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Objective * To investigate the occurrence of left atrial spontaneous echo contrast (LA SEC) both before and after left atrial appendage closure (LAAC) in the atrial fibrillation (AF) patients, and its relationship with device-related thrombus (DRT) and clinical prognosis. Methods * This study was a retrospective, cross-sectional study. A total of 126 nonvalvular AF patients receiving LAAC with LAmbre and completing transesophageal echocardiography (TEE) review were enrolled from August 2018 to December 2020 in Shanghai Pudong New Area Zhoupu Hospital, Shanghai University of Medicine & Health Sciences. The proportion of AF patients with LA SEC was 19.8% (25/126) before LAAC. The AF patients were divided into LA SEC group (n=25) and non-LA SEC group (n=101), and the clinical data, LAAC-related data, and perioperative complications were analyzed. TEE review time median was 72 d after LAAC. The patients were redivided into LA SEC group (n=58) and non-LA SEC group (n=68) for analysis. The average follow-up was (12±6) months. The incidence of DRT was compared, and the incidences of ischemic stroke and cerebral hemorrhage events were followed up. Results * Before LAAC, the proportion of oral anticoagulation was low, the left atrium diameter and the left ventricle diameter increased, and the left ventricle ejection fraction decreased in the LA SEC group. The incidence of LA SEC after LAAC reviewed by TEE increased to 46.0%, including 38.1% (48/126) new occurred LA SEC patients, and 40.0% (10/25) LA SEC patients with LA SEC. The redivided LA SEC group had longer left atrial appendage orifice diameter and lower application rate of anticoagulant treatment regimen. There was no significant difference in the incidence of death, ischemic stroke/transient ischemic attack, and cerebral hemorrhage between the two groups (all P>0.05). Conclusion * The AF patients undergoing LAAC with LA SEC before operation are characterized by low anticoagulation ratio, left atrium and left ventricle enlargement, and decreased left ventricle ejection fraction. After LAAC with LAmbre, the LA SEC patients diagnosed by TEE review have longer left atrial appendage ostium diameter and lower anticoagulant treatment regimen ratio. LASEC does not affect the clinical prognosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical characteristics and prognosis of coronavirus disease 2019 (COVID-19) patients with Omicron variant combined with atrial fibrillation (AF)., Methods: From March 23, 2022 to May 15, 2022, 2 675 aged ≥ 50 years old COVID-19 patients with AF were admitted to Zhoupu Hospital, the designated hospital for COVID-19 in Shanghai. Patients were divided into mild symptoms group, normal group, and serious/critical group according to the symptoms. The clinical data, imaging examination and laboratory results and prognosis of the three group patients were compared., Results: The median age of 2 675 COVID-19 patients was 69.0 (60.0, 81.0) years old, the incidence of AF was 5.05% (135/2 675), the age range of AF patients were from 55 to 101 years old, with a median age of 84.0 (74.0, 89.0), and the number of mild symptoms, normal, serious/critical patients were 68, 30, 37, respectively, including 9 of serious and 28 of critical patients. In the serious/critical patients, aged 55-75 years old accounted for 43.2%, the rate of 2019 novel coronavirus vaccination was 32.4%. The identified new-onset AF was the highest among the three groups, but the rate of persistent AF was the highest in the mild symptoms group (58.8%). The severe/critical group complicated with fever (29.7%), hepatic insufficiency (13.5%), renal insufficiency (46.0%), type 2 diabetes (46.0%), and heart failure were higher in NYHA classification [compared with the mild symptoms and normal group (score): 1.8±1.1 vs. 1.1±0.8, 1.2±0.7, respectively, all P < 0.05]. In term of laboratory examinations, C-reactive protein (CRP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were significantly higher in serious/critical patients compared to the mild symptoms and normal groups [CRP (mg/L): 27.2 (6.0, 60.8) vs. 7.6 (3.1, 19.3), 12.8 (4.9, 26.3), ALT (U/L): 31.3±15.4 vs. 15.4±9.3, 19.3±11.7, AST (U/L): 78.0±21.7 vs. 34.7±15.6, 38.1±24.4, all P < 0.05]. The hemoglobin (Hb) and albumin (ALB) levels were significantly lower than those in the mild symptoms and normal groups [Hb (g/L): 105.3±22.5 vs. 125.8±25.4, 123.0±20.4, ALB (g/L): 33.7±6.0 vs. 39.0±5.5 and 39.6±13.1, all P < 0.05]. In addition, MB isoenzyme of creatine kinase (CK-MB) was significantly higher in the serious/critical group than that in the mild symptoms group [μg/L: 2.5 (1.5, 3.4) vs. 2.2 (1.2, 2.8), P < 0.05]. In terms of the treatment, the percentage of antiplatelet agents and low-molecular heparin ratio compared among the three groups were statistically significant, with the serious/critical group using the lowest percentage of antiplatelet agents (27.0%) and a higher percentage of low-molecular heparin usage than that in mild symptoms group [81.1% (30/37) vs. 51.5% (35/68), P < 0.05]. In terms of prognosis, the mortality of patients with AF was 18.5% (25/135), all of whom were critical ill, including 32.0% (8/25) with cerebral embolism, pulmonary embolism and cerebral hemorrhage. Among them, 40.0% (10/25) died of multiple organ failure (40.0% combined with gastrointestinal hemorrhage), 20.0% (5/25) died of heart failure, and 12.0% (3/25) died of respiratory failure; while there were no death cases recorded in the mild symptoms, normal group and 9 serious patients., Conclusions: The serious/critical patients infected with COVID-19 Omicron variant with AF, have a worse prognosis and high mortality. Multiple organ failure, heart failure, sudden cardiac death, respiratory failure and embolic disease are the major causes of death.

