One of its primary surgical treatments of tricuspid regurgitation is tricuspid valve biological valve replacement. Catheter tricuspid valve-in-valve implantation is a novel interventional alternative for biological valve failure. The non-invasive lung fluid measuring device remote dielectric sensing (ReDSTM) has been increasingly incorporated into clinical practice as a means of monitoring chronic heart failure in recent years. This report describes the process and outcomes of the first instance of perioperative lung fluid volume evaluation following transcatheter tricuspid valve implantation utilizing ReDSTM technology. The patient has a short-term, substantial increase in postoperative lung fluid volume as compared to baseline.

After two decades of development, transcatheter left atrial appendage closure has emerged as a safe and effective intervention for stroke prevention in patients with atrial fibrillation. In 2024, significant advancements were made in the field of left atrial appendage closure in terms of evidence-based medicine, device research and development, and guideline consensus. The annual report on transcatheter left atrial appendage closure systematically reviews global academic progress in 2024, encompassing newly published clinical evidence, recently developed occlusion devices, and updated international guidelines/consensus statements. In the future, the development direction of transcatheter left atrial appendage closure mainly includes expanding surgical indications, optimizing imaging assistance technology, improving closure device design, and exploring individualized strategies for postoperative antithrombotic therapy.

Objective To study the distribution and trend of HIV-1 drug resistance mutation in Dalian blood donors be-tween 2011 and 2020.Methods The protease-reverse transcriptase(PR-RT)region was sequenced in Dalian blood donors tested HIV-1 positive between 2011 and 2020.Drug resistance mutation(DRM)rate and level of resistance to selected drugs were analyzed by the Stanford HIV Drug Resistance Database.Results DRM were detected in 17.2%(30/174)of samples,while transmitted drug resistance(TDR)was5.7%(10/174).Between2011 and2020,DRM and TDR rates in-creased significantly in 2019 and reached their highest levels in 2020(44.4%and 22.2%,respectively).DRM carriage was associated with people with college degree or above and with local residents(P<0.05).NNRTI DRMs were the most fre-quently detected(12.6%,22/174),followed by PIs(5.7%,10/174),with V179D/E/T and M46I being the main DRMs detected.Only one HIV-1strain(0.57%,1/174)carried a NRTI DRM(L74I).The overall rate of predicted high level re-sistance to antiretroviral drugs was 6.9%(12/174),with the highest proportion of NNRTI resistance(83.3%,10/12).Two samples were classified as highly resistant to EFV and NVP,accounting for 1.1%(2/174).CRF55_01B strains showed a significantly higher DRM rate than strains of other HIV-1 genotypes(P<0.05).Conclusion Between 2011 and 2020,the rate of HIV-1 DRMs in blood donors in Dalian showed a significant upward trend,particularly in 2019-2020,with NNRTI resistance being the most common.The combination of DRMs detection before and after implementation of ART un-der the latest national ART treatment plan would improve the effectiveness of HIV-1 prevention and control locally.

Objective:To explore the effects of the LAmbre device and mitral annulus(MA), as well as left atrium(LA) in patients with non-valvular atrial fibrillation(NVAF) after left atrial appendage closure (LAAC) using real-time-three-dimensional transesophageal echocardiography (3D TEE).Methods:Fity-six consecutive patients who underwent LAAC with the LAmbre device in Zhongshan Hospital of Fudan University from June 2019 to March 2023 were retrospectively enrolled, with no or less than moderate mitral regurgitation (MR). All patients underwent pre-operative and follow-up two-and three-dimensional transesophageal echocardiography (2D TEE, 3D TEE) at 60 days after the operation. The quantitative parameters of MA and LA were obtained by offline analysis using QLab 13.0 (Philips Healthcare, Andover, MA). Importantly, mitral annular measurements were made at seven time points throughout the cardiac cycle: early diastole, mid-diastole, late diastole, mitral valve closure, early systole, mid-systole, and late systole, which facilitates constructing the dynamic model of MA to assess the annular morphology and dynamics.Results:The values of AP diameter (APD), AL-PM diameter (ALPMD), 3D annulus circumference (3DAC), 3D annulus area (3DAA) decreased significantly compared with pre-operative values at all time points of the cardiac cycle (all P<0.05), while non-planar angle (NPA) and AH/CD were not apparently changed (all P>0.05 ). Throughout the cardiac cycle, MA showed regular changes, gradually increased in systole with the saddle shape deepened, and gradually decreased in diastole with the saddle shape shallowed.During systole, there was an increase in the rate of change of AP in MA [pre-operative (3.01±2.64)%, post-operative (3.81±3.51)%, P=0.037] after LAAC, with no significant difference in the rate of change of ALPM, 3DAC, and 3DAA.Meanwhile, we observed an evident reduction in LA minimal volume (LAVmin) [pre-operative (78.36±25.16)ml, post-operative (70.73±22.78)ml, P=0.004] and an obvious increase in LA ejection function [pre-operative (22.88±10.09)%, post-operative (31.41±12.28)%, P<0.05] during follow-up. Conclusions:3D TEE can accurately assess the impact of LAAC on the MA and LA. The LAmbre device can affect the morphology of MA, as well as the structure and function of LA, while the change of the dynamics of MA is not so prominent.

