Objectives:To evaluate the incidence of neurological complications following left ventricular assist device(LVAD)implantation and to investigate related risk factors.Methods:A retrospective analysis was conducted on 151 patients who underwent LVAD implantation at Fuwai Hospital between June 2017 and September 2024.Clinical characteristics and postoperative survival outcomes were compared between patients with and without neurological complications.Results:Neurological complications occurred in 21 patients(13.9%)postoperatively,15 cases were ischemic strokes,5 cases were symptomatic intracranial hemorrhages or subarachnoid hemorrhages,and 1 case was transient ischemic attack(TIA).The total incidence of neurological complications was 0.08 events per person-year(EPPY),ischemic stroke was 0.06 EPPY and hemorrhagic stroke was 0.02 EPPY.Compared with patients without neurological complications,patients with neurological complications had a higher proportion of preoperative aortic regurgitation and tricuspid regurgitation,lower triglyceride levels,a lower rate of concurrent left atrial appendage resection and a higher rate of concurrent aortic valve replacement surgery.Multivariate cox regression analysis revealed that higher preoperative triglyceride levels(HR=0.21,95%CI:0.08-0.56,P=0.002)were associated with neurological complications.The median follow-up time was 508.0(186.5,931.5)days,12 out of 15 cases of ischemic stroke experienced no long-term sequelae,while 3 patients had varying degrees of residual deficits.All 5 patients with hemorrhagic stroke died,with 2 deaths directly attributed to hemorrhage.Kaplan-Meier survival curve analysis indicated that patients with neurological complications had a significantly lower survival rate(log-rank P=0.005).Conclusions:Neurological complications after LVAD implantation are predominantly ischemic strokes.Although less frequent,hemorrhagic strokes are associated with worse outcomes.Higher preoperative triglyceride levels is associated with neurological complications.

Objectives:To evaluate the incidence of neurological complications following left ventricular assist device(LVAD)implantation and to investigate related risk factors.Methods:A retrospective analysis was conducted on 151 patients who underwent LVAD implantation at Fuwai Hospital between June 2017 and September 2024.Clinical characteristics and postoperative survival outcomes were compared between patients with and without neurological complications.Results:Neurological complications occurred in 21 patients(13.9%)postoperatively,15 cases were ischemic strokes,5 cases were symptomatic intracranial hemorrhages or subarachnoid hemorrhages,and 1 case was transient ischemic attack(TIA).The total incidence of neurological complications was 0.08 events per person-year(EPPY),ischemic stroke was 0.06 EPPY and hemorrhagic stroke was 0.02 EPPY.Compared with patients without neurological complications,patients with neurological complications had a higher proportion of preoperative aortic regurgitation and tricuspid regurgitation,lower triglyceride levels,a lower rate of concurrent left atrial appendage resection and a higher rate of concurrent aortic valve replacement surgery.Multivariate cox regression analysis revealed that higher preoperative triglyceride levels(HR=0.21,95%CI:0.08-0.56,P=0.002)were associated with neurological complications.The median follow-up time was 508.0(186.5,931.5)days,12 out of 15 cases of ischemic stroke experienced no long-term sequelae,while 3 patients had varying degrees of residual deficits.All 5 patients with hemorrhagic stroke died,with 2 deaths directly attributed to hemorrhage.Kaplan-Meier survival curve analysis indicated that patients with neurological complications had a significantly lower survival rate(log-rank P=0.005).Conclusions:Neurological complications after LVAD implantation are predominantly ischemic strokes.Although less frequent,hemorrhagic strokes are associated with worse outcomes.Higher preoperative triglyceride levels is associated with neurological complications.

