Objective To assess mid- and long-term outcomes of ascending aortic wrapping (AAW) in adult patients undergoing aortic valve replacement (AVR). Methods We retrospectively analyzed clinical data of adult patients who underwent AVR and AAW in Fuwai Hospital from January 2010 to August 2019. Ascending aorta diameter (AAD) was measured by echocardiography or CT scan preoperatively and postoperatively. Results A total of 33 patients were enrolled, including 23 males and 10 females aged 22-73 (51.06±12.61) years. There was no perioperative death. The mean preoperative, postoperative and follow-up AAD of the patients were (46.06±3.54) mm, (34.55±5.17) mm, and (37.12±5.64) mm, respectively. The differences in the AAD between pre-operation and post-operation, and between pre-operation and the last follow-up were both statistically significant (P<0.05). The median follow-up time was 38.20 (18.80-140.30) months. The median increase rate of diameter was 0.63 (−0.11, 1.36) mm per year after the surgery. The increase rate was >5 mm per year in 1 patient, and >3 mm in another one. Conclusion The mid- and long-term outcomes of AAW in adult patients undergoing AVR are satisfactory and encouraging.

Objective    To assess mid- and long-term outcomes and share our clinical method of reduction ascending aortoplasty (RAA) in adult patients undergoing aortic valve replacement (AVR). Methods    We retrospectively analyzed clinical data of 41 adult patients with aortic valve disease and ascending aortic dilatation before and after operation of RAA+AVR in Fuwai Hospital from January 2010 to July 2017. There were 28 male and 13 female patients aged 28-76 (53.34±12.06) years. Twenty-three patients received AVR+RAA using the sandwich technique (a sandwich technique group), while other 18 patients received AVR+ascending aorta wrap (a wrapping technique group). Ascending aorta diameter (AAD) was measured by echocardiography or CT scan preoperatively and postoperatively. Results    There was no perioperative death. The mean preoperative AAD in the sandwich technique group and the wrapping technique group (47.04±3.44 mm vs. 46.67±2.83 mm, P=0.709) was not statistically different. The mean postoperative AAD (35.87±3.81 mm vs. 35.50±5.67 mm, P=0.804), and the mean AAD at the end of follow-up (41.26±6.54 mm vs. 38.28±4.79 mm, P=0.113) were also not statistically different between the two groups. There were statistical differences in AAD before, after operation and at follow-up in each group. All 41 patients were followed up for 23-108 (57.07±28.60) months, with a median follow-up of 51.00 months. Compared with that before discharge, the AAD growth rate at the last follow-up was –1.50-6.78 mm/year, with a median growth rate of 0.70 mm/year, and only 3 patients had an annual growth rate of above 3 mm/year. Conclusion    Mid- and long-term outcomes of RAA in adult patients undergoing AVR with both methods are satisfying and encouraging.

Ginsenoside Rg5 is a rare ginsenoside showing promising tumor-suppressive effects.This study aimed to explore its radio-sensitizing effects and the underlying mechanisms.Human lung adenocarcinoma cell lines A549 and Calu-3 were used for in vitro and in vivo analysis.Bioinformatic molecular docking prediction and following validation by surface plasmon resonance(SPR)technology,cellular thermal shift assay(CETSA),and isothermal titration calorimetry(ITC)were conducted to explore the binding between ginsenoside Rg5 and 90 kD heat shock protein alpha(HSP90α).The effects of ginsenoside Rg5 on HSP90-cell division cycle 37(CDC37)interaction,the client protein stability,and the downstream regulations were further explored.Results showed that ginsenoside Rg5 could induce cell-cycle arrest at the G1 phase and enhance irradiation-induced cell apoptosis.It could bind to HSP90α with a high affinity,but the affinity was drastically decreased by HSP90α Y61A mutation.Co-immunoprecipitation(Co-IP)and ITC assays confirmed that ginsenoside Rg5 disrupts the HSP90-CDC37 interaction in a dose-dependent manner.It reduced irradiation-induced upre-gulation of the HSP90-CDC37 client proteins,including SRC,CDK4,RAF1,and ULK1 in A549 cell-derived xenograft(CDX)tumors.Ginsenoside Rg5 or MRT67307(an IKKe/TBK1 inhibitor)pretreatment suppressed irradiation-induced elevation of the LC3-Ⅱ/β ratio and restored irradiation-induced downregulation of p62 expression.In A549 CDX tumors,ginsenoside Rg5 treatment suppressed LC3 expression and enhanced irradiation-induced DNA damage.In conclusion,ginsenoside Rg5 may be a potential radiosensitizer for lung adenocarcinoma.It interacts with HSP90α and reduces the binding between HSP90 and CDC37,thereby increasing the ubiquitin-mediated proteasomal degradation of the HSP90-CDC37 client proteins.

Objective:To investigate clinical characteristics for in-stent reocclusion lesions after coronary stent implantations in aged patients.Methods:229 patients diagnosed with chronic total reocclusions were recruited from Jan 2005 to Dec 2019 in this retrospective study.According to age, patients were divided into a 40-49 year-old group(n=60), a 50-59 year-old group(n=58), a 60-69 year-old group(n=55), and a 70-80 year-old group(n=56)to examine different lesion characteristics after coronary stent implantations.Results:In the 40-49 year-old group, the 50-59 year-old group, the 60-69 year-old group and the 70-80 year-old group, the rates of multi-vessel reocclusions were 11.6%, 15.5%, 21.8% and 25.0%, respectively( χ2=10.03, P=0.01). For each group, lesions with concurrent proximal and middle coronary reocclusions accounted for 8.3%, 12.0%, 30.9% and 35.7%, respectively( χ2=11.83, P=0.005); Reocclusions with severe coronary calcification accounted for 6.6%, 15.5%, 36.3% and 37.5%, respectively( χ2=11.56, P=0.006); Long coronary reocclusion lesions(36-47 mm)accounted for 15.0%, 17.2%, 21.8% and 25.0%, respectively( χ2=11.56, P=0.007); Coronary reocclusions with diffuse long calcified lesions accounted for 8.3%, 13.7%, 32.7% and 35.7%, respectively( χ2=10.80, P=0.01). Conclusions:The clinical characteristics of in-stent reocclusion lesions after coronary stent implantations include multiple chronic total coronary reocclusions, concurrent proximal and middle coronary reocclusions, heavily calcified coronary reocclusions, long coronary reocclusions and diffuse long calcified coronary reocclusions in aged patients.

Objective    To assess mid-term outcomes of reduction ascending aortoplasty (RAA) in adult patients undergoing aortic valve replacement (AVR). Methods    We retrospecctively analyzed clinical data of 30 adult patients with aortic valve diseases and ascending aortic dilatation in Fuwai Hospital from 2010 to 2019. There were 20 males and 10 females with an age of 38-72 (55.73±9.95) years. All patients received AVR+RAA using the wedge resection technique. Ascending aorta diameter (AAD) was measured by echocardiography or CT scan preoperatively and postoperatively. Results    There was no perioperative death. The mean preoperative and postoperative AAD in all patients were 48.23±3.69 mm and 37.60±5.02 mm, respectively. And the mean AAD of follow-up was 40.53±4.65 mm. There was a statistical difference in AAD between preoperation and postoperation, postoperation and final follow-up, preoperation and final follow-up. The median follow-up time was 28.50 (12-114) months. The median rate of increase in AAD postoperatively was 0.76 mm per year. And the rate of increase was ≥3 mm per year in 5 patients, while ≥5 mm per year in 4 patients with indications for reoperation. Conclusion    Mid-term outcomes of RAA in adult patients undergoing aortic valve replacement using the wedge resection technique are satisfying and encouraging. However, some patients still need surgical re-intervention.

Since December 2019, an outbreak of novel coronavirus pneumonia (COVID-19) in Wuhan, Hubei Province, which has caused wide public concern all through the world. Although artificial intelligence is a priority development fields in recent years, there is no study on the application and effect of AI in this epidemic. Based on the application of AI scenarios in typical cases, the research analyzes the practice and effectiveness of AI in epidemic surveillance, clinical diagnose, public health management and other related scientific research. Besides, combined with the current situation of development, some suggestions are put forward in order to better play the role of artificial intelligence in the public health emergency system in China.

An implantable axial blood pump was designed according to the circulation assist requirement of severe heart failure patients of China. The design point was chosen at 3 L/min flow rate with 100 mm Hg pressure rise when the blood pump can provide flow rates of 2-7 L/min. The blood pump with good hemolytic and anti-thrombogenic property at widely operating range was designed by developing a structure that including the spindly rotor impeller structure and the diffuser with splitter blades and cantilevered main blades. Numerical simulation and particle image velocimetry (PIV) experiment were conducted to analyze the hydraulic, flow fields and hemolytic performance of the blood pump. The results showed that the blood pump could provide flow rates of 2-7 L/min with pressure rise of 60.0-151.3 mm Hg when the blood pump rotating from 7 000 to 11 000 r/min. After adding the splitter blades, the separation flow at the suction surface of the diffuser has been reduced efficiently. The cantilever structure changed the blade gap from shroud to hub that reduced the tangential velocity from 6.2 m/s to 4.3-1.1 m/s in blade gap. Moreover, the maximum scalar shear stress of the blood pump was 897.3 Pa, and the averaged scalar shear stress was 37.7 Pa. The hemolysis index of the blood pump was 0.168% calculated with Heuser's hemolysis model. The PIV and simulated results showed the overall agreement of flow field distribution in diffuser region. The blood damage caused by higher shear stress would be reduced by adopting the spindle rotor impeller and diffuser with splitter blades and cantilevered main blades. The blood could flow smoothly through the axial blood pump with satisfactory hydraulics performance and without separation flow.
China ; Computer Simulation ; Equipment Design ; Heart Failure ; therapy ; Heart-Assist Devices ; Hemolysis ; Humans ; Models, Cardiovascular

