Abstract:Objective To analyse the clinical characteristics and pregnancy outcomes of pregnant women after mitral valve replacement with mechanical prosthetic valves,in order to provide evidence for the safe diagnosis and treatment of this population.Methods The clinical data of 49 pregnant women after mechanical mitral valve replacement admitted to Beijing Anzhen Hospital,Capital Medical University from January 2013 to January 2023 were retrospectively analyzed.The maternal age,gestational age,valve replacement time,neonatal weight,inter-national normalized ratio,delivery mode and echocardiography differences were retrospectively analyzed,and the clinical data characteristics and pregnancy outcomes of the patients were summarized.Results Forty-nine pregnant women were aged(31±4)years,gestational week(26±14)weeks,gestational time to valve replacement(8±5)years,hemoglobin(115±10)g/L,glutamate transaminase(13±8)U/L,blood creatinine(45±7)μmol/L,international standardized ratio 1.8±0.6,mitral mechanical valve orifice area(2.4±0.6)cm2,mitral mechanical valve orifice velocity(197±49)cm/s,left ventricular end diastolic diameter(47±5)mm,and left ventricular ejection fraction(61±6)％.Among them,5 cases were found to have valve dysfunction,of which 3 cases had mechanical valve blockage during mid pregnancy(28 weeks in case 1,30 weeks in case 2 and 19 weeks in case 5).Case 1 suffered fetal death at 28 weeks and underwent valve replacement.Case 2 was treated with conservative dual antiplatelet therapy and delivered by cesarean section at 34 weeks of gestation with normal birth.In case 5,valve replacement was performed to protect the fetus,and the fetus was delivered by cesarean section at 37 weeks of gestation.Conclusion A reasonable anticoagulation strategy should be developed for pregnant women after mechanical valve replacement.Due to changes in physiological conditions during pregnancy,the anticoagulation regimen needs to be continuously adjusted.During the whole pregnancy,blood pressure,heart rate and various anticoagulation indicators should be closely monitored,and echocardiography should be performed regularly.At the same time,a multidisciplinary comprehensive evaluation method should be taken to ensure the safety of pregnancy and provide reliable diagnosis and treatment basis for pregnant women to ensure the safety of mother and child.

Abstract:Objective To investigate the relationship between serum syndecan-1(SDC-1)and peptidyl arginine deiminase2(PAD2)levels and the condition and prognosis of patients with septic shock(SS).Methods A total of 124 SS patients(SS group)admitted to the Department of Intensive Care Unit,the Fifth Affiliated Hospital of Xinjiang Medical University from January 2021 to January 2024 and 53 healthy subjects(control group)in the same period were selected.SS patients were divided into mild SS group(33 cases),moderate SS group(42 cases)and severe SS group(49 cases)according to the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score.According to the 28 d prognosis,they were divided into death group and survival group.The levels of serum SDC-1 and PAD2 were detected by enzyme-linked immunosorbent assay.Spearman correlation coefficient was used to analyze the correlation between serum SDC-1,PAD2 levels and APACHE Ⅱ score in SS patients.With the prognosis of SS as the dependent variable,multivariate unconditional Logistic regression was used to determine the influencing factors.Receiver operating characteristic curve was drawn to evaluate the predictive value of serum SDC-1 and PAD2 levels on the death of SS patients.Results The levels of SDC-1 and PAD2 in SS group were higher than those in control group[(17.2±3.4)pg/L vs(9.5±2.1)pg/L,(43±6)μg/L 比(29±5)pg/L](both P＜0.001).The serum levels of SDC-1 and PAD2 in severe SS group were higher than those in moderate and mild SS groups,and those in moderate SS group were higher than those in mild SS group(all P＜0.001).The serum levels of SDC-1 and PAD2 in SS patients were positively correlated with APACHE Ⅱ score(rs=0.840,0.846,both P＜0.001).Among 124 SS patients,51 patients died(death group)and 73 patients survived(survival group)at 28 days.Logistic regression analysis showed that duration of mechanical ventilation ≥3 days,increased APACHE Ⅱ score,increased SDC-1 and PAD2 were independent risk factors for death in SS patients,and increased oxygenation index was an independent protective factor(all P＜0.05).The area under the ROC curve of the combination of serum SDC-1 and PAD2 in predicting the death of SS patients was 0.869,which was larger than 0.779 and 0.784 of serum SDC-1 and PAD2 alone(both P＜0.05).Conclusion The increased levels of serum SDC-1 and PAD2 are related to the aggravation and poor prognosis of SS patients.The combination of serum SDC-1 and PAD2 levels has a higher value in predicting the death of SS patients.

