based on comprehensive imaging features,5 cases of grade 1,13 cases of grade 11,11 cases of grade Ⅲ,and 3 cases of grade Ⅳ,IBD-SpA were diagnosed.In the control group,1 case of sacroiliitis was detected,of which 1 case of grade Ⅱ.The detection rate of CT in the IBD group(30.6％)was significantly higher than that in the control group(5％)(P＜0.05).Conclusion The incidence of SpA is relatively high in patients with IBD.Both CT and MRI have certain diagnostic value for IBD-SpA.CT has diagnostic advantages in bone sclerosis and joint space narrowing,while MRI can better reflect minor lesions and early bone marrow edema changes.The com-bination of CT and MRI examinations can provide diagnostic evidence for clinicians and effectively improve patient symptoms.

The application of digital technology in teaching and clinical practice has been hindered by the lack of integrity,consis-tency and accuracy in current digital models.Despite the efforts of domestic and international scholars,the localization,refining and standardization of model data for digital dental models remain inadequate,which limits the promotion and application of digital dental models.A preliminergly produced precise,standardized and multi-form applicable 3D dental-cranio-cervical digital model based on Chinese anatomical data is reported in this paper.The further improvement,application and promotion of this model are expected to contribute to the improvement of the quality of dental education and clinical efficiency.

Primary abdominal wall tumors constitute approximately 10%of the total spectrum of soft tissue tumors.Based on their biological characteristics,these tumors can be classified into three distinct categories:benign,malignant,and borderline.Different subtypes of abdominal wall tumors exhibit significant heterogeneity in clinical manifestations,pathological features,and prognostic outcomes.A comprehensive preoperative evaluation by a multidisciplinary team,incorporating both pathological and radiological assessments,is indispensable for tailoring individualized treatment strategies.In recent years,laparoscopic surgery has emerged as a promising modality for resection and reconstruction of abdominal wall tumors,particularly those deep-seated or intramural.Compared with conventional open surgery,laparoscopic surgery offers several advantages,including reduced tissue trauma,precise tumor resection,lower rate of postoperative complications,faster recovery,and enhanced cosmetic results.Nevertheless,the long-term efficacy and the breadth of applications of laparoscopic surgery in the management of abdominal wall tumors warrant further investigation through rigorous clinical trials.

Objective:To construct an evaluation index system for(magnetic resonance imaging)MRI equipment allocation management in hospitals,and to provide objective basis for MRI equipment allocation decision-making.Methods:Following the principles of practicality,objectivity and accessibility,the evaluation index system of hospital MRI equipment allocation management was designed and constructed,based on the actual work needs of the hospital,the index system and evaluation rules were determined by combining literature research method,expert seminars,and expert consultation method.The evaluation index system was used to evaluate and analyze the MRI equipment application allocation management of the two hospitals included in the study in 2023(Hospital A and Hospital B),By comprehensively considering hospital grading and index score,the allocation requirements of MRI were quantitatively calculated and evaluated,and comparable and quantifiable evaluation results were achieved.Results:The MRI equipment allocation management index system formed update scenarios,additional scenarios and ladder allocation scenarios,and established relevant evaluation matrices and multi-category indicators based on the allocation scenarios.The evaluation results showed that Hospital A's application for one mid-range MRI equipment was approved,and Hospital B's application was not approved,and the evaluation results were consistent with the actual decision-making.Conclusion:The evaluation index system for hospital MRI allocation management can realize the evaluation of MRI equipment allocation management,provide effective data support for MRI allocation decision-making,and have a guiding role in improving equipment service capabilities,refined management,and optimized resource allocation.

