Objective To summarize and analyze the preliminary clinical outcomes of the KokaclipTM transcatheter edge-to-edge mitral valve repair system for severe degenerative mitral regurgitation (DMR). Methods This study was a single-arm, prospective, single-group target value clinical trial that enrolled patients who underwent the KokaclipTM transcatheter edge-to-edge repair (TEER) system for DMR in the Department of Heart Surgery of Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute from June 2022 to January 2023. Differences in the grade of mitral regurgitation (MR) during the perioperative and follow-up periods were compared, and the incidences of adverse events such as all-cause death, thoracotomy conversion, reoperation, and severe recurrence of MR during the study period were investigated. Results The enrolled patient population consisted of 14 (50.0%) females with a mean age of 70.9±5.4 years. Twenty-eight (100.0%) patients were preoperatively diagnosed with typeⅡ DMR, with a prolapse width of 12.5 (11.0, 16.1) mm, a degree of regurgitation 4+ leading to pulmonary venous reflux, and a New York Heart Association cardiac function class≥Ⅲ. All patients completed the TEER procedure successfully, with immediate postoperative improvement of MR to 0, 1+, and 2+ grade in 2 (7.1%), 21 (75.0%), and 5 (17.9%) patients, respectively. Mitral valve gradient was 2.5 (2.0, 3.0) mm Hg. Deaths, thoracotomy conversion, or device complications such as unileaflet clamping, clip dislodgement, or leaflet injury were negative. Twenty-eight (100.0%) patients completed at least 3-month postoperative follow-up with a median follow-up time of 5.9 (3.6, 6.8) months, during which patients had a mean MR grade of 1.0+ (1.0+, 2.0+) grade and a significant improvement from preoperative values (P<0.001). There was no recurrence of ≥3+ regurgitation, pulmonary venous reflux, reoperation, new-onset mitral stenosis, or major adverse cardiovascular events. Twenty-two (78.6%) patients’ cardiac function improved to classⅠorⅡ. Conclusion The domestic KokaclipTM TEER system has shown excellent preliminary clinical results in selected DMR patients with a high safety profile and significant improvement in MR. Additional large sample volume, prospective, multicenter studies, and long-term follow-up are expected to validate the effectiveness of this system in the future.

Objective:To compare clinical characteristics,treatment patterns and physiological indicators in bipolar disorder(BD)patients with different age of onset.Methods:Totally 380 patients with DSM-5 BD were se-lected in this study.Psychiatrists diagnosed the patients using the Mini International Neuropsychiatric Interview.The clinical information questionnaire and the Global Assessment of Functioning scale were utilized to collected clinical characteristics,treatment status,and physiological indicators.The onset age of BD was divided into 21 and 35 years as cut-off points.Multivariate logistic regression and linear regression were used to analyze related factors.Results:Among the 380 patients with BD,199 cases were early-onset group(52.4％),121 cases were middle-onset group(31.8％),and 60 cases were late-onset group(15.8％).There were 26.6％of patients in the early-onset group in-itially diagnosed as depression,23.1％in the middle-onset group,and 11.7％in the late-onset group.Multivariate analysis revealed that compared to the early-onset group of BD,the middle-onset(OR=2.22)and late-onset(OR=4.99)groups had more risk to experience depressive episodes,and the late-onset group(OR=6.74)had 6.74 times of risk to suffer from bipolar Ⅱ disorder.Additionally,patients in the middle-onset(β=-1.52)and late-on-set(β=-4.29)groups had shorter durations of delayed treatment,and those in the middle-onset(β=-1.62)and late-onset(β=-3.14)groups had fewer hospitalizations.Uric acid levels were lower in both the middle-onset(β=-28.39)and late-onset(β=-31.47)groups,and total cholesterol level was lower in the middle-onset group(β=-0.23).Conclusion:Patients with BD in different age of onset show significant differences in clinical charac-teristics,treatment conditions and physiological indicators.