Abstract:Objective To investigate the effect of the modified model for end-stage liver disease(MELD-XI)score on the prognosis of patients after heart transplantation.Methods The clinical data of 192 recipients who underwent single-organ heart transplantation in the 7th People's Hospital of Zhengzhou,Henan Province from May 2018 to July 2023 were retrospectively analyzed.The survival status of all heart transplant recipients within 5 years after operation was used as the state variable,and the preoperative MELD-XI score was used as the test variable.The X-tile software was used to determine the optimal threshold of preoperative MELD-XI score for predicting the postoperative survival of heart transplant recipients.According to the optimal threshold,the recipients were divided into two groups.Kaplan-Meier survival analysis was used to compare the 5-year overall survival rates between the two groups.The perioperative conditions and long-term prognosis of the two groups were compared,and the relationship between clinical indicators under MELD-XI score and the risk of postoperative death was explored.Results X-tile analysis showed that the best diagnostic point of preoperative MELD-XI score in predicting postop-erative survival of heart transplantation patients was 8.3.According to the best diagnostic point of preoperative MELD-XI score,the patients were divided into MELD-XI score＞8.3 group(46 cases)and MELD-XI score ≤8.3 group(146 cases).Kaplan-Meier survival analysis showed that the overall survival rates of heart transplant recipients in the MELD-XI score＞8.3 group were significantly lower than those in the MEID-XI score ≤8.3 group at 1,3,and 5 years postoperatively(P＜0.001).Logistic regression analysis showed that preoperative extracor-poreal membrane oxygenation,donor age,and postoperative ventilator use time were significantly correlated with the risk of death after heart transplantation(all P＜0.05).Cox regression analysis showed that postoperative ventilator use time(hazard rate=1.001,95％confidence interval:1.001-1.001,P＜0.001)was a high risk factor for death of heart transplant recipients.Preoperative hemoglobin(hazard rate=0.970,95％confidence interval:0.955-0.985,P＜0.001)was a protective factor for death in heart transplant recipients.Conclusion Preoperative MELD-XI score can be used to evaluate the risk of postoperative mortality and long-term overall survival in heart transplant recipients.

Abstract:Objective To investigate the improvement of pulmonary arterial hypertension(PAH)in patients with aortic stenosis(AS)and PAH after transcatheter aortic valve implantation(TAVI)and analyze the related factors.Methods A total of 168 AS patients with PAH undergoing TAVI in Beijing Anzhen Hospital,Capital Medical University from January 2022 to December 2023 were retrospectively analyzed.According to the pulmonary artery pressure 1 month after surgery,the patients were divided into PAH improvement group and PAH non-improvement group.The preoperative general data and echocardiographic parameters of the two groups were compared,and the influencing factors of the improvement of PAH after operation were analyzed.Results Among 168 patients,123 patients(73.2％)had improvement in PAH after surgery(PAH improvement group),and 45 patients(26.8％)did not improve(PAH non-improvement group).There were significant differences in atrial fibrillation,left atrial diameter(LAD),left ventricular end-diastolic diameter,left ventricular end-diastolic volume,left ventricular end-systolic volume,and moderate or severe tricuspid regurgitation(TR)between the two groups(all P＜0.05).Multivariate Logistic regression analysis showed that atrial fibrillation(odds ratio=0.444,95％confidence interval:0.201-0.981,P=0.045),LAD(odds ratio=1.086,95％confidence interval:1.008-1.169,P=0.029),combined with moderate or severe TR(odds ratio=0.428,95％confidence interval:0.189-0.967,P=0.041)were independent influencing factors for the improvement of PAH after TAVI.Conclusions TAVI can effectively improve the degree of PAH in AS patients with PAH.Preoperative atrial fibrillation,preoperative LAD and moderate or severe TR are the influencing factors for the improvement of PAH after TAVI.

