Objective:To compare the effects of high-power and conventional power atrial fibrillation ablation on intraoperative acute pulmonary vein isolation, postoperative troponin levels, and atrial fibrillation recurrence.Methods:A retrospective selection was conducted on 105 patients with paroxysmal atrial fibrillation admitted to the Baoding NO.1 Central Hospital from January 2017 to December 2020. According to different treatment methods, they were divided into a high-power ablation group of 52 cases and a conventional power ablation group of 53 cases. The intraoperative rate of single circle acute pulmonary vein isolation, the recovery of electrical conduction after acute pulmonary vein isolation, and the location and number of points that need to be added were compared between the two groups; At the same time, two groups were compared in terms of surgical time, ablation time, surgical radiation exposure time and radiation dose, intraoperative complications postoperative cardiac troponin levels at 12 hours, and recurrence of atrial fibrillation within 1 year after ablation.Results:The intraoperative single loop pulmonary vein isolation rate and postoperative troponin levels in the high-power atrial fibrillation ablation group were higher than those in the conventional atrial fibrillation ablation group (all P<0.05). The surgical time, ablation time, and the number of sites and points that need to be added during surgery were less than those in the conventional atrial fibrillation ablation group (all P<0.05). There was no statistically significant difference in the incidence of intraoperative complications and postoperative atrial fibrillation recurrence between the two groups (all P>0.05). Conclusions:High power atrial fibrillation ablation has a higher single loop acute pulmonary vein isolation rate, fewer patch sites and points, shorter surgical time, and greater ablation damage compared to conventional ablation, and the clinical efficacy of the two groups is similar after surgery.

Objective To observe the value of MRI combined with serum carbohydrate antigen 125(CA125)and human epididymis protein 4(HE4)for differential diagnosis of type Ⅰ and Ⅱ epithelial ovarian cancers(EOC).Methods Totally 87 EOC patients were retrospectively enrolled.According to pathology,35 cases of type Ⅰ EOC were taken as type Ⅰ group,while 52 cases of type Ⅱ EOC were taken as type Ⅱ group.Conventional MRI manifestations and apparent diffusion coefficient(ADC)value of lesions,as well as CA125 and HE4 were compared between groups,and their efficacy for differential diagnosis of type Ⅰ and Ⅱ EOC were analyzed.Results Significant differences of conventional MRI manifestations of lesions,including composition,mural nodules,peritoneal diffusion and lymph node metastasis,of ADC value of lesions,also of patients'CA125 and HE4 were found between groups(all P＜0.05).The area under the curve(AUC)of conventional MRI manifestations and ADC value of lesions,patients'CA125 and HE4 for distinguishing typeⅠ and type Ⅱ EOC was 0.694,0.730,0.670 and 0.708,respectively,while of the combination of the above four was 0.865,higher than that of each one alone(Z=3.008,2.138,3.005,2.746,all P＜0.05).Conclusion MRI combined with CA125 and HE4 was helpful for differential diagnosis of type Ⅰ and Ⅱ EOC.

The eutR gene deletion mutant of Salmonella enteritidis was successfully constructed by homologous recombination.Through the study of its biochemical characteristics,motility,resist-ance to stress in vitro and survival ability in RAW 264.7 cells,it was found that the biochemical characteristics and motility of the eutR gene deletion mutant of Salmonella enteritidis had no sig-nificant change compared with the wild type of Salmonella enteritidis.The ability of eutR gene de-letion strain of Salmonella enteritidis to resist acid,alkali and oxidation was significantly reduced,while the ability to resist heat was not significantly changed;the survival ability of eutR gene dele-tion strain in RAW 264.7 cells was significantly reduced compared with the wild type.In order to further analyze the effect of eutR gene on the expression of virulence factors of Salmonella enterit-idis,the relative expression levels of invH,ssav,ssrA,xthA,orf245,sodC,lrp,mrr1 and hflk virulence genes of the deletion strain and the wild strain were detected by SYBR Green PCR.It was found that the expression of the virulence factors mentioned above in the eutR gene deletion strain of Salmonella enteritidis was significantly down-regulated compared with that in the wild-type strain.The LD50 of the eutR gene-deleted strain of Salmonella enteritidis was determined by ani-mal experiments,and the results showed that the LD50 of the eutR gene-deleted strain was higher than that of the wild-type strain,indicating that the eutR gene could affect the virulence of Salmonella.This study clarified the effect of eutR gene on the survival ability,some biological characteristics and virulence of Salmonella enteritidis in macrophages,and provided a new gene knockout target for the development of attenuated Salmonella enteritidis genetic engineering vac-cine.

