Objective To investigate the infection status and changing trend of hepatitis C virus(HCV)infection in hospitalized patients in medical institutions,and provide reference for formulating HCV infection prevention and control strategies.Methods HCV infection surveillance results from cross-sectional survey data reported to China Healthcare-associated Infection(HAI)Surveillance System in 2020 were summarized and analyzed,HCV positive was serum anti-HCV positive or HCV RNA positive,survey result was compared with the survey results from 2003.Results In 2020,1 071 368 inpatients in 1 573 hospitals were surveyed,738 535 of whom underwent HCV test,4 014 patients were infected with HCV,with a detection rate of 68.93％and a HCV positive rate of 0.54％.The positive rate of HCV in male and female patients were 0.60％and 0.48％,respectively,with a statistically sig-nificant difference(x2=47.18,P＜0.001).The HCV positive rate in the 50-＜60 age group was the highest(0.76％),followed by the 40-＜50 age group(0.71％).Difference among all age groups was statistically signifi-cant(x2=696.74,P＜0.001).In 2003,91 113 inpatients were surveyed.35 145 of whom underwent HCV test,resulting in a detection rate of 38.57％;775 patients were infected with HCV,with a positive rate of 2.21％.In 2020,HCV positive rates in hospitals of different scales were 0.46％-0.63％,with the highest in hospital with bed numbers ranging 600-899.Patients'HCV positive rates in hospitals of different scales was statistically signifi-cant(X2=35.34,P＜0.001).In 2020,12 provinces/municipalities had over 10 000 patients underwent HCV-rela-ted test,and HCV positive rates ranged 0.19％-0.81％,with the highest rate from Hainan Province.HCV posi-tive rates in different departments were 0.06％-0.82％,with the lowest positive rate in the department of pedia-trics and the highest in the department of internal medicine.In 2003 and 2020,HCV positive rates in the depart-ment of infectious diseases were the highest,being 7.95％and 3.48％,respectively.Followed by departments of orthopedics(7.72％),gastroenterology(3.77％),nephrology(3.57％)and general intensive care unit(ICU,3.10％)in 2003,as well as departments of gastroenterology(1.35％),nephrology(1.18％),endocrinology(0.91％),and general intensive care unit(ICU,0.79％)in 2020.Conclusion Compared with 2003,HCV positive rate decreased significantly in 2020.HCV infected patients were mainly from the department of infectious diseases,followed by departments of gastroenterology,nephrology and general ICU.HCV infection positive rate varies with gender,age,and region.

The kidney governs water and is the congenital foundation.The kidney plays an important role in the transportation and distribution of body fluid,has the interior-exterior relationship with the waterffu-organ bladder,and has the meridian connection with the stomach,the reservoir of water and food,through the thoroughfare vessel.Therefore,the kidney plays a key role in the formation of phlegm.Professor CHEN Bo-Lai believes that low back pain of kidney deficiency and phlegm obstruction type is characterized by deficiency in the origin and excess in the superficiality.Excess in the superficiality is manifested as phlegm obstruction,and deficiency in the origin is manifested as kidney deficiency.Clinically,the patients with low back pain of kidney deficiency and phlegm obstruction type mainly have the manifestations of lumbosacral dull pain and fixed pain,stiffness in the waist,limb numbness or hemiplegia,accompanied by soreness and weakness of waist and knees,and preference for pressing and kneading.The treatment of low back pain of kidney deficiency and phlegm obstruction type can be based on theory of kidney being the root of phlegm,follows the therapy of tonifying kidney and eliminating phlegm,and can be performed by the modified use of basic prescription of Litan Decoction(mainly composed of Euryales Semen,Pinelliae Rhizoma,Sesami Semen Nigrum,Platycladi Semen,Paeoniae Radix Alba,Citri Reticulatae Pericarpium and Poria)together with the assistance of herbs for strengthening spleen and dispersing lung based on the differentiation of the complicated symptoms.The thoughts of Professor CHEN Bo-Lai for the differentiation and treatment of low back pain of kidney deficiency and phlegm obstruction type can be used as a reference for the treatment of low back pain with Chinese medicine.