Abstract:Objective To analyze the application value of clinical,ultrasound radiomics and fusion model in evaluating the clinical course of Hashimoto's thyroiditis(HT).Methods The retrospective analysis method was used in this article.The clinical data of 80 patients with HT admitted to the Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University from February to November 2023 were collected.The patients were included in the observation group and randomly divided into a training set(50 cases)and a validation set(30 cases).Another 80 healthy people in the same period were selected as the control group.The clinical data and ultrasound radiomics features of the two sets of patients were compared.The radiomics model was established.The independent risk factors affecting the clinical course of patients were analyzed by univariate and multivariate regression methods.The clinical ultrasound radiomics fusion model was constructed,and the calibration curve,receiver operating characteristic(ROC)curve and clinical decision curve were used to evaluate the efficacy of the model.Results There was no significant difference in clinical data and ultrasound radiomics features between the two sets of patients(all P＞0.05).Multivariate analysis showed that thyroid stimulating hormone,free thyroxine,thyroid peroxidase antibody,thyroglobulin antibody,gland enlargement,diffuse hypoechoic and shear wave velocity were independent risk factors affecting the clinical course of HT patients(all P＜0.05).The sensitivity of the fusion model(area under the curve:0.807)was 73.19％,the specificity was 72.65％,and the accuracy was 74.28％,and the area under the curve was higher than that of the clinical model and ultrasound radiomics model(0.718 and 0.741).The results of calibration curve and clinical decision curve showed that the fitting effect of the fusion model was significant,and the consistency index was 0.866(95％confidence interval:0.702-0.943),and its prediction performance was good.Conclusion The application value of the fusion model in the evaluation of the clinical process of HT is higher than those of clinical and ultrasound radiomics alone,and it can be used as a clinical basis for predicting the clinical process of HT patients.

Abstract:Objective To investigate the relationship between serum purinergic receptor P2X7(P2RX7)and YTH structural domain N6-methyladenosine RNA binding protein 2(YTHDF2)and hemorrhagic transformation(HT)after intravenous thrombolysis in patients with acute ischemic stroke(AIS).Methods A total of 192 AIS patients admitted to Shaanxi Kangfu Hospital from January 2020 to December 2023 were selected as the AIS group(after thrombolysis,it was divided into hemorrhagic transformation group and non-hemorrhagic transformation group),and 150 healthy people in the same period were selected as the control group.Serum P2RX7 and YTHDF2 levels were detected by enzyme-linked immunosorbent assay.With HT after intravenous thrombolysis as the dependent variable,a Logistic regression model was established to determine the related factors of HT in AIS patients after intravenous thrombolysis.The receiver operating characteristic curve was drawn to evaluate the predictive value of serum P2RX7 and YTHDF2 levels for HT.Results The serum levels of P2RX7 and YTHDF2 in AIS group were higher than those in control group[(1.6±0.3)μg/L vs(1.2±0.3)μg/L,(1.32±0.26)μg/L vs(1.03±0.16)μg/L](both P＜0.001).The levels of serum P2RX7 and YTHDF2 in the hemorrhagic transformation group were higher than those in the non-hemorrhagic transformation group(both P＜0.001).Multivariate Logistic regression analysis model results showed that high National Institutes of Health Stroke Scale score,cardiogenic embolism,high P2RX7 level and high YTHDF2 level were independent risk factors for HT in AIS patients after intravenous thrombolysis(all P＜0.05).The area under the curve of serum P2RX7 combined with YTHDF2 for predicting hemorrhagic transformation was 0.886,which was larger than 0.780 and 0.784 predicted by P2RX7 or YTHDF2 alone(both P＜0.001).Conclusion Elevated serum P2RX7 and YTHDF2 levels are independent risk factors for HT in patients with AIS after intravenous thrombolysis,and serum P2RX7 combined with YTHDF2 detection has a high predictive value for HT.

