In recent years, with the continuous development and increasing maturity of interventional techniques, interventional treatment for congenital heart disease (CHD) has been progressively disseminated to county- and city-level hospitals in China. Concurrently, the standardized management of adult CHD (particularly patent foramen ovale) and the lifelong management of complex CHD are gaining increasing clinical attention, while the emergence of new techniques and products continuously advances the discipline. This article aims to review the new progress made in the field of interventional treatment for congenital heart disease in China during 2024. It specifically reviews and analyzes the following key aspects: (1) annual statistics on interventional closure procedures for CHD; (2) recent insights into patent foramen ovale closure; (3) advances in transcatheter pulmonary valve replacement; (4) interventional treatment and lifelong management strategies for complex CHD; (5) new interventional techniques for acquired heart disease; and (6) the application of artificial intelligence in CHD management. Through the synthesis and discussion of these topics, this article seeks to provide a detailed analysis of the current landscape of interventional treatment for CHD in China and project its future development trends.

One case of knee infection after anterior cruciate ligament reconstruction caused by the gram-positive anaerobic bacterium Finegoldia magna was reported. The patient was admitted to hospital due to fever and knee joint swelling and pain after anterior cruciate ligament reconstruction. Through medical history, physical examination, imaging examination and next-generation sequencing, it was confirmed that the infection was caused by Finegoldia magna. Through literature review, 37 literatures on infectious diseases caused by Finegoldia magna was retrieved and analyzed, and the identification points of anaerobic bacteria, the application of second-generation sequencing technology and the treatment status of infection after anterior cruciate ligament reconstruction were reviewed. The incidence of infection after arthroscopic anterior cruciate ligament reconstruction is low, while anaerobic infection is even more rare and difficult to culture. The next-generation sequencing can be used to assist the diagnosis. On the basis of giving priority to the preservation of the reconstructed ligament, the combined use of arthroscopic debridement, irrigation and sensitive antibiotics is the main treatment method.

Objective:To explore CT and MRI features of the endolymphatic sac tumor (ELST).Methods:The CT and MRI morphology confirmed by surgical pathology for 19 patients with ELST were retrospectively analyzed from June 2011 to May 2019 in Eye & ENT Hospital of Fudan University. The features of CT and MRI included location, size, adjacent structures invasion, CT values, bone destruction, features of T 1WI and T 2WI, enhancement distribution characteristics, dynamic enhancement curve morphology, DWI signal characteristics. The ADC values of the lesions and ipsilateral medial pterygoid muscles were compared using a paired t test. Results:Nineteen ELST patients (one with bilateral diseases) were included. Totally 20 ears (right 9 and left 11) of 13 females and 6 males were studied. The masses with slightly high-density and obscure boundary were located around the vestibular aqueduct at the posterior edge of the petrosal bone. Bone destruction involved mastoid process of the middle ear (16 ears), jugular foramen (11 ears), semicircular canal (10 ears), facial nerve canal (7 ears) and internal auditory canal (9 ears). A large amount of residual bone could be found in the interior of nineteen masses. The CT value was (78.6±21.9) HU. The lesion showed central iso-intensity and peripheral hyperintensity on T 1WI and T 2WI in 16 ears, while no obvious hyperintensity on T 1WI in the other 4 ears. The hyperintensity on T 1WI was around the margin of the lesion in 10 ears, situated at lateral side in 5 ears and all over the lesion in 1 ear. Flow voids signals could be seen in 9 ears as well. Liquid-liquid plane was seen on T 2WI in 2 ears. The solid mass portion which showed iso-intensity on both T 1WI and T 2WI presented marked enhancement on contrast-enhanced T 1WI, while other part of the mass no enhancement. DWI of 14 ears illustrates no evidence of restricted diffusion, and the ADC value [(1.25±0.08)×10 -3 mm 2/s] was slightly higher than that of the medial pterygoid muscles ( t=4.437, P=0.001). The style of time-signal intensity curves of the dynamic contrast-enhanced MRI was rapidly ascending followed by descending curves in 2 ears. Conclusion:Imaging findings of ELST have some characteristics, including located around the vestibular aqueduct at the posterior edge of the petrosal bone, bone destruction, peripheral hyperintensity on T 1WI and no restricted diffusion, which is helpful for its diagnosis.

