Objective To summarize the clinical features of infectious intracranial aneurysm (IIA) related to infective endocarditis (IE) and share our experiences in the diagnosis and treatment of IIA. Methods A retrospective analysis was conducted on the clinical data of 554 patients who underwent cardiac surgery for IE at the Department of Cardiac Surgery, Guangdong Provincial People's Hospital from September 2018 to August 2023. Patients with secondary IIA were included and reviewed. Based on the treatment strategies, patients were stratified into two groups: an antibiotic-only group and an endovascular treatment group. Results The cohort comprised 21 males and 10 females, with a median age of 33 years (IQR 26-53). Fifteen (48.4%) patients showed no significant neurological symptoms before IIA diagnosis. Seven patients received antibiotic therapy alone, while 24 underwent additional endovascular embolization, achieving technical success in 23 (95.8%) patients. The median interval between endovascular embolization and cardiac surgery was 2 days (IQR 0-6), with 9 patients undergoing concurrent procedures. In the antibiotic-only group, 3 (42.9%) patients suffered fatal IIA rupture. In contrast, only 1 (4.2%) death due to aneurysm rupture occurred in the endovascular treatment group. All surviving patients recovered well without new neurological deficits. Conclusion Routine neuroimaging screening for IIA is critical in IE patients. For those requiring cardiac surgery, endovascular embolization combined with antimicrobial therapy represents a reasonable strategy to mitigate rupture risks and improve outcomes.

OBJECTIVES: The prevalence of overweight and obesity among children and adolescents continues to rise, becoming one of the most serious global public health issues of the 21st century. Given the differing growth and development environments between urban and rural children, associated risk factors also vary. This study aims to explore the distribution characteristics and influencing factors of overweight and obesity among urban and rural primary and secondary school students in Hunan Province, providing scientific evidence for targeted interventions. METHODS: A stratified, randomized cluster sampling method was used to select participants. A total of 197 084 students from primary and secondary schools across 14 prefectures in Hunan Province underwent physical examinations and questionnaire surveys. Population and spatial distribution characteristics of overweight and obesity were analyzed. Spatial distribution maps and spatial autocorrelation analyses were conducted using ArcGIS. Multivariate Logistic regression was used to identify influencing factors for overweight and obesity. RESULTS: The overall overweight and obesity rates among students in Hunan Province were 14.7% and 10.9%, respectively. Both rates were higher in urban areas than in rural counties (16.0% vs 13.9% for overweight; 12.1% vs 10.2% for obesity). Among both urban and rural students, boys had higher rates of overweight and obesity than girls. Higher-grade students had a higher overweight rate but a lower obesity rate than lower-grade students. In urban areas, the overweight and obesity rates of Han Chinese primary and secondary school students are lower than those of ethnic minority students (both P<0.05). In rural areas, the obesity rate of Han primary and secondary school students is lower than that of ethnic students (P<0.05). Across cities and prefectures, urban overweight and obesity rates ranged from 14.7% to 18.7% and 8.4% to 20.6% respectively, while rural rates ranged from 10.9% to 17.2% and 6.6% to 13.7% respectively. Spatial autocorrelation analysis revealed high-value clusters of overweight/obesity in urban areas of Changde and Zhangjiajie, and in rural areas of Loudi, Huaihua, and Shaoyang. Multivariate Logistic regression showed that gender, school stage, ethnicity, frequency of fresh vegetable intake, and sleep duration were associated with overweight and/or obesity in both urban and rural students. In urban students, frequency of fried food and fresh fruit intake, breakfast habits, physical activity on weekdays and holidays, and screen time on computers were also significant. In rural students, TV viewing time and sedentary duration were additional relevant factors. CONCLUSIONS The situation of overweight and obesity among primary and secondary school students in Hunan Province remains concerning. Greater attention should be paid to regions with high-value clusters of overweight/obesity, and targeted interventions should be developed based on urban-rural differences in influencing factors.
Humans ; China/epidemiology* ; Adolescent ; Male ; Female ; Rural Population/statistics & numerical data* ; Child ; Overweight/epidemiology* ; Students/statistics & numerical data* ; Urban Population/statistics & numerical data* ; Risk Factors ; Prevalence ; Obesity/epidemiology* ; Surveys and Questionnaires ; Pediatric Obesity/epidemiology* ; Schools

