BACKGROUND: Patients with atrial fibrillation (AF) and prior stroke history have a high risk of cardiovascular events despite anticoagulation therapy. It is unclear whether catheter ablation (CA) has further benefits in these patients. METHODS: AF patients with a previous history of stroke or systemic embolism (SE) from the prospective Chinese Atrial Fibrillation Registry study between August 2011 and December 2020 were included in the analysis. Patients were matched in a 1:1 ratio to CA or medical treatment (MT) based on propensity score. The primary outcome was a composite of all-cause death or ischemic stroke (IS)/SE. RESULTS: During a total of 4.1 ± 2.3 years of follow-up, the primary outcome occurred in 111 patients in the CA group (3.3 per 100 person-years) and in 229 patients in the MT group (5.7 per 100 person-years). The CA group had a lower risk of the primary outcome compared to the MT group [hazard ratio (HR) = 0.59, 95% CI: 0.47-0.74, P < 0.001]. There was a significant decreasing risk of all-cause mortality (HR = 0.43, 95% CI: 0.31-0.61, P < 0.001), IS/SE (HR = 0.73, 95% CI: 0.54-0.97, P = 0.033), cardiovascular mortality (HR = 0.32, 95% CI: 0.19-0.54, P < 0.001) and AF recurrence (HR = 0.33, 95% CI: 0.30-0.37, P < 0.001) in the CA group compared to that in the MT group. Sensitivity analysis generated consistent results when adjusting for time-dependent usage of anticoagulants. CONCLUSIONS In AF patients with a prior stroke history, CA was associated with a lower combined risk of all-cause death or IS/SE. Further clinical trials are warranted to confirm the benefits of CA in these patients.

In this study, ultra-performance liquid chromatography-quadrupole/time-of-flight mass spectrometry(UPLC-Q-TOF-MS) and gas chromatography-mass spectrometry(GC-MS) were combined with non-targeted metabonomic analysis based on multivariate statistics analysis, and the content of five indicative components in nardosinone was determined and compared by UPLC. The main chemical components of Nardostachyos Radix et Rhizoma with imitative wild cultivation and wild Nardostachyos Radix et Rhizoma were comprehensively analyzed. The results of multivariate statistical analysis based on liquid chromatography-mass spectrometry(LC-MS) and GC-MS were consistent. G1 and G2 of the imitative wild cultivation group and G8-G19 of the wild group were clustered into category 1, while G7 of the wild group and G3-G6 of the imitative wild cultivation group were clustered into category 2. After removing the outlier data of G1, G2, and G7, G3-G6 of the imitative wild cultivation group were clustered into one category, and G8-G19 of the wild group were clustered into the other category. Twenty-six chemical components were identified according to the positive and negative ion modes detected by LC-MS. The content of five indicative components(VIP>1.5) was determined using UPLC, revealing that chlorogenic acid, isochlorogenic acid A, isochlorogenic acid C, linarin, nardosinone, and total content in the imitative wild cultivation group were 1.85, 1.52, 1.26, 0.90, 2.93, and 2.56 times those in the wild group, respectively. OPLS-DA based on GC-MS obtained 10 diffe-rential peaks. Among them, the relative content of α-humulene and aristolene in the imitative wild cultivation group were extremely significantly(P<0.01) and significantly(P<0.05) higher than that in the wild group, while the relative content of 7 components such as 5,6-epoxy-3-hydroxy-7-megastigmen-9-one, γ-eudesmol, and juniper camphor and 12-isopropyl-1,5,9-trimethyl-4,8,13-cyclotetrade-catriene-1,3-diol was extremely significantly(P<0.01) and significantly(P<0.05) lower than that in the wild group, respectively. Therefore, the main chemical components of the imitative wild cultivation group and wild group were basically the same. However, the content of non-volatile components in the imitative wild cultivation group was higher than that in the wild group, and the content of some volatile components was opposite. This study provides scientific data for the comprehensive evaluation of the quality of Nardostachyos Radix et Rhizoma with imitative wild cultivation and wild Nardostachyos Radix et Rhizoma.
Gas Chromatography-Mass Spectrometry ; Chromatography, Liquid ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal/chemistry* ; Tandem Mass Spectrometry

