Abstract:Objective To evaluate the clinical efficacy and value of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbar disc herniation in middle-aged and elderly patients. Methods A prospective study was performed to analyze 50 patients (50 to 72 years old) with lumbar disc herniation undergoing PTED resection of the nucleus pulposus of the intervertebral disc in our department from March 2016 to September 2018. Another 50 patients aged 50-71 years who underwent fenestration or semi-laminar resection and decompression of the disc nucleus pulposus during the same period were recruited and served as control group. The intraoperative blood loss volume, operation time, postoperative length of hospital stay, pain visual analogue scale (VAS) scores at 1 day, 1 and 3 months postoperatively, and Oswestry dysfunction index (ODI) at 3 months postoperatively, and results of modified MacNab criteria at 6 months postoperatively were used to assess the efficacy of surgery. MRI was performed in 3-6 months after operation to observe the changes of the spinal canal and intervertebral disc protrusion before and after operation.STATA statistics 12.0 was used to perform the statistical analysis. Results No significant difference was seen in age and VAS and ODI scores before operation between the two groups (P>0.05), but the postoperative VAS and ODI scores were significantly decreased than those before surgery (P<0.01). The VAS scores in 1 day and 1 month were significantly lower in the PTED group than the control group (P<0.01), but no such difference was observed in the scores at 3 months postoperatively (P>0.05). The results of modified MacNab criteria at 6 months after surgery indicated that there was no significant difference in the function between the two groups (P>0.05). The PTED group had less intraoperative blood loss and shorter postoperative length of hospital stay than the control group (P<0.01), and no difference in operation time (P>0.05). As shown by MRI,compared with preoperative conditions, the herniation of intervertebral disc disappeared or decreased obviously, and the spinal canal was unobstructed and the area was increased obviously in 3-6 months after operation. Conclusion PTED technique can obtain similar mid-term outcomes as open surgery in the treatment of intervertebral disc herniation in middle-aged and elderly patients. PTED has good short-term effect, less damage, quick recovery and less complications.

Abstract:Objective To explore the relationship between activated partial thromboplastin time (aPTT) and intracoronary thrombus burden in patients with acute myocardial infarction. Methods From January 2011 to December 2013, a total of 424 patients with acute ST-segment elevation myocardial infarction were enrolled, who were admitted to the Emergency Department of Beijing Friendship Hospital affiliated to Capital Medical University and received primary percutaneous coronary intervention (PCI) within 6 hours. According to the findings of coronary artery angiography and the coronary intervention, they were divided into the high thrombus burden (HTB) group (n=199) and the low thrombus burden (LTB) group (n=225). Baseline hematologic indices and thrombus burden were measured on the visit at the Emergency Department. SPSS statistics 19.0 was used to process the data and multivariate logistic regression analysis was employed for comparison between groups. Results Compared with the LHB group, the HTB group had lower average age[(59.4±11.7) vs(61.9±11.8)years], aPTT[(24.9±3.2) vs(26.6±4.0)s], PT [(11.3±0.8) vs(11.5±1.0)s]and LCX proportion[9.5%(19/199) vs 18.0%(40/225)], but higher male proportion[84.3%(168/199) vs 74.3%(167/225)] , white blood cell count[(10.0±3.1)×10⁹ vs(9.3±3.1)×10⁹/L] and RCA proportion [45.2%(90/199) vs 29.8%(68/225)], the differences being statistically significant (all P<0.05). aPTT in the HTB group was significantly lower than that of the LTB group. There was no statistically significant difference between the two groups in smoking status, medication, previous hypertension and diabetes, liver function, kidney function, electrolytes, PTA, AT-Ⅲ, FBG and other indicators (P>0.05). Multivariate logistic regression analysis showed aPTT (OR=1.175,95%CI 1.102-1.252) and RCA (OR=2.783,95%CI 1.409-5.497)as independent predictors for thrombus burden (P<0.01). The area under the receiver operating characteristic curve of aPTT was 0.660 (95%CI 0.608-0.711, P<0.001). The results suggest that the best cut-off value for aPTT excluding high thrombus load was 26.05 with a sensitivity of 53.5% and a specificity of 72.6%. Conclusion Shortened aPTT on admission is significantly related to angiographic thrombus burden in the patients with acute ST-segment elevation myocardial infarction.

