Objective: To investigate the incidence of occult hepatitis B virus infection (OBI) in spouses of asymptomatic hepatitis B virus (HBV) infected individuals in Shenzhen, China, and to analyze their serological and molecular characteristics and possible transmission routes, so as to propose refined strategies for blood safety. Methods: After rapid screening for HBsAg at the blood collection sites, samples from HBsAg-positive blood donors and their concurrently donating spouses were collected. All samples were tested for hepatitis B serological markers by electrochemiluminescence immunoassay (ECLI). Simultaneously, HBV nucleic acid extractiona, nested PCR amplification, gene sequencing of S and BCP/PC regions and qPCR were conducted. Results: A total of 112 samples were collected, including 56 from HBsAg positive donors and 56 from their spouses. All donors were confirmed as HBsAg+/DNA+/anti-HBc+, indicative of asymptomatic chronic hepatitis (CHB) infection. Among their 56 spouses, 11 (19.6%) were identified as HBV DNA+. The prevalence was higher in males (23.1%) than in females (16.7%). Six spouses (10.8%) had OBI, three of whom (5.4%) were negative in routine blood screening tests. The residual risk of HBV were estimated as 1∶127 (95%CI, 1∶356 to 1∶66). Among infected couples, immune escape mutation (E164D) and glycosylation mutations (I126T and T131N/M133T) were identified. Furthermore, sequence analysis suggested partner-to-partner transmission in eight cases. Conclusion: A substantial proportion (19.6%) of spouses of asymptomatic HBV infected donors were HBV-positve, with an OBI prevalence of 10.9%. Among these, 5.4% were negative in routine tests. To ensure blood safety, we recommend that spouses of HBV infected individuals be deferred from blood donation.

Objective To explore the feasibility of using high-definition thoracoscopy to identify sympathetic ganglia during thoracic sympathicotomy for primary palmar hyperhidrosis. Methods The clinical data of patients with primary palmar hyperhidrosis who underwent high-definition thoracoscopic sympathicotomy in Taikang Xianlin Drum Tower Hospital from June to July 2023 were retrospectively analyzed. Intraoperative visualization rates and anatomical variations of sympathetic ganglia were recorded, and the consistency between white-light thoracoscopy and near-infrared fluorescence imaging was compared. Additionally, surgical videos from previous fluorescence-guided procedures were reviewed. Results Finally 100 patients were collected, including 54 females and 46 males, with an average age of (21.92±6.56) years. All patients underwent endoscopic thoracic sympathicotomy at R3 level. The overall intraoperative ganglion visualization rate was 92.5% (740/800), with G2-G5 rates of 95.5% (191/200), 94.0% (188/200), 94.0% (188/200), and 86.5% (173/200), respectively. Ganglion variations occurred in 32.0% (237/740), predominantly at G3 (29.8%) and G4 (42.6%). In 5 indocyanine green-enhanced patients, the concordance rate between white-light and near-infrared fluorescence imaging was 100.0% (38/38). Video analysis of 14 near-infrared fluorescence-guided surgeries demonstrated a 99.1% (107/108) consistency rate. Postoperative palmar hyperhidrosis improvement reached 100.0% (100/100) with no Horner’s syndrome. Conclusion With the wide clinical application of high-definition thoracoscopy, accurate thoracic sympathicotomy has the feasibility of clinical application.

