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

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 hospital stay(7.5 ± 2.4 day vs. 9.6 ± 2.8 day, P = 0.001) in the CT group was significantly shorter compared to the control group. However, the total radiation dose was higher in the CT group compared to the control group(904.9 ± 348.0 m Gy vs.711.9 ± 211.2 m Gy, P = 0.002). There were no significant differences in periprocedural pericardial effusion(3.3% vs. 6.3%, P = 0.8) between the two groups. The rate of postprocedural adverse events(13.3% vs. 18.3%, P = 0.55) were comparable between both groups at 12 months *** CCTA is capable of detailed LAAO procedure 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

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plasma metabolites and risk of myocardial infarction:a bidirectional Mendelian randomization study

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Journal of Geriatric cardiology 2024年第2期21卷 219-231页

作者： Dong-Hua LI Qiang WU Jing-Sheng LAN Shuo CHEN You-Yi HUANG Lan-Jin WU Zhi-Qing QIN Ying HUANG Wan-Zhong HUANG Ting ZENG Xin HAO Hua-Bin SU Qiang SU department of Cardiovascular Medicine Minzu Hospital of Guangxi Zhuang Autonomous RegionGuangxiChina Senior department of cardiology the Sixth Medical CenterChinese PLA General HospitalBeijingChina Library of Graduate School Chinese PLA General HospitalBeijingChina department of cardiology Jiangbin Hospital of Guangxi Zhuang Autonomous RegionGuangxiChina Health Management Institute the Second Medical CenterChinese PLA General HospitalBeijingChina

BACKGROUND Myocardial infarction(MI)is a critical cardiovascular event with multifaceted etiology,involving several genetic and environmental *** is essential to understand the function of plasma metabolites in the development of MI and unravel its complex *** This study employed a bidirectional Mendelian randomization(MR)approach to investigate the causal relationships between plasma metabolites and MI *** used genetic instruments as proxies for plasma metabolites and MI and conducted MR analyses in both directions to assess the impact of metabolites on MI risk and vice *** addition,the large-scale genome-wide association studies datasets was used to identify genetic variants associated with plasma metabolite(1400 metabolites)and MI(20,917 individuals with MI and 440,906 individuals without MI)*** variance weighted was the primary method for estimating causal *** estimates are expressed as beta coefficients or odds ratio(OR)with 95%*** We identified 14 plasma metabolites associated with the occurrence of MI(Pplasma metabolites[propionylglycine levels(OR=0.922,95%CI:0.881–0.965,Pplasma metabolites[1-palmitoyl-2-arachidonoyl-GPE(16:0/20:4)levels(OR=1.051,95%CI:1.018–1.084,P=0.002),behenoyl dihydrosphingomyelin(d18:0/22:0)levels(OR=1.076,95%CI:1.027–1.128,P=0.002),1-stearoyl-2-docosahexaenoyl-GPE(18:0/22:6)levels(OR=1.067,95%CI:1.027–1.109,P=0.001),alpha-ketobutyrate levels(OR=1.108,95%

关键词： infarction alterations diagnosis

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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

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chinese expert consensus on the clinical application of drugcoated balloon(2^(nd) Edition)

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Journal of Geriatric cardiology 2024年第2期21卷 135-152页

作者： The Expert Writing Committee of the chinese Expert Consensus on Clinical Applications of Drug-Coated Balloon(2^(nd)Edition) Jun-Bo GE Yun-Dai CHEN 不详 Zhongshan hospital Fudan University chinese pla general hospital

Percutaneous coronary interventions have progressed through the era of plain balloon dilation, bare-metal stent insertion to drug-eluting stent treatment, which has significantly reduced the acute occlusion and restenosis rates of target vessels and improved patient prognosis, making drug-eluting stents the mainstream interventional treatment for coronary artery disease. In recent years, drug-coated balloons(DCBs) have become a new treatment strategy for coronary artery disease, and the drugs used in the coating and the coating technology have progressed in the past years. Without permanent implant, a DCB delivers antiproliferative drugs rapidly and uniformly into the vessel wall via the excipient during a single balloon dilation. Many evidence suggests that DCB angioplasty is an effective measure for dealing with in-stent restenosis and de novo lesions in small coronary *** more clinical studies are published, new evidence is emerging for the use of DCB angioplasty in a wide range of coronary diseases, and the indications are expanding internationally. Based on the latest research from China and elsewhere, the Expert Writing Committee of the chinese Expert Consensus on Clinical Applications of Drug-Coated Balloon has updated the previous DCB consensus after evidence-based discussions and meetings in terms of adequate preparation of in-stent restenosis lesions, expansion of the indications for coronary de novo lesions, and precise guidance of DCB treatment by intravascular imaging and functional evaluation.

