Objective: To explore the long-term clinical efficacy of transcatheter repair of mitral paravalvular leak (PVL) post surgical mitral valve replacement. Methods: This study is a retrospective study. Patients who completed transcatheter repair of paravalvular leak after surgical mitral valve replacement at Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine from March 2010 to December 2018 were included. Technical success was defined as the occluder being stably implanted in the paravalvular leak site without affecting the function of the mitral valve and surrounding tissues; and there were no intervention-related complications, such as new hemolysis or aggravated hemolysis, and echocardiography confirmed mitral paravalvular regurgitation reduced by more than 1 grade. Patients were followed up at 30 days, 1, and 3 years after the intervention. The main endpoints were all-cause death and re-surgery due to interventional failure or serious complications. The occurrence of occluder-mediated hemolysis and chronic renal insufficiency was recorded, and patients were monitored with echocardiography during follow up. Results: A total of 75 patients were included, aged (54.3±22.9) years old, and 38 patients were males. All patients had decreased cardiac function and/or hemolysis before intervention. Procedural success was achieved in 54 patients (72.0%). Incidence of device-mediated hemolysis was 18.7% (14/75). During the follow-up period, all-cause death occurred in 7 patients (9.3%), and 3 were cardiac deaths.The 3-year event-free survival rate was 81.3% (61/75). The need for cardiac surgery was 9.3% (7/75): 3 cases due to severe device-mediated hemolysis, 2 cases due to prosthetic valve failure and 2 cases due to moderate to severe residual regurgitation. The echocardiography follow-up results showed that the position of the occluder was stable, there was no impact on the artificial valve function and surrounding structures, and the residual regurgitation was stable without progressive increase in event-free patients. Compared with pre-intervention, the left ventricular end systolic diameter ((33.9±7.4)mm vs. (38.3±8.9) mm, P=0.036), end diastolic diameter ((53.7±8.3) mm vs. (58.4±9.1) mm, P=0.045) and left atrial diameter (59.3 (44.5, 90.7) mm vs. 64.3 (44.8, 96.6) mm, P=0.049) were significantly reduced, pulmonary artery systolic pressure was also significantly decreased ((36.5±15.8) mmHg vs. (46.3±14.9) mmHg, P=0.022, 1 mmHg=0.133 kPa). There was no significant difference between 3 years and 1 year after transcatheter repair of mitral paravalvular leak post surgical mitral valve replacement (all P>0.05). Conclusion: Transcatheter repair of mitral paravalvular leak post surgical mitral valve replacement is an effective treatment option in selective patients.
Male ; Humans ; Adult ; Middle Aged ; Aged ; Female ; Mitral Valve/surgery* ; Heart Valve Prosthesis Implantation ; Heart Valve Prosthesis ; Retrospective Studies ; Hemolysis ; China ; Mitral Valve Insufficiency/surgery* ; Treatment Outcome ; Cardiac Catheterization ; Prosthesis Failure

Humans ; Transcatheter Aortic Valve Replacement/adverse effects* ; Heart Septal Defects, Ventricular/surgery* ; Heart Valve Prosthesis Implantation ; Iatrogenic Disease ; Ventricular Outflow Obstruction/surgery* ; Treatment Outcome ; Aortic Valve/surgery*

Humans ; Transcatheter Aortic Valve Replacement/adverse effects* ; Heart Septal Defects, Ventricular/surgery* ; Heart Valve Prosthesis Implantation ; Iatrogenic Disease ; Ventricular Outflow Obstruction/surgery* ; Treatment Outcome ; Aortic Valve/surgery*

