1.Herbal Textual Research on Stemonae Radix in Famous Classical Formulas
Gang XU ; Li AN ; Xiaomei WANG ; Erhuan WANG ; Yichen YANG ; Cunde MA ; Yang YANG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):241-251
This article systematically reviews and verifies the historical evolution of Stemonae Radix from the aspects of name, origin, harvesting and processing, quality and others by consulting ancient and modern literature, in order to provide reference for the development and utilization of famous classical formulas containing this medicinal herb. Stemonae Radix has a long history of application, and it derives its name from its distinctive growth pattern, featuring clusters of ten to several dozen underground tuberous roots. This morphology resembles that of certain plants in the genus Asparagus, leading to historical instances where tuberous roots from genus Asparagus were mistakenly used as Stemonae Radix. After the research, it can be concluded that Stemonae Radix was first recorded in Mingyi Bielu, and throughout history, Baidu has been recognized as its official name, though it also bears alternative names such as Baibing, Pofucao and Ye Tianmendong. The mainstream sources used throughout history have been the dried tuberous roots of Stemona sessilifolia, S. japonica or S. tuberosa from the family Stemonaceae. This aligns with the 2025 edition of Pharmacopoeia of the People's Republic of China(hereinafter referred to as Chinese Pharmacopoeia). Additionally, Asparagus filicinus and A. officinalis from the genus Asparagus are common sources of confusion with Stemonae Radix. The three primitive plants are mainly distributed in the Yangtze River basin and southern China, exhibiting a wide distribution. Historically, wild harvesting was predominant, but cultivation is now established. In ancient times, the harvesting time was mostly in the second, third, and eighth lunar months, when roots were harvested and dried. Nowadays, it is more common to pick and excavate in the spring and autumn seasons. After excavation, the roots are washed, fibrous roots removed, briefly blanched in boiling water or steamed until no white core remains, and then sun-dried or oven-dried. In ancient times, the processing of Stemonae Radix primarily involved roasting(stir-frying), wine roasting, or raw materials. Modern mainstream processing specifications include two types of raw and honey-roasted products. In terms of quality evaluation of the medicinal materials, ancient criteria of "preferring plump and moist roots" align with modern requirement favoring "thick, robust stems with firm texture". Evaluating quality with authenticity, since the Song dynasty, it has been highly praised to produce in Chuzhou and Hengyang as the best. It was an ancient method of fixing the production area to stabilize the medicinal origin, reflecting the ancient recognition of the therapeutic efficacy of plants belonging to the genus Stemona. The main functions of Stemonae Radix remain consistent throughout history, including relieving coughs, eliminating phlegm and parasites. Based on the research results, it is recommended that when developing famous classical formulas containing the medicinal material Stemonae Radix, the botanical source specified in the 2025 edition of Chinese Pharmacopoeia should be selected. The specific species can be determined according to the distribution of resources and the main production areas, and the origin and corresponding botanical source should be fixed. Processing methods should be chosen based on the prescription requirements. It is recommended to use raw products without specified requirements.
