Objective To investigate the efficacy and safety of the Corheart 6 left ventricular assist system in patients with end-stage heart failure. Methods A retrospective study was conducted on patients with end-stage heart failure who were treated with Corheart 6 left ventricular assist system from March 2022 to June 2024 in 4 hospitals in Jiangsu Province. The efficacy of the device was evaluated by comparing changes in clinical indicators at preoperative, discharge, 3-month postoperative, and 6-month postoperative timepoints, including the New York Heart Association (NYHA) functional classification, left ventricular ejection fraction (LVEF), and left ventricular end-diastolic diameter (LVEDD). The safety of the device was assessed by analyzing the intraoperative position and orientation of the blood pump inlet cannula, as well as the incidence of adverse events. Results In this study, 39 patients were collected, including 34 males and 5 females with a mean age of (56.4±12.5) years, ranging from 20 to 75 years. There was no operative death. There was no death in postoperative 3 months with a survival rate of 100.0%. There were 3 deaths in 6 months postoperatively, with a survival rate of 92.3%. All patients had a preoperative NYHA cardiac function classification of class Ⅳ. The NYHA cardiac function class of the patients improved (P<0.05) at discharge, 3 and 6 months after surgery when compared to the preoperative period. LVEF was significantly higher at 3 months after surgery than that during the preoperative period (P<0.05). LVEDD was significantly smaller at discharge, 3 and 6 months after surgery than that during the preoperative period (P<0.05). The safety evaluation's findings demonstrated that all 39 patients' intraoperative blood pump inlet tubes were oriented correctly, the artificial blood vessel suture sites were appropriate, there were no instances of device malfunction or pump thrombosis, or instances of bleeding or hemolysis, and the rate of the remaining adverse events was low. Conclusion With a low rate of adverse events and an excellent safety profile, the Corheart 6 left ventricular assist system can efficiently enhance cardiac function in patients with end-stage heart failure. It also has considerable clinical uses.

Depression is a common mental illness in adolescents, and some patients do not respond well after medication, which may be partly related to vitamin D deficiency and insufficient calcium intake. This paper reports a 15-year-old patient with depression, whose condition was still unstable and the effect was not good despite routine use of antidepressant drugs and psychological intervention. After adequate supplementation of vitamin D and calcium, the patient's depression improved significantly, and the follow-up for 4 months, the condition was stable and did not recur.

Objective To understand the composition of death causes of residents in Tianzhu Tibetan Autonomous County,Wuwei City,and to analyze the current situation of life expectancy and life loss of residents,so as to provide evidence for disease control and health promotion.Methods According to the international classification of diseases(ICD-10),the population data and death cause monitoring data of Tianzhu Tibetan Autonomous County in 2021 were analyzed,standardized with the data of the seventh national census,and analyzed with SPSS 21.0 software and life expectancy statistics.Results The crude mortality rate of residents in Tianzhu Tibetan Autonomous County was 642.25/100 000,The male crude mortality(727.12/100 000)rate was higher than the female(553.29/100 000).The overall life expectancy was 79.07 years.The life expectancy in males was 76.77 years and the life expectancy in females was 81.47 years.The first five causes of death were circulatory system(mortality 270.14 per 100,000),nervous system(mortality 159.57 per 100,000),malignant tumor(mortality 101.97 per 100,000),respiratory system(mortality 27.81 per 100,000)and gastrointestinal disease disease(mortality 26.48 per 100,000).The first five places of AYLL were injury and poisoning(24.81 years/person),spirit and blood(15.42 Years/person),infectious diseases(13.06 years/person),malignant tumor(11.78 Years/person)and urogenital diseases(9.94 years/person).Conclusion The highest mortality rate in the 2021 Bairi Tibetan Autonomous County was circulatory system disease,and the major causes of premature death were injury and poisoning.

Humans ; Cytomegalovirus ; Cytomegalovirus Infections ; Antigens, Viral ; Immunity ; Autoimmune Diseases ; CD8-Positive T-Lymphocytes

Objective:To analyze the clinical features of patients with infective endocarditis (IE) and to improve the awareness of this disease.Methods:A total of 425 IE patients hospitalized in Peking Union Medical College Hospital from January 2011 to December 2018 were included in this study. The clinical features, predisposing cardiac diseases, pathogens and outcomes were retrospectively analyzed. The binary logistic regression model was adopted to analyze the risk factors.Results:Among 425 IE patients, the median period from onset of disease to diagnosis was 10 weeks. Fever (423 cases, 99.5%) and cardiac murmur (372 cases, 87.5%) were the most common clinical manifestations. Congestive heart failure (219 cases, 51.5%) and embolism (158 cases, 37.2%) were the most common complications. Two hundred and fifty (58.8%) patients had predisposing cardiac diseases with congenital heart diseases (121 cases, 28.5%) as the leading cause. Vegetations were found in 410(96.5%) patients through echocardiography and surgery. Totally 343(80.7%) patients got a positive pathogen test with Streptococcus viridans accounted for 59.5%(204/343) as the major pathogen of IE.All 425 patients received antimicrobial therapy, 342(80.5%) patients received surgery, among them 332 cases (97.1%) were early surgery, and the in-hospital mortality rate was 4.5%(19/425). Logistic regression analysis showed that New York heart function assessment Ⅲ/Ⅳ (odds ratio ( OR)=3.40, 95% confidence interval ( CI) 1.30 to 11.68), cerebral embolism ( OR=4.45, 95% CI 1.50 to 13.22) and septic shock ( OR=19.41, 95% CI 3.81 to 99.02) were independent risk factors for in-hospital death(all P<0.050), while surgery was an independent protective factor against in-hospital death ( OR=0.15, 95% CI 0.05 to 0.47, P=0.001). Conclusions:There is still a significant delay in the diagnosis of IE. Physicians should be alert to IE. Multiple sets of blood cultures should be obtained before administration of antibiotics, and echocardiography should be performed in all patients with suspected IE as soon as possible. Bactericidal antimicrobial therapy and early surgery in patients with indications are critical aspects in the management of IE patients.