Objective: To explore the association between greenness surrounding school and aggression among primary school students, and to explore the potential mediating roles of social support, loneliness, particulate matter (PM2.5) and Nitrogen Dioxide (NO2) in this association, in order to provide a scientific reference for preventing and ameliorating aggressive behaviors of primary school students. Methods: The data was used from a survey of children and adolescents conducted in 2015. The Chinese version of the Buss-Warren Aggression Questionnaire was used to assess total and subtypes of aggression, and the mean values of normalized difference vegetation index (NDVI) of 100 m, 500 m, 1 000 m circular buffers surrounding school were used to indicate the participants greenness exposure. PM2.5 and NO2 datas were obtained from the China High Air Pollutants Dataset.Generalized Linear Mixed Models were used to assess the associations of greenness surrounding school with total and subtypes of aggression. Results: Per IQR increment of NDVI-500 m [OR(95%CI)=1.09(1.03-1.15)] and NDVI-1 000 m[OR(95%CI)=1.07(1.02-1.13)] were positively correlated with physical aggression among primary school children, and per IQR increment of NDVI-100 m [OR(95%CI)=0.94(0.90-0.99)], NDVI-500 m [OR(95%CI)=0.93(0.89-0.98)] and NDVI-1 000 m [OR(95%CI)=0.95(0.91-1.00)] were negatively associated with verbal aggression (P<0.05). Mediation analyses revealed that social support partially mediated the association between the NDVI-500 m and physical aggression (mediation ratio:18.0%) and verbal aggression (mediation ratio:-8.3%) among primary school students, and loneliness partially mediated the association between the NDVI-500 m and physical aggression and verbal aggression among elementary school students effects, with proportion mediated ratios of -10.0% and 21.0%, respectively (P<0.05). Conclusions Exposure to school surrounding greenness is likely to associated with physical aggression and verbal aggression in primary school students, and social support and loneliness may partially mediate these associations.

Objective     To evaluate the early clinical outcomes of the Renatus® balloon-expandable valve in the treatment of severe aortic stenosis. Methods    From November 2021 to April 2022, a total of 38 patients who received Renatus® balloon-expandable valve for severe aortic stenosis in Guangdong Provincial People's Hospital were included. There were 22 males and 16 females, with an average age of 73.7±5.3 years. Mean aortic gradient and peak aortic jet velocity at baseline, post-procedure, and follow-up were compared. Clinical outcomes including all-cause mortality, perivalvular leakage, serious adverse cardiovascular events and the occurrence of permanent pacemaker implantation were assessed. Results    All patients completed the procedure successfully without conversion to thoracotomy or perioperative death. The post-implant mean aortic pressure gradient was decreased from 41.5 (27.8, 58.8) mm Hg to 6.0 (3.0, 8.0) mm Hg, and the peak aortic jet velocity was also decreased from 4.1±0.9 m/s to 1.7±0.4 m/s (P<0.001). Pacemakers were required in 2 (5.3%) patients. The median follow-up time was 27.5 (23.0, 87.5) d, with a follow-up rate of 100.0%. The mean aortic gradient was 8.0 (7.0, 10.8) mm Hg and peak aortic jet velocity was 2.0±0.3 m/s, showing significant improvement compared with those in the preoperative period (P<0.001). No severe aortic regurgitation or paravalvular leak was observed. There was no serious cardiovascular adverse event or reoperative event during the study period. Conclusion    Transcatheter aortic valve replacement with the domestic Renatus® balloon-expandable valve system is a safe and effective procedure for selected patients with severe aortic stenosis who are at high risk or not candidates for surgical aortic valve replacement.

Various pancreatic diseases can cause dyspepsia due to pancreatic exocrine insufficiency （PEI） caused by pancreatic parenchymal injury and/or pancreatic duct obstruction， which further leads to impaired digestive function and a series of severe clinical outcomes such as malnutrition， weight loss， and shortened survival time. Therefore， pancreatic disease-related dyspepsia should be taken seriously in clinical practice to improve its diagnosis and treatment rates， so as to improve the quality of life of patients with pancreatic diseases and prolong overall survival time.

Objective: To establish colorectal cancer LoVo and SW620 cell lines that stably interfere with the expression of LINC01224, and to explore the effect of down-regulating the expression of LINC01224 on cell apoptosis. Methods: The GEPIA2 database was used to analyze the expression of LINC01224 in colorectal cancer tissues; qPCR method was used to detect the expression of LINC01224 in 10 human colorectal cancer cells. Three different LINC01224 siRNAs were respectively transfected into human colorectal cancer LoVo cells, and the LINC01224 shRNA lentiviral vector was constructed with the siRNA sequence with the most obvious inhibitory effect of LINC01224 expression. Recombinant lentiviral particles were packaged in HEK293 T cells and then infected with LoVo and SW620 cells. After selection by puromycin, the monoclonal cells that stably interfere with LINC01224 were obtained by limiting dilution method. MTS method detects cell proliferation ability, and flow cytometry detects cell apoptosis rate. Results: The expression of LINC01224 in colorectal cancer tissues was higher than that in normal colorectal tissues, and its expression in 10 types of colorectal cancer cells was also higher than that in normal colorectal epithelial cells HCOEPic. The inhibition rate of siRNA-3 on the expression of LINC01224 in LoVo cells was higher than that of siRNA-1 and siRNA-2. Therefore, siRNA-3 was chosen to design LINC01224 shRNA.Compared with the control group(sh-NC group), the expression level of LINC01224 in the LoVo and SW620 cells of the stable interference LINC01224 group(sh-LINC01224 group) was reduced(P<0.01), and the cell growth rate was slowed down(P<0.01), the rate of apoptosis also increased(P<0.01). Conclusion The shRNA lentiviral interference vector of LINC01224 is successfully constructed, which can stably infect LoVo and SW620 cells, down-regulate the expression of LINC01224 and induce cell apoptosis.

