An Exploratory Pilot Study on the Application of Radiofrequency Ablation for Atrial Fibrillation Guided by Computed Tomography-Based 3D Printing Technology.

Radiofrequency ablation (RFA) is the treatment of choice for atrial fibrillation (AF). Additionally, the utilization of 3D printing for cardiac models offers an in-depth insight into cardiac anatomy and cardiovascular diseases. The study aims to evaluate the clinical utility and outcomes of RFA following in vitro visualization of the left atrium (LA) and pulmonary vein (PV) structures via 3D printing (3DP). Between November 2017 and April 2021, patients who underwent RFA at the First Affiliated Hospital of Xinxiang Medical University were consecutively enrolled and randomly allocated into two groups: the 3DP group and the control group, in a 1:1 ratio. Computed tomography angiography (CTA) was employed to capture the morphology and diameter of the LA and PV, which facilitated the construction of a 3D entity model. Additionally, surgical procedures were simulated using the 3D model. Parameters such as the duration of the procedure, complications, and rates of RFA recurrence were meticulously documented. Statistical analysis was performed using the t-test or Mann-Whitney U test to evaluate the differences between the groups, with a P-value of less than 0.05 considered statistically significant. In this study, a total of 122 patients were included, with 53 allocated to the 3DP group and 69 to the control group. The analysis of the morphological measurements of the LA and PV taken from the workstation or direct entity measurement showed no significant difference between the two groups (P > 0.05). However, patients in the 3DP group experienced significantly shorter RFA times (97.03 ± 28.39 compared to 120.51 ± 44.76 min, t = 3.05, P = 0.003), reduced duration of radiation exposure (2.55 [interquartile range 2.01, 3.24] versus 3.20 [2.28, 3.91] min, Z = 3.23, P < 0.001), and shorter modeling times (7.68 ± 1.03 compared to 8.89 ± 1.45 min, t = 5.38, P < 0.001). 3DP technology has the potential to enhance standard RFA practices by reducing the time required for intraoperative interventions and exposure to radiation.

Evaluating the consistency in different methods for measuring left atrium diameters.

BACKGROUND: The morphological information of the pulmonary vein (PV) and left atrium (LA) is of immense clinical importance for effective atrial fibrillation ablation. The aim of this study is to examine the consistency in different LA diameter measurement techniques. METHODS: Retrospective imaging data from 87 patients diagnosed with PV computed tomography angiography were included. The patients consisted of 50 males and 37 females, with an average age of (60.74 ± 8.70) years. Two physicians independently measured the anteroposterior diameter, long diameter, and transverse diameter of the LA using six different methods. Additionally, we recorded the post-processing time of the images. Physician 1 conducted measurements twice with a one-month interval between the measurements to assess intra-rater reliability. Using the intraclass correlation coefficient (ICC), the consistency of each LA diameter measurement by the two physicians was evaluated. We compared the differences in the LA diameter and the time consumed for measurements using different methods. This was done by employing the rank sum test of a randomized block design (Friedman M test) and the q test for pairwise comparisons among multiple relevant samples. RESULTS: (1) The consistency of the measured LA diameter by the two physicians was strong or very strong. (2) There were statistical differences in the anteroposterior diameter, long diameter, and transverse diameter of LA assessed using different methods (χ2 = 222.28, 32.74, 293.83, P < 0.001). (3) Different methods for measuring the diameters of LA required different amounts of time (χ2 = 333.10, P < 0.001). CONCLUSION: The results of left atrium (LA) diameter measurements conducted by different physicians were found to be reliable. However, the LA diameters obtained through various techniques exhibited variations. It was observed that measuring LA long diameters using only the VR (volume rendering) picture was the most clinically applicable method.

Abnormal Expression of YAP Is Associated With Proliferation, Differentiation, Neutrophil Infiltration, and Adverse Outcome in Patients With Nasal Inverted Papilloma.

BACKGROUND: Nasal inverted papilloma (NIP) is a common benign tumor. Yes-associated protein (YAP) is the core effector molecule of the Hippo pathway, which regulates the proliferation and differentiation of airway epithelium. While its role in proliferation may be connected to NIP formation, no definitive association has been made between them. METHODS: We compared the difference of YAP expression and proliferation level between the control inferior turbinate, NP (nasal polyps), and NIP groups. In addition, we further used PCR, immunofluorescence, and immunohistochemistry to investigate YAP's role in the proliferation and differentiation of the nasal epithelium and inflammatory cell infiltration, correlating them with different grades of epithelial remodeling. We further used an IL-13 remodeling condition to investigate YAP's role in differentiation in an in vitro air-liquid interface (ALI) human nasal epithelial cell (hNECs) model. Finally, we also explored the correlation between YAP expression and clinical indicators of NIP. RESULTS: The expression of YAP/active YAP in the NIP group was significantly higher than that in the NP group and control group. Moreover, within the NIP group, the higher grade of epithelial remodeling was associated with higher YAP induced proliferation, leading to reduced ciliated cells and goblet cells. The finding was further verified using an IL-13 remodeling condition in differentiating ALI hNECs. Furthermore, YAP expression was positively correlated with proliferation and neutrophil infiltration in NIP. YAP expression was also significantly increased in NIP patients with adverse outcomes. CONCLUSION: Abnormal expression of YAP/active YAP is associated with proliferation, differentiation, neutrophil infiltration, and adverse outcome in NIP and may present a novel target for diagnosis and intervention in NIP.

