Objective To investigate the efficacy and safety of the Corheart 6 left ventricular assist system in patients with end-stage heart failure. Methods A retrospective study was conducted on patients with end-stage heart failure who were treated with Corheart 6 left ventricular assist system from March 2022 to June 2024 in 4 hospitals in Jiangsu Province. The efficacy of the device was evaluated by comparing changes in clinical indicators at preoperative, discharge, 3-month postoperative, and 6-month postoperative timepoints, including the New York Heart Association (NYHA) functional classification, left ventricular ejection fraction (LVEF), and left ventricular end-diastolic diameter (LVEDD). The safety of the device was assessed by analyzing the intraoperative position and orientation of the blood pump inlet cannula, as well as the incidence of adverse events. Results In this study, 39 patients were collected, including 34 males and 5 females with a mean age of (56.4±12.5) years, ranging from 20 to 75 years. There was no operative death. There was no death in postoperative 3 months with a survival rate of 100.0%. There were 3 deaths in 6 months postoperatively, with a survival rate of 92.3%. All patients had a preoperative NYHA cardiac function classification of class Ⅳ. The NYHA cardiac function class of the patients improved (P<0.05) at discharge, 3 and 6 months after surgery when compared to the preoperative period. LVEF was significantly higher at 3 months after surgery than that during the preoperative period (P<0.05). LVEDD was significantly smaller at discharge, 3 and 6 months after surgery than that during the preoperative period (P<0.05). The safety evaluation's findings demonstrated that all 39 patients' intraoperative blood pump inlet tubes were oriented correctly, the artificial blood vessel suture sites were appropriate, there were no instances of device malfunction or pump thrombosis, or instances of bleeding or hemolysis, and the rate of the remaining adverse events was low. Conclusion With a low rate of adverse events and an excellent safety profile, the Corheart 6 left ventricular assist system can efficiently enhance cardiac function in patients with end-stage heart failure. It also has considerable clinical uses.

Objective To analyze the epidemic characteristics of plague epidemics, host and vector community structure, and abundance in plague focus of wild rodents in Yunnan Province, 2017-2023, providing a scientific basis for formulating plague prevention strategies and forecasting warning for this epidemic foci. Methods　Following the requirements of the "National Plague Surveillance Plan" and the "Yunnan Provincial Plague Surveillance Plan", host-vector surveillance, etiology, and serological testing were carried out, and plague epidemic data and host-vector surveillance data in plague focus of wild rodents in Yunnan Province, 2017-2023 were collected and sorted using Excel 2019 software to create a database for descriptive analysis. Results From 2017 to 2023, 11 animal plague epidemics were discovered in the wild plague foci of Yunnan Province, with 18 epidemic spots. From the altitude distribution point of view, 7 epidemic spots were distributed at an altitude of 2 800-3 000 meters, another seven at 3 000 and 3 200 meters, and four spots were located in areas with an altitude of ≥3 200 meters; a total of 36 samples of host and vector animals were detected positive, including 28 positive samples of host animals and 8 positive samples of vector animals, and 29 strains of Yersinia pestis were isolated; in terms of species composition, Eothenomys miletus accounted for the largest proportion of 41.67%, followed by Apodemus chevrieri at 22.22%; Ctenophthalmus quadratus at 11.11%; Rattus tanezumi and Neopsylla specialis each at 8.33%, and Dremomys pernyi, rat carcass, and Frontopsyllas padix each accounted for 2.78%; the epidemic peaked in April, and no human cases were found. A total of 453 220 rat cages (traps) were placed, capturing 27 677 rodents, with an average capture rate of 6.11%. A total of 25 075 main hosts, Apodemus chevrieri and Eothenomys miletus, were captured, accounting for 90.60% of the total capture rate. A total of 14 700 fleas were seized on the surface of small animals, with a total flea infection rate of 23.13% and a flea index of 0.59. The main vectors were Ctenophthalmus quadratus and Neopsylla specialis, with constituting ratios of 45.71% and 22.69%, respectively. Conclusions From 2017 to 2023, the population density of main host animals in Yunnan's wild rodent plague foci was relatively high and showed an upward trend, possibly related to the local planting structures. Plague plays a regulatory role in host population structures. Epidemics among animals showed obvious seasonality, with a trend of expanding epidemic areas. No human cases were found, but Yersinia pestis was detected in Rattus tanezumi in human settlements, raising the possibility that animal plague could spread to humans. It suggests strengthening the monitoring of areas adjacent to the epidemic source, eradicating rats and fleas in spring, improving the accuracy of plague prediction and early warning, providing strong technical support for the early detection of plague among animals, and preventing the spread of the epidemic to humans.