Objective:To investigate predictive value of dynamic electrocardiogram heart rate variability(HRV)combined with three-dimensional spot tracking echocardiography(3D-STE)for postoperatively major adverse cardiovascular events(MACE)in patients with coronary heart disease(CHD).Methods:The clinical data of 80 CHD patients,who underwent percutaneous coronary intervention(PCI)treatment at Beijing Rehabilitation Hospital affiliated with Capital Medical University from January 2022 to December 2023,were retrospectively collected.All patients underwent dynamic electrocardiogram HRV and 3D-STE examination before surgery,and 1-year follow-up.The condition of occurring MACE during the follow-up period was analyzed as statistical method,and the patients were divided into occurrence group(21 cases)and non-occurrence group(59 cases).The relevant parameters of dynamic electrocardiogram HRV and 3D-STE examination of occurring MACE of CHD patients between two groups were compared,and the predictive value of dynamic electrocardiogram HRV combined with 3D-STE examination for postoperative MACE of CHD patients was analyzed.Results:In 80 CHD patients,21 cases occurred postoperative MACE,with an incidence rate of 26.25%.The standard deviation of the average NN intervals(SDANN)(65.26±9.65)ms of 5-minute sinus,the standard deviation of normal-to-normal intervals index(SDNN Index)(40.15±6.36)ms of 5-minute in continuous 24 hours,the root mean square of successive differences(r-MSSD)(36.86±4.55)ms between the normal adjacent cardiac cycles,the left atrial emptying fraction(LAEF)(40.25±4.53)%,and the left atrial storage phase strain(LASr)(15.24±3.62)%in CHD patients with MACE were lower than those without MACE[(87.45±10.22)ms,(52.45±7.85)ms,(46.54±6.25)ms,(48.54±6.33)ms,(19.99±4.55)%],and the left atrial pre-contraction volume(LAVp)(42.51±3.65)ml was higher than that(35.18±2.99)mL in patients without MACE,with statistically significant differences(t=8.666,6.457,6.499,9.093,5.510,4.317,P<0.05).Logistic regression analysis showed that SDANN,SDNN Index,r-MSSD,LAVp,LAEF,LASr were correlations with the occurrence of postoperative MACE in CHD patients(OR=0.756,0.772,0.694,2.481,0.721,0.739,P<0.05).The receiver operating characteristics(ROC)curves indicated that the area under curve(AUC)values of SDANN,SDNN Index,r-MSSD,LAVp,LAEF and LASr were all greater than 0.70 in predicting postoperative MACE in CHD patients,which indicated all of them had predictive value,and the predictive value of the combined detection was higher.Conclusion:Dynamic electrocardiogram HRV and 3D-STE parameters have a certain predictive value for the occurrence of postoperative MACE in CHD patients,and the predictive value of the combined detection for the them are higher.Therefore,dynamic electrocardiogram HRV and 3D-STE parameters can be used as one of the important reference schemes of assessing postoperative MACE of patients.

Objective:To analyze the relationship between cuprotosis-realted gene DLD expression in pan-cancer and progno-sis,tumor microenvironment and tumor immune infiltration by bioinformatics methods combined with multiple databases.Methods:TCGA,GTEx,TISDB,GEO,UCSC,TARGET,TIMER2.0,GEPIA2,SangerBox,PrognoScan and related R software packages were used to analyze the difference of DLD expression between human cancer and adjacent normal tissues,inestigate relationship between prognosis,explore expression of DLD in different immune subtypes and molecular subtypes of human cancer,analyze correlation between DLD expression and tumor immune infiltration and tumor microenvironment,detecet relationship between DLD expression and 60 immune checkpoint genes.Results:There were differences in expression of DLD in different tumor tissues;low DLD expression in 6 tumors and high DLD expression in 3 tumors were significantly associated with better prognosis;15 tumor immune subtypes,11 molecular subtypes of tumors were significantly correlated with DLD expression;DLD expression was significantly correlated with immune infiltration in 37 cancer types;DLD expression was significantly associated with immune infiltration in 23 tumor stroma scores,26 tumor immune scores and 25 tumor ESTIMATE scores;60 immune checkpoint genes in 39 tumors were significantly associated with DLD expression.Conclusion:Expression of DLD in pan-cancer is related to tumor prognosis and immune invasion,DLD may be a potential predictor of prognosis in tumors,and may be an immunomodulator of tumors.