Objective To evaluate the impact of environmental and climatic factors on the distribution of suitable habitats of Haemaphysalis longicornis, and to predict the potential distribution of H. longicornis under different climate patterns in China. Methods Data pertaining to the distribution of H. longicornis were retrieved from public literatures. The effects of 19 climatic factors (annual mean temperature, annual mean temperature difference between day and night, isothermality, standard deviation of seasonal variation of temperature, maximum temperature of the warmest month, minimum temperature of the coldest month, temperature annual range, mean temperature of the wettest season, mean temperature of the driest season, mean temperature of the warmest season, mean temperature of the coldest season, annual mean precipitation, precipitation of the wettest month, precipitation of the driest month, coefficient of variance of precipitation, precipitation of the wettest season, precipitation of the driest season, precipitation of the warmest season and precipitation of the coldest season) and 4 environmental factors (elevation, slope, slope aspect and vegetation coverage) on the potential distribution of H. longicornis were assessed using the maximum entropy (MaxEnt) model based on the H. longicornis distribution data and climatic and environmental data, and the potential distribution of H. longicornis was predicted under the RCP 2.6 and 8.5 emissions scenarios. Results Among the environmental and climatic factors affecting the geographical distribution of H. longicornis in China, the factors contributing more than 10% to the distribution of H. longicornis mainly included the precipitation of the driest month (26.0%), annual mean temperature (11.2%), annual mean precipitation (10.0%) and elevation (24.2%). Under the current climate pattern, the high-, medium- and low-suitable habitats of H. longicornis are 1 231 900, 1 696 200 km² and 1 854 400 km² in China, respectively. The distribution of H. longicornis increased by 336 100 km² and 367 300 km² in 2050 and 2070 under the RCP 2.6 emissions scenario, and increased by 381 000 km² and 358 000 km² in 2050 and 2070 under the RCP 8.5 emissions scenario in China, respectively. Conclusions Climatic and environmental factors, such as precipitation, temperature and elevation, greatly affect the distribution of H. longicornis in China, and the suitable habitats of H. longicornis may expand in China under different climate patterns in future.

Objective To evaluate the effects of environmental factors the distribution of Ixodes persulcatus, and to predict the future suitable habitats of I. persulcatus in China. Methods The known distribution sites of I. persulcatus in China were captured from national and international published literatures. The effects of 14 environmental factors on the distribution of I. persulcatus were examined using the Jackknife test, including mean annual temperature, mean monthly temperature range, isothermality, temperature seasonality, maximum temperature of the warmest month, minimum temperature of the coldest month, temperature annual range, mean temperature of the wettest quarter, mean temperature of the driest quarter, mean temperature of the wet-test quarter, mean temperature of the coldest quarter, annual mean precipitation, precipitation of the wettest month, precipitation of the driest month, precipitation seasonality, precipitation of the wettest quarter, precipitation of the driest quarter, precipitation of the warmest quarter, precipitation of the coldest quarter, elevation, slope, aspect and vegetation. The suitable habitats of I. persulcatus were predicted in China using the maximum entropy model and ArcGIS 10.7 software with the environmental factors. Results Currently, the highly suitable habitats of I. persulcatus covered an area of 886 600 km² in China, which were predominantly located in northeastern China. The environmental factors that contributed more than 10% to the distribution of the suitable habitats of I. persulcatus in China included annual temperature variation range (39.1%), the coldest quarterly precipitation (23.2%), and the annual mean precipitation (11.9%). Based on the maximum entropy model, the suitable habitats of I. persulcatus were predicted to show a shrinking tendency towards northeastern China in 2070. Conclusions The suitable habitat of I. persulcatus strongly correlates with temperature and precipitation, and climate and environmental changes may lead to shrinking of the future suitable habitat of I. persulcatus in China.

Objective: To investigate the influencing factors of in-stent restenosis (ISR) following successful stent implantation in patients with ablation-associated severe pulmonary vein stenosis (PVS) who undergo atrial fibrillation ablation. Methods: Data of patients who underwent pulmonary vein angiography to confirm PVS after radiofrequency ablation for atrial fibrillation (AF) and received pulmonary vein stenting at Shanghai Chest Hospital from March 2010 to December 2017 were retrospectively analysed. All patients were followed up for a long period of time (pulmonary vein contract-enhanced CT within 6 to 12 months after operation was performed, and pulmonary angiography was performed if CT indicated stenosis>50%). The incidence of ISR was recorded. According to angiography, the patients were divided into ISR group and non-ISR group. The clinical and intraoperative imaging characteristics and interventional data were compared between the two groups. Logistic regression was used to analyse the influencing factors of ISR. Results: A total of 47 patients ((47.1±12.2) years old) were enrolled in this study, including 28 males(59.6%). There were 19 cases in ISR group and 28 cases in non-ISR group. Compared with the non-ISR group, the ISR group received more pulmonary vein isolation ((2.8±0.9) vs. (1.8±1.3), P=0.02), and the interval between last ablation and stenting was longer ((19.4±9.6) vs. (13.0±12.4), P=0.03). The incidence of ISR in patients with stent diameter≤8 mm was significantly higher than those with stent diameter>8 mm (33.3%(20/60) vs. 8.1%(3/37), P<0.01). Logistic regression analysis found that the number of radiofrequency ablation>1 (OR=2.1, 95%CI 1.3-3.9, P=0.02), and the time from the last ablation to stent placement>12 months (OR=1.5, 95%CI 1.1-2.5, P=0.03), reference diameter of stenosed distal vessel (OR=0.7, 95%CI 0.5-0.9, P=0.04), post procedural minimal luminal diameter (OR=0.4, 95%CI 0.2-0.8, P=0.02) and stent diameter (OR=0.6, 95%CI 0.3-0.9, P=0.03) were independent factors of ISR. Conclusions: The greater number of radiofrequency ablations and the longer time from the last ablation to stent placement increase the risk of ISR. The larger reference diameter of the stenosed distal vessel, stent diameter and post procedural minimal luminal diameter are the protective factors of ISR.
Adult ; Atrial Fibrillation ; Catheter Ablation ; China ; Constriction, Pathologic ; Coronary Restenosis ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; Retrospective Studies ; Stenosis, Pulmonary Vein ; Stents ; Treatment Outcome

Objective To explore the strategy and countermeasures of Oncomelania hupensis snail control and evaluate the effect in inside-embankment areas of lake-type schistosomiasis endemic area,for providing the effective method for controlling and interrupting the schistosomiasis transmission. Methods The data of schistosomiasis epidemic and its control and preven-tion were collected in Junshan District,Hunan Province,and the effect of snail control countermeasures were evaluated and the trend of indexes of snails was drafted in the inside-embankment areas of Junshan District,Hunan Province from 1998 to 2007. Results The area with snails in the inside embankment areas of Junshan District decreased by 98.43%,from 1496.66 hm2 in 1998 to 23.48 hm2 in 2017. The occurrence rate and average density of of living snails decreased from 20.61%and 0.45 snail/0.1 m2 in 2003 to 2.06%and 0.03 snail/0.1 m2 in 2017. The highest area with schistosome infected snails was found in 2001 and the total area was 79.36 hm2,however,no infected snails were found since 2007. The total fiscal investment for schistosomiasis pre-vention and control was 398.857 million RMB in Junshan District,including molluscicide(81.7709 million RMB)and environ-ment reform(213.5 million RMB)respectively. Conclusion The comprehensive measures,mainly including the combination of molluscicide and environment reform have gotten a significant effect in snail control and elimination in the inside-embankment areas,but the snail surveillance still need to be strengthened in the historic areas with snails.

OBJECTIVETo study the relationship between the levels of erythropoietin (EPO) in serum and brain injury in preterm infants.

METHODSThree hundred and four preterm infants (gestational age: 28-34 weeks) born between October 2014 and September 2015 were enrolled in this study. Brain injury was diagnosed using cerebral ultrasound and MRI. The levels of EPO, S100 protein, neuron-specific enolase (NSE) and myelin basic protein (MBP) in serum were detected using ELISA. To compare the incidence of brain injury in different serum EPO levels in preterm infants, and the relationship between brain injury and serum EPO levels was analyzed.

RESULTSThe incidence rate of brain injury in preterm infants was 41.1% (125/304). The incidence rate of brain injury in the low EPO level group was significantly higher than that in the middle-high EPO level groups (P<0.01). The serum levels of S100 protein, NSE, and MBP in the brain injury groups were significantly higher than in the control group (P<0.01). The serum EPO levels were negatively correlated with serum S100 protein concentration and NSE levels (P<0.05). According to the multiple logistic regression analysis, low gestational age, low birth weight, asphyxia, prolonged mechanical ventilation, anemia and low serum EPO levels were the risk factor for brain injury in preterm infants.

CONCLUSIONSThere is a higher incidence rate of brain injury in preterm infants with lower serum EPO levels. The serum EPO levels may be correlated with brain injury in preterm infants.

Brain Injuries ; blood ; epidemiology ; Erythropoietin ; blood ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; blood ; Male ; Myelin Basic Protein ; blood

Ellagitannins is a kind of phenolic compounds with many biological activities. Recent studies have found that the effective ingredients of these compounds have close relationship with their colon-derived bacteria metabolites, that is urolithins. The objective of this study was to review the structure characteristics, types and distribution of urolithins, improvement in diseases related to prostate, breast and colon, as well as anti-cancer, anti-oxidation, anti-inflammation and other biological activities. The present review will lay the foundation for development and utilization of urolithins.

Animals ; Animals, Newborn ; Calcium ; metabolism ; Cell Hypoxia ; Cells, Cultured ; Flavones ; isolation & purification ; pharmacology ; Gynostemma ; chemistry ; Male ; Myocardial Reperfusion Injury ; metabolism ; Myocytes, Cardiac ; cytology ; metabolism ; Nitric Oxide ; analysis ; metabolism ; Nitric Oxide Synthase ; metabolism ; Rats ; Rats, Wistar ; Serum