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Minimalistic approach to left atrial appendage occlusion guided by cardiac computed tomography angiography

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Journal of Geriatric Cardiology 2024年第4期21卷 431-442页

作者： Xian-Sai MENG Qing-Song WANG Xin-Yan WANG Xu LU Yang MU Jing WANG Ting-Ting SONG Yun-Dai CHEN Tao CHEN Jun GUO Graduate School of chinese pla Medical College BeijingChina Senior Department of Cardiology the Sixth Med-ical CenterChinese PLA General HospitalBeijingChina

OBJECTIVE To assess the feasibility and safety of the minimalistic approach to left atrial appendage occlusion(LAAO) guided by cardiac computed tomography angiography(CCTA).METHODS Ninety consecutive patients who underwent LAAO, with or without CCTA-guided, were matched(1:2). Each step of the LAAO procedure in the computed tomography(CT) guidance group(CT group) was directed by preprocedural CT planning. In the control group, LAAO was performed using the standard method. All patients were followed up for 12 months, and device surveillance was conducted using *** A total of 90 patients were included in the analysis, with 30 patients in the CT group and 60 matched patients in the control group. All patients were successfully implanted with Watchman devices. The mean ages for the CT group and the control group were 70.0 ± 9.4 years and 68.4 ± 11.9 years(P = 0.52), respectively. The procedure duration(45.6 ± 10.7 min vs. 58.8 ± 13.0 min,P planning. Minimalistic LAAO with preprocedural CCTA planning was feasible and safe, with shortened procedure time and acceptable increased radiation and contras consumption. For patients with contraindications to general anesthesia and/or transesophageal echocardiography, this promising method may be an alternative to conventional LAAO.

关键词： anesthesia matched approach

Data driven analysis reveals prognostic genes and immunological targets in human sepsis-associated acute kidney injury

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World Journal of Emergency Medicine 2024年第2期15卷 91-97页

作者： Qing Zhao Jinfu Ma Jianguo Xiao Zhe Feng Hui Liu Department of Diagnosis and Treatment of Cadres the First Medical CenterChinese PLA General HospitalBeijing 100853China Intensive Care Unit the 305th Hospital of Chinese PLABeijing 100032China Department of Critical Care Medicine the First Medical CenterChinese PLA General HospitalBeijing 100853China Nephrology Department the First Medical CenterChinese PLA General HospitalBeijing 100853China

BACKGROUND:The molecular mechanism of sepsis-associated acute kidney injury(SA-AKI)is *** analyzed co-differentially expressed genes(co-DEGs)to elucidate the underlying mechanism and intervention targets of ***:The microarray datasets GSE65682,GSE30718,and GSE174220 were downloaded from the Gene Expression Omnibus(GEO)*** identified the co-DEGs and constructed a gene co-expression network to screen the hub *** analyzed immune correlations and disease correlations and performed functional annotation of the hub *** also performed single-cell and microenvironment analyses and investigated the enrichment pathways and the main transcription ***,we conducted a correlation analysis to evaluate the role of the hub ***:Interleukin 32(IL32)was identified as the hub gene in SA-AKI,and the main enriched signaling pathways were associated with hemopoiesis,cellular response to cytokine stimulus,inflammatory response,and regulation of kidney ***,IL32 was significantly associated with mortality in SA-AKI ***,macrophages,T cells,and NK cells were closely related to IL32 and were involved in the immune microenvironment in SA-AKI ***32 expression increased significantly in the kidney of septic ***-like receptor 2(TLR2)was significantly and negatively correlated with ***:IL32 is the key gene involved in SA-AKI and is significantly associated with ***2 and relevant immune cells are closely related to key genes.

