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Machine Learning-Based Intelligent Auscultation Techniques in Congenital Heart Disease:Application and Development

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Congenital Heart Disease 2024年第2期19卷 219-231页

作者： Yang Wang Xun Yang Mingtang Ye Yuhang Zhao Runsen Chen Min Da Zhiqi Wang Xuming Mo Jirong Qi department of cardiothoracic Surgery Children’s Hospital of Nanjing Medical UniversityNanjingChina

Congenital heart disease(CHD),the most prevalent congenital ailment,has seen advancements in the“dual indi-cator”screening *** facilitates the early-stage diagnosis and treatment of children with CHD,subse-quently enhancing their survival *** cardiac auscultation offers an objective reflection of cardiac abnormalities and function,its evaluation is significantly influenced by personal experience and external factors,rendering it susceptible to misdiagnosis and *** recent years,continuous progress in artificial intelli-gence(AI)has enabled the digital acquisition,storage,and analysis of heart sound signals,paving the way for intelligent CHD auscultation-assisted diagnostic *** there has been a surge in studies based on machine learning(ML)within CHD auscultation and diagnostic technology,most remain in the algorithmic research phase,relying on the implementation of specific datasets that still await verification in the clinical *** paper provides an overview of the current stage of AI-assisted cardiac sounds(CS)auscultation technology,outlining the applications and limitations of AI auscultation technology in the CHD *** aim is to foster further development and refinement of AI auscultation technology for enhanced applications in CHD.

关键词： Congenital heart disease heart sound auscultation artificial intelligence machine learning

Feeding the vasculature with cruciferous vegetables:a secret for organ protection

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Signal Transduction and Targeted Therapy 2024年第3期9卷 828-830页

作者： Priya Veluswamy Jens Wippermann Max Wacker Heart Surgery Research Department of Cardiothoracic SurgeryOtto-von-Guericke University HospitalMagdeburgGermany

Two very recent back-to-back papers published in Nature1,2 decipher the holistic role of the aryl hydrocarbon receptor(AHR)/dietary-ligand axis,in enteric and pulmonary vasculature to emphasize tolerance induction and vessel integrity during homeostasis,sterile inflammation and *** studies spectacularly highlight the significance of endothelium in orchestrating tissue tolerance by demonstrating the multifaceted activities of endothelial-expressed AHR that protects the vasculature to maintain organ homeostasis.

关键词： maintain sterile homeostasis

Arterial Duct Stenting Versus Modified Blalock-Taussig Shunt in Patient with Ductal-Dependent Pulmonary Circulation: Systematic Review & Meta-Analysis

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Congenital Heart Disease 2024年第2期19卷 139-156页

作者： Ketut Putu Yasa Nyoman Satria Sadu Bhaskara Putu Febry Krisna Pertiwi department of cardiothoracic&Vascular Surgery Prof.Dr.I.G.N.G Ngoerah General HospitalDenpasar80113Indonesia Faculty of medicine Udayana UniversityDenpasar80232Indonesia

Objective:Patients with ductal-dependent pulmonary circulation require alternative bloodflow to provide and maintain adequate *** Blalock-Taussig Shunt(MBTS)has been the standard for providing such a ***,less invasive methods such as Arterial Duct(AD)stenting have been performed as *** study aims to compare the outcome of AD stenting and ***:Systematic research was performed in online databases using the PRISMA *** outcomes measured were 30-day mortality,com-plication,unplanned intervention,oxygen saturation,duration of hospital,and ICU length of *** compara-tive study provided with full text is *** outcome of each study was analyzed using a trandom effects model with relative risk and mean difference as the effect *** risk assessment was conducted using the New-castle-Ottawa *** analyses were performed using Review Manager ***:A total of 11 studies with 3154 samples included in this *** is no significant difference in 30-day mortality between the two groups(p-value=0.10).However,there is significantly less complication(RR 0.53[0.35,0.82];p-value=0.004)and unplanned intervention(RR 0.59[0.38,0.92];p-value=0.02)in the AD stent *** of the Nakata index showed no significant difference(p-value=0.88).Post-operative oxygen saturation was measured signifi-cantly higher in the AD stenting(MD 1.80[0.85,2.74];p-value=0.0002).However,AD stent group shows sig-nificantly lower long-term oxygen saturation(MD-8.43[-14.38,-2.48];p-value=0.005).Both hospital and ICU length of stay was significantly shorter in the AD stent group(MD-8.30[-11.13,-5.48];p-value<0.00001;MD-5.09[-7.79,-2.38];p-value=0.0002).Conclusion:AD stenting provides comparable outcomes relative to MBTS as it provides less complication and unplanned intervention and higher post-procedural O2 ***,MBTS proved its superiority in maintaining higher long-term oxygen saturation and still beca