Purpose: Intrahepatic cholangiocarcinoma (ICC) is one of the most common liver primary tumors but its treatments are limited. Bioinformatics showed that the expression level of long non-coding RNA cancer-associated susceptibility 15 gene (CASC15) is correlated with ICC progression, but its functional mechanism remains unclear. Materials and Methods: Tissues from ICC patients, tumor and adjacent tissue, were used for detection of the expression of CASC15. Clinical data were also collected for clinicopathologic and survival analysis. Short interfering RNA and lentiviral short hairpin RNA were used to knock down CASC15 and PRDX2 expression in ICC cell lines, for the analysis of changes of cell function and xenografts. RNA-pulldown and RNA immunoprecipitation assays were used to detect RNA-binding protein, PRDX2. Male nude mice were used for ICC xenografts, and livers were collected after 4 weeks for immunohistochemistry. Results: CASC15 is highly expressed in ICC tissues and is related to higher TNM stage. Knockdown of CASC15 in ICC cells reduced cell proliferation, migration, invasiveness and increased apoptosis, and G1/S block. PRDX2 bound to CASC15. Knockdown of CASC15 decreased PRDX2 expression which was rescued by the inhibition of proteasome formation. Downregulation of PRDX2 resulted in G1/S block, reduced ICC cell invasion. Downregulation of CASC15 inhibited phosphoinositide 3-kinase (PI3K)/AKT/c-Myc pathway through downregulating of PRDX2 and overexpressed PRDX2 rescued the block. CASC15 knockout in ICC xenografts suppressed tumor development in vivo, decreased the expression of PRDX2 and Ki67 and inhibited PI3K/AKT pathway. Conclusion CASC15 promotes ICC possibly by targeting PRDX2 via the PI3K/AKT pathway, indicating poor prognosis and high degree of malignancy of ICC.

Objective:To investigate the application value of hybrid approach in laparoscopic radical resection of left hemicolon cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 96 patients with left hemicolon cancer who were admitted to Henan Provincial People′s Hospital between January 2015 and March 2018 were collected. There were 52 males and 44 females, aged from 29 to 75 years, with an average age of 61 years. Patients underwent laparoscopic radical resection of left hemicolon cancer. Observation indicators: (1) surgical situations and postoperative recovery; (2) postoperative pathological examination; (3) postoperative chemotherapy; (4) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival, tumor recurrence and metastasis of patients up to October 2019. Measurement data with skewed distribution were represented as M (range), and count data were described as absolute numbers. Results:(1) Surgical situations and postoperative recovery: all the 96 patients underwent laparoscopic radical resection of left hemicolon cancer with hybrid approach. Of 96 patients, 5 underwent laparoscopic multiple organ resection including 2 combined with splenectomy, 2 combined with gastric wall wedge resection, 1 combined with splenectomy and distal pancreatectomy; 7 underwent hand-assisted laparoscopic surgery including 5 undergoing multiple organ resection due to tumor invasion, 2 combined with terminal ileostomy due to poor exposure caused by severe obstruction in proximal intestinal canal; 84 underwent laparoscopic-assisted surgery. There was no intraoperative conversion to laparotomy. Of 96 patients, 3 received posterior ileum anastomosis, 2 received rotating ascending colon anastomosis, 91 received in situ anastomosis. Operation time, volume of intraoperative blood loss, and time to first flatus were 140 minutes (range, 70-250 minutes), 50 mL (range, 30-140 mL), 2 days (range, 1-4 days), respectively. Of 96 patients, 5 had postoperative incision infection, 5 had pulmonary infection, 3 had adhesive intestinal obstruction, 1 had anastomotic leakage, and they were cured after conservative treatment. Duration of postoperative hospital stay of the 96 patients was 8 days(range, 5-27 days). (2) Postoperative pathological examination: of the 96 patients, the number of lymph nodes dissected and length of surgical specimen were 19 (range, 13-25) and 35 cm (range, 25-50 cm). All the 96 patients had negative surgical margin. Pathological T staging of 96 patients: 5 patients were in pT1 stage, 46 in pT2 stage, 37 in pT3 stage, 8 in pT4 stage. Pathological N staging of 96 patients: 32 patients were in pN0 stage, 47 in pN1 stage, 17 in pN2 stage. Pathological types of 96 patients: 7 patients had mucinous adenocarcinoma, 16 had poorly differentiated adenocarcinoma, 46 had moderately differentiated adenocarcinoma, and 27 had well differentiated adenocarcinoma. (3) Postoperative chemotherapy: 68 of the 96 patients underwent standard chemotherapy of XELOX regimen, and 28 had no chemotherapy. (4) Follw-up: 86 patients were followed up for 19-58 months, with a median time of 11 months. During the follow-up, all the 86 patients survived, of which 82 had no tumor recurrence, 3 survived with tumor after detection of liver metastasis, and 1 survived with tumor after detection of liver and pulmonary metastasis.Conclusion:The hybrid approach is safe and feasible in the laparoscopic radical resection of left hemicolon cancer.

