Objective:To compare the effectiveness and safety of in vitro fenestration and in situ fenestration for reconstruction of the left subclavian artery in patients with aortic arch diseases.Methods:A retrospective analysis was conducted on 80 patients with thoracic aortic dissection, aortic aneurysm, and aortic intramural hematoma involving the left subclavian artery at our center from Jan 2020 to Oct 2023.Results:Thirty-eight patients underwent in vitro fenestration to reconstruct the left subclavian artery, while 42 patients underwent in situ laser fenestration to reconstruct the left subclavian artery. The technical success rates were 97.4% and 97.6% respectively, without statistically significance ( P>0.05). Postoperative CTA examination showed that the primary rupture of the dissection was completely closed, 3 cases had type Ⅱ endoleak in vitro fenestration, and 2 cases had type Ⅱ endoleak in laser in situ fenestration. The blood flow inside the fenestration stent was fluent. During the perioperative period, one patient in the in vitro fenestration group experienced mild cerebral infarction (2.6%), one patient had mild paraplegia, and no related complications occurred in the other patients. Conclusion:For patients with aortic arch diseases, both in situ laser fenestration and in vitro fenestration are safe and effective.

Increasing evidences suggest the important role of calcium homeostasis in hallmarks of cancer, but its function and regulatory network in metastasis remain unclear. A comprehensive investigation of key regulators in cancer metastasis is urgently needed. Transcriptome sequencing (RNA-seq) of primary esophageal squamous cell carcinoma (ESCC) and matched metastatic tissues and a series of gain/loss-of-function experiments identified potassium channel tetramerization domain containing 4 (KCTD4) as a driver of cancer metastasis. KCTD4 expression was found upregulated in metastatic ESCC. High KCTD4 expression is associated with poor prognosis in patients with ESCC and contributes to cancer metastasis in vitro and in vivo. Mechanistically, KCTD4 binds to CLIC1 and disrupts its dimerization, thus increasing intracellular Ca²⁺ level to enhance NFATc1-dependent fibronectin transcription. KCTD4-induced fibronectin secretion activates fibroblasts in a paracrine manner, which in turn promotes cancer cell invasion via MMP24 signaling as positive feedback. Furthermore, a lead compound K279-0738 significantly suppresses cancer metastasis by targeting the KCTD4‒CLIC1 interaction, providing a potential therapeutic strategy. Taken together, our study not only uncovers KCTD4 as a regulator of calcium homeostasis, but also reveals KCTD4/CLIC1-Ca²⁺-NFATc1-fibronectin signaling as a novel mechanism of cancer metastasis. These findings validate KCTD4 as a potential prognostic biomarker and therapeutic target for ESCC.

Abstract: Objective　To collect extensively drug-resistant tuberculosis (XDR-TB) Mycobacterium tuberculosis strains isolated from Xi'an City between 2019 and 2020, and analyze the drug resistance patterns of XDR-TB strains to second-line anti-tuberculosis drugs and the occurrence of new defined extensively drug-resistant tuberculosis in Xi'an, in order to provide evidence for guiding clinical drug use of multidrug-resistant tuberculosis (MDR-TB) patients. Methods A total of 3 088 strains of Mycobacterium tuberculosis that underwent phenotypic drug susceptibility testing at Xi'an Chest Hospital from January 2019 to December 2020 were retrospectively selected to analyze the resistance of anti-tuberculosis drug. Among the stored MDR-TB strains, 114 strains of preserved multidrug-resistant Mycobacterium tuberculosis were randomly selected for bedaquiline and linezolid susceptibility testing. Combined with the results of previous second-line drug susceptibility testing, the incidence of newly defined extensive drug resistance was analyzed. Results Among the 3 088 Mycobacterium tuberculosis strains analyzed, 411 strains (14.3%) showed resistance to isoniazid, 347 strains (11.2%) showed resistance to rifampicin, 142 strains (4.6%) showed resistance to ethambutol, 550 strains (17.8%) showed resistance to streptomycin, and 237 strains (7.6%) exhibited multidrug resistance. Of 237 MDR-TB strains, the resistance rates of ethambutol, moxifloxacin, rifampicin, sodium para-aminosalicylate, prothioconazole, capreomycin, amikacin, and clofazimine were 44.3%, 26.6%, 33.3%, 24.1%, 5.1%, 4.2%, 3.0%, and 2.5%, respectively. Among the randomly selected 114 MDR-TB strains, none showed resistance to bedaquiline, three showed resistance to linezolid, and one strain met the new definition for extensively drug-resistant tuberculosis. Conclusion In Xi'an City, high rates of resistance among MDR-TB strains are observed for ethambutol, quinolone and sodium para-aminosalicylate, and the drug susceptibility tests should be obtained as much as possible when using these drugs. The incidence of new definition extensively drug-resistant tuberculosis is low, and bedaquiline and linezolid remain effective drugs for the treatment of multidrug-resistant tuberculosis even without drug susceptibility testing results.