Objectives:To compare the efficacy of transcatheter aortic valve replacement(TAVR)combined with percutaneous coronary intervention(PCI)versus surgical aortic valve replacement(SAVR)combined with coronary artery bypass grafting(CABG)in patients with intermediate or high risk severe aortic stenosis(AS)and coronary artery disease(CAD). Methods:Embase,Medline,the Cochrane Library,PubMed,VIP,Wanfang Database,CNKI were searched for studies comparing the efficacy of TAVR combined with PCI and SAVR combined with CABG in patients with intermediate or high risk severe aortic stenosis complicated with CAD,from the establishment of the database to July 4,2023. Results:Six studies were included,including one randomized controlled study and five observational cohort studies.A total of 2 137 patients were enrolled,including 833 in the TAVR+PCI group and 1 304 in the SAVR+CABG group.The results of the meta-analysis showed that compared with SAVR+CABG,TAVR+PCI did not significantly increase the risk of myocardial infarction(OR=0.65,95%CI:0.28-1.46,P=0.29),stroke(OR=0.81,95%CI:0.45-1.48,P=0.50)within 30 days and the risk of acute kidney injury(OR=0.38,95%CI:0.14-1.02,P=0.05),major bleeding(OR=0.66,95%CI:0.22-2.00,P=0.47)during follow-up,and significantly reduced all-cause mortality within 30 days(OR=0.66,95%CI:0.44-0.99,P=0.04),but significantly increased all-cause mortality(OR=1.47,95%CI:1.12-1.93,P=0.005)and vascular complications(OR=11.48,95%CI:2.69-48.94,P=0.001),pacemaker implantation(OR=3.09,95%CI:1.68-5.68,P<0.001)during long-term(≥2 years)follow-up. Conclusions:In patients with intermediate or high risk severe AS and CAD,compared with SAVR+CABG,TAVR+PCI significantly reduced the risk of all-cause mortality within 30 days,but significantly increased the risk of all-cause mortality,vascular complications,and pacemaker implantation during long-term follow-up.

Objective To explore the effect of Yunnan specialty rice products on blood sugar by measuring the glycemic index of 5 Yunnan special rice foods:rice noodles,rice cakes,rice rolls,sour rice noodles and dry rice noodles.Methods Following the national standard method to determine the carbohydrate content of 5 Yunnan specialty rice products,and the target amount of the test substance was calculated.Food Glycemic Index Determination Method was used to determine the glycemic index of 5 Yunnan specialty rice products and observe their impact on blood sugar.Results The GI value of Yunnan specialty food rice noodle is 63,rice cake is 64,rice roll is 46,sour rice noodles is 38,and dry rice noodles is 33.Conclusion Yunnan specialty foods rice noodle and rice cake belong to medium GI foods,and diabetes patients should reduce consumption;rice roll,sour rice noodles,and dry rice noodles belong to low GI foods and can be a better staple food source for diabetes patients.

