Abstract:China is a country with high incidence of gastrointestinal (GI) cancer. Gastric cancer, esophageal cancer and colon cancer seriously threaten the health of people, and leads to heavy medical burdens. This review discusses the current screening protocol of GI cancer and pancreatic cancer. It also interprets the relevant policies issued by the state in recent years, and evaluates the effects of new technologies such as serum pepsinogen combined with gastrin in detecting gastric cancer, fecal and blood gene detection for colon cancer, and "serum liquid biopsy" of pancreatic cancer for early cancer screening. We also point out the difficulties and challenges in cancer screening at early stage, and the significance of promoting early cancer screening to reduce the mortality of GI cancer in China.

Abstract:Objective To quantitatively evaluate the changes of texture features extracted from two-dimensional high frequency ultrasonograms of human muscle injured by acute contusion using the multiscale decomposition of echo intensity of interface reflections, and to preliminarily explore its clinical value. Methods Two-dimensional ultrasound images of local muscles of 10 male patients with acute upper limb muscle contusion were obtained using high-frequency ultrasound. The region of interest (ROI) of normal muscle texture and the ROI of muscle texture with suspected injury on the same image of the patients were selected by Matlab 7.0 software in offline state. Eight texture parameters including mean of gray scale (Mean), standard variance of gray scale (SDev), number of blobs (NOB) of texture density, irregularity (IRGL) of texture primitive shape, mean size of blobs (SOB) of texture primitive, homogeneity of distribution (HOD) of texture uniformity, directionality of texture distribution (DOD) and periodicity of texture distribution (POD) of the two ROIs were extracted. The similarity difference values of the eight texture parameters between the two ROIs were automatically calculated by the multiscale decomposition of echo intensity of interface reflections. Two-dimensional ultrasound images of normal muscles in the same part of 10 healthy male volunteers were selected as controls, and two ROIs were randomly selected to calculate the similarity difference values of the above eight texture features between them. The similarity difference values of the eight texture features between patients with upper limb muscle contusion and healthy volunteers were compared. Results Local hyperechoic lesions were found with disordered muscle fibers and fuzzy textures in the patients with acute upper extremity muscle contusion. There were significant differences in the similarity difference of five textural parameters (IRGL, DOD, POD, Mean and SDev) between patients with acute upper limb muscle contusion and healthy controls (P<0.01). Conclusion Computer-aided quantitative evaluation based on multiscale decomposition of echo intensity of interface reflections can lead to more accurate and detailed quantitative diagnosis of texture features extracted from two-dimensional high frequency ultrasonic images of muscle injured by acute contusion than human eyes, and it may have clinical values.

Abstract:Objective To investigate the incidence, clinical characteristics and related risk factors of dyspnea in acute coronary syndrome (ACS) patients taking ticagrelor after percutaneous coronary intervention (PCI). Methods This prospective study included 283 ACS patients under the treatment of ticagrelor after PCI from Dec. 2018 to Jun. 2019. Patients with lung diseases, cardiac insufficiency grade Ⅲ or above (New York Heart Association[NYHA] heart function classification), or with medicine intervention were excluded from the study. Dyspnea was assessed by Borg scale. The hemorrhage was evaluated by thrombolysis in myocardial infarction (TIMI) bleeding classification. Risk factors of ticagrelor-related dyspnea were analyzed by one-way ANOVA and multivariable logistic regression analysis. Receiver operating characteristic (ROC) curve was drawn to calculate left ventricular ejection fraction (LVEF) in the diagnosis of ticagrelor-related dyspnea. Results The incidence of ticagrelor-related dyspnea was 16.3% (46/283), and 60.9% (28/46) of the patients developed dyspnea within 1 week after taking ticagrelor. Mild dyspnea manifested in 56.5% (26/46) patients, moderate dyspnea in 28.3% (13/46) patients and severe dyspnea in 15.2% (7/46) patients. Discontinuation of ticagrelor due to adverse drug reactions accounted for 8.5% (24/283), and 62.5% (15/24) of them terminated ticagrelor because of intolerable dyspnea. The bleeding events, proportion of male patients, smoking history, and left atrial volume (LA) of the dyspnea group were significantly higher than those of the non-dyspnea group (all P<0.05). LVEF of the dyspnea group was significantly lower than that of the non-dyspnea group (P<0.01). Multivariate logistic regression analysis showed that bleeding events, low LVEF, male and smoking were independent risk factors for ticagrelor-related dyspnea (P<0.05). The risk of dyspnea in patients with bleeding events was 2.925 times higher than that in patients without bleeding events (odds ratio[OR]=2.925, 95% confidence interval[CI]:1.386-6.175, P=0.005). ROC curve analysis showed that the cut-off of LVEF for diagnosis of ticagrelor-related dyspnea was 61%. Conclusion Ticagrelor-related dyspnea is very common in Chinese ACS patients. Mild dyspnea presents within 1 week after taking the drug in most patients. Bleeding events, low LVEF, smoking, and male are risk factors for ticagrelor-related dyspnea.