2.Herbal Textual Research on Stemonae Radix in Famous Classical Formulas
Gang XU ; Li AN ; Xiaomei WANG ; Erhuan WANG ; Yichen YANG ; Cunde MA ; Yang YANG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):241-251
This article systematically reviews and verifies the historical evolution of Stemonae Radix from the aspects of name, origin, harvesting and processing, quality and others by consulting ancient and modern literature, in order to provide reference for the development and utilization of famous classical formulas containing this medicinal herb. Stemonae Radix has a long history of application, and it derives its name from its distinctive growth pattern, featuring clusters of ten to several dozen underground tuberous roots. This morphology resembles that of certain plants in the genus Asparagus, leading to historical instances where tuberous roots from genus Asparagus were mistakenly used as Stemonae Radix. After the research, it can be concluded that Stemonae Radix was first recorded in Mingyi Bielu, and throughout history, Baidu has been recognized as its official name, though it also bears alternative names such as Baibing, Pofucao and Ye Tianmendong. The mainstream sources used throughout history have been the dried tuberous roots of Stemona sessilifolia, S. japonica or S. tuberosa from the family Stemonaceae. This aligns with the 2025 edition of Pharmacopoeia of the People's Republic of China(hereinafter referred to as Chinese Pharmacopoeia). Additionally, Asparagus filicinus and A. officinalis from the genus Asparagus are common sources of confusion with Stemonae Radix. The three primitive plants are mainly distributed in the Yangtze River basin and southern China, exhibiting a wide distribution. Historically, wild harvesting was predominant, but cultivation is now established. In ancient times, the harvesting time was mostly in the second, third, and eighth lunar months, when roots were harvested and dried. Nowadays, it is more common to pick and excavate in the spring and autumn seasons. After excavation, the roots are washed, fibrous roots removed, briefly blanched in boiling water or steamed until no white core remains, and then sun-dried or oven-dried. In ancient times, the processing of Stemonae Radix primarily involved roasting(stir-frying), wine roasting, or raw materials. Modern mainstream processing specifications include two types of raw and honey-roasted products. In terms of quality evaluation of the medicinal materials, ancient criteria of "preferring plump and moist roots" align with modern requirement favoring "thick, robust stems with firm texture". Evaluating quality with authenticity, since the Song dynasty, it has been highly praised to produce in Chuzhou and Hengyang as the best. It was an ancient method of fixing the production area to stabilize the medicinal origin, reflecting the ancient recognition of the therapeutic efficacy of plants belonging to the genus Stemona. The main functions of Stemonae Radix remain consistent throughout history, including relieving coughs, eliminating phlegm and parasites. Based on the research results, it is recommended that when developing famous classical formulas containing the medicinal material Stemonae Radix, the botanical source specified in the 2025 edition of Chinese Pharmacopoeia should be selected. The specific species can be determined according to the distribution of resources and the main production areas, and the origin and corresponding botanical source should be fixed. Processing methods should be chosen based on the prescription requirements. It is recommended to use raw products without specified requirements.
3.Changes in levels of serum leukocyte cell-derived chemotaxin 2 and complement C3 in patients with autoimmune hepatitis and their clinical significance
Qianying WANG ; Yichen XIE ; Dan XU ; Huihui MA
Immunological Journal 2025;41(4):258-263
Objective To investigate the expression of leukocyte cell-derived chemotaxin 2(LECT2)and complement C3 in the serum of patients with autoimmune hepatitis(AIH),and their correlation with liver function grading and prognosis.Methods A total of 109 AIH patients admitted to our hospital from January 2022 to February 2024 were included as the observation group.According to the disease activity upon admission,they were grouped into the active group(59 cases)and the remission group(50 cases).According to the Child-Pugh grading,they were assigned into the grade A group(47 cases),the grade B group(40 cases),and the grade C group(22 cases).According to the prognosis,they were assigned into a poor prognosis group(35 cases)and a good prognosis group(74 cases),with 110 healthy volunteers who underwent physical checkup in our hospital as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to measure serum LECT2 level.Immunoturbidimetry was applied to detect serum complement C3 level.The correlation between LECT2,complement C3 and clinical indexes was analyzed by Pearson correlation analysis.Spearman correlation analysis was applied to analyze the relationship between serum LECT2,complement C3,and Child-Pugh grading.Receiver operating characteristic(ROC)curves were established to evaluate the predictive value of LECT2 and complement C3 levels for poor prognosis in AIH patients.Results The serum level of LECT2 in the observation group was higher than that in the control group,and the level of complement C3 was lower than that in the control group(P<0.05).The expression level of ELECT2 in the grade C group was prominently higher than that in the grade B group and grade A group,while the expression level of complement C3 was prominently lower than that in the grade B group and grade A group(P<0.05).The level of serum LECT2 in poor prognosis group was higher than that in good prognosis group,and the level of serum complement C3 was lower than that in good prognosis group(P<0.05).Pearson correlation analysis showed that LECT2 was positively correlated with IgG,IL-6,TNF-α and Th17/Treg,and negatively correlated with TGF-β,while complement C3 was negatively correlated(all P<0.05);Spearman correlation analysis showed that LECT2 level was positively correlated with Child-Pugh grading,while complement C3 level was negatively correlated with Child-Pugh grading(rs=0.803,-0.875,both P<0.05).ROC curve reveled that the AUC of serum LECT2 and complement C3 levels in predicting poor prognosis of AIH patients was 0.802 and 0.805,respectively,the AUC of their combined detection was 0.905,which was higher than that of single indicator detection(P<0.05).Conclusion Serum LECT2 level is elevated and complement C3 level is reduced in AIH patients,and they are correlated with liver function grading and disease severity.The combined detection of the two can serve as serological indicators for evaluating liver function and predicting prognosis.