Using the internet search data to investigate symptom characteristics of COVID-19: A big data study.

OBJECTIVE: Analyzing the symptom characteristics of Coronavirus Disease 2019(COVID-19) to improve control and prevention. METHODS: Using the Baidu Index Platform (http://index.baidu.com) and the website of Chinese Center for Disease Control and Prevention as data resources to obtain the search volume (SV) of keywords for symptoms associated with COVID-19 from January 1 to February 20 in each year from 2017 to 2020 and the epidemic data in Hubei province and the other top 9 impacted provinces in China. Data of 2020 were compared with those of the previous three years. Data of Hubei province were compared with those of the other 9 provinces. The differences and characteristics of the SV of COVID-19-related symptoms, and the correlations between the SV of COVID-19 and the number of newly confirmed/suspected cases were analyzed. The lag effects were discussed. RESULTS: Comparing the SV from January 1, 2020 to February 20, 2020 with those for the same period of the previous three years, Hubei's SV for cough, fever, diarrhea, chest tightness, dyspnea, and other symptoms were significantly increased. The total SV of lower respiratory symptoms was significantly higher than that of upper respiratory symptoms (P＜0.001). The SV of COVID-19 in Hubei province was significantly correlated with the number of newly confirmed/suspected cases (r confirmed = 0.723, r suspected = 0.863, both p < 0.001). The results of the distributed lag model suggested that the patients who searched relevant symptoms on the Internet may begin to see doctors in 2-3 days later and be confirmed in 3-4 days later. CONCLUSION: The total SV of lower respiratory symptoms was higher than that of upper respiratory symptoms, and the SV of diarrhea also increased significantly. It warned us to pay attention to not only the symptoms of the lower respiratory tract but also the gastrointestinal symptoms, especially diarrhea in patients with COVID-19. Internet search behavior had a positive correlation with the number of newly confirmed/suspected cases, suggesting that big data has an important role in the early warning of infectious diseases.

CT-pathologic correlation in lung adenocarcinoma and squamous cell carcinoma.

Distinguishing lung adenocarcinoma from squamous cell carcinoma (SCC) is clinically important. Computed tomography (CT) scan is an economical, effective, noninvasive, commonly available, and quick diagnostic way for lung cancer. In this study, we aim to compare the CT characteristics in adenocarcinoma and SCC.Data from 275 cases (259 adenocarcinoma and 16 SCC) were retrospectively compared. CT characteristics, including lesion size and shape, single/multifocal lesions, location of the tumor, the margin of lobes, whether the lesion had deep lobulated margin, bronchial cut-off sign, signs of dilated bronchial arteries, signs of vascular bundle thickening, signs of short burrs, spinous processes, and pleural indentation, were compared in 148 cases (137 adenocarcinoma and 11 SCC).Patients with adenocarcinoma were more likely to be female (44.2% vs 25.0%, P = .017). Compared with SCC, adenocarcinomas were more likely to have deep lobulated margin (81.0% vs 54.5%, P = .038), less likely to have smooth lobes margin (2.7% vs 83.3%, P < .001), more likely to have vascular bundle thickening (37.2% vs 0, P = .016) and pleural indentation (59.9% vs 18.2%, P = .01), and marginally less likely to have dilated bronchial arteries (17.5% vs 45.5%, P = .064). No significant difference was observed regarding to characteristics, including tumor size, location of the tumor, signs of bronchial cut-off, dilated bronchial arteries, short burrs, or spinous processes.CT scan has the potential to help to distinguish lung adenocarcinoma and SCC in a fast and commonly available way. CT could be a rough but fast way to diagnosis, and may thus shorten the waiting time to treatment and allow more time for clinicians, patients, and their families to prepare for future treatment.

Using integrated problem- and lecture-based learning teaching modes for imaging diagnosis education.