Abstract:Objective To investigate the role of the distal fourth fixation factor in the treatment of unstable femoral intertrochanteric fractures with intramedullary nails. Methods A total of 108 patients with unstable femoral intertrochanteric fractures (AO type:A2.2-A.3.3) treated from Jun. 2014 to Jun. 2018 in our hospital were selected and divided into three groups. The injury was fixed with short intramedullary nails and had matched medullary cavity in group A (n=42). The injury was fixed with short intramedullary nails and had mismatched medullary cavity in group B (n=40). The injury was fixed with long intramedullary nails in group C (n=26). Operation time, intraoperative blood loss, fracture healing time, postoperative complications and clinical efficacy were compared among the three groups. The efficacy was evaluated by the Harris hip score. Results There was no significant difference in the age, gender composition, or causes of injury between groups (P>0.05), but there was statistic difference in the AO type between groups (P<0.01). The operation time of group A was (62.26±31.03) min, which was significantly shorter than that of group C ([89.54±26.70] min, P<0.05), but not statistically different from group B ([64.53±29.22] min, P>0.05). The amount of intraoperative bleeding in group A was (149.19±45.97) mL, which was significantly less than that in group C ([230.77±57.40] mL, P<0.05), but not statistically different from group B ([153.43±40.30] mL, P>0.05). The fracture healing time in group B was (14.10±2.22) months, which was significantly longer than that in group A ([11.43±2.95] months) and group C ([12.35±4.47] months, P<0.05). At the last follow-up, the Harris score in group B was 77.33±8.18, which was significantly lower than that in group A and C (85.52±10.76, 89.12±9.14, P<0.05). Two patients in group A developed coxa vara. Eight patients had lost restoration in group B. No complications occurred in group C. There was significant difference in the incidence of complication among the three groups (Fisher exact test, P=0.013). Conclusion The technique using the distal fourth fixation factor can reduce the complications of unstable femoral intertrochanteric fractures such as postoperative loss of restoration and internal fixation failure, shorten the fracture healing time, and achieve early weight-bearing exercise.

Abstract:Objective To explore the effect of individualized nutritional therapy on nutritional status of patients with nutritional risk in the perioperative period of the digestive system operation. Methods This study was a prospective, randomized, controlled clinical trial. Patients undergoing elective digestive surgery were screened for nutritional risk. And 231 patients who had nutritional risk and signed informed consent were randomized into study group (n=115) and control group (n=116). Individualized and non-individualized nutritional treatments were given for 15 d (5 d before surgery and 9 d after surgery) in two groups. The baseline data were collected. At admission, and on day 5, 9 and 15 after nutrition treatment, venous blood samples were collected, and relevant indicators, such as the body mass index (BMI), serum total protein, albumin, prealbumin, blood glucose, total cholesterol, triglyceride, lymphocyte count and white blood cell count, were measured. Results At the end of the trial, 217 patients were collected from the study group (n=112) and control group (n=105). Fourteen patients (6.1%) withdrew from the study. In the study group, the levels of serum total protein, albumin and prealbumin were first increased, then decreased, and then increased again (P<0.05); the lymphocyte count and white blood cell count were first decreased and then increased (P<0.05); all were within the normal range. In the control group, serum albumin level was first decreased and then increased (P<0.05); serum prealbumin level and lymphocyte count were increased, then decreased, and then increased again (P<0.05); all were within the normal range; there were no significant differences in the other indicators (P>0.05). Serum total protein and albumin levels were significantly higher in the study group than those in the control group (P<0.05). White blood cell count was lower in the study group than that in the control group on day one before surgery (P<0.05), but white blood cell count was higher in the study group than that in the control group on day 9 after surgery (P<0.05). There was no significant difference in the other indexes between the two groups (P>0.05). The duration of nutrition treatment was not related to nutritional or immune indexes (P>0.05). Conclusion Individualized nutritional therapy can improve the nutritional status of patients with nutritional risks in the perioperative period of the digestive system operation.