Objective To compare the clinical outcomes of mitral valvuloplasty (MVP) and mitral valve replacement (MVR) for infective endocarditis, and to investigate the effect of MVP under different surgical risks. Methods A retrospective study was done on the patients with mitral infective endocarditis, who underwent surgical treatment in our department from January 2018 to March 2022. According to the procedures, the patients were divided into a MVP group and a MVR group. Propensity score matching method was applied with a ratio of 1:1 to eliminate the biases. The early and midterm outcomes were compared between the two groups after matching. According to the European System for Cardiac Operative Risk Evaluation Ⅱ(EuroSCORE-Ⅱ), the effect of MVP was compared between high and low risk patients. Results A total of 195 patients were collected. There were 141 patients in the MVP group (120 males, 85.1%) and 54 patients in the MVR group (41 males, 75.9%). The mean follow-up time was (34.0±16.1) months. Patients in the MVP group were younger [(42.7±14.6) years vs. (56.8±13.0) years, P<0.001] and had better preoperative conditions. The patients in the MVP group had a shorter ICU stay [3.0 (2.0, 5.0) d vs. 4.0 (3.0, 8.0) d, P=0.004], and lower incidences of low cardiac output syndrome (0.7% vs. 9.3%, P=0.007), in-hospital mortality (0.0% vs. 3.7%, P=0.023), and follow-up mortality (4.3% vs. 15.4%, P=0.007). However, after 1:1 propensity score matching, there were no statistical differences in the baseline data or postoperative and follow-up adverse events between the two groups (P>0.05). Also, there was no statistical difference in the mortality of high-risk patients between MVP and MVR group (P>0.05). There was no statistical difference in the reoperation or recurrent severe mitral regurgitation between high and low-risk patients in the MVP group (P>0.05). Conclusion MVP is feasible for treating mitral lesions caused by infective endocarditis with good early and midterm outcomes. For patients with severer preoperative conditions, if the leaflet damage is not severe, MVP may be a viable option, but validation with larger sample sizes is needed.

Objective To analyze the short- and mid-term outcomes of patients undergoing reconstruction of intervalvular fibrous body (IVFB) via double valve replacement (Commando procedure) or aortic valve replacement and mitral valve repair (Hemi-Commando procedure). Methods The patients who underwent Commando or Hemi-Commando procedure between September 2014 and September 2022 in Guangdong Provincial People’s Hospital were collected. The perioperative and follow-up data were reviewed and analyzed for the assessment of short- and mid-term outcomes. Results Eleven patients received Commando procedure (a Commando group), including 4 males and 7 females with a median age of 61 (33, 68) years; 7 patients received Hemi-Commando procedure (a Hemi-Commando group), including 5 males and 2 females with a median age of 50 (36, 58) years. Two patients died in the postoperative 30 days (1 patient in the Commando group and 2 patients in the Hemi-commando group). Low cardiac output syndrome complicated with multiple organ dysfunction syndrome was the main cause of death. Fifteen patients were discharged and followed up for 13 (6, 42) months, with a survival rate of 100%. The rates of free from recurrent endocarditis or re-operation were both 100%. Conclusion Commando and Hemi-Commando procedures are effective strategies for IVFB reconstruction, and can achieve excellent mid-term outcomes if patients survive from the frailest period of early postoperative stage.

Objective:To report the surgical experience and long-term survival in patients with infective endocarditis associated with aortic periannular abscess.Methods:We retrospectively analyzed collected data on all 162 patients who underwent surgical treatment between December 2010 and May 2023 in our hospital.Results:128 were male(79.0%). Patients' mean age was(47.9±15.1) years. The infected valve was prosthetic in 11 patients(6.8%). All patients underwent aortic valve replacement(100%) and 22 patients(13.5%) received aortic root replacement. Operative mortality was 6.8% (n=11)(prosthetic valve endocarditis vs native valve endocarditis, 18.2% vs. 6.0%, P=0.17). Postoperative mean follow-up was (34.00±2.19) months. 1 patient(1.2%) died during follow-up. Endocarditis recurred in 3 patients(1.8%) at a mean of (2.1±0.6) years. Survival at 3 years and 5 years were 90.0% and 86.9%, respectively. Conclusion:Infective endocarditis with a secondary aortic root abscess can lead to necrosis of the valve's surrounding tissues. Positive surgical intervention can improve the patient's prognosis and survival.