Objective:To explore the application effect of the "4M1E" comprehensive management mode (man, machine, material, method, environment) in ultrasonic examination, and to provide reference for the health management center of hospitals to formulate reform measures to improve the quality and efficiency of ultrasonic examination.Methods:By adoping a non-randomized controlled research, a total of 400 clients who underwent physical examination in the Health Management Center of Zhujiang Hospital, Southern Medical University were selected as subjects by convenience sampling method. Among them, 200 clients who underwent physical examination from August to October 2021 were selected as the control group to implement routine physical examination mode, another 200 clients who underwent physical examination from August to October 2022 were selected as the experimental group to implement the "4M1E" comprehensive management mode. The ultrasonic examination time, passing rate, bladder filling, pre-examination knowledge score and satisfaction of the two groups were compared.Results:The ultrasonic examination time of experimental group was (9.54 ± 3.25) min, lower than (12.33 ± 5.07) min of control group, and the difference was statistically significant ( t=6.53, P<0.05). The passing rates of ultrasonic examination at 1 time, 2 times and 3 times in the experimental group were 86.0% (172/200), 12.0% (24/200) and 2.0% (4/200), respectively, which were better than 73.5% (147/200), 20.5% (41/200) and 6.0% (12/200) in the control group with statistical significance ( χ2=10.05, P<0.05); the proportions of overfilling, proper filling and poor filling in the experimental group were 1.0% (2/200), 86.0% (172/200) and 13.0% (26/200), respectively, which were better than 2.0% (4/200), 70.0% (140/200) and 28.0% (56/200) in the control group, the differences of two groups were statistically significant ( χ2=14.93, P<0.05). Pre-examination knowledge score of experimental group (8.16 ± 1.43) was higher than that of control group (6.19 ± 1.94) points, and the difference was statistically significant ( t=-11.48, P<0.05). The overall satisfaction score of the experimental group (20.55 ± 2.46) was higher than that of the control group (18.45 ± 2.86). The differences was statistically significant ( t=-7.87, P<0.05). Conclusions:The "4M1E" comprehensive management mode can make physical examination clients fully prepare for the examination, reduce the time of ultrasonic examination, complete the examination efficiently, and comprehensively improve the sense of experience and satisfaction.

Objective:To conduct a systematic review of clinical manifestations, treatment, and associated genotyping of Sorsby fundus dystrophy (SFD).Methods:An evidence-based medicine study. Sorsby fundus dystrophy, anti-vascular endothelial growth factor therapy, choroidal neovascularization, macular neovascularization, and TIMP3 gene were hereby used as search terms. Relevant literature was searched in CNKI, Wanfang, PubMed of the National Library of Medicine, and Embase of the Netherlands. The time span for literature searching ranged from the establishment of the database to April 2022, and two reviewers independently screened the literature and extracted relevant data, with duplicates, incomplete or irrelevant articles, and review articles excluded. SPSS26.0 software was used for analysis. The 95% confidence interval ( CI) was used as an estimate of the effect size. The clinical manifestations, treatment and related pathogenic genes of SFD were counted and recorded. Results:According to the search strategy, 157 pieces of literature were initially retrieved, and 49 eyes of 35 patients from 16 articles were finally included for analysis, among which, 17 patients were male, 13 patients were female, and 5 patients were unknown gender; 16 involved left eyes, 19 involved right eyes, and 14 involved unidentified eyes. The age of the disease onset was 42.33±2.19 years (28-59) years old. There were 19 cases with a positive family history, and the total positive rate was 54.3% (19/35, 95% CI 36%-72%). There were 31 cases of gene mutation, all of which were TIMP3. In the included literature, there were 2 and 2 cases with no mutation and unreported loci, respectively, with a total positive rate of 93.9% (31/33, 95% CI 85%-100%). Among the 31 cases with gene mutation, 22, 4, 1, and 4 cases were in the UK, Germany, Switzerland, and Chinese, respectively, and the detection rates were all 100% (22/22, 4/4, 1/1, 4/4). The clinical manifestations of SFD were mainly yellow-white deposits in the fundus and choroidal neovascularization (CNV) in the macula, thereby leading to a decrease in central vision, followed by the expansion of the deposits to the periphery, the further development of CNV, and a severe decline in vision caused by peripheral retinal and choroidal atrophy. The treatment methods for SFD include photodymatic therapy, anti-VEGF drugs, glucocorticoids, vitamin A, etc., among which, anti-VEGF drugs were considered the first-line treatment, and the combined treatment was provided with a better prognosis than a single treatment. Conclusions:Variations in the TIMP3 gene cause SFD, the fundus characteristic manifestations of which, are yellowish-white deposits and CNV, which develop from the center to the periphery, thus resulting in progressive decline of visual acuity. Current studies have shown that combined therapy presents a better prognosis than monotherapy.