关键词： balloon drugs dealing

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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

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Nicotinamide adenine dinucleotide phosphate oxidase in pancreatic diseases:Mechanisms and future perspectives

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World Journal of Gastroenterology 2024年第5期30卷 429-439页

作者： Ya-Wei Bi Long-Song Li Nan Ru Bo Zhang Xiao Lei department of Gastroenterology The First Medical Center of Chinese PLA General HospitalBeijing 100853China department of Radiation Oncology Chinese PLA General HospitalBeijing 100853China

Pancreatitis and pancreatic cancer(PC)stand as the most worrisome ailments affecting the *** have dedicated efforts to unraveling the mechanisms underlying these diseases,yet their true nature continues to elude their *** this realm,oxidative stress is often believed to play a causal and contributory role in the development of pancreatitis and *** accumulation of reactive oxygen species(ROS)can cause oxidative stress,and the key enzyme responsible for inducing ROS production in cells is nicotinamide adenine dinucleotide phosphate hydrogen oxides(NOX).NOX contribute to pancreatic fibrosis and inflammation by generating ROS that injure acinar cells,activate pancreatic stellate cells,and mediate macrophage *** ROS production occurs during malignant transformation and pancreatic carcinogenesis,creating an oxidative microenvironment that can cause abnormal apoptosis,epithelial to mesenchymal transition and genomic ***,understanding the role of NOX in pancreatic diseases contributes to a more in-depth exploration of the exact pathogenesis of these *** this review,we aim to summarize the potential roles of NOX and its mechanism in pancreatic disorders,aiming to provide novel insights into understanding the mechanisms underlying these diseases.

关键词： Nicotinamide adenine dinucleotide phosphate hydrogen oxides Pancreatitis Pancreatic cancer Reactive oxygen species Mechanism

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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

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Analysis of metabolic characteristics of metabolic syndrome in elderly patients with gastric cancer by non-targeted metabolomics

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2419-2428页

作者： Huan Zhang Wen-Bing Shen Lin Chen Medical School of chinese pla Chinese PLA General HospitalBeijing 100853China department of Gastrointestinal Surgery Shanghai Sixth People’s HospitalShanghai 250063China department of general Surgery The First Medical Center of Chinese PLA General HospitalBeijing 100853China

BACKGROUND The relationship between metabolic syndrome(MetS)and gastric cancer(GC),which is a common metabolic disease,has attracted much ***,the specific metabolic characteristics of MetS in elderly patients with GC remain *** To investigate the differentially abundant metabolites and metabolic pathways between preoperative frailty and MetS in elderly patients with GC based on nontargeted metabolomics *** In this study,125 patients with nonfrail nonmeal GC were selected as the control group,and 50 patients with GC in the frail group were selected as the frail ***-five patients with GC combined with MetS alone were included in the MetS group,and 50 patients with GC combined with MetS were included in the MetS *** metabolomics techniques were used to measure plasma metabolite levels by ultrahigh-performance liquid chromatography-mass *** statistical analysis was performed by principal component analysis,orthogonal partial least squares,pattern recognition analysis,cluster analysis,and metabolic pathway *** A total of 125 different metabolites,including amino acids,glycerophospholipids,sphingolipids,fatty acids,sugars,nucleosides and nucleotides,and acidic compounds,were identified via nontargeted metabolomics *** with those in the control group,there were 41,32,and 52 different metabolites in the MetS group,the debilitated group,and the combined group,*** metabolites were significantly increased in the MetS *** the weak group,amino acids and most glycerol phospholipid metabolites decreased significantly,and fatty acids and sphingosine increased *** combined group was characterized by significantly increased levels of nucleotide metabolites and acidic *** alanine,aspartic acid,and glutamate metabolic pathways were obviously enriched in the asthenic group,and the glycerol and phospholipid metabolic pathways were obv

关键词： Nervous breakdown Metabolic syndrome Elderly individuals Gastric cancer Nontargeted metabolomics

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Early and minimal changes in serum creatinine can predict prognosis in elderly patients receiving invasive mechanical ventilation:A retrospective observational study

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Journal of Intensive Medicine 2024年第3期4卷 368-375页

