Objective To assess the clinical short-term outcomes of implanting D-shant atrial shunt device(aSD)in a single center for patients with heart failure with reduced ejection fraction(HFrEF).Methods From January 2022 to January 2023,a retrospective analysis was conducted on 12 patients with HFrEF who underwent percutaneous implantation of a D-shant aSD.We assessed cardiac chamber size and ventricular function using echocardiography,right heart catheterization measurements and patient clinical indicators were collected,follow up data of 12 months postoperative and pre-implantation D-shant were compared.The primary endpoint of the study was the cumulative occurrence of adverse cardiac,neurologic,or renal events during the follow-up period.Secondary endpoints were improvements in functional status included cardiac function,quality of life,and exercise capacity.Results All 12 patients underwent successful percutaneous inter-atrial shunting procedures using the D-shant.Postoperative immediately fluoroscopy and echocardiography confirmed accurate localization and patency of the atrial shunt devices in all cases.Postoperative hemodynamic assessment revealed a significant decrease in pulmonary capillary wedge pressure[(29.8±3.4)mmHg vs.(17.8±0.8)mmHg,P＜0.001].During 12 months follow-up,the cumulative adverse event rate was 8.3％(one patient received a heart transplant),a significant reduction in left atrial diameter from(65.8±6.5)mm to(48.0±4.5)mm(P＜0.001)was observed.Furthermore,there was notable improvement in clinical cardiac function indices quality of life,and exercise capacity of the patients.Conclusions This single-center retrospective study found that the use of a D-shant aSD to perform percutaneous interatrial shunting in patients with HFrEF is safe and effective.Short-term follow-up demonstrated sustained patency of the shunt and that the intervention was associated with improved functional status.

Objective:To investigate the epidemic trend and risk change of acquired immunodeficiency syndrome (AIDS) complicated with malignant tumors after combination antiretroviral therapy (cART).Methods:The types of malignant tumors in patients with AIDS at different stages of cART were analyzed among anti-human immunodeficiency virus (HIV)-positive population in Hubei Province screened in National AIDS/HIV prevention and control information system from 1st January, 2004 to 31st December, 2018. The standardized incidence ratios(SIR) of malignant tumors in AIDS patients was analyzed based on the incidence of malignant tumors in the general population in Hubei Province or China in 2013. The changes in risks for development of malignant tumors in AIDS patients at different cART stages from 2004 to 2013 and 2014 to 2018 were compared.Chi-square test was used for statistical analysis.Results:Three hundred and twenty-three out of 22 994 AIDS patients were diagnosed with malignant tumors. Non-Hodgkin lymphoma(NHL) and cervical cancer were most common types in acquired immunodeficiency syndrome-defining cancers (ADC), while liver cancers and lung cancers were the most common types in non-acquired immunodeficiency syndrome-defining cancers (NADC). The overall risk of malignancy in AIDS patients was similar to that in the general population (SIR=1.06, χ2=0.62, P=0.426). However, the risks of Kaposi sarcoma, NHL, Hodgkin lymphoma, cervical cancer, and head and face cancers (excepting nasopharyngeal cancer) in AIDS patients were significantly higher than those in the general population (SIR=834.09, 9.65, 13.33, 5.22 and 2.94, respectively, χ2=11 747.27, 625.54, 56.65, 184.21 and 13.66, respectively, all P<0.01). The risks of lung cancer, colorectal anal cancer, stomach cancer and breast cancer in AIDS patients were significantly lower than those in the general population (SIR=0.33, 0.36, 0.43 and 0.45, respectively, χ2=33.43, 12.84, 9.01 and 7.21, respectively, all P<0.05). The SIR of cervical cancer, liver cancer and colorectal anal cancer from 2014 to 2018 were 4.06, 0.43 and 0.10, respectively, which were significantly lower than those from 2004 to 2013 (7.42, 1.96 and 0.84, respectively). The differences were all statistically significant ( χ2=5.39, 19.52 and 10.86, respectively, all P<0.05). Conclusions:At present, there are no significant differences of the incidences of malignant tumors between AIDS patients and general population, but the tumor types are different. The most common malignant tumors in this region are NHL and cervical cancer, which should be noted that HIV screening among patients with such tumors is conducive to comprehensive treatment to improve the efficacy.