4.Herbal Textual Research on Dioscoreae Hypoglaucae Rhizoma, Dioscoreae Spongiosae Rhizoma, Smilacis Chinae Rhizoma and Smilacis Glabrae Rhizoma in Famous Classical Formulas
Li LU ; Yichen YANG ; Erhuan WANG ; Hui CHANG ; Li AN ; Shibao WANG ; Cunde MA ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):218-247
This article systematically reviews and verifies the medicinal materials of Dioscoreae Hypoglaucae Rhizoma(DHR), Dioscoreae Spongiosae Rhizoma(DSR), Smilacis Chinae Rhizoma(SCR) and Smilacis Glabrae Rhizoma(SGR) from the aspects of name, origin, producing area, quality, harvesting, processing and efficacy by consulting historical literature, in order to provide reference for the development and utilization of famous classical formulas containing the four medicinal materials. DHR, DSR, SCR and SGR have a long history of application as medicinal materials. However, due to their similar growth environment and medicinal properties, as well as their functions of promoting dampness, dispelling wind and removing numbness, there have been instances of homonymous foreign objects and homonymous synonyms throughout history, resulting in confusion of the origin. Therefore, it is necessary to conduct comparative analysis and systematic research for clarifying the historical development and changes of the four, in order to provide a basis for safe and effective medication. According to research, Bixie was first recorded in Shennong Bencaojing and has been historically known as Baizhi, Chijie, Zhumu, and other aliases. From ancient times to the mid-20th century, there has always been a situation where the rhizomes of Dioscorea plants and Smilax plants, and even the rhizomes of Heterosmilax plants, were mixed together to be used as medicinal herbs for Bixie. However, since the Tang dynasty, it has been clearly advocated that the rhizomes of Dioscorea plants have excellent quality and have been the mainstream throughout history. The 2020 edition of Chinese Pharmacopoeia categorized it into two types of medicinal herbs(DHR and DSR). Among them, the origin of DHR is the dry rhizomes of Dioscorea hypoglauca, and the origins of DSR are the dry rhizomes of D. spongiosa and D. futschauensis. In ancient times, due to different types, the corresponding production areas of DHR and DSR were also different. Nowadays, They are mainly produced in the southern region of the Yangtze River. Since the Tang dynasty, the quality of Bixie has been characterized by its white color and soft nature. In modern times, it has been summarized that those with white color, large and thin pieces, powdery texture, tough and elastic texture, and neat and unbreakable are the best. The harvesting times of DHR and DSR are in spring or autumn, with the best quality harvested in autumn. The mainstream processing methods of them are slicing and then using the raw products or wine-processed products. SCR was first recorded in Mingyi Bielu and has been known as Jinganggen, Tielingjiao, Tieshuazi, and other aliases in history. The mainstream source is the dry rhizomes of Smilax china in the past dynasties, with the best quality being those that are tough and rich in powder. The harvesting time is from the late autumn to the following spring, and the main processing method throughout history has been slicing for raw use. SGR was first recorded under the item of Yuyuliang in Variorum of Shennong's Classic of Materia Medica. It was listed as an independent medicinal material from Bencao Gangmu. In history, there were such aliases as Cao Yuyuliang, Lengfantuan, Xianyiliang, Tubixie, etc. The main source of the past dynasties was dry rhizomes of S. glabra. In history, there have also been instances of multiple plants belonging to the same genus, and even cases of mixing the rhizomes of plants in the genus Heterosmilax. It is mainly produced in Guangdong, Hunan, Hubei, Zhejiang, Sichuan, Anhui and other regions, its quality has been summarized as large in size, powdery in texture, with few veins, and light brown in cross-section since modern times. The harvesting time is in spring or autumn, and the main processing method throughout history has been slicing for raw use. DHR, DSR, SCR and SGR all have the effects of promoting dampness, dispelling wind, relieving rheumatism and detoxifying. However, their detoxification abilities are ranked as follows:SGR>SCR>Bixie(DHR and DSR). Especially for the treatment of limb spasms, arthralgia and myalgia, scrofula, and scabies caused by syphilis and mercury poisoning, SGR has a unique effect. Based on the research results, DHR is recommended to develop the famous classical formulas containing Bixie as the first choice for medicinal herbs. It should be harvested in autumn, sliced thinly while fresh, and processed according to the requirements of the famous classical formulas, without any requirements for raw use. Selecting the rhizomes of S. china, harvested in late autumn, and thinly sliced while fresh. If there are no special processing requirements in the formulas, use it raw. Selecting the rhizomes of S. glabra, it is harvested in autumn and thinly sliced while fresh. If there are no special processing requirements in the formulas, raw products can be used.