作者： Qinglin Li Guanggang Li Dawei Li Yan Chen Feihu Zhou department of Critical Care Medicine The First Medical CenterChinese PLA General HospitalBeijingChina department of Critical Care Medicine The Seventh Medical CenterChinese PLA General HospitalBeijingChina department of Critical Care Medicine The Sixth Medical CenterChinese PLA General HospitalBeijingChina department of Anesthesiology The First Medical CenterChinese PLA General HospitalBeijingChina Medical Engineering Laboratory of chinese pla general hospital BeijingChina

BackgroundEmerging evidence suggests that minimal acute kidney injury (stage 1 AKI) is associated with increased hospital mortality rates. However, for those who do not meet the AKI diagnostic criteria, whether a small increase in serum creatinine (SCr) levels is associated with an increased mortality rate in elderly patients is not known. Therefore, we aimed to investigate small elevations in SCr of general conditions and clinical characteristics were compared between the six groups. Prognostic survival factors were identified using Cox regression analysis. Kaplan–Meier survival analysis was employed for the accumulative survival *** total of 1292 patients (1171 men) with a median age of 89 (interquartile range: 85–92) with MV were suitable for further analysis. In all, 376 patients had any stage of early AKI, and 916 patients had no AKI. Among 916 non-AKI patients, 349 patients were in the ratio <10%, 291 in the 10%–<20% group, 169 in the 20%–<30% group, 68 in the 30%–<40% group, 25 in the 40%–<50% group, and 14 in the ≥50% group. The 28-day mortality rates in the six groups from the lowest (<10%) to the highest (≥50%) were 8.0%, 16.8%, 28.4%, 54.4%, 80.0%, and 85.7%, respectively. In the multivariable-adjusted a

关键词： Mechanical ventilation Aged Mortality Ratio △SCr

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Mortality from cerebrovascular diseases in China:Exploration of recent and future trends

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chinese Medical Journal 2024年第5期137卷 588-595页

作者： Bin Lv Ge Song Feng Jing Mingyu Li Hua Zhou Wanjun Li Jiacai Lin Shengyuan Yu Jun Wang Xiangyu Cao Chenglin Tian department of Neurology The First Medical CenterChinese PLA General HospitalBeijing 100853China department of Neurology the 305 Hospital of Chinese PLABeijing 100017China department of Internal Medicine Gucheng County Hospital of Traditional Chinese MedicineHengshuiHebei 253800China department of Neurology Tangshan Hospital of Traditional Chinese MedicineTangshanHebei 063000China department of Neurology Hainan Hospital of Chinese PLA General HospitalSanyaHainan 572013China

Background:Cerebrovascular disease(CVD)ranks among the foremost factors responsible for mortality on a global *** mortality patterns of CVDs and temporal trends in China need to be well-illustrated and ***:We collected mortality data on patients with CVD from chinese Center for Disease Control and Prevention’s Disease Surveillance Points(CDC-DSP)*** mortality of CVD in 2020 was described by age,sex,residence,and *** temporal trend from 2013 to 2019 was evaluated using joinpoint regression,and estimated rates of decline were extrapolated until 2030 using time series ***:In 2019,the age-standardized mortality in China(ASMRC)per 100,000 individuals was *** ASMRC for males(137.7/10^(5))and rural areas(123.0/10^(5))were both higher when stratified by gender and urban/rural *** central region had the highest mortality(126.5/10^(5)),the western region had a slightly lower mortality(123.5/10^(5)),and the eastern region had the lowest mortality(97.3/10^(5)).The age-specific mortality showed an accelerated upward trend from aged 55-59 years,with maximum mortality observed in individuals over 85 years of *** age-standardized mortality of CVD decreased by 2.43%(95%confidence interval,1.02-3.81%)annually from 2013 to ***,the age-specific mortality of CVD increased from 2013 to 2019 for the age group of over 85 *** 2020,both the absolute number of CVD cases and the crude mortality of CVD have increased compared to their values in *** estimated total deaths due to CVD were estimated to reach 2.3 million in 2025 and 2.4 million in ***:The heightened focus on the burden of CVD among males,rural areas,the central and western of China,and individuals aged 75 years and above has emerged as a pivotal determinant in further decreasing mortalities,consequently presenting novel challenges to strategies for disease prevention and control.

关键词： Cerebrovascular diseases Mortality Epidemiology Global Burden of Disease China COVID-19 pandemic

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