Objective:To evaluate the correlation and consistency between quantitative coronary flow fraction (QFR) and cardiac magnetic resonance imaging (CMR) in assessing myocardial ischemia in patients with coronary heart disease (CAD).Methods:A retrospective analysis was conducted on the data of coronary heart disease patients who underwent load CMR examination and coronary angiography at the Beijing Anzhen Hospital, Capital Medical University from August 2017 to March 2022. CMR examination includes cardiac cine, load/rest myocardial perfusion imaging, and delayed enhancement sequence. According to the results of CMR examination, the patient′s left ventricular myocardial segments were divided into normal segment group and abnormal segment group (further divided into ischemic segment group and infarcted segment group). On the basis of coronary angiography, an artificial intelligence based platform (AngioPlus system) was applied to calculate the preoperative coronary artery QFR value of patients undergoing percutaneous coronary intervention treatment. Kappa test was used to evaluate the consistency of QFR and CMR in diagnosing abnormal myocardium; Mann Whitney U test was used to compare the differences in QFR between groups; The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of QFR in diagnosing abnormal myocardium; Spearman correlation analysis was used to clarify the relationship between myocardial infarction area and QFR value of the supplying coronary artery in patients.Results:Among the 70 CAD patients enrolled, there were 60 males and 10 females, aged (54.1±11.1)years. At the vascular level, the consistency between QFR and CMR in diagnosing myocardial injury (including ischemia and infarction) is moderate (Kappa value=0.514). The sensitivity and specificity of detecting abnormal myocardial segments in CAD patients were 57% and 91%, respectively. The area under the curve (AUC) value of QFR predicting abnormal myocardium in CAD patients was 0.769, and the optimal cutoff value was QFR=0.865. At this time, the sensitivity and specificity of QFR predicting myocardial injury in CAD patients were 67.2% and 84.3%, respectively. The difference in vascular QFR between the normal segment group, ischemic segment group, and infarcted segment group was statistically significant ( P<0.001), with the infarcted segment group having significantly lower QFR values than the other two groups (all P<0.01). The range of myocardial infarction was negatively correlated with the QFR value of the supplying coronary artery ( r=-0.45, P<0.001). At the patient level, the consistency between QFR and CMR in diagnosing myocardial injury (including ischemia and infarction) was moderate (Kappa value=0.445), with a sensitivity of 74% and a specificity of 81% for diagnosing myocardial injury in CAD patients. Conclusions:Compared with CMR, QFR has better specificity in detecting myocardial injury in CAD patients. The QFR value of the infarcted segment group is significantly lower than that of the ischemic group and the normal group. The area of myocardial infarction is negatively correlated with the QFR value of the supplying coronary artery.

Objective To compare and analyze the differences between customized models and commercial universal models in the segmentation of organs-at-risk in cervical cancer,and to investigate the feasibility of customized models.Methods A retrospective analysis was conducted on 270 cervical cancer patients.Senior clinicians manually delineated organs-at-risk,including the bladder,rectum,small intestine,pelvic bone marrow,femoral heads,and kidneys.The cases were randomly selected to develop customized models,with 202 cases allocated to the training set,38 cases to the test set,and 30 cases to the validation set.The universal and customized models were used for segmentation on the test set,and the automatic segmentation results obtained by the two models were compared with manual segmentation results to assess the performance of the customized model.Results Both customized model and universal model had comparable DSC values to manual segmentation,demonstrating satisfactory delineation outcomes(DSC values ranging from 0.7 to 0.9).However,in terms of deviation of centroid and 95％Hausdorff distance,the customized model surpassed the universal model.Conclusion Compared with the universal model,the customized model offers superior accuracy in delineating the structures of organs-at-risk in cervical cancer.As the customized model is optimized based on specific datasets,it provides precise support for clinical decision-making and holds promising applications in the treatment of cervical cancer.

