Objective:To investigate the risk factors and prognosis of postoperative atrial fibrillation(POAF) and delayed-onset POAF(dPOAF).Methods:In a retrospective cohort study involving consecutive patients who underwent cardiac surgery across provincial cardiovascular consortium consisted of 57 hospitals in Jiangsu Province from January 2015 to December 2022, the incidence and implications of dPOAF were examined. dPOAF was defined as being diagnosed within 30 days of discharge.Results:Among 2 788 patients with postoperative new-onset POAF, 154(5.5%)cases had dPOAF, median onset time 21(15, 26)days following surgery. Compared to in-patient diagnosed POAF, dPOAF was associated with increased rates of hypertension(28.6% vs. 9.0%, P<0.001), diabetes(10.4% vs. 3.2%, P<0.001), heart failure(39.6% vs. 19.3%, P<0.001), peripheral vascular disease(13.6% vs. 2.2%, P<0.001), and higher CHA2DS2-VASc score(≥2)(59.8% vs. 43.2%, P<0.001). Female patients were less likely to develop dPOAF( OR=0.44, 95% CI: 0.30-0.63, P<0.001). During follow-up period, there was no significant difference in major adverse cardiovascular events(MACEs)( HR=1.33, 95% CI: 0.82-2.17), overall mortality( HR=0.58, 95% CI: 0.07-4.67), or thromboembolism events( HR=0.57, 95% CI: 0.26-1.25). Conclusion:This study underscores the risk factors and prognosis associated with dPOAF compared to in-hospital POAF. It highlights the imperative for vigilant monitoring and individualized management strategies tailored to patients at risk of dPOAF.

Objective:To investigate the risk factors and prognosis of postoperative atrial fibrillation(POAF) and delayed-onset POAF(dPOAF).Methods:In a retrospective cohort study involving consecutive patients who underwent cardiac surgery across provincial cardiovascular consortium consisted of 57 hospitals in Jiangsu Province from January 2015 to December 2022, the incidence and implications of dPOAF were examined. dPOAF was defined as being diagnosed within 30 days of discharge.Results:Among 2 788 patients with postoperative new-onset POAF, 154(5.5%)cases had dPOAF, median onset time 21(15, 26)days following surgery. Compared to in-patient diagnosed POAF, dPOAF was associated with increased rates of hypertension(28.6% vs. 9.0%, P<0.001), diabetes(10.4% vs. 3.2%, P<0.001), heart failure(39.6% vs. 19.3%, P<0.001), peripheral vascular disease(13.6% vs. 2.2%, P<0.001), and higher CHA2DS2-VASc score(≥2)(59.8% vs. 43.2%, P<0.001). Female patients were less likely to develop dPOAF( OR=0.44, 95% CI: 0.30-0.63, P<0.001). During follow-up period, there was no significant difference in major adverse cardiovascular events(MACEs)( HR=1.33, 95% CI: 0.82-2.17), overall mortality( HR=0.58, 95% CI: 0.07-4.67), or thromboembolism events( HR=0.57, 95% CI: 0.26-1.25). Conclusion:This study underscores the risk factors and prognosis associated with dPOAF compared to in-hospital POAF. It highlights the imperative for vigilant monitoring and individualized management strategies tailored to patients at risk of dPOAF.

Objective:To explore the effects of restricting swallowing combined with gargling strategy before examination on the quality of gastric preparation for magnetically controlled capsule gastroscopy.Methods:A total of 300 patients who underwent magnetically controlled capsule gastroscopy in Binzhou Medical University Hospital from March 2022 to August 2023 were selected and randomly divided into the control group of 150 cases and the intervention group of 150 cases at a ratio of 1∶1. Gastric preparation was conducted in the control group before the examination in accordance with the guidelines for magnetically controlled capsule gastroscopy. Restricted swallowing combined with gargling was added to the intervention group before the examination. The intragastric cleanliness, the degree of gastric mucosal visualization, the lesion detection rate, and the gastric examination time were used as evaluation indices.Results:Compared with the control group, the intervention group had significantly better scores in intragastric cleanliness (20.15±1.20 points VS 18.28±1.39 points, t=-21.884, P<0.001) and the degree of gastric mucosal visualization (20.30±6.67 points VS 18.80±1.04 points, t=-28.545, P<0.001), also showed higher lesion detection rate [94.7% (142/150) VS 77.3% (116/150), χ2=18.720, P<0.001], and lower gastric examination time (28.00±10.31 min VS 32.01±11.69 min, t=-2.328, P=0.023). Conclusion:Restricted swallowing combined with gargling strategy before examination can effectively improve the quality of gastric preparation for magnetically controlled capsule gastroscopy.