Objective:To analyze the relationship between cuprotosis-realted gene DLD expression in pan-cancer and progno-sis,tumor microenvironment and tumor immune infiltration by bioinformatics methods combined with multiple databases.Methods:TCGA,GTEx,TISDB,GEO,UCSC,TARGET,TIMER2.0,GEPIA2,SangerBox,PrognoScan and related R software packages were used to analyze the difference of DLD expression between human cancer and adjacent normal tissues,inestigate relationship between prognosis,explore expression of DLD in different immune subtypes and molecular subtypes of human cancer,analyze correlation between DLD expression and tumor immune infiltration and tumor microenvironment,detecet relationship between DLD expression and 60 immune checkpoint genes.Results:There were differences in expression of DLD in different tumor tissues;low DLD expression in 6 tumors and high DLD expression in 3 tumors were significantly associated with better prognosis;15 tumor immune subtypes,11 molecular subtypes of tumors were significantly correlated with DLD expression;DLD expression was significantly correlated with immune infiltration in 37 cancer types;DLD expression was significantly associated with immune infiltration in 23 tumor stroma scores,26 tumor immune scores and 25 tumor ESTIMATE scores;60 immune checkpoint genes in 39 tumors were significantly associated with DLD expression.Conclusion:Expression of DLD in pan-cancer is related to tumor prognosis and immune invasion,DLD may be a potential predictor of prognosis in tumors,and may be an immunomodulator of tumors.

Objective:To investigate predictive value of dynamic electrocardiogram heart rate variability(HRV)combined with three-dimensional spot tracking echocardiography(3D-STE)for postoperatively major adverse cardiovascular events(MACE)in patients with coronary heart disease(CHD).Methods:The clinical data of 80 CHD patients,who underwent percutaneous coronary intervention(PCI)treatment at Beijing Rehabilitation Hospital affiliated with Capital Medical University from January 2022 to December 2023,were retrospectively collected.All patients underwent dynamic electrocardiogram HRV and 3D-STE examination before surgery,and 1-year follow-up.The condition of occurring MACE during the follow-up period was analyzed as statistical method,and the patients were divided into occurrence group(21 cases)and non-occurrence group(59 cases).The relevant parameters of dynamic electrocardiogram HRV and 3D-STE examination of occurring MACE of CHD patients between two groups were compared,and the predictive value of dynamic electrocardiogram HRV combined with 3D-STE examination for postoperative MACE of CHD patients was analyzed.Results:In 80 CHD patients,21 cases occurred postoperative MACE,with an incidence rate of 26.25%.The standard deviation of the average NN intervals(SDANN)(65.26±9.65)ms of 5-minute sinus,the standard deviation of normal-to-normal intervals index(SDNN Index)(40.15±6.36)ms of 5-minute in continuous 24 hours,the root mean square of successive differences(r-MSSD)(36.86±4.55)ms between the normal adjacent cardiac cycles,the left atrial emptying fraction(LAEF)(40.25±4.53)%,and the left atrial storage phase strain(LASr)(15.24±3.62)%in CHD patients with MACE were lower than those without MACE[(87.45±10.22)ms,(52.45±7.85)ms,(46.54±6.25)ms,(48.54±6.33)ms,(19.99±4.55)%],and the left atrial pre-contraction volume(LAVp)(42.51±3.65)ml was higher than that(35.18±2.99)mL in patients without MACE,with statistically significant differences(t=8.666,6.457,6.499,9.093,5.510,4.317,P<0.05).Logistic regression analysis showed that SDANN,SDNN Index,r-MSSD,LAVp,LAEF,LASr were correlations with the occurrence of postoperative MACE in CHD patients(OR=0.756,0.772,0.694,2.481,0.721,0.739,P<0.05).The receiver operating characteristics(ROC)curves indicated that the area under curve(AUC)values of SDANN,SDNN Index,r-MSSD,LAVp,LAEF and LASr were all greater than 0.70 in predicting postoperative MACE in CHD patients,which indicated all of them had predictive value,and the predictive value of the combined detection was higher.Conclusion:Dynamic electrocardiogram HRV and 3D-STE parameters have a certain predictive value for the occurrence of postoperative MACE in CHD patients,and the predictive value of the combined detection for the them are higher.Therefore,dynamic electrocardiogram HRV and 3D-STE parameters can be used as one of the important reference schemes of assessing postoperative MACE of patients.

