The feasibility and safety of intracardiac echocardiography (ICE)-guided catheter ablation for atrial fibrillation (AF) using a minimal/zero-fluoroscopy approach have recently been reported. This approach helps to reduce ionizing radiation exposure and orthopedic complications resulting from using lead aprons. The objectives of this planned prospective, multicenter randomized controlled trial (RCT) (paroxysmal AF (PAF)-ICE trial; ChiCTR2000033624) are to evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF and the impact on occupational hazards among lab staff.Patients will be randomized in a 1:1 ratio to 2 groups: minimal fluoroscopy group ( n = 216) and traditional approach group ( n = 216). In the minimal fluoroscopy group, an ICE catheter will be used for geometry/anatomic construction, transseptal puncture, catheter tracking, and effusion monitoring. Pulmonary vein isolation (PVI) will be performed using an open-irrigated radiofrequency SmartTouch Surround Flow or SmartTouch catheter (Biosense Webster, Diamond Bar, California, USA), and confirmed by a multipolar Lasso or PentaRay catheter (Biosense Webster). In the traditional approach group, an ICE catheter will not be used. Transseptal puncture will be performed under fluoroscopic guidance, with all geometries constructed by mapping the catheters. The primary efficacy endpoint is freedom from AF recurrence (without antiarrhythmic medications) at 12 months after ablation. Other endpoints include duration of lead apron use, measures of intra-procedural efficiency, and peri-procedural complications. This RCT will evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF, also evaluate the benefits to lab staff (regarding reducing occupational hazards) related to this "minimal/zero-fluoroscopy" and "leadless" mode.

The feasibility and safety of intracardiac echocardiography (ICE)-guided catheter ablation for atrial fibrillation (AF) using a minimal/zero-fluoroscopy approach have recently been reported. This approach helps to reduce ionizing radiation exposure and orthopedic complications resulting from using lead aprons. The objectives of this planned prospective, multicenter randomized controlled trial (RCT) (paroxysmal AF (PAF)-ICE trial; ChiCTR2000033624) are to evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF and the impact on occupational hazards among lab staff.Patients will be randomized in a 1:1 ratio to 2 groups: minimal fluoroscopy group ( n = 216) and traditional approach group ( n = 216). In the minimal fluoroscopy group, an ICE catheter will be used for geometry/anatomic construction, transseptal puncture, catheter tracking, and effusion monitoring. Pulmonary vein isolation (PVI) will be performed using an open-irrigated radiofrequency SmartTouch Surround Flow or SmartTouch catheter (Biosense Webster, Diamond Bar, California, USA), and confirmed by a multipolar Lasso or PentaRay catheter (Biosense Webster). In the traditional approach group, an ICE catheter will not be used. Transseptal puncture will be performed under fluoroscopic guidance, with all geometries constructed by mapping the catheters. The primary efficacy endpoint is freedom from AF recurrence (without antiarrhythmic medications) at 12 months after ablation. Other endpoints include duration of lead apron use, measures of intra-procedural efficiency, and peri-procedural complications. This RCT will evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF, also evaluate the benefits to lab staff (regarding reducing occupational hazards) related to this "minimal/zero-fluoroscopy" and "leadless" mode.

