Objective:This study aims to investigate the feasibility and safety of implanting leadless pacemakers in the low septum and its impact on cardiac electrical synchronization.Methods:A total of 36 patients who received leadless pacemaker implantation at Fuwai Central China Cardiovascular Hospital from January 2021 to August 2023 were included in this study.According to implantation sites of leadless pacemakers,patients were divided into mid-septal group(n=16)and low-septal group(n=20).The clinical characteristics and cardiac electrical synchronization were compared between the two groups.Results:There were 21 male patients,mean age was(68±13)years old.There was no statistical difference in the type of brady-arrhythmia between the two groups(P=0.73).There were 61 implant attempts in these 36 patients,and there was no significant difference in the number of attempts,procedure time,and pacemaker parameters between the two groups,but the average procedure time tended to be shorter in the low-septal group([84±37]minutes vs.[105±35]minutes,P=0.09).In terms of electrical synchronization,there was no statistical difference in QRS duration between the low-septal group and the mid-septal group([162.0±21.1]ms vs.[174.0±14.8]ms,P=0.20).There were no vascular puncture complications,cardiac perforation,or pericardial tamponade during the procedure.There were no complications and readmissions related to the leadless pacemaker during follow-up period.Conclusions:Our results show that the implantation of a leadless pacemaker in the low ventricular septum is safe and effective,has a similar impact on cardiac electrical synchronization as mid-septal pacing.

Objectives:This study aims to explore the impact of new-onset heart conduction block post transcatheter aortic valve replacement(TAVR)on the cardiac conduction status during 1-year follow-up.Methods:A total of 130 patients who completed TAVR surgery at Fuwai Central-China Cardiovascular Hospital from July 2019 to October 2022 were screened.Among them,56 cases with postoperative heart conduction block were selected for analysis.According to the degree of heart block,patients were divided into mild block group(n=36),moderate block group(n=9),and severe block group(n=11).The clinical characteristics and cardiac conduction conditions at 1-year follow-up between different groups were compared.Results:During a mean(8.5±4.1)months follow-up period,10(17.9%)patients had long-term atrioventricular conduction block,and 46(82.1%)patients had partial or complete recovery of heart block,with 28(50.0%)patients with completely recovered cardiac conduction.In the mild block group,22(61.1%)cases were completely recovered,9(25.0%)patients partly recovered,and 5(13.9%)cases uncovered.In the moderate block group,2(22.2%)cases were completely recovered,5(55.6%)patients partly recovered,and 2(22.2%)cases uncovered.Difference in long-term atrioventricular conduction block among three groups was statistically significant(P<0.001).The Kaplan-Meier curve shows that patients with moderate to severe heart block have a higher rate of long-term atrioventricular conduction block(86.1%vs.77.8%vs.72.7%,log-rank P=0.03).Cox multivariate analysis exhibited that old age(≥75 years old,HR=1.204,95%CI:1.051-1.525,P=0.041)and severe heart conduction block(HR=1.106,95%CI:1.100-1.616,P=0.031)are the two independent risk factors for long-term atrioventricular conduction block post TAVR.Conclusions:The ratio of complete cardiac conduction recovery post TAVR is 50.0%.Older age(≥75 year)and new-onset severe heart conduction block are independent risk factors for long-term atrioventricular conduction block post TAVR procedure.

Objective:This study aims to investigate the feasibility and safety of implanting leadless pacemakers in the low septum and its impact on cardiac electrical synchronization.Methods:A total of 36 patients who received leadless pacemaker implantation at Fuwai Central China Cardiovascular Hospital from January 2021 to August 2023 were included in this study.According to implantation sites of leadless pacemakers,patients were divided into mid-septal group(n=16)and low-septal group(n=20).The clinical characteristics and cardiac electrical synchronization were compared between the two groups.Results:There were 21 male patients,mean age was(68±13)years old.There was no statistical difference in the type of brady-arrhythmia between the two groups(P=0.73).There were 61 implant attempts in these 36 patients,and there was no significant difference in the number of attempts,procedure time,and pacemaker parameters between the two groups,but the average procedure time tended to be shorter in the low-septal group([84±37]minutes vs.[105±35]minutes,P=0.09).In terms of electrical synchronization,there was no statistical difference in QRS duration between the low-septal group and the mid-septal group([162.0±21.1]ms vs.[174.0±14.8]ms,P=0.20).There were no vascular puncture complications,cardiac perforation,or pericardial tamponade during the procedure.There were no complications and readmissions related to the leadless pacemaker during follow-up period.Conclusions:Our results show that the implantation of a leadless pacemaker in the low ventricular septum is safe and effective,has a similar impact on cardiac electrical synchronization as mid-septal pacing.

