Objective To analyze epidemiological characteristics and influencing factors of atrial fibrillation (AF) in Suqian in 2019-2023. Methods A total of 1 869 patients with AF admitted to medical institutions in Suqian from January 2019 to December 2023 were selected as the survey subjects. The diagnosis and treatment data of the AF patients were retrospectively analyzed to explore epidemiological characteristics. A total of 2 000 healthy controls during the same period were selected as the control group. The influencing factors of AF were analyzed by univariate and multivariate logistic regression models. Results The incidence of AF in Suqian increased with the increase of year, age and labor intensity. The incidence rate was higher (>50%) in patients with male gender, old age, education level of junior high school and below, city living, heavy physical labor, smoking history, drinking history and underlying diseases (coronary heart disease, stroke, heart failure, hyperuricemia, hyperthyroidism, hypertension, diabetes mellitus, and hyperlipidemia). Multivariate logistic regression analysis showed that hyperuricemia, hyperthyroidism, cognitive dysfunction and anxiety/depression were influencing factors of AF in Suqian (P<0.05). Conclusion From 2019 to 2023, AF risk is relatively high in patients in Suqian, which is closely related to hyperuricemia, hyperthyroidism, cognitive dysfunction and anxiety/depression.

Objective:To construct an explainable artificial intelligence(AI) model of risk characteristics of papillary thyroid carcinoma(PTC), and to explore its value of it combined with clinical features in predicting cervical lymph node metastasis(CLNM) in PTC patients.Methods:From January 2021 to September 2022, 422 patients(422 nodules) with pathologically confirmed PTC underwent thyroidectomy and neck lymph node dissection in the Second Affiliated Hospital of Xi′an Jiaotong University were retrospectively collected, the patients were randomly divided into training set and test set according to the ratio of 7∶3. Ultrasonographic features highly correlated with PTC risk characteristics were extracted by traditional machine learning method, and an intelligent prediction model with optimal probability of risk characteristics was established. Then, a risk model for predicting CLNM of PTC patients was constructed in combination with clinical features. The diagnostic effectiveness of the model was evaluated by drawing a ROC curve and calculating the area under curve (AUC).Results:In the AI explaineable model of PTC risk characteristics in the test set, the intelligent diagnosis model of calcification based on logistic regression classification showed the highest diagnostic efficiency, with an AUC of 0.87 ( P<0.05). Compared with the probability model of risk characteristic of PTC alone, the comprehensive model combined with clinical characteristics showed higher diagnostic efficiency in predicting CLNM of PTC patients, with AUC of 0.97, diagnostic critical value of 0.15, corresponding accuracy, sensitivity and specificity of 92.65%, 92.76% and 92.54%, respectively (all P<0.05). Conclusions:The explaineble risk characteristics of PTC AI model combined with clinical features can effectively predict the cervical lymph node metastasis of PTC, and then provide effective information for clinical decision-making of PTC patients.

The intervention and prevention of perioperative hypothermia is not only reflected in the technical level, but also reveals the important role of humanistic care in the whole intervention work. If perioperative patients have hypothermia, it is likely to cause a series of complications such as postoperative shivering, which seriously threatens the life safety of patients. Prevention and intervention was based on a comprehensive understanding of the causes and hazards of hypothermia, especially the impact on the lives of the elderly. Effective supervision was implemented in the whole process of operation, such as dynamic monitoring of vital signs including body temperature, followed by room temperature regulation, body temperature protection and preoperative and postoperative psychological nursing. At this time, the sense of responsibility, good humanistic care of medical staff are of positive significance to effectively prevent and reduce the probability of perioperative hypothermia and accelerate the postoperative rehabilitation of patients.

The column chromatography and semi-preparative liquid phase chromatography with several chromatographic packing materials, including macroporous adsorbent resin, silica gel, ODS, and Sephadex LH-20, were used for the separation and purification of n-butanol-soluble portion of ethanol extract of Leonurus japonicus Houtt. The structures of isolates were identified by HR-MS, IR, NMR, and acid hydrolysis reaction. Six phenylethanol glycosides were obtained from L. japonicus and identified as leonoside G (1), leonoside E (2), leonoside B (3), leonoside F (4), cistanoside G (5), and salidroside (6). Compound 1 is a new phenylethanol glycoside.