Objective To investigate the anatomical features of aortic arch lesions in the Chinese population in order to provide anatomical reference for the development of domestic arch en-dografts.Methods Clinical data of 83 patients with aortic arch lesions were collected from a first prospective multi-center study of WeFlow-Arch stent system,which was carried out between June 1,2021 and January 1,2024 in 17 centers across China.According to their pathologic types,they were divided into an aneurysm group(67 patients)and an ulcer group(16 patients).Preoperative computed tomography angiography images were analyzed using three-dimensional reconstruction techniques to quantify the anatomical characteristics of the aorta.The resulting data were subse-quently compared to assess the anatomical suitability of the Zenith and Relay stents for use in Chinese patients.Results The anatomical feasibility of Zenith stent and Relay stent was 39.8％and 63.9％,respectively in this investigation.No significant differences were observed between the two groups in terms of anatomical features,including arch type,aortic diameter and length,di-mensions,orientation,and angulation of arch branch vessels,as well as diameters of the left and right femoral arteries,and proximal and total aortic tortuosity indices(P＞0.05).The tortuosity index of the ascending aorta was lower in the aneurysm group than the ulcer group(1.17±0.06 vs 1.22±0.08,P=0.010),but the index within the coverage region of the stent was higher in the aneurysm group than the ulcer group(2.97±0.46 vs 2.66±0.36,P=0.020).Conclusion There are significant variations in the tortuosity indexes of the ascending aorta and the coverage region of the stent among the patients with different aortic arch lesions,and thus,attention should be paid to the variations due to their prognostic implications.The anatomical suitability of foreign de-vices is not good enough for Chinese patients,so it is of great significance for developing en-dografts specifically designed for the patients of our own country.

Objective To investigate the anatomical features of aortic arch lesions in the Chinese population in order to provide anatomical reference for the development of domestic arch en-dografts.Methods Clinical data of 83 patients with aortic arch lesions were collected from a first prospective multi-center study of WeFlow-Arch stent system,which was carried out between June 1,2021 and January 1,2024 in 17 centers across China.According to their pathologic types,they were divided into an aneurysm group(67 patients)and an ulcer group(16 patients).Preoperative computed tomography angiography images were analyzed using three-dimensional reconstruction techniques to quantify the anatomical characteristics of the aorta.The resulting data were subse-quently compared to assess the anatomical suitability of the Zenith and Relay stents for use in Chinese patients.Results The anatomical feasibility of Zenith stent and Relay stent was 39.8％and 63.9％,respectively in this investigation.No significant differences were observed between the two groups in terms of anatomical features,including arch type,aortic diameter and length,di-mensions,orientation,and angulation of arch branch vessels,as well as diameters of the left and right femoral arteries,and proximal and total aortic tortuosity indices(P＞0.05).The tortuosity index of the ascending aorta was lower in the aneurysm group than the ulcer group(1.17±0.06 vs 1.22±0.08,P=0.010),but the index within the coverage region of the stent was higher in the aneurysm group than the ulcer group(2.97±0.46 vs 2.66±0.36,P=0.020).Conclusion There are significant variations in the tortuosity indexes of the ascending aorta and the coverage region of the stent among the patients with different aortic arch lesions,and thus,attention should be paid to the variations due to their prognostic implications.The anatomical suitability of foreign de-vices is not good enough for Chinese patients,so it is of great significance for developing en-dografts specifically designed for the patients of our own country.