METTL3 and METTL14 are two components that form the core heterodimer of the main RNA m6A methyltransferase complex (MTC) that installs m6A. Surprisingly, depletion of METTL3 or METTL14 displayed distinct effects on stemness maintenance of mouse embryonic stem cell (mESC). While comparable global hypo-methylation in RNA m6A was observed in Mettl3 or Mettl14 knockout mESCs, respectively. Mettl14 knockout led to a globally decreased nascent RNA synthesis, whereas Mettl3 depletion resulted in transcription upregulation, suggesting that METTL14 might possess an m6A-independent role in gene regulation. We found that METTL14 colocalizes with the repressive H3K27me3 modification. Mechanistically, METTL14, but not METTL3, binds H3K27me3 and recruits KDM6B to induce H3K27me3 demethylation independent of METTL3. Depletion of METTL14 thus led to a global increase in H3K27me3 level along with a global gene suppression. The effects of METTL14 on regulation of H3K27me3 is essential for the transition from self-renewal to differentiation of mESCs. This work reveals a regulatory mechanism on heterochromatin by METTL14 in a manner distinct from METTL3 and independently of m6A, and critically impacts transcriptional regulation, stemness maintenance, and differentiation of mESCs.
Animals ; Mice ; Methylation ; Chromatin ; Histones/metabolism* ; RNA, Messenger/genetics* ; Methyltransferases/metabolism* ; RNA/metabolism*

Objective:To explore the mediating effect of self-efficacy of family caregivers of dementia patients between patient-related impairment and caregivers' health-related quality of life.Methods:This study was a aross-sectional study. Using the convenient sampling method, family caregivers of dementia patients who accompanied patients in two ClassⅢ Grade A hospitals in Shanghai from December 2015 to September 2019 were selected as the research objects. Self-Efficacy Questionnaire for Chinese Family Caregivers (SEQCFC) , the MOS 36-item Short Form Health Survey (SF-36) and the Chinese Version of the Relevant Outcome Scale for Alzheimer's disease (CROSA) were used to conduct the questionnaire survey. SPSS 22.0 and AMOS 22.0 software were used for statistical analysis, Pearson correlation was used to calculate the correlation between variables and structural equation model was established to test the relationship between variables.Results:A total of 291 caregivers who met the inclusion criteria completed the questionnaire assessment, and the completion rate of the questionnaire was 100%. The impairment score of dementia patients was (87.13±23.88) , the total score of self-efficacy of care givers was (57.49±16.42) , the overall physical health score of health-related quality of life was (41.33±9.71) and the total score of mental health was (48.85±7.69) . The results of Pearson correlation analysis showed that in addition to the self-efficacy of the support dimension, the total score of the patients' dementia-related impairment was positively correlated with the total score of the caregivers' self-efficacy and the self-efficacy of the care giving behavior dimensions ( P< 0.05) . The total score of dementia-related impairment of patients was positively correlated with the total score of physical health and the total score of mental health of caregivers ( P<0.01) . The total score of caregivers' self-efficacy and the self-efficacy of each dimension of caregiving behavior were positively correlated with the total score of physical health and mental health of caregiver ( P<0.01) . Caregivers' self-efficacy was a partial mediator between dementia-related impairment and physical and mental health related quality of life of caregivers, and the mediation effect accounted for 29.79% and 43.67% of the total effect, respectively. Conclusions:The dementia-related damage of patients can directly affect the caregivers' health-related quality of life and it can also indirectly affect the caregivers' health-related quality of life through the caregivers' sense of self-efficacy. Therefore, it can reduce effects of dementia-related impairment on health-related quality of life of caregivers by improving caregivers' sense of self-efficacy.

Objective:The current systematic review aims to evaluate the effectiveness and quality of interventions on depressive symptoms of informal caregivers of people with dementia in China and to provide evidences regarding protocols for the most effective interventions.Methods:A systematic literature search of Chinese and English databases was performed, covering randomized controlled trails published up to March 2019. The papers for final review were selected based on the inclusion and exclusion criteria. Data were extracted and analyzed with RevMan 5.3, after a quality appraisal of the included studies.Results:A total of 17 papers were identified as eligible for descriptive analysis and 14 of the papers provided estimates for meta-analysis, with 991 participants. An overall mean reduction in depression was identified among the participants of intervention group, compared to those in the control group ( SMD value was -0.75, 95% CI -0.88 - -0.62, P<0.01). Psychotherapeutic ( SMD value was -0.59, 95% CI -0.78 - -0.40, P<0.01) and psychoeducational interventions ( SMD value was -0.84, 95% CI -1.02 - -0.67, P<0.01) showed significant reductions of depressive symptoms among the caregivers. In addition, Evidence exists for the effectiveness across from the short-term ( SMD value was -0.54, 95% CI -0.82 - -0.26, P<0.01), medium-term ( SMD value was -0.68, 95% CI -0.83 - -0.52, P<0.01) to the long-term interventions ( SMD value was -0.80, 95% CI -1.08 - -0.53, P<0.01). Conclusion:Interventions targeting to reduce depressive symptoms are effective among informal caregivers of persons with dementia in China. However, insufficient evidences are found regarding the most effective protocols and more high-quality studies are needed for the target population.

