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Aim To explore the safety and efficacy of a novel strategy (bi-atrial linear catheter ablation guided by electrophysiological mapping) for persistent atrial fibrillation (PeAF) treatment. Methods 83 patients with PeAF were enrolled for evaluation of ablation strategy. 43 patients were subjected to pulmonary vein isolation (PVI) strategy (PVI group). 40 patients were subjected to bi-atrial linear ablation strategy guided by electrophysiological mapping (PVI, left atrial BOX ablation, coronary sinus endocardial linear ablation, tailored left atrial anterior wall linear ablation, mitral isthmus linear ablation with necessary ethanol infusion into the vein of Marshall, right atrial posterior wall linear ablation and cavo-tricuspid isthmus ablation) (linear ablation group). Patients were followed up every 3 months. Results During a median follow-up of 12 (4–16) months, freedom from atrial fibrillation/atrial tachycardia recurrence was 87.5% in the linear ablation group and 65.1% in the PVI group ( P  < 0.01). A Cox regression multivariate analysis revealed that ablation strategy group (tailored bi-atrial linear ablation) (HR 0.33, 95% CI 0.12–0.91, P  = 0.03) was the only independent predictor of recurrence. Conclusion Tailored bi-atrial linear ablation strategy guided by electrophysiological mapping resulted in improved outcomes without compromising safety for patients with PeAF.

Objective Ablation index (AI) is an effective ablation quality marker. Impedance is also an important factor for lesion formation. The present study evaluated the influence of the baseline impedance in the effect of ablation for atrial fibrillation (AF) guided by AI. Methods This was a retrospective study. 101 patients with paroxysmal AF (PAF) were enrolled. All patients underwent radiofrequency ablation guided by the same AI strategy. The ablation strategy was pulmonary vein (PV) isolation with non-PV triggers ablation. The baseline impedance of the ablation points was recorded. The patients were followed up every 3 months or so. Results During a median follow-up of 12 (4–14) months, freedom from AF/atrial tachycardia recurrence were 82.2%. No difference existed in baseline characteristics between the success group and the recurrence group. The average baseline impedance was 124.3 ± 9.7 Ω. The baseline impedance of the ablation points in success group was lower compared to the recurrence group (122.9 ± 9.4 vs. 130.5 ± 8.8 Ω, P  < 0.01). The ratio of impedance drop in the success group was higher than the recurrence group ([8.8 ± 1.4]% vs. [8.1 ± 1.2]%, P  = 0.03). Multivariate analysis revealed that baseline impedance, PAF duration and AI were the independent predictors of AF recurrence. The cumulative free of recurrence rate of low-impedance group (≤ 124 Ω, n = 54) was higher than that of high-impedance group. Conclusion Baseline impedance correlates with clinical outcome of radiofrequency ablation for PAF guided by AI. Higher impedance in the same AI strategy may result in an ineffective lesion which probably causes recurrence.

With the continuous progress of our modern science and information technology, network computer distance teaching has gradually become an indispensable part of our school education. In view of the major shortcomings of the current network physical education teaching system, such as the isolation of information resources and the difficulty of updating, the comprehensive research and application of network education information grid management technology and education metadata processing model are established. In the research and analysis, this paper selects 235 network teaching model involved in the sample survey, and through the survey of network teaching mode and traditional teaching mode multimedia, non-linear, independent comparative analysis, from the comparative results show that the network teaching mode is superior to the traditional teaching mode, not only can promote the development of computer teaching mode, but also can improve computer teaching effect. Through the investigation, it is found that both teachers and students have more than 85% recognition of the network teaching mode, which provides a guarantee for the network teaching mode.

The clinical application of the frailty phenotype and frailty index still has some limitations, and whether the classification of frailty based on metabolites is beneficial to the management of the frailty population remains unclear. This study analyzed 160,407 UK Biobank participants to define frailty subtypes using metabolic profiles. Based on 251 biomarkers, machine learning identified 11 key metabolites, leading to four novel frailty subtypes. Subtypes III and IV, characterized by adverse metabolic features such as high GlycA and low LA/FA, were designated as high-risk groups. These subtypes showed significantly increased risks for 13 chronic diseases and all-cause mortality compared to lower-risk subtypes. Adherence to a healthy diet was associated with risk reduction in the high-risk groups. These findings demonstrate the heterogeneity of frailty and suggest that metabolite-based subtyping could improve prognostic precision and guide targeted dietary interventions in clinical practice.