5.Establishment of reference intervals of serum immunoglobulin and complement by Hoffmann and refineR algorithms and evaluation of their feasibility
Danni MU ; Chaochao MA ; Yichen MA ; Yumeng GAO ; Xinqi CHENG
Chinese Journal of Laboratory Medicine 2025;48(2):241-248
Objective:To calculate the reference intervals of immune globulinG (IgG), IgA, IgM, complement 3 (C3) and C4 for adults using Hoffmann and refineR methods, and to compare them with the reference interval reported by WS/T 645 of the People′s Republic of China, exploring the clinical application value of the indirect methods.Methods:Cross-sectional study. The physical examination data were collected at Peking Union Medical College Hospital from 2013 to 2023. Box-Cox was used to normalize the data distribution, and the Tukey method was used to remove outliers. Mann-Whitney test and Kruskal-Wallis test were used to compare the differences between gender and age, respectively. Quantile regression analysis was used to examine the effects of age and gender. Hoffmann and refineR methods were employed to calculate RIs of the five parameters.Results:There were 82 251, 82 483, 49 236, 20 027 and 19 942 test results for IgG, IgA, IgM, C3 and C4, respectively. Gender was significantly correlated with IgG, IgA, IgM, C3, and C4 levels, and age was significantly correlated with IgA, IgM, C3, and C4 levels. Reference intervals were calculated using both Hoffmann and refineR methods, yielding comparable results: IgG (7.58-16.85 g/L; 7.54-16.88 g/L), IgA (0.97-4.26 g/L; 0.97-4.34 g/L), C3 (0.73-1.43 g/L; 0.73-1.44 g/L), and C4 (0.11-0.32 g/L). Gender-specific intervals were established for IgM: women (0.44-2.57 g/L; 0.44-2.62 g/L) and men (0.33-1.91 g/L; 0.31-1.87 g/L). Gender and/or age-specific reference intervals were further calculated according to the bias ratio values. The reference intervals calculated by Hoffmann and refineR are in good agreement. The upper and lower limits of reference intervals for IgA and C3, the lower limits of IgG, the upper limits of IgM and C3 calculated by the indirect methods have good comparability with those reported by standards.Conclusions:The total and gender/age-specific reference intervals of IgG, IgA, IgM, C3 and C4 in our hospital population were established by Hoffmann and refineR methods, and the reference intervals established by the two indirect methods were comparable. The reference intervals calculated using these indirect methods were also comparable with those established using the direct method reported in current health standards.
