Objective To analyze the outcomes of catheter ablation for persistent atrial fibrillation(AF)and the independent risk factors for its recurrence in the elderly.Methods A total of 194 patients with persistent AF who underwent catheter ablation at our department from January 2019 to December 2021 were enrolled in this study.They were divided into elderly group(≥60 years old,99 cases)and non-elderly group(＜60 years old,95 cases).Their surgical characteris-tics,postoperative complications and recurrence were compared between the two groups,and the independent risk factors for postoperative recurrence were analyzed in the elderly group.Results Advanced age,higher B-type natriuretic peptide,larger proportions of hypertension and coronary heart disease,and increased CHA2DS2-VASc and HAS-BLED scores,while lower male ratio and estimated glomerular filtration rate were observed in the elderly group than the non-elderly group(P＜0.05,P＜0.01).The elderly group had a higher proportion of left atrial fibrosis than the non-elderly group(30.3％vs 8.4％,P=0.001).Postoperative complications in the elderly group in-cluded 1 case of pericardial effusion and 2 cases of hematoma at the puncture site,and all of these were improved after treatment.There were no significant differences in the 1-year success rate(71.7％vs 69.5％,P=0.763)or recurrence rate during blanking period(21.2％vs 21.1％,P=0.981)between the elderly and non-elderly groups.AF duration(HR=1.020,95％CI:1.007-1.032,P=0.002)and recurrence during blanking period(HR=6.781,95％CI:3.078-14.935,P=0.001)were independent risk factors for postoperative recurrence in the elderly group.Conclu-sion Catheter ablation is safe and effective in the treatment of persistent AF in the elderly.The elderly patients with long duration of AF and recurrences during blanking period are more likely to experience recurrences within 1 year after ablation.

Hepatocellular carcinoma (HCC) is characterized by high postoperative recurrence and mortality rates. In recent years, researchers have identified a significant correlation between microvascular invasion (MVI) and early postoperative recurrence and metastasis of HCC, making it a focal point of HCC research. Accurate preoperative prediction of MVI occurrence and the implementation of relevant interventions (such as expanded resection) could provide substantial benefits to patients. This study analyzes global research over the past decade on MVI predictive indicators based on tumor biological characteristics, genetic measurements, imaging examinations, and tumor markers. The aim is to use these predictive indicators to objectively forecast the occurrence of MVI, thereby aiding in preoperative individual assessments and enhancing treatment plans.

Objective:To investigate the relationship of urinary 8-oxoguanosine(8-oxoGsn)with muscle mass, muscle strength, advanced glycation end products(AGEs), trace elements, heavy metals and other health-related indictors in different age groups of the Beijing area.Methods:A cross-sectional research was conducted.Healthy adults aged 25 to 93 years who sought health examination in the Health Examination Center of Beijing Hospital were recruited.Participants were divided into the young and middle-aged group and the elderly group with age 60 as the cutoff.Urinary 8-oxoGsn levels were detected by mass spectrometry and adjusted using urine creatinine values.Body composition was measured by multifrequency bioelectrical impedance analysis(BIA). Grip strength, 6-meter walking speed and 5-times sit to stand test were conducted by experienced team members.Skin autofluorescence was used to detect skin AGEs.A portable optical scanner was used to detect heavy metals and trace elements using reference points of the palm.Levels of fasting blood glucose, glycosylated hemoglobin, high-density lipoprotein and other common blood biochemical indicators were measured.Results:A total of 106 subjects were enrolled, including 68 in the young and middle-aged group and 38 in the elderly group.The proportion of patients with hypertension(14 ases or 36.8% vs.7 ases or 10.3%), systolic blood pressure[130(120, 140) vs.120(110, 126)mmHg], fasting blood glucose[5.7(5.2, 5.9)mmol/L vs.5.2(4.9, 5.5)mmol/L], glycosylated hemoglobin[6.0(5.7, 6.2)% vs.5.7(5.4, 5.9)%], 8-oxoGsn/Cre[1.9(1.4, 2.6) vs.1.3(1.0, 1.6)], AGEs(2.44±0.46 vs.2.01±0.29), 5-times sit to stand test scores[7.8(6.9, 9.8)s vs.6.0(5.0, 6.8)s], magnesium(31.4±7.2 vs.27.7±6.4), mercury(0.013±0.003 vs.0.008±0.003)and silver[0.011(0.010, 0.012) vs.0.010(0.009, 0.011)]were higher in the elderly group than in the young and middle-aged group, while grip strength[28.0(22.0, 35.1)kg vs.36.6(28.5, 49.1)kg], fat-free mass[44.9(37.5, 51.1)kg vs.53.3(42.4, 58.5)kg], trunk muscle mass[21.0(17.5, 23.9)kg vs.25(19.8, 27.4)kg], appendicular skeletal muscle mass[20.9(17.6, 23.9)kg vs.24.9(19.8, 27.3)kg], calcium[273.3(219.1, 480.0) vs.457.8(428.5, 489.1)], cobalt[0.029(0.027, 0.031) vs.0.031(0.028, 0.034)], selenium[1.44(0.93, 1.71) vs.1.61(1.53, 1.68)]and nickel[3.5(3.3, 4.0)*10 -3vs.3.8(3.6, 4.1)*10 -3]were lower in the elderly group than in the young and middle-aged group( P<0.05). Urinary 8-oxoGsn/Cre levels were positively correlated with age, time of 5-times sit to stand test, AGEs, fasting blood glucose, mercury and aluminum( rs=0.443, 0.292, 0.357, 0.205, 0.316 and 0.214, P<0.05), and negatively correlated with trunk muscle mass, appendicular skeletal muscle mass, fat-free mass, grip strength, silicon and manganese( rs=-0.334, -0.333, -0.332, -0.366, -0.246 and -0.234, P<0.05), with statistical significance. Conclusions:Increased urinary 8-oxoGsn/Cre levels are correlated with decreased muscle mass, poor physical function, accumulation of AGEs, decreased trace element levels and increased heavy metal levels.Therefore, 8-oxoGsn has the potential to be a broadly representative and sensitive indicator for health assessment.