Abstract:Objective To investigate the relationship between serum osteopontin and interleukin-17(IL-17)expression and the prognosis of triple-negative breast cancer(TNBC).Methods The clinical data and serum samples of 102 TNBC patients who underwent surgical treatment in Zhongshan Hospital Affiliated Fudan University from May 2018 to May 2021 were collected.Totally 18(17.6％)TNBC patients who had recurrence or metastasis within 3 years after surgery were classified into the poor prognosis group,and the remaining 84(82.4％)TNBC patients were classified into the good prognosis group.The relationship between serum osteopontin and IL-17 and the prognosis of TNBC after surgery were analyzed by dose-response relationship,interaction and receiver operating characteristic(ROC)curve.Results The levels of serum osteopontin and IL-17 in the poor prognosis group were higher than those in the good prognosis group[(99±12)μg/L vs(85±11)µg/L,(43±4)ng/L vs(37±4)ng/L](both P＜0.05).The analysis of restricted cubic spline showed that the serum levels of osteopontin and IL-17 had a non-linear dose-response relationship with the prognosis of TNBC patients treated with surgery(all P＜0.05).When the serum levels of osteopontin and IL-17 were＞85.12 μg/L and＞37.40 ng/L,respectively,the risk of poor prognosis increased with the increase of the levels of the indexes.After adjusting the confounding factors,there was a positive interaction between serum osteopontin and IL-17 on the prognosis of TNBC treated with surgery.When both of them were overexpressed,the risk of poor prognosis was 13.000 times as high as that when both were low.When both of them were overexpressed,the risk of poor prognosis was 11.307 times as high as that of other factors.The synergistic effect was 5.198 times of the sum of the effects of the two alone,and 75.38％of the risk of their coexistence was caused by their interaction.ROC curve analysis showed that the area under the curve of serum osteopontin,IL-17 and their combination for predicting the prognosis of TNBC after surgery was 0.810,0.826 and 0.891,respectively.The value of combined prediction was better than that of single prediction(both P＜0.05).Conclusions Serum osteopontin and IL-17 are related to the prognosis of TNBC after surgical treatment.High expression of serum osteopontin and IL-17 May increase the risk of poor prognosis of TNBC after surgical treatment.There is a positive interaction between the two factors,which synergistically increases the risk of poor prognosis of TNBC after surgical treatment,which should be paid attention to in clinical practice.

Abstract:In recent years,the relationship between attention deficit hyperactivity disorder(ADHD)and cardiovascular disease has attracted increasing attention.The risk of cardiovascular disease in patients with ADHD is significantly increased.It is very important to understand its pathogenesis and early identification and intervention.The mechanisms of ADHD comorbid with cardiovascular disease can be divided into biological and behavioral mechanisms.The biological mechanisms include genetic correlation,inflammatory dysregulation,hypothalamic-pituitary-adrenal axis imbalance,oxidative stress,and lipid abnormalities,etc.The behavioral mechanisms include obesity,smoking,psychiatric comorbidities,and drug treatment,etc.This article aims to review the latest research progress on the risk mechanism of ADHD comorbid with cardiovascular disease,in order to provide ideas for the identification,diagnosis,treatment and prevention of ADHD comorbid with cardiovascular disease.