关键词： Duct-dependent pulmonary circulation arterial duct stenting modified Blalock-Taussig shunt

Pachymic acid exerts antitumor activities by modulating the Wnt/β-catenin signaling pathway via targeting PTP1B

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Asian Pacific Journal of Tropical Biomedicine 2024年第4期14卷 170-180页

作者： Hao Zhang Kun Zhu Xue-Feng Zhang Yi-Hui Ding Bing Zhu Wen Meng Qing-Song Ding Fan Zhang department of Emergency Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310006ZhejiangChina department of cardiothoracic Surgery The Third Affiliated Hospital of Qiqihar Medical CollegeQiqihar 161000HeilongjiangChina department of cardiothoracic Surgery The Affiliated Heilongjiang Provincial Hospital of Harbin Institute of TechnologyHarbin 150036HeilongjiangChina

Objective:To determine the inhibitory effects of pachymic acid on lung adenocarcinoma(LUAD)cells and elucidate its underlying ***:CCK-8,wound healing,Transwell,Western blot,tube formation,and immunofluorescence assays were carried out to measure the effects of various concentrations of pachymic acid on LUAD cell proliferation,metastasis,angiogenesis as well as ***,molecular docking technology was used to detect the potential targeted binding association between pachymic acid and protein tyrosine phosphatase 1B(PTP1B).Moreover,PTP1B was overexpressed in A549 cells to detect the specific mechanisms of pachymic ***:Pachymic acid suppressed LUAD cell viability,metastasis as well as angiogenesis while inducing cell *** also targeted PTP1B and lowered PTP1B ***,PTP1B overexpression reversed the effects of pachymic acid on metastasis,angiogenesis,and autophagy as well as the expression of Wnt3a andβ-catenin in LUAD ***:Pachymic acid inhibits metastasis and angiogenesis,and promotes autophagy in LUAD cells by modulating the Wnt/β-catenin signaling pathway via targeting PTP1B.

关键词： Pachymic acid Lung adenocarcinoma Protein tyrosine phosphatase 1B Wnt/β-catenin signaling pathway Metastasis Angiogenesis Autophagy

Impact of propofol and sevoflurane anesthesia on cognition and emotion in gastric cancer patients undergoing radical resection

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 79-89页

作者： Ao-Han Li Su Bu Ling Wang Ai-Min Liang Hui-Yu Luo department of Anesthesiology Xiangyang No.1 People's HospitalHubei University of MedicineXiangyang 441000Hubei ProvinceChina department of cardiothoracic Surgery Xiangyang No.1 People's HospitalHubei University of MedicineXiangyang 441000Hubei ProvinceChina department of Rehabilitation Xiangyang No.1 People's HospitalHubei University of MedicineXiangyang 441000Hubei ProvinceChina department of Internal medicine-Cardiovascular Xiangyang No.1 People's HospitalHubei University of MedicineXiangyang 441000Hubei ProvinceChina

BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric ***,there is a debate concerning their differential effects on cognitive function,anxiety,and depression in patients undergoing this *** To compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function,anxiety,depression,and organ function in patients undergoing radical resection of gastric *** A total of 80 patients were involved in this *** subjects were divided into two groups:Propofol group and sevoflurane *** evaluation scale for cognitive function was the Loewenstein occupational therapy cognitive assessment(LOTCA),and anxiety and depression were assessed with the aid of the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Hemodynamic indicators,oxidative stress levels,and pulmonary function were also *** The LOTCA score at 1 d after surgery was significantly lower in the propofol group than in the sevoflurane ***,the SAS and SDS scores of the sevoflurane group were significantly lower than those of the propofol *** sevoflurane group showed greater stability in heart rate as well as the mean arterial pressure compared to the propofol ***,the sevoflurane group displayed better pulmonary function and less lung injury than the propofol *** Both propofol and sevoflurane could be utilized as maintenance anesthesia during radical resection of gastric *** anesthesia has a minimal effect on patients'pulmonary function,consequently enhancing their postoperative *** anesthesia causes less impairment on patients'cognitive function and mitigates negative emotions,leading to an improved postoperative mental ***,the selection of anesthetic agents should be based on the individual patient's specific circumstances.

关键词： Propofol Sevoflurane Radical resection of gastric cancer Anesthetic effect Cognitive function Negative emotion

Editorial: Welcome Message from Editor-in-Chief, Xuming Mo

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Congenital Heart Disease 2024年第1期19卷 1-3页

作者： Xuming Mo department of cardiothoracic Surgery Children’s Hospital of Nanjing Medical UniversityNanjing210008China

1 Introduction The release of the most recent volume of Congenital Heart Disease(CHD)(Issue 19,Volume 1,2024)coincides with my assumption of the role of Co-Editor-In-Chief for CHD.I would like to express my appreciation to CHD for providing me with the opportunity to use the Editorial page.I took on this responsibility on November 18,2023.I would like to take this opportunity to share reflections and convey my *** in 2006,CHD stands as the pioneering professional periodical exclusively dedicated to the exploration and treatment of congenital cardiac abnormalities across all age *** paramount goal is to elevate the scholarly and educational dimension of CHD,driven by an unwavering commitment to provide optimal,holistic cardiac care to patients spanning infancy to *** commitment remains steadfast,with a focus on community service,research,and education quality,regardless of the patient’s financial situation.

关键词： cardiac education release

Hypoxia in the pulmonary vein increases pulmonary vascular resistance independently of oxygen in the pulmonary artery

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Animal Models and Experimental medicine 2024年第2期7卷 156-165页

作者： Sigridur Olga Magnusdottir Carsten Simonsen Dan Stieper Karbing Bodil Steen Rasmussen Benedict Kjaergaard Biomedical Research Laboratory Aalborg University HospitalAalborgDenmark department of Clinical medicine Aalborg UniversityAalborgDenmark department of cardiothoracic Surgery Aalborg University HospitalAalborgDenmark department of Health Science and Technology Aalborg UniversityAalborgDenmark department of Anesthesia and Intensive Care Aalborg University HospitalAalborgDenmark

Introduction:Hypoxic pulmonary vasoconstriction(HPV)can be a challenging clinical *** is not fully elucidated where in the circulation the regulation of resistance takes *** is often referred to as if it is in the arteries,but we hypothesized that it is in the venous side of the pulmonary ***:In an open thorax model,pigs were treated with a veno-venous extra corporeal membrane oxygenator to either oxygenate or deoxygenate blood passing through the pulmonary *** the same time the lungs were ventilated with extreme variations of inspired air from 5%to 100%oxygen,making it possible to make combinations of high and low oxygen content through the pulmonary circulation.A flow probe was inserted around the main pulmonary artery and catheters in the pulmonary artery and in the left atrium were used for pressure monitoring and blood *** different combinations of oxygenation,pulmonary vascular resistance(PVR)was ***:With unchanged level of oxygen in the pulmonary artery and reduced inspired oxygen fraction lowering oxygen tension from 29 to 6.7 kPa in the pulmonary vein,PVR was *** more extreme hypoxia PVR suddenly *** with low oxygenation in the pulmonary artery did not systematic influence PVR if there was enough oxygen in the inspired air and in the pulmonary ***:The impact of hypoxia occurs from the alveolar level and forward with the blood *** experiments indicated that the regulation of PVR is mediated from the venous side.

关键词： animal models cardiopulmonary support Hypoxic pulmonary vasoconstriction pulmonary circulation

Recent advances in the diagnostic methods and therapeutic strategies of transthyretin cardiac amyloidosis

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World Journal of Cardiology 2024年第7期16卷 370-379页

作者： Christos Kourek Alexandros Briasoulis Dimitrios E Magouliotis Panagiotis Georgoulias Grigorios Giamouzis Filippos Triposkiadis John Skoularigis Andrew Xanthopoulos Clinical Ergospirometry Exercise and Rehabilitation Laboratory1^(st)Critical Care Medicine DepartmentEvangelismos HospitalNational and Kapodistrian University of AthensAthens 10676Greece department of Clinical Therapeutics Alexandra HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 11528Greece department of cardiothoracic Surgery University of ThessalyLarissa BiopolisLarissa 41110Greece department of Nuclear medicine University Hospital of LarissaLarissa 41110Greece department of Cardiology School of MedicineUniversity Hospital of LarissaLarissa 41110Greece

