Objective To assess the long-term prognosis of nonparoxysmal atrial fibrillation(NPAF)patients after radiofrequency catheter ablation(RFCA)and identify influencing factors.Methods A prospective,randomized controlled trial was conducted from October 2021 to June 2023 at our center.A total of 183 consecutive NPAF patients undergoing RFCA were randomly assigned to the ARNI group(n=91)or control group(n=92).Data collected included baseline characteristics,procedure-related parameters,low voltage areas(LVAs),left atrial mean pressure(LMP),and clinical outcomes at 12 months.The primary endpoint included freedom from atrial fibril-lation recurrence at 12 months post-ablation and secondary endpoints comprised complication rates,mean arterial pressure(MAP),left atrial diameter(LAD),and cardiac function.Results The two groups presented no significant differences in baseline characteristics(P>0.05).The ARNI group demonstrateda significantly higher rate of freedom from AF recurrence compared to the control group at 12 months(79.12%vs.66.30%,HR=0.56,P=0.039).More-over,the ARNI group showed significantly smaller LAD[(40.17±4.72)mm vs.(42.29±6.08)mm,P=0.013)and a significantly lower N-terminal proB-type natriuretic peptide(NT-proBNP)level[98.00(45.00,456.00)vs.128.50(73.50,586.50),P=0.039].Both groups showed no significant differences in complication rates or MAP post-ablation(P>0.05).Cox regression analysis identified ARNI as an independent predictor for maintaining freedom from AF recurrence at 12 months post-ablation(HR=0.524,P=0.038).Subgroup analyses showed that high LMP patients had a lower rate of freedom from AF recurrence than those with normal pressures(51.61%vs.83.47%,P<0.001),and demonstrated significantly improved ARNIoutcomes(64.52%vs.38.71%,P=0.042).Conclusion ARNI improves long-term outcomes for NPAF patients following RFCA,particularly in those with highLMP.

Objective To assess the long-term prognosis of nonparoxysmal atrial fibrillation(NPAF)patients after radiofrequency catheter ablation(RFCA)and identify influencing factors.Methods A prospective,randomized controlled trial was conducted from October 2021 to June 2023 at our center.A total of 183 consecutive NPAF patients undergoing RFCA were randomly assigned to the ARNI group(n=91)or control group(n=92).Data collected included baseline characteristics,procedure-related parameters,low voltage areas(LVAs),left atrial mean pressure(LMP),and clinical outcomes at 12 months.The primary endpoint included freedom from atrial fibril-lation recurrence at 12 months post-ablation and secondary endpoints comprised complication rates,mean arterial pressure(MAP),left atrial diameter(LAD),and cardiac function.Results The two groups presented no significant differences in baseline characteristics(P>0.05).The ARNI group demonstrateda significantly higher rate of freedom from AF recurrence compared to the control group at 12 months(79.12%vs.66.30%,HR=0.56,P=0.039).More-over,the ARNI group showed significantly smaller LAD[(40.17±4.72)mm vs.(42.29±6.08)mm,P=0.013)and a significantly lower N-terminal proB-type natriuretic peptide(NT-proBNP)level[98.00(45.00,456.00)vs.128.50(73.50,586.50),P=0.039].Both groups showed no significant differences in complication rates or MAP post-ablation(P>0.05).Cox regression analysis identified ARNI as an independent predictor for maintaining freedom from AF recurrence at 12 months post-ablation(HR=0.524,P=0.038).Subgroup analyses showed that high LMP patients had a lower rate of freedom from AF recurrence than those with normal pressures(51.61%vs.83.47%,P<0.001),and demonstrated significantly improved ARNIoutcomes(64.52%vs.38.71%,P=0.042).Conclusion ARNI improves long-term outcomes for NPAF patients following RFCA,particularly in those with highLMP.

Objective To investigate the effects of hyperbaric oxygen (HBO) on inflammatory factors and oxidative stress levels in the rats with pancreatitis.Methods Eighty SD adult male rats were randomly divided into 4 groups:the control group,the sham surgery group,the model group and the HBO oxygen group,with 20 rats in each group.Pancreatitis model was developed in the rats of the model and HBO groups.The rats in the sham surgery group were just anesthetized and abdomen was opened,and then the opened abdomen was sutured,while the animals in the control group were fed as routine.Following HBO treatment,pancreatic pathological scores of each group were evaluated,and the expression levels of inflammatory factors of IL-6,IL-10,IL-1β and TGF-α as well as oxidative stress factors of MPO,MDA,ROS in serum were detected.Results The pathological scores of the model group were significantly higher than those of the control group and the sham surgery group(6.58 ± 1.51 vs.0.45 ± 0.05,0.46 ± 0.04) (all P ＜ 0.01).Swelling of the pancreatic tissue and infiltration of inflammatory cells could clearly been seen in the rats of the HBO group.As compared with the model group,ascetic fluid level was less,with less hemorrhagic spots and clear pancreatic marbling.Furthermore,pathological scores were significantly higher than those of the model group (P ＜ 0.01).As compared with the control group and the sham surgery group,the expression levels of IL-6,IL-1β,TNF-α and IL-10 in the model group considerably elevated,and stastical significance could be seen when comparisons were made between them (P ＜ 0.01),while the expression levels of IL-6,IL-1β,TNF-α and IL-10 in the HBO group were noticeably up-regulated in the model group,also with stastical significance(P ＜ 0.01).As compared with the control group and the sham surgery group,the expression levels of MDA,MPO and ROS in the model group were obviously up-regulated,also with stastical significance (P ＜ 0.01),while the expression levels of MDA,MPO and ROS in the HBO group were significantly down-regulated as compared with the model group,also with statistical significance (P ＜ 0.05).Conclusion HBO treatment could significantly reduce the inflammatory reaction and oxidative stress levels in the rats with pancreatitis,and reduce necrosis and hemorrhage of pancreatic acinus,thus effectively improving pancreatic symptoms of the rats.

