Objective:To investigate short-term safety, efficacy and the learning curve of this self-developed novel transcatheter valve repair system (Neonova?) in patients with mitral regurgitation, and explore the role of perioperative echocardiography.Methods:Ten patients who visited the Union Hospital of Tongji Medical College, Huazhong University of Science and Technology from June 2021 to March 2022 and met the inclusive criteria were prospectively enrolled. All the patients were at high risk of surgery with moderate to severe or severe mitral regurgitation (MR). Clamps of Neonova? were implanted under guidance of transesophageal echocardiography and digital subtraction angiography. Clinical outcomes, echocardiography indexes and learning curves of this technique were evaluated immediately after intervention, 7 d, 1 month and 3 months post-intervention.Results:The technical success rate was 100% with MR relieved in all patients immediately after intervention. The device and procedural success rates were both 90.0% with 1 patient received surgical replacement at 37 days post-intervention while the others′ reduced to mild (8/9) and moderate (1/9) MR. New York Heart Association class and the Kansas City Cardiomyopathy Questionnaire improved significantly (all P<0.001). Mean mitral valve pressure gradient didn′t increase significantly after intervention when compared with that before intervention( P=0.324), and no mitral stenosis was observed. Left ventricular end-diastolic diameter decreased significantly ( P=0.008) during follow up.Procedure duration ranged from 60 to 300 (175.8±75.2)minutes. The simple linear regression model between procedure volume and duration showed that procedure duration decreased significantly with the increase of procedure volume ( F=15.857, P=0.004). Conclusions:Neonova? implantation can improve MR severity and clinical symptoms safely and effectively. Transthoracic echocardiography and transesophageal echocardiography are essential for perioperative management of transcatheter mitral valve repair.

Objective:To construct a traditional Chinese medicine syndrome differentiation model for tinnitus using automatic machine learning technology, and to explore the key factors that affect the results of tinnitus syndrome differentiation.Methods:The clinical characteristics of 594 patients with subjective tinnitus in seven medical units in Shanghai from January 2021 to January 2022 were retrospectively analyzed. The Auto-sklearn automatic machine learning method was used to compare 15 algorithms, and the model with the best classification effect was selected to analyze the key factors affecting tinnitus.Results:The results showed that the optimal algorithm for classification results was the random forest, its accuracy, precision, sensitivity, specificity, F1-score, AUC and kappa coefficient were 87.37%, 88.34%, 89.06%, 96.63%, 88.38%, 97.50%, and 83.37%, respectively. It is concluded that the key factors affecting the classification of the pattern of kidney yin deficiency and fire effulgence, the pattern of liver fire disturbing upward, the pattern of stagnation and binding of phlegm and fire, the pattern of spleen and stomach deficiency, the pattern of wind and heat attacking the external are smooth pulse, string pulse, smooth pulse, weak tongue, and floating pulse respectively.Conclusions:Random forest can provide a good classification prediction function for structured clinical data, suggesting that machine learning technology has clinical application value in assisting the diagnosis of subjective tinnitus.

ObjectiveTo study the effects of Toddalia asiatica alcohol extract on autophagy and apoptosis of non-small cell lung cancer A549 cells， and to explore its possible mechanism. MethodA549 cells were cultured in vitro. Cell counting kit-8 （CCK-8） was used to detect the proliferation of A549 cells， and cell survival rate was calculated to screen the drug concentration. The apoptosis in each dose group and that after the use of 3-methyladenine （3-MA）， an autophagy inhibitor， were detected by flow cytometry combined with Annexin V-FITC/PI double staining. Western blot was used to detect the expression levels of apoptosis-related proteins such as B cell lymphocytoma-2（Bcl-2）， Bcl-2-associated X protein（Bax）， microtubule-associated protein 1 light chain 3 （LC3）， cleaved cysteinyl aspartate-specific protease-3 （cleaved Caspase-3）， activated poly （Adenosine diphosphate） ribonucleotide polymerase （cleaved PARP1）， PARP1， activated death activator （t-Bid）， Bid， and ubiquitin-binding protein p62 in each group and those after the use of 3-MA. ResultCompared with the conditions in the control group， the cell survival rate in 0.25 g·L^-1 group （P<0.05）， and 0.5， 1， 2， 4 g·L^-1 groups （P<0.01） was decreased after 24 h intervention. Additionally， the cell survival rate was reduced in a concentration-dependent manner at 48 h and it was less than 10% at 4 g·L^-1 （P<0.01）. Compared with the conditions in the control group， the total apoptosis rate in 0.5 g·L^-1 group was increased （P<0.05）， and the apoptosis rate in 1 and 2 g·L^-1 groups was also increased （P<0.01）. Compared with the 2 g·L^-1 group and 3-MA group， the 3-MA combined with T. asiatica alcohol extract had significantly decreased apoptosis rate （P<0.01）. Compared with the conditions in the control group， elevated expression of pro-apoptotic proteins cleaved PARP1， Bax and t-Bid in 1 and 2 g·L^-1 groups （P<0.05， P<0.01）， and reduced expression of Bid in the 2 g·L^-1 group （P<0.01） were found. Compared with the conditions in the control group， the expression of anti-apoptotic protein Bcl-2 （P<0.05， P<0.01） and the level of p62 （P<0.01） were down-regulated in 0.5， 1， 2 g·L^-1 groups， while the level of LC3 Ⅱ protein was up-regulated （P<0.01）， with certain concentration dependence. ConclusionT. asiatica alcohol extract could significantly inhibit the proliferation of A549 cells， which might be related to promoting autophagy and inducing apoptosis.