Abstract:Objective To explore the roles of dynamic electrocardiography (DCG) combined with echocardiography in the evaluation of cardiac function in patients with preexcitation syndrome. Methods A total of 87 patients with preexcitation syndrome who received Holter monitoring and echocardiography from January 2012 to June 2019 in our hospital were enrolled in this study and served as the study group. And another 87 individuals without identified heart disease who received the two examinations at the same period were subjected to normal control group. The differences in the indices of Holter and echocardiography were compared between the two groups. SPSS statistics 21.0 was used for statistical analysis. Intergroup data comparison was performed using t text or Mann-whitney U test. Results The pulmonary artery diameter [(20.77±2.61) vs (19.94±2.19) mm], left atrial transverse diameter [(32.44±4.86) vs (30.93±3.21) mm], interventricular septal thickness [(10.1±2.37) vs (9.26±1.33) mm], left ventricular diastolic diameter [(44.55±4.33) vs (42.91±4.07) mm] and aortic velocity [(130.91±34.60) vs(118.95±21.42) cm/s] were all significantly larger (P<0.05), but left ventricular ejection fraction was obviously lower [(64.93±5.93)% vs (66.95±5.04)%, P<0.05] in the study group than the control group. There was no significant difference in the indicators of heart rate variability between the two groups. Conclusion Echocardiography can be used as a reference for the diagnosis of preexcitation syndrome related cardiac morphological changes. Further study should be performed for the diagnostic significance of the indicators of heart rate variability by DCG for preexcitation syndrome.

Abstract:Objective To investigate the risk factors of the properties of carotid plaque and the relationship between the carotid plaque properties and the severity of coronary artery disease in patients with coronary heart disease. Methods A total of 127 patients with coronary artery disease confirmed by coronary angiography admitted to our Department of Cardiology or Geriatrics from March 2018 to April 2019 were enrolled in this study. According to the results of carotid artery color Doppler ultrasound, they were divided into unstable plaque group (n=78) and stable plaque group (n=49). The general information, blood indices, Gensini score, and number of lesioned coronary artery were collected, and risk factors affecting the properties of carotid plaque and the relationship between the carotid plaque properties and the severity of coronary artery disease were analyzed. SPSS statistics 22.0 was used to perform the statistical analysis. Student′s t test or Chi-square test was employed for comparison between groups. The risk factors for the properties of carotid plaque were analyzed by binary logistic regression analysis. Results The levels of serum uric acid and homocysteine were (19.87±13.13) and (331.87±60.53)μmol/L, respectively in the unstable plaque group, and (13.40±3.74) and (282.28±49.91)μmol/L in the stable plaque group, with significant differences between the two groups (P<0.05). But no such differences were observed in the levels of fasting blood glucose [(5.76±2.32) vs (5.59±1.79)mmol/L], cystatin C [(0.98±0.24) vs (0.89±0.19)mg/L], serum creatinine[(71.24±14.89) vs (67.43±10.88)μmol/L] and fibrinogen[(3.09±0.73) vs (2.90±0.57)g/L] between the two groups (all P>0.05). The results of binary logistic regression analysis showed serum uric acid was associated with plaque instability (OR=1.020, 95%CI 1.005-1.036; P<0.05). The Gensini score was 41.72±16.26 and 31.80±9.54, and the number of lesioned coronary artery was 1.96±0.79 and 1.51±0.50, respectively in the unstable plaque group and the stable plaque group, with significantly differences between the two groups (P<0.05). Conclusion The increase of serum uric acid level is closely related to the instability of carotid plaque in patients with coronary heart disease. The instability of carotid plaque can be used as an index to predict and evaluate the severity of coronary artery disease in these patients.

Abstract:Objective To explore the risk factors of hemorrhagic transformation (HT) in elderly patients with acute ischemic stroke (AIS) after intravenous thrombolysis. Methods The clinical data of 326 elderly AIS patients undergoing intravenous thrombolysis in our department from January 2016 to March 2019 were retrospectively collected. They were divided into HT group (n=51) and non-HT group (n=275) according to whether HT occurred after intravenous thrombolysis. SPSS statistics 22.0 was used for data analysis. Univariate analysis and multivariate logistic regression were used to analyze the risk factors of HT in elderly patients with AIS after intravenous thrombolysis. Results Univariate analysis showed that atrial fibrillation, positive urinary protein, systolic blood pressure 24h after thrombolysis, blood glucose, international standardized ratio, National Institutes of Health Stroke Scale (NIHSS) score before thrombolysis, NIHSS score 24h after thrombolysis and the time from onset to thrombolysis >3h were significantly higher in the HT group than the non-HT group (P<0.05). Multivariate logistic regression analysis indicated that systolic blood pressure (OR=1.935, 95%CI 1.226-4.162), blood glucose (OR=2.240,95%CI 1.638-5.237), NIHSS score before thrombolysis (OR=2.435, 95%CI 1.805-5.726) and 24h after thrombolysis (OR=3.381,95%CI 2.216-7.250) and thrombolytic time >3h (OR=2.703,95%CI 1.914-6.116) were independent risk factors for HT after intravenous thrombolysis in elderly AIS patients (P<0.05). Conclusion Systolic blood pressure 24h after thrombolysis, blood glucose, NIHSS scores before and 24h after thrombolysis and time from onset to thrombolysis >3h are independent risk factors for HT in elderly patients with AIS after intravenous thrombolysis, and these indicators can provide reference for clinical thrombolysis treatment.