Cardiac amyloidosis is a progressive disease characterized by the buildup of amyloid fibrils in the extracellular space of the *** is divided in 2 main types,immunoglobulin light chain amyloidosis and transthyretin amyloidosis(ATTR),and ATTR amyloidosis is further divided in 2 subtypes,non-hereditary wild type ATTR and hereditary mutant variant *** and prevalence of ATTR cardiac amyloidosis is increasing over the last years due to the improvements in diagnostic *** rates are improving due to the development of novel therapeutic *** is the only disease-modifying approved therapy in ATTR amyloidosis so ***,the most recent advances in medical therapies have added more options with the potential to become part of the therapeutic armamentarium of the *** including acoramidis,eplontersen,vutrisiran,patisiran and anti-monoclonal antibody NI006 are being investigated on cardiac function in large,multicenter controlled trials which are expected to be completed within the next 2-3 years,providing promising results in patients with ATTR cardiac ***,further and ongoing research is required in order to improve diagnostic methods that could provide an early diagnosis,as well as survival and quality of life of these patients.

关键词： Transthyretin cardiac amyloidosis Tafamidis Acoramidis Eplontersen Vutrisiran Patisiran

A Comparative Analysis on Surgical Outcomes and Complications of Endoscopic and Open Vein Harvesting Techniques

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Open Journal of Thoracic Surgery 2024年第2期14卷 29-39页

作者： Mohammed Fawzy Eltaweel Ismail N. El-Sokkary Ahmed Alherazi Mohamed Wael Badawi Mohammed G. Abdellatif Bahaa A. Elkhonezy Ibrahim K. Gamil Haytham Mohamed Abd El Moaty Sarra Sadmi Mahmoud Khalil department of cardiothoracic Surgery Faculty of Medicine Menoufia University Shibin El Kom Egypt department of Cardiovascular & Thoracic Surgery Faculty of Medicine Al-Azhar University Cairo Egypt department of cardiothoracic Surgery Faculty of Medicine Alexandria University Alexandria Egypt Faculty of medicine University of Algiers Algiers Algeria department of Cardiac Surgery Sabah Al-Ahmed Cardiac Center Al-Amiri Hospital Kuwait City Kuwait

Objective: The great saphenous vein (GSV) is commonly used as a conduit for grafting during CABG surgery, and open GSV harvesting (OVH), commonly used with long incision to expose the vein. However, endoscopic vein harvesting (EVH) is an alternative approach, utilizing specialized instruments and small incisions to harvest the vein. Methods: A retrospective analysis was conducted on a cohort of patients who underwent Coronary artery bypass graft (CABG) requiring great saphenous vein (GSV) harvesting which was done by EVH or OVH procedures. Demographic variables, including age and gender, were assessed for both groups. Intraoperative variables such as the number of grafts, cardiopulmonary bypass time, X clamp time, and type of procedure were analyzed. Postoperative variables, including infection and bleeding rates, were also evaluated. Results: The study included 30 patients each undergoing Coronary artery bypass graft (CABG) with need of great saphenous vein harvesting which was done by EVH and OVH. Demographic variables were well-matched between the two groups in terms of age, while a significant difference in gender distribution was observed. Obesity and smoking were more prevalent in the OVH group, and EVH was associated with a higher mean number of grafts compared to OVH. Conversion to an open technique occurred in a portion of the EVH cases, and infection rates did not significantly differ between the EVH and OVH groups. However, the incidence of postoperative bleeding was significantly higher in the EVH group. Conclusion: This study provides valuable insights into the demographic, intraoperative, and postoperative variables associated with EVH and OVH techniques. EVH demonstrated advantages in terms of reduced infection rates compared to OVH. However, the higher incidence of postoperative bleeding associated with EVH raises concerns about potential risks.

关键词： Endoscopic Vein Harvesting (EVH) Open Vein Harvesting (OVH) Coronary Artery Bypass Grafting (CABG) Great Saphenous Vein (GSV) Surgical Outcomes