Abstract:Objective To explore the influence of different reconstruction methods of digestive tract on postoperative short-term nutritional status of patients with early malignant tumor in upper gastric body. Methods Retrospective analysis was conducted on 109 patients with early upper gastric cancer who underwent surgical treatment in our hospital from Jun. 2016 to Jan. 2018. Double-tract reconstruction was performed in 59 patients (double-tract reconstruction group), and total gastrectomy was performed in 50 patients (total gastrectomy group). Nutritional indexes (hemoglobin, total protein, albumin and prealbumin) were compared between the two groups during hospitalization (at admission, 1, 3, 5 days after operation, and at discharge) and one year after operation. The changes in body weight were observed in the first year after operation. Results There were no significant differences in age, gender, body weight or nutritional indexes (hemoglobin, albumin, total protein, prealbumin) at admission, operation time, operation method, tumor location, tumor maximum diameter, or tumor differentiation between the two groups (P>0.05). On the 3^rd day after the operation, albumin in the total gastrectomy group was significantly lower than that in the double-tract reconstruction group (t=2.30, P=0.023). There were no significant differences in the hemoglobin, total protein or prealbumin between the two groups on day 1, 3 and 5 after operation, and at discharge (P>0.05). The levels of hemoglobin, total protein, albumin and prealbumin were significantly decreased in both groups at discharge as compared with that at admission (P<0.05). At 1 year after the operation, there was no significant difference in the nutritional indexes between the two groups (P>0.05). But the body weight loss in the double-tract reconstruction group was significantly lower than that in the total gastrectomy group (-10.45%[-17.11%, -5.19%) vs -17.83%[-22.06%, -13.10%], Z=4.31, P<0.01). Conclusion In comparison to total gastrectomy, double-tract reconstruction surgery can effectively improve the nutritional status of patients with early upper gastric cancer.

Abstract:Objective To explore the clinical rescue, clinical outcomes and complications in neonates with extremely low birth weight (ELBW, <1 000 g) and very low birth weight (VLBW, <1 500 g) in a single center in Shanghai. Methods Clinical data of neonates with birth weight less than 1 500 g admitted to Shanghai Children's Hospital between Jan. 2008 and Dec. 2017 were retrospectively analyzed. Results A total of 690 neonates were enrolled in this study. The overall survival rate was 72.7% (502/690) and in-hospital mortality rate was 13.9% (96/690). There was 13.3% (92/690) discharge against medical advice and the outcome was uncertain. The survival rate of VLBW neonates in 2013-2017 was significantly lower than that in 2008-2012 (45.2%[33/73] vs 64.7%[11/17], P<0.05). The most common complication was hypothermia, but there was no significant difference in the incidence of hypothermia between the latest 5 years and the first 5 years (81.0%[363/448] vs 82.6%[200/242], P>0.05). In 2013-2017, there was a significant increase in the occurrence of neonatal respiratory distress syndrome (NRDS) (70.1%[314/448] vs 26.9%[65/242], P<0.01), bronchopulmonary dysplasia (BPD) (19.4%[87/448] vs 9.5%[23/242], P<0.01), necrotizing enterocolitis (NEC) (16.3%[73/448] vs 6.2%[15/242], P<0.01) and infection (50.4%[226/448] vs 29.8%[72/242], P<0.01), while asphyxia (36.6%[164/448] vs 41.7%[101/242], P<0.01), retinopathy of prematurity (ROP) (1.3%[6/448] vs 5.0%[12/242], P<0.01) and hypoglycemia (11.2%[50/448] vs 17.8%[43/242], P<0.05) were decreased as compared with those in 2008-2012. Conclusion The overall survival rate is still low in neonates with ELBW and VLBW. Asphyxia and infection are still poorly controlled. The cooperation between institutions of obstetrics and neonatalogy is needed to improve the outcome of neonates with ELBW and VLBW.