Liver failure is a common severe liver disease syndrome in clinical practice and is one of the critical medical conditions in internal medicine. Massive hepatocyte death is the main pathological feature of liver failure, and its core mechanisms include endotoxin, immune response, and inflammatory cascade reaction. Effective regeneration of hepatocytes to compensate liver function is the physiological basis for promoting the good prognosis of liver failure, which directly affects the prognosis and quality of life of patients with liver failure. It has been found in clinical practice that liver failure patients with a low serum level of cholesterol tend to have an extremely high mortality rate, but as an index of hepatocyte anabolism, the association between cholesterol and hepatocyte regeneration has not been taken seriously. Based on the association between cholesterol and liver regeneration, this article reviews its significance and potential value in the clinical treatment of liver failure, in order to understand the pathogenesis of liver failure from another perspective and provide new ideas for the diagnosis and treatment of liver failure and the development of drugs.

Objective:To evaluate the efficacy of the domestic D-Shant device for the treatment of patients with chronic heart failure (CHF) using echocardiography.Methods:Twenty-four CHF patients who were treated with domestic D-Shant device in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from September 2020 to December 2021 were enrolled in the study. Pulmonary capillary wedge pressure (PCWP)/ left atrial pressure (LAP), right atrial pressure (RAP), pulmonary artery pressure, interatrial septal gradient pressure, cardiac index and pulmonary/systemic blood flow ratio (Qp/Qs) were measured before and after implantation using right heart catheterization.Left atrial end-diastolic area index (LAEDAI), left atrial end-diastolic volume index (LAEDVI), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), right atrial end-diastolic diameter, right ventricular end-diastolic diameter, tricuspid annular plane systolic excursion (TAPSE), right ventricular tractional area change (RVFAC), device shunt aperture, velocity and pressure, together with mitral and tricuspid regurgitation severity were measured using echocardiography before, and 1 month as well as 3 months after D-Shant device implantation. Clinical data were collected and analyzed including 6-minute walking test (6MWT), New York Heart Association (NYHA) classification and the Kansas City Cardiomyopathy Questionnaire (KCCQ). Spearman correlation analysis was used to determine the relation between the changes in PCWP/LAP as well as echocardiographic parameters before and 3 months after implantation and NYHA classification. Binary Logistic regression analysis was performed to determine the predictive factors of NYHA classification improvement at 3-month follow-up after D-Shant device implantation.Results:①D-Shant devices were successfully implanted in all patients. ②Compared with preoperative values, invasive PCWP/LAP systolic, diastolic and mean pressures, transatrial septal gradient, and pulmonary systolic, diastolic and mean pressures decreased significantly after implantation(all P<0.001); Qp/Qs increased significantly after implantation( P<0.001). ③Compared with preoperative values, TAPSE, RVFAC and pulmonary artery flow velocity increased at 1 month after implantation(all P<0.05), whereas a significant reduction in mitral regurgitation grade, and an increase in LVEF and pulmonary artery flow velocity at 3 months after implantation(all P<0.05). Right atrial end-diastolic diameter, right ventricular end-diastolic diameter, LAEDAI, LAEDVI, LVEDVI, LVESVI, ratio of early to late diastolic peak velocities of mitral inflow(E/A), systolic peak velocity of mitral annulus at septal site(S′), ratio of early diastolic peak velocity of mitral inflow to diastolic peak velocity of mitral annulus(E/e′), pulmonary artery diameter, inferior vena cava diameter and degree of tricuspid regurgitation did not change among before, and 1 month as well as 3 months after implantation. There were no significant changes in the device shunt aperture, velocity and pressure between 1 month and 3 months after implantation(all P>0.05). ④The significant improvements in NYHA classification, KCCQ scores and 6MWT were observed at 1 and 3 months after implantation compared with preoperative values (all P<0.01). ⑤NYHA classification at 3 months after implantation was correlated with LVEF pre-post, PCWP/LAP pre-post, TAPSE pre-post and RVFAC pre-post ( rs=0.738, -0.730, 0.738, 0.723; all P<0.001). Logistic regression analysis showed that LVEF pre-post was an independent predictor for NYHA classification improvement at 3 months after implantation ( OR=0.687, 95% CI=0.475-0.992, P=0.045) . Conclusions:Domestic D-Shant device can effectively improve the cardiac function and clinical symptoms in patients with CHF. Echocardiography is a feasible and effective method to evaluate the benefits of domestic D-Shant device for the treatment of CHF.