Objective:To compare the effects of enhanced heat preservation strategies and conventional heat preservation strategies in the operation room on body temperature, coagulation function, and myocardial injury in patients with cervical spinal cord injuries.Methods:A retrospective cohort study was conducted to analyze the clinical data of 160 patients with cervical spinal cord injuries admitted to Second Affiliated Hospital of Xi′an Jiaotong University and Affiliated Honghui Hospital of Xi′an Jiaotong University from February to October 2022, including 82 males and 78 females, aged 38-64 years [(50.6±8.7)years]. Injured segments included C 3 in 19 patients, C 4 in 33, C 5 in 39, C 6 in 38, and C 7 in 31. According to American Spinal Injury Association (ASIA) classification, 10 patients were classified into grade A, 83 grade B, 39 grade C, and 28 grade D. All the patients underwent cervical laminoplasty, decompression and bone graft fusion surgery. According to different heat preservation strategies intraoperatively, the patients were divided into conventional heat preservation group ( n=80) and enhanced heat preservation group ( n=80). The body temperature changes before surgery, at 2 hours during surgery, immediately after surgery, at 2 and 24 hours after surgery were compared between the two groups. The changes of coagulation function before surgery and at 4 hours after surgery were compared between the two groups, including the prothrombin time (PT), thrombin time (TT), and activated partial thromboplastin time (APTT). The incidence of myocardial injury and the number of patients with myocardial injury measured by the indicators of cardiac troponin I (cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) at 48 hours after surgery. Before surgery and at 14 days after surgery, ASIA classification was used to evaluate the neurological functions, including sensory and motor functions between the two groups. The incidence of cardiovascular events at 12 months after surgery were compared between the two groups. Results:A total of 145 patients were followed up for 12-18 months [(15.7±1.6)months]. At 12 months after operation, there were 7 patients in the enhanced heat preservation group were lost to follow-up, compared to 8 patients in the conventional heat preserration group. There was no statistically significant difference in body temperature between the two groups before surgery or at 24 hours after surgery ( P>0.05). At 2 hours during surgery, immediately after surgery and at 2 hours after surgery, the body temperature was (36.90±0.12)℃, (37.00±0.06)℃, and (37.16±0.06)℃ in the enhanced heat preservation group, which were significantly higher than those in the conventional heat preservation group [(36.56±0.03)℃, (36.74±0.08)℃, and (36.84±0.08)℃] ( P<0.01). The serum levels of PT, TT and APTT were not significantly different between the two groups before surgery ( P>0.05), while they were (13.1±1.2)seconds, (19.2±1.1)seconds, and (36.2±3.3)seconds in the enhanced heat preservation group at 4 hours after surgery, which were significantly lower than those in the conventional heat preservation group [(14.3±1.0)seconds, (20.2±1.1)seconds, and (38.7±3.4)seconds] ( P<0.01). The incidence of myocardial injury in the enhanced heat preservation group was 5.0% (4/80) at 48 hours after surgery, which was lower than 12.5% (12/80) in the conventional heat preservation group ( P<0.05). With cTnI as the indicator of myocardial injury, there were 2 patients [2.6%(2/76)] with myocardial injury in the enhanced heat preservation group, which was much lower than 8 patients [11.8%(8/68)] in the conventional heat preservation group ( P<0.05). With hs-cTnT as the indicator of myocardial injury, 8 patients [10.5%(8/76)] in the enhanced heat preservation group experienced myocardial injury, similar with 10 patients [14.7%(10/68)] in the conventional heat preservation group ( P>0.05). There were no statistically significant differences in the ASIA scores of the sensory and motor functions between the two groups before surgery and at 14 days after surgery ( P>0.05). The incidence of cardiovascular events at 12 months after surgery in the conventional heat preservation group was 27.8% (20/72), which was significantly higher than 9.6% (7/73) in the enhanced heat preservation group ( P<0.01). Conclusion:For patients with cervical spinal cord injuries, compared with conventional heat preservation strategies, the enhanced heat preservation strategies in the operating room can improve the patients′ core body temperature and coagulation function, and significantly reduce the incidence of myocardial injury and cardiovascular events.

Heart failure(HF)is the end stage of almost all cardiovascular diseases,including coronary heart disease and structural heart disease.For end-stage HF,medications and cardiac assist devices have limited therapeutic effects,and heart transplantation is associated with donor shortage and immune rejection.Alginate hydrogel has the ability to mechanically support and induce cardiac tissue regeneration and repair.In March 2021,we conducted the world's first transcatheter endocardial alginate-hydrogel implantation in patients with end-stage heart failure,and explored the safety and feasibility of the treatment.Given that patients with heart failure who had undergone cardiac resynchronization therapy defibrillator(CRT-D)were excluded from previous studies,this paper is the first to report a case of transcatheter endocardial alginate-hydrogel implantation in a patient with heart failure who did not respond to CRT-D,with a significant reduction in the number of visits to the doctor and a significant improvement in the quality of life during the post-procedure follow-up,which may expand the indications for the use of this technology.