Abstract:Objective To measure the parameters of optic disc and macula by spectral domain-optical coherence tomography (SD-OCT) in healthy controls and patients with mild or moderate primary open-angle glaucoma (POAG), and to analyze the related influencing factors. Methods Forty patients (40 eyes) with mild or moderate POAG who were admitted to our department from Sep. 2015 to Aug. 2018 were enrolled, including 20 patients aged 20-39 years old and 20 patients aged 60-79 years old. Contemporaneous 40 healthy controls (40 eyes) were also included (20 aged 20-39 years old and 20 aged 60-79 years old). All subjects received comprehensive ophthalmic examination. SD-OCT was used to measure the thickness of peripapillary retinal nerve fiber layer (pRNFL), the thickness of macular average ganglion cell layer combined with the inner plexiform layer (GCL-IPL), the macular minimum GCL-IPL thickness, and the average thickness of the macular cube. Results The average and minimum GCL-IPL thickness decreased significantly with age in both healthy control and POAG groups (P<0.05, P<0.01). With the increase of age, the average macular cube thickness did not change significantly in the two groups. In the healthy control group, there was no significant difference in the pRNFL thickness between 20-39 and 60-79 years old subgroups (P>0.05). The mean, superior, inferior and temporal thicknesses of pRNFL in the POAG group (both 20-39 years old and 60-79 years old subgroups) were significantly thinner than those in the healthy control group (P<0.05, P<0.01). Moreover, the thickness of pRNFL in POAG patients aged 60-79 years was significantly thinner than those in POAG patients aged 20-39 years (P<0.05, P<0.01). There was no significant difference in the nasal thickness of pRNFL between 20-39 and 60-79 years old patients in the POAG group (P>0.05). And no significant difference was found in the nasal thickness of pRNFL between POAG group and healthy control group of the same age (P>0.05). Conclusion The pRNFL thickness measured by SD-OCT is related to POAG, and it can be used as a detection index for early diagnosis of POAG.