The aim of this study was to identify some biomarkers for predicting lymph node metastasis and prognosis of human epidermal growth factor receptor 2 (Her-2)-positive breast cancer (BC). We analyzed correlations between microRNAs (miRNAs) and the prognosis of patients with BC based on data collected from The Cancer Genome Atlas (TCGA) database. The expression levels of miR-455, miR-143, and miR-99a were measured in clinical samples of Her-2-positive BC patients with different degrees of lymph node metastasis. We investigated the impacts of overexpressed miR-455 on the proliferation and invasiveness of MDA-MB-453 cells and measured its effects on the expression of long non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) by quantitative real-time polymerase chain reaction (qRT-PCR). The expression of miR-455 was significantly and positively correlated to the prognosis and overall survival (OS) of the BC (P=0.028), according to TCGA information. The expression level of miR-455 was positively correlated with OS and relapse-free survival (RFS) of patients with Her-2-positive BC, and was negatively correlated with the number of metastatic lymph nodes (P<0.05). Transwell assay suggested that MDA-MB-453 cells became much less invasive (P<0.01) after being transfected with miR-455 mimics. During the qRT-PCR, the expression level of MALAT1 declined significantly after transfection (P<0.01). Overexpressed miR-455 significantly inhibited the proliferation and migration of MDA-MB-453 cells and the expression of MALAT1. We conclude that miR-455 may be a useful potential biomarker for forecasting lymph node metastasis and the prognosis of Her-2-positive BC patients. miR-455 may play an important role in lymph node metastasis of BC by interacting with MALAT1.

The data of patients with HIV/AIDS from Hubei Province during 2004 to 2018 were obtained from the National AIDS Comprehensive Prevention and Control Information System. A total of 22 980 HIV-positive or AIDS patients were followed up for 113 164 person-years and 323 malignant tumors were diagnosed. Non-Hodgkin′s lymphoma (NHL), cervical cancer, liver cancer, lung cancer, and Kaposi sarcoma (KS) accounted for 70.0% (226/323) of all malignant tumors in this population. The average crude incidence and mortality of malignant tumors in HIV-infected patients were 285.43/100 000(269.11/100 000 in males and 325.87/100 000 in females), and 169.67/100 000(184.78/100 000 in males and 132.19/100 000 in females), respectively. The result indicates that the overall cancer incidence and mortality in HIV/AIDS population under widely implementation of combination anti-retroviral therapy (cART) are similar to those in the general population of the region. But the incidence and mortality of AIDS-related tumors such as KS, NHL, HD and cervical cancer are higher than those in general population, and attention should be given to screening of these malignancies in HIV/AIDS population.

Coronary Artery Bypass ; adverse effects ; Female ; Humans ; Male ; Mammary Arteries ; injuries

Objective: To analysis the manifestations of chest CT imaging in acquired immunodeficiency syndrome (AIDS) patients complicated with pulmonary cryptococcosis. Methods: The clinical data of 72 AIDS patients complicated with pulmonary cryptococcosis were analyzed retrospectively. There were 3 cases (4.2%) diagnosed with pulmonary cryptococcosis by biopsy, including 1 case of pulmonary cryptococcosis and 2 cases of disseminated cryptococcosis; 69 cases (95.8%) with pulmonary manifestations and clinically diagnosed with pulmonary cryptococcosis, including 43 cases of cryptococcal meningitis and 26 cases of disseminated cryptococcosis. The imaging features of chest CT, in terms of the morphology, size, number, distribution, internal features and margins of the lesions were analyzed. Results: The chest CT findings were solid nodules or mass in 49 cases (68.1%), patchy shadows in 40 cases (55.6%), cavitary nodules or mass in 10 cases (13.9%), mediastinal and hilar lymph node enlargement in 17 cases (23.6%) and pleural effusion in 10 cases (13.9%). Conclusion The chest CT findings of AIDS patients complicated with pulmonary cryptococcosis mainly are multiple solid nodules or masses, patchy shadows and solitary cavitary pulmonary nodules or mass. For early diagnosis and treatment, cryptococcus screening should be performed in HIV-infected patients with pulmonary nodules or mass on chest CT.