Objective: To compare the clinical characteristics of different types of human adenovirus (HAdV) infection in hospitalized children with acute respiratory infection in Beijing, and to clarify the clinical necessity of adenovirus typing. Methods: In a cross-sectional study, 9 022 respiratory tract specimens collected from hospitalized children with acute respiratory infection from November 2017 to October 2019 in Affiliated Children's Hospital, Capital Institute of Pediatrics were screened for HAdV by direct immunofluorescence (DFA) and (or) nucleic acid detection. Then the Penton base, Hexon and Fiber gene of HAdV were amplified from HAdV positive specimens to confirm their HAdV types by phylogenetic tree construction. Clinical data such as laboratory results and imaging data were analyzed for children with predominate type HAdV infection using t, U, or χ² test. Results: There were 392 cases (4.34%) positive for HAdV among 9 022 specimens from hospitalized children with acute respiratory infection. Among those 205 cases who were successfully typed, 131 were male and 74 were female, age of 22.6 (6.7, 52.5) months,102 cases (49.76%) were positive for HAdV-3 and 86 cases (41.95%), HAdV-7, respectively, while 17 cases were confirmed as HAdV-1, 2, 4, 6, 14 or 21. In comparison of clinical characteristics between the predominate HAdV type 7 and 3 infection, significant differences were shown in proportions of children with wheezing (10 cases (11.63%) vs. 25 cases (24.51%)), white blood cell count >15 ×10⁹/L (4 cases (4.65%) vs.14 cases (13.73%)), white blood cell count <5×10⁹/L (26 cases (30.23%) vs.11 cases (10.78%)), procalcitonin level>0.5 mg/L (43 cases (50.00%) vs. 29 cases (28.43%)), multilobar infiltration (45 cases (52.33%) vs.38 cases (37.25%)), pleural effusion (23 cases (26.74%) vs. 10 cases (9.80%)), and severe adenovirus pneumonia (7 cases (8.14%) vs. 2 cases (1.96%)) with χ²=5.11, 4.44, 11.16, 9.19, 4.30, 9.25, 3.91 and P=0.024, 0.035, 0.001, 0.002, 0.038, 0.002, 0.048, respectively, and also in length of hospital stay (11 (8, 15) vs. 7 (5, 13) d, Z=3.73, P<0.001). Conclusions: HAdV-3 and 7 were the predominate types of HAdV infection in hospitalized children with acute respiratory tract infection in Beijing. Compared with HAdV-3 infection, HAdV-7 infection caused more obvious inflammatory reaction, more severe pulmonary symptoms, longer length of hospital stay, suggesting the clinical necessity of further typing of HAdVs.
Adenovirus Infections, Human/epidemiology* ; Adenoviruses, Human/genetics* ; Beijing/epidemiology* ; Child ; Child, Hospitalized ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Male ; Phylogeny ; Respiratory Tract Infections/epidemiology*

The fingerprint of Boenninghausenia albiflora var. albiflora was established by ultra performance liquid chromatography(UPLC), and the content of 12 active components including chlorogenic acid was determined. Multivariate statistical analysis was used to explore the indicator components of B. albiflora var. albiflora and a comprehensive evaluation system was created for the quality of B. albiflora var. albiflora. In this study, 33 batches of B. albiflora var. albiflora with different sources were collected and studied, and the UPLC fingerprint of B. albiflora var. albiflora was developed. There were 37 common peaks, of which 12 components were identified, and the content of these 12 components was measured. In combination of the common peaks and the content of chemical components, multivariate statistical analysis was performed, and the results showed that 6 components [daphnoretin, isoimperatorin, astragalin, imperatorin, neochlorogenic acid, and isoquercitrin(weight coefficient>0.1)] were selected as chemical markers for the quality of B. albiflora var. albiflora. Technique for order of preference by similarity to ideal solution(TOPSIS) analysis and chemometrics revealed that the quality of S32, S28 and S29 were superior, while that of S12, S7 and S16 were inferior. The quality evaluation method of B. albiflora var. albiflora constructed in this study was accurate and reliable, with simpleness and easiness to operate. It is suggested that the 6 above-mentioned active components could be used as indicator components for quality control of B. albiflora var. al-biflora. The samples were harvested during the flowering and fruiting period, which is from the beginning of July to the end of August.
Chromatography, High Pressure Liquid/methods* ; Chromatography, Liquid ; Drugs, Chinese Herbal/chemistry* ; Multivariate Analysis ; Quality Control