关键词： Sepsis Acute kidney injury Interleukin 32 Toll-like receptor 2 Bioinformatics analysis

Real-Time 3D Ultrasound Imaging System Based on a Hybrid Reconstruction Algorithm

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chinese Journal of Electronics 2024年第1期33卷 245-255页

作者： Yifei LYU Yu SHEN Mingbo ZHANG Junchen WANG School of Mechanical Engineering and Automation Beihang University The First Medical center General Hospital of Chinese PLA

As a safe and convenient imaging technology in clinical routine diagnosis, ultrasound imaging can provide real-time 2D images of internal tissues and organs. To realize real-time 3D image reconstruction, pixel nearest neighbor interpolation(PNN) reconstruction algorithm and Bezier interpolation algorithm are combined into a hybrid reconstruction algorithm. On this basis, a real-time interactive 3D ultrasound imaging system is *** temporal calibration and spatial calibration, the six degrees of freedom poses of 2D ultrasound images can be accurately collected. The 3D volume reconstructed by the proposed 3D reconstruction algorithm is visualized by volume rendering. A multi-thread software system allows parallel operation of data acquisition, 3D reconstruction,volume visualization and other functions. 3D imaging experiments on a 3D printing femur model, a neck phantom and the neck of human volunteers were performed for systematic evaluation. When the reconstruction voxel size was set to be(0.53 mm3, 1.03 mm3, 1.53 mm3), the reconstruction errors of the femur and trachea model were respectively(0.23 mm, 0.31 mm, 0.56 mm) and(0.62 mm, 0.88 mm, 1.41 mm). Clinical feasibility was demonstrated by application of the 3D ultrasound imaging on the neck of human volunteers.

关键词： Interpolation Three-dimensional displays Ultrasonic imaging Imaging Data visualization Reconstruction algorithms Real-time systems

Robotic versus laparoscopic surgery for sporadic benign insulinoma:Short-and long-term outcomes

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 399-405页

作者： Zhu-Zeng Yin Yuan-Xing Gao Zhi-Ming Zhao Ming-Gen Hu Wen-Bo Tang Rong Liu Faculty of Hepato-Pancreato-Biliary Surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Institute of Hepatobiliary Surgery of chinese pla Beijing 100853China Key Laboratory of Digital Hepatobiliary Surgery of chinese pla Beijing 100853China

Background:Minimally invasive surgery is the optimal treatment for *** present study aimed to compare short-and long-term outcomes of laparoscopic and robotic surgery for sporadic benign ***:A retrospective analysis of patients who underwent laparoscopic or robotic surgery for insulinoma at our center between September 2007 and December 2019 was *** demographic,perioperative and postoperative follow-up results were compared between the laparoscopic and robotic ***:A total of 85 patients were enrolled,including 36 with laparoscopic approach and 49 with robotic *** was the preferred surgical ***-nine patients(69.4%)underwent enucleation;among them,26 and 33 patients underwent laparoscopic and robotic surgery,*** enucleation had a lower conversion rate to laparotomy(0 vs.19.2%,P=0.013),shorter operative time(102.0 vs.145.5 min,P=0.008)and shorter postoperative hospital stay(6.0 vs.8.5 d,P=0.002)than laparoscopic *** were no differences between the groups in terms of intraoperative blood loss,the rates of postoperative pancreatic fistula and *** a median follow-up of 65 months,two patients in the laparoscopic group developed a functional recurrence and none of the patients in the robotic group had a ***:Robotic enucleation can reduce the conversion rate to laparotomy and shorten operative time,which might lead to a reduction in postoperative hospital stay.

关键词： Robotic surgical procedures Laparoscopy Insulinoma Enucleation Pancreatectomy

Identification of Early Warning Signals of Infectious Diseases in Hospitals by Integrating Clinical Treatment and Disease Prevention

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Current Medical Science 2024年第2期44卷 273-280页

作者： Lei ZHANG Min-ye LI Chen ZHI Min ZHU Hui MA Sixth Medical center Chinese PLA General HospitalBeijing100048China The Nursing Department Chinese PLA General HospitalBeijing 100853China

The global incidence of infectious diseases has increased in recent years,posing a significant threat to human *** typically serve as frontline institutions for detecting infectious ***,accurately identifying warning signals of infectious diseases in a timely manner,especially emerging infectious diseases,can be ***,there is a pressing need to integrate treatment and disease prevention data to conduct comprehensive analyses aimed at preventing and controlling infectious diseases within *** paper examines the role of medical data in the early identification of infectious diseases,explores early warning technologies for infectious disease recognition,and assesses monitoring and early warning mechanisms for infectious *** propose that hospitals adopt novel multidimensional early warning technologies to mine and analyze medical data from various systems,in compliance with national strategies to integrate clinical treatment and disease ***,hospitals should establish institution-specific,clinical-based early warning models for infectious diseases to actively monitor early signals and enhance preparedness for infectious disease prevention and control.