Metaphorical narrative, as a kind of image, has a remarkable effect on the research of children’s psychological intervention. It is an important way of human cognition of the world, and its essence is the cross-domain mapping between the source domain and the target domain. Taking intractable diseases in children as an example, this paper illustrated the importance of metaphorical narrative in children’s diseases narrative, life and health education, disease science popularization, diseases notification, as well as the treatment communication. This paper aimed to arouse more researchers’ attention to the metaphorical narrative, actively apply metaphorical narrative to clinical practice, guide disease subjects to eliminate fear, accept diseases, so as to achieve the doctor-patients’ vision fusion and positively cooperate with clinical treatment. Not only can an appropriate metaphor help people get out of psychological difficulties, but it can renew a healthy life story.

Objective:To explore the attitudes of Chinese medical students toward the elderly and their willingness to practice in geriatrics, and to investigate the influence of geriatrics education on their attitudes.Methods:Medical students studying diagnostics in four medical universities were enrolled in a cross-sectional survey and, for the intervention study, graduate trainees from non-geriatrics specialties taking a geriatrics course were interviewed before and after the course.An electronic questionnaire was used to collect general information, the experience of interacting with the elderly, attitudes towards the elderly and the willingness to develop careers in geriatric medicine.Changes in attitudes towards the elderly and their willingness to practice in geriatrics before and after the 40-hour geriatric medicine course were compared.Results:A total of 648 medical students completed the cross-sectional survey, with the highest score in compassion for the elderly(3.54±0.54)and the lowest score for medical services for elderly patients(3.36±0.78). Only 2.2%(14/648)of the students showed strong interest in geriatric medicine.The results of the intervention from 42 graduate trainees showed that the average scores of revised Geriatric Attitude Scale(r-GAS)were 3.80±0.43 and 3.92±0.40 before and after the course, respectively, and the difference was statistically significant( t=2.148, P=0.038). At the end of the course, 7 trainees(16.7%, 7/42)showed great interest in geriatrics, significantly different from 2 trainees(4.8%, 2/42)before the course( χ2=8.211, P=0.025). Conclusions:Chinese medical students show a serious lack of interest in geriatrics, and geriatrics education can improve their attitudes towards the elderly and their willingness to work in geriatrics.With the rapid population aging in China, it is urgent to strengthen the education of geriatric medicine.

Objectives: To explore and summarize the beneficial effects of a traditional Chinese medicine prepara-tion, Tripterygium glycosides tablets (TGT), in rheumatoid arthritis (RA) animal models of neo-vascularization, and to provide a reference for future clinical applications and research on its pharmacologic mechanism.Methods: We searched the databases PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure, VIP, Wan Fang and SinoMed (China Biomedical Document Service System) to identify studies of TGT with outcome indicators of angiogenesis-related factors that were published before April 2020. Subgroup analysis and meta-regression were performed for dosage and duration of TGT. Statistical tests and subgroup analysis were conducted using RevMan 5.3, and meta-regression and sensitivity analysis were conducted using STATA/SE 15.0. Results: Fourteen studies of TGT in RA rats were included in this analysis. Treatment with TGT signifi-cantly reduces synovial microvessel density and the expression of vascular endothelial growth factor (VEGF), VEGF receptor 2, hypoxia inducible factor α, c-Fos, c-Jun, angiopoietin-1 and angiopoietin-2 compared with control groups (P < .05). Subgroup analysis did not show a significant association of the mRNA levels of VEGF in synovium, assessed using quantitative real-time PCR, with duration or dosage of TGT. Meta-regression analysis also indicated that the effects of dosage and duration were not significantly associated with differences in VEGF mRNA levels. Sensitivity analysis on VEGF mRNA levels did not fundamentally change the results. Conclusions: TGT can reduce synovial neovascularization by decreasing synovial microvessel density and expression of VEGF, VEGF receptor 2, hypoxia-inducible factorα, c-Fos, c-Jun, Ang-1 and Ang-2, thereby suppressing pannus formation and bone destruction in rat models of RA. Additional well-designed studies are required to confirm these findings.