1.2024 annual report of interventional treatment for congenital heart disease
Changdong ZHANG ; Yucheng ZHONG ; Geng LI ; Jun TIAN ; Gejun ZHANG ; Nianguo DONG ; Yuan FENG ; Daxin ZHOU ; Yongjian WU ; Lianglong CHEN ; Xiaoke SHANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(07):909-918
In recent years, with the continuous development and increasing maturity of interventional techniques, interventional treatment for congenital heart disease (CHD) has been progressively disseminated to county- and city-level hospitals in China. Concurrently, the standardized management of adult CHD (particularly patent foramen ovale) and the lifelong management of complex CHD are gaining increasing clinical attention, while the emergence of new techniques and products continuously advances the discipline. This article aims to review the new progress made in the field of interventional treatment for congenital heart disease in China during 2024. It specifically reviews and analyzes the following key aspects: (1) annual statistics on interventional closure procedures for CHD; (2) recent insights into patent foramen ovale closure; (3) advances in transcatheter pulmonary valve replacement; (4) interventional treatment and lifelong management strategies for complex CHD; (5) new interventional techniques for acquired heart disease; and (6) the application of artificial intelligence in CHD management. Through the synthesis and discussion of these topics, this article seeks to provide a detailed analysis of the current landscape of interventional treatment for CHD in China and project its future development trends.
2.Application of high hip center technique in total hip arthroplasty in patients with Crowe type Ⅱ and Ⅲ developmental dysplasia of hip and severe hip osteoarthritis
Hao HU ; Jun-Zhong YANG ; Liang LI ; Chuan-Wen HUANG ; Ling-Lin WANG ; Li-Yan YI
China Journal of Orthopaedics and Traumatology 2024;37(2):166-172
Objective To explore the clinical efficacy of high hip center technique total hip arthroplasty(THA)for CroweⅡ and Ⅲ developmental dysplasia of hip(DDH)and severe hip osteoarthritis(HOA).Methods From January 2018 to Jan-uary 2020,74 patients with Crowe type Ⅱ and Ⅲ DDH and severe HOA were admitted,and 37 cases of anatomical hip center reconstruction were taken as control group,including 7 males and 30 females,aged from 42 to 65 years old with an average of(58.40±4.98)years old,body mass index(BMI)ranged from 18 to 29 kg·m-2 with an average of(23.02±2.21)kg·m-2.Thirty-seven routine high hip center technical reconstruction were performed as study group,including 5 males and 32 females,aged from 41 to 65 years old with an average of(57.31±5.42)years old,BMI ranged from 18 to 29 kg·m-2 with an average of(23.14±2.07)kg·m-2.The patients presented with hip pain,limited function and range of motion,and gait instability before surgery.All patients underwent THA,the control group underwent intraoperative anatomical hip center reconstruction,and the study group underwent intraoperative high hip joint reconstruction.The perioperative indicators of the two groups were com-pared.The hip joint function,balance function and gait of the patients were evaluated before surgery,3 months,6 months,and 12 months after surgery.The length difference of both lower limbs,horizontal distance of rotation center,vertical distance of ro-tation center and femoral eccentricity were measured before operation and 1 year after operation.The incidence of complica-tions in the two groups during the operation and postoperative follow-up was counted.Results The operation time of the study group was shorter than that of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).After 12-months follow-up,1 was lost to followvup in study group and 2 were lost to follow-up in control group.The Har-ris scores and Berg balance scale(BBS),pace,stride frequency and single step length in the study group were higher than those in the control group at 3 months and 6 months after operation(P<0.05);there was no statistically significant difference between the two groups in the indexes 12 months after operation(P>0.05).The vertical distance of the center of rotation of the study group was greater than that of the control group 12 months after operation(P<0.05),and there was no significant difference in the length difference of the lower limbs,the horizontal distance of the center of rotation,and the femoral eccentricity between two groups(P>0.05).There were no complications in either group.Conclusion The long-term effects of TH A in patients with DDH and severe HO A were similar between the two central hip reconstruction methods,and the safety was good,and the high hip central reconstruction technique could shorten the operation time and reduce the amount of intraoperative blood loss.At the same time,it has certain advantages in early recovery of hip joint function,balance function and walking function of patients.