6.Changes in levels of serum leukocyte cell-derived chemotaxin 2 and complement C3 in patients with autoimmune hepatitis and their clinical significance
Qianying WANG ; Yichen XIE ; Dan XU ; Huihui MA
Immunological Journal 2025;41(4):258-263
Objective To investigate the expression of leukocyte cell-derived chemotaxin 2(LECT2)and complement C3 in the serum of patients with autoimmune hepatitis(AIH),and their correlation with liver function grading and prognosis.Methods A total of 109 AIH patients admitted to our hospital from January 2022 to February 2024 were included as the observation group.According to the disease activity upon admission,they were grouped into the active group(59 cases)and the remission group(50 cases).According to the Child-Pugh grading,they were assigned into the grade A group(47 cases),the grade B group(40 cases),and the grade C group(22 cases).According to the prognosis,they were assigned into a poor prognosis group(35 cases)and a good prognosis group(74 cases),with 110 healthy volunteers who underwent physical checkup in our hospital as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to measure serum LECT2 level.Immunoturbidimetry was applied to detect serum complement C3 level.The correlation between LECT2,complement C3 and clinical indexes was analyzed by Pearson correlation analysis.Spearman correlation analysis was applied to analyze the relationship between serum LECT2,complement C3,and Child-Pugh grading.Receiver operating characteristic(ROC)curves were established to evaluate the predictive value of LECT2 and complement C3 levels for poor prognosis in AIH patients.Results The serum level of LECT2 in the observation group was higher than that in the control group,and the level of complement C3 was lower than that in the control group(P<0.05).The expression level of ELECT2 in the grade C group was prominently higher than that in the grade B group and grade A group,while the expression level of complement C3 was prominently lower than that in the grade B group and grade A group(P<0.05).The level of serum LECT2 in poor prognosis group was higher than that in good prognosis group,and the level of serum complement C3 was lower than that in good prognosis group(P<0.05).Pearson correlation analysis showed that LECT2 was positively correlated with IgG,IL-6,TNF-α and Th17/Treg,and negatively correlated with TGF-β,while complement C3 was negatively correlated(all P<0.05);Spearman correlation analysis showed that LECT2 level was positively correlated with Child-Pugh grading,while complement C3 level was negatively correlated with Child-Pugh grading(rs=0.803,-0.875,both P<0.05).ROC curve reveled that the AUC of serum LECT2 and complement C3 levels in predicting poor prognosis of AIH patients was 0.802 and 0.805,respectively,the AUC of their combined detection was 0.905,which was higher than that of single indicator detection(P<0.05).Conclusion Serum LECT2 level is elevated and complement C3 level is reduced in AIH patients,and they are correlated with liver function grading and disease severity.The combined detection of the two can serve as serological indicators for evaluating liver function and predicting prognosis.
7.Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in anterior mediastinal masses
Junmin ZHU ; Junjie WANG ; Jianming YUE ; Yixin SUN ; Yichen LIU ; Lei WANG ; Lin LIN ; Jie LI ; Jinlan ZHAO ; Xuehua TU ; Ningying DING ; Jianrong HU ; Chunmei HE ; Leilei TIAN ; Hongtao TANG ; Jiasheng ZHAO ; Cheng CHEN ; Yongxiang SONG ; Yunwei TIAN ; Yong XIAO ; Kaidi LI ; Lin MA ; Yun WANG ; Longqi CHEN ; Dong TIAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(11):1603-1609
Objective To assess the clinical value of a novel surgical technique—Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in the resection of anterior mediastinal masses. Methods Patients who underwent tubeless subxiphoid uniportal video-assisted thoracoscopic surgery via balance-shaped sternal elevation device in anterior mediastinal masses process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to April 2025 were included, and their clinical data were analyzed. Results A total of 4 patients were included, with 2 males and 2 females, aged 58-75 years. The diameter of the tumor was 2.5-3.0 cm. The operation time was 60.0-150.0 min, intraoperative blood loss was 5-10 mL, pain score on the 3rd day after surgery was 0 points, and postoperative hospital stay was 2-3 days. All patients achieved complete resection of the masses and thymus without perioperative complications. Conclusion The tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device technique optimizes surgical visualization and instrument maneuverability while avoiding complications related to conventional anesthesia and tubing, thereby markedly enhancing the minimally invasive profile of anterior mediastinal masses resections. In addition to maintaining procedural safety, this approach effectively reduces postoperative pain and accelerates patient recovery, highlighting its potential for widespread clinical adoption.