Abstract:Objective To analyze the clinical characteristics and prognosis of patients with anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV). Methods Clinical data (general information, clinical manifestation, and laboratory indexes) of 168 patients newly diagnosed as AAV between Jul. 2008 and Dec. 2016 were retrospectively analyzed. Patients were followed up for a median period of 12 months (range, 1-96 months). End-point event was death. Results There were 152 cases of microscopic polyangiitis (MPA), 14 cases of granulomatous polyangiitis (GPA) and 2 cases of eosinophilic granulomatosis with polyangiitis (EGPA). MPO-ANCA was positive in 145 (86.3%) patients and PR3-ANCA was positive in 20 (11.9%) patients. Forty-nine patients died, 91 patients survived, and 28 patients lost their visits. Interstitial lung disease and renal involvement were more common in MPA patients as compared with GPA patients (50.7%[77/152]vs 14.3%[2/14], 78.9%[120/152]vs 50.0%[7/14], all P<0.05). Estimated glomerular filtration rate (eGFR) in MPA patients was significantly lower than that in GPA patients (14.23[7.27, 71.49]mL/[min·1.73 m²]vs 104.08[16.61, 135.72]mL/[min·1.73 m²], P<0.05). Compared with PR3-ANCA positive patients, MPO-ANCA positive patients was more elder ([64.01±10.62]years vs[50.50±16.88]years), had more renal involvement (77.9%[113/145]vs 50.0%[10/20]) and lower eGFR (19.00[9.40, 42.85] mL/[min·1.73 m²]vs 149.40[86.75, 249.45] mL/[min·1.73 m²], all P<0.05). Compared with the survivals, the dead patients were older ([67.45±10.61]years vs[61.98±12.52]years), had higher incidence of interstitial lung disease (59.2%[29/49]vs 41.8%[38/91]), higher Birmingham vasculitis activity score (BVAS) (18.53±8.02 vs 13.68±5.98), lower eGFR (8.58[5.73, 22.07]mL/[min·1.73 m²]vs 45.15[11.54, 120.79]mL/[min· 1.73 m²], lower blood sodium concentration (137.00[134.00, 140.00]mmol/L vs 139.00[136.00, 141.00] mmol/L), lower albumin level ([28.41±5.24] g/L vs[31.92±5.91]g/L), and higher serum D-dimer level (2.84[1.20, 6.28]mg/L vs 2.24[0.80, 3.69]mg/L) (all P<0.05). Multivariate Cox proportional regression analysis showed that age, eGFR, serum albumin level and BVAS were independent influence factors of death (hazard ratio=1.058, 0.987, 0.932, and 1.086, all P<0.05). Conclusion The clinical manifestations of AAV are mostly pulmonary and renal involvement. Age, eGFR, serum albumin level and BVAS are independent risk factors of death in AAV patients. Interstitial lung disease, high level of D-dimer and hyponatremia may be associated with prognosis of AAV.

Abstract:Objective To study the preventive effects of heat shock-pretreated rat bone marrow-derived mesenchymal stem cells (MSCs) on the apoptosis of ovarian granulosa cells (GCs) induced by cisplatin. Methods Rat bone marrow-derived MSCs were isolated, cultured and identified. After heat shock pretreatment for different durations, the apoptotic rates of MSCs were detected to determine the optimal condition of heat shock pretreatment. Cisplatin was added to simulate chemotherapy microenvironment in the ovary. MSCs were divided into normal group (without treatment), heat shock pretreatment group, cisplatin group (without heat shock pretreatment), and heat shock pretreatment+cisplatin group. The apoptotic rate of MSCs was determined. The ovarian GCs were isolated and divided into normal group (without treatment), cisplatin group, MSC prevention group (co-cultured with MSCs before adding cisplatin), and heat shock pretreatment MSC (HS-MSC) prevention group (co-cultured with HS-MSCs before adding cisplatin). The apoptotic rate of GCs was detected. Results Heat shock pretreatment could reduce the apoptosis of MSCs. After receiving heat shock pretreatment at 42℃ for 1 h, MSCs presented the lowest apoptotic rate. After adding cisplatin, the apoptotic rate of MSCs in heat shock pretreatment+ cisplatin group was significantly lower than that of cisplatin group ([11.94±0.63]% vs[14.30±0.80]%, P<0.05). The apoptotic rate of GCs in HS-MSC prevention+cisplatin group was significantly lower than that of cisplatin group ([39.88±1.65]% vs ([53.81±1.89]%, P<0.05). Conclusion Heat shock pretreatment can alleviate the apoptosis of MSCs during chemotherapy. Heat shock-pretreated MSCs have preventive effects on cisplatin-induced GC apoptosis.

Abstract:Objective To introduce a technical innovation for the treatment of severe multi-level thoracic ossification of posterior longitudinal ligament (OPLL). Methods The detailed surgical procedure included isolation of vertebra-OPLL complex (VOC), implantation of screws and rods, and antedisplacement of the VOC. A patient diagnosed as multi-level thoracic OPLL with myelopathy was treated by this technique and the outcomes were reported. Results Neurological outcomes achieved an evident improvement, with the recovery rate of modified-Japanese Orthopaedic Association score being 75%. The operation took 480 min and the intraoperative bleeding was 1 000 mL. Postoperative computed tomography and magnetic resonance imaging showed sufficient decompression of spinal cord. The occupation ratio of spinal canal improved from 86.6% to 58.8% in T_2/3, and from 68.2% to 45.9% in T_3/4. Conclusion Posterior thoracic vertebra-OPLL complex antedisplacement and fixation is a feasible, theoretically safe and effective surgical option for the treatment of severe multi-level thoracic OPLL with myelopathy. The operation is simple and performed outside the spinal canal, and no ossified mass is removed. However, further studies with large-scale cases and control groups are required to reveal the applicability and safety of this technique.

