Objective:To compare and discuss the mid-to-long-term outcomes of mitral valve repair (MVP) versus biological mitral valve replacement (bMVR) in patients aged 60 years and above with rheumatic mitral valve disease.Methods:This is a retrospective cohort study. A total of 765 patients aged 60 years and older, diagnosed with rheumatic mitral valve disease and who underwent MVP or bMVR at Beijing Anzhen Hospital from January 2010 to January 2023, were retrospectively included. Among them, 186 were male and 579 were female, with an age of (66.1±4.5) years (range: 60 to 82 years). Patients were divided into two groups based on the surgical method: the mitral valve repair group (MVP group, n=256) and the bioprosthetic mitral valve replacement group (bMVR group, n=509). A 1∶1 propensity score matching was performed using a caliper value of 0.2 based on preoperative data. Paired sample t-tests, χ2 tests, or Fisher′s exact tests were used for intergroup comparisons. Kaplan-Meier method was employed to plot survival curves and valve-related reoperation rate curves for both groups before and after matching, and Log-rank tests were used to compare the mid-to long-term survival rates and valve-related reoperation rates between the two groups. Results:A total of 765 patients who completed follow-up were ultimately included, with a follow-up period ( M(IQR)) of 5.1(5.0) years (range: 1.0 to 12.9 years). After matching, each group consisted of 256 patients. The incidence of early postoperative atrial fibrillation (39.1% vs. 49.2%, χ2=4.95, P=0.026) and early mortality rates (2.0% vs. 6.2%, χ2=4.97, P=0.026) were lower in the MVP group. Unadjusted Kaplan-Meier analysis showed significantly higher 5-year and 10-year survival rates for the MVP group (92.54% vs. 83.02%, 86.22% vs. 70.19%, Log-rank: P=0.001). After adjustment with propensity scores, the Kaplan-Meier analysis still indicated higher 5-year and 10-year survival rates in the MVP group compared to the bMVR group (92.54% vs. 85.89%, 86.22% vs. 74.83%, Log-rank: P=0.024). There were no significant differences in the rates of valve-related reoperation between the two groups before and after matching (5-year and 10-year reoperation rates pre-matching: 1.75% vs. 0.57%, 5.39% vs. 7.54%, Log-rank: P=0.207; post-matching: 1.75% vs. 0, 5.39% vs. 9.27%, Log-rank: P=0.157). Conclusion:For patients aged 60 years and above with rheumatic mitral valve disease, mitral valve repair offers better mid-to-long-term survival compared to biological valve replacement.

Objective:To evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) for refractory glaucoma.Methods:A prospective multicenter observational case series study was conducted.A total of 63 refractory glaucoma patients (67 eyes) who underwent MP-TSCPC treatment were enrolled at Zhongshan Ophthalmic Center, Sun Yat-sen University, Chengdu First People's Hospital (Chengdu Integrated TCM& Western Medicine Hospital), and Changsha Aier Eye Hospital from August 2022 to April 2023.Among these cases, there were 40 eyes (59.7%) with unreduced intraocular pressure (IOP) after glaucoma surgery, 4 eyes (6.0%) with secondary glaucoma after vitrectomy, 2 eyes (3.0%) with secondary glaucoma after keratoplasty, 8 eyes (11.9%) with neovascular glaucoma, 3 eyes (4.5%) with secondary glaucoma due to iridocorneal endothelial syndrome, 6 eyes (9.0%) with primary open-angle glaucoma and 4 eyes (6.0%) with primary angle-closure glaucoma.Best corrected visual acuity (BCVA) was measured using the ETDRS chart and the IOP was measured using the Goldmann applanation tonometry before and 6 months after the surgery.The usage of anti-glaucoma medications before and after surgery and postoperative complications were recorded.Surgical success rate was calculated and surgical success was defined as an IOP reduction of more than 20% from baseline or a reduction in the number of ocular hypotensive medications with no change in IOP.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University (No.2022KYPJ225).Written informed consent was obtained from each subject.Results:There was a statistically significant overall difference in IOP at different time points before and after surgery ( F=60.10, P<0.001), and the IOP at different time points after surgery was significantly lower than that before surgery, with statistically significant differences (all at P<0.001).IOP reduction at 6 months after surgery was (43.7±20.7)%.The number of anti-glaucoma medications used postoperatively was 2(0, 3) types, which was significantly less than the 3(2, 3) types used preoperatively ( Z=-2.70, P=0.007).The 6-month postoperative BCVA (LogMAR) was 1.40(0.52, 2.70), which showed no significant change compared to the preoperative 1.40(0.70, 2.70) ( Z=-0.10, P=0.952).The surgical success rate was 83.6%(56/67) at 6 months postoperatively.Postoperative complications included mydriasis (11/67), conjunctival hemorrhage (11/67), mild anterior chamber inflammation (1/67), mild ciliary body detachment (3/67), local choroidal detachment (1/67), and cystoid macular edema (1/67), all of which were reversible after treatment. Conclusions:MP-TSCPC appears to be a safe and effective treatment option for refractory glaucoma.