Objective:To investigate the outcome of asthma in young children after 3 years and the factors associated with the outcome.Methods:A total of 494 children aged 2 to 5 years with asthma diagnosed in 5 hospitals in Beijing from 2016 to 2017 were followed up by telephone using questionnaire survey.Information on the asthma attack, the disease control level, and the comorbidities of allergic diseases in the past 3 years was collected and analyzed.Results:Questionnaires were conducted in 387 children, including 261 males(67.4%)and 126 females(32.6%). Two hundred and forty-six patients(63.6%)had no any asthma symptom(remission) within 3 years, while 141 patients(36.4%)were found with asthma symptom(without remission). The main symptoms were as follows: wheezing in 116 cases(82.3%), recurrent cough in 59 cases(41.8%), shortness of breath in 45 cases(31.9%), chest tightness or waking up at night due to wheezing in 22 cases(15.6%). The causes of asthma attack were respiratory tract infection in 80 cases(56.7%), allergen exposure in 46 cases(32.6%), climate change or cold air stimulation in 59 cases(41.8%), strenuous exercise in 36 cases(25.5%), and irritating odor in 3 cases(2.1%). One-way anova analysis showed that significant difference( P<0.05)was respectively observed in age at follow-up, postnatal tobacco smoke exposure history, repeated respiratory tract infection before asthma onset, personal allergy history, snoring, allergic rhinitis, allergic rhinitis within 1 year, allergic conjunctivitis within 1 year between the remission group and without remission group.Multivariate unconditional logistic regression analysis showed that tobacco exposure after birth, allergic rhinitis and allergic conjunctivitis within 1 year were independent risk factors for the continuation of asthma symptoms to school age( P<0.05). Conclusion:Till the school age, more than 1/3 children still had asthma symptom and the risk factors for the unalleviated symptom were postnatal tobacco exposure, allergic rhinitis within 1 year and allergic conjunctivitis within 1 year.

Objective To compare the differences of corneal biomechanics in different types of glaucoma and its related influence factors,and to investigate the change trends of cornea biomechanics after the operations.Methods In a prospective comparative case series,61 eyes of 61 acute primary angle-closure glaucoma (APACG)(remission or chronic phase)patients,94 eyes of 94 chronic primary angle-closure glaucoma (CPACG) patients,70 eyes of 70 primary open angle glaucoma (POAG) patients and 64 eyes of 64 age-related cataract (ARC) patients were recruited in Tianjin Eye Hospital from January to July,2017.Corneal biomechanical properties were measured by using Corvis ST.The differences of corneal biomechanics in different types of glaucoma and the change trends after surgeries were assessed;the association between parameters and the age,intraocular pressure after correction (IOPcc),central cornea thickness (CCT),axial length (AL),average corneal diopter (K) were assessed by multiple linear regression analysis.This study followed the Declaration of Helsinki.This study protocol was approved by Ethic Committee of Tianjin Eye Hospital (TJYYLL-2016-17).Written informed consent was obtained from each subject prior to any medical examination.Results Compared with the ARC group,the first applanation velocity (A1V)and second applanation time (A2T) were both smaller in preoperative CPACG,POAG groups (all at P＜0.05);compared with the ARC group and APACG group,second applanation velocity (A2V) was larger in preoperative CPACG,POAG groups,the differences were all statistically significant (all at P＜0.05).A1V,A2T,deformation amplitude (DA) and peak distance (PD) were negatively correlated with IOPcc (r =-0.494,-0.612,-0.652,-0.277;all at P＜0.05),A2V,first applanation time (A1T) and central curvature radius (CCR) were positively correlated with IOPcc (r =0.508,0.960,0.249;all at P ＜ 0.05);first applanation length (A1 L) and second applanation length (A2L) were negatively correlated with K (r =-0.323,-0.227;both at P＜0.05);A 1 V,A2T and DA were positively correlated with K (r =0.214,0.256,0.242;all at P＜0.05).Compared with preoperative,the A1T and A2V were reduced,A1V,A2T and DA were increased in one month after surgery in CPACG group;the A1T and A2V were reduced,the A2T and DA were increased in one month after surgery in POAG group,and the differences were all statistically significant (all at P＜0.05).Compared with preoperative,there were no statistically significant differences between the parameters in one month after surgery in APACG group and ARC group (all at P ＞0.05).Conclusions CPACG and POAG have poorer ability of corneal deformation,which gradually returns to normal after surgery;because the intraocular pressure of APACG (remission or chronic stage) return to normal after transient elevated stage,the corneal biomechanics is basically similar to ARC,which has no difference between pre-and pos-operation.The parameters of corneal biomechanics are affected by IOPcc and K.