Objective To observe ultrasonic manifestations of ovarian cysts in neonates and infants.Methods Totally 40 neonates or infants with large or complicated ovarian cysts were retrospectively enrolled,and ultrasonic manifestations,surgical operation findings or follow-up data were analyzed.Results Among 40 cases,thin wall and echoless unicellular cysts were found in 20 cases,among which 9 were accompanied by"ascus",and these cases were classified into simple cyst group.Thick wall cysts with spot-like,flocculent or heterogeneous solid components were observed in 19 cases,including 11 cases with"double wall sign",8 with solid-liquid stratification and 1 case with"ascus",and these cases were taken as complex cyst group.Atrophic solid cyst was found in 1 case.The long diameter,anteroposterior diameter and short diameter of simple cyst group were all larger than those of complex cyst group(all P＜0.05).Ultrasound correctly diagnosed ovarian origin tumors in 14 cases(14/40,35.00％).Hemorrhage combined with torsion necrosis was detected in 18 cases of complicated ovarian cysts in surgical operation.Thirty-eight cases were confirmed by surgical pathology,while 2 cases were confirmed by follow-up,including 1 case of simple ovarian cyst spontaneously subsided and 1 case of complicated ovarian cyst fell off and migrated to right lower liver margin.Conclusion Ovarian cysts in neonates and infants could be roughly divided into simple and complex and atrophic solid ovarian cysts,with ultrasonic manifestations having certain characteristics,which were helpful for diagnosis.

Blinding is an important means to control and reduce measurement bias in clinical research， and blinding assessment is the main method to measure the success of the blinding method. By summarizing the current situation of blinding assessment in randomized controlled trials （RCT） of acupuncture， it was found that the report rate of blinding assessment by acupuncture RCT was relatively low， and the studies reporting blinding assessment had several problems， such as incomplete assessment individuals， unreasonable assessment questionnaires， and unscientific analysis methods， and the setting of the assessment time point is controversial. Given the above problems， this paper discussed the key elements of blinding assessment individuals， assessment questionnaires， assessment time points， and analysis methods. It is suggested that blinding assessment should be carried out on all blinded participants and personnel in the study； the assessment questionnaire should be designed by direct inquiry， with responses designed using three or more categorical options that include an "unclear" option； the early stage of the trial should be taken as the mandatory time point for assessment， integrating the evaluation index of the James blinding index and the Bang blinding index， in order to standardize the application of blinding assessment in acupuncture RCT and improve the quality of acupuncture clinical research.

Objective To observe ultrasonic manifestations of ovarian cysts in neonates and infants.Methods Totally 40 neonates or infants with large or complicated ovarian cysts were retrospectively enrolled,and ultrasonic manifestations,surgical operation findings or follow-up data were analyzed.Results Among 40 cases,thin wall and echoless unicellular cysts were found in 20 cases,among which 9 were accompanied by"ascus",and these cases were classified into simple cyst group.Thick wall cysts with spot-like,flocculent or heterogeneous solid components were observed in 19 cases,including 11 cases with"double wall sign",8 with solid-liquid stratification and 1 case with"ascus",and these cases were taken as complex cyst group.Atrophic solid cyst was found in 1 case.The long diameter,anteroposterior diameter and short diameter of simple cyst group were all larger than those of complex cyst group(all P＜0.05).Ultrasound correctly diagnosed ovarian origin tumors in 14 cases(14/40,35.00％).Hemorrhage combined with torsion necrosis was detected in 18 cases of complicated ovarian cysts in surgical operation.Thirty-eight cases were confirmed by surgical pathology,while 2 cases were confirmed by follow-up,including 1 case of simple ovarian cyst spontaneously subsided and 1 case of complicated ovarian cyst fell off and migrated to right lower liver margin.Conclusion Ovarian cysts in neonates and infants could be roughly divided into simple and complex and atrophic solid ovarian cysts,with ultrasonic manifestations having certain characteristics,which were helpful for diagnosis.