The rapid advancements in artificial intelligence(AI)and computational sciences,particularly through the introduction of artificial intelligence drug design(AIDD)and computer-aided drug design(CADD)technologies,have revolutionized pathways in drug development.These include techniques such as natural language processing,image recognition,deep learning,and machine learning.By employing advanced algorithms and data processing techniques,these technologies have significantly enhanced the efficiency and success rate of R&D processes.In drug discovery,AI technologies have accelerated the identification of drug targets,screening of candidate drugs,pharmacological assessments,and quality control,effectively reducing R&D risks and costs.This article delves into the application of AIDD and CADD in drug development,analyzing their roles in enhancing the success rates and efficiencies of drug design,exploring their future trends,and addressing the potential challenges.

Objective:To compare and discuss the mid-to-long-term outcomes of mitral valve repair (MVP) versus biological mitral valve replacement (bMVR) in patients aged 60 years and above with rheumatic mitral valve disease.Methods:This is a retrospective cohort study. A total of 765 patients aged 60 years and older, diagnosed with rheumatic mitral valve disease and who underwent MVP or bMVR at Beijing Anzhen Hospital from January 2010 to January 2023, were retrospectively included. Among them, 186 were male and 579 were female, with an age of (66.1±4.5) years (range: 60 to 82 years). Patients were divided into two groups based on the surgical method: the mitral valve repair group (MVP group, n=256) and the bioprosthetic mitral valve replacement group (bMVR group, n=509). A 1∶1 propensity score matching was performed using a caliper value of 0.2 based on preoperative data. Paired sample t-tests, χ2 tests, or Fisher′s exact tests were used for intergroup comparisons. Kaplan-Meier method was employed to plot survival curves and valve-related reoperation rate curves for both groups before and after matching, and Log-rank tests were used to compare the mid-to long-term survival rates and valve-related reoperation rates between the two groups. Results:A total of 765 patients who completed follow-up were ultimately included, with a follow-up period ( M(IQR)) of 5.1(5.0) years (range: 1.0 to 12.9 years). After matching, each group consisted of 256 patients. The incidence of early postoperative atrial fibrillation (39.1% vs. 49.2%, χ2=4.95, P=0.026) and early mortality rates (2.0% vs. 6.2%, χ2=4.97, P=0.026) were lower in the MVP group. Unadjusted Kaplan-Meier analysis showed significantly higher 5-year and 10-year survival rates for the MVP group (92.54% vs. 83.02%, 86.22% vs. 70.19%, Log-rank: P=0.001). After adjustment with propensity scores, the Kaplan-Meier analysis still indicated higher 5-year and 10-year survival rates in the MVP group compared to the bMVR group (92.54% vs. 85.89%, 86.22% vs. 74.83%, Log-rank: P=0.024). There were no significant differences in the rates of valve-related reoperation between the two groups before and after matching (5-year and 10-year reoperation rates pre-matching: 1.75% vs. 0.57%, 5.39% vs. 7.54%, Log-rank: P=0.207; post-matching: 1.75% vs. 0, 5.39% vs. 9.27%, Log-rank: P=0.157). Conclusion:For patients aged 60 years and above with rheumatic mitral valve disease, mitral valve repair offers better mid-to-long-term survival compared to biological valve replacement.