Abstract:Objective To investigate the relationship between serum levels of heparin cofactor-Ⅱ(HC-Ⅱ)and dipeptidyl peptidase 4(DPP4)and coronary artery in-stent restenosis(ISR)after drug-coated balloon(DCB)dilation.Methods A total of 158 ISR patients who underwent DCB expansion in Yan'an University Affiliated Hospital from January 2021 to March 2023 were selected.The clinical data were collected,and the serum levels of HC-Ⅱ and DPP4 were detected by enzyme-linked immunosorbent assay.Taking ISR after DCB expansion in ISR patients as the dependent variable,a multivariate unconditional Logistic regression model was established to determine its influencing factors.Receiver operating characteristic(ROC)curve was drawn to evaluate the value of serum HC-Ⅱ and DPP4 levels in predicting ISR after DCB dilatation.Results After 1 year of follow-up,54 of 158 ISR patients(34.2％)with ISR after DCB expansion were included in the ISR group,and 104 patients were in the non-ISR group.Multivariate Logistic regression analysis showed that increased stenosis rate of the official carity,increased neutrophil to lymphocyte ratio and increased DPP4 were independent risk factors for ISR after DCB expansion,and increased HC-Ⅱ was an independent protective factor(all P＜0.05).The ROC curve showed that the area under the curve(AUC)of the combination of serum HC-Ⅱ and DPP4 levels in predicting ISR after DCB dilatation was 0.873,which was larger than 0.789 and 0.788 of HC-Ⅱ and DPP4 levels alone(all P＜0.05).Conclusion The decrease of serum HC-Ⅱ level and the increase of DPP4 level are closely related to ISR after DCB dilatation.The combination of serum HC-Ⅱ and DPP4 levels has a higher value in predicting coronary artery ISR after DCB dilatation in patients with ISR.

Abstract:In recent years,microneedles have attracted much attention due to their small size(500 to 1 000 μm in length)and high surface area,which allow painless and effective drug delivery through the skin.In addition to the great success of microneedle-based transdermal drug delivery,an increasing number of studies have shown that the application of microneedles has expanded to various organ applications,including the delivery of alopecia,eye diseases,and oral mucosal treatments.This article discusses the current treatment of hair loss,eye diseases,oral diseases and cardiovascular diseases,and outlines the latest progress in the application of microneedle drug delivery system in these four non-skin organ and tissue diseases.At the same time,the development trend and challenges of microneedle drug delivery systems in the future are emphasized.

Abstract:Objective To explore the situation of pregnancy complicated with arrhythmia and its influence on the pregnancy outcome of pregnant women,in order to provide new ideas and theoretical basis for clinical practice.Methods The clinical data of 287 pregnant women who delivered in the Department of Obstetrics,Beijing Anzhen Hospital,Capital Medical University from January 1,2019 to December 31,2023 were collected and analyzed retrospectively.The pregnant women were divided into arrhythmia group(142 cases)and non-arrhythmia group(145 cases)according to whether they were complicated with arrhythmia.The differences in general data,laboratory tests indicators and pregnancy outcomes between the two groups were compared.Results The maternal age,pre-pregnancy body mass index,gravidity and prevalence of congenital heart disease in the arrhythmia group were greater/higher/more than those in the non-arrhythmia group,while the maternal height and gestational age were lower/less than those in the non-arrhythmia group(all P＜0.05).There were no significant differences in pre-pregnancy body weight and parity between the two groups(both P＞0.05).The levels of creatine kinase isoenzyme,high-density lipoprotein cholesterol and C-reactive protein in the arrhythmia group were higher than those in the non-arrhythmia group(all P＜0.05).There was no significant difference in total cholesterol and low-density lipoprotein cholesterol between the two groups(all P＞0.05).The rates of cesarean section,premature delivery and postpartum hemorrhage in the arrhythmia group were higher than those in the non-arrhythmia group,and the rate of natural delivery was lower than that in the non-arrhythmia group[82.4％(117/142)vs 17.2％(25/145),33.1％(47/142)vs0(0),17.6％(25/142)vs 0(0),17.6％(25/142)vs 82.8％(120/145)](all P＜0.05).Conclusion Pregnant women with arrhythmia have an increased risk of adverse pregnancy outcomes such as cesarean section,postpartum hemorrhage,and premature delivery,which should be paid attention to in clinical practice.