Abstract:Objective To analyze the key points of differential diagnosis between stage Ⅲ pneumoconiosis and secondary tuberculosis with large nodular shadow using high-resolution CT (HRCT) in the elderly with a view to improving the diagnostic accuracy of stage Ⅲ pneumoconiosis in the elderly. Methods A retrospective analysis was made of 43 cases of stage Ⅲ pneumoconiosis and 55 cases of secondary tuberculosis with large nodular shadow in the elderly. The two groups were compared in their general information and imaging characteristics. Statistical analysis was performed using SPSS statistics 22.0. Results As for clinical manifestations, there were significant differences between the two groups in five factors:gender, hemoptysis, chest pain, wheeze, and dyspnea(P＜0.05). As for CT features, there were significant differences between the two groups in 10 factors:bilateral upper lobes, upper left lobe, calcification in the big shadow, cavity, emphysema around the big shadow, miliary shadow in the lung, bronchiectasis, hilar lymph node enlargement,hilar lymph node calcification and calcification of mediastinal lymph nodes(P＜0.05). Conclusions HRCT shows specificity of some degree for stage Ⅲ pneumoconiosis in the elderly, which can improve the diagnostic accuracy if combined with the clinical manifestations.

Abstract:Objective To explore the relationship between neutrophil-to-lymphocyte ratio (NLR) and percutaneous coronary intervention (PCI) in the patients with unstable angina pectoris (UAP). Methods A total of 260 UAP patients admitted to the Department of Cardiology of the First Affiliated Hospital of Henan University of Science and Technology from January 2018 to June 2019 were enrolled in this study. According to the results of coronary angiography, they were divided into PCI group (n=167) and the group without the need for the procedure (n=93). The clinical data were collected and compared between the two groups. SPSS statistics 24.0 was used for data processing. Logistic regression analysis was employed to analyze the risk factors for PCI in UAP patients. Receiver operating characteristic (ROC) curve was plotted to analyze the diagnostic value of NLR for UAP patients who needed PCI. Results There were statistical differences between the two groups in age, gender, history of diabetes mellitus, neutrophil count, levels of total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C) and low-density lipoprotein cholesterol(LDL-C), and NLR (P<0.05). Spearman correlation analysis showed that NLR was positively correlated to the necessity of PCI in UAP patients (r=0.353, P<0.001). Multivariate logistic regression analysis indicated that NLR was independent risk factor for PCI in UAP patients (OR=1.982, 95%CI 1.168～3.362). ROC curve showed that the area under the curve of NLR in the diagnosis of unstable angina requires PCI treatment was 0.719 (95%CI 0.651～0.776). Conclusion NLR can be regarded as one of the predictors for PCI in UAP patients.

Abstract:Objective To investigate the feasibility of dexmedetomidine administered locally for lumbar plexus combined with sciatic nerve block in the elderly patients undergoing hip fracture surgery. Methods Sixty patients (ASAⅡ－Ⅲ) undergoing elective hip fractures surgery in the First Center Hospital of Baoding were randomly assigned into group R (0.4%ropivacaine 50ml for lumbar plexus and sciatic nerve blocks) and group RD (0.4% ropivacaine 50ml containing dexmedetomidine 0.5μg/kg for lumbar plexus and sciatic nerve blocks). The onset time of sensory and motor block, durations of sensory and motor block and duration of analgesia, mean arterial blood pressure (MAP), heart rate (HR) and SpO₂, and occurrences of adverse reactions, such as nausea and vomiting, nerve injury and poisoning of local anesthetic were observed and recorded. SPSS statistics 17.0 was used to analyze the data. Results Compared with group R, the durations of sensory and motor block, and analgesia were significantly longer in group RD (all P<0.05). At 15,30, 45,60 and 90min after administration, the MAP were obviously decreased and HR were remarkably lower in group RD than the corresponding basic values and those in group R (all P<0.05). However, there were no adverse reactions such as hypotension, bradycardia, hypoxemia, nausea and vomiting, nerve injury and local anesthetic poisoning in both groups. Conclusion Dexmedetomidine of 0.5μg/kg combined with ropivacaine for lumbar plexus and sciatic nerve blocks can significantly prolong the duration of block and analgesia, without increasing the incidence of adverse reactions such as bradycardia and hypotension, and can be safely and effectively used for the anesthesia of hip fracture surgery in elderly patients.