Objective:To evaluate the effect of inhalation of sevoflurane during cardiopulmonary bypass (CPB) on early postoperative brain injury in the patients undergoing cardiac valve replacement.Methods:Forty-two American Society of Anesthesiaologists physical status Ⅱ or Ⅲ patients of either sex, aged 40-70 yr, weighing 47-86 kg, scheduled for elective single valve replacement under CPB, were divided into 3 groups ( n=14 each) using a random number table method: control group (group C), combined intravenous-inhalational anesthesia group (group CA) and sevoflurane group (group S). During CPB, propofol 4-6 mg·kg -1·h -1 was intravenously infused in group C, propofol 2-3 mg·kg -1·h -1 was intravenously infused, and 0.5 MAC sevoflurane was inhaled via the membrane oxygenator in group CA, and 1.0-1.5 MAC sevoflurane was inhaled via the membrane oxygenator in group S. The anesthesia and sedation index values were maintained at 40-60 during operation in the three groups.Blood samples were taken from arteries before anesthesia induction (T 1), at 30 min and 6 and 24 h after termination of CPB (T 2-4) for determination of plasma concentrations of neuron-specific enolase (NSE) and Tau protein. Results:Compared with group C, the plasma concentration of NSE was significantly decreased at T 2, 3, and plasma concentration of Tau protein was decreased at T 2-4 in group S, and the plasma concentration of Tau protein was decreased at T 2 in group CA ( P<0.05). Compared with group CA, the plasma concentration of NSE was significantly decreased at T 2, 3, and the plasma concentration of Tau protein was decreased at T 2-4 in group S ( P<0.05). Conclusions:Inhalation of sevoflurane during CPB can reduce early postoperative brain injury to a certain extent in the patients undergoing cardiac valve replacement.

Objective:To analyze the epidemic situation and influencing factors of plague in Dehong Dai and Jingpo Autonomous prefectures (Dehong) from 1950 to 2019, for the improvement of strategies on prevention and control of the disease.Methods:The epidemic situation and surveillance data of animal and human plague in Dehong prefecture from 1950 to 2019 were collected and analyzed by descriptive epidemiological methods. Multiple linear regression equations were established by SPSS 20.0 software to analyze the relationship between plague among animals and rat density and flea index, as well as the relationship between human plague and plague among animals.Results:In Dehong prefecture, plague experienced a phenomenon of epidemic-resting-epidemic-resting cycle, between 1950 and 2019. During this period, 614 epidemic spots were identified in 36 townships of five counties/cities,. Human plague had been prevalent for 15 years, with 1 153 human cases and 379 deaths involved. Between 1982 and 2019, 261 319 rodents were captured, of which Rattus flavipectus accounted for 70.95%(185 421/261 319). A total of 70 124 fleas were seized with 76.65%(53 752/70 124), xenopsylla cheopis as fleas. The index of fleas and free fleas were 0.57 and 0.22 respectively. A total of 1 577 strains of Yersinia pestis were isolated from 285 091 animal specimens and 418 strains of Yersinia pestis were isolated from 60 119 groups of fleas, with 255 F1 antibody positive samples were detected from 64 157 sera samples. Neither Yersinia pestis nor the outbreak of plague had been noticed since 2008. Correlations between both animal plagues and rat density, as well as human plague and animals plague were noticed from the regression analysis. Conclusions:The epidemics of plague were with long-term and stable nature, in Dehong prefecture. Affected by many factors, plague seemed in a resting period currently. However, we should be reminded that the fact that outbreak of plague may revive at some uncertaint point. Hence in order to prevent human plague, strategies as careful surveillance programs on animals, need to be strenthened.