Abstract:Objective To investigate the effect of Yixintong tablets combined with atorvastatin in the treatment of hyperlipidemia.Methods A total of 102 patients with hyperlipidemia admitted to the Affiliated Hospital of Inner Mongolia Medical University from May 2021 to May 2024 were selected.According to the random number table method,they were divided into observation group and control group,with 51 cases in each group.The control group was treated with atorvastatin calcium tablets,and the observation group was treated with Yixintong tablets on the basis of the control group.The clinical efficacy,blood lipid index,vascular endothelial function,hemorheology index and treatment safety were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[92.2％(47/51)vs 74.5％(38/51)](P=0.017).After treatment,the levels of total cholesterol,triglyceride,low-density lipoprotein cholesterol,dimethyl-argenine,endothelin-1,whole blood viscosity,plasma viscosity,fibrinogen and hematocrit in the observation group were lower than those in the control group,and the level of high-density lipoprotein cholesterol was higher than that in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.505).Conclusion The effect of Yixintong tablets combined with atorvastatin in the treatment of hyperlipidemia is good,which can significantly reduce the blood lipid level of patients,improve the vascular endothelial function of patients,reduce blood viscosity,and the treatment safety is good.

Abstract:Objective To investigate the effect of traditional Chinese medicine therapy of Yiqi Wenyang Lishui on serum uric acid level in patients with chronic heart failure(CHF)complicated with hyperuricemia(HUA).Methods Totally 54 patients with CHF combined with HUA and Yang qi deficiency syndrome were selected from the Department of Cardiology,the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from May 2021 to April 2023.The patients were divided into the control group(24 cases,treated with conventional western medicine)and the observation group(30 cases,treated with Yiqi Wenyang Lishui on the basis of conventional western medicine)according to whether they took traditional Chinese medicine.The serum uric acid levels of the two groups were compared after treatment.The relationship between serum uric acid level and age,gender,left ventricular ejection fraction(LVEF),New York Heart Association(NYHA)cardiac function classification,body mass index,whether complicated with hypertension,whether complicated with diabetes,whether with ischemic diseases history,whether taking anti-heart failure drugs,whether taking traditional Chinese medicine and other factors were analyzed.Results There was no significant difference in the level of uric acid between the two groups at baseline(P＞0.05).After treatment,the uric acid levels of the two groups were lower than those at baseline,and the decrease in the observation group was greater than that in the control group(all P＜0.05).After treatment,the serum uric acid level of the observation group decreased by 27.102 µmol/L more than that of the control group(β value was-27.102,95％confidence interval:-38.000--16.203,P＜0.001).The serum uric acid level of CHF patients with HUA was significantly positively correlated with age,LVEF,NYHA cardiac function classification,body mass index,and whether to take Yiqi Wenyang Lishui treatment traditional Chinese medicine(all P＜0.05).There was no significant correlation with gender,hypertension,diabetes,ischemic history,and use of anti-heart failure drugs(all P＞0.05).Conclusion Traditional Chinese medicine therapy of Yiqi Wenyang Lishui has a positive effect on improving serum uric acid level in CHF patients with HUA.

Abstract:Objective To observe the therapeutic effect of Anshen Buxin Liuwei pills combined with clopidogrel on patients with coronary atherosclerotic heart disease and angina pectoris(CHDA).Methods A total of 105 CHDA patients admitted to the Second Hospital of Heilongjiang Province from February 2023 to January 2024 were selected.According to the random number table method,they were divided into the control group(52 cases)and the observation group(53 cases).The control group was treated with clopidogrel on the basis of routine treatment,and the observation group was treated with Anshen Buxin Liuwei pills on the basis of the control group.Both groups were treated for 1 month.The clinical efficacy was evaluated after treatment,and the intervention and occurrence of angina pectoris,cardiac function index,hemorheology index,vascular endothelial function index before and after treatment and the incidence of adverse reactions during treatment were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[96.2％(51/53)vs 82.7％(43/52)](x2=5.126,P=0.024).After treatment,the single dosage of nitroglycerin,the number and duration of angina pectoris attack,left ventricular end-systolic diameter,plasma viscosity,whole blood high shear viscosity and low shear viscosity,and endothelin level in the two groups were less/shorter/smaller/lower than those before treatment,those in the observation group were less/shorter/smaller/lower than those in the control group,the left ventricular ejection fraction,cardiac output and nitric oxide levels were greater/higher than those before treatment,and those in the observation group were greater/higher than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group during the treatment[3.8％(2/53)vs 5.8％(3/52)](x2=0.191,P=0.663).Conclusions Anshen Buxin Liuwei pills combined with clopidogrel has good clinical effect in the treatment of CHDA,which can significantly reduce the incidence of angina pectoris,improve the cardiac function,hemorheology and vascular endothelial function of patients,and has good safety.

