Objective To evaluate the safety and efficacy of valve-in-valve transcatheter mitral valve replacement(ViV-TMVR)in patients with bioprosthetic valve degeneration who are at high surgical risk.Methods This study is a multi-center,retrospective cohort analysis of 20 consecutive patients who underwent transseptal ViV-TMVR using the Edwards SAPIEN 3 transcatheter heart valve(THV).The primary endpoints include technical success and procedural success,both defined according to the Mitral Valve Academic Research Consortium(MVARC)criteria,as well as mortality and functional change assessed based on New York Heart Association(NYHA)classification at 30-days and six months post-procedure.Clinical follow-up assessments are conducted at 30-days and six months.Results From February 2021 to October 2022,a total of 20 patients with symptoms of bioprosthetic valve degeneration were enrolled across nine sites in China.The patients had a mean age of(73.5±5.5)years,with 85.0％being females and 70.0％classified as NYHA class Ⅲ/Ⅳ.The study achieved a 100.0％technical success rate and a 90.0％procedural success rate finally.All patients remained alive during the 30-day follow-up period.However,six months post-intervention,two patients(10.0％)were re-hospitalized due to heart failure,and sadly,one of them(5.0％)died.None of the patients reported any adverse events related to ViV-TMVR during the follow-up period.Notably,there was a significant improvement in NYHA class compared to baseline(P=0.0004)at six-month follow-ups.Conclusions The transseptal ViV-TMVR technique proved to be highly successful and was associated with significant improvement in NYHA class function.These findings strongly suggest that it serves as a safe and efficient treatment alternative for high-risk patients suffering from bioprosthetic valve degeneration.

This study explores the mechanism of Guben Jiannao Liquid on Alzheimer's disease(AD) by regulating autophagy based on the liver kinase B1(LKB1)/adenosine monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR) pathway. Male SD rats were randomly divided into the blank group, model group, low-dose and high-dose groups of Guben Jiannao Liquid, and rapamycin group, with 10 rats in each group. Except for the blank group, all other groups of rats were injected bilaterally in the hippocampus with β-amyloid(Aβ)_(1-42) to establish the AD model. The low-dose(6.21 g·kg~(-1)) and high-dose(12.42 g·kg~(-1)) groups of Guben Jiannao Liquid and rapamycin group(1 mg·kg~(-1)) were given the corresponding drugs by gavage, and the blank and model groups were given an equal volume of saline by gavage for four weeks. Morris water maze was used to test the learning and memory ability of rats in each group; hematoxylin-eosin(HE) and Nissl staining were used to observe the morphological and quantitative changes of neurons and Nissl bodies in the CA1 region of rat hippocampus; immunohistochemistry was utilized to detect Aβ-positive cell expression in the CA1 region of rat hippocampus; transmission electron microscopy was employed to observe ultrastructural changes in rat hippocampal tissue, and Western blot was used to examine the protein expression levels of LKB1, p-AMPK/AMPK, p-mTOR/mTOR, Beclin1, p62, and LC3-Ⅱ in the hippocampal tissue of the rats. The results showed that compared with those in the blank group, rats in the model group had elevated evasion latency and decreased number of platform transversal and residence time in the platform quadrant. The number of neurons in the hippocampal area was reduced, and the morphology was impaired. The average integral optical density value of Aβ-positive cells was elevated; the expression levels of LKB1, p-AMPK/AMPK, Beclin1, and LC3-Ⅱ were decreased, and the expression levels of p-mTOR/mTOR and p62 were increased. Compared with those in the model group, rats in the low-dose and high-dose groups of Guben Jiannao Liquid had shorter evasion latency, higher number of platform transversal, longer residence time in the platform quadrant, increased number of neurons, decreased expression of Aβ-positive cells and average integral optical density values, and increased number of autophagic lysosomes in hippocampal tissue. The expression levels of LKB1, Beclin1, and LC3-Ⅱ were elevated in the hippocampus of rats in the low-dose group of Guben Jiannao Liquid. The expression levels of LKB1, p-AMPK/AMPK, Beclin1, and LC3-Ⅱ were elevated in the hippocampal tissue of rats in the high-dose group of Guben Jiannao Liquid, and the expression levels of p-mTOR/mTOR and p62 were decreased. The findings suggest that Guben Jiannao Liquid can improve cognitive impairment in AD rats, and its mechanism of action may be related to the activation of the LKB1/AMPK/mTOR signaling pathway and the up-regulation of autophagy level.
Animals ; Alzheimer Disease/physiopathology* ; Male ; TOR Serine-Threonine Kinases/genetics* ; Autophagy/drug effects* ; Rats, Sprague-Dawley ; Protein Serine-Threonine Kinases/genetics* ; AMP-Activated Protein Kinases/genetics* ; Rats ; Drugs, Chinese Herbal/administration & dosage* ; Signal Transduction/drug effects* ; AMP-Activated Protein Kinase Kinases ; Humans ; Hippocampus/metabolism*