3.Clinical study of constructing nomogram model based on multi-dimensional clinical indicators to predict prognosis of knee osteoarthritis
Xin WANG ; Cong-Jun YE ; Zhen-Zhong DENG ; Yan XUE ; Chen-Hui WEI ; Qing-Biao LI ; Yang-Ming LUO ; Jian-Zhong GAN
China Journal of Orthopaedics and Traumatology 2024;37(2):184-190
Objective To analyze the factors affecting the prognosis of patients with knee osteoarthritis,and to construct a nomogram prediction model in conjunction with multi-dimensional clinical indicators.Methods The clinical data of 234 pa-tients with knee osteoarthritis who were treated in our hospital from January 2015 to June 2021 were retrospectively analyzed,including 126 males and 108 females;age more than 60 years old for 135 cases,age less than 60 years old for 99 cases.Lysholm knee function score was used to evaluate the prognosis of the patients,and the patients were divided into good progno-sis group for 155 patients and poor prognosis group for 79 patients according to the prognosis.The clinical data of the subjects in the experimental cohort were analyzed by single factor and multiple factors.The patients were divided into experimental co-hort and verification cohort,the results of the multiple factor analysis were visualized to obtain a nomogram prediction model,the receiver operating characteristic curve(ROC),calibration curve and decision curve were used to evaluate the model's dis-crimination,accuracy and clinical benefit rate.Results The results of multivariate analysis showed that smoking,pre-treatment K-L grades of Ⅲto Ⅳ,and high levels of interleukin 6(IL-6)and matrix metallo proteinase-3(MMP-3)were risk factors for the prognosis of patients with knee osteoarthritis.ROC test results showed that the area under the curve of the nomogram model in the experimental cohort and validation cohort was 0.806[95%CI(0.742,0.866)]and 0.786[(95%CI(0.678,0.893)],re-spectively.The results of the calibration curve showed that the Brier values of the experimental cohort and verification cohort were 0.151 points and 0.134 points,respectively.When the threshold probability value in the decision curve was set to 31%,the clinical benefit rates of the experimental cohort and validation cohort were 51%and 56%,respectively.Conclusion The prognostic model of patients with knee osteoarthritis constructed based on multi-dimensional clinical data has both theoretical and practical significance,and can provide a reference for taking targeted measures to improve the prognosis of patients.
4.Single mini-incision combined with honeycomb titanium plate in treatment of acute acromioclavicular joint disloca-tion
Yu-Chen WANG ; Wei-Zhong YU ; Yun-Feng LI ; Wen-Ke ZHU ; Chuan JIA ; Jun-Qi WU ; Hua GAO ; Lin JI
China Journal of Orthopaedics and Traumatology 2024;37(6):576-582
Objective To explore clinical effect of single small incision with honeycomb titanium plate in treating acute acromioclavicular dislocation.Methods The clinical data of 40 patients with acute acromioclavicular dislocation admitted from December 2019 to December 2021 were retrospectively analyzed and divided into two groups according to different surgical methods.Among them,20 patients were fixed with single small incision with honeycomb titanium plate(titanium plate group),including 11 males and 9 females,aged from 23 to 65 years old with an average of(47.40±12.58)years old;12 patients on the left side,8 patients on the right side;11 patients with type Ⅲ,3 patients with type Ⅳ,and 6 patients with type Ⅴ according to Rockwood classification.Twenty patients were fixed with clavicular hook plate(clavicular hook group),including 8 males and 12 females,aged from 24 to 65 years old with an average of(48.40±12.08)years old;12 patients on the left side,8 patients on the right side;10 patients with type Ⅲ,2 patients with type Ⅳ,and 8 patients with type V according to Rockwood classifica-tion.Operative time,incision length,intraoperative blood loss,hospital stay,visual analogue scale(VAS)and Constant-Murley score of shoulder joint function were compared