Abstract:Objective To analyze the distribution and drug resistance of pathogenic bacteria in respiratory tract of the elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in order to guide rational clinical drug use. MethodsThe clinical data of 93 elderly AECOPD patients who had positive sputum culture results admitted in the Department of Emergency Critical Care Medicine of the Affiliated Hospital of Xuzhou Medical University from December 2014 to June 2019 were collected and retrospectively analyzed. The sputum samples of the patients were tested for pathogenic bacteria and drug susceptibility test to study the distribution and drug resistance of pathogenic bacteria. Results Among the elderly AECOPD patients with positive sputum culture results, there were 55 cases (59.14%) of single infection, including 50 cases (53.76%) of bacterial infection and 5 cases (5.38%) of fungal infection; and 38 cases (40.86%) of mixed infection, including 24 cases (25.81%) of mixed infection of multiple bacteria and 14 cases (15.05%) of bacterial and fungal mixed infection. In the 138 detected pathogens, there were 15 strains of Gram-positive bacteria (10.87%), 103 strains of Gram-negative bacteria (74.64%) and 20 strains of fungi (14.49%). Gram-positive bacteria were mainly Staphylococcus aureus. Gram-negative bacteria were mainly Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, etc. And fungi were mainly Candida albicans, Aspergillus, etc. The drug resistance rates of Staphylococcus aureus in Gram-positive bacteria to penicillin, oxacillin, clindamycin and erythromycin were all 100%, and those to teicoplanin, vancomycin, daptomycin, linezolid, quinupristin and nitrofurantoin were 0%. The drug resistance rates of Gram-negative bacteria to cefazolin and ceftriaxone were all 100%, those to ceftazidime, levofloxacin, ciprofloxacin and cotrimoxazole were larger than 40%, and the sensitivity to tigacycline and polymyxin was higher. Conclusion Respiratory pathogens in the elderly AECOPD patients are mainly Gram-negative bacteria, with Acinetobacter baumannii the most common. There are many drug-resistant bacteria in the detected pathogenic bacteria, so antimicrobial drugs should be reasonably selected according to the results of bacterial culture and drug resistance analysis.

Abstract:Objective To observe the efficacy and safety of levosimendan in the treatment of very elderly patients with acute exacer-bation of chronic heart failure. Methods A total of 47 very elderly patients with acute exacerbation of chronic heart failure admitted to the Zhangzhou Zhengxing Hospital and No.909 Hospital of PLA from January 2016 to February 2019 were recruited in this study. They were randomly divided into control group (conventional treatment, n=23) and treatment group (conventional treatment+levosimendan, n=24). All patients were followed up for at least three months. The results of echocardiography, serum level of N-terminal pro-brain natriuretic peptide (NT-proBNP), New York Heart Association (NYHA) Functional Classification at acute attack, and heart failure readmission during 3-month follow-up were compared between the two groups. SPSS statistics 17.0 was used for data processing. Results There were no statistic differences in systolic blood pressure and heart rate immediately and in 3 month after treatment between the 2 groups (P>0.05). At 5 d and 3 months after treatment, the results of echocardiography revealed that left ventricular ejction fraction were better in the treatment than the control group [(48.6±11.9)% vs (44.5±11.4)%; (47.8±12.1)% vs (43.6±11.7)%, P<0.05]. At the same time point, serum NT-proBNP level was significantly lower in the treatment group than the control group (2437.5±1104.8 vs 2926.3±1248.2 pg/L; 2649.1±1155.6 vs 3 327.8±1 293.7 pg/L, P<0.05). And the treatment group obtained better NYHA class than the control group (P<0.05). During the 3-month follow-up, the readmission rate due to heart failure was obviously lower in the treatment group than the control group (4.2% vs 30.4%, 1 vs 7 cases, P<0.05). Conclusion Levosimendan is effective and safe in the treatment of very elderly patients with acute exacerbation of chronic heart failure.