关键词： infectious disease disease prevention and control medical data warning signals

Multimodal cardiac imaging assisted tumor characterization and surgical planning of a patient with rare primary cardiac paraganglioma

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Journal of Geriatric Cardiology 2024年第2期21卷 246-250页

作者： Shu-Yu MENG Li-Qun WANG Hao-Dan DANG Lin ZHANG Sheng-Li JIANG Bo-Han LIU Department of Ultrasound Diagnosis the First Medical CenterChinese PLA General HospitalBeijingChina Department of Nuclear Medicine the First Medical CenterChinese PLA General HospitalBeijingChina Department of Pathology the First Medical CenterChinese PLA General HospitalBeijingChina Department of Cardiovascular Surgery the First Medical CenterChinese PLA General HospitalBeijingChina

Paragangliomas,also known as pheochromocytomas(1–9 cases per million),arise in the paraganglia.[1]Pheochromocytomas occur in the adrenal glands,while paragangliomas occur elsewhere.[2]Paragangliomas originate from paraganglion cells,which are derived from the neural ectoderm of the nerves and migrate along both sides of the median axis from the base of the skull to the pelvis during embryonic development.

关键词： glioma cardiac nerves

Treatment patterns and survival outcomes in patients with nonmetastatic early-onset pancreatic cancer

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World Journal of Gastroenterology 2024年第12期30卷 1739-1750页

作者： Le-Tian Zhang Ying Zhang Bi-Yang Cao Chen-Chen Wu Jing Wang Graduate School Chinese PLA Medical SchoolBeijing 100853China Department of Radiation Oncology First Medical Center of Chinese PLA General HospitalBeijing 100853China Department of Internal Medicine Hospital of University of Science and Technology BeijingBeijing 100083China Department of Medical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND The incidence of patients with early-onset pancreatic cancer(EOPC;age≤50 years at diagnosis)is on the rise,placing a heavy burden on individuals,families,and *** role of combination therapy including surgery,radiotherapy,and chemotherapy in non-metastatic EOPC is not *** To investigate the treatment patterns and survival outcomes in patients with non-metastatic *** A total of 277 patients with non-metastatic EOPC who were treated at our institution between 2017 and 2021 were investigated *** survival(OS),disease-free survival,and progression-free survival were estimated using the Kaplan-Meier *** and multivariate analyses with the Cox proportional hazards model were used to identify prognostic *** With a median follow-up time of 34.6 months,the 1-year,2-year,and 3-year OS rates for the entire cohort were 84.3%,51.5%,and 27.6%,*** median OS of patients with localized disease who received surgery alone and adjuvant therapy(AT)were 21.2 months and 28.8 months,respectively(P=0.007).The median OS of patients with locally advanced disease who received radiotherapy-based combination therapy(RCT),surgery after neoadjuvant therapy(NAT),and chemotherapy were 28.5 months,25.6 months,and 14.0 months,respectively(P=0.002).The median OS after regional recurrence were 16.0 months,13.4 months,and 8.9 months in the RCT,chemotherapy,and supportive therapy groups,respectively(P=0.035).Multivariate analysis demonstrated that carbohydrate antigen 19-9 level,pathological grade,T-stage,N-stage,and resection were independent prognostic factors for non-metastatic *** AT improves postoperative survival in localized *** after NAT and RCT are the preferred therapeutic options for patients with locally advanced EOPC.

关键词： Pancreatic cancer Early-onset Non-metastatic Multimodal treatment Radiotherapy Overall survival

Safety,immunogenicity and protective effect of sequential vaccination with inactivated and recombinant protein COVID-19 vaccine in the elderly:a prospective longitudinal study

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Signal Transduction and Targeted Therapy 2024年第6期9卷 2738-2747页