BACKGROUND: Patients with atrial fibrillation (AF) and prior stroke history have a high risk of cardiovascular events despite anticoagulation therapy. It is unclear whether catheter ablation (CA) has further benefits in these patients. METHODS: AF patients with a previous history of stroke or systemic embolism (SE) from the prospective Chinese Atrial Fibrillation Registry study between August 2011 and December 2020 were included in the analysis. Patients were matched in a 1:1 ratio to CA or medical treatment (MT) based on propensity score. The primary outcome was a composite of all-cause death or ischemic stroke (IS)/SE. RESULTS: During a total of 4.1 ± 2.3 years of follow-up, the primary outcome occurred in 111 patients in the CA group (3.3 per 100 person-years) and in 229 patients in the MT group (5.7 per 100 person-years). The CA group had a lower risk of the primary outcome compared to the MT group [hazard ratio (HR) = 0.59, 95% CI: 0.47-0.74, P < 0.001]. There was a significant decreasing risk of all-cause mortality (HR = 0.43, 95% CI: 0.31-0.61, P < 0.001), IS/SE (HR = 0.73, 95% CI: 0.54-0.97, P = 0.033), cardiovascular mortality (HR = 0.32, 95% CI: 0.19-0.54, P < 0.001) and AF recurrence (HR = 0.33, 95% CI: 0.30-0.37, P < 0.001) in the CA group compared to that in the MT group. Sensitivity analysis generated consistent results when adjusting for time-dependent usage of anticoagulants. CONCLUSIONS In AF patients with a prior stroke history, CA was associated with a lower combined risk of all-cause death or IS/SE. Further clinical trials are warranted to confirm the benefits of CA in these patients.

OBJECTIVE: To study the cytokine patterns in patients with rheumatoid arthritis (RA) and healthy individuals and identify candidate serum biomarkers for clinical diagnosis of RA. METHODS: This study was conducted among 59 patients diagnosed with RA in our hospital from 2015 to 2019 with 46 age- and gender-matched healthy subjects who received regular physical examinations in our hospital as the control group. Serological autoimmune profiles of 5 RA patients and 5 healthy control subjects were obtained from human cytokine microarrays. We selected 4 differentially expressed cytokines (LIMPII, ROBO3, Periostin and IGFBP-4) and 2 soluble cytokine receptors of interest (2B4 and Tie-2) and examined their serum levels using enzyme-linked immunosorbent assay in 54 RA patients and 41 healthy control subjects. Spearman correlation test was performed to assess the correlation of serum cytokine and soluble receptor expression levels with the clinical features including rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), disease activity score (DAS28) and health assessment questionnaire (HAQ). Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic capability of these cytokines. RESULTS: We identified 6 dysregulated cytokines and soluble receptors (2B4, LIMPII, Tie-2, ROBO3, periostin and IGFBP-4) in RA patients (P < 0.01). The serum levels of LIMPII, ROBO3 and periostin were significantly correlated with the disease activity indicators including RF (P < 0.001), CRP (P < 0.001), DAS28 (P < 0.001) and HAQ (P < 0.001) in RA patients. Among the 6 candidate cytokines, 2B4 showed the largest area under the curve (AUC) of 0.861 for RA diagnosis (P < 0.001), followed then by LIMPII, ROBO3, periostin, Tie-2 and IGFBP-4. CONCLUSION Serum levels of LIMPII, ROBO3 and periostin can be indicative of the disease activity of RA, and serum 2B4, LIMPII, periostin, ROBO3, IGFBP-4 and Tie-2 levels may serve as biomarkers for the diagnosis of RA.
Arthritis, Rheumatoid/diagnosis* ; Biomarkers ; C-Reactive Protein ; Cytokines ; Humans ; Insulin-Like Growth Factor Binding Protein 4 ; Protein Array Analysis ; Receptors, Cell Surface