BACKGROUND: There are two parts included in traditional imaging diagnosis teaching: theoretical lessons and experimental lessons. Most of the time, the experimental lesson is a review of the theoretical lesson. The teacher is the centre of the course and students are passive learners. Thus, in this study we included the patient problem of the imaging centre in our imaging diagnosis education. The traditional theoretical lessen was used to discuss prior knowledge, the discussion and analysis of patient problems was arranged under class, and the experimental lesson was used to synthesize and test the newly acquired information. The aim of this study is to determine whether or not integration of problem- and lecture-based learning teaching modes in imaging diagnosis education was associated with a good teaching effect. Forty-six of sixty students (76.7%) like integrated problem- and lecture-based learning teaching mode and 53 of 60 students (88.3%) think that integrated problem- and lecture-based learning teaching mode can make their ability of self-study be improved. METHODS: Sixty students participated in a prospective study with a two-phase cross-over design. All of the students were divided into 2 groups of 30 each. In the first term, the first group participated in an integration of the problem- and lecture-based learning teaching mode, whereas students in the second group underwent the lecture-based learning teaching mode alone. During the second term, the teaching modes were exchanged between the two groups. A close-exam and survey were used to evaluate the teaching effect, and the data were analysed means of analysis of variance with a two-phase cross-over design and a χ2 test with a 2-tailed α of 0.05. RESULTS: There was a statistically significant difference in the test scores between the integration of the problem- and lecture-based learning teaching mode and the lecture-based learning teaching mode alone (P < 0.05). The integration of problem- and lecture-based learning teaching mode was well-appraised. CONCLUSION: Integration of the problem- and lecture-based learning teaching modes in teaching imaging diagnosis education resulted in a good teaching effect.

Application of esophageal irradiation stents coated with 125I particles in advanced esophageal cancer.

PURPOSE: The current study was designed to investigate the primary efficacy of esophageal irradiation stents coated with 125I particles in the treatment of elderly patients with advanced esophageal cancer. METHODS: Forty-three elderly patients with advanced esophageal cancer were treated with esophageal stents in the First Affiliated Hospital of Xinxiang Medical University between September 2009 and December 2010. Patients were randomly divided into group A (N=18), treated with irradiation stents, and group B (N=25), treated with ordinary stents. There were no significant intergroup differences in age, lesion length, degree of stenosis, or cancer stage. The stent implantation success rate, relief of dysphagia and complication rate, and survival were assessed. RESULTS: The stent implantation success and short-term dysphagia relief rates were 100.0% in both groups. The mean survival time was 9.8 months and 4.8 months in groups A and B, respectively (p<0.01). However, no significant difference in pain (5/18) or esophageal restenosis (7/25) was found (both p>0.05). CONCLUSION: Dysphagia was relieved and survival was prolonged in advanced esophageal cancer cases treated with 125I particle-coated esophageal stents. This method may be superior to the traditional stents method.

Platelet-derived growth factor-ß expression in rabbit models of cerebral vasospasm following subarachnoid hemorrhage.

Subarachnoid hemorrhage (SAH), one of the serious types of stroke incurred by bleeding into the space surrounding the brain, occurs when brains are deprived of oxygen by various factors, particularly an interruption to the blood supply or a ruptured aneurysm. Cerebral vasospasm (CVS) is one of the most common complications of SAH. It has been proposed that platelet­derived growth factor (PDGF) is involved in CVS. The aim of the present study was to analyze expression of PDGF in rabbit models of CVS. Post-SAH CVS rabbit models were created using endovascular puncture and employed to analyze the expression patterns of PDGF by enzyme-linked immunosorbent assay and immunohistochemistry. The results indicated that the creation of the rabbit model of CVS induced using endovascular puncture was successful and demonstrated the double phase changes observed in human CVS. The acute stage started at 12 h post-SAH with narrowing of the vascular lumen diameter. This narrowing appeared again on the seventh day in delayed CVS alongside increased thickness of vessel walls. PDGF-ß expression was observed in vascular smooth muscle cells of the rabbit models. PDGF-ß was expressed as early as 3 h post-SAH, it was evident after 1 day and reached a peak in 7 days, suggesting that PDGF-ß is involved in the early stages of CVS. In the current study, it was confirmed that PDGF-ß expression was present in the rabbit models of CVS, which may aid the elucidation of the pathogenesis of CVS, and also provide useful information for diagnosis and treatment of CVS.

Magnetic resonance image manifestations of the atypical meningioma.

Through retrospective analysis of 13 cases of magnetic resonance image (MRI) manifestations of atypical meningiomas confirmed by operation and pathology in the First Affiliated Hospital of Xinxiang Medical University, the objective of this study was to evaluate the diagnostic value of MRI in order to improve the accuracy rate of preoperative diagnosis. In this retrospective analysis of MRI findings for atypical meningiomas in First Affiliated Hospital of Xinxiang Medical University from January to July in 2012, the location, morphology and tumor signals and other tumor imaging characteristics were covered. In 13 cases of atypical meningioma patients of this group, most tumors were located at typical sites (10/13), mainly the falx cerebri, parasagittal, convexity, saddle area. Only two cases were at atypical locations, 1 in the cerebellar hemisphere and 1 in a lateral ventricle. Most of the tumors showed T1 and T2 isointensity signals, and necrosis, calcification, and peritumoral edema were always featured. DWI showed isointensity in 11 cases (11/13), and hyperintensity in 2. Some 9 cases had dural tail signs, 12 had accurate positioning (12/13), and 2 were postoperative recurrences. MRI has high value in the diagnosis of atypical meningiomas, with important roles in early clinical diagnosis, treatment and prognosis evaluation.