Objective:To investigate the value of dynamic contrast-enhanced(DCE)-MRI based textural analysis in differentiating IDH mutated high-grade gliomas from IDH gene wild types.Methods:Twenty-nine patients with high grade gliomas collected from April 2016 to December 2019 in First People's Hospital of Changzhou were assessed retrospectively, including 10 patients with IDH mutation and 19 patients with IDH gene wild type. All patients underwent DCE, conventional plain and enhanced MR scanning. Omni Kinetics software was used to perform DCE-MRI data processing, volume transfer constant (K trans), ratio constant of tracer refluxing from tissue to plasma (Kep), extravascular extracellular space per unit volume of tissue (Ve), blood plasma volume (Vp) and area under the gadolinium concentration-time curve (AUC) were obtained. Five commonly used textural features, including Energy, Entropy, Inertia, Correlation, and Inver Difference Moment (IDM), were generated based on gray-level co-occurrence matrices. The independent samples t test (normal distributionand equal variance) or Mann-Whitney rank sum test (abnormal distribution or unequal variance) was used to compare the differences in textural features of DCE-MRI parameters between IDH mutated group and IDH gene wild type group. Receiver operating characteristic (ROC) curves were used to evaluate the efficiency of textural features of DCE-MRI parameters in differentiating IDH mutated high-grade gliomas from IDH gene wild types for statistically significant textural features. Results:Entropy of K trans and Ve for IDH mutated group were 5.368±1.458 and 6.698±1.081, respectively; while the corresponding values were 7.334±1.385 and 8.213±1.320 for IDH gene wild type group, respectively. The difference between the two groups was statistically significant ( t values were-3.570, -3.113, P values were 0.001, 0.004, respectively). Inverse difference moment of K trans and Ve for IDH mutated group were 0.567±0.147 and 0.417±0.106, respectively; while for IDH gene wild type group, the values were 0.393±0.119 and 0.296±0.101, respectively. The difference between the two groups was statistically significant ( t values were 3.452, 3.014, P values were 0.002, 0.006, respectively). In all textural features, the area under the ROC curve of entropy of K trans was the largest (0.874), and the sensitivity was the highest (100%), and the specificity of IDM of Ve was the highest (94.7%). Conclusion:Textural analysis of DCE-MRI can help to differentiate IDH mutated high-grade gliomas from IDH gene wild types.

Objective This study aimed to explore the association between blood lipid indices and bone mineral density (BMD).Methods A total of 2,396 individuals (1 198 males and 1 198 females,average age 55.24±12.12 years) who underwent physical examination between April 2015 and April 2016 at the medical examination center of the Inner Mongolia Autonomous Region People's Hospital were recruited.The blood lipid indices,including high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),total cholesterol (TC),and triglycerides,were collected,and BMD at the total hip and its sub-regions was measured.The association between lipid indices and BMD was analyzed using SPSS 16.0 software,with adjustment for the covariates of age,sex,height,and weight.The association between blood lipid indices and BMD was then tested by linear regression analysis.Results Regression analysis demonstrated that in the combined sample with both sexes,HDL-C was negatively associated with total and sub-region BMD (regression coefficients,-0.11 to-0.06;all P＜0.01).LDL-C was negatively associated with femur neck BMD (regression coefficient,-0.01;P=0.01) and Ward's triangle BMD (regression coefficient,-0.01;P＜0.01).TC was negatively associated with trochanter BMD,femoral neck BMD,and Ward's triangle BMD (beta coefficients,-0.02 to-0.01;P＜0.05).In the female group,TC was positively associated with trochanter BMD (regression coefficient,0.06;P＜0.01).In the male group,both LDL-C and TC were negatively associated with femoral neck BMD (regression coefficients,-0.05 and-0.04,respectively;P＜0.05).Conclusion While blood lipid indices are associated with sub-region and total hip BMD,the association pattern and magnitude vary according to body region and sex.

Objective To investigate the features and neural mechanisms of sustained attention and executive function in patients with acute mild traumatic brain injury (mTBI) by comparing and analyzing behavioral and event-related potentials of patients and healthy controls.Methods Seventeen patients with acute mTBI and seventeen healthy controls participated in a cued continuous performance test.Behavioral data and event-related potentials were collected and analyzed.Results 1.There were significant differences between the mTBI group and the control group in hitting number ((66.76±3.27), (69.12± 1.41)) ,reaction time((533.66±144.20) ms, (413.03±94.57) ms) and the number of errors of omission ((3.24±3.27), (0.88± 1.41)) (P＜0.05), but no significant differences in the number of false errors ((0.35±1.00), (0.53±0.87)) (P＞0.05).2.The amplitude of Go-N2 and Nogo-N2 were significantly smaller in mTBI group than that in control group (P＜0.05).The main effect of group was significant of N2 amplitude (P＜0.05), but main effect of condition and the interaction effect were not significant(P＞0.05).Group and condition had no significant main effect and interaction effect on the latency of N2 (P＞0.05).The amplitude of Go-P3 was significantly smaller in mTBI group than that in control group (P＜0.05),while not on the amplitude of Nogo-P3(P＞0.05).The main effect of group and condition were significant on P3 amplitude (P＜0.05),but the interaction effect was not significant(P＞0.05).Group and condition had no significant main effect and interaction effect on the amplitude of P3 (P＞0.05).Conclusion Patients with mTBI show impairments in sustained attention and conflict monitoring, but not in response inhibition.