Objective:To explore the role of mechanical hemodynamic support (MHS) in mapping and catheter ablation of patients with hemodynamically unstable ventricular tachycardia (VT), report single-center experience in a cohort of consecutive patients receiving VT ablation during MHS therapy, and provide evidence-based medical evidence for clinical practice.Methods:This was a retrospective cohort study. Patients with hemodynamically unstable VT who underwent catheter ablation with MHS at Beijing Anzhen Hospital, Capital Medical University between August 2021 and December 2023 were included. Patients were divided into rescue group and preventive group according to the purpose of treatment. Their demographic data, periprocedural details, and clinical outcomes were collected and analyzed.Results:A total of 15 patients with hemodynamically unstable VT were included (8 patients in the rescue group and 7 patients in the preventive group). The acute procedure was successful in all patients. One patient in the rescue group had surgical left ventricular assist device (LVAD) implantation, remaining 14 patients received extracorporeal membrane oxygenation (ECMO) for circulation support. ECMO decannulation was performed in 12 patients due to clinical and hemodynamic stability, of which 6 patients were decannulation immediately after surgery and the remaining patients were decannulation at 2.0 (2.5) d after surgery. Two patients in the rescue group died during the index admission due to refractory heart failure and cerebral hemorrhage. During a median follow-up of 30 d (1 d to 12 months), one patient with LVAD had one episode of ventricular fibrillation at 6 months after discharge, and no further episodes of ventricular fibrillation and/or VT occurred after treatment with antiarrhythmic drugs. No malignant ventricular arrhythmia occurred in the remaining 12 patients who were followed up.Conclusions:MHS contributes to the successful completion of mapping and catheter ablation in patients with hemodynamically unstable VT, providing desirable hemodynamic status for emergency and elective conditions.

Background::Oral anti-coagulants (OAC) are the intervention for the prevention of stroke, which consistently improve clinical outcomes and survival among patients with atrial fibrillation (AF). The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in China.Methods::Using data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation (CCC-AF) registry, guideline-recommended OAC use in eligible patients was assessed.Results::A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019, of whom 38,203 were at a high risk of stroke, 9717 were at a moderate risk, and 4610 were at a low risk. On admission, only 20.0% (6075/30,420) of patients with a diagnosed AF and a high risk of stroke were taking OAC. The use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population (adjusted odds ratio: 0.54, 95% confidence interval: 0.43–0.68; P <0.001). At discharge, the prescription rate of OAC was 45.2% (16,757/37,087) in eligible patients with high stroke risk and 60.7% (2778/4578) in eligible patients with low stroke risk. OAC utilization in patients with high stroke risk on admission or at discharge both increased largely over time (all P <0.001). Multivariate analysis showed that OAC utilization at discharge was positively associated with in-hospital rhythm control strategies, including catheter ablation (adjusted odds ratio [OR] 11.63, 95% confidence interval [CI] 10.04–13.47; P <0.001), electronic cardioversion (adjusted OR 2.41, 95% CI 1.65–3.51; P <0.001), and anti-arrhythmic drug use (adjusted OR 1.45, 95% CI 1.38–1.53; P <0.001). Conclusions::In hospitals participated in the CCC-AF project, >70% of AF patients were at a high risk of stroke. Although poor performance on guideline-recommended OAC use was found in this study, over time the CCC-AF project has made progress in stroke prevention in the Chinese AF population.Registration::ClinicalTrials.gov, NCT02309398.

Electrical impedance tomography(EIT)is a non-invasive imaging technique that generates cross-sec-tional images of chest by measuring changes in impedance as electric currents passing through human body.In peri-operative respiratory management,EIT provides a real-time,consecutive monitoring of lung ventilation and perfusion status,guiding respiratory management of perioperative patients including medication for COPD and asth-ma,personalized PEEP settings for specific patient populations,lung protection for pediatric perioperative cases,and predicting postoperative pulmonary complications.Application of EIT in the perioperative period helps clinicians to manage patient respiratory status more accurately,reduces complications and improves outcomes.Through real-time monitoring and individualized treatment guidance,EIT enhances the safety and effectiveness of perioperative respiratory management,becoming an essential part of the operating room.This review summarises the application of EIT in the perioperative period,aiming to provide reference for the clinical application of EIT.