Objective: To summarize the experience of reoperations on patients who had late complications related to previous aortic surgery for Stanford type A dissection. Methods: From August 2008 to October 2016, 14 patients (10 male and 4 female patients) who underwent previous cardiac surgery for Stanford type A aortic dissection accepted reoperations on the late complications at Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University. The range of age was from 41 to 76 years, the mean age was (57±12) years. In these patients, first time operations were ascending aorta replacement procedure in 3 patients, ascending aorta combined with partial aortic arch replacement in 4 patients, aortic root replacement (Bentall) associated with Marfan syndrome in 3 patients, aortic valve combined with ascending aorta replacement (Wheat) in 1 patient, ascending aorta combined with Sun′s procedure in 1 patient, Wheat combined with Sun′s procedure in 1 patient, Bentall combined with Sun′s procedure in 1 patient. The interval between two operations averaged 0.3 to 10.0 years with a mean of (4.8±3.1) years. The reasons for reoperations included part anastomotic split, aortic valve insufficiency, false aneurysm formation, enlargement of remant aortal and false cavity. The selection of reoperation included anastomotic repair, aortic valve replacement, total arch replacement and Sun′s procedure. Results: Of the 14 patients, the cardiopulmonary bypass times were 107 to 409 minutes with a mean of (204±51) minutes, cross clamp times were 60 to 212 minutes with a mean of (108±35) minutes, selective cerebral perfusion times were 16 to 38 minutes with a mean of (21±11) minutes. All patients survived from the operation, one patient died from severe pulmonary infection 50 days after operation. Three patients had postoperative complications, including acute renal failure of 2 patients and pulmonary infection of 1 patient, and these patients were recovered after treatment. Thirteen patients were finally recovered from hospital. The patients were followed up for 16 to 45 months, and no aortic rupture, paraplegia and death were observed in the follow-up. Conclusions Patients for residual aortic dissection after initial operations on Stanford type A aortic dissection should be attached great importance and always need emergency surgery, but the technique is demanding and risk is great for surgeons and patients, which need enough specification and accurate on aortic operation. More importantly, the Sun′s procedure also should be performed on the treatment of residual aortic dissection or distal arch expansion, and obtains the short- and long-term results in the future.

Objective To explore the relationship between sudomotor function and peripheral artery disease (PAD),and to evaluate the effectiveness of sudomotor function testing to screen diabetic patients at high risk of PAD comparing to ankle-brachial index (ABI) and toe-brachial index (TBI).Methods A total of 263 diabetes mellitus (DM) outpatients in the 306th Hospital of PLA from August 2014 to April 2015 were enrolled in the study.ABI and TBI were measured by the Doppler method.Sudomotor function was evaluated by measuring the electrochemical skin conductance (ESC) of the hands and feet using the Sudoscan instrument.Cardiovascular autonomic neuropathy (CAN) was assessed and recorded as cardiac autonomic neuropathy risk-score (CAN-RS) by Sudoscan.Results ESC values of the feet and hands were positively correlated with ABI and TBI.The diabetes patients with abnornal ABI and TBI had significantly lower hand ESC [(45.63±12.87) μS vs.(68.10±17.40) μS,(59.17±19.58) μS vs.(68.57±17.11) μS;P＜ 0.05] and feet ESC [(44.54±25.48) μS vs.(70.92±19.46) μS,(59.21±24.52) μS vs.(71.71±19.02) μS;P＜ 0.05],and higher CAN-RS[(49.17± 15.41)％ vs.(36.33±16.25)％,(44.90±16.09)％ vs.(35.39±16.05)％;P＜ 0.05],than diabetes patients with normal ABI and TBI.Using ABI as the gold standard,the areas under the receiver operating characteristics (ROC) curve of the diagnostic performance of hands ESC,feet ESC and CAN-RS to identify PAD were 0.87,0.84 and 0.74,respectively (P＜0.001).Conclusion Sudomotor function testing can be helpful and beneficial to identify PAD in patients with diabetes.

Objective To explore the value of improved CT perfusion in delineation of brain arteriovenous malformation(AVM) target for stereotactic radiosurgery.Methods 22 patients diagnosed with AVM by DSA were included in this study.14 cases of AVM were detected from initial symptoms of intracereb.ral hemorrhage,of which 4 cases were given immediate intracranial hematoma evacuation,then in 3 cases postoperative embolization was performed,and other 10 cases received conservative treatment including 3 cases treated by embolization.8 cases of AVM were detected from initial symptoms of epilepsy or headache,without surgery or embolization treatment.In all patients,the improved CT perfusion and MRA examinations were performed before treatment to evaluate the diagnostic efficacy of different methods in AVM.Results The interference rates of hemorrhage and granulation tissue on MRA images were 27.3 ％ and 54.5 ％,respectively,while those on enhanced CT and improved CT perfusion images were 0 ％.The interference rate of embolization material on enhanced CT and improved CT perfusion images was 27.3％,while that on MRA images were 0％.The contrast-enhancement rates of MRA,CT and improved CT perfusion images were 4 5.5 ％,5 4.5 ％ and 7 2.7 ％,respectively.Conclusion Improved CT perfusion technique is helpful in delineation of brain AVM target for stereotactic radiosurgery in patients with AVM combined with intracerebral hemorrhage or postoperative patients.