Objectives:This study aims to explore the impact of new-onset heart conduction block post transcatheter aortic valve replacement(TAVR)on the cardiac conduction status during 1-year follow-up.Methods:A total of 130 patients who completed TAVR surgery at Fuwai Central-China Cardiovascular Hospital from July 2019 to October 2022 were screened.Among them,56 cases with postoperative heart conduction block were selected for analysis.According to the degree of heart block,patients were divided into mild block group(n=36),moderate block group(n=9),and severe block group(n=11).The clinical characteristics and cardiac conduction conditions at 1-year follow-up between different groups were compared.Results:During a mean(8.5±4.1)months follow-up period,10(17.9%)patients had long-term atrioventricular conduction block,and 46(82.1%)patients had partial or complete recovery of heart block,with 28(50.0%)patients with completely recovered cardiac conduction.In the mild block group,22(61.1%)cases were completely recovered,9(25.0%)patients partly recovered,and 5(13.9%)cases uncovered.In the moderate block group,2(22.2%)cases were completely recovered,5(55.6%)patients partly recovered,and 2(22.2%)cases uncovered.Difference in long-term atrioventricular conduction block among three groups was statistically significant(P<0.001).The Kaplan-Meier curve shows that patients with moderate to severe heart block have a higher rate of long-term atrioventricular conduction block(86.1%vs.77.8%vs.72.7%,log-rank P=0.03).Cox multivariate analysis exhibited that old age(≥75 years old,HR=1.204,95%CI:1.051-1.525,P=0.041)and severe heart conduction block(HR=1.106,95%CI:1.100-1.616,P=0.031)are the two independent risk factors for long-term atrioventricular conduction block post TAVR.Conclusions:The ratio of complete cardiac conduction recovery post TAVR is 50.0%.Older age(≥75 year)and new-onset severe heart conduction block are independent risk factors for long-term atrioventricular conduction block post TAVR procedure.