Objective To investigate whether diffusion kurtosis imaging(DKI)can be predictive in high-aggressive prostate cancer (PCa).Methods 51 patients with pathologically confirmed PCa underwent preoperative DK-MR imaging(b of 0,700,1 400 and 2 100 s/mm2).Data was post-processed by mono-exponential and non-Gauss DK model,respectively,for quantitation of apparent diffusion coefficient(ADC),apparent non-Gaussian diffusion coefficient(Dapp)and apparent non-Gauss kurtosis coefficient(Kapp). The ability of Dapp,Kapp and ADC for predicting high-aggressive(Gleason score>4+3)PCa was analyzed by ROC regression.Results There were 29 low-aggressive and 33 high-aggressive PCa on pathologic findings.High-aggressive PCa had significantly lower ADC[(0.764 ± 0.114)×10-3mm2/s vs(0.825 ± 0.116)×10-3mm2/s,P=0.004],lower Dapp[(1.212 ± 0.194)×10-3mm2/s vs (1.472 ± 0.297)×10-3mm2/s,P< 0.001],while higher Kapp(1.114 ± 0.177 vs 0.835 ± 0.192,P<0.001)than that for low-aggressive PCa.Dapp and Kapp had significantly higher sensitivity(Dapp:75.3%;Kapp:74.1%),specificity(Dapp:85.4%;Kapp:86.7%)and area under curve(AUC)(Dapp:0.889;Kapp:0.894)than that for ADC(64.1%;76.4%;0.738;P<0.01)in differentiating low-aggressive from high-aggressive PCa.Conclusion DKI can be a reliable way for predicting high-aggressive PCa.

Objective To investigate the correlation between hepatic fat fraction(HFF)and some clinical indicators by measuring HFF and summarize its clinical significance.Methods A total of 95 patients were included in this study.MR data were acquired with Dixon technique,and the HFF of liver were measured.According to the HFF,all patients were divided into high-fat group and low-fat group.Subcutaneous fat area(SA),visceral fat area(VA)and total fat area(TA)were also measured.The age of patients,blood pressure, fasting blood glucose(FPG),total cholesterol (TC),triglyceride (TG),low density cholesterol (LDL-c)and high density cholesterol (HDL-c) were recorded and the body mass index(BMI)was calculated.Results The levels of FPG,TG,LDL-c,systolic blood pressure,diastolic blood pressure,BMI,VA,TA and visceral fat percentage (VFP)in high-fat group were significantly higher than those in low-fat group (P<0.05), while the abdominal subcutaneous fat percentage (SFP)was significantly lower than that in low-fat group (P<0.05).HFF was positively correlated with FPG,TG,LDL-c,VA,TA,VFP,age and BMI (r=0.354,0.370,0.415,0.299,0.285,0.238,0.203,0.221,respectively;P<0.05).Conclusion Semi-quantitative analysis of hepatic fat using MR Dixon technique can reflect the degree of hepatic fatty infiltration, and can be used as a quantitative indicator for early diagnosis and treatment evaluation of nonalcoholic fatty liver disease.

Thirty nine patients with pathologically confirmed parotid tumors,including 18 cases of pleomorphic adenomas,12 cases of papillary cystadenoma lymphomatosum and 9 cases of malignant tumors,were enrolled in the study.Characteristics on routine MR image,diffusion weighted imaging (DWI),timesignal intensity curve (TIC) and apparent diffusion coefficient (ADC) value in different types of tumors were evaluated.There were significant differences in imaging features between benign and malignant tumors (P ＜ 0.01).The TIC types were A,B and C for pleomorphic adenomas,papillary cystadenoma lymphomatosum and malignant tumors,respectively.The mean ADC value of pleomorphic adenomas was significantly higher than that of papillary cystadenoma lymphomatosum and malignant tumors (P ＜ 0.01).No significant difference in ADC values between papillary cystadenoma lymphomatosum and malignant tumors was detected (P =0.73).The study indicates that MR plain scan combined with dynamic contrast enhanced MRI and DWI may be helpful in pre-operative differentiation of common parotid tumors.