Objective To explore the safety and feasibility of guiding catheter passing through spasmodic vessels in patients undergoing percutaneous coronary intervention (PCI) via radial artery access by the aid of PCI guiding wire and balloon .Methods The clinical data of 33 coronary artery disease (CAD) patients undergoing PCI via radial artery access with radial artery or (and) brachial artery spasm ( group A ) were retrospectively analyzed .Among all these patients , guiding catheters were delivered through the spasmodic vessels successfully by the aid of PCI guiding wires and balloons .The clinical data of other 38 CAD patients having PCI during the same period performed by other operators via radial artery or ( and ) brachial artery approach and experienced vessel spasm were anlysed as the control ( group B ) .All patients in group B received conventional anti-spasm management during PCI .All vessel spasm was identified by angiography.For patients in group A , a diameter of 0.014 inch guiding wire was chosen to pass through the spasmodic vessel segment carefully and gently .The diameter of balloon should be chosen according to the diameter of guiding catheter .A balloon diameter of 2.0 mm and 2.5 mm was corresponded to 6F and 7F guiding catheter respectively .The balloon was advanced to the tip of guiding catheter , keeping a half in catheter and a half in vessel followed by inflating the balloon with a pressure of 8 atm.The balloon was kept inflated the guiding catheter was pushed in vitro carefully and slowly until the catheter passed through the spasmodic vessel segment .Then the balloon was deflated and pulled out together with PCI guiding wire . Exchanged a diameter of 0.035 inch wire and completed the positioning of guiding catheter .After finishing the PCI, radial or ( and) brachial angiography was performed again to observe if spasm disappeared and to determine if there any contrast medium exudation .For patients in group B , routine approach was applied including administration of nitroglycerine , diltiazem or nitroprusside etc . to relieve vessel spasm. Results The location of vessel spasm was similar in group A and group B ( P=0.150 ) , and the incidence rate of spasm in brachial artery was higher than that in radial artery in both groups .The chance of guiding catheter crossing the spasmodic vessel segment was significantly higher in group A than in group B ( 100%vs.39.5%, P=0.00).In patients whose guiding catheter could pass through the spasmodic vessel segment successfully , time spent in group A was shorter than in group B ( P=0.000 ) .The patient number which time spent was less than five minutes , five to 15 minutes and more than 15 minutes was 30 and 2 ( 90.1%vs.13.3%) , 3 and 7 ( 9.9% vs.46.7%) and 0 and 6 ( 0% vs.40.0%) in group A and in group B respectively.The incidence of forearm hematoma was lower in group A than in group B without statistical difference [6.1%(2/33) vs.18.4%(7/38), P =0.113].Conclusions It is safe and feasible for passing guiding catheter through spasmodic vessels during PCI via radial artery access by the aid of PCI guiding wire and balloon .

