Objective To assess the echogenicity of the ultrasound-guided catheter and its associated delivery system. Methods The study consisted of in vitro characterization experiments and animal studies. In the in vitro phase, the acoustic and mechanical properties of the ultrasound-guided catheter were compared with those of the traditional MPA2 catheter, including parameters such as echo intensity, recognizability, and angle dependence. In the animal experiments, a ventricular septal defect (VSD) model was established in miniature pigs to compare the procedural performance of the ultrasound-guided delivery system versus the conventional system. Evaluation indicators included the time required for the system to cross the VSD, the detection rate of the system within the right ventricle, and the occurrence of intraoperative complications. Results The ultrasound-guided catheter demonstrated a significantly higher mean echo intensity than the MPA2 catheter [(237.3±1.8) dB vs. (190.9±13.1) dB, P<0.001] and a markedly improved recognizability rate (82.3%±5.6% vs. 26.7%±3.2%, P<0.001), along with better angle independence and image quality. In animal experiments, the ultrasound-guided delivery system significantly reduced the time required to cross the VSD [(18.5±5.7) min vs. (30.3±4.5) min, P<0.001] and substantially increased the detection rate within the right ventricle (100.0% vs. 30.0%). No severe complications occurred in any experimental animal. Conclusion The ultrasound-guided catheter and its corresponding delivery system exhibite superior ultrasound visibility and operational performance in both in vitro and animal experiments, indicating strong potential for clinical application.

This article reports the first case of percutaneous closure of patent foramen ovale(PFO)using a biodegradable occluder under echocardiography guidance.The patient is a 43-year-old female diagnosed with PFO-related stroke.The procedure was successfully completed under echocardiography guidance without complications.During the 48-month follow-up period,the patient experienced no recurrent strokes,and the occluder was fully degraded.

This article reports the first case of percutaneous closure of patent foramen ovale(PFO)using a biodegradable occluder under echocardiography guidance.The patient is a 43-year-old female diagnosed with PFO-related stroke.The procedure was successfully completed under echocardiography guidance without complications.During the 48-month follow-up period,the patient experienced no recurrent strokes,and the occluder was fully degraded.

Currently, transcatheter intervention is the preferred treatment for patients with anatomically suitable atrial septal defects. However, the use of nickel-titanium alloy occluders in interventional procedures results in lifelong presence of the implant in the body, leading to complications such as metal allergies and arrhythmias in some patients. To overcome the short-term and long-term complications associated with the presence of metal, and to avoid radiation exposure and metal toxicity, this paper reports a case of successful transcatheter closure of atrial septal defect in a pediatric patient with metal allergies using fully biodegradable occluder under ultrasound guidance, achieving excellent results by interventional therapy.

Objective To investigate the pathomorphological features of mucosa-associated lymphoid tissue(MALT)lymphoma of the lacrimal gland and the expression and significance of BCL10 and MALT1 in tumor tissues.Methods Diseased lacrimal gland tissue specimens from 19 patients with lacrimal gland MALT lymphoma(19 eyes,including nine right eyes and ten left eyes)were selected as the experimental group,and normal lacrimal gland tissue specimens from eight patients with orbital content removal(eight eyes,including three right eyes and five left eyes)were selected as the control group.Hematoxylin-eosin(HE)staining was performed to observe the mor-phological characteristics of the lacrimal gland tissues,and immunohistochemical(IHC)staining was performed to observe the expression of BCL10 and MALT1 in the lacrimal gland tissues.Results In the experimental group,marginal B cells,monocyte-like tumor cells,small lymphocyte-like tumor cells,and plasma cell-like tumor cells appeared in the marginal zone.Large cells were occasionally distri-buted among these cells.The tumor cells invaded the lymphoid follicles and epithelium,destroyed normal tissue structure,and formed follicular colonization and lymphoepithelial lesions.The positive expression area of BCL10 and MALT1 in the experimental group was sig-nificantly larger than that in the control group(Z=-2.177,P=0.029;t=3.237,P=0.003).Conclusion Lacrimal gland MALT lymphoma shows pathological changes in diffusely distributed marginal B cells and tumor cells with diverse morphology,acquired lymphoid follicles,and scattered distribution of large cells.This may be related to apoptosis blockage caused by the upregulation of BCL10 and MALT1 expression.

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.

The clinical efficacy of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) in reducing major cardiovascular adverse events related to atherosclerotic cardiovascular disease (ASCVD) has been well established in recent large randomized outcome trials. Although the cardiovascular and all-cause mortality benefit of PCSK9i remains inconclusive, current cholesterol management guidelines have been modified toward more aggressive goals for lowering low-density lipoprotein cholesterol (LDL-C). Consequently, the emerging concept of "the lower the better" has become the paradigm of ASCVD prevention. However, there is evidence from observational studies of a U-shaped association between baseline LDL-C levels and all-cause mortality in population-based cohorts. Among East Asian populations, low LDL-C was associated with an increased risk for hemorrhagic stroke in patients not on antithrombotic therapy. Accumulating evidence showed that low LDL-C was associated with an enhanced bleeding risk in patients on dual antiplatelet therapy following percutaneous coronary intervention. Additionally, low LDL-C was associated with a higher risk for incident atrial fibrillation and thereby, a possible increase in the risk for intracranial hemorrhage after initiation of anticoagulation therapy. The mechanism of low-LDL-C-related bleeding risk has not been fully elucidated. This review summarizes recent evidence of low-LDL-C-related bleeding risk in patients on antithrombotic therapy and discusses potential measures for reducing this risk, underscoring the importance of carefully weighing the pros and cons of aggressive LDL-C lowering in patients on antithrombotic therapy.