Greater trochanteric pain syndrome(GTPS)is a disease caused by structural lesions of the muscles,fascia,ligaments,and bursae near the greater trochanter of the femur.GTPS causes lateral hip joint pain,severely affecting patients' quality of life.Ultrasound has many advantages,such as real-time diagnosis,portable operation,non-radiation,and high resolution,demonstrating a high application value in the diagnosis and interventional therapy of GTPS.This article reviews the current status of ultrasound in the diagnosis and interventional therapy of GTPS and prospects its application.
Humans ; Ultrasonography ; Femur/diagnostic imaging* ; Hip Joint/diagnostic imaging* ; Arthralgia/therapy*

Objective:Near-infrared(NIR)spectroscopy technology faces the problem of insufficient model generalization due to individual differences in non-invasive blood glucose testing,in order to solve this problem,to improve data utilization,and to build predictive models with stronger generalization ability,this study introduces a transfer learning method to study the NIR spectroscopy non-invasive glucose testing.Methods:Migration learning is a machine learning technique that aims to improve task performance in the target domain by transferring knowledge from the source domain to the target domain.In this study,we used community population data as the source domain and student population data as the target domain to improve the performance of the noninvasive glucose detection model on the target domain.In order to verify the effectiveness of migration learning,this study compares the performance of the model before and after migration learning.Results:the model's performance on the noninvasive glucose detection task is significantly improved by the migration learning strategy,and the MAPE and MAE of the migrated model decreases by 52.5460％and 6.0805％,respectively,and the RMSE and MSE decreases by 10.7215％and 12.1135％.Conclusions:This study demonstrates the promising application of transfer learning in the field of non-invasive blood glucose detection,which is expected to realize portable and continuous blood glucose monitoring in the future by migrating the features that are difficult to access in the source domain but are related to blood glucose values to the target domain,which will greatly improve the quality of life of diabetic patients.Advances in noninvasive glucose testing technology will not only reduce patients' pain,but also provide a more convenient means of glucose monitoring,which will provide strong support for diabetes management.

Objective To construct a glioma grading evaluation model based on magnetic resonance diffusion tensor imaging(DTI)parameters,systemic immune-inflammation index(SII),and albumin to globulin ratio(AGR),and analyze its evaluation effect.Methods A total of 120 patients with brain glioma treated in our hospital from January 2022 to January 2024 were selected and divided into a high-grade glioma(HGG)group of 53 cases and a low-grade glioma(LGG)group of 67 cases according to the WHO tumor classification.The magnetic resonance DTI parameters,SII,and AGR of patients between the two groups were compared.A binary Logistic regression analysis model was constructed to analyze the risk factors for the occurrence of HGG;the receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to analyze the evaluation value of the glioma grading model.Results Compared with the LGG group,the HGG group had lower fractional anisotropy(FA)value,apparent diffusion coefficient(ADC),and AGR of the tumor body and the peritumoral edema area(P<0.05),and higher SII(P<0.05).Binary Logistic regression analysis showed that decresed ADC value of the tumor body and the peritumoral edema area,decreased AGR,and increased SII were all the risk factors for the occurrence of HGG(P<0.05).The ROC curve analysis showed that the AUC of the combined assessment of FA value and ADC of the tumor body,FA value and ADC of the peritumoral edema area,SII and AGR for glioma grading was higher than that of their individual assessment(P<0.05).Conclusion The occurrence of HGG is related to the ADC of the tumor body and peritumoral edema area,SII,and AGR.The model constructed based on magnetic resonance DTI parameters,SII and AGR has high evaluation value for the grading of glioma.

Objective To evaluate the safety and efficacy of valve-in-valve transcatheter mitral valve replacement(ViV-TMVR)in patients with bioprosthetic valve degeneration who are at high surgical risk.Methods This study is a multi-center,retrospective cohort analysis of 20 consecutive patients who underwent transseptal ViV-TMVR using the Edwards SAPIEN 3 transcatheter heart valve(THV).The primary endpoints include technical success and procedural success,both defined according to the Mitral Valve Academic Research Consortium(MVARC)criteria,as well as mortality and functional change assessed based on New York Heart Association(NYHA)classification at 30-days and six months post-procedure.Clinical follow-up assessments are conducted at 30-days and six months.Results From February 2021 to October 2022,a total of 20 patients with symptoms of bioprosthetic valve degeneration were enrolled across nine sites in China.The patients had a mean age of(73.5±5.5)years,with 85.0％being females and 70.0％classified as NYHA class Ⅲ/Ⅳ.The study achieved a 100.0％technical success rate and a 90.0％procedural success rate finally.All patients remained alive during the 30-day follow-up period.However,six months post-intervention,two patients(10.0％)were re-hospitalized due to heart failure,and sadly,one of them(5.0％)died.None of the patients reported any adverse events related to ViV-TMVR during the follow-up period.Notably,there was a significant improvement in NYHA class compared to baseline(P=0.0004)at six-month follow-ups.Conclusions The transseptal ViV-TMVR technique proved to be highly successful and was associated with significant improvement in NYHA class function.These findings strongly suggest that it serves as a safe and efficient treatment alternative for high-risk patients suffering from bioprosthetic valve degeneration.