Atrial fibrillation (AF) is the most common cardiac arrhythmia at the clinic. Recent GWAS identified several variants associated with AF, but they account for <10% of heritability. Gene-gene interaction is assumed to account for a significant portion of missing heritability. Among GWAS loci for AF, only three were replicated in the Chinese Han population, including SNP rs2106261 (G/A substitution) in ZFHX3, rs2200733 (C/T substitution) near PITX2c, and rs3807989 (A/G substitution) in CAV1. Thus, we analyzed the interaction among these three AF loci. We demonstrated significant interaction between rs2106261 and rs2200733 in three independent populations and combined population with 2,020 cases/5,315 controls. Compared to non-risk genotype GGCC, two-locus risk genotype AATT showed the highest odds ratio in three independent populations and the combined population (OR=5.36 (95% CI 3.87-7.43), P=8.00×10-24). The OR of 5.36 for AATT was significantly higher than the combined OR of 3.31 for both GGTT and AACC, suggesting a synergistic interaction between rs2106261 and rs2200733. Relative excess risk due to interaction (RERI) analysis also revealed significant interaction between rs2106261 and rs2200733 when exposed two copies of risk alleles (RERI=2.87, P<1.00×10-4) or exposed to one additional copy of risk allele (RERI=1.29, P<1.00×10-4). The INTERSNP program identified significant genotypic interaction between rs2106261 and rs2200733 under an additive by additive model (OR=0.85, 95% CI: 0.74-0.97, P=0.02). Mechanistically, PITX2c negatively regulates expression of miR-1, which negatively regulates expression of ZFHX3, resulting in a positive regulation of ZFHX3 by PITX2c; ZFHX3 positively regulates expression of PITX2C, resulting in a cyclic loop of cross-regulation between ZFHX3 and PITX2c. Both ZFHX3 and PITX2c regulate expression of NPPA, TBX5 and NKX2.5. These results suggest that cyclic cross-regulation of gene expression is a molecular basis for gene-gene interactions involved in genetics of complex disease traits.

PR interval variations have recently been associated with an increased risk of long-term atrial fibrillation (AF), heart block and all-cause mortality. Genome-wide association studies have linked the PR interval with several common variants in the TBX5 gene. Several variants in the TBX5 gene, including rs7312625 and rs883079, have been associated with AF. The purpose of this study was to determine the association of single-nucleotide polymorphisms (SNPs) in the TBX5 gene, rs7312625 and rs883079, with AF in Chinese Han patients. In this case-control association study, large cohorts of AF patients (n = 1132) and controls (n = 1206) were recruited from different hospitals. The genotyping was performed using a Rotor-Gene TM 6000 high-resolution melt system. Rs7312625, rs3825214 and rs883079 were analyzed. We found that SNP 3825214 was significantly associated with AF (P-obs = 0.002, odds ratio [OR] = 0.82), and lone AF (P-obs = 6.77x10-5, odds ratio [OR] = 0.71). SNP rs7312625 was significantly associated with lone AF (P-obs = 0.015, odds ratio [OR] = 1.27), although its association with AF was not significant. No significant association of SNP rs883079 with AF or lone AF was observed. Thus, we analyzed the interaction among these three loci. We demonstrated significant interaction among rs3825214, rs7312625 and rs883079. Four-locus risk alleles showed the highest odds ratio in combined rs3825214 and rs7312625 (P-obs<0.0001, odds ratio [OR] = 2.21). Six-locus risk alleles showed the highest odds ratio in combined rs3825214, rs7312625 and rs 883079(P-obs<0.0001, odds ratio [OR] = 2.35). Significance was established with the trend test (P<0.0001). For the first time, we report the strong association of SNP rs3825214 in the TBX5 gene with AF and lone AF in a Chinese Han population. Rs7312625 was significantly associated with lone AF, and snp-snp interaction increased the risk of atrial fibrillation. Our data might provide new insights into understanding AF pathogenesis and designing novel genetic therapies for AF patients.

A prolonged PR interval is a sign of increased risk of cardiac arrhythmia. Recent genome-wide association studies found that the single-nucleotide polymorphism (SNP) rs3825214 in T-box 5 (TBX5) was positively associated with PR interval, QRS duration, QT interval, and common arrhythmia disorders such as atrial fibrillation (AF) and advanced atrioventricular block. However, other independent replication studies are required to validate the result. This study assessed associations between rs3825214 and ECG parameters, AF, and ventricular tachycardia (VT) in a Chinese Han population. To assess the association between rs3825214 and AF and VT, we carried out case-control association studies with 692 AF patients (including 275 lone AF patients), 235 VT patients, and 856 controls. Genotyping was performed using a Rotor-Gene TM 6000 High Resolution Melt system. Statistical analyses of associations were adjusted for potential confounding factors. A moderate association was detected between rs3825214 and AF (P(adj) = 0.036, OR = 0.79) and a highly significant association was detected between the G allele of rs3825214 and lone AF (P(adj) = 0.001, OR = 0.65; genotypic P = 3.75×10⁻⁴ with a dominant model). We also found that rs3825214 showed a significant association with atrial-ventricular block (AVB; P = 0.028; P(adj) = 0.035, OR = 0.494). Our results indicate that rs3825214 conferred a significant risk of lone AF in this Chinese Han population.