ObjectiveTo evaluate the clinical efficacy and safety of Xianqi Qinglong Formula （仙芪青龙方， XQF） in the treatment of cough variant asthma （CVS） patients with lung and kidney deficiency and exuberant wind-induced spasm and tension syndrome. MethodsA randomized， positive-controlled， non-inferiority clinical trial was designed. Totally， 102 CVS patients with lung and kidney deficiency and exuberant wind-induced spasm and tension syndrome were randomly divided into a treatment group （52 cases） and a control group （50 cases）. The treatment group was given XQF granules orally， 1 dose per day， 2 bags each time （9.25 g/bag）， twice a day， after breakfast and dinner； the control group was given XQF granules placebo orally combined with inhaled fluticasone propionate inhalation aerosol （125 μg each time， twice a day）. Both groups were treated for 12 weeks and followed up for 12 weeks， with a total of 24 weeks. The primary outcome was the cough symptom score （including daytime， nighttime and total score）， evaluated before treatment （at enrollment）， during treatment （after the 6th week of enrollment）， at the end of treatment （after the 12th week of enrollment）， and at the end of follow-up （after the 24th week of enrollment）. The non-inferiority was determined by the lower limit （LCL） of the unilateral 95% confidence interval. The secondary outcomes included cough relief and disappearance， total score of TCM syndrome， cough visual analogue （VAS） score， Leicester Cough Questionnaire （LCQ） score， and lung function indicators including forced expiratory volume in 1 second （FEV1）， percentage of predicted forced expiratory volume in 1 second （FEV1%pred）， forced vital capacity （FVC）， and peak expiratory flow （PEF）. Blood routine and liver and kidney function were tested before and after treatment， and the adverse events were recorded. ResultsA total of 101 patients were included in the full analysis set （FAS）， including 52 cases in the treatment group and 49 cases in the control group. After treatment， the daytime， nighttime and total cough symptom scores during treatment， at the end of treatment and at the end of follow-up all decreased in both two groups （P＜0.01）. The unilateral 95% LCL of the total cough symptom scores during treatment， at the end of treatment and at the end of follow-up of the two groups were -0.14， -0.47 and -0.27 （95% LCL all＞-0.6）. There were no significant differences in the cough relief rate， cough disappearance rate， cough relief days and cough disappearance days between the two groups at each time point （P＞0.05）. Compared to those before treatment， the TCM syndrome scores and cough VAS scores during treatment， at the end of treatment and at the end of follow-up decreased in both groups， while the LCQ scores increased （P＜0.01）， but there were no significant differences in FEV1， FEV1%， FVC and PEF before and after treatment （P＞0.05）. There were no significant differences in TCM syndrome scores， cough VAS scores， LCQ scores， FEV1， FEV1%， FVC， and PEF between the two groups at each time point （P＞0.05）. No clinically significant abnormal liver and kidney function were found in the two groups before and after treatment. ConclusionXQF is not inferior to fluticasone propionate inhalation aerosol in relieving cough symptoms， reducing cough scores， decreasing the number of cough attack days， and improving the quality of life when treating CVS patients with lung and kidney deficiency and exuberant wind-induced spasms and tension syndrome， and relatively safe.

OBJECTIVE To assess the efficacy and safety of different treatment modalities for moderate to severe Henoch- Schönlein purpura nephritis （HSPN）. METHODS Literature searches were conducted in the CNKI， VIP， Wanfang Data， SinoMed， PubMed， OVID， Web of Science， Embase， and the Cochrane Library to collect randomized controlled trials （RCTs） and cohort studies on the treatment of moderate to severe HSPN with 12 intervention measures： monotherapy with glucocorticoid （GC）， as well as cyclophosphamide， mycophenolate mofetil （MMF）， Tripterygium wilfordii multiglucoside （TWM）， leflunomide， mizoribine， tacrolimus， cyclosporin A， hemoperfusion， tonsillectomy combined with GC， and double filtration plasmapheresis （DFPP） combined with GC and cyclophosphamide or mycophenolate mofetil. The search period was from the inception of the databases to March 2024. After literature screening， data extraction， and quality assessment， a network meta- analysis was performed using Stata 16.0 software. RESULTS A total of 28 articles were included， with 14 RCTs and 14 cohort studies， involving 1 746 patients. The network meta-analysis results showed the combination of tacrolimus and GC had the highest probability of being the best in overall remission rate， followed by the combination of TWM and GC， and DFPP combined with GC and MMF. The combination of leflunomide and GC had the highest probability of being the best in complete remission rate， followed by the combination of mizoribine and GC， and DFPP combined with GC and cyclophosphamide. The combination of mizoribine and GC had the highest probability of being the best in terms of reducing 24-hour urinary protein quantification， followed by DFPP combined with GC and MMF， and the combination of leflunomide and GC. Moreover， the combination of tacrolimus and GC had the highest probability of being the best in safety， followed by the combination of cyclosporin A and GC， and the combination of leflunomide and GC. CONCLUSIONS Compared to other treatment methods， the combination therapy of tacrolimus and GC shows better efficacy and safety in the treatment of moderate to severe HSPN.