Objective: To investigate the associations between the single nucleotide polymorphism(SNP) in vestigial like family member 4(VGLL4) gene and Helicobacter pylori(H. pylori) infection. Methods: The blood samples of 450 normal physical examiners were collected , and the samples were divided into H. pylori negative group( n =220) and H. pylori positive group(n = 230) using enzyme⁃linked immunosorbent assay(ELISA) . SNP rs1803489 ,rs7617620 , and rs13078528 in VGLL4 gene were genotyped using polymerase chain reaction ( PCR) Ⅳrestriction fragment length polymorphism ( RFLP) technology. Results: SNP rs1803489 , rs7617620 , and rs13078528 in VGLL4 gene were not associated with H. pylori infection in the Han population in Baotou , Inner Mongolia. Conclusion SNP rs1803489 , rs7617620 , and rs13078528 in VGLL4 gene may not play a major role in H. pylori infection in Baotou Han population.

Total volatile organic compounds (TVOCs) are the main indoor pollutants. Long-term exposure to excessive TVOCs will cause acute and chronic adverse health effects. In order to understand current indoor TVOCs pollution in urban residential buildings in China, we searched related literature of indoor TVOCs in urban residential buildings published in CNKI, Wanfang, VIP, Web of Science, and PubMed from 2000 to 2021, and analyzed the pollution characteristics and main sources of indoor TVOCs in urban residential buildings in China. The results showed that the average TVOCs concentration range in urban residential buildings in China was 0.18-1.45 mg·m⁻³, which was widely distributed and exceeded the relevant national standard. The concentrations of TVOCs in bedrooms, study rooms, and kitchens were relatively high among different rooms. Indoor sources such as decoration materials and human activities after moving in were the main sources of TVOCs, and the concentration of TVOCs decreased the most in 4-6 months after the completion of decoration. However, extending the vacancy time after the completion of decoration is not the best method to effectively remove indoor TVOCs, especially for the areas where indoor air pollutants severely exceeding the national limit, it is necessary to control pollution sources to reduce indoor TVOCs concentration. For the study of indoor air TVOCs, future study directions could be the ratio of indoor and outdoor TVOCs concentration and the analysis of indoor human activities and other pollution sources.

Objective:To analyze the outcomes of isoniazid (INH) mono-resistant pulmonary tuberculosis, and risk factors associated with adverse treatment outcomes of INH mono-resistant pulmonary tuberculosis.Methods:A total of 114 cases of INH mono-resistant pulmonary tuberculosis in Xi′an Chest Hospital from January 1, 2018 to December 31, 2020 were retrospectively recruited for analysis. The general information, clinical symptoms, and laboratory test results of patients were collected. With treatment success and adverse treatment outcomes as dependent variables, binary logistic regression analysis was used to analyze the risk factors for the adverse treatment outcome of INH mono-resistant pulmonary tuberculosis.Results:Among 114 patients with INH mono-resistant tuberculosis, 46 cases (40.4%) were cured and 41 cases (36.0%) completed treatment with the success rate of 76.3%(87/114), while 11 cases (9.6%) failed treatment, 13 cases (11.4%) lost to follow up, three cases (2.6%) died.The binary logistic regression analysis showed that male (odds ratio ( OR)=7.22, 95% confidence interval ( CI) 1.47 to 35.43)), no fever at onset ( OR=12.97, 95% CI 2.74 to 61.55), not containing amikacin in the regimen ( OR=5.28, 95% CI 1.20 to 23.31), sputum bacteria load >1+ ( OR=5.87, 95% CI 1.76 to 19.60) were the risk factors for adverse treatment outcomes of INH mono-resistant tuberculosis. Conclusions:The treatment success rate of INH mono-resistant pulmonary tuberculosis patients is high. The risk factors for adverse treatment outcome are male, no fever at the onset, not containing amikacin in the regimen, and sputum bacteria load >1+ .

Objective: To investigate the associations of the single nucleotide polymorphism(SNP) rs1803489, rs7617620 and rs13078528 in vestigial like family member 4(VGLL4) gene with the risk of non-cardia gastric cancer. Methods: The case-control study design was used. 450 cases with non-cardia gastric cancer confirmed by pathology and 450 normal controls were collected in the Han population in Baotou; SNP rs1803489, rs7617620, and rs13078528 inVGLL4were genotyped using polymerase chain reaction(PCR)-restriction fragment length polymorphism(RFLP) technology. Results: VGLL4gene SNP rs1803489 was associated with the risk of non-cardia gastric cancer in the Han population in Baotou. Compared with the carriers of GG genotype, the carriers of AG genotype had a higher risk of non-cardia gastric cancer(OR=1.511, 95%CI=1.095-2.085,P<0.05). SNP rs7617620 and rs13078528 were not associated with non-cardia gastric cancer(P>0.05). Conclusion SNP rs1803489 inVGLL4may have an effect on the risk of non-cardia gastric cancer in the Han population in Baotou. SNP rs7617620 and rs13078528 may not play a major role in the risk of non-cardia gastric cancer.