ObjectiveTo investigate the effect of intraoperative Viatorr stent implantation for shunting of blood flow in the left or right branch of the portal vein on the clinical outcome of patients with cirrhotic portal hypertension undergoing transjugular intrahepatic portosystemic shunt (TIPS). MethodsA retrospective analysis was performed for the clinical data of 120 patients with cirrhotic portal hypertension who underwent TIPS in The General Hospital of Western Theater Command from March 2016 to December 2019, and according to the target position of portal vein puncture determined by intraoperative angiography, the patients were divided into left branch group and right branch group. The two groups were compared in terms of the incidence rates of postoperative recurrence and bleeding, stent dysfunction, and hepatic encephalopathy (HE) and survival. The t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier curve was used to calculate rebleeding rate, stent patency rate, incidence rate of HE, and survival rate. ResultsThe surgical success rate was 100% for all 120 patients, with a short-term hemostasis rate of 100%. Among the 120 patients, 52 underwent shunting of the left branch of the portal vein and 68 underwent shunting of the right branch. There was a significant reduction in portal venous pressure after surgery (9.98±2.84 mm Hg vs 24.72±5.11 mm Hg, t=37.76, P＜0.01). The cumulative rebleeding rates at 12 and 24 months after surgery were 3.2% and 11.0%, respectively, and the cumulative incidence rates of HE at 3, 6, 12, and 24 months after surgery were 10.8%, 13.6%, 21.2%, and 24.5%, respectively. Among the 29 patients who experienced HE, 23 had grade Ⅰ-Ⅱ HE and 6 had grade Ⅲ HE. The cumulative incidence rates of stent dysfunction at 12 and 24 months after surgery were 7.1% and 21.4%, respectively. The cumulative survival rates at 12 and 24 months after surgery were 92.0% and 86.5%, respectively. As for comparison of the left branch group and the right branch group, there were no significant differences in postoperative stent patency rate, rebleeding rate, incidence rate of HE, and survival rate(all P＜0.05). ConclusionTIPS is a safe and effective method for the treatment of cirrhotic portal hypertension, and intraoperative Viatorr stent implantation, no matter for establishing the shunt of the left or right branch of the portal vein, will not affect the clinical outcome of patients.