Objective To investigate the plasma level of interleukin-31(IL-31)in patients with pulmonary arterial hypertension(PAH)and its clinical relevance.Methods The patients who were diagnosed as PAH in Zhongshan Hospital,Fudan University from January 1,2021 to December 30,2023(PAH group)and the healthy people in the same period(control group)were selected.The clinical data and follow-up records were collected.Plasma levels of IL-31,IL-1β,IL-6,IL-10,IL-12p70,monocyte chemoattractant protein-1(MCP-1),tumor necrosis factor-α(TNF-α)and transforming growth factor-β1(TGF-β1)were detected by enzyme-linked immunosorbent assay(ELISA).Pearson correlation test was used to evaluate the correlations between IL-31 and right cardiac catheterization parameters,echocardiography parameters and blood indices in patients with PAH.Cox proportional hazard model was used to analyze the prognostic factors of patients in PAH group.Results A total of 50 patients with PAH and 22 healthy controls were included.There was no significant difference in age,gender,body mass index and left ventricular ejection fraction between the two groups.Compared with the control group,the plasma level of IL-31 in the PAH group was significantly higher(168.82[149.14,177.26]pg/mL vs 152.76[145.58,159.41]pg/mL,P=0.001).Pearson correlation test showed that the plasma level of IL-31 in PAH patient was positively correlated with mean pulmonary artery pressure(r=0.652,P＜0.001)and pulmonary vascular resistance(r=0.651,P＜0.001),but was negatively correlated with tricuspid annular plane systolic excursion(r=-0.496,P＜0.001).Cox proportional hazard model showed that higher plasma level of IL-31 was an independent predictor of readmission for heart failure/all-cause mortality in patients with PAH(HR=1.130,95％CI 1.052-1.214,P=0.001).Conclusions Plasma level of IL-31 may be significantly increased in patients with PAH and be positively correlated with the severity of PAH,and elevated level of IL-31 is predictive of poor prognosis in PAH patients.

Objective:To evaluate the application value of extended latissimusdorsi musculocutaneous flap combined with breast precision hand in stage Ⅰ breast reconstruction.Methods:Twelve cases of extended latissimusdorsi musculocutaneous flap combined with stage Ⅰ breast reconstruction for breast cancer precision surgery were collected from January 2022 to February 2023 in our department, the postoperative complications of surgical techniques were analyzed, and the cosmetic effects of breast reconstruction were evaluated according to Harris standards.Results:All 12 cases underwent breast reconstruction with extended latissimusdorsi musculocutaneous flap, and the survival rate of the flap was 100%. There was local cutaneous margin necrosis in 1 case of back incision, partial ischemic necrosis of the nipple in 1 case, and effusion in the donor area of the back in 5 cases. Harris evaluation of cosmetic effect of breast reconstruction was excellent in 3 cases, good in 6 cases, and fair in 3 cases. Follow-up time was 4-16 months (median was 12 months), and no local recurrence or distant metastasis was observed during follow-up.Conclusions:The extended latissimusdorsi musculocutaneous flap combined with precision mastectomy stage Ⅰ reconstruction is a safe and feasible treatment method for breast cancer.

Objective To analyze the awareness of retinopathy of prematurity (ROP) among medical workers in Neonatal Intensive Care Unit (NICU) and obstetrical department, and parents of premature infants in Xiangyang area of Hubei Province. Methods This study used a questionnaire survey to select 115 parents of premature infants who underwent ROP screening from October 2020 to October 2022 and 85 neonatologists and obstetricians in NICU and obstetrics departments of Xiangyang Central Hospital in Hubei Province. The basic situation of premature infants was recorded, and the questionnaires were used to investigate the cognitive status of parents of premature infants, neonatologists, and obstetricians on ROP-related knowledge, and the results were recorded. Results A total of 115 valid questionnaires were collected from parents. Fifty-four parents (46.96%) had heard of ROP, and 61 parents (53.04%) had never heard of ROP. Among all parents who had heard of ROP, 10 parents (18.52%) learned through online queries or friends, 41 parents (75.93%) learned through NCIU doctors, and 1 guardian learned through NCIU nurses, 1 through obstetricians, and 1 through obstetric nurses. There were significant differences in the ways parents heard about ROP (χ²=122.709, P < 0.001). A total of 95 valid questionnaires were collected from medical staff, and only 7 medical staff could correctly write the ROP screening criteria, all of whom were NICU doctors. The NICU doctors had a higher rate of informing parents of premature infants about ROP than NICU nurses, obstetricians, and obstetric nurses (P < 0.05). Conclusion Parents of premature infants who undergo ROP screening in Xiangyang, Hubei Province have a serious lack of knowledge about ROP-related knowledge, and education level is an important factor influencing parents' understanding of ROP-related knowledge. Medical staff in relevant departments should also strengthen their learning of ROP-related knowledge. NICU doctors play the most important role in promoting ROP, and the publicity of ROP-related knowledge should be strengthened.

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