Objective To explore the differential expression of the key microfilament cytoskeleton-binding proteins in immature dendritic cells(imDCs)during antigen phagocytosis.Methods Monocytes(MOs)were isolated from peripheral blood of healthy individuals and cultured with recombinant human granulocyte-macrophage colony stimulating factor(rhGM-CSF)and recombinant human interleukin-4(rhIL-4)for 6 days to obtain imDCs.ImDCs were co-cultured with low molecular weight(40 kDa)and high molecular weight(150 kDa)dextrans for 1,3 and 6 hours,respectively.Flow cytometry was used to detect the percentage of imDCs phagocytosing dextran and the expression of immunophenotype molecules.The localization of filamentous actin(F-actin),PFN1,WASP,and α-actinin in cells were observed by immunofluorescence imaging.The differential expression of MCBPs at the mRNA and protein levels were respectively detected by q-PCR and Western blotting.Finally,the MCBPs with the highest component coefficients were identified based on the stepwise regression and principal component analysis method in systems biology algorithms.Results During the process of antigen phagocytosis,imDCs phagocytized low molecular weight antigens at a faster rate,with a phagocytic duration of approximately three hours.Their cell phenotypes and morphology gradually differentiated into mDCs,and F-actin remodeling was occurred significantly.The expression of MCBPs such as PFN1,CDM,WASP,CAPZB,Filamin A,α-actinin were downregulated,while the expression of WAVE1,Arp2/3 complex,and Fascin were upregulated.The mRNA expression of signaling protein Rac1 was upregulated,while the mRNA expressions of CDC42 and RhoA were downregulated.The immunofluorescence results showed that PFN1,WASP,and α-actinin were transposed during the antigen phagocytosis process of imDCs.The results of stepwise regression and principal component analysis showed that PFN1 had the highest component coefficient.Conclusions PFN1 may be a key MCBPs involved in the process of antigen phagocytosis of imDCs,which is of great significance for further understanding the relationship between changes in the cytoskeleton structure of imDCs and their immunological functions.

Objective:To analyze the clinical characteristics of invasive intervention-related intestinal fistula in patients with acute pancreatitis (AP).Methods:We retrospectively analyzed the clinical data of 177 moderately severe acute pancreatitis (MSAP) or severe acute pancreatitis (SAP) patients who received invasive intervention in Peking Union Medical College Hospital from January 2003 to December 2022. Patients were divided into fistula group and non-fistula group based on the presence or absence of fistula after or during receiving invasive interventions. The age, gender, etiology, systemic inflammatory response syndrome(SIRS), impairment of organ function, revised Atlanta classification, bedside index of severity of acute pancreatitis(BISAP), Balthazar CT classification, extra-pancreatic involvement and secondary infection of local complications, indications, timing and modalities of invasive interventions, length of hospitalization, length of intensive care and outcomes were recorded. The differences on clinical characteristics were compared between the two groups.Results:Intestinal fistulae were found in 21(11.9%) cases during or after invasive intervention, including 8 during or after percutaneous drainage and 13 during or after surgeries. 51 cases received endoscopic drainage or debridement and no intestinal fistula occurred after endoscopic management. Compared to patients without fistula, the median age was younger in the fistula group (36 vs 45 years, P=0.014), and the occurrence of SIRS (95.2% vs 59.6%, P=0.001), extra-pancreatic invasion (100.0% vs 67.3%, P=0.002), and secondary infection (71.4% vs 36.5%, P=0.002) were higher. Patients with fistula had a longer median length of hospitalization (71 vs 40 days, P=0.016) and intensive care (8 vs 0 days, P=0.002). All patients in the fistula group had peri-pancreatic, abdominal and retroperitoneal involvement seen on imaging or intraoperatively. The intestinal fistulae mainly occurred in the colon ( n=13, 61.9%) and the duodenum ( n=6, 28.6%). The confirmed diagnosis of fistulae was based on transfistula imaging ( n=11) or digestive tract imaging ( n=5). Among 13 cases with colonic fistulae, nonsurgical treatment was preferred in 9 cases, and surgeries of fistula repairmen or proximal ostomy were preferred in 4 cases. Among 8 cases with non-colonic fistulae, nonsurgical treatment was preferred in 7 cases, and only 1 case repaired the fistula immediately during the intraoperative detection. Conclusions:Intestinal fistula is an important complication of severe AP, and it is closely associated with invasive interventions. Improved invasive intervention strategies may help prevent intestinal fistula formation; timely and effective management of intestinal fistula may help avoid complications and shorten hospitalization.