Objective:To explore the association between blood pressure control and risk of ischemic stroke (IS) in patients with hypertension.Methods:A total of 5 488 patients with hypertension from 60 communities were randomly selected from 101 communities in 8 streets of Nanshan District in Shenzhen City by using two-stage sampling method. The social demographic characteristics, behavior and life style, coronary heart disease and diabetes were collected and the physical condition, blood pressure and blood biochemical indexes were measured. From April 1, 2010 to August 31, 2017 as the follow-up period, the incidence of IS was annually collected by using telephone survey. Cox proportional hazard regression model was used to analyze the relationship between blood pressure control, systolic blood pressure (SBP), diastolic blood pressure (DBP) and the risk of IS.Results:The age of all patients was (58.50±12.14) years old, including 2 712 males (49.42%) and 3 112 patients with well-controlled blood pressure (56.71%). During the follow-up period, 358 new cases of IS were confirmed, and the incidence density was 1 346.27/100 000 person-years. Cox proportional hazard regression model analysis showed after adjusting for confounding factors, unstable blood pressure control, SBP≥150 mmHg (1 mmHg=0.133 kPa; compared with SBP<120 mmHg), and DBP≥95 mmHg (compared with DBP<80 mmHg) were associated with risk of IS. The HR (95% CI) was 1.29 (1.04, 1.59), 2.00 (1.26, 3.17) and 1.52 (1.01, 2.64), respectively. Subgroup analyses showed these associations only existed in female patients with hypertension. The HR (95% CI) was 1.39 (1.05, 1.85), 2.53 (1.41, 4.56) and 1.73 (1.00, 3.36), respectively. Conclusion:Unstable blood pressure control increases the risk of IS in female patients with hypertension.

Objective:To explore the association between blood pressure control and risk of ischemic stroke (IS) in patients with hypertension.Methods:A total of 5 488 patients with hypertension from 60 communities were randomly selected from 101 communities in 8 streets of Nanshan District in Shenzhen City by using two-stage sampling method. The social demographic characteristics, behavior and life style, coronary heart disease and diabetes were collected and the physical condition, blood pressure and blood biochemical indexes were measured. From April 1, 2010 to August 31, 2017 as the follow-up period, the incidence of IS was annually collected by using telephone survey. Cox proportional hazard regression model was used to analyze the relationship between blood pressure control, systolic blood pressure (SBP), diastolic blood pressure (DBP) and the risk of IS.Results:The age of all patients was (58.50±12.14) years old, including 2 712 males (49.42%) and 3 112 patients with well-controlled blood pressure (56.71%). During the follow-up period, 358 new cases of IS were confirmed, and the incidence density was 1 346.27/100 000 person-years. Cox proportional hazard regression model analysis showed after adjusting for confounding factors, unstable blood pressure control, SBP≥150 mmHg (1 mmHg=0.133 kPa; compared with SBP<120 mmHg), and DBP≥95 mmHg (compared with DBP<80 mmHg) were associated with risk of IS. The HR (95% CI) was 1.29 (1.04, 1.59), 2.00 (1.26, 3.17) and 1.52 (1.01, 2.64), respectively. Subgroup analyses showed these associations only existed in female patients with hypertension. The HR (95% CI) was 1.39 (1.05, 1.85), 2.53 (1.41, 4.56) and 1.73 (1.00, 3.36), respectively. Conclusion:Unstable blood pressure control increases the risk of IS in female patients with hypertension.

Objective To explore the relationship between different smoking status and hypothyroidism in six iodine-suitable areas of China. Methods A total of 8187 residents were investigated by cluster sampling in six cities, and 7448 residents were included in the survey. The height, weight, waist circumference, and blood pressure were measured by filling out epidemiological questionnaire. Blood samples were collected to detect thyroid stimulating hormone ( TSH) , thyroid peroxidase antibody ( TPOAb) , and thyroglobulin antibody ( TgAb) . Results The mean TSH, TPOAb, and TgAb positive rates in passive smoking and active smoking groups were all lower than those in non-smoking group ( all P<0.01) . In the active smoking group, the TSH value decreased by 0.023 units for every unit increase in smoking index. The positive rates of TgAb and TPOAb in both passive smoking and active smoking groups were lower than those in non-smoking group (all P<0.01). Active and passive smoking reduced the prevalence of hypothyroidism (both P<0.01). Among women, the risks of clinical hypothyroidism and subclinical hypothyroidism were reduced in both active and passive smoking groups. Besides, the risk of subclinical hypothyroidism decreased significantly when the smoking index was more than 70. In male population, the risk of subclinical hypothyroidism in active and passive smoking group decreased. Besides, the risk of clinical hypothyroidism and subclinical hypothyroidism decreased significantly when the smoking index was more than 70. Conclusion Smoking in iodine-suitable areas may reduce TSH level and the positive rates of TPOAb and TgAb.