OBJECTIVE To screen the best compatibility ratio and administration conditions of Panax ginseng -Poria cocos pair against aging ，and investigate its mechanism . METHODS P. ginseng-P. cocos pair extracts with different compatibility ratios （1∶1，1∶2，2∶1，1∶4，4∶1，m/m）were prepared ；taking Saccharomyces cerevisiae as the aging model organism ，the S. cerevisiae growth curve was drawn by MTT method ，the best compatibility ratio ，administration concentration and administration time point of P. ginseng-P. cocos pair were screened out ；the activities of antioxidant related enzymes [superoxide dismutase （SOD），peroxidase （POD），catalase（CAT）]，the levels of reactive oxygen species （ROS）and malondialdehyde （MDA），the content of adenosine triphosphate（ATP），and the mitochondrial membrane potential （MMP）in S. cerevisiae cells were detected ；mRNA expressions of SOD1，CTT1，GSH1，ATP1，MRS1 and CDC 19 were also detected . RESULTS The optimal ratio of P. ginseng-P. cocos pair for anti-aging activity was 1∶4（m/m），the optimal administration concentration was 220 μg/mL，and the optimal administration time point was the 28th hour . The extracts of P. ginseng-P. cocos pair（1∶4，m/m）could significantly increase the activities of SOD ， POD and CAT ，ATP content ，MMP，mRNA expression of CTT 1，GSH1 and MRS 1（P＜0.01），but decrease the levels of MDA and ROS ，mRNA expressions of SOD 1，ATP1 and CDC 19（P＜0.05 or P＜0.01）. CONCLUSIONS P. ginseng-P. cocos pair（1∶4， m/m）has a good anti -aging effect on S. cerevisiae ，its mechanism may be related to the positive regulation of oxidative stress and energy metabolism of S. cerevisiae cell.

Objective:To systematically review the severe risk in common chronic diseases and coronavirus disease 2019 (COVID-19) cases.Methods:PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, China Biology Medicine disc, medRxiv, SSRN and ChinaXiv were searched for clinical and epidemiological studies that reported chronic diseases in patients with COVID-19. Only studies of severe COVID-19 in comparison with non-severe controls were included. The prevalence rates of chronic diseases including chronic obstructive pulmonary disease (COPD), diabetes mellitus, hypertension, malignant tumor, cardiovascular diseases, cerebrovascular disease, chronic kidney disease, and chronic liver disease were estimated. Pooled odds ratio ( OR) with 95% confidence interval ( CI) between patients with severe COVID-19 and non-severe groups were calculated. R 3.6.3 software was used for meta-analysis. Results:The search yielded 2 455 articles. A total of 19 eligible comparative studies with 4 792 patients were included in a quantitative analysis. Meta-analysis showed that there was a proportion of 55.0% (95% CI 40.0%-80.0%) male among patients with COVID-19, and the overall pooled prevalence of any chronic diseases in COVID-19 cases was 30.4% (95% CI 24.0%-37.0%). The most prevalent comorbidity was hypertension (16.9%(95% CI 14.0%-20.0%)), followed by diabetes mellitus (8.3%(95% CI 8.0%-9.0%)). The proportion of male patients with severe COVID-19 was higher than that of male patients with non-severe COVID-19 (64.4% vs 52.8%, OR=1.49, 95% CI 1.08-2.05, Z=4.63, P<0.01). The prevalence rates of COPD, cerebrovascular disease, diabetes mellitus, chronic kidney disease, hypertension, cardiovascular diseases and malignant tumor in severe COVID-19 patients were higher than those of non-severe patients ( OR=5.77, 95% CI 3.80-8.74; OR=4.47, 95% CI 2.71-7.38; OR=3.55, 95% CI 2.86-4.40; OR=3.05, 95% CI=1.76-5.28; OR=2.82, 95% CI=1.96-3.97; OR=2.39, 95% CI=1.77-3.23; OR=2.15, 95% CI 1.27-3.66, respectively, Z=8.37, 6.01, 11.60, 4.20, 5.46, 5.71, 3.12, all P<0.01). There was no significant difference in the prevalence of chronic liver disease between severe and non-severe patients ( OR=1.35, 95% CI 0.84-2.17, P=0.11). Conclusion:COVID-19 patients with chronic diseases have higher risk of developing severe disease, and the ORs from high to low are COPD, cerebrovascular disease, diabetes mellitus, chronic kidney disease, hypertension, cardiovascular diseases and malignant tumor.

Objective　Our study aimed to investigate the relationship between post-stroke cognitive function and pre-stroke Chinese language input in patients with cerebral infarction,and to assess the writing function of patients with post-stroke cognitive impairment.Methods　(1)A total of 196 patients diagnosed with cerebral infarction were selected.Scores of various diagnostic scales,as well as writing,reading and use of electronic products before stroke were compared.The correlation between post-stroke cognitive function and pre-stroke Chinese language input,and the relationship between writing ability with cognition in various domains as well as the trend of changes were analyzed.(2)Chinese character writing training was used to analyze the prevention of post-stroke cognitive impairment and restoration of neurological function.Aphasia battery of Chinese (ABC) was used to assess the writing function of patients.Furthermore,the relationship between writing and cognitive functions,and the ABC scores were analyzed.(3)Patients’cognitive and neurological functions were evaluated again at 1st,3rd and 6th months after writing training to analyze the effect of writing training on the cognitive impairment and neurological function recovery.Results　(1)The total MMSE score and total MoCA score were significantly correlated with the writing and reading of Chinese characters in pre-stroke patients (all P<0.05),but were not significantly correlated with the use limit of electronic products.(2)Total score of MMSE was significantly correlated with transcribing,dictating,graph writing,and active writing (all P<0.05),while the total score of MoCA only had a significant positive correlation with the dictating, graph writing,and active writing (all P<0.05).(3)The total MMSE score at the 3rd and 6th months were significantly increased (both P<0.05).Conclusions　Pre-stroke writing and reading habits were associated with better post-stroke cognitive performance,whereas good pre-stroke writing and reading habits might have a protective effect on post-stroke cognitive function.There was a positive correlation between the level of post-stroke writing and the level of post-stroke cognitive function,suggesting that the post-stroke writing ability may affect the level of post-stroke cognitive function.Writing training might improve cognitive impairment after stroke.

OBJECTIVE:To study therapeutic efficacy of total hip arthroplasty(THA)combined with Alendronate sodium tablets in the treatment of femoral neck fracture and its effects on bone mineral density(BMD). METHODS:A total of 98 patients with femoral neck fractures in our hospital during 2014-2016 were divided into observation group and control group by random digital table method,with 49 cases in each group. Both groups were treated with THA. 7 days after operation,control group was given routine anti-osteoporosis treatment [Gaierqi D tablets(containing 600 mg calcium/vitamin D3125 IU in each tablet),p.o., one tablet/time,once a day;Calcitriol soft capsules(25 μ g each pill,p.o.,2 pills/time,once a day)]. Observation group was additionally given Alendronate sodium tablets(10 mg/time,once a day)on the basis of control group. Both groups were treated for consecutive 3 months. The hip function excellent rate was evaluated by using Harris scoring system at 7 days,3 months and 6 months after operation. The periprosthetic 7 cases of egion interest(ROI1-7)BMD were detected and compared between 2 groups. RESULTS:The excellent rate of hip joint function in the control group were 16.33%,40.82%,69.39% 7 days,3 months,6 months after operation,respectively;those of observation group were 17.78%,73.33%,88.89% respectively. There was no statistical significance in the excellent rates of hip joint function between 2 groups 7 days after operation(P>0.05). The excellent rate of hip joint function in observation group was higher than control group 3 months and 6 months after operation(P<0.05). There was no significant difference in periprosthetic BMD between 2 groups 7 days after operation(P>0.05). Compared with 7 days after operation,BMD of ROI1,ROI6 and ROI7 in 2 groups were decreased gradually 3 months and 6 months after operation (P<0.05 or P<0.01). BMD of ROI2,ROI3 and ROI5 decreased first and then increased(P<0.05 or P<0.01). There was no significant change in BMD of ROI4(P>0.05). There was no significant difference in BMD of each area between 2 groups 3 months after operation(P>0.05). BMD of ROI1,ROI2,ROI3,ROI5,ROI6 and ROI7 in observation group were significantly higher than control group 6 months after operation(P<0.05 or P<0.01). CONCLUSIONS:THA combined with Alendronate sodium tablets and conventional anti-osteoporosis treatment can improve the excellent rate of hip joint function in patients with femoral neck fracture and the level of periprosthetic BMD.