Objective:To systematically search and evaluate risk prediction models for ventilator-associated pneumonia (VAP) of ICU in order to provide references for developing higher-quality VAP risk prediction models.Methods:Relevant literature was retrieved from databases including China Biology Medicine disc, WanFang data, China National Knowledge Infrastructure, Embase, PubMed, CINAHL, Web of Science, and Cochrane Library. The search timeframe was from the establishment of the databases to September 30, 2023, limited to English and Chinese languages. Two researchers independently screened the literature and extracted data, and the PROBAST tool was used to evaluate the risk of bias and applicability of the included studies.Results:A total of 15 studies on VAP risk prediction models were included. The area under the receiver operating characteristic curve for the 15 models ranged from 0.722 to 0.982. The most frequently involved predictors were age, duration of mechanical ventilation, ICU length of stay, and comorbid chronic obstructive pulmonary disease. The overall adaptability was good, but the risk of bias was high. The main sources of bias included insufficient sample size, inappropriate data sources, lack of model performance evaluation, and inadequate attention to missing data.Conclusions:The risk of bias in studies on VAP risk prediction models is high, indicating that the field is still developing. Future research should focus on the effectiveness of different risk assessment methods to construct models with low bias, excellent predictive performance, and suitability for clinical practice in China.

Objective:pH low insertion peptide (pHLIP)-variant 7 (var7)-fluorescein isothiocyanate (FITC) was used to explore an accurate imaging tool that targeted burn wounds to better perform burn debridement.Methods:Twelve rat models of burn wound were established and pHLIP-var7-FITC with different concentrations (0.5, 1.5 and 2.0 mg/ml) were injected from the rat tail vein for in vivo fluorescence imaging. By determining the concentration of fluorescent conjugates to the burn wound, the scope of wound injury necrosis was judged by combining pathological sections, and its residue and toxicity in important organs such as heart, liver, kidneys, and brain were detected. The Kruskal-Wallis rank sum test, Bonferroni correction method and one-way analysis of variance were used for data analysis. Results:Within 24 h, the fluorescence photons per unit area of the burn wound in the group of 0.5 mg/ml, 1.5 mg/ml and 2.0 mg/ml were 1.49(1.31, 1.65), 2.46(1.88, 2.68), 2.77 (1.94, 3.10)×10 7 p·s -1·cm -2·Sr -1, with significant differences in the overall distribution of fluorescence photons ( H=73.55, P<0.001). The fluorescence intensity was stronger in the group with higher concentration, but with no significant difference in the number of fluorescence photons between the group of 1.5 mg/ml and 2.0 mg/ml ( P=0.263, Bonferroni correction method). At 14 time points (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 7.0, 8.0, 12, 24 h), there was no significant difference in the overall mean of fluorescence photons ( F=1.04, P=0.419), and the tissue with burn necrosis seen in tissue sections was highly consistent with the fluorescence imaging region. There was no obvious fluorescence residue in the heart, liver, kidney and brain sections. Conclusion:In superficial second-degree burn tissue, pHLIP-var7-FITC can accurately target and gather on the burn wound within 24 h, showing a clear boundary between burn tissue and normal tissue, which can assist clinical surgical debridement to determine the extent of injury.

Objective:To explore the effects of restricting swallowing combined with gargling strategy before examination on the quality of gastric preparation for magnetically controlled capsule gastroscopy.Methods:A total of 300 patients who underwent magnetically controlled capsule gastroscopy in Binzhou Medical University Hospital from March 2022 to August 2023 were selected and randomly divided into the control group of 150 cases and the intervention group of 150 cases at a ratio of 1∶1. Gastric preparation was conducted in the control group before the examination in accordance with the guidelines for magnetically controlled capsule gastroscopy. Restricted swallowing combined with gargling was added to the intervention group before the examination. The intragastric cleanliness, the degree of gastric mucosal visualization, the lesion detection rate, and the gastric examination time were used as evaluation indices.Results:Compared with the control group, the intervention group had significantly better scores in intragastric cleanliness (20.15±1.20 points VS 18.28±1.39 points, t=-21.884, P<0.001) and the degree of gastric mucosal visualization (20.30±6.67 points VS 18.80±1.04 points, t=-28.545, P<0.001), also showed higher lesion detection rate [94.7% (142/150) VS 77.3% (116/150), χ2=18.720, P<0.001], and lower gastric examination time (28.00±10.31 min VS 32.01±11.69 min, t=-2.328, P=0.023). Conclusion:Restricted swallowing combined with gargling strategy before examination can effectively improve the quality of gastric preparation for magnetically controlled capsule gastroscopy.