Objective To apply the personal digital assistant(PDA)scanning positioning two-dimensional code recognition technology in writing nursing records in patients with acute ischemic stroke treated with intravenous thrombolysis,and to evaluate the application effect.Methods The quasi-experimental design was conducted.The nursing records routinely written by emergency nurses using mobile nursing cart for 58 patients with acute ischemic stroke treated with intravenous thrombolysis admitted to department of emergency of Zhejiang Hospital from September 2021 to February 2022 was taken as the control group,and the nursing records written by emergency nurses using PDA for 51 patients with acute ischemic stroke treated with intravenous thrombolysis from March 2022 to August 2022 through scanning positioning two-dimensional code recognition technology was used as the observation group.The differences of time required for writing nursing records and the incidence of errors in nursing records were compared between the two groups,and the satisfaction of emergency nurses in the observation group using PDA scanning positioning two-dimensional code to write nursing records was evaluated.Results The time required for writing nursing records in the observation group was significantly shorter than that in the control group[seconds:137(109,192)vs.480(436,604),P<0.05],the incidence of inadequate records of the first course of specialist assessment[3.92％(2/51)vs.20.69％(12/58)],and the incidence of insufficiently detailed records of thrombolytic observations[7.84％(4/51)vs.43.10％(25/58)]were significantly lower than the control group(both P<0.05).The differences between the observation group and the control group were not statistically significant when comparing the incidence of irregularities in thrombolytic drug pump records[0％(0/51)vs.1.72％(1/58)],incidence of irregularities in muscle strength assessment records[1.96％(1/51)vs.5.17％(3/58)],and the occurrence of typos in the nursing records[0％(0/51)vs.3.44％(2/58),all P>0.05].In addition,the overall satisfaction of emergency nurses in the observation group using PDA scanning positioning two-dimensional code to write nursing records was 92.94％(2 844/3 060),and the average score of each item in the synchronous nursing record of the positioning two-dimensional code was>4.5 points,among which the satisfaction score of ease of operation was(4.78±0.50),the acceptance of emergency nurses using PDA scanning positioning two-dimensional code to write nursing records was good,and could meet the clinical needs.Conclusion Using PDA scanning positioning two-dimensional code assists the writing of nursing records in the stroke treatment process,shortens the time required for writing nursing records of emergency nurses,reduces the incidence of errors in nursing records,and improves the quality of nursing records;At the same time,for emergency nurses,it can effectively reduce the burden of writing nursing records and improve their satisfaction with nursing records,which is worthy of clinical promotion.

Objective : To investigate the relevance between vitamin D receptor ( VDR) gene promoter methylation level and idiopathic hypocitraturia of the Bai nationality in Yunnan province． Methods : Fifteen patients with idiopathic hypocitrouria of the Bai nationality in Yunnan province with double dominant expression (FF type) of single nucleotide polymorphism shot (SNP shot) rs2228570 (Fok Ⅰ ) genotype were selected as the experimental group. Fifteen people of the Bai nationality in Yunnan province with normal content of urinary citric acid were the control group．First，blood samples were taken from both groups．Next，the blood samples were treated with sulfites，RNA products of each sample were obtained by PCR amplification and in vitro transcription of T7 DNA polymerase．Then the corresponding RNA fragments were digested by base-specific enzymes．Finally the degree of methylation at each test site was obtained through the EpiTYPER procedure. Results: In the statistical results of DNA methylation level，the methylation level of VDR Ⅰ fragment experimental group was 4. 136% ( 1. 655% ，5. 152% ) which was higher than 1. 261% (0. 827% ，1. 930% ) in the control group，and the difference was statistically significant (P ＜0. 001) ．Among the 33 CpG sites on VDR Ⅰ fragment，there were significant differences in DNA methylation levels of CPG-5 (F = 8. 831，P = 0. 008) and CpG-8 (F = 16. 155，P = 0. 001) between the experimental group and the control group． Conclusion The increased methylation level of VDR gene promoter is related with idiopathic hypocitric of the Bai nationality of Yunnan province．And compared with the normal Bai nationality people，the DNA methylation level of VDR gene promoter significantly increased in the Bai nationality patients with FF type of VDR gene SNP shot Fok Ⅰ .

Although there is insufficient evidence supporting the link between septate uterus and infertility, there are many studies demonstrated the effect of spetal incision on pregnancy in women diagnosed with septate uterus associated with infertility. Hysteroscopic metroplasty can significantly improve the reproductive performance of those with septate uterus. Some Müllerian malformations can be healed by surgery. The accurate diagnosis and appropriate therapeutic approch are fundamental for successful treatment. Any attempt at surgical correction of uterine abnormalities must be aimed at preserving or improving reproductive function. Among congenital uterine anomalies, septate uterus is the most amenable to simple hysteroscopic treatment. The resection of the septum is performed as standard treatment worldwide.
Female ; Humans ; Septate Uterus