Objective To evaluate enteral nutrition treatment on nutritional status of patients with esophageal cancer during radiotherapy in Chinese population. Methods We searched domestic and foreign relevant databases (PubMed, Medline, Cochrane Library, Wanfang Data, Chinese Journal Database, VMIS) by key words (esophageal cancer, chemoradiotherapy, enteral nutrition) , meeting the conditions of the clinical randomized controlled trials, and evaluated the quality of each document. We used meta-analysis method to analysis the published literatures about clinical randomized controlled trials, which were enteral nutrition treatment on nutritional status of patients with esophageal cancer during radiotherapy in Chinese population.RevMan5.1 statistical analysis software were used. Results Seven separate clinical randomized controlled trials including 503 cases were included into the meta-analysis. The following five indexes of nutritional status in enteral nutrition treatment (ENT) group were superior to routine treatment (RT) group (P<0.05): body weight, Body Mass Index (BMI), hemoglobin, serum albumin, serum prealbumin. The MD Values and 95％CI (confidence interval) were 5.54 (3.61-7.46), 2.20 (2.02-2.39), 12.46 (5.86-19.05), 4.04 (2.48-5.61), 49.53 (20.93-78.13) .The funnel plot showed no significant publication bias in each indexes. Conclusion Enteral nutrition treatment can improve the nutritional status of patients with esophageal cancer during radiotherapy compare only with routine treatment.

Objective To evaluate the application of “OmniView”, a new three-dimensional ultrasound technology, in displaying the fetal palate. Methods The three-dimensional volume data was acquired from 100 normal fetuses, analysed by OmniView technology with the facial midsagittal plane as the starting plane. The imaging of fetal palate was obtained in axial plane (through maxilla, oral cleft), coronal plane, oblique coronal plane (through piriform aperture, oral cleft, submental triangle), and the palate′s curved plane tiled imaging by drawing the anatomical lines on referenced sagittal plane (facial midsagittal plane). The volumes of ifve fetuses with cleft lip and palate were obtained and analysed by the same technology. Results The volume dataset of 91 (91.0%, 91/100) normal fetuses were acquired successfully, and analyzed by OmniView technology, the results of 91 normal fetal palate in different plane were: (1) In axial plane through maxilla, the visualization of alveolar process bow was 91 (100%, 91/91). It was shown as“C”shaped arcuate structure, the anechoic structure of alveolar socket could be seen on the bow, and the ifrst 6 alveolar sockets were displayed clearly. The visualization number of hard palate was 91 (100%, 91/91), it was shown as hyperechoic lfake between two sides of alveolar bones. In axial plane through oral cleft, the visualization number of soft palate was 81 (89.0%, 81/91), it was shown as a strip of soft tissue echo band. (2) In coronal plane, the visualization number of hard palate was 91 (100%, 91/91), it was shown as a strip of hyperechoic band and separated the oral and nasal cavity. (3) In oblique coronal plane through piriform aperture, the visualization number of hard palate was 91 (100%, 91/91), it was shown as a short strip of hyperechoic band. In oblique coronal plane through oral cleft, the visualization number of hard palate was 91 (100%, 91/91). In oblique coronal plane through submental triangle, the visualization number of hard palate was 91 (100%, 91/91). In the above two planes, the hard palate was shown as a strip of hyperechoic band, due to acoustic shadow behind the hard palate, the nasal cavity and nasal septum above the hard palate couldn’t be displayed. (4) In oblique coronal plane through piriform aperture, the visualization number of soft palate was 81 (89.0%, 81/91). The visualization number of uvula was 25 (27.5%, 25/91). The soft palate was shown as a lfake of soft tissue echo behind the hard palate, and the uvula was shown as papillary protrusions on the edge of the soft palate in the midline. In oblique coronal plane through oral cleft, the visualization number of soft palate was 81 (89.0%, 81/91). In oblique coronal plane through submental triangle, the visualization number of soft palate was 81 (89.0%, 81/91). In the above two planes, the soft palate was shown as a strip of soft tissue echo band, the soft tissue echo of fetal tongue was in the lower front of soft palate, and the anechoic region of nasopharynx was superior behind the soft palate. (5) In the curved plane tiled imaging of palate, the visualization number of alveolar process bow (primary palate) was 91 (100%, 91/91). The visualization number of hard palate was 91 (100%, 91/91). The visualization number of soft palate was 81 (89.0%, 81/91). the visualization number of uvula was 25 (27.5%, 25/91), the planar panorama of alveolar process bow, hard palate and soft palate could be visualized intuitively, the alveolar arch and hard palate were shown as bone-like hyperecho, and the soft palate was shown as soft tissue hypoecho. In iffteen cases′volume involved cleft lip and palate, all five cases of malformations were detected through three-dimensional data analysis, the position and range of the cleft palate could also be conifrm. Abnormal fetuses were all veriifed after induction of labor. Conclusions By three-dimensional ultrasound technology-“OmniView”, the axial and coronal plane of fetal palate could be obtained easily which was dififcult by two-dimensional ultrasound, and the special oblique coronal plane of secondary palate could be displayed easily. The panorama of the palate could be visualized intuitively though curved plane tiled imaging by drawing a line tracking the structure of the palate. This technology could simplify the ultrasound examination procedure of the fetal palate, reduce the operators′skill-dependence, and quickly evaluated the integrity of the fetal primary palate and secondary palate. For the cleft lip fetus, this technology can determine whether the cleft palate exist or not, together with their position and range.