Objective:To compare the injury of renal blood vessels using different puncture pathways and access sizes.Methods:Between April 2018 and June 2019, eighty fresh pig kidneys were selected to perform percutaneous puncture and dilation, which was used to compare the injury of renal blood vessels with different puncture pathways and access sizes. The puncture pathway included the centerline of the normal renal pyramid (A), centreline of one side pyramid of the fused renal pyramid (FRP) (B), midline of the entire FRP (C) and midline of the renal column (D). The access size included F8, F12, F16, F20, F24 and F30. Histopathological methods were used to analyze the injury of renal blood vessels.Results:The puncture through paths A and B mainly caused injury to the grade Ⅴ and Ⅵ arteries in renal cortex. The puncture often directly injures the grade Ⅳ artery in path C. The puncture often simultaneously injures the grade Ⅲ-Ⅵ arteries in path D. Grade Ⅲ artery injury began to occur when paths A, B, C, and D were dilated to F30, F24, F16, and F12, respectively. The degree of arterial injury among the four different puncture pathways was significantly different in F8, F12, F16, F20, F24 and F30 ( P<0.05). Statistical differences were found between paths A and D in F12, F16, F20, F24 and F30 ( P<0.05), and between paths A and C in F16, F20 and F24 ( P<0.05). No significant difference was found between paths A and B in all access sizes ( P>0.05). Compared with F8, the degree of arterial injury of the F30 in path A and the F24 and F30 in path B were increased significantly ( P<0.05). Conclusions:Vascular injury in path D was the most serious followed by that in path C. Relatively little vascular injury can be achieved in paths A and B. The vascular injury increased when the path B was dilated to F24, while the path A needed to be dilated to F30.

Objective:To observe the status of the sinus membrane using fiber optic endoscope during the lateral window approach sinus floor elevation to provide a reference for clinicians when evelvating the sinus mucoperiosteum.Methods:Sixty-six patients (72 sides) who underwent maxillary sinus floor elevation in Beijing Ruicheng Stomatology Hospital from September 2016 to December 2019 were selected, including 40 males and 26 females, aged 26-80 years old [(56.2±11.5) years]. And fiber optic endoscopy was used to observe the maxillary mucoperiosteum during the operation.Results:The status of maxillary sinus mucoperiosteal during lateral window approach sinus floor elevation can be divided into four categories: ① Class Ⅰ, complete periosteal, no damage to mucoperiosteum; ②Class Ⅱ, periosteal injury, unexposed laminae propria; ③Class Ⅲ, periosteal Rupture, exposed lamina propria; ④ Class Ⅳ, mucoperiosteum perforation, rupture of periosteum, lamina propria and epithelial layer. A total of 72 operations were performed, including 18 cases of class I, 28 cases of class Ⅱ, 4 cases of class Ⅲ, and 22 cases of class Ⅳ.Conclusions:The status of maxillary sinus mucoperiosteal during lateral window approach sinus floor elevation can be divided into four categories. Fiberoptic endoscopy as a clinical auxiliary examination method can improve the operator′s control of the status of the maxillary sinus membrane and assist the peeling of the mucosa.

Objective To evaluate the clinical curative effect and prognosis of hand-assisted laparoscopic (HALS) and laparoscopic assisted surgery for Siewert Ⅱ,Ⅲ gastroesophageal junction adenocarcinoma (AEG).Methods A retrospective analysis of 105 patients with advanced Siewert type Ⅱ and Ⅲ AEG between Jan 2012 and Jan 2013 was made on the operation time,amount of blood loss,number of lymph nodes dissected,postoperative complications,postoperative hospital stay and postoperative 5-year survival rate.Results HALS resulted in significantly shorter operation time and the average postoperative hospital stay [(203±54) min比(283±72) min,t=-4.902,P=0;(10±4) d 比(13±3)d,t=-0.939,P =0.002] for advanced Siewert type Ⅱ and Ⅲ AEG.There was no conversion to open surgery in HALS group,while there was 3 cases in laparoscopy assisted surgery group (x2 =4.118,P =0.042).5 year overall survival (OS) in HALS group was 46.7％ (95％ CI39.98-53.88),and it was 60.9％ for stage Ⅱ patients 37.8％ for stage Ⅲ.5 years OS rate was not significantly different between the two groups.Conclusion HALS compared with laparoscopy assisted surgery in the treatment of advanced Siewert type Ⅱ and type Ⅲ AEG has shorter operation time,higher safety operation,shorter postoperative recovery time.The number of patients with postoperative complications and the 5-year survival rate after surgery are not significantly different between the two groups.