Objective: To explore the feasibility and safety of intracardiac ultrasound-assisted atrial septal puncture (ASP) during radiofrequency ablation for atrial fibrillation. Methods: We enrolled 241 consecutive patients scheduled to radiofrequency ablation for atrial fibrillation in Beijing Anzhen Hospital from July to September 2020. Inclusion criteria: patients aged over 18 years with a clear electrocardiogram record of atrial fibrillation. Patients were divided into 2 groups: ASP with ultrasound-assisted X-ray (ultrasound group, n=123), ASP under X-ray alone (X-ray group, n=118). Clinical features of patients including age, sex, percent of paroxysmal atrial fibrillation, and repeat ablation, CHA₂DS₂-VASc score and past history (hypertension, diabetes mellitus, coronary artery disease, stroke/transient ischemic attack (TIA), valve diseases) and echocardiographic parameters (left atrial dimension, left ventricular ejection fraction, left ventricular end-diastolic dimension) were obtained and compared. The first-pass rate, radiation exposure time, duration of ASP, and complications of ASP were also compared between the two groups. Results: The age of patients in this cohort was (62.5±8.0) years, and the proportion of males was 57.0% (n=138). Among them, the proportion of paroxysmal atrial fibrillation was 56.0% (n=135), and the ratio of repeat ablation was 17.8% (n=43). Age, sex, percent of paroxysmal atrial fibrillation, history of hypertension, diabetes mellitus were similar between the two groups. The first-pass rate was significantly higher in the ultrasound group than in the X-ray group (94.3% (116/123) vs. 79.7% (94/118), P=0.001); the exposure time of X-ray was significantly shorter in the ultrasound group than in the X-ray group ((31.3±7.9) s vs. (124.8±35.7) s, P<0.001), while the duration of ASP was longer in the ultrasound group ((10.1±1.8) minutes vs. (8.2±1.3) minutes, P<0.001). In terms of complications, the incidence of puncture into the pericardium was lower in the ultrasound group (0 vs.3.4% (4/118), P=0.039); the rate of transient ST-segment elevation post ASP was similar between the ultrasound group and X-ray group (2.4% (3/123) vs. 1.7% (2/118), P=0.999). Conclusion: Intracardiac ultrasound-assisted atrial septal puncture can effectively improve the accuracy of atrial septal puncture, shorten the radiation exposure time, and reduce the complications related to atrial septal puncture.
Adult ; Aged ; Atrial Fibrillation/surgery* ; Catheter Ablation ; Feasibility Studies ; Heart Septal Defects, Atrial ; Humans ; Male ; Middle Aged ; Punctures ; Radiofrequency Ablation ; Stroke Volume ; Ventricular Function, Left

The minimally invasive cardiovascular surgery developed rapidly in last decades. In order to promote the development of minimally invasive cardiovascular surgery in China, the Chinese Minimally Invasive Cardiovascular Surgery Committee (CMICS) has gradually standardized the collection and report of the data of Chinese minimally invasive cardiovascular surgery since its establishment. The total operation volume of minimally invasive cardiovascular surgery in China has achieved substantial growth with a remarkable popularization of concepts of minimally invasive medicine in 2019. The data of Chinese minimally invasive cardiovascular surgery in 2019 was reported as a paper for the first time, which may provide reference to cardiovascular surgeons and related professionals.

Objective To investigate the significance of the expression of phosphatidic acid phosphatase type 2 domain containing 1A(PPAPDC1A) in human colorectal cancer cell lines.Methods The high metastatic potential cells LOVO,SW620 and low metastatic potential cells SW480,RKO,HCT116 and DLD-1 were cultured,the expression of PPAPDC1A mRNA and protein in different colorectal cancer cells in logarithmic growth period was detected by real-time quantitative polymerase chain reaction and Western blot.Results There were significant differences in the expressions of PPAPDC1A mRNA and protein among the six human colorectal cancer cells (F =41.213,344.1 16;P ＜ 0.05).The expression of PPAPDC1 A mRNA and protein in highly metastatic potential cells LOVO and SW620 was significantly higher than that in DLD-1,HCT116,RKO and SW480 cells (P ＜0.05).The expression of PPAPDC1A protein in LOVO cells with high metastatic potential was significantly higher than that in SW620 cells(P ＜ 0.05).The expression of PPAPDC1A protein in DLD-1 cells was significantly higher than that in HCT116,RKO and SW480 cells (P ＜0.05).The expression of PPAPDC1 A protein in HCT116 cells with low metastatic potential was significantly higher than that in RKO and SW480 cells (P ＜ 0.05).The expression of PPAPDC1 A protein in RKO cells was significantly higher than that in SW480 cells (P ＜ 0.05).There was no significant difference in the expression of PPAPDC1A mRNA between LOVO and SW620 cells (P ＜ 0.05).There was no significant difference in the expression of PPAPDC1A mRNA between SW480,RKO,HCT116 and DLD-1 cells (P＜ 0.05).Conclusion PPAPDC1A expresses differentially in colorectal cancer cell lines,which may be involved in the invasion and metastasis of colorectal cancer.