between two groups.Anteroposterior radiographs of the affected shoulder joint were recorded before,immediately and 6 months after surgery,and the coracoclavicular distance was measured and compared.Results Both groups of patients were successfully completed operation without serious complications.All patients were fol-lowed up for 6 to 15 months with an average of(11.9±4.8)months.There were no incisional infection,internal plant fracture or failure,bone tunnel fracture and other complications occurred.The incision length of titanium plate group(35.90±3.14)mm was significantly shorter than that of clavicular hook group(49.30±3.79)mm(P<0.05).There were no significant difference in operative time,intraoperative blood loss and hospital stay between two groups(P>0.05).At 1 and 3 months after operation,VAS of titanium plate group was lower than that of clavicular hook group(P<0.05).Connstant-Murley scores in titanium plate group at 1,3 and 6 months after operation were(86.80±1.36),(91.60±2.32)and(94.90±2.22),respectively;and in clavicular hook group were(78.45±5.47),(85.55±2.01)and(90.25±1.92),which were higher than that of clavicular hook group(P<0.05).There was no significant difference in coracoclavicular distance between two groups immediately and 6 months after op-eration(P>0.05).Conclusion For the treatment of acute acromioclavicular joint dislocation,single small incision combined with honeycomb titanium plate have advantages of shorter incision,fast recovery of shoulder joint function without the second operation,and has good satisfaction of patient.
5.Ultrasonic anatomical study and clinical application of stellate ganglion block via C7 transverse process
Ai-Li HU ; Jun-Li WANG ; Xiao-Ai CHU ; Jie-Qing CHEN ; Zong-Yu ZHA ; Da-Sheng LU ; Qin-Zhong XIA
Journal of Regional Anatomy and Operative Surgery 2024;33(7):571-575
Objective To investigate the high-frequency ultrasonic anatomical features of the adjacent C7 transverse process and its clinical value in stellate ganglion block(SGB).Methods High-frequency ultrasound was applied to obtain ultrasonographic anatomical sonogram features in the plane of bilateral C7 transverse processes in 52 cases(104 sides in total)of healthy adults and then stored for the operator to learn and correctly label each tissue structure.Fifty patients who underwent ultrasound-guided SGB were selected and divided into the BC7 group(25 cases before study)and AC7 group(25 cases after study).The operation time,SGB success rate,number of adjusted needle tips,dosage of anaesthetic and adverse reaction of patients in both group were recorded.Results The main muscles observed in the C7 plane were the longissimus and anterior scalene muscles,the ultrasonographic anatomical relationships of the vagus nerve located in the carotid sheath,the pleura located posterior to the subclavian artery,and the recurrent laryngeal nerve located in the vicinity of the branches of the inferior thyroid artery are described,and the stellate ganglion was illustrated as a flattened hypoechogenic structure visible on the deep surface of the prevertebral fascia in the region of the external cervical longissimus muscle,vertebral artery and vein,and the medial aspect of the anterior oblique muscle,and emanated the sonographic features of several hypoechoic nerve bundles.Ultrasound guided SGB was completed uneventfully in patients of both groups,and all patients developed Horner syndrome,with the SGB success rate of 100%.The operation time[(5.36±1.11)minutes]of patients in the BC7 group was longer than that in the AC7 group[(3.08±0.86)minutes],the number of adjusted needle tips[(4.20±1.00)times]of patients in the BC7 group was more than that in the AC7 group[(2.24±0.87)times],and the dosage of anaesthetic[(1.82±0.28)mL]of patients in the BC7 group was more than that in the AC7 group[(1.64±0.22)mL],all the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reaction between the two groups(P>0.05).Conclusion After ultrasonic learning of adjacent structures through C7 transverse process,SGB is safe and easy to perform.