OBJECTIVETo investigate the protective effect of ischemic postconditioning (IP) against different degrees of testicular ischemia-reperfusion (IR) injury in rabbits.

METHODSForty-two white male rabbits were equally randomized into 7 groups: a control, 3 IR (R1, R2 and R3), and 3 IP (P1, P2 and P3) groups. Testicular models of different degrees of ischemia were established in the IR and IP groups. Before reperfusion, ultrasonography showed homogeneous echoes with slightly decreased blood flow in R1 and P1, heterogeneous echoes with obviously decreased blood flow in R2 and P2, lamellar or fragmental low echo areas absent of blood flow signals in R3 and P3. Then the IR groups were directly subjected to perfusion, and the IP groups to 3 episodes of 30-second reperfusion followed by 30-second ischemia. All the groups underwent contrast-enhanced ultrasonography (CEUS) before reperfusion and, after 3 days, examined for the contents of malonaldehyde (MDA), superoxide dismutase (SOD) and histology, and observed for the pathological changes of the testicular tissue.

RESULTSBefore reperfusion, no significant differences were found in the CEUS parameters beta, time-to- peak (TTP), peak-base intensity (PBD) and half of declining time (DT/2) between R1 and P1, R2 and P2, and R3 and P3 (P>0.05). There were remarkable differences in MDA and SOD between R1 and P1, and R2 and P2 (P<0.05), but not between R3 and P3 (P >0.05). Johnson's score, apoptosis index and ultrastructure showed marked differences between R1 and P1 (P<0.05) but not between R2 and P2, and R3 and P3 (P >0.05).

CONCLUSIONIP can attenuate IR-induced testis injury, but the effect varies with the degree of ischemia, and its pathological manifestation differs from the biochemical one.

Animals ; Ischemic Postconditioning ; Male ; Malondialdehyde ; analysis ; Rabbits ; Reperfusion Injury ; Superoxide Dismutase ; analysis ; Testis ; pathology

OBJECTIVETo investigate the clinical significance of the expression of serum differential protein in patients with chronic hepatitis B (CHB) related liver fibrosis.

METHODSOne hundred and ten CHB patients confirmed by liver biopsies were enrolled, 83 for modeling and 27 for verification. According to Ishak staging, 55 patients in the modeling group were with significant liver fibrosis ( F is more than or equal to 3 ) and 28 patients with normal/mild liver fibrosis ( F0-F2 ). While that in the verification group were 15 ( F is more than or equal to 3 ) and 12 ( F0-F2 ), respectively. MALDI-TOF-MS/MS was used to detect serum proteins and the spectrum for each sample was analyzed in FlexAnalysis3.0 to produce the spectrum of differential proteins. The results were compared with clinicopathologic diagnosis and the diagnosis model based on genetic algorithm was established and evaluated.

RESULTSThere were 15 proteins differentially expressed in significant liver fibrosis group and normal/mild fibrosis group ( P value is less than 0.01), in which the differences on proteins 2081.73 m/z and 1944.41 m/z were the most significant. Based on these two proteins, the coordinate system was set up and the diagnosis model based on genetic algorithm was established by six characteristic peaks. After detecting 12 cases of normal/mild liver fibrosis and 15 cases of significant liver fibrosis, the results showed that the diagnostic model could identify significant fibrosis ( F is more than or equal to 3 ) and normal/mild liver fibrosis ( F0-F2 ) at 100% recognition, 94.14% prediction and 100% accuracy.

CONCLUSIONSerum differential proteins examination can be used for early prediction of CHB related fibrosis. The study provides the basis for non-invasive diagnosis of hepatic fibrosis according to identifying the potential differences of the serum samples from patients with HBV related fibrosis.

Adult ; Blood Proteins ; analysis ; Female ; Hepatitis B, Chronic ; blood ; diagnosis ; pathology ; Humans ; Liver ; pathology ; Liver Cirrhosis ; blood ; diagnosis ; pathology ; Male ; Middle Aged ; Proteomics