OBJECTIVE: To investigate the effects of resveratrol (Res) on aging of marrow mesenchymal stem cells (MSCs), and to explore its mechanism. METHODS: MSCs were isolated from young SD rats and cultured in vitro. The optimal D-gal concentration for induction of MSCs senescence was determined. Then MSCs were randomly divided into four groups, namely the control group, 10μmol/L, 50μmol/L and 100μmol/L Res groups. After the cells were treated with different concentration of Res for 48 h, the senescence-associated changes were examined with senescence-associated-β-galactosidase (SA-β-gal) staining; the expression of p53, p16 and γ-H2AX was evaluated by Western blot. The total active oxygen species (ROS) level was determined by flow cytometry with DCFH-DA staining. In order to assess the effect of Res on the mitochondrial function, MitoSox Red staining was used to detect mitochondrial ROS levels in each group, mitochondrial membrane potential was detected by JC-1 assay, mPTP method was used to detect mitochondrial membrane channel opening level, and Western blot was used to detect the expression level of cytoplasmic cytochrome C (Cyt-C). RESULTS D-gal 10 and 50 g/L significantly increased the number of SA-β-gal positive cells and the level of mitochondrial ROS (all P<0.01). Therefore, 10 g/L D-gal was used to induce the senescence of MSCs in subsequent experiment. Compared with the control group, the number of SA-β-gal positive cells in Res groups significantly decreased (all P<0.01), the expression of p53, p16 and γ-H2AX decreased, and the total and mitochondrial ROS level also decreased (all P<0.01). Moreover, mitochondrial membrane potential, open level of mitochondrial membrane channels and the levels of cytoplasm Cyt-C in the Res treatment groups decreased compared with the control group (P<0.05 or P<0.01). CONCLUSIONS Resveratrol can protect the mitochondrial function of MSCs, and effectively delay the MSC senescence.

Objective: To study the safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver during hepatectomy. Methods: The databases of PubMed, Cochrane Center, CNKI, VIP, Wan Fang were searched to extract the relevant data for the meta-analysis using the Revmanage 5.3 software. Results: A total of 14 studies with 1595 patients were included in this meta-analysis. The results showed that total bleeding during the combined clamping was significantly lower than that of the Pringle’s maneuver alone (MD=-314.59, 95%CI: -362.37~-266.81, P<0.05). Bleeding during hepatectomy was significantly lower (MD=-217.79, 95% CI: -284.57~-151.00, P<0.05); so was the intraoperative blood transfusion rate (OR=0.48, 95% CI: 0.36~0.62, P<0.05). The incidence of complications was significantly lower (OR=0.74, 95% CI: 0.57~0.95, P<0.05). However, there were no significant differences in operation time, length of hospital stay, intraoperative monitoring index and postoperative liver and kidney function recovery (P>0.05). Conclusions Infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver in hepatectomy was safe and reliable. Compared with the Pringle’s maneuver alone, the combined technique reduce bleeding and the incidence of complications. This technique is worth promoting in clinical practice.

Objective:To investigate the effect of Tongrnai Yangxin Pill on the serum hepcidin level of patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease.Methods:Seventy patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease whose age were above 40 years old were enrolled as the research group and divided into the medication group (group Ⅱ) (n=35) and the nonmedication group (group Ⅲ)(n=35),while 40 CAD patients were enrolled as the normal control group (group Ⅰ).Before and after medication,the Hepc,Hb,etc levels were compared between two groups.Results:Before medication,the levels of Hepc in the two research subgroup were significantly higher than that of the control group (P＜0.05).At 8 weeks after treatment,the Hepc level of group Ⅱ was significantly declined,and the level of Hb was increased than those before treatment (P ＜0.05);the Hepc levels of group Ⅰ and group Ⅲ showed no significant difference (P＞0.05),the Hepc levels of group Ⅱ and group Ⅲ were obviously higher than that of the control group (P ＜0.05),the Hepc levels of group Ⅲ was obviously higher than that of the group Ⅱ(P＜0.05),the Hb level of group Ⅲ was obviously lower than those of group Ⅰ and group Ⅱ (P＜0.05).Conclusion:Tongmai Yangxin Pill could reduce the level of Hepc and enhance the Hb levels of patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease.It was useful to the patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease,especially patients with mild anemia.