8.Establishment of reference intervals of serum immunoglobulin and complement by Hoffmann and refineR algorithms and evaluation of their feasibility
Danni MU ; Chaochao MA ; Yichen MA ; Yumeng GAO ; Xinqi CHENG
Chinese Journal of Laboratory Medicine 2025;48(2):241-248
Objective:To calculate the reference intervals of immune globulinG (IgG), IgA, IgM, complement 3 (C3) and C4 for adults using Hoffmann and refineR methods, and to compare them with the reference interval reported by WS/T 645 of the People′s Republic of China, exploring the clinical application value of the indirect methods.Methods:Cross-sectional study. The physical examination data were collected at Peking Union Medical College Hospital from 2013 to 2023. Box-Cox was used to normalize the data distribution, and the Tukey method was used to remove outliers. Mann-Whitney test and Kruskal-Wallis test were used to compare the differences between gender and age, respectively. Quantile regression analysis was used to examine the effects of age and gender. Hoffmann and refineR methods were employed to calculate RIs of the five parameters.Results:There were 82 251, 82 483, 49 236, 20 027 and 19 942 test results for IgG, IgA, IgM, C3 and C4, respectively. Gender was significantly correlated with IgG, IgA, IgM, C3, and C4 levels, and age was significantly correlated with IgA, IgM, C3, and C4 levels. Reference intervals were calculated using both Hoffmann and refineR methods, yielding comparable results: IgG (7.58-16.85 g/L; 7.54-16.88 g/L), IgA (0.97-4.26 g/L; 0.97-4.34 g/L), C3 (0.73-1.43 g/L; 0.73-1.44 g/L), and C4 (0.11-0.32 g/L). Gender-specific intervals were established for IgM: women (0.44-2.57 g/L; 0.44-2.62 g/L) and men (0.33-1.91 g/L; 0.31-1.87 g/L). Gender and/or age-specific reference intervals were further calculated according to the bias ratio values. The reference intervals calculated by Hoffmann and refineR are in good agreement. The upper and lower limits of reference intervals for IgA and C3, the lower limits of IgG, the upper limits of IgM and C3 calculated by the indirect methods have good comparability with those reported by standards.Conclusions:The total and gender/age-specific reference intervals of IgG, IgA, IgM, C3 and C4 in our hospital population were established by Hoffmann and refineR methods, and the reference intervals established by the two indirect methods were comparable. The reference intervals calculated using these indirect methods were also comparable with those established using the direct method reported in current health standards.
9.Application effect of preoperative muscle strength training combined with postoperative BIODEX balance training in treatment of patients with total hip arthroplasty
Zhanlei ZHANG ; Guo CHEN ; Fujuan YONG ; Shangshang ZHANG ; Mengna BI ; Yichen WANG ; Zou MA
Journal of Clinical Medicine in Practice 2024;28(2):84-87
Objective To observe the effect of preoperative muscle strength training combined with postoperative BIODEX balance function training in improving the motor function of patients with total hip arthroplasty (THA). Methods A total of 110 patients with THA from January 2021 to December 2022 were selected as research objects, and were divided into observation group and control group by the simple randomization method, with 55 cases in each group. The control group received conventional postoperative rehabilitation training, while the observation group was treated with muscle strength training and BIODEX balance function training. Imaging indicators (acetabular abduction angle, anterior inclination angle, proportion of acetabular cup in safe zone, and centering rate of femoral prosthesis) at 5 days after surgery were compared between two groups; the joint motor function (Harris score for hip joint), balance ability [Berg Balance Scale (BBS)] and daily activity ability [Activities of Daily Life Scale (ADL)] before treatment and one month after treatment were compared between the two groups. Results There were no significant differences in acetabular abduction angle, anterior inclination angle, proportion of acetabular cup in safe zone and centering rate of femoral prosthesis between the two groups at 5 days after surgery (
10.Transseptal Puncture Guided by Transthoracic Echocardiography in Percutaneous Transcatheter Closure of Patent Foramen Ovale
Zhen MA ; Xiaoming LI ; Hang YANG ; Yichen GONG ; Yuanhao FU ; Xinpeng JIANG ; Zhe ZHANG ; Yu FU
Chinese Journal of Minimally Invasive Surgery 2024;24(8):540-544
Objective To assess the safety of transeptal puncture(TSP)guided by transthoracic echocardiography(TEE)in percutaneous transcatheter closure of patent foramen ovale(PFO).Methods From March 2022 to December 2022,our department performed TSP guided by TEE in 45 patients with PFO who were unable to pass through the PFO with transcatheter standard technique.After guiding the delivery of the sheath,the foramen ovale was occluded.Results PFO closure with TSP technique guided by transthoracic echocardiography was successfully finished in all the 45 patients,with an operative time of(15.0±3.7)min.No complications such as arrhythmia or cardiac perforation happened immediately and at 12 h after surgery.All the patients recovered and were discharged on the next day after surgery.All the 45 patients were followed up by outpatient echocardiography and dynamic electrocardiogram at 3 months after surgery,and no complications such as intracardiac shunt,pericardial effusion,atrial fibrillation,aortic regurgitation,or arrhythmia were observed.Conclusion TSP guided by TEE is safe and feasible,and it can be used as a supplementary method for complex PFO.


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