OBJECTIVEOn the basic therapy, to assess the clinical effects of dynamic scalp acupuncture, scalp acupuncture combined with proprioceptive neuromuscular facilitation (PNF) therapy and simple PNF therapy for upper limb motor impairment in ischemic post-stroke spastic hemiplegia.

METHODSA total of 90 cases were randomly assigned into a PNF group, a dynamic scalp acupuncture group and a scalp acupuncture group, 30 cases in each group. Basic therapy and PNF therapy were applied in the three groups. PNF therapy was used during scalp acupuncture in the dynamic scalp acupuncture group. PNF therapy was applied after scalp acupuncture in the scalp acupuncture group. The points were the upper 1/5 and middle 2/5 of (MS 6) and (MS 7) at the lesion side, the hemiparalysis contralateral side. The treatment was given for 6 months, once a day and 1 month as a course. The modified Ashworth scale (MAS), the Fugl-Meyer motor assessment (FMA) and Barthel index (BI) were observed before treatment and 2 weeks, 1 month, 3 months, and 6 months after treatment.

RESULTSThe MAS 1 month, 3 months and 6 months after treatment were improved compared with those before treatment in the three groups ( all <0.05), and the MAS results in the dynamic scalp acupuncture group were better than those in the PNF and scalp acupuncture group (all <0.05). The FMA and BI scores 1 month, 3 months and 6 months after treatment were higher than those before treatment (all <0.05). The FMA Scores in the 3 time points and after treatment in the dynamic scalp acupuncture group were higher than those in the other two groups (all <0.05).

CONCLUSIONPNF therapy during scalp acupuncture can relieve the spasmodic condition of patients with upper limb motor impairment in ischemic post-stroke spasmodic hemiplegia, and improve the limb function and life activity, which is better than PNF therapy after scalp acupuncture and simple PNF therapy.

Acupuncture Therapy ; Brain Ischemia ; complications ; rehabilitation ; Combined Modality Therapy ; Hemiplegia ; rehabilitation ; therapy ; Humans ; Scalp ; Stroke ; complications ; Stroke Rehabilitation ; Treatment Outcome

Objective To optimize the HT22 cell oxygen-glucose deprivation/re-oxygenation models in hippocampal neurons of mice,discuss the basis of model establishment and test the related parameters.Methods HT22 cell growth curve was plotted by cell counting and cell doubling time was calculated,and then,the oxygen-glucose deprivation time and re-oxygenation time were determined by LDH assay.The CCK-8 assay,cell counting,cell morphology and flow cytometry were performed to further optimize the parameters of the models.Results The HT22 cell doubling time was 17 h 18 min.The oxygen-glucose deprivation time was 18 h and the re-oxygenation was 20 h.CCK-8 assay indicated that absorbance in cells of oxygen-glucose deprivation 18 h/re-oxygenation 20 h (OGD 18 h/R20 h) group was 0.334±0.138,which was significantly lower than that in the control group (0.756±0.026,P＜0.05);cells in the OGD18 b./R20 h group were shrank obviously.Flow cytometry indicated that the percentage of cells in terminal apoptosis or non-viable non-apoptotic cells was 24.56％±5.76％ and that of viable apoptotic cells was 2.63％±0.55％ in the OGD18 h/R20 h group,which were significantly higher than those in the control group,respectively (8.13％±0.87％ and 0.80％±0.10％,/P＜0.05).Conclusion The HT22 cell oxygen-glucose deprivation/re-oxygenation models are successfully established;both oxygen-glucose deprivation time and re-oxygenation time are related to the cell doubling time,and OGD18 h/R20 h can preferably help the establishment;.