Objective To evaluate the efficacy of extracorporeal membrane oxygenation(ECMO)in patients with reduced left ventricular ejection fraction(LVEF)undergoing transcatheter aortic valve implantation(TAVR).Methods This was a single-center,retrospective study enrolling a total of 30 patients with reduced LVEF undergoing TAVR from January 2020 to January 2024.Of these,12 patients underwent TAVR with ECMO.Baseline clinical characteristics,preprocedural echocardiographic and computed tomographic(CT)measurements,TAVR procedural details,and follow-up data at 60-day and 6-month were collected.Results Among the 30 patients,there were 20 males with an average age of(67.0±10.4)years,an average STS score of(8.2±1.8)points,and an average LVEF of(21.2±5.3)％.This study included 11 AR patients,all of whom were in the group without ECMO implantation,and the difference between the two groups was statistically significant(P=0.027).During the operation,there were 0 cases of circulatory collapse in the ECMO group,and 5 cases(5/18)of circulatory collapse in the non ECMO group.All 5 patients underwent emergency ECMO placement.There were statistically significant differences(P＜0.05)in the comparison of two groups with circulatory collapse and salvage ECMO implantation.The technical success rate of 30 patients was 76.7％(23/30),and the instrument success rate was 60.0％(18/30).Among them,the technical success rate and instrument success rate of the ECMO group were higher than those of the non ECMO group,but the differences were not statistically significant(both P＞0.05).During a 30 day follow-up,there were 0 all-cause deaths in the ECMO group and 9 all-cause deaths(9/18)in the non ECMO group.Among them,7 cases(7/18)died from cardiovascular causes.The differences in all-cause and cardiovascular cause deaths between the two groups were statistically significant(both P＜0.05).During a 6-month follow-up,one patient with ECMO died due to extensive cerebral infarction.The all-cause mortality rate during the 6-month follow-up was 1/12(8.3％),while the all-cause mortality rate without ECMO was 9/18(5.0％).The difference between the two groups was statistically significant(P=0.024).The incidence of stroke with ECMO was 1/12(8.3％),while without ECMO it was 0.There was no statistically significant difference between the two groups(P=0.978).Conclusions In patients with reduced LVEF undergoing TAVR,periprocedural ECMO support does seem to improve patient outcome.

Element doping is one of the strategies for increasing the activity of enzyme-like materials.In this study,cobalt,nitrogen and chlorine-doped carbon dots(Co,N,Cl-CDs)were prepared by one-step hydrothermal synthesis utilizing CoCl2 and glutamate as raw ingredients.In weakly acidic environments,Co,N,Cl-CDs exhibited high peroxidase-like activity and could catalyze the oxidation of 3,3′,5,5′-tetramethylbenzidine(TMB)by hydrogen peroxide into oxided TMB(oxTMB),resulting in a distinct color change.Free radical scavenging and electron spin resonance techniques were used to further investigate the catalytic reaction mechanism of Co,N,Cl-CDs,and the reactive intermediates produced during the reaction were identified as hydroxyl radical.Acid phosphatase(ACP)could catalyze the hydrolysis of sodium ascorbyl phosphate to release ascorbic acid,which could reduce the blue oxTMB into colorless TMB.Based on this principle,a colorimetric-switching sensing system for detection of ACP was developed by coupling Co,N,Cl-CDs and ACP.The sensing system demonstrated good linearity in ACP activity range of 0.5-20 U/L,with a detection limit of 0.17 U/L.The developed sensing system was used to detection of ACP in real serum samples with good recoveries(97.1%-105.7%)and reproducibility(RSD<5%).The sensing system developed here based on Co,N,Cl-CDs had many advantages such as low detection cost,process visualization,and high sensitivity,providing reference for detection of ACP.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Objective To investigate the efficacy and safety of nusinersen sodium in the treatment of children with spinal muscular atrophy(SMA).Methods A retrospective analysis was conducted on the clinical data of 50 children with 5q SMA who received nusinersen sodium treatment and multidisciplinary treatment management in Shanxi Children's Hospital from February 2022 to February 2024.Results Compared with the baseline data,67%(8/12),74%(35/47),and 74%(35/47)of the SMA children had a clinically significant improvement in the scores of Philadelphia Infant Test of Neuromuscular Disorders,Hammersmith Functional Motor Scale Expanded,and Revised Upper Limb Module,respectively,and the distance of 6-minute walking test increased from 207.00(179.00,281.50)meters to 233.00(205.25,287.50)meters(P<0.05)after nusinersen sodium treatment.Of all 50 children with SMA,24(48%)showed good tolerability after administration,with no significant or persistent abnormalities observed in 2 034 laboratory test results,and furthermore,there were no serious or immunological adverse events related to the treatment.After treatment,there was a significant change in forced vital capacity as a percentage of the predicted value in 27 children with restrictive ventilatory dysfunction,as well as a significant change in the level of 25-(OH)vitamin D in 15 children with vitamin D deficiency(P<0.05).Conclusions For children with SMA,treatment with nusinersen sodium can continuously improve the response rates of motor function scales,with good tolerability and safety.