Tricuspid regurgitation (TR) interventions are under rapid development. The K-Clip? system is the first domestic transcatheter tricuspid annuloplasty system with unique clamping procedure to achieve annular reduction.Intraoperative echocardiographic monitoring procedures for transcatheter tricuspid annuloplasty have not been reported yet in China. Thus, this review aimed to propose the standard two-dimensional and three-dimensional transesophageal echocardiographic workplanes and procedures to guide and monitor the implantation of K-Clip system based on our experience in Zhongshan Hospital, Fudan University to provide a reference point for the intraoperative echocardiographic monitoring of future transcatheter tricuspid annuloplasty devices in China.

Objective:To investigate the clinical features and influencing factors of long-term prognosis of tuberculous meningitis(TBM), and to provide a recommendation for treatment and early intervention of TBM.Methods:Clinical data of TBM patients were retrospectively collected at Peking Union Medical College Hospital from January 2014 to December 2021. Patients who were followed-up more than one year were divided into two groups according to modified Rankin Scale (mRS). Risk factors associated with long-term prognosis were analyze by conditional logistic stepwise regression.Results:A total of 60 subjects were enrolled including 33 (55%) males and 27 (45%) females with age 15-79 (44.5±19.8) years. There were 30 cases (50%) complicated with encephalitis, 21 cases (35%) with miliary tuberculosis. The diagnosis was microbiologically confirmed in 22 patients (36.7%), including 5 cases (22.7%, 5/22) by acid-fast staining, 8 cases (36.4%, 8/22) by Mycobacterium tuberculosis (MTB) culture, and 20 cases (90.9%, 20/22) by molecular biology. The median follow-up period was 52(43, 66 ) months in 55 cases surviving more than one year. Among them, 40 cases (72.7%) were in favorable group (mRS 0-2) and 15 cases (27.3%) were in unfavorable group (mRS 3-6) with poor prognosis. The mortality rate was 20% (11/55). Elderly ( OR=1.06, P=0.048 ) , hyponatremia( OR=0.81, P=0.020), high protein level in cerebrospinal fluid (CSF) ( OR=3.32, P=0.033), cerebral infarction( OR=10.50, P=0.040) and hydrocephalus( OR=8.51, P=0.049) were associated with poor prognosis in TBM patients. Conclusions:The mortality rate is high in patients with TBM. Molecular biology tests improves the sensitivity and shorten the diagnosis time of TBM. Elderly, hyponatremia, high protein level in CSF, cerebral infarction and hydrocephalus are independent risk factors of long-term survival in TBM patients.

Objective To summarize the clinical features of spontaneous remission in classic fever of unknown origin (FUO). Methods Medical records of 121 patients diagnosed with FUO at admission in Peking Union Medical College Hospital between January 2018 and June 2018 were reviewed retrospectively. Patients who were discharged without etiological diagnoses were followed for 2 years. The clinical features and outcomes of these patients were summarized. Multivariate logistic regression was used to analyze related factors of spontaneous remission of FUO. Results After excluding 2 patients who lost to follow-up, the etiology of 119 FUO patients were as follows: infectious diseases in 30 (25.2％) cases, connective tissue diseases in 28 (23.5％) cases, tumor diseases in 8 (6.7％) cases, other diseases in 6 (5.0％) cases, and unknown diagnoses in 47 (39.5％) cases. Totally, 41 patients experienced spontaneous remission of fever (the median time from onset to remission was 9 weeks, ranging from 4 to 39 weeks). In patients with spontaneous remission in FUO, lymphadenopathy was less common clinical manifestation, the levels of inflammatory markers including leukocyte count, neutrophil count, neutrophil ratio, C-reactive protein, and ferritin were lower, and the proportion of CD8 positive T lymphocytes expressing CD38 was lower. Multivariate logistic regression analysis of factors with a P-value < 0.05 in univariate analysis shown that white blood cell count (OR: 0.545, 95％CI: 0.306-0.971, P = 0.039), neutrophil count (OR: 2.074, 95％CI: 1.004-4.284, P = 0.049), and proportion of neutrophils (OR: 0.928, 95％CI: 0.871-0.990, P = 0.022) were independent significant factors associated with spontaneous remission in FUO. Conclusions This study suggested that most patients discharged with undiagnosed classic FUO would remit spontaneously. Thus, for patients with stable clinical conditions, follow-up and observation could be the best choice. Patients with lower level of some inflammatory factors may have a high likelihood of spontaneous remission in classic FUO.

For effective resistance to virus attack and infection, reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. This paper summarizes the development causes, common locations, and prevention ways about the device related pressure injuries on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the nursing strategy for device related pressure injuries and other nursing strategy is proposed to take care efficiently the device related pressure injuries. Meantime, a corresponding nursing strategy is also suggested to deal with the correlative skin diseases during the application of medical-grade protective equipment. These paper aims to provide reference for the prevention of device related pressure injuries and the care of skin-related diseases for clinical working staff, especially to the respectable personnel in front line of fighting against Corona virus disease 2019.

For effective resistance to virus attack and infection and reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. The paper summarizes the occurrence causes, common locations, and prevention ways about the device related pressure ulcers on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the prevention and nursing strategies for device related pressure ulcers and other related skin injuries during application of medical-grade protective equipment. The paper aims to provide reference for the prevention and nursing of device related pressure ulcers and related skin diseases for clinical medical staff, especially to the respectable personnel in front line of fighting against coronavirus disease 2019.