Genetic factors are often involved in the pathogenesis of young adult stroke, and its subtype, atherosclerotic type of large arteries, may be caused by a combination of genetic and environmental factors, but little is known about its underlying pathogenesis. To provide clues for better understanding of identifying relevant stroke etiological genetic factors and adopting effective preventive strategies, the role of genetic factors in atherosclerosis and related risk factors was described, and the possible genetic mechanisms of large-artery atherosclerotic stroke in young people were explored, which may be further investigated in future research in the following areas: etiological typing of stroke in young people and the related genetic mechanisms; modifiable vascular risk factors and the development of secondary prevention strategies; high-resolution vascular imaging magnetic resonance imaging in the etiological typing of stroke in young people and the pathogenesis of premature atherosclerosis and vulnerable plaques.

Genetic factors are often involved in the pathogenesis of young adult stroke, and its subtype, atherosclerotic type of large arteries, may be caused by a combination of genetic and environmental factors, but little is known about its underlying pathogenesis. To provide clues for better understanding of identifying relevant stroke etiological genetic factors and adopting effective preventive strategies, the role of genetic factors in atherosclerosis and related risk factors was described, and the possible genetic mechanisms of large-artery atherosclerotic stroke in young people were explored, which may be further investigated in future research in the following areas: etiological typing of stroke in young people and the related genetic mechanisms; modifiable vascular risk factors and the development of secondary prevention strategies; high-resolution vascular imaging magnetic resonance imaging in the etiological typing of stroke in young people and the pathogenesis of premature atherosclerosis and vulnerable plaques.

A corresponding calibration method was proposed for the key performance parameters of the endoscopic liquid expansion pump,such as the pressure indication error,the flow rate indication error and the flow rate repeatability.4 different brands of endoscopic liquid expansion pumps in clinical use in the hospital were selected for calibration,and the feasibility of the calibration method was evaluated.In the pressure and flow range of the endoscope liquid expansion pump,3 calibration points of high,medium and low were selected,and each flow point was calibrated 3 times.The calibration results showed that the maximum error of pressure indication was 4.3%,the maximum error of flow indication was 9.3%,and the maximum repeatability of flow indication value was 0.8%,all of which met the technical requirements for the maximum allowable error of"Medical Endoscopes.Endoscope Functional Supply Units.Irrigation Pump"(YY/T 0864-2011)and"Calibration Specification for Syringe Pumps and Infusion Pumps"(JJF 1259-2018).The calibration method for endoscopic liquid expansion pump can improve the metrological traceability system of this type of equipment,ensure the accuracy and reliability of equipment values,improve product quality,and ensure medical safety.

Objective:To analyze the short-term clinical outcomes of total laparoscopic distal gastrectomy (TLDG) and laparoscopic-assisted distal gastrectomy (LADG) combined with Billroth-Ⅱ+Braun anastomosis.Methods:Clinical characteristics of patients undergoing laparoscopic distal gastrectomy combined with Billroth-Ⅱ+Braun anastomosis at Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University from Jan 2020 to Oct 2022 were analyzed. Patients were divided into TLDG group ( n=62) and LADG group ( n=62) according to the surgical approach. Results:There were significant differences in the preoperative clinical data section between the two groups, and 124 patients (62 in each group) were enrolled after using propensity score matching to balance significant variables. Compared with the LADG group, the TLDG group showed statistically differences in time to first venting [(2.9±1.3) vs. (2.3±0.8) d, Z=-3.072, P=0.002], time to first fluid diet [(5.9±1.3) vs. (5.4±1.4) d, Z=-2.031, P=0.042] and incision length [(7.1±1.4) vs. (4.8±0.8) cm, Z=-6.331, P=0.000]. Total postoperative complication rate in the TLDG group and the LADG group (29% vs. 37%, χ2=0.911, P=0.340) was not statistically significant. Incidence of postoperative pneumonia was lower in the TLDG group than in the LADG group (3% vs. 13%, χ2=3.916, P=0.048), and incidence of all remaining postoperative complications were not statistically significant. There was no statistically significant difference in the incidence of serious postoperative complications between the TLDG and LADG groups ( P=1.000). Multifactorial analysis revealed that male ( P=0.023) and age ≥65 years ( P=0.001) were independent risk factors for postoperative complications. Conclusion:TLDG is safe and feasible and has better short-term clinical efficacy than LADG.