Objective::Calcific aortic valve disease (CAVD) affects millions of elderly people, and there is currently no effective way to stop or slow down its progression. Therefore, exploring the pathogenesis of CAVD is very important for prevention and treatment. Cartilage oligomeric matrix protein (COMP) have important role in cell phenotype change. This study is aimed to confirm whether COMP participate in CAVD and try to find the possible mechanisms.Methods::Human aortic valve tissues from Nanjing First Hospital (CAVD group, n=20; control group, n=11) were harvested. The expression level of COMP was tested by western blot and immunohistochemistry. Dual immunofluorescence staining was used for locating COMP. Bone morphogenetic protein-2 (BMP2) signalling were tested by western blot. The animal model was also used to detect COMP level by immunohistochemistry. Results::The results showed that the expression level of COMP was significantly increased in the calcific valve samples when compared with that of the control valve ( P<0.05); COMP was expressed near the calcific nodules and co-localized with α-smooth muscle actin (α-SMA). The protein levels of BMP2 and p-Smads 1/5/9 were markedly more highly expressed in the CAVD group than the control group ( P<0.05). Furthermore, immunofluorescence detection showed that COMP and BMP2 were co-located in calcific valves. Conclusions::The above results suggested that upregulation of COMP and BMP2 may be associated with aortic valve calcification and that COMP may become a potential therapeutic target in human CAVD.

Objective::Calcific aortic valve disease (CAVD) affects millions of elderly people, and there is currently no effective way to stop or slow down its progression. Therefore, exploring the pathogenesis of CAVD is very important for prevention and treatment. Cartilage oligomeric matrix protein (COMP) have important role in cell phenotype change. This study is aimed to confirm whether COMP participate in CAVD and try to find the possible mechanisms.Methods::Human aortic valve tissues from Nanjing First Hospital (CAVD group, n=20; control group, n=11) were harvested. The expression level of COMP was tested by western blot and immunohistochemistry. Dual immunofluorescence staining was used for locating COMP. Bone morphogenetic protein-2 (BMP2) signalling were tested by western blot. The animal model was also used to detect COMP level by immunohistochemistry. Results::The results showed that the expression level of COMP was significantly increased in the calcific valve samples when compared with that of the control valve ( P<0.05); COMP was expressed near the calcific nodules and co-localized with α-smooth muscle actin (α-SMA). The protein levels of BMP2 and p-Smads 1/5/9 were markedly more highly expressed in the CAVD group than the control group ( P<0.05). Furthermore, immunofluorescence detection showed that COMP and BMP2 were co-located in calcific valves. Conclusions::The above results suggested that upregulation of COMP and BMP2 may be associated with aortic valve calcification and that COMP may become a potential therapeutic target in human CAVD.

Objective To compare the effects of different doses of sufentanil on theα1?band of quantitative pharmaco?electroencephalography (QPEEG)during the induction of general anesthesia by tracheal intubation(TI). Methods Forty selected patients under general anesthesia were randomly divided into two groups,with 20 patients per group. Patients in group Ⅰ were administered 0.2μg/kg sufentanil,whereas patients in group Ⅱ were administered 0.3μg/kg sufentanil. Subsequently,the patients were administered 2 mg/kg propofol and 0.15 mg/kg cisatracurium. HR,MAP,and QPEEG were recorded before induction(T0),after induction(T1),and after insertion of the cannula(T2). Using the method of power spectrum analysis,theα1?band power percentage of QPEEG was calculated. Results In comparison with T0,the values of HR,MAP,andα1?band power percentage in most areas of the brain were both decreased at T1(P<0.05). Furthermore,in comparison with T1,the parameters were increased in group Ⅰ at T2(P<0.05),but no significant changes were observed in group Ⅱ (P>0.05). Conclusion The administration of 0.3μg/kg sufentanil during anesthesia induction can effectively depress the cardiovascular response to TI and stabilize theα1?band power per?centage. This suggests that theα1?band power percentage of QPEEG can be an effective means to monitor the depth of sedation.

Objective To investigate the effects of transcutaneous electrical acupoint stimulation (TEAS) on electroencephalography (EEG) in piglets anesthetized with sevoflurane.Methods Twelve piglets,aged three to seven days,weighing 1.5 to 3.5 kg,were randomly divided into 2 groups:TEAS (group T,n =6) and control (group C,n =6).Group T received continuous TEAS at points baihui and tianmen for 30 minutes.Anesthesia was induced with 8.0％ sevoflurane over 3 minutes and maintained with 3.5％ sevoflurane in both groups.The changes were observed on EEG.Results The heart rates (HR) at intubation and extubation were lower in group T than group C (P ＜ 0.05).Compared with group C,the EEG spike frequency was lower in group T during anesthesia induction and maintenance (P ＜ 0.05).Conclusion Sevoflurane can induce EEG spikes in piglets,which can be reduced by TEAS.