Abstract:Objective To observe whether titration of recombinant human brain natriuretic peptide (rhBNP) is better than the current fixed-dose method and to evaluate its safety in the treatment of refractory acute decompensated heart failure. Methods Enrolled in the study were a total of 60 patients with acute and chronic decompensated heart failure with left ventricular ejection fraction lower than 35% in NYHA cardiac function grades IVa and IVb. They were randomly divided into two groups:fixed-dose group and titrated-dose group, with 30 in each group. The fixed-dose group was not given a preload, and the rhBNP 0.015μg/(kgmin) was intravenously pumped for 48 hours according to the baseline blood pressure. The titrated-dose group was first loaded with rhBNP 1.5μg/kg and titrated with an initial dose of 0.0075μg/(kgmin), which was increased by 0.0025μg every 15min until the maximum of 0.030μg/(kgmin); or the dose was titratably increased based on the target blood pressure and maintained for 48-96h after the target blood pressure was achieved. Indicators observed included improvement of subjective symptoms, 24-hour cumulative urine volume, systolic blood pressure and mean arterial pressure, heart rate and heart rhythm, aldosterone, serum creatinine and creatinine clearance before and after drug administration. SPSS statistics 18.0 was used for data analysis. The measurement data were expressed as mean±standard deviation (±s), and the t test was used for comparison between groups; the numeration data were expressed as the number of cases (percentage), and the χ² test was used for comparison between groups. Results Compared with the fixed-dose group, the titrated-dose group had more obvious relief of heart failure symptoms, better improvement rate and higher urine volume at the initial 24 hours, greater decrease of NT-proBNP, greater increase in pulmonary artery pressure, and more improved ventricular artery coupling ratio, the differences being statistically significant (P<0.05). Conclusion Titrated dose of rhBNP can relieve the clinical symptoms of acute heart failure faster than the fixed dose, with the safety being not inferior to that of the latter. The efficacy and tolerability are better in the patients with normal or high baseline blood pressure and severe systemic congestion.

Abstract:Objective To investigate the role of glucagon-like peptide-1 (GLP-1) receptor in the lipopolysaccharide(LPS)-induced acute lung injury (ALI) and its mechanism. Methods ALI in rats was induced by intratracheal administration of LPS. A total of 30 rats were randomly divided into 5 groups, with 6 in each:the control group, sham model treated with normal saline (NS); the drug-blank group, sham model treated with liraglutide (2mg/kg); the model group, ALI model treated with NS; the treatment group, ALI model treated with liraglutide (2mg/kg); and the inhibitor group, ALI model treated with liraglutide (2mg/kg) and 3-methyladenine (10mg/kg). Expression of LC3II, Beclin-1, P62, Bax and Bcl-2 were detected by Western blotting. Cell apoptosis was determined by the terminal deoxyribonucleotidyl transferase-mediated deoxyuridine 5-Triphosphate-Digoxigenin nick end labeling (TUNEL) assay. SPSS statistics 20.0 was used for data processing, and one-way analysis of variance and LSD multiple comparisons were used for comparison between groups. Results The expression of LC3II, Beclin-1 and P62 in the model group were 100.0%±5.3%, 100.0%±5.6%, 100.0%±6.1%, respectively. The expression of LC3II and Beclin-1 in treatment group increased respectively to 214.0%±12.3% and 329.0%±33.8%, and that of P62 decreased to 50.0%±7.0% (P<0.01). The control group had a lung injury score of 0.3±0.5, a wet/dry weight ratio (W/D) of 4.08±0.14, a Bax of 100.0%±7.0%, a Bcl-2 of 100.0%±3.6%, and apoptotic cells of 1.0±0.9. In the model group, the lung injury score, wet/dry weight (W/D), expression of Bax and apoptotic cells increased respectively to 4.6±0.8,4.83±0.23,284.0%±25.6% and 42.5±8.2, and expression of Bcl-2 decreased to 63.0%±6.2% (all P<0.01). Compared with the model group, the lung injury score, W/D, expression of Bax and apoptotic cells in treatment group decreased respectively to 2.5±1.0,4.42±0.15,198.0%±24.8% and 17.0±3.4, and the expression of Bcl-2 in treatment group increased to 83.0%±5.3% (all P<0.01). Compared with the treatment group, the lung injury score, W/D, expression of Bax and apoptotic cells in inhibitor group increased respectively to 4.3±0.8, 4.77±0.25,277.0%±25.5% and 39.5±6.2, and expression of Bcl-2 in inhibitor group decreased to 54.0%±5.0% (all P<0.01). Conclusion Activation of GLP-1 receptor significantly alleviates LPS-induced ALI, and the mechanism is associated with the up-regulation of autophagy that prevents cell apoptosis.