Off-line high-power tests of the fundamental power couplers prior to their on-line operations are of importance for ensuring their operating reliability and stability. To test the couplers using a limited power supply effectively, a movable standing wave (SW) resonant test system with an extraordinary power gain has been developed at Institute of Modern Physics, Chinese Academy of Sciences (IMP, CAS). The system consists of a movable resonator having two movable shorts for the enhancement and movement of the SW field, and a tunable secondary coupler for feeding power into the resonator without reflection. The proof-of-principle structure of the system has been built and tested both at the low-power and at the high-power levels. The low-power test demonstrates that the moving range of the SW resonant field is over half a wavelength which ensures that the fundamental couplers can be tested by SW field at all reflected phases, and the system can provide a power gain ranging from 50 to 94, corresponding to 200–376 (4×50–4×94) of power gain in the case of traveling wave resonant ring system. Two types of multipacting inside the couplers were observed during the high-power tests and the mechanism of their influences on the power gain was analyzed. This movable and high-power-gain solution can be beneficial for the promotion of SW resonant test systems for fundamental couplers.

Atrial fibrillation (AF) is the most common cardiac rhythm disorder at the clinical setting and accounts for up to 15% of all strokes. Recent genome-wide association studies (GWAS) identified two single nucleotide polymorphisms (SNPs), rs2106261 and rs7193343 in ZFHX3 (zinc finger homeobox 3 gene) and rs13376333 in KCNN3 (encoding a potassium intermediate/small conductance calcium-activated channel, subfamily N, member 3) that showed significant association with AF in multiple populations of European ancestry. Here, we studied a Chinese Han, GeneID cohort consisting of 650 AF patients and 1,447 non-AF controls to test whether the GWAS findings on ZFHX3/KCNN3 and AF can be expanded to a different ethnic population. No significant association was detected for rs7193343 in ZFHX3 and rs13376333 in KCNN3. However, significant association was identified between rs2106261 in ZFHX3 and AF in the GeneID population for both allelic frequencies (P = 0.001 after adjusting for covariates of age, gender, hypertension, coronary artery disease, and diabetes mellitus; OR = 1.32), and genotypic frequencies assuming either an additive or recessive model (OR = 1.29, P = 0.001 and OR = 1.77, P = 0.00018, respectively). When only lone AF cases were analyzed, the association remained significant (OR = 1.50, P = 0.001 for allelic association; OR = 1.45, P = 0.001 for an additive model; OR = 2.24, P = 0.000043 for a recessive model). Our results indicate that rs2106261 in ZFHX3 confers a significant risk of AF in a Chinese Han population. The study expands the association between ZFHX3 and AF to a non-European ancestry population and provides the first evidence of a cross-race susceptibility of the 16q22 AF locus.

Patients with atrial fibrillation (AF) are prone to complications such as heart failure with preserved ejection fraction (HFpEF), which accelerates the progress of the disease and can lead to death. It is of great practical importance to predict the onset timing and probability of HFpEF, which can guide the personalized treatment of patients with AF and improve their survival rate. However, there are no models for predicting HFpEF in patients with AF at present. A multi-label learning prediction model based on expert knowledge of disease duration is proposed in this paper to achieve accurate prediction of HFpEF in patients with AF. First, the expert knowledge of the relationship between the duration of disease progression and outcome is adopted to divided the duration of AF disease into different periods. Next, multi-label decision tree models were used to build different multi-label prediction models for each stage. With the multi-label design, the model can learn the intrinsic correlation between different labels and achieve dual-task prediction of HFpEF attack time and probability. Finally, the results from different periods were fused and output. The proposed method considers the time dependence of medical data and the development pattern of the disease, which realizes 0.0352 hloss, 0.8571 micro-F1 score, and 0.90 average micro-AUC. The experimental results show that the proposed model achieved better prediction of onset time and outcomes in HFpEF patients, which will help the prognosis and personalize the treatment of patients.