The ecological corridors considering bird movement characteristics and habitat requirements would mitigate species extinction caused by habitat loss or habitat fragmentation and facilitate species gene dispersal and exchange. These functions may in turn benefit urban residents' physical and mental health as well as appreciation of real estates. Nonetheless, main ecological corridor construction methods developed by foreign scholars have not internally considered the movement and habitat characteristics of birds, while corridor research for birds by domestic scholars have focused on explorations of foreign technical methods yet lacked enough knowledge on studied birds' characteristics. Therefore, there is still much room for improvement in the study of urban ecological corridor construction from the perspective of birds. Based on the analyses of domestic and foreign related research from 1975 to 2020, we identified seven corridor construction methods and three corridor optimization methods within which bird ecology can be integrated. The advantages, drawbacks, and applicable scenarios of all the methods were explored accordingly. Finally, we argued that the develop-ment of computational models, which could not only combine bird species' observation data and spatial movement data with landscape structures but could also possess efficient computation power as well as simulate corridor's ecological benefits, would be a trend for constructing ecological corridor for birds.

Objective: To investigate the tribology characteristics of two ceramic materials in vitro:feldspathic glass-ceramic (veneer porcelain) and lithium disilicate glass-ceramic (heat-pressed ceramic), and to evaluate the wear resistance of different ceramic materials from the dynamic chewing perspective., Methods: Wear tests were performed in simulated oral environment with stainless steel ball antagonists (r = 3 mm), veneer porcelain (CERAMCO 3) and heat-pressed ceramic (IPS e.max Press HT type) in the chewing simulator. The tribological tests were carried out under artificial saliva lubrication condition in room temperature with a vertical load of 10 N for 1.2×10(6) cycles (f = 1.5 Hz, uniform circular motion, revolving speed = 90 r/min, radius = 0.5 mm). The wear volumes were measured using three-dimensional profiling, and surface microscopic morphology were observed using scanning electron microscopy at time point of 200 000, 400 000, 600 000, 800 000, 1 000 000, and 1 200 000 cycles., Results: In a simulated oral environment, the wear rates of veneer porcelain were (0.001 20 ± 0.00 018) , (0.000 10 ± 0.000 03) , (0.000 50 ± 0.000 05), (0.000 10 ± 0.000 02) , (0.004 10 ± 0.000 38) , and (0.019 00 ± 0.003 53) (×10(-4) mm(3)/cycles) at 200 000, 400 000, 600 000, 800 000, 1 000 000, 1 200 000 cycles. The wear rates of heat-pressed ceramic were (0.139 50 ± 0.030 94), (0.124 40 ± 0.031 20), (0.054 80 ± 0.005 38), (0.038 80 ± 0.006 10), (0.011 10 ± 0.003 75), (0.198 90 ± 0.045 80) (×10(-4) mm(3)/cycles) at 200 000, 400 000, 600 000, 800 000, 1 000 000, 1 200 000 cycles. Three stages were observed in the wear loss process of the two materials: running-in stage, steady wear stage and severe wear stage. In running-in and steady wear stage, the shallow wear tracks of veneer porcelain were produced by the fatigue effect.While in severe wear stage, the wear tracks turned into ploughing. In running-in stage, the surface of heat-pressed ceramic was characterized by dense and shallow ploughing. In steady wear stage, the wear tracks turned into flake peeling produced by fatigue effect. At last, the whole layer was worn off by the effects of ploughing., Conclusions: In a simulated oral environment, the wear rate and wear loss of heat-pressed ceramic are greater than that of veneer porcelain.

Objective: To determine the quantitative changes of choroidal thickness in central serous chorioretinopathy., Methods: Cross-sectional study. Twenty-three patients with unilateral central serous chorioretinopathy (CSC) in acute and chronic stages were diagnosed after fluorescein angiography, indocyanine angiography and enhanced depth imaging optical coherence tomography (EDI OCT). EDI OCT scan across the fovea was performed in each eye and the result was compared with that from an age-, sex-matched and spherical equivalent-matched control subject. Subfoveal thickness of choroid was calculated by a onboard software in HRA2., Results: Choroidal thickness in the CSC eyes and the fellow eyes was (464.43 ± 97.15) µm and (399.91 ± 124.01) µm, respectively. No significant difference between the two groups (t = 4.653, P < 0.05). Choroidal thickness was (313.09 ± 70.67) µm in the control group. There was statistically significant difference in thickness between the CSC group and the control group (t = 5.077, -2.085; P < 0.05). Choroidal thickness in the fellow eyes with choroidal vascular hyperpermeability was (506.44 ± 75.66) µm, which was differed significantly (t = 4.749, P < 0.05)from the non-hypermeability eyes (331.43 ± 97.94) µm., Conclusions: Subfoveal choroid thickness in the symptomatic eye and the fellow eyes in CSC group is thicker than that of the control group. The subfoveal choroidal thickness of eyes with hypermeability is thicker than that in the non-hypermeability eyes. EDI-OCT is a noninvasive procedure which can be used to evaluate the choroidal hypermeability in CSC.

Objective: To study the characteristic and rule of macular disease involved by Coats disease and macular changes after photocoagulation., Methods: A retrospective study was performed on patients firstly diagnosis in our hospital from October 2004 to June 2007. 25 cases (26 eyes) were included in this study. Enrollment criteria: all the cases had examination of regular anterior segment and indirect biomicroscopy associated with fluorescein angiography and optical coherence tomography. The relationship among macular disease extent, distance from macular to peripheral disease, ratio of retinal vessel leakage scale to the whole retina, and different age group was analyzed through cumulative odds logistic regression with SAS 8.0., Results: The distance between the border of macular disease and posterior border of peripheral leakage ranges from 0-9 PD. There was negative relationship between macular disease extent and the distance from macular to peripheral disease (chi(2) = 7.3212, P = 0.0068). The ratio of retinal leakage scale to the whole retina ranges from 1/8 to 1/1. There was positive relationship between macular disease extent and ratio of retinal vessel leakage scale to the whole retina (chi(2) = 4.8853, P = 0.0271). Macular disease extent shows no significant difference between different age group (chi(2) = 0.1491, P = 0.6994). The follow-up time after photocoagulation range from 1 to 4 years. 10 cases (11 eyes) of macular edema complicated with hard exudate showed apparent decrease in size and extent of macular disease. The best corrected visual acuity stay unchanged or get better., Conclusions: Macular disease involved in Coats disease progresses from peripheral fundus to posterior pole, early diagnosis and treatment can avoid or reduce the incidence of macular disease. The key point of treatment is to photocoagulated the dilated blood vessel.

Objective: The purpose of the present study was to compare the plaque composition between patients with acute coronary syndrome (ACS) and stable coronary artery disease (SCAD) by intravascular ultrasound virtual histological analysis., Methods: Two hundred and ten patients were divided into ACS group (n = 131, 188 diseased vessels) and SCAD group (n = 79, 158 diseased vessels). A total of 346 de novo lesions with > 50% stenosis in native coronary arteries with diameters > 2.5 mm were studied with intravascular ultrasonography. Geometric and compositional data were obtained using intravascular ultrasound virtual histology software., Results: There were no significant differences in overall lesions for fibrous (51.2% +/- 12.5% vs. 52.6% +/- 9.6%), fibrolipidic (11.3% +/- 10.6% vs. 12.9% +/- 9.4%), calcium (15.1% +/- 8.9% vs. 20.5% +/- 12.5%) or necrotic core (23.1% +/- 9.8% vs. 20.4% +/- 6.8%, all P > 0.05) components between ACS and SCAD patients. Culprit lesions for fibrous (49.1% +/- 11.2% vs. 50.3% +/- 9.7%), fibrolipidic (10.2% +/- 9.5% vs. 12.7% +/- 9.5%), calcium (15.4% +/- 8.9% vs. 17.4% +/- 24.8%), or necrotic core (24.0% +/- 11.5% vs. 19.7% +/- 5.3%, all P > 0.05) components were also similar between ACS and SCAD patients. High density lipoprotein-cholesterol (HDL) levels > 1.04 mmol/L was associated with more fibrolipidic (15.6% +/- 9.6% vs. 7.4% +/- 5.9%) and less necrotic core (19.4% +/- 8.6% vs. 28.6% +/- 11.2%, all P < 0.05 vs. patients with HDL < or = 1.04 mmol/L) components in ACS patients., Conclusion: Coronary plaque composition was similar between ACS and SCAD patients.