Objective To investigate the effects of hyperbaric oxygen (HBO) on inflammatory factors and oxidative stress levels in the rats with pancreatitis.Methods Eighty SD adult male rats were randomly divided into 4 groups:the control group,the sham surgery group,the model group and the HBO oxygen group,with 20 rats in each group.Pancreatitis model was developed in the rats of the model and HBO groups.The rats in the sham surgery group were just anesthetized and abdomen was opened,and then the opened abdomen was sutured,while the animals in the control group were fed as routine.Following HBO treatment,pancreatic pathological scores of each group were evaluated,and the expression levels of inflammatory factors of IL-6,IL-10,IL-1β and TGF-α as well as oxidative stress factors of MPO,MDA,ROS in serum were detected.Results The pathological scores of the model group were significantly higher than those of the control group and the sham surgery group(6.58 ± 1.51 vs.0.45 ± 0.05,0.46 ± 0.04) (all P ＜ 0.01).Swelling of the pancreatic tissue and infiltration of inflammatory cells could clearly been seen in the rats of the HBO group.As compared with the model group,ascetic fluid level was less,with less hemorrhagic spots and clear pancreatic marbling.Furthermore,pathological scores were significantly higher than those of the model group (P ＜ 0.01).As compared with the control group and the sham surgery group,the expression levels of IL-6,IL-1β,TNF-α and IL-10 in the model group considerably elevated,and stastical significance could be seen when comparisons were made between them (P ＜ 0.01),while the expression levels of IL-6,IL-1β,TNF-α and IL-10 in the HBO group were noticeably up-regulated in the model group,also with stastical significance(P ＜ 0.01).As compared with the control group and the sham surgery group,the expression levels of MDA,MPO and ROS in the model group were obviously up-regulated,also with stastical significance (P ＜ 0.01),while the expression levels of MDA,MPO and ROS in the HBO group were significantly down-regulated as compared with the model group,also with statistical significance (P ＜ 0.05).Conclusion HBO treatment could significantly reduce the inflammatory reaction and oxidative stress levels in the rats with pancreatitis,and reduce necrosis and hemorrhage of pancreatic acinus,thus effectively improving pancreatic symptoms of the rats.

Objective To evaluate the curative effect and feasibility of catheter-directed thrombolysis with urokinase for acute limb ischemia. Methods The clinical data of a total of 21 patients with acute limb ischemia, who were treated with infusion of urokinase through UniFuse thrombolytic catheter, were retrospectively analyzed. The clinical curative efficacy, prognosis and complications of catheter - directed thrombolysis (CDT) were summarized. Results In all patients, thrombolysis therapy was effective, the clinical symptoms were alleviated, and successful limb salvage was achieved. One patient died of cerebral hemorrhage due to renal decompensation. No other serious complications such as hemorrhage, hematoma or disability occurred. Conclusion Preliminary clinical study shows that CDT with urokinase is effective and safe for the treatment of acute limb ischemia. This therapy can help reduce unnecessary surgical procedures or stent implantation, and the risk of thrombolysis is controllable. (J Intervent Radiol, 2018, 27: 262-265)

In view of the problems existing in medical image network teaching, such as redundant and rigid curriculum system, obsolete structure, untimely updates, lack of supervision system and poor stability of network security and so on, we explored how to improve the medical image network teaching from the fusion of traditional teaching, optimizing curriculum system, perfecting the medical imaging system of autonomous learning, encouraging online communication, creating a good atmosphere, increasing invest-ment in software development and multi-sectoral collaboration, in order to complete the transfer of knowl-edge more effectively, and promote the good development of medical imaging teaching.

Objective To prepare a novel extravascular human epithelial growth factor receptor 2 (HER2)-targeted polylactic-co-glycolic acid (PLGA)-COOH ultrasound contrast agent with liquid perfluorocarbons(PFH-PLGA-tra),and to observe it's general properties and it's effects on ultrasound imaging in vitro.Methods Polymeric nanocapsules of liquid perfluorocarbons were prepared by the single emulsion technique and conjugated with trastuzumab monoclonal antibody by EDC/NHS.The general characteristics were observed.The conjugation was demonstrated by immunofluorescence and the targeting performance of the agent was checked in human MCF-7 cells line in vitro.The encapsulation of liquid fluorocarbons was detected by heating in vitro.The effects on ultrasound imaging were observed in vitro.Results The mean diameter of agents was (261 ± 28)nm.The targeted nanocapsules were positive in immunofluorescence.In the targeted study,it was shown that a number of targeted nanocapsules conjugated with MCF-7 cells in vitro.Droplet-to-bubble transition experiment in vitro showed that there were no nano/microbubbles formed by heating in control groups at 80℃,while there were a lot of nano/microbubbles appeared in nanocapsules formulations at 80 ℃.The agents presented a good ultrasound imaging in vitro.Conclusions The HER2-targeted polymeric nanocapsules of liquid perfluorocarbons are successfully prepared,which may become a novel extravascular targeted ultrasound contrast agents.

Purpose To explore the apoptosis mechanism of human ovarian cancer cells SKOV3 processed with ultrasound (US) combined with photodynamic therapy (PDT), with self-contained lactic acid/glycolic acid (PLGA) microbubbles (MBQDs/PLGA) containing quantum dots (QDs) as a photosensitizer. Materials and Methods MBQDs/PLGA was prepared with double emulsion method, and MTT was used to compare the cytotoxic activity difference between QDs and MBQDs/PLGA, to determine the proper treatment condition. SKOV3 cells were treated under selective conditions, cell damage manifestation was observed with HE staining, and double staining flow cytometry was used to detect cell apoptosis. Results When cells were treated with PDT with energy density of 180.0 J/cm2 and US with sound intensity of 0.5 W/cm2 (1.0 MHz, 10 s), cell deformation could be observed under a microscope in both US-PDT-MBQDs/PLGA group and PDT-MBQDs/PLGA group, and cell connections were absent between cells;transmission electron microscope showed dense chromatin gathered along the nuclear membrane, with the formation of apoptotic bodies also be displayed. Maximum apoptosis rate was (22.17±0.38)% Conclusion MBQDs/PLGA-mediated PDT contains proliferation inhibition effect for SKOV3 cells, which can be synergied with low-power ultrasonic irradiation due to sonoporation effect.

Objective To prepare polyclactic-co-glycolic acid(PLGA) polymer ultrasound contrast agent loading sudan black dye (SB-PLGA) and study the enhancement effect of it on rabbit lymph nodes imaging and as a sentinel lymph node (SLN) biopsy in the feasibility and value of the indicator.Methods SB-PLGA ultrasound contrast agent was made by double emulsion and freeze-drying methods.Thigh subcutaneous rabbit VX2 tumor model of eight lymph nodes were set up with the foot pad subcutaneous injection of contrast agents to get contrast-enhanced ultrasound imaging of the popliteal lymph node and the second inguinal lymph node stations.Then the blue stained lymph nodes were resected by popliteal lymph node dissection and the second station lymph nodes were also observed after 30 mins respectively,lymph nodes were examined by frozen sections HE staining in parallel.Results SB-PLGA microbubbles had a tight size distribution.Ultrasound imaging can be significantly enhanced lymph node imaging,the second station lymph node imaging was not obvious.Popliteal lymph node dissection for lymph node staining,30minutes later,frozen sections HE staining were seen within the lymph node contrast agent present in the lymphatic sinus and a large entry of macrophages.Inguinal lymph node dissection showed the second station of lymph nodes no blue staining.Conclusions SB-PLGA ultrasound contrast agent is good for sentinel lymph node imaging and biopsy indicator.Contrast agent retention and accumulation in the lymph nodes by the uptake of macrophages may be associated with the mechanisms of lymph node enhanced imaging.

Objective To prepare a kind of superparamagnetic iron oxide (SPIO) and doxorubicin loaded multifunctional polymer microbubbles (MPMBs),and to explore its potential application as an ultrasound(US)/magnetic resonance (MR) imaging contrast agent in vitro.Methods The MPMBs and normal polymer microbubbles (PMBs) were made by double emulsion and freeze-drying methods.The physical property,drug encapsulation efficiency and the drug-loading efficiency of MPMBs were determined,and the release property and US/MR imaging enhancement of MPMBs were observed.Results The MPMBs had a regular shape and narrow size distribution.The drug encapsulation efficiency was (60.20±2.69) ％,and the drug-loading efficiency was (6.02 ± 0.27) ％.The in vitro release experiment showed that ultrasound can promote the release of doxorubicin in MPMBs.US imaging in vitro showed that the enhancement of MPMBs was better than PMBs,and MR imaging in vitro conformed that MPMBs could well enhance MR imaging.Conclusions The MPMBs is a multifunctional contrast agent with the treatment function as well as US/MR dual-mode imaging enhancement effect.