Objective　To analyze the causes of death of one case of imported falciparum malaria in Guangxi Zhuang Autonomous Region in January 2023, to provide a reference for the prevention of fatal malaria cases. Methods Interviews were conducted with the doctors who received and consulted the patient, as well as the family members of the patient. Clinical data from the patient's diagnosis and treatment process were collected, and the patient's clinical records and epidemiological investigation data were analyzed. Results The patient, Mr. He, a 53-year-old male from Pingnan County, Guigang City, Guangxi Zhuang Autonomous Region, returned from working in Côte d'Ivoire, Africa, and entered Guangxi on December 26, 2022. He returned home after his centralized quarantine was lifted on January 3, 2023. On January 4th, 2023, the patient developed dizziness and vomiting, considering himself to a possible COVID-19 infection, he did not seek treatment. On the morning of January 6, the patient developed a fever (peak body temperature of 40 ℃), accompanied by fatigue and sore throat, and the preemptive symptoms were aggravated. The patient was admitted to the Guancheng Town Health Center with "Pneumonia" and treated with ribavirin, dexamethasone, ceftriaxone sodium, etc. On January 7, the patient again experienced a high fever (40 ℃) and was discharged to the Emergency Department of the First Affiliated Hospital of Guangxi Medical University. Upon admission, the patient's blood pressure was measured at 78/53mmHg, further comprehensive examination showed a decrease in platelets and abnormalities in liver and renal function, procalcitonin levels at 49.9 ng/mL. Chest CT showed pneumonia, and fluid supplements and antibiotics were given. On January 8, malaria parasites were found in the patient's blood smear, and the patient was diagnosed with malaria (not classified, confirmed as falciparum malaria on January 9th). The patient was recommended to transfer to the provincial malaria-designated hospital, but his family refused. On January 8 at 13:27, the patient excreted approximately 700 g of dark red bloody stools accompanied by blurred consciousness and received hemostasis treatment. After coordinating with multiple parties, four doses of "artemisinin injection " (60 mg/dose) were taken for treatment. At 18:59 on January 8, intravenous administration of 60 mg injectable Artesunate was given, accompanied by symptomatic treatment for fever reduction and rehydration. At 19:40, the patient developed severe hypoglycemia, and severe metabolic acidosis, and blood pressure continued to decrease despite the use of vasopressors. After comprehensive treatment at 3:00 am on January 9, the patient's condition continued to deteriorate, the patient's shock could not be corrected, he lapsed into a coma, and the family requested to be discharged from the hospital. The patient returned home at 7:00 am and died of multiple organ failure at 7:30 am. Conclusions For imported malaria, early and precise diagnosis based on epidemiological history, clinical symptoms, laboratory test results, early antimalarial treatment, and management of organ dysfunction are the keys to avoiding fatal outcomes.

The testis is pivotal for male reproduction, and its progressive functional decline in aging is associated with infertility. However, the regulatory mechanism underlying primate testicular aging remains largely elusive. Here, we resolve the aging-related cellular and molecular alterations of primate testicular aging by establishing a single-nucleus transcriptomic atlas. Gene-expression patterns along the spermatogenesis trajectory revealed molecular programs associated with attrition of spermatogonial stem cell reservoir, disturbed meiosis and impaired spermiogenesis along the sequential continuum. Remarkably, Sertoli cell was identified as the cell type most susceptible to aging, given its deeply perturbed age-associated transcriptional profiles. Concomitantly, downregulation of the transcription factor Wilms' Tumor 1 (WT1), essential for Sertoli cell homeostasis, was associated with accelerated cellular senescence, disrupted tight junctions, and a compromised cell identity signature, which altogether may help create a hostile microenvironment for spermatogenesis. Collectively, our study depicts in-depth transcriptomic traits of non-human primate (NHP) testicular aging at single-cell resolution, providing potential diagnostic biomarkers and targets for therapeutic interventions against testicular aging and age-related male reproductive diseases.
Animals ; Male ; Testis ; Sertoli Cells/metabolism* ; Transcriptome ; Spermatogenesis/genetics* ; Primates ; Aging/genetics* ; Stem Cells

Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.

Objective To analyze factors that affect axial mechanical performance of the posterior pedicle fixation system. Methods The mechanical model for axial mechanical properties of the posterior pedicle fixation system was established to perform mechanical analysis. By referring to the Standard YY/T 0961-2014, tests on axial ejection force and axial clamping torque of JHL-I multi-axis components, JHL-I single-axis components, JHL-V multi-axis components and JHL-V single-axis components were performed by using Instron E3000 and Instron E10000 mechanical testing machines. Results The ejection rigidity of the single-axis component of vertebral nail system was significantly higher than that of the multi-axis component of vertebral nail system; the torsion rigidity of JHL-V was higher than that of JHL-I. The type and size of the locking bolt as well as its locking torque were the main factors affecting axial ejection force of the posterior spinal pedicle fixation system; the size of the locking bolt and the diameter of the connection rod were the main factors affecting axial clamping torque of the system; axial mechanical properties of the system could be improved by increasing the diameter of the connecting rod, the coefficient of friction between each connecting element, and the pitch diameter of the locking bolt. Conclusions The research findings provide references for optimizing and improving axial mechanical properties of the posterior pedicle fixation system.