6.Application of costal cartilage framework with perichondrium scaffold in comprehensive rhinoplasty
Ai ZHONG ; Zheng-Yong LI ; Jun-Jie CHEN
Journal of Regional Anatomy and Operative Surgery 2024;33(8):727-731
Objective To explore the clinical application effect of a novel prefabricated costal cartilage framework with perichondrium scaffold in the comprehensive rhinoplasty.Methods A retrospective analysis was conducted on the clinical data of 40 patients who underwent comprehensive rhinoplasty by using a prefabricated costal cartilage framework with perichondrium scaffold from December 2017 to December 2022 in our hospital.The postoperative tension of nasal tip,blood supply of nasal columella skin flap,and occurrence of perioperative complications were observed.The changes of nasal dorsum length,nasal tip height,and nasolabial angle before and after surgery were measured based on facial photographs taken to evaluate patients' satisfaction.Results The surgeries on 40 patients were successfully performed,with a less intraoperative bleeding and few perioperative complications.All postoperative wounds healed in the first phase.After 12 to 36 months of follow-up,no implant displacement,implant extrusion,or cartilage framework displacement,deformation or bending was found.One patient developed bacterial infection,who healed after symptomatic management.There were significant increases in the nasal dorsum length,nasal tip height,and nasolabial angle after operation compared with those before operation,with statistically significant differences(P<0.001).The patients'satisfaction in terms of morphological outcomes after surgery was 97.5%.Conclusion The application of prefabricated costal cartilage framework with perichondrium scaffold in comprehensive rhinoplasty is safe and reliable,with good outcome and fewer complications,as well as high patients' satisfaction.
7.Analysis of risk factors for bile leakage after laparoscopic common bile duct exploration with primary closure
Wu GUO ; Jun-Jian LIU ; Hai-Tao SHANG ; De-Lin ZHANG ; Xi-Bo ZHANG ; Zhong-Lian LI
Journal of Regional Anatomy and Operative Surgery 2024;33(10):844-848
Objective To explore the risk factors for bile leakage after laparoscopic common bile duct exploration(LCBDE)with primary closure.Methods The clinical data of 560 patients with choledocholithiasis who underwent LCBDE with primary closure in Tianjin Hospital of Integrated Traditional Chinese and Western Medicine from September 2021 to September 2023 were retrospectively analyzed,and the patients were divided into the bile leak group and the non-bile leak group according to the occurrence of postoperative bile leakage.The risk factors affecting the occurrence of postoperative bile leakage were analyzed by multivariate analysis.Results A total of 64 cases(11.4% )experienced varying degrees of bile leakage,including 55 cases of grade A bile leakage,7 cases of grade B,and 2 cases of grade C.The thin common bile duct(OR=0.07,P<0.001),history of hypertension(OR=4.56,P<0.001),and high BMI(OR=1.17,P=0.002)were the risk factors for postoperative bile leakage in patients with choledocholithiasis.Conclusion Patients with thin common bile duct,hypertension and obesity are more likely to occur postoperative bile leakage.Patients with choledocholithiasis who have the above high-risk factors should be cautious in choosing LCBDE with primary closure.
8.Investigation of tick species and potential pathogenic ricks in certain areas of Wuwei City,Gansu Province
Rui-Shan LI ; Zhen HE ; Xiang YUAN ; Shi-Wei SUN ; Yi-Wen LIU ; Wen-Kai ZHANG ; Lin ZHANG ; Yu-Hua WANG ; Zhen-Hua LU ; Zhao-Hua JI ; Zhong-Jun SHAO
Chinese Journal of Zoonoses 2024;40(4):328-333
To understand the distribution of ticks in the Wuwei Region,enrich tick species data,and provide a basis for the prevention of tick-borne diseases,tick were collected using flagging and tick-picking methods during the highest activity period from April to September in 2021 and 2022 in the mountainous areas of Wuwei City.The ticks were identified based on morpho-logical and molecular biological characteristics,and characteristic sequences were obtained.A systematic evolutionary tree was constructed using the neighbor-joining method in MEGA 11.0 software.In total,7 342 ticks collected in Wuwei,which be-longed to 5 species from 4 genera with in the Ixodidae family,which included Dermacentor nuttalli,Hyalomma asiaticum,Ixodes canisuga,Haemaphysalis longicornis and Haema-physalis danieli.Ticks of the same species clustered together into the same branch of an evolutionary tree.In the Wuwei Re-gion,five common tick species are found across various habi-tats,with each habitat featuring different distributions of tick species and populations.The Dermacentor nuttalli is the dom-inant tick species in this area.
