Objective To evaluate the clinical efficacy of valve-in-valve transcatheter mitral valve replacement for the management of degenerated bioprosthetic mitral valves. Methods This study retrospectively analyzed the clinical data of patients who underwent transcatheter mitral valve replacement due to degenerated bioprosthetic mitral valves at the First Affiliated Hospital of Zhengzhou University from 2020 to 2023. The analysis included baseline characteristics, surgical details, perioperative complications, and hemodynamic changes during the early postoperative period and subsequent follow-up. Results A total of 31 patients were included in the study, comprising 7 males and 24 females, with an average age of (66.57±9.32) years. The average duration since the initial surgical placement of the bioprosthetic valves was (9.92±3.71) years. The procedures included 7 patients utilizing the transfemoral venous-atrial septal approach and 24 patients employing the transapical approach. All patients exhibited significant improvement in cardiac function postoperatively, with a reduction in the number of patients classified as New York Heart Association (NYHA) grade Ⅲ or Ⅳ and those with moderate to severe tricuspid valve regurgitation. Echocardiographic assessments revealed a decrease in peak flow velocity across the mitral valve and a reduction in the average transvalvular pressure gradient, while left ventricular ejection fraction remained unchanged. One patient experienced a recurrent stroke and died on the fifth postoperative day; however, the remaining patients were discharged uneventfully, without complications such as cardiac death, left ventricular outflow tract obstruction, or pacemaker implantation. During a median follow-up period of 12 months, no adverse events were reported, and hemodynamic stability was maintained. Conclusion Valve-in-valve transcatheter mitral valve replacement is a safe and effective option for patients with degenerated bioprosthetic mitral valves, demonstrating favorable hemodynamic outcomes and satisfactory short-term clinical results.

Objective:To describe a systematic approach on identification of poisonous mushroom by investigating two cases of Omphalotus guepiniformis poisoning in Jianyang district, Nanping, Fujian province. Methods:Two incidents of food poisoning on 10 migrant workers were investigated. The remaining suspected mushroom samples were collected and the same fresh mushroom specimens were also collected in the following field investigations from the same dead tree and fallen trunk. These mushroom specimens were identified based on morphological and phylogenetic analyses.Results:On November 24 and 26, 2018, 8 and 2 migrant workers from Jianyang District, Nanping ate wild mushrooms and developed acute nausea, vomiting, abdominal pain and other symptoms within 10 to 90 min after consumption. They were diagnosed as mushroom poisoning, with gastroenteritis as the main manifestation. Further analysis showed that the more poisonous mushroom were consumed, the shorter latency and longer duration of nausea and vomiting were resulted. After admission, gastric lavage, catharsis, acid preparation, gastric protection, fluid replenishment and other symptomatic support treatments were given in time, all patients were discharged in 1-3 d. Based on morphological and phylogenetic analyses, the samples were identified as O. guepiniformis. Conclusions:The two incidents were caused by accidental consumption of O. guepiniformis. Awareness education about poisonous mushroom should be provided to migrant workers to prevent more such poisoning incidents in the future.

Objective To compare the clinical efficacies of vasiculation moxibustion with pastes prepared in different ways and at different acupoint groups in treating allergic rhinitis due to deficient cold of lung qi. Method Eighty subjects were randomized into 4 groups, 20 in each group. Raw Bai Jie Zi (Semen Brassicae) was used in the vesiculation paste for group 1 and 2;stir-baked Bai Jie Zi (Semen Brassicae) was used for group 3 and 4. In group 1 and group 3, bilateral Feishu (BL 13), Fengmen (BL12), and Gaohuang (BL 43) were selected; in group 2 and group 4, bilateral Dazhu (BL11), Geshu (BL17), and Shenshu (BL23) were selected. The symptom and sign scores were compared before and after intervention. Result There were significant differences in comparing the symptoms and signs among the four groups (P＜0.05), and paired comparisons showed that the therapeutic efficacies of group 1 and group 3 were significantly higher than that of group 2 and group 4 (P＜0.05), while the differences in the therapeutic efficacy between group 1 and group 3, group 2 and group 4 were statistically insignificant (P>0.05). Conclusion Vesiculation moxibustion at the point group of Fengmen (BL12), Feishu (BL13), and Gaohuang (BL43) can markedly improve the symptoms and signs of allergic rhinitis due to deficient cold of lung qi;raw and stir-baked Bai Jie Zi (Semen Brassicae) can work equally in vesiculation paste for allergic rhinitis.

ObjectiveThe purpose of this study is to describe the clinicopathologic characteristics and the survival of pulmonary carcinosarcoma.Methods Clinical data of 26 patients with pulmonary carcinosarcoma who underwent surgical treatment was analyzed retrospectively using Statistical Package for the Social Sciences ( Release 17.0,SPSS,Inc).Survival analysis was estimated using the Kaplan-Meier method and compared using the log-rank test.ResultsThe overall 5-year survival rate of the patients was 31.7％.The 5-year survival rate of patients with stage Ⅰ,stage Ⅱ and stage Ⅲ/Ⅳ disease was 69.7％,38.6％ and 9.8％ respectively ( P =0.03 ) Conclusionp-TNM was correlated with survival.Early diagnosis and radical operation is important to the survival of the patients with pulmonary carcinosarcoma.

Objective To investigate the surgical treatment and indications for primary lesion in patients with stage Ⅳ rectal cancer.nethods Clinical data of 118 patients with stage Ⅳ rectal cancer undergoing surgical treatment from January 1988 to December 2005 in Cancer Hospital of Chinese Academy of Medical Sciences were analyzed retrospectively using Statistical Package for the Social Sciences(Release 13.0,SPSS,Inc).Survival was estimated using the Kaplan-Meier method and compared using the log-rank test.Cox regression was used in multivariate analysis.Results One hundred and five of 118 patients received rectal primary lesion resection,including 16 cases with simultaneously metastatic tumor resection.13 of 118 patients received ostomy.The overall 5-year survival rate of the primary lesion resection group was 8.57%,the 5-year survival rate of the metastatic tumor resection group was 31.2%.The median survival in the primary lesion resection group and the ostomy group was 15 months and 13 months respectively(X2=0.736.P=0.778).Multivariate analysis showed that degree of differentiation of primary tumor,maximal diameter of liver metastasis and chemotherapy were the most important prognostic factor of the primary tumor resection group.Conclusion Simultaneous resection of primary and metastatic tumor can prolong suivival time of patients with resectable stage Ⅳ rectal cancer.