作者： Hong-Hong Liu Yunbo Xie Bao-Peng Yang Huan-Yue Wen Peng-Hui Yang Jin-E Lu Yan Liu Xi Chen Meng-Meng Qu Yang Zhang Wei-Guo Hong Yong-Gang Li Junliang Fu Fu-Sheng Wang Out-patient Department of Day Diagnosis and Treatment The Fifth Medical Center of Chinese PLA General HospitalBeijing 100039China Senior Department of Infectious Diseases The Fifth Medical Center of Chinese PLA General HospitalNational Clinical Research Center for Infectious DiseasesBeijing 100039China chinese pla Medical School Chinese PLA General HospitalBeijing 100039China Hunyuan County People’s Hospital Datong 037499 Shanxi ProvinceChina Faculty of Hepato-Pancreato-Biliary Surgery Institute of Hepatobiliary SurgeryThe First Medical CenterChinese PLA General HospitalBeijing 100853China

The safety and efficacy of COVID-19 vaccines in the elderly,a high-risk group for severe COVID-19 infection,have not been fully *** clarify these issues,this prospective study followed up 157 elderly and 73 young participants for 16 months and compared the safety,immunogenicity,and efficacy of two doses of the inactivated vaccine BBIBP-CorV followed by a booster dose of the recombinant protein vaccine *** results showed that this vaccination protocol was safe and tolerable in the *** administering two doses of the BBIBP-CorV,the positivity rates and titers of neutralizing and anti-RBD antibodies in the elderly were significantly lower than those in the young *** the ZF2001 booster dose,the antibody-positive rates in the elderly were comparable to those in the young;however,the antibody titers remained ***,age,and underlying diseases were independently associated with vaccine immunogenicity in elderly *** pseudovirus neutralization assay showed that,compared with those after receiving two doses of BBIBP-CorV priming,some participants obtained immunological protection against BA.5 and BF.7 after receiving the ZF2001 *** infection symptoms last longer in the infected elderly and pre-infection antibody titers were negatively associated with the severity of post-infection *** antibody levels in the elderly increased significantly after breakthrough infection but were still lower than those in the *** data suggest that multiple booster vaccinations at short intervals to maintain high antibody levels may be an effective strategy for protecting the elderly against COVID-19.

关键词： vaccination vaccine doses

Sirolimus can promote the disappearance of renal angiomyolipoma associated with tuberous sclerosis complex:a prospective cohort study

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World Journal of Pediatrics 2024年第6期20卷 602-610页

作者： Shuo Dun Yang-Yang Wang Lin Wan Qiu-Hong Wang Qian Lu Xiao-Yan Yang Qi Zhang Hui-Min Chen Lu-Peng Qiu Li-Ping Zou Medical School of chinese pla Beijing 100853China Department of Pediatrics The First Medical CenterChinese PLA General HospitalBeijing 100853China center of Epilepsy Beijing Institute for Brain DisordersBeijing 100069China

Background Renal angiomyolipoma(RAML)is the most common kidney lesion in patients with tuberous sclerosis complex(TSC),affecting about 80%of *** is a benign tumor that grows over time,usually bilaterally,and can easily lead to kidney complications such as acute ***,we investigated the efficacy and safety of sirolimus in children with TSC-associated RAML and explored the factors affecting tumor disappearance under sirolimus treatment through subgroup *** A prospective cohort study was *** was initiated at 1 mg/(m^(2)×day),and dose adjustments were made by a 2-week titration period to attain a trough blood concentration of 5-10 ng/*** disappearance of RAML in chil-dren after sirolimus treatment was observed,and Cox regression was used to screen the factors affecting tumor *** One hundred and twenty-six patients who met the criteria were *** 3 months,6 months,12 months,and 24 months of follow-up,tumors disappeared in 18(14.3%),30(23.8%),39(31.0%),and 42(33.3%)children,*** disappeared in 50(39.7%)children by the last visit of each individual,and 30(60%)of them occurred within 6 *** multivariate Cox regression analysis showed that patients with a smaller maximum tumor diameter at baseline had a higher tumor disappearance ***-six(29%)patients had stomatitis during the entire treatment period,and no serious *** Sirolimus could promote the disappearance of TSC-related *** disappearance rate was correlated with the maximum diameter at baseline,and the smaller the tumor was,the higher the disappearance *** is well tolerated in the treatment of RAML associated with TSC.

关键词： Angiomyolipoma mTOR inhibitor Sirolimus Tuberous sclerosis