Objective To explore the change of proportion of peripheral blood dendritic cells (DCs) in patients with stroke. Methods 56 patients (30 cases of cerebral infarction and 26 cases of cerebral hemorrhage) in Beijing Bo'ai hospital from June to September, 2014 and 14 healthy controls were investigated. The severity of stroke was assessed with the National Institutes of Health Stroke Scale (NIHSS). Flow cy-tometry analysis was employed to detect the proportion of DCs subtypes in the peripheral blood. Results No obvious difference was found in DCs between the stroke patients and the controls. Compared to the control group, the percentages of peripheral blood myeloid dendritic cells (mDCs) decreased in the cerebral hemorrhage and the cerebral infarction subgroups (P<0.001). The percentages of plasmacytoid den-dritic cells (pDCs) reduced significantly in the cerebral hemorrhage and the cerebral infarction subgroups (P<0.05). The stroke patients were divided into NIHSS≤7 subgroup and NIHSS>7 subgroup. The percentages of pDCs in the cerebral hemorrhage and the cerebral infarction patients were significantly lower in the NIHSS>7 subgroup than in the NIHSS≤7 subgroup (P<0.05). While there was no statistical differ-ence between NIHSS≤7 subgroups and NIHSS>7 subgroups in the percentages of mDCs in the cerebral hemorrhage and cerebral infarction patients. Conclusion The proportion of DCs subtypes in the peripheral blood in stroke patients changed significantly, indicating inflamma-tion responds play a role in stroke.

Objective To investigate types of knee joint injury among island garrison force and the effect of arthroscopy,and also to recommend related preventive measures.Methods Forty-two cases of knee joint injury were collected from the medical data registered from March,2012 to April,2013,and diagnosis and treatment were performed by arthroscopy.Results Of the 42 cases of knee joint injury,there were 31 cases of anterior cruciate ligament injury,14 cases of internal meniscus injury combined with external meniscus injury,2 cases of simple meniscus injury,1 case of external discoid cartilage injury,2 cases of chondromalacia patellae,3 cases of traumatic synovitis,1 case of posterior cruciate ligament injury,and 1 case of traumatic knee joint arthritis.Following treatment by arthroscopy,all the patients returned to duty.Conclusion In the knee joint injury that occurred among island garrison military per-sonnel,the highest incidence was anterior cruciate ligament injury,with complete rupture of ligament in most cases.There was a rela-tively high rate of misdiagnosis and treatment delay.For this reason,attention should be paid to knee joint injury occurred among mili-tary personnel,and early arthroscopy should be performed as early as possible,so as to improve cure rate.

Objective To investigate the role and mechanism of low-dose aspirin concurrent with IFN-a in inducing hepatocellular carcinoma apoptosis in BEL-7402 cells. Methods BEL-7402 cells were cultured and treated with IFN-α,or low dose aspirin or both.MTT and flow cytometry were used to measure the cell proliferation and apoptosis after treatment with a singular drug or the combined regiment.The expressions of the apoptosis-related proteins were detected by Western blot.Results MTT assay revealed after IFN α administration alone or combined with aspirin treatment for 48 h,the proliferation ratio of the IFN-α or aspirin group were 82.45％ ± 1.71％ and 83.22％ ±2.26 ％,compared with the control group.The group which received the combined therapy had a proliferation ratio of 69.84 ％ ±1.18 ％,which was significantly lower than the single groups (P＜0.05).The flow cytometry revealed that the apoptosis ratio in IFN-α group and aspirin group were 14.78 ％ ±1.93％ and 14.00％±0.61％,respectively,while the IFN-α + aspirin group was 21.68％±1.28％,which was also significantly higher than that of the single groups (P＜0.05).Western blot detected that IFN-α and aspirin (1 mmol/L) could promote caspase-3 and caspase-9 protein expressions,and when the two drugs were combined,caspase-3 and caspase-9 were also significantly activated.IFN-α alone or combined with aspirin can promote the expression of pro-apoptotic protein Bax (P＜0.05),while the anti-apoptotic proteins expression of Bcl-2 and Bcl-xl did not change significantly (P＞0.05).Conclusions Low-dose aspirin can cooperate with IFN-α in inhibiting the BEL-7402 cell growth and inducing the cell apoptosis by activating and increasing caspase-3 and caspase-9 levels,which may be related to the increased expression of pro-apoptotic protein Bax.