According to the parameters of main indicators of pressurization device of blood transfusion and infusion,the calibration method was designed based on key technical parameters,which included pressure indication error,pressure output velocity,pressure release velocity,pressure bag airtightness,and overpressure protection. Three used pressurization devices of blood transfusion and infusion with different brands (labeled as Test Equipment A,Test Equipment B,and Test Equipment C) were selected to conduct calibration in the hospital,so as to assess the feasibility of calibration method,and to provide technique reference for evaluating the parameters of the performance. The calibration methods of pressurization device of blood transfusion and infusion were formulated from five aspects:pressure indication error,pressure output velocity,pressure deflation velocity,pressure bag airtightness and overpressure protection of pressurization device of blood transfusion and infusion. The results showed that the calibration method for pressurization device of blood transfusion and infusion,and the pressure and time recorder equipped with standard instrument of calibration can effectively calibrate the performance parameters of pressurization device of blood transfusion and infusion. The recorded data can meet the maximum limit output value of the manufacturer's technical requirements. The calibration method of pressurization device of blood transfusion and infusion can improve the metrological traceability system of such equipment,and ensure the safety and effectiveness of equipment performance,and enhance product quality,and reduce risks of clinical use,and guarantee medical safety.

According to the parameters of main indicators of pressurization device of blood transfusion and infusion,the calibration method was designed based on key technical parameters,which included pressure indication error,pressure output velocity,pressure release velocity,pressure bag airtightness,and overpressure protection. Three used pressurization devices of blood transfusion and infusion with different brands (labeled as Test Equipment A,Test Equipment B,and Test Equipment C) were selected to conduct calibration in the hospital,so as to assess the feasibility of calibration method,and to provide technique reference for evaluating the parameters of the performance. The calibration methods of pressurization device of blood transfusion and infusion were formulated from five aspects:pressure indication error,pressure output velocity,pressure deflation velocity,pressure bag airtightness and overpressure protection of pressurization device of blood transfusion and infusion. The results showed that the calibration method for pressurization device of blood transfusion and infusion,and the pressure and time recorder equipped with standard instrument of calibration can effectively calibrate the performance parameters of pressurization device of blood transfusion and infusion. The recorded data can meet the maximum limit output value of the manufacturer's technical requirements. The calibration method of pressurization device of blood transfusion and infusion can improve the metrological traceability system of such equipment,and ensure the safety and effectiveness of equipment performance,and enhance product quality,and reduce risks of clinical use,and guarantee medical safety.

[This corrects the article DOI: 10.1016/j.apsb.2021.08.015.].

Osteosarcoma is a kind of bone tumor with highly proliferative and invasive properties, a high incidence of pulmonary metastasis and a poor prognosis. Chemotherapy is the mainstay of treatment for osteosarcoma. Currently, there are no molecular targeted drugs approved for osteosarcoma treatment, particularly effective drugs for osteosarcoma with pulmonary metastases. It has been reported that fibroblast activation protein alpha (FAPα) is upregulated in osteosarcoma and critically associated with osteosarcoma progression and metastasis, demonstrating that FAPα-targeted agents might be a promising therapeutic strategy for osteosarcoma. In the present study, we reported that the FAPα-activated vinblastine prodrug Z-GP-DAVLBH exhibited potent antitumor activities against FAPα-positive osteosarcoma cells in vitro and in vivo. Z-GP-DAVLBH inhibited the growth and induced the apoptosis of osteosarcoma cells. Importantly, it also decreased the migration and invasion capacities and reversed epithelial-mesenchymal transition (EMT) of osteosarcoma cells in vitro and suppressed pulmonary metastasis of osteosarcoma xenografts in vivo. Mechanistically, Z-GP-DAVLBH suppressed the AXL/AKT/GSK-3β/β-catenin pathway, leading to inhibition of the growth and metastatic spread of osteosarcoma cells. These findings demonstrate that Z-GP-DAVLBH is a promising agent for the treatment of FAPα-positive osteosarcoma, particularly osteosarcoma with pulmonary metastases.

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.