Objective:To investigate the etiology of acute pancreatitis (AP) in Inner Mongolia and its correlation with gender, age and severity of the disease.Methods:From January 2015 to December 2018, the clinical data of 4 168 patients with AP admitted to six large tertiary general hospitals in Inner Mongolia were retrospectively collected and the etiology of AP was summarized. The etiology of different gender, age and severity of AP was analyzed. Chi-square test and adjusted chi-square test were used for statistical analysis.Results:The etiology of 4 168 patients with AP included 2 060 cases (49.4%) of biliary diseases, 608 cases (14.6%) of hypertriglyceridemia, 579 cases (13.9%) of idiopathic causes, 399 cases (9.6%) of alcohol intake, 256 cases (6.1%) of overeating and 266 cases (6.4%) of other causes. The proporation of biliary AP in male patients was lower than that in female patients (39.2%, 917/2 340 vs. 62.5%, 1 143/1 828), however the proporations of hypertriglyceridemic AP, alcoholic AP, overeating AP and AP caused by other causes were all higher than those of female patients (17.4%, 406/2 340 vs. 11.1%, 202/1 828; 14.9%, 349/2 340 vs. 2.7%, 50/1 828; 7.6%, 178/2 340 vs. 4.3%, 78/1 828 and 7.1%, 165/2 340 vs. 5.5%, 101/1 828), and the differences were statistically significant ( χ2=223.645, 32.693, 175.859, 19.858, and 4.001, all P<0.05). The proporation of biliary AP in patients aged between 19 and 59 years was lower than that in patients aged less than 18 years and over 60 years (42.4%, 1 100/2 593 vs. 55.1%, 54/98 and 61.3%, 906/1 477), and the differences were statistically significant ( χ2=6.199 and 134.746, both P<0.016). The proporation of hypertriglyceridemic AP in patients aged over 60 years was lower than that in patients aged between 19 and 59 years and less than 18 years (6.9%, 102/1 477 vs. 18.9%, 491/2 593 and 15.3%, 15/98), and the differences were statistically significant ( χ2=109.403 and 9.430, both P<0.016). The proporation of idiopathic AP in patients aged between 19 and 59 years was higher than that of patients aged over 18 years (14.8%, 384/2 593 vs. 6.1%, 6/98), and the difference was statistically significant ( χ2=5.750, P<0.016). The proporation of alcoholic AP in patients aged between 19 and 59 years was higher than that of patients aged less than 18 years and over 60 years (11.7%, 303/2 593 vs. 1.0%, 1/98 and 6.4%, 95/1 477), the differences were statistically significant ( χ2=10.718 and 29.435, both P<0.016). And the proporation of other causes of AP of the patients aged less than 18 years was higher than those of patients aged between 19 and 59 years and over 60 years (14.3%, 14/98 vs. 5.9%, 152/2 593 and 6.8%, 100/1 477), and the differences were statistically significant ( χ2=0.559 and 0.959, P<0.016). Among the biliary causes, the proporation of moderate severe acute pancreatitis (MSAP) was higher than those of mild acute pancreatitis (MAP) and severe acute pancreatitis (SAP) (59.6%, 336/564 vs. 47.5%, 1 522/3 204 and 50.5%, 202/400), and the differences were statistically significant ( χ2=27.959 and 7.814, both P<0.016). In terms of hypertriglyceridemia and other causes, the proporation of MAP was the lowest (12.7%, 407/3 204 and 4.0%, 127/3 204), and the proporations were statistically significant compared with the proporation of MSAP and SAP (23.0%, 130/564; 12.2%, 69/564 and 17.8%, 71/400; 17.5%, 70/400; χ2=42.013, 7.874, 66.520 and 126.094, all P<0.016). The proporation of MSAP was the lowest among the idiopathic causes (0.7%, 4/564), and the difference was statistically significant compared with the proporation of MAP and SAP (16.6%, 533/3 204 and 10.5%, 42/400; χ2=99.540 and 49.369, both P<0.016). The proporation of SAP was lower than that of MAP, and the difference was statistically significant ( χ2=9.983, P<0.016). In alcoholic and overeating causes, the proporation of MAP was the highest (11.4%, 365/3 204, 7.8%, 250/3 204), and the differences were statistically significant compared with MSAP and SAP (3.5%, 20/564; 0.9%, 5/564; 3.5%, 14/400 and 0.2%, 1/400; χ2=32.182, 23.537, 36.358 and 31.307, all P<0.016). Conclusions:Consistent with reports in most areas of China, the etiology of AP in Inner Mongolia area is mainly biliary diseases and hypertriglyceridemia. Most of the patients with biliary acute pancreatitis are female, mostly in patients more than 60 years old and most of them are MSAP. Hyperlipidemic and alcoholic AP are more common in middle-aged and young male patients, and are mostly MSAP and SAP; while most of alcoholic AP is MAP.

Background and objective Pulmonary ifbrosis is a common pathological phenomenon in lung cancer patients atfer chemotherapy or radiotherapy. It is also a key hindrance to the transport of drugs to lung tissue. Peptide trans-porters have become a target of the rational design of peptides and peptide drugs. hTe aim of this study is to investigates the expression of peptide transporter 2 (PEPT2) mRNA in the lungs of rats with bleomycin (BLM)-induced pulmonary ifbrosis. Methods Fitfy healthy adult Sprague-Dawley rats were randomly divided into ifve groups. One group was untreated (control), the second group was injected with normal saline solution (NS), and the three remaining groups were treated with a single dose of bleomycin to induce pulmonary ifbrosis (BLM). Rats from the NS group were killed by exsanguination on day 14. Rats from the BLM group were killed by exsanguination on days 7, 14, and 28. hTe lung samples were observed under light microscopy and the hydroxyproline concentration was determined. hTe expression levels of PEPT2 mRNA were measured by RT-PCR. Results hTe morphological study showed that collagenous ifber proliferated in the lungs of rats injected with BLM, indicating pulmonary ifbrosis. hTis proliferation was apparent at 14 d post-injection and especially at 28 d post-injection. Hydroxyproline levels increased seven days post-injection compared with the control group and NS group, but there was no signiifcant statisti-cal difference (P>0.05). Hydroxyproline levels signiifcantly increased (P<0.05) 14 d and 28 d post-infection. hTe change in the lung tissue pathology coincided with the change in hydroxyproline levels. hTere were no signiifcant changes of pulmonary PEPT2 mRNA expression levels among the different groups (P>0.05). Conclusion PEPT2 is a potential peptide drug target in the treatment of pulmonary ifbrosis, although there were no signiifcant changes of PEPT2 mRNA expression in the lungs of rats with bleomycin-induced pulmonary ifbrosis.