Acute liver failure is a serious and complex liver disease with a high short-term mortality rate. Its pathogenesis remains unknown and there is still a lack of effective drugs. Animal models play an important role in further revealing the pathogenesis of acute liver failure and the therapeutic mechanism of drugs, and the selection of experimental animals and preparation methods is the key to the effective implementation of research. This article summarizes the commonly used and new animal models of acute liver failure in recent years and the corresponding preparation methods and divides the animal models of acute liver failure into following four categories: chemical drug model, surgical model, infection model, and other models. Meanwhile, the above models are evaluated based on Terblanche and Hickman evaluation criteria for liver failure models, hoping to provide a reference for model selection and evaluation in basic research on this disease.

Management of bone defects caused by fractures，bone tumors or infections is clinically difficult as well as a hot topic in current studies. With further researches over bone defects，the construction of tissue-engineered bone has played a great role in the treatment of bone defects. Blood vessels not only provide the necessary nutritional mineral salts，growth factors，hormones for bone formation，also are able to mediate the interaction among osteoblasts and osteoclasts，osteocytes，bone autonomic nerve and endothelial cells，since bone formation exist spatially and temporally connection with angiogenesis. Therefore，the authors make a systematic literature review on the research progress of the coupling mechanism of angiogenesis and osteogenic differentiation，blood vessels and related signal pathways on osteogenic differentiation and angiogenesis-related molecules in osteogenic differentiation during the process of traumatic bone defects，so as to provide new ideas for the treatment of bone defects.

At present, sexual route is the main transmission route of AIDS in China, and its role in the process of AIDS epidemic has been evolving. Various modes of transmission in sexual transmission and the prevention and control strategies adopted by China have also been changing. This paper mainly summarizes the epidemic characteristics of different periods and different modes of transmission of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in China in recent years. The strategies of prevention and control were described from seven aspects, including health education, promotion of condom use, expanded testing, HIV/AIDS antiviral treatment, pre-exposure prophylactic medication, post-exposure prophylactic medication, social organization participation and sexually transmitted diseases prevention and control. Only when innovative and targeted measures according to the evolution of the HIV/AIDS epidemic and various specific methods are complemented by each other, can the transmission of HIV/AIDS through sexual route be effectively prevented and controlled.

Objective To understand the overall development of TCM technique patent in Guangdong Province through the analysis on the patent application and authorization status of TCM technique patent in Guangdong Province from 2006 to 2015. Methods CNIPR and State Intellectual Property Office platform was searched, and 2006-2015 TCM technique patent application literature in Guangdong Province were obtained, the patent application and authorization status were analyzed. Results The number of application for TCM technique patent in Guangdong Province was 1434 during 2006-2015, and the number of application and authorization rates were increasing. The number of application in the Pearl River Delta (PRD) region of Guangdong Province was greater than that of the non-PRD regions, with individual application of 65.9% and enterprise application of 25.9%; A61K36 accounted for 98.7% in TCM technique patent classification statistics. Conclusion The quantity of patent application of TCM technique in Guangdong Province is large, but the number of application of non-individuals, the rate of authorization, technology statistical classification and innovation ability of TCM technique are low.