Abstract:Objective To investigate the effect of laminarin (Lam) on the protein expression of glucose regulated protein-78 (GRP-78) and cysteine-dependent aspartate-specific protrases 12 (Caspase12) in rat model of myocardial ischemia-reperfusion injury (MI/RI) and whether it has protective effect on rat myocardium. Methods Thirty-two male SD rats were randomly divided into 4 groups:sham operation group, MI/RI group, low- and high-dose Lam treatment groups. The rat MI/RI model was established by left coronary artery ligation. The serum content of creatine kinase isoenzyme MB (CK-MB) was measured by enzyme-linked immunosorbent assay (ELISA), the content of myeloperoxidase (MPO) in the myocardial tissue was measured by colorimetric assay, and the protein expression levels of GRP78, Caspase 12, B-cell lymphoma-2 (Bcl-2) in myocardium was detected by Western blotting. The pathomorphological changes of myocardial tissue were observed by light microscopy. Myocardial infarction area was measured by Evans Blue and 2,3,5-triphenyltetrazolium chloride (TTC) double staining. SPSS statistics 21.0 was used to perform the statistical analysis. Results The low- and high-dose Lam treatment groups had significantly decreased serum level of CK-MB [(72.71±5.63) vs (59.79±9.67) vs (93.74±5.37)U/L], myocardial content of MPO [(58.92±4.88) vs(46.06±5.74) vs(72.66±3.40)U/L] and protein levels of GRP-78 [(0.81±0.01) vs (0.66±0.01) vs (1.13±0.02)] and Caspase 12 [(0.82±0.06) vs (0.62±0.02) vs (1.45±0.10)], but obviously enhanced expression of Bcl-2 [(1.19±1.10) vs (1.41±0.02) vs (1.01±0.04)] when compared with the MI/RI group (all P<0.01). The myocardial tissue damage in the Lam treatment groups was alleviated to different extents than that in the MI/RI group. And the area of myocardial infarction was remarkably reduced in the low-and high-dose Lam treatment groups than the MI/RI group [(55.36±2.47)% vs (46.63±2.10)% vs (38.40±2.07)%, P<0.05]. Conclusion Lam can alleviate MI/RI and exerts protective effect on the injury in rats. The mechanism may be that Lam can inhibit the overexpression of GRP-78, reduce the activation of apoptosis pathway mediated by endoplasmic reticulum stress, down-regulate the apoptosis pathway of Caspase 12 and enhance the expression of Bcl-2, and thus inhibit the apoptosis of cardiomyocytes.

Abstract:Atrial fibrillation (AF) is a common arrhythmia. Currently, catheter ablation is one of the effective treatments and has been widely used in clinical practice. Atrial esophageal fistula is a rare complication of AF catheter ablation but is the most dreadful and deadly one. Therefore, to reduce the risk of its occurrence, we need to fully understand it and take active and effective preventive measures. This article reviews its pathogenesis, risk factors, diagnosis and treatment, and summarizes some of the preventive measures that may be effective at present.

Abstract:Patients with coronary microvascular dysfunction (CMVD) have a poor prognosis. At present, Chinese experts agree that CMVD is divided into CMVD without obstructive coronary artery disease, CMVD with obstructive coronary artery disease, and other types of CMVD. The studies of the first category is deeper and more evidence-based. This paper reviews the new progress in the management of CMVD without obstructive coronary artery disease.

Abstract:Mitochondria constitute an important part of cell infrastructure. They are the main places for energy production and participants in such processes as cell differentiation, cell information transmission and cell apoptosis. Mitochondria in sepsis are damaged in many ways, including hypoxia, damaged respiratory chain, endocrine changes, mitochondrial permeability transition, calcium overload, and mitochondrial DNA damage. Recently, many researchers have studied the methods for mitochondrial repair in sepsis, hoping to find new treatment methods for sepsis patients. This article reviews the mechanism of mitochondrial damage and repair methods in sepsis, providing theoretical basis and research hotspots for the diagnosis and treatment of sepsis.