Objective: To evaluate the effect of catheter ablation (CA) by endpoint of left atrium (AF)- pulmonary vein (PV) with bi-directional electrical isolation in treating the patients with paroxysmal atrial fibrillation (PAF) with remote electro-cardio graphic monitoring.
Methods: A total of 82 AF patients received radio frequency catheter ablation (RFCA) in our hospital and 76 PAF patients were observed. Based on circumferential pulmonary vein isolation (CPVI) judgment, the PAF patients were divided into 2 groups: Bi-directional block (BDB) group,n=20 and Entrance block (EB) group,n=56. The post-operative rhythm was followed-up by remote electro-cardio graphic monitoring and the clinical efifcacy of CA was prospectively observed.
Results:①All 76 patients finished CA, 1 patient died in EB group at 4 days after operation for pulmonary embolism, the rest 75 patients were followed-up for (31±19) months. The overall success rates of single ablation procedure at 3 months and 6 months after operation were 85.33% and 77.33%; in BDB group were 95.00% and 85.00%, in EB group were 81.82% and 74.55% respectively, the result was similar between 2 groups,P>0.05.②The overall occurrence rates of arrhythmia at 1 week and 3 months after operation were 35.53% and 17.33%; in BDB group were 15.00% and 5.00%, in EB group were 42.86% and 21.82% respectively, the differences between 2 groups were at P=0.049 andP>0.05.③Remote electro-cardio graphic monitoring recorded the patients with asymptomatic atrial arrhythmia at 1 week and 3 months after operation were at 22.22% and 23.08% respectively.
Conclusion:①Compared with EB group, BDB group had obviously lower occurrence rate of arrhythmia at short term after CA.②The overall success rate of single ablation procedure was similar between 2 groups which might be because less patients were studied.③Remote electro-cardio graphic monitoring has certain advantage for evaluating the occurrence of atrial arrhythmia after operation.

Objective: To explore the feasibility and safety of three dimensional (3D) electro-anatomical mapping system (Carto3) in treating the patients with paroxysmal supra-ventricular tachycardia (PSVT) by radiofrequency catheter ablation (RCFA).
Methods: A total of 180 PSVT patients were divided into 2 groups, n=90 in each group. 3-D group, the patients received RCFA with 3-D reconstructed valve ring model under Carto3 guidance. 2-D group, the patients received RCFA under conventional X-ray guidance. The procedural and X-ray exposure times, rates of success and complications, tachycardia recurrence at 6 months after procedure and the cost were observed and compared between 2 group.
Results: The procedural time was similar between 2 groups, P=0.1403. The patients in 3-D group had the lower X-ray exposure time (2.1 ± 0.7 vs 7.8 ± 3.6) min, particularly in those with right-sided accessory pathway (3.4 ± 0.7 vs 20.2 ± 7.1) min, and dual atrio-ventricular (A-V) nodal pathways (1.1 ± 0.3 vs 5.5 ±1.7) min, all P<0.0001. There was 1 patient in 3-D group without RCFA and all the others were successes. 2-D group had 3 patients with failed RFCA including 2 of right-sided accessory pathway, 1 of dual A-V nodal pathways and received 2nd RCFA under Carto3 guidance. 3-D group had no complication, no recurrence. In 2-D group, 1 patient suffered from complete A-V block (AVB) during ablation and 1-year later, the Holter showed II° to III° AVB;2 patients with recurrence including 1 of dual A-V nodal pathways and had successful 2nd ablation. The cost was higher in 3-D treatment.
Conclusion: RFCA was feasible for treating PSVT patients under Carto3 guidance, which had the higher success rate with lower X-ray exposure and complication.

Aged ; Aortic Rupture ; diagnostic imaging ; therapy ; Catheter Ablation ; methods ; Female ; Humans ; Radiography

Endogenous beta retroviruses (enJSRV) are highly homologous with Jaagsiekte sheep retrovirus (exJSRV),this exogenous retrovirus is the aetiological agent of ovine pulmonary adenocarcinoma (OPA).The aim of this study was to clarify the function of enJSRV and the immunological mechanisms of its corresponding antibody,that is undetectable in JSRV-infected ovine serum.The expression of enJSRV envelope protein and Hyal-2 mRNA in immune organs and lungs of ovine fetuses and lambs were analyzed by Real-Time reverse transcription PCR and In Situ Hybridization using specific probes.In Situ Hybridization results indicated that the enJSRV envelope protein and Hyal-2 mRNA were expressed in thymus,spleen,mesenteric lymph nodes and lungs at different times,while no positive signals were detected in the negative controls.On the other hand,results from Real-Time reverse transcription PCR analysis showed that in 130d fetuses and 3d newborn lambs the enJSRV mRNA levels were much higher in organs associated with the immune system than that in lungs,especially in the thymus and spleen,but levels of Hyal-2 mRNA expression was not significantly different in all collected tissue.These results provided evidence from an immunology point of view to understand why the circulating antibodies against exJSRV are undetectable in JSRV-infected ovine,and will help to unravel the pathogenesis of JSRV-infected ovine.