Objective To investigate the hematological characteristics of patients with light β- thalassae-mia and rapidly identify different mutational genotypes. Methods RBC、Hb、MCV、MCH、MCHC、RDW-CV and HbA2 were studied in the 646 patients,the differences between β0/βN and β +/βN mutations were also compared. Results Most of them were microcytic hypochromic anemia. The most common genotype were β654/βN(33%)、β41-42/βN(32.5%)、β17/βN(14.4%)、β - 28/βN(10%)respectively,β0/βN were relatively higher. The differences in RBC、MCV、MCH、RDW-CV and HbA2 were significant between β0/βN and β +/βN. Compared with β +/βN patients,the MCV and MCH of β0/βN were significantly reduced,RDW-CV and HbA2 were significantly higher. Conclusion Light β- thalassaemia with different genotypes has its own unique hematological features and can be quickly and ef-fectively identified. Clinical efficiency can be improved through hematological analysis.

Objective To understand the situation of medical students' social adaptability and analyze its relationship with their family upbringing style.Methods A cross-sectional study was adopted,and the random sampling method was used to selected medical students as targeted population in a medical university in Jilin City.Parenting Style Assessment Scale and Social Adaptation Diagnostic Scale were applied to know the family rearing styles and social adaptability status of medical college students.Results Among the 198 responders,the proportion of good and strong social adaptability among medical college studies accounted for only 8.1％ (16) and 2.0％ (4);The social adaptation ability of the urban students and the only child students was higher than that of the rural and non only child students (P＜0.05);In parental rearing pattems,regardless of sex,whether students were the only child and where their census register was,emotional warmth and understanding were all positively correlated with medical students' social adaptation ability (P＜0.05),while refusal and denial were negatively correlated with medical students' social adaptation ability (P＜0.05);In addition,the punishment,severe over protection and other parenting styles also showed a certain degree of negative correlation with social adaptability(P＜0.05).Conclusion The social adaptability of medical students is poor,and their parenting styles was correlated with their social adaptation ability.Parents should give their children warmth and understanding,rather than rejection,denial,punishment,and overprotection,which will help to improve medical students' social adaptability.

Objective To analyze the long-term prognosis and prognostic factors of idiopathic collapsing focal segmental glomerulosclerosis (FSGS) and not otherwise specified FSGS in children. Methods The clinical, pathology and follow-up data of patients with idiopathic collapsing FSGS and not otherwise specified FSGS were analyzed retrospectively by Kaplan-Meier method, univariate and multivariate Cox regression analysis. Results A total of 64 patients (29 idiopathic collapsing FSGS and 35 not otherwise specified FSGS) were diagnosed by renal biopsy. The 4-year renal survival rate of idiopathic collapsing FSGS and not otherwise specified FSGS were 48.3%, 74.3% respectively. Univariate analysis revealed that the renal survival time were 25.41±3.28 months in idiopathic collapsing patients, and 35.53±2.73 months in not otherwise specified patients. The different is significant (χ2=4.07,P=0.044). Multivariate Cox regression analysis showed that poor treatment response (HR=5.92, P<0.05) and renal insufficiency at early stage (HR=2.45, P<0.05) were independent risk factors of prognosis. Conclusions Compared with patients with not otherwise specified FSGS, the renal survival time is shorter in idiopathic collapsing FSGS patients. Patients with renal insufficiency and poor response to treatment have poorer prognosis.

Objective To explore the effect of comprehensive intervention on constipation caused by antipsychotic drugs.Methods Ninty patients with antipsychotic drug induced constipation who were admitted to our hospital from June 2012 to October 2013 were enrolled in this investigation and randomly assigned to the comprehensive intervention group(CIG,n=46) and the routine care group(RCG,n=44).The subjects of the RCG received routine diet and medication therapy; and those of CIG received comprehensive intervention of life style,psychological ability,cognition,nursing and traditional chinese medicine(TCM) for 3 months.Constipation symptoms scale and Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) were assessed before and after the intervention.Results CIG showed significant improvement in defecation difficulty,defecation force,defecation duration,frequency,abdominal distension,total symptom score,PAC-QOL,physical discomfort,psycho-social discomfort,anxiety and treatment satisfaction were(2.8±2.1),(2.2±1.6),(2.4±1.3),(2.1±1.7),(1.5±0.9),(14.0±8.1)respectively (t values were 2.629,3.818,2.328,2.593,2.578,2.913,7.499,2.570,5.012,2.249 and 12.259,respectively; all P＜0.05).Conclusion Comprehensive intervention may be an effective therapy against psychiatric drug induced constipation.