Abstract:Objective To explore the pathogenic gene and mutation site of a patient with myxoid mitral valve disease and the family.Methods According to the results of whole exome sequencing in a patient with mitral regurgitation who had been admitted to the Valve Surgery Center,Beijing Anzhen Hospital,Capital Medical University due to myxoid mitral valve disease,blood samples were taken from the parents,brother and twin sister of the patient's family.Peripheral venous blood was collected to extract genomic DNA from the family members.Whole exome sequencing was performed on the proband's parents and siblings using a high-throughput sequencing platform.Suspected mutations were verified by Sanger sequencing in family members.Results Sequencing results showed that the proband and his sister had c.7819+1G＞A splice variant at the junction of exon 63 and intron 63 of the FBN1 gene.This mutation was a novel and pathogenic mutation.The myxoid mitral valve lesions in this family were syndromic.Conclusions FBN1 gene(NM000138.4)on chromosome 15 is the pathogenic gene.The c.7819+1 G＞A splice variant at the junction of exon 63 and intron 63 is reported for the first time in China and the third time in the world,which provides a basis for gene screening and treatment in the future.

Abstract:Idiopathic pulmonary fibrosis(IPF)is a fatal lung disease characterized by progressive fibrosis of lung tissue,and its pathogenesis is not fully understood.Recent studies have found that a variety of signaling pathways play a key role in the occurrence and progression of IPF.Including transforming growth factor β,Wnt/β-catenin,mitogen-activated protein kinase,phosphatidylinositol 3 kinase/protein kinase B,Rho/Rho-associated kinase,Janus kinase/signal transducer and activator of transcription protein,mammalian target of rapamycin,etc.These pathways promote the process of pulmonary interstitial fibrosis by enhancing the proliferation,differentiation and extracellular matrix deposition of fibroblasts.However,many upstream and downstream signaling molecules have yet to be defined.In addition,cytokines such as vascular endothelial growth factor,fibroblast growth factor and platelet-derived growth factor also play an important role in the occurrence and development of IPF.An in-depth understanding of these signaling pathways and their interactions will help to provide new targets and strate-gies for early diagnosis and treatment of IPF.This article aims to summarize the current research progress and explore future research directions in order to provide a scientific basis for the clinical management of IPF.

Abstract:Objective To investigate the effect of Mongolian medicine Eridun Wurile on prothrombotic state(PTS)and quality of life in elderly patients with hypertension.Methods From January 2023 to February 2024,60 elderly patients with hypertension were selected from the outpatient and inpatient Department of Mongolian Medicine,People's Hospital of Inner Mongolia Autonomous Region.According to the random number table method,they were divided into control group and observation group,with 30 cases in each group.The control group was treated with amlodipine besylate tablets,and the observation group was treated with Mongolian medicine Eridun Wurile on the basis of the control group.Both groups were treated for 8 weeks.The levels of PTS molecular markers(four items of blood coagulation,D-dimer),quality of life scale scores,blood pressure and safety indicators were observed before and after treatment in the two groups.Results Among the 60 patients,1 case dropped out of the observation group,1 case was lost to follow-up in the control group,and 58 cases completed the trial,with a dropout rate of 3.3％(2/60).There were statistically significant differences in four items of coagulation and D-dimer before and after treatment in the observation group(all P＜0.05).After treatment,the differences of fibrinogen and D-dimer in the observation group were greater than those in the control group[1.46(1.23,1.85)g/L vs 0.06(0.02,0.14)g/L,0.16(0.13,0.22)mg/L vs 0.03(0.02,0.04)mg/L](both P＜0.05).There were statistically significant differences in systolic blood pressure and diastolic blood pressure in the two groups between before and after treatment(all P＜0.05).There were statistically significant differences in the scores of each dimension of the quality of life scale before and after treatment in the observation group(all P＜0.05).There were statistically significant differences in the scores difference before and after treatment of physiological symptoms,working status and interpersonal sensitivity between the two groups(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.313).Conclusions Mongolian medicine Eridun Wurile combined with amlodipine besylate tablets has a certain effect on the improvement of PTS molecular markers and quality of life in elderly patients with hypertension,and the improvement of fibrinogen,D-dimer,physiological symptoms,working status,interpersonal sensitivity and other indicators is significantly better than amlodipine besylate monotherapy.