Objective:Near-infrared(NIR)spectroscopy technology faces the problem of insufficient model generalization due to individual differences in non-invasive blood glucose testing,in order to solve this problem,to improve data utilization,and to build predictive models with stronger generalization ability,this study introduces a transfer learning method to study the NIR spectroscopy non-invasive glucose testing.Methods:Migration learning is a machine learning technique that aims to improve task performance in the target domain by transferring knowledge from the source domain to the target domain.In this study,we used community population data as the source domain and student population data as the target domain to improve the performance of the noninvasive glucose detection model on the target domain.In order to verify the effectiveness of migration learning,this study compares the performance of the model before and after migration learning.Results:the model's performance on the noninvasive glucose detection task is significantly improved by the migration learning strategy,and the MAPE and MAE of the migrated model decreases by 52.5460％and 6.0805％,respectively,and the RMSE and MSE decreases by 10.7215％and 12.1135％.Conclusions:This study demonstrates the promising application of transfer learning in the field of non-invasive blood glucose detection,which is expected to realize portable and continuous blood glucose monitoring in the future by migrating the features that are difficult to access in the source domain but are related to blood glucose values to the target domain,which will greatly improve the quality of life of diabetic patients.Advances in noninvasive glucose testing technology will not only reduce patients' pain,but also provide a more convenient means of glucose monitoring,which will provide strong support for diabetes management.

Objective To construct a glioma grading evaluation model based on magnetic resonance diffusion tensor imaging(DTI)parameters,systemic immune-inflammation index(SII),and albumin to globulin ratio(AGR),and analyze its evaluation effect.Methods A total of 120 patients with brain glioma treated in our hospital from January 2022 to January 2024 were selected and divided into a high-grade glioma(HGG)group of 53 cases and a low-grade glioma(LGG)group of 67 cases according to the WHO tumor classification.The magnetic resonance DTI parameters,SII,and AGR of patients between the two groups were compared.A binary Logistic regression analysis model was constructed to analyze the risk factors for the occurrence of HGG;the receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to analyze the evaluation value of the glioma grading model.Results Compared with the LGG group,the HGG group had lower fractional anisotropy(FA)value,apparent diffusion coefficient(ADC),and AGR of the tumor body and the peritumoral edema area(P<0.05),and higher SII(P<0.05).Binary Logistic regression analysis showed that decresed ADC value of the tumor body and the peritumoral edema area,decreased AGR,and increased SII were all the risk factors for the occurrence of HGG(P<0.05).The ROC curve analysis showed that the AUC of the combined assessment of FA value and ADC of the tumor body,FA value and ADC of the peritumoral edema area,SII and AGR for glioma grading was higher than that of their individual assessment(P<0.05).Conclusion The occurrence of HGG is related to the ADC of the tumor body and peritumoral edema area,SII,and AGR.The model constructed based on magnetic resonance DTI parameters,SII and AGR has high evaluation value for the grading of glioma.

Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

Objective:To systematically evaluate the effectiveness of Kunxian capsule related regimens for patients with lupus nephritis(LN)in order to provide a reference basis for treatment strategies for LN patients.Methods:The computer searched the rele-vant studies of Kunxian capsule in PubMed,Web of Science,Cochrane Library,CBM,CNKI,Wanfang and VIP databases on the treatment of LN,the limited time for the establishment of the database is April 6,2022,and used R 4.0.2 software and Revman 5.3 software for Meta-analysis.Results:Four RCTs with 1 cohort study including 310 patients were finally included.The results of the Me-ta-analysis showed that:In terms of 24 h urinary protein and SLEDAI score,Glucocorticoid+Cyclophosphamide+Kunxian capsule achieved the best result after treatment;in terms of Scr,IgE,and IgG,the levels of each index were significantly lower in Glucocorti-coid+Cyclophosphamide+Kunxian capsules than in Glucocorticoid+Cyclophosphamide(P<0.05).Conclusion:The 5 regimens may work best as Glucocorticoids+Cyclophosphamide+Kunxian capsules in terms of clinical efficacy in treating LN patients.Because of the quality and quantity limitations of the included studies,more high-quality studies are needed for validation.