Objective: To evaluate the significance of detecting macular edema by the Retina Module of the Heidelberg retina tomograph II (HRTII)., Methods: Comparative clinical study, One hundred and twenty-six eyes were divided into two groups according to FFA results, one with macular edema and the other without macular edema. Morphological changes in macular edema were observed by HRTII and e (edema index) in two areas of each eye were determined. E value in these two groups and the correlation of e with retinal thickness, BCVA, amplitude and latency of N1 and P1 by multifocal electroretinogram were analyzed., Results: HRTII-RM scan could distinguish different kinds of macular edema (cystoid, local and diffused) and the difference of e between these two groups was significant (e1: t = -19.238, e2: t = -12.436; P < 0.01). The best critical value of e was 1.475 and 1.411 (e1 = 1.475, e2 = 1.411). The sensitivity of e was 92.9% and 91.8% (e1 = 92.9%, e2 = 91.8%). The specificity of e was 97.6% and 95.1% (e1 = 97.6%, e2 = 95.1%). The correlation coefficient between e and retinal thickness was 0.816 and 0.587 (e1: r = 0.816, e2: r = 0.587; P < 0.01); was -0.658 and -0.640 (e1: r = -0.658, e2: r = -0.640; P < 0.01) between e and BCVA; was 0.266 and 0.312 (e1: r = 0.266, e2: r = 0.312; P < 0.01) between e and latency of N1; was -0.609 and -0.586 (e1: r = -0.609, e2: r = -0.586; P < 0.01) between e and amplitude of N1; was 0.529 and 0.431 (e1: r = 0.529, e2: r = 0.431; P < 0.01) between e and latency of P1 and was -0.783 and -0.714 (e1: r = -0.783, e2: r = -0.714; P < 0.01) between e and amplitude of P1, respectively., Conclusions: There are characteristic changes in the appearance of macular edema as examined by HRT II-RM. The quantitative index e value also shows remarkable changes. HRT II-RM not only detects morphological changes, but also relates to functional changes. This method is capable for evaluating the macular edema.

Objective: To investigate the clinical features of choroidal neovascularization (CNV) in different classifications., Methods: In this retrospective case series, 393 eyes of 312 patients with CNV between May 2005 and March 2007 in our department was classified based on their etiology, location, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) findings., Results: The relative frequency of various causes in CNV was as follows: there were 153 cases (49.04%) from age-related macular degeneration (AMD) , 94 cases (30.13%) from idiopathic CNV, 37 cases (11.86%) from pathologic myopia, 15 cases (4.81%) from inflammatory disorders, 7 cases (2.24%) from polypoidal choroidal vasculopathy (PCV), 3 cases (0.96%) from angioid streaks and 1 case (0.32%) from either hereditary disease or trauma or tumor, respectively. The majority cases from AMD was male (64.71%), whereas most from pathologic myopia, idiopathic CNV and inflammatory disorders were female (78.38%, 73.40%, 73.33%). The age range of the cases from AMD was 49-95 years (68.73 +/- 8.31), and 98.04% of them were at least 50 years old. Patients with idiopathic CNV aged 13-43 years old (29.86 +/- 6.45), and 84.04% of them were between 20 and 40 years old. The sex (chi2 = 57.17, P<0.05) and age (F=172.57, P< 0.05) had significant difference in each etiological group. FFA showed that CNV in 43.48% from AMD and 66.67% from PCV were occult and non-classic. CNV in 91.67% from pathologic myopia, 76.19% from inflammatory disorders and 95.00% from idiopathic CNV was classic. In each group, most of the CNV was subfoveal type (58.00%-100.00%), followed by juxtafoveal type (0%-35.00%). In the ICGA of 54 eyes with AMD, 11 eyes (20.37%) were occult CNV (plaque, spot and mixed CNV), 17 eyes (31.48%) were CNV fibrosis. CNV was active in most cases. The frequency of active and inactive CNV in AMD was approximately 61.11% and 37.04%, respectively, no lesions were noted in 1 eye (1.85%) in ICGA., Conclusions: The clinical characteristics and frequency of various types of CNV are different due to different causes. Classification of CNV based on its etiology, FFA and ICGA findings, location, and activity in detail is important for the diagnosis, treatment and prognosis judgment in CNV.