Objective To analyze the diagnostic value of parameters derived from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and dynamic contrast-enhanced MRI (DCE-MRI) in cervical cancer and to explore the correlation of parameters between DCE-MRI and IVIM-DWI.Methods MRI data of 30 patients with cervical cancer confirmed by surgical pathology and 26 patients with normal cervix confirmed by clinical or MRI examination were analyzed retrospectively.All patients underwent IVIM-DWI and DCE-MRI.The IVIM-DWI was performed to calculate the values of ADC,D,D* and f.The values of Ktrans,Kep and Ve were measured on DCE-MRI.All parameters between cervical cancer and normal cervix were compared by two independent sample t-test.Diagnostic efficacy of these parameters in cervical cancer group was evaluated by using area under curve(AUC).The correlation of these parameters between IVIM-DWI and DCE-MRI was analyzed by Pearson correlation.Results The D*,f,Ktrans,Kep and Ve in cervical cancer were significantly higher than those in normal cervix.The ADC and D in cervical cancer were significantly lower than those in normal cervix.The differences of these parameters between the two groups were statistically significant (P ＜0.05).The AUC of Ktrans was the maximum (0.958),with diagnostic sensitivity of 86.7％ and specificity of 100％.F and K were positively correlated (r=0.446,P＜0.05).F and Kep were positively correlated (r=0.400,P＜0.05).Conclusion IVIM-DWI and DCE-MRI can improve the diagnostic value of cervical cancer.DCE-MRI has better diagnostic performance than IVIM-DWI.Significantly positive correlations were found between perfusion paramenters from IVIM-DWI and quantitative perfusion paramenters from DCE-MRI.

Objective To explore the application of diffusion tensor imaging(DTI) in neonates with hypoxic ischemic encephalopathy(HIE).Methods 37 cases of full-term neonates diagnosed as HIE by pediatricians and 12 normal neonates were selected.All subjects underwent MRI and DTI at 3.0 Tesla.The correlation of FA value in posterior limb of internal capsule and neonatal NBNA score was examined.Results The FA values in posterior limb of internal capsule, splenium had significant difference between the HIE group (mild group, moderate group, severe group) and control group (P<0.05);in central white matter of the frontal lobe, thalamus had significant difference between HIE severe group and control group (P<0.05);in nucleus of the bean had no statistic difference between the HIE group (mild group, moderate group,severe group) and control group (P>0.05).The FA in posterior limb of internal capsule and NBNA score(12-14 d;26-28 d)showed significant correlation (r=0.96,P<0.05),as well as the sequelae shape (r=0.87,P<0.05).Conclusion DTI is promising for early diagnosis of anisotropic index changes to evaluate HIE brain damage and prognosis.

Objective To observe the therapeutic efficacy of Tiao Shen Tong Luo (regulating mind and unblocking collaterals) needling plus hyperbaric oxygen in treating leukoaraiosis (LA) coupled with mild cognitive impairment (MCI). Method Totally 112 patients with LA and MCI were randomized into a treatment group and a control group. In addition to the basic treatment, the treatment group was intervened by Tiao Shen Tong Luo needling plus hyperbaric oxygen, while the control group was given hyperbaric oxygen. The scales and event-related potential (P300) were evaluated and compared before and after the intervention. Result The scales scores and P300 were significantly changed in both groups after the treatment, and the therapeutic efficacy was higher in the treatment group than in the control group (P<0.05). Conclusion In addition to the basic treatment, Tiao Shen Tong Luo needling plus hyperbaric oxygen can produce a significant efficacy in treating LA couple with MCI.