Objective To investigate the clinical efficacy of 3D printing technique combined with osteotomy in the treatment of complex tibial plateau fractures involving the posterolateral condyle.Methods The clinical data of 47 patients with complicated tibial plateau fractures involving the posterolateral condyle who were treated with 3D printing technology and tibial lateral condyle osteotomy from January 2012 to February 2015 were retrospectively analyzed.There were 19 males and 28 females aged from 21 to 69 years (mean 50.3 years).All of them were closed fractures without neurological and vascular injuries.The time between injury and operation was 4 to 19 days (average,6.7 days).All the patients were treated with tibial lateral condyle osteotomy and bilateral plate fixation with anterolateral approach and posteromedial approach.Three-dimensional CT scans were performed preoperatively and 1 ∶ 1 to mimics model was made by 3D printing technique based on the data after conversion.Refer to the 3D fracture model to accurately design the osteotomy line to improve the operation scheme.During the operation,anterior and lateral anterior combined with posterior medial incision were performed,and the tibia external condyle osteotomy was conducted to accurately expose the external posterior condyle fracture block of the tibia platform,and bilateral plate was applied after reduction.The fracture reduction was evaluated according to the Rasmussen score of the knee joint.The knee joint function was evaluated by the score of the hospital for special surgery (HSS).Results All 47 patients were followed up for 13.2 months (range,7-19 months).Immediate postoperative X-ray showed good fracture reduction.The union time of fracture was 14.3 weeks (range,12-18 weeks).The knee joint Rasmussen score one year after operation was 13-18 (average,15.73),including 33 cases excellent,12 cases good and 2 cases fair.The excellent and good rate was 95.7％ (45/47).HSS score was 67 to 94 (average,82.67),among which 31 cases were excellent,13 cases good,2 cases fair,and 1 case poor (postoperative refusal to rehabilitate exercise resulted in joint stiffness).The excellent and good rate of 89.9％ (44/47).Knee joint activity was-5°-0°-135°,with the average range of 125.5°.No common peroneal nerve injury,important vascular injury,postoperative infection,internal fixation failure and other serious complications was found.Conclusion 3D printing technology can help to accurately display the specific situation of the posterior tibial condyle fractures,which is conducive to the surgeon to develop a more intuitive plan of reduction.The method of tibial lateral condyle osteotomy can clearly reveal the tibial plateau posterolateral condylar fractures.With accurate osteotomy the surgical field can be fully exposed,and ultimately achieve a satisfactory result.Therefore,3D printing combined with tibial lateral condyle osteotomy is an effective method for complex tibial plateau fractures involving the posterolateral condyle.

Objective To analyze the causes for the thigh pain after treatment of femoral trochanteric fractures by proximal femoral nail antirotation Ⅱ( PFNA Ⅱ) . Methods Included in this ret-rospective study were 236 patients who had been treated by us for femoral trochanteric fracture from October 2011 to December 2015. They were 103 men and 133 women, aged from 42 to 86 years (average, 50. 3 years) . According to AO classification, 13 cases belonged to type 31-A1. 2, 32 to type 31-A1. 3, 35 to type 31-A2. 1, 27 to type 31-A2. 2, 33 to type 31-A2. 3, 38 to type 31-A3. 1, 39 to type 31-A3. 2 and 19 to type 31-A3. 3. All the fractures were single, fresh and closed and treated with PFNAⅡinternal fixation. Results This cohort was followed up for 8 to 26 months (average, 13. 2 months). Nonunion occurred in one case who had to accept artificial hip replacement. The remaining 235 cases obtained bony union after 22 to 39 weeks (average, 29. 3 weeks). By the Harris evaluation at final follow-ups, the affected hips scored from 81 to 93 points (average, 85. 1 points) . Post-operative thigh pain was reported in 19 cases (8. 05％) . The causes included varied anatomic morphology of the proximal femur in 6 cases, distal defects of the intramadullary nails in 4, insufficient stability of internal fixation or uneven biomecanical distribution in 3, unskillful operation in 2, and severe oesteoporosis in 4. Avascular necrosis of femoral head was not observed during follow-ups. Conclusions Postoperative thigh pain is worthy of serious atention from orthopaedists following PFNA Ⅱtreatment of femoral trochanteric fractures. PFNA Ⅱshould be modified according to the specific Chinese features of the proximal femur, especially in the respects of anterior arch and distal structure of the main nail and lateral declination as well.