Objective To investigate the inhibitory effect of cordycepin on immune function injury in lung cancer rats after radiation therapy through JAK2/STAT3 signaling pathway. Methods Fifty rats were used to establish tumor-bearing model and other 10 rats were taken as normal group. After successful modeling, the rats were randomly divided into model group, radiotherapy group, cordycepin group, agonist group and agonist+cordycepin group (10 rats in each group). We compared tumor weight, tumor volume, tumor inhibition rate, IL-6, TNF-α, spleen index and thymus index, the number of T lymphocyte subsets, JAK2, p-JAK2, STAT3 and p-STAT3 protein expression levels among all groups. Results Compared with normal group, IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 in model group were increased, while spleen index, thymus index, CD4+ and CD4+/CD8+ were decreased (P < 0.05). Compared with model group, tumor weight, tumor volume, spleen index, thymus index, CD4+ and CD4+/CD8+ were decreased in radiotherapy group, while IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 were increased (P < 0.05). Compared with radiotherapy group, tumor weight, tumor volume, IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 were decreased in cordycepin group, while tumor inhibition rate, spleen index thymus index, CD4+ and CD4+/CD8+ were increased; tumor weight, tumor volume, IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 protein expression were increased in agonist group, while tumor inhibition rate, spleen index, thymus index, CD4+ and CD4+/CD8+ were decreased (P < 0.05). Compared with agonist+cordycepin group, tumor weight, tumor volume, IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 were decreased in cordycepin group, while tumor inhibition rate, spleen index, thymus index, CD4+ and CD4+/CD8+ were increased; tumor weight, tumor volume, IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 were increased in agonist group, while tumor inhibition rate, spleen index, thymus index, CD4+ and CD4+/CD8+ were decreased (P < 0.05). Conclusion Cordycepin can effectively inhibit the immune function injury in lung cancer rats after radiation therapy, and may play a regulatory role by inhibiting the JAK2/STAT3 signal pathway.

Objective:To develop a framework for a national system of elderly health standards in response to population aging in China and to meet the need for health service standards for elderly care, thus providing a roadmap for the development of elderly health standards.Methods:Preliminary indicators for a framework of a Chinese elderly health standards system were established by literature review and expert consultations.Using the Delphi method, we invited 23 experts to form a consultation panel.After two rounds of expert consultations, the preliminary framework was updated and the weight of each indicator was calculated by using the analytic hierarchy process.Results:A framework of the Chinese elderly health standards system was established after two rounds of expert consultations.The expert authority coefficient was 0.847.The framework proposed four primary indicators, including basic health standards, medical service standards, public health standards and social support standards, for the elderly, with a weight of 0.204, 0.346, 0.260 and 0.189 for each indicator.There were 22 secondary indicators, including standardized terminologies, medical services, health education, geriatrics personnel training, etc., for elderly care.Conclusions:Our research has generated a preliminary framework of an elderly health standards system that incorporates China's specific issues, takes into consideration of the needs of various parties and covers many relevant aspects.It will provide the basis for decision-making in the elderly health standardization process in China and safeguard the implementation of the Healthy China strategy.

Objective:To investigate the role of multimodal neuronavigation intraoperative and sodium fluorescein-guided techniques in microsurgery for intracranial malignant neoplasm.Methods:A retrospective analysis was conducted on 50 patients with intracranial malignant tumors treated by microsurgery from 2016 to 2019 in Inner Mongolia People′s Hospital. Preoperative imaging included computed tomography (CT), computed tomographic angiography (CTA), magnetic resonance imaging (MRI), MRI: MRA, MRV, DWI, PWI, DTI, DTI, MRS sequence scan, and before the operation, they were fused with the functional nervous system navigation workstation of Bo Yilai to make the navigation plan. During the operation, the functional navigation was combined with low dose fluorescein sodium (2 mg/kg) for operation. Intraoperative neuronavigation was used to determine the location of the tumor and its spatial relationship with the pyramidal tract of the main fiber conduction tract and the large blood vessels, and intraoperative yellow fluorescence mode of pentero900 Zeiss microscope showed the boundary between the tumor and normal brain tissue for tumor resection.Results:There were 38 cases of glioma, 10 cases of brain metastasis of lung cancer, 1 case of brain metastasis of renal clear cell carcinoma and 1 case of spindle cell tumor. The accuracy of preoperative neuronavigation was 95%. Compared with the preoperative lesions, MRI of the head was reexamined 3 days after operation to judge the degree of tumor resection. In this group, 38 cases (76%) were totally resected and 12 cases (24%) were subtotal resected. The 6-month survival rate was 85.9%, the 12-month survival rate was 53.1%, the 18-month survival rate was 24.5%, and the survival time was (15.0 ± 3.2) months.Conclusion:Multimodal functional neuronavigation combined with fluorescein sodium staining can locate and label tumors in real time, improve tumor resection rate, and improve the prognosis of brain cancer patients.