Objective To study the characteristics and mechanism of mine blast injury that wading in shoal of different depths through an animal model.Methods Ninety-six healthy adult New Zealand white rabbits weighing 2.19 ± 0.12kg were randomly divided into land group (n=16),limb wading group (n=16,the water depth reaching up the middle of the thighs of rabbits),and chest wading group (n=16,the water depth reaching up the thoracic xiphoid),stress test group (n=30),fake injury group (n=18).Punctiform burster was used to simulate landmine.Electric ignited the simulated mine away,causing landmine explosion injury to rabbits' one-sided hind limbs in upright state.High-speed photography was used to observe the movement of water accompanying the simulated mine explosion.Arterial blood serum markers of myocardial injury (CK-MB,cTnⅠ) and nerve injury (MBP,NSE) were detected before injury,and 3,6 and 12h after injury,and echocardiography,electrocardiography,CT,DSA and other examinations were implemented at the same time.Survival animals were killed 12h after injury for anatomy to record their injuries to the limbs and distant organs.The histopathological examination was done to define the injury characteristics furthen Results Feet and distal tibia were broken,and closed femoral fractures and arterial damage were often found away from the stump in limb wading group.This type of injury was different from the mop-like tearing tissue in the land group.Chest,abdominal organs and the brain,spinal cord injury in wading group were more severe than those in land group.There were higher incidences of chest,abdominal organs and spinal cord injury in chest wading Group.Conclusion The energy transfer of underwater explosion is affected by water depth and limbs or trunk mutually,which is an important mechanism of the complex and serious injuries in the wading group.The wading depth is an important factor affecting severity of the injury.Based on characteristics and unique mechanism of wading explosion,emergency treatment and the principle of early treatment for injury warrant further explored.

BACKGROUND:In recent years, bacterial celulose modified by nano-composite technology has been endowed with new properties. OBJECTIVE:To review the combination of bacterial celulose and nanosilver to prepare wound dressing. METHODS: A computer-online search was performed in PubMed (2013-01/2015-04) and CNKI (2007-01/2015-04) databases to retrieve studies on bacterial celulose, nanosilver and their compound method and application using the key words of “bacterial celulose, nano-silver” in English and Chinese, respectively. RESULTS AND CONCLUSION:Bacterial celulose/nano-silver compound can be prepared by three methods: solution impregnation, in situ composite and biocomposite. Solution impregnation method can lower the concentration of nanosilver ions in the fiber matrix to highly control the release of silver ions, but the genetic toxicity and biocompatibility are unclear.In situcomposite method can reduce the damage to the mesh structure of celulose on which silver ions can be bonded firmly to reduce the toxic damage to cels, but the reducing agent used has a higher toxicity, which is difficult to remove. Biocomposite method cannot produce toxic substance, which is friendly to the environment, and the synthetic biomaterials have less harm to the human body and can be controled highly.

Objective To study the injury cases of armored biological target by bullet and its causes, and provide references for revealing the wound mechanism of armored human by bullet and the corresponding medical treatment. Methods A 60 kg live pig was selected as the biological target, and the testing physical quantity and specific location within the biological target were identified by reference to the vulnerability in the head and chest of the soldier with armor. Three rounds of 9 mm Bala Baerum pistols in 25 meter-range were shot, respectively, on the head and chest of the biological live target with armor, and the multi-mechanical parameters (acceleration, pressure, loads, etc.) that played an important role in blunt trauma of armored biological target under pistol impacts were measured. Results (1) Blunt injury to the head of the biological target by pistol generated negative pressure pulse inside the calvarium with far reaching effects, and pressure pulse appeared in the spine and carotid; (2) Blunt injury to the chest of the biological target by pistol caused high-G impact on the heart, with high pressure wave in the lungs. Conclusions The measurement results in this study provided the basis for quantitatively understanding the injury mechanism of the pistol impacted by live armored target.