Objective: The purpose of the study was to determine whether hematopoietic stem cell (HSCs) mobilization can regulate early diabetic retinopathy in mice., Methods: Mice were divided into four groups: control group, normal mice HSC-mobilized group, diabetic mice control group and diabetic mice HSC-mobilized group. Murine stem cell growth factor (SCF) and recombined human granulocyte colony stimulating factor (rhG-csf) were administered to the mice with diabetes and without diabetes for continuous 5 days to induce autologous HSCs mobilization, and subcutaneous injection of physiological saline was used as control. The changes associated with autologous HSCs mobilization were characterized using flow cytometry, Immunohistochemistry and semiquantitative RT-PCR. Evans blue quantitative test was used to measure the breakdown level of blood-retina barrier., Results: HSCs were marked by CD34-/low and Sca1+ in this study. The acceleration of endothelial cell regeneration was observed. A decrease of VEGF expression due to autologous stem cell mobilization was found. HSCs could increase the content of VEGFR-2 in mouse retina and significantly downregulated the expression of VEGF and ang-2 in diabetic mice., Conclusions: The experiment suggest that autologous HSCs mobilization can be approach of therapeutic vascular reconstruction and functional restoration of blood-retina barrier in mice.

Objective: To compare the results for diagnosis of macular edema between Heidelberg retina tomography (HRT-II macular edema module) and optical coherence tomography (OCT)., Methods: Two hundred and twelve eyes of 106 macular edema patients were diagnosed with fundus fluorescein angiography (FFA). HRT-II was used to obtain Edema Index and OCT was used to measure the retina thickness in the fovea. The results were compared with FFA., Results: As FFA for gold standard, we compared with other diagnosis method. With regard to the diagnosis of macular edema by OCT, the Kappa value was 0.553, the odds ratio (OR) was 8.519. The Kappa value of HRT-II was 0.403 and OR was 3.210. In two groups of patients with and without macular edema, which were diagnosed by FFA, the difference of Macular edema Index P assayed by HRT-II between these two groups was significant (P = 0.00); while the difference of fovea retina thickness P assayed by OCT between these two groups was significant, too (P = 0.00). The best critical value of E was 2.00 and the ROC curve's area was 0.673 in the detection of macular edema by HRT-II. The best critical value of retina thickness for the diagnosis of macular edema was 170 microm and the ROC curve's area was 0.774 in the detection of macular edema by OCT., Conclusions: In regard to the diagnosis of macular edema, the sensitivity of HRT-II is better than that from OCT, with a lower false-negative result. However, HRT-II has a relatively low specialty with a higher false- positive result. As for the localization of macular edema, HRT-II has its advantage. Compared with FFA, the consistence of OCT for the diagnosis of macular edema is better than that of HRT-II. We can conclude from the OR value that OCT has greater influence than HRT-II in the diagnosis of macular edema. In addition, as for the diagnosis and different diagnosis, the clinical value of OCT is higher than that of HRT-II. Combination of these two different diagnostic methods might provide an accurate quantitative analysis of macular edema.

Objective: To study the effect of retrobulbar injection with anisodamine on ocular blood velocity in anterior ischemic optic neuropathy (AION)., Methods: 15 minutes before injection, 15 minutes and 1 hour after injection, the blood flow velocity in 39 cases (39 eyes) diagnosed as AION was measured and analyzed by CDI, timed average maximum velocity, peak systolic velocity, end diastolic velocity, resistance index and pulsatility index of OA, CRA and PCA were recorded., Results: Compared with the normal eyes, each parameter of SPCA was statistically significant. 15 minutes and 1 hour after post ocular injection of anisodamine, every parameter examined in the experiment was increased except resistance index compared with pre-injection (P < 0.01)., Conclusions: retrobulbar injection with anisodamine can effectively improve flow velocity of nasal and tempo short posterior ciliary artery and central retinal artery.