Objective:To explore the safety and effectiveness of high power short duration (HPSD) ablation technique in elderly patients with atrial fibrillation.Methods:A total of 108 elderly patients with atrial fibrillation in the Department of Cardiology, the First Affiliated Hospital of Bengbu Medical University from January 2021 to June 2023 were randomly divided into the observation group (54 patients), who underwent HPSD catheter ablation and the control group (54 patients), who received conventional low power long duration (LPLD) catheter ablation. The radiation dose, ablation time, fluid infusion volume, pulmonary vein single lap isolation, and surgical complications were compared between the two groups. Follow up for 1 year after surgery to compare the success rates of the two groups.Results:The observation group had significantly lower radiation dose [(51.30±14.71)mGy vs. (77.77±13.97) mGy, P <0.01], ablation time [(57.98±16.95)min vs. (82.19±16.78)min, P <0.01]and saline infusion volume[(1284.31±212.07)mL vs.(1783.33±242.25)mL, P <0.01] compared with the control group. The pulmonary vein single lap isolation rates were similar in the two groups, and there were no serious surgical complications in the two groups. There were 17 cases of atrial fibrillation recurrence in the control group, higher than in the observation group (9 cases of recurrence), but there was no statistically significant difference between the two groups ( P =0.072). KM curve analysis showed that the maintenance time of sinus rhythm in the observation group was longer than that in the control group (Log Rank P =0.043). Conclusions:HPSD can significantly shorten the ablation time, reduce intraoperative saline infusion and radiation dose, and have a longer sinus rhythm time in elderly patients with atrial fibrillation. It is a safe and effective ablation method.

OBJECTIVE: To observe the therapeutic effect of scalp-nape acupuncture for pharyngeal dysphagia of stroke at recovery stage on the basis of neuromuscular electrical stimulation (NMES) and rehabilitation training. METHODS: A total of 42 patients with pharyngeal dysphagia of stroke at recovery stage were randomized into an observation group and a control group, 21 cases in each group. Conventional medical symptomatic treatment was given in both groups. NMES and rehabilitation training were adopted in the control group, 30 min for each one. On the basis of the treatment in the control group, scalp-nape acupuncture was given in the observation group, scalp acupuncture was applied at lower 2/5 of anterior and posterior oblique lines of parietal and temporal, nape acupuncture was applied at Fengchi (GB 20), Yiming (EX-HN 14), Gongxue (Extra), Zhiqiang (Extra), Tunyan (Extra), etc. The treatment was given once a day, 5 days a week for 3 weeks in both groups. Before and after treatment, the videofluoroscopic dysphagia scale (VDS) score, the Kubota water swallowing test grade, the functional oral intake scale (FOIS) grade and the swallowing quality of life (SWAL-QOL) score were observed in both groups. RESULTS: After treatment, the VDS scores were decreased and the SWAL-QOL scores were increased compared before treatment (P<0.05), the Kubota water swallowing test grade and FOIS grade were improved compared before treatment (P<0.05) in both groups. The changes of VDS score and SWAL-QOL score, Kubota water swallowing test grade and FOIS grade in the observation group were superior to those in the control group (P<0.05). CONCLUSION Based on NMES and rehabilitation training, scalp-nape acupuncture can enhance the therapeutic effect on pharyngeal dysphagia of stroke at recovery stage, and improve the patients' swallowing function and quality of life.
Acupuncture Points ; Acupuncture Therapy ; Deglutition ; Deglutition Disorders/therapy* ; Humans ; Quality of Life ; Scalp ; Stroke/therapy* ; Stroke Rehabilitation ; Treatment Outcome ; Water