Abstract:Objective To investigate the effect of Jianpi Buxue granules combined with trivitamins ferrous chewable tablets in the treatment of iron deficiency anemia during pregnancy.Methods A total of 168 patients with iron deficiency anemia during pregnancy admitted to the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Shaanxi University of Chinese Medicine from March 2022 to December 2023 were selected as the research objects.A total of 168 patients with iron deficiency anemia during pregnancy were divided into control group and observation group by random number table method,with 84 cases in each group.The control group was treated with tri vitamins ferrous chewable tablets,and the observation group was treated with Jianpi Buxue granule on the basis of the control group.Both groups were treated for 1 month.The therapeutic effects,anemia indexes,iron metabolism indexes,and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[95.2％(80/84)vs 85.7％(72/84)](x2=4.421,P=0.035).After 1 month of treatment,the levels of hemoglobin,mean corpuscular volume and mean corpuscular hemoglobin in the two groups were higher/greater than those before treatment,and those in the observation group were higher/greater than those in the control group(all P＜0.05).After 1 month of treatment,the ferritin levels of the two groups were higher than those before treatment,and the serum soluble transferrin receptor and total iron binding capacity were lower than those before treatment;the ferritin level of the observation group was higher than that of the control group,and the serum soluble transferrin receptor and total iron binding capacity were lower than those of the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group[7.1％(6/84)vs 4.8％(4/84)](x2=0.425,P=0.514).Conclusion Jianpi Buxue granule combined with trivitamins ferrous chewable tablets is more effective in the treatment of iron deficiency anemia during pregnancy,which can effectively improve hemoglobin,mean corpuscular volume and mean corpuscular hemoglobin level,supplement the body's iron reserve,improve iron metabolism indicators,and has few and mild adverse reactions.

Abstract:At present,with the increasing incidence of chronic diseases such as hypertension,diabetes,and renal failure,these adverse factors significantly promote the pathological process of coronary artery calcification(CAC).Although the technology of coronary intervention has made significant progress,CAC lesions are still a major challenge in the field of interventional therapy.This article discusses the mechanism of CAC and analyzes the characteristics of intimal calcification and outer membrane calcification.At the same time,the application characteristics of various imaging techniques in CAC imaging are systematically reviewed,including coronary CT angiography,coronary angiography,intravascular ultrasound,optical coherence tomography,etc.In addition,this article describes the application value of non-compliance balloon,ultra-high pressure non-compliance balloon,cutting balloon,rotational atherectomy,and endovascular lithotripsy in the treatment of different CAC lesions.The aim of this study is to provide a scientific and effective reference for interventional radiologists to manage CAC lesions.

Abstract:Serum uric acid is the end product of the metabolism of purine compounds in humans and apes.Some epidemiological studies have shown that elevated serum uric acid is associated with gout attack,cardiovascular disease(including hypertension,coronary atherosclerotic heart disease,atrial fibrillation),metabolic syndrome,insulin resistance,obesity,non-alcoholic fatty liver disease and chronic kidney disease.At the same time,a large number of studies have shown that serum uric acid is closely related to the occurrence and development of heart failure with preserved ejection fraction(HFpEF).Control of serum uric acid can improve the prognosis and survival rate of HFpEF patients.Clarifying the effect and related mechanism of serum uric acid on HFpEF has important clinical value for disease assessment and prognosis.