Objective To systematically evaluate the efficacy and safety of different non-steroidal anti-inflammatory drugs (NSAIDs) in middle-aged and old Chinese patients with osteoarthritis(OA). Methods A systematic literature search was conducted through PubMed, Cochrane Library, CNKI, Wan Fang Data and VIP databases to collect randomized controlled trials with non-steroidal anti-inflammatory drugs in middle-aged to old Chinese OA patients. The search time was from the establishment of the database to November 17, 2020. Two researchers independently carried out literature screening, data extraction and literature quality evaluation. Bayesian network meta-analysis was conducted with R3.6.0 software. Results 28 RCTs were included with 2531 patients. Based on the last follow-up pain visual analogue scale (VAS) score, the ranking chart showed that Etoricoxib had the highest probability of having the lowest pain VAS score (88.55%). In terms of total effective rate, the ranking chart showed that the probability of Etoricoxib as first choice was the highest (92.49%). As far as safety, diclofenac sodium patch had the lowest adverse effects rate (59.10%). Conclusion The results of this study indicated that Etoricoxib was the most effective treatment for middle-aged and old Chinese OA patients. It can significantly reduce the OA pain. Diclofenac sodium patch had the least adverse effects.

Objective:To systematically compare the prognosis in non-compressible torso hemorrhage（NCTH）treated by resuscitative endovascular balloon occlusion of the aorta（REBOA）and resuscitation thoracotomy（RT）.Methods:Data were searched form MEDLINE, EMBASE, PubMed, WanFang, CNKI and VIP databases to collect studies on the prognosis of patients with NCTH undergone REBOA and RT from inception to December 2020. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. The Meta-analysis was performed using Revman 5.3. The patients were divided into REBOA group and RT group according to the different surgical treatment methods on admission, and the prognosis of each group was evaluated. The difference of mortality rate, reoperation rate of laparotomy after operation, reoperation rate of embolization after operation and mortality rate in different operating room area were compared between the two groups. Publication bias was assessed using the Egger test.Results:A total of 2 prospective studies and 4 retrospective studies involving 2, 588 subjects were included. There were 1, 591 patients in REBOA group and 997 patients in RT group. Significant differences were observed in the mortality rate（ I2=68%, OR=0.33, 95% CI 0.26-0.42, P<0.01）, reoperation rate of laparotomy after operation（ I2=76%, OR=1.41, 95% CI 1.11-1.77, P<0.01）and reoperation rate of embolization after operation（ I2=84%, OR=0.76, 95% CI 0.59-0.99, P<0.05）between REBOA group and RT group. Subgroup analysis showed that the mortality rate in the ICU were not statistically different between the two groups（ I2=83%, OR=0.69, 95% CI 0.45-1.05, P>0.05）, but the mortality rate in the emergency room was lower in REBOA group than that in RT group（ I2=94%, OR=0.52, 95% CI 0.38-0.70, P<0.01）. Egger test showed that publication bias had little effect on the results. Conclusions:For patients with NCTH, REBOA can reduce the mortality rate and reoperation rate of embolization after operation, but increase the reoperation rate of laparotomy after operation when compared with RT. In addition, the emergency room may be a more suitable operationg room area for REBOA.

Objective    To discuss the diagnosis and treatment of culture-negative aortic infective endocarditis. Methods    The clinical data of 73 patients with infective endocarditis of the aortic valve whose results of bacteria culture were negative from January 2013 to January 2018 were retrospectively analyzed, including 59 males and 14 females aged 14-71 (39.2±14.8) years. Results    Sixty seven (91.8%) patients received aortic valve replacement, 2 (2.7%) patients received the second operation in hospital, and 12 (16.4%) patients had concomitant mitral valvuloplasty. In-hospital death occurred in 8 (11.0%) patients. Postoperatively, 11 (20.7%) patients had a low cardiac output and 4 (11.0%) patients had heart block, and 1 patient required implantation of a permanent pacemaker. The 1- and 5- year survival rates were 92.3%±2.3% and 84.5%±4.5%, respectively. Conclusion    There are difficulties in the diagnosis and treatment of culture-negative infective endocarditis. Most of the affected patients are in a healed status, which could be a cause of negative culture results. In-hospital mortality in the patients is associated with a history of previous cardiac surgery, whereas the long-term survival rate is good for the patients after surgery.