OBJECTIVE: To investigate the incidence rate and risk factors for metabolic bone disease of prematurity (MBDP) in very low birth weight/extremely low birth weight (VLBW/ELBW) infants. METHODS: The medical data of 61 786 neonates from multiple centers of China between September 1, 2013 and August 31, 2016 were retrospectively investigated, including 504 VLBW/ELBW preterm infants who met the inclusion criteria. Among the 504 infants, 108 infants diagnosed with MBDP were enrolled as the MBDP group and the remaining 396 infants were enrolled as the non-MBDP group. The two groups were compared in terms of general information of mothers and preterm infants, major diseases during hospitalization, nutritional support strategies, and other treatment conditions. The multivariate logistic regression analysis was used to investigate the risk factors for MBDP. RESULTS: The incidence rate of MBDP was 19.4% (88/452) in VLBW preterm infants and 38.5% (20/52) in ELBW preterm infants. The incidence rate of MBDP was 21.7% in preterm infants with a gestational age of < 32 weeks and 45.5% in those with a gestational age of < 28 weeks. The univariate analysis showed that compared with the non-MBDP group, the MBDP group had significantly lower gestational age and birth weight, a significantly longer length of hospital stay, and a significantly higher incidence rate of extrauterine growth retardation ( CONCLUSIONS A lower gestational age, hypocalcemia, extrauterine growth retardation at discharge, and neonatal sepsis may be associated an increased risk of MBDP in VLBW/ELBW preterm infants. It is necessary to strengthen perinatal healthcare, avoid premature delivery, improve the awareness of the prevention and treatment of MBDP among neonatal pediatricians, and adopt positive and reasonable nutrition strategies and comprehensive management measures for preterm infants.
Birth Weight ; Bone Diseases, Metabolic/etiology* ; China/epidemiology* ; Female ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Pregnancy ; Retrospective Studies ; Risk Factors

Objective: To explore the protective effect of formula of Gougancai decoction (FGD) on acute liver injury induced by carbon tetrachloride (CCl₄) in rats, in order to provide basis for the development of pharmaceutical preparations or healthcare products. Method: Sixty rats were randomly divided into normal group, Silymarin group (120 mg·kg^-1) and FGD groups (475, 950, 1 900 mg·kg^-1). The normal group and the model group were given equal volume of saline by gavage, while the other groups were administered with the corresponding dose of drugs according to the body weight. After 10 days, the acute liver injury model was established with 12% carbon tetrachloride peanut oil solution (5 mL·kg^-1), except the normal group. All of the rats were put to death to collect serum and liver tissues. The contents of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total bilirubin (TBIL), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were detected by biochemical methods, the levels of tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) in liver tissues were determined by enzyme-linked immunosorbnent assay(ELISA). Nuclear factor-κB (NF-κB) and peroxisome proliferator-activated receptor-γ (PPAR-γ) protein expression in liver tissues were detected by Western blot, and htoxylin eosin (HE) staining was used to observe the variation of liver histopathological. Result: Compared with the normal group, the serum activities of AST, ALT, ALP and the content of TBIL, MDA in the model group were significantly increased (P<0.01), the levels of TNF-α, IL-1β, IL-6 in liver tissue were remarkably increased (P<0.01), but the serum activities of SOD, GSH-Px were significantly decreased (P<0.01), the expression of NF-κB was enhanced in liver tissue (P<0.01), and PPAR-γ was down-regulated (P<0.01), indicating the successful modeling of acute liver injury. Compared with the model group, FGD could reduce the activities of AST, ALT, ALP and the contents of TBIL, MDA (P<0.05, P<0.01), decease the level of TNF-α, IL-1β, IL-6 (P<0.05, P<0.01), and down-regulate the expression of NF-κB (P<0.05, P<0.01), but up-regulate the activities of SOD, GSH-Px and the expression of PPAR-γ (P<0.05, P<0.01). The liver tissue lesions were alleviated to varying degrees. Conclusion: FGD has a protective effect on CCl₄-induced acute liver injury in rats, and its mechanism may be related to the activation of PPAR-γ and the inhibition of NF-κB signaling pathway, with anti-inflammatory and anti-oxidative effects.