9.Optimized expression of the diphtheria toxin mutant CRM197 in Escherichia coli and population analysis of serum antibody levels
Xiao-Li CHEN ; Yi-Xin GU ; Hai-Rui WANG ; Gui-Lan ZHOU ; Xin ZHANG ; Chang LIU ; Jian-Zhong ZHANG ; Zhu-Jun SHAO ; Mao-Jun ZHANG
Chinese Journal of Zoonoses 2024;40(5):430-434
A prokaryotic expression vector for the mutant diphtheria toxin CRM197 was constructed and expressed in Esch-erichia coli cells.Anti-CRM197 antibody concentrations were detected in serum samples of healthy volunteers.The crm 197 gene was codon-optimized in E.coli and cloned into the plasmid pET28a(+)under optimized expression conditions.CRM197 was purified using Ni-NTA spin columns and ion exchange chromatography,and confirmed by western blot analysis.The puri-fied CRM197 was used to detect specific anti-CRM197 antibody levels in serum samples of different age groups.The results showed that soluble codon-optimized CRM197 was successfully expressed under optimized expression conditions.The purity of CRM197 was more than 95%,as determined with Ni-NTA spin columns and ion exchange chromatography,consistent with the single specific bands obtained by western blot analysis and detection of serum levels of the anti-CRM197 antibody.Collec-tively,these results confirmed that the proposed expression strategy achieved high-yield production of soluble CRM197,al-though high levels in human serum may affect evaluation of immune interactions with glycan-CRM197 conjugates for applica-tion as a diagnostic antigen.The diphtheria mutant toxin CRM197 is used in many conjugate vaccines.The synthetic crm 197 gene with codon optimization in pET28a was transformed into E.coli Origami B(DE3)cells.CRM197 was induced by isopro-pyl β-d-1-thiogalactopyranoside and high level accumulation of soluble CRM197 was purified using Ni-NTA spin columns and ion exchange chromatography.The purity of the final prepara-tion reached 95%.CRM197 was used to detect the concentra-tions of the anti-CRM197 antibody in serum samples of healthy volunteers of different ages.The proposed expression strategy yielded high production of CRM197,which could interfere with evaluations of induced immune interactions by glycan-CRM197 conjugates and prohibit application as a diagnostic antigen.
10.Molecular Diagnosis and Pedigree Analysis of Rare Mutations in Non-coding Region of HBA2 Gene
Li-Zhu CHEN ; Ti-Zhen YAN ; Jun HUANG ; Qing-Yan ZHONG ; Xue QIN ; Ning TANG ; Shi-Qiang LUO
Journal of Experimental Hematology 2024;32(3):940-944
Objective:To perform molecular diagnosis and pedigree analysis for one case with α-thalassemia who does not conform to the genetic laws,and explore the effects of a newly discovered rare mutation(HBA2:c.*12G>A)on clinical phenotypes.Methods:Blood samples of the proband and her family members were collected for blood routine analysis,and the hemoglobin components were analyzed by capillary electrophoresis.The common α-and β-globin gene loci in Chinese population were detected by conventional techniques(Gap-PCR,RDB-PCR).The α-globin gene sequences(HBA1,HBA2)were analyzed by Sanger sequencing.Results:By analyzing the test results of proband and her family members,the genotype of the proband was-α3,7/HBA2:c.*12G>A,her father was HBA2:c.*12G>A heterozygous mutation carrier.Conclusion:This study identifies a rare α-globin gene mutation(HBA2:c.*12G>A)that has not been reported before.It is found that heterozygous mutation carriers present with static α-thalassemia.

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