Background and objective Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs)significantly improve the survival of advanced lung adenocarcinoma patients harboring EGFR mutation.Limited to the standards of tumor tissue samples and detection methods,still some people can't receive target therapy following genetic guidance.This study was to explore the relevance between serum tumor markers and treatment of EGFR-TKIs.Methods We retrospectively collected the clinical information of advanced lung adenocarcinoma patients harboring EGFR mutation,who received EGFR-TKIs as first-line therapy from June 2009 to June 2014 in Peking University Cancer Hospital,analyzed the relationship between serum tumor markers and efficacy of EGFR-TKIs.Results The objective response rate (ORR)was 52.8％ and the disease control rate (DCR) was 89.3％.The results showed that,patients with high CEA level before treatment responded better to TKIs (ORR 61.3％ vs 35.9％,DCR 95.2％ vs 74.4％,P＜0.001).Similar phenomena was found in patients with CEA decreased 1 month later (61.5％ vs 25％,P=0.002).Progression-free survival (PFS) significantly prolonged in patients with elevated baseline CEA (mPFS 9.8 mo vs 5.9 mo,P=0.027).To the opposite,PFS was significantly shorter in patients with elevated baseline CYFRA21-1 and CA125 (mPFS 9.0 mo vs 11.4 mo,P=0.029;9.0 mo vs 11.5 mo,P=0.023,respectively).Multivariate analysis showed that Eastern Cooperative Oncology Group (ECOG) score of 0-1,normal baseline CYFRA21-1 and CEA decline predicted longer PFS.The overall survival (OS) was highly associated with elevated CYFRA21-1 and CA125 (median OS 25.1 mo vs 52.5 mo,P=0.003;22.7 mo vs 55.0 mo,P＜0.001,respectively),while independent of CEA.Conclusion High level of baseline CEA and decline 1 month after treatment could predict the efficacy of EGFR-TKIs in patients with advanced lung adenocarcinoma.While high levels of baseline CYFRA21-1 and CA125 indicated shortened survival.

Objective To study the efficacies and adverse reactions of urapidil and nicardipine in the treatment of the chronic renal failure patients with hypertensive emergencies .Methods 59 chronic renal failure patients with hypertensive emer-gencies were randomly divided into nicardipine treatment group and urapidil treatment group .The patients in the nicardipine group were given a 1 mg nicardipine intravenous injection ,and 30-100 μg/min intravenous transfusion was given continuously . The patients in the urapidil group were given a 12 .5 mg urapidil intravenous injection ,and 150-500μg/min intravenous trans-fusion was given continuously .The dosage were changed according to the patients′blood pressure in both of the groups .The patients′blood pressure ,heart rate and adverse reactions were recorded .Results The patients′blood pressure in both of the groups were significantly lower after treatment (P<0 .05) .The SBP in nicardipine treatment group was significant lower than SBP in urapidil treatment group in the first hour after treatment (P<0 .05) .There was no significant difference in SBP be-tween the two groups 2 hours after treatment (P>0 .05) .There was no significant difference in DBP between the two groups after treatment (P>0 .05) .In the nicardipine group ,the heart rate rose after the treatment ,the difference was statistically significant (P<0 .05) .While in the urapidil group ,the heart rate went down after the treatment ,and the difference was statis-tically significant (P<0 .05) .There was no significant difference in adverse reactions between the two groups (P>0 .05) . Conclusion Both of nicardipine and urapidil were effective in the treatment of chronic renal failure patients with emergency hy-pertensive .Nicardipine was more effective in reducing the SBP in the first stage of treatment .

Purpose To summarize the characteristics of computed tomography enteroclysis (CTE) in active ulcerative colitis (UC), and to explore the value of multi-slice CTE in the evaluation of UC. Materials and Methods Thirty-five patients with active UC confirmed by clinical manifestation, colonoscopy and pathology underwent CTE examination in the study. According to the modiifed Mayo-score, the patients were divided into mild group, moderate group and severe group, and the CTE manifestations were compared among the three groups. Results Among 35 patients, 6 patients were in the mild group, 13 in the moderate group, and 16 in the severe group. Submucosal bubbles had signiifcant differences between mild and moderate groups (P<0.05), bowel wall stratiifcation, disappearance of haustra and enlarged mesenteric lymph nodes were signiifcantly different between moderate and severe groups (P<0.05), and engorged vasa recta was significantly different between the 3 groups (P<0.05). However, bowel wall thickening, mural hyperenhencement, narrow lumen and fatty deposits around the rectum showed no difference between the three groups (P>0.05). Conclusion Multi-slice CTE can provide image features of bowel wall, intestinal tube and structures outside intestine in the evaluation of UC, thus it is useful in the diagnosis of active UC as well as in its clinical grading.