Collecting different commodity grade Gardenia jasminoides of wild and cultivated varieties all over the country, obtaining color information from each batch of G. jasminoides by the standard D65 light source and image acquisition system, quantifing the gardenia plumpness information by the digital display vernier caliper, determinating 6 kinds of effective components of G. jasminoides by HPLC, classifing from ten indicators by two step clustering analysis and correspondence analysis method of statistics, clearing the importance of the traditional identification indexes, establishing multiple corresponding relation between the skin color and commercial specification of G. jasminoides,exploring the correlation of the skin color and chemical composition, to provide the reference for the reasonable division of commercial specifications and grades of G. jasminoides. Medicine is divided into two classes and has obvious distinguish meaning, The importance of the skin color is greater than the plumpness in traditional identification characteristics, it can accurately distinguish the specifications of G. jasminoides. We improve and rebuild the standard of commodity specifications and grades of Gardenia jasminoides Ellis and establish the rapid evaluation method by the study, it provide a new way and idea for the comprehensive evaluation of G. jasminoides quality.

Objective: We used intravascular ultrasound (IVUS) to analyze the features of coronary artery atheromatous plaque in patients with impaired glucose tolerance and mild-to-moderate angiographic coronary stenosis. The aim was to determine the clinical significance of plaque characteristics as well as the relationship between hemoglobin A1c (HbA1c) levels and coronary artery lesions. Methods: HbA1c levels were evaluated in 85 patients (96 lesions), of whom 46 had impaired glucose tolerance (IGT Group) and 39 had normal blood glucose (NBG Group). IVUS was used to analyze the lesion vessel of both groups qualitatively and quan-titatively. The external elastic membrane area (EEMA), minimal lumen area (MLA), plaque area (PA), and plaque burden (PB) were measured for both the target lesion and the reference segments (reference external elastic membrane area (REEMA), reference minimal lumen area (RMLA), reference plaque area (RPA), and reference plaque burden (RPB), respectively). Results: HbA1c levels were significantly higher in the IGT Group than in the NBG Group (P<0.05). In the IGT Group there was more soft plaque, eccentric plaque, and positive remodeling, and less calcification, while in the NBG Group there was much harder plaque and calcification, no reconstruction, and negative remodeling (P<0.05). MLA was smaller in the IGT Group than in the NBG Group, while EEMA, PA, and PB were clearly greater (P<0.05). In the meantime, RMLA was clearly smaller in the IGT Group than in the NBG Group, while RPA and RPB were greater (P<0.05). HbA1c levels were positively correlated with PA and PB, and negatively correlated with MLA. Conclusion: IVUS is very valuable for the evaluation of mild-to-moderate coronary lesions. The coronary artery lesions in patients with IGT are more serious and widespread than those in patients with NBG. HbA1c levels might be of some value in assessing the severity of coronary artery lesions.

Objective: We used intravascular ultrasound (IVUS) to analyze the features of coronary artery atheromatous plaque in patients with impaired glucose tolerance and mild-to-moderate angiographic coronary stenosis. The aim was to determine the clinical significance of plaque characteristics as well as the relationship between hemoglobin A1c (HbA1c) levels and coronary artery lesions. Methods: HbA1c levels were evaluated in 85 patients (96 lesions), of whom 46 had impaired glucose tolerance (IGT Group) and 39 had normal blood glucose (NBG Group). IVUS was used to analyze the lesion vessel of both groups qualitatively and quan-titatively. The external elastic membrane area (EEMA), minimal lumen area (MLA), plaque area (PA), and plaque burden (PB) were measured for both the target lesion and the reference segments (reference external elastic membrane area (REEMA), reference minimal lumen area (RMLA), reference plaque area (RPA), and reference plaque burden (RPB), respectively). Results: HbA1c levels were significantly higher in the IGT Group than in the NBG Group (P<0.05). In the IGT Group there was more soft plaque, eccentric plaque, and positive remodeling, and less calcification, while in the NBG Group there was much harder plaque and calcification, no reconstruction, and negative remodeling (P<0.05). MLA was smaller in the IGT Group than in the NBG Group, while EEMA, PA, and PB were clearly greater (P<0.05). In the meantime, RMLA was clearly smaller in the IGT Group than in the NBG Group, while RPA and RPB were greater (P<0.05). HbA1c levels were positively correlated with PA and PB, and negatively correlated with MLA. Conclusion: IVUS is very valuable for the evaluation of mild-to-moderate coronary lesions. The coronary artery lesions in patients with IGT are more serious and widespread than those in patients with NBG. HbA1c levels might be of some value in assessing the severity of coronary artery lesions.