Abstract:Heart failure is a complicated pathophysiological syndrome. Balancing autonomic nervous activity and inhibiting myocardial remodeling are important methods for improving long-term efficacy in patients with heart failure. Pharmacologic management has been greatly developed, for example, the use of β-blockers is intended to inhibit the toxic effect of sympathetic activation on the heart and has become a classic treatment for heart failure. However, the incidence of heart failure is still on the rise and survivability is persistently reduced. In recent years, surgical treatments for inhibiting excessive activation of the sympathetic nervous system have emerged, such as vagus nerve stimulation, baroreceptor activation therapy. Some methods have obtained significant benefits in animal experiments and preliminary clinical study. It is essential to further verify the role of the above treatments in patients with heart failure in clinical trials.

Abstract:The incidence of type 2 diabetes in China is increasing annually, and its chronic complications are very common. Macrovascular complications are the main cause of death in patients with type 2 diabetes mellitus. The pathogenesis of diabetic macrovascular complications is different from that of traditional cardiovascular diseases. It has been found that macrovascular complications of type 2 diabetes are not only related to traditional cardiovascular disease risk factors (age, gender, hypertension, smoking, body mass index, diabetes duration, serum lipid, and glycosylated hemoglobin), but also diabetic microvascular complications, some specific molecular proteins and individual genetic background. This article reviews the clinical factors, molecular proteins and genetic background that affect the incidence of macrovascular complications in type 2 diabetes.

Abstract:Diabetes mellitus can result in many ocular complications, such as retinopathy, optic neuropathy, neovascular glaucoma and metabolic cataract, and plays an important role in causing blindness. In addition to diabetic retinopathy, the incidence of diabetic ocular surface diseases is also increased. Diabetes can lead to changes in the ocular surface including the lacrimal glands, tarsal glands, conjunctiva, tear film and cornea, such as dry eye, meibomian gland dysfunction, and corneal epithelial damage. This article reviews the research progress of ocular surface lesions and the pathogenesis in type 2 diabetes mellitus, hoping to provide theoretical basis for its clinical diagnosis and treatment.

Abstract:Select-in and select-out are two completely different strategies of military psychological selection. The two strategies vary from each other theoretically and practically. Select-in is a process of predicting job performance based on person-job fit theory and competency theory. Psychological selection of military officers in Germany is a typical select-in selection. Select-out is actually a kind of physiological and psychological screening. Select-out psychological selection aims at screening out retarded or mentally ill candidates. Psychological selection for Chinese recruits is a typical select-out selection. Select-in and select-out are different in test items and test administration. Three factors should be taken into account in the trade-off between select-in and select-out:selection objects, number of candidates and admission ratio, and cost-benefit ratio. Select-in and select-out can be merged perfectly, which can be seen in Subscreen of US submarine. In practice, selection objects, number of candidates to admission ratio, and cost-benefit ratio suggest that the select-in strategy should be taken as priority. The combination of select-in and select-out can also be used in the large-scale personnel selection in the army.

Abstract:Objective To investigate the feasibility of emergency thumb reconstruction for traumatic thumb amputation with bone and tendon from the amputated part, when the soft tissue is severely damaged and the amputated thumb is not replantable. Methods When the soft tissues of the amputated thumb was severely damaged and replantation was not applicable, thumb reconstruction as phase one emergency management was proceeded. The skin and nail bed of the amputated thumb was removed. The bone was in situ replanted, and the tendon was repaired. The nail flap from the ipsilateral toe was grafted and the bone and tendon was wrapped around to reconstruct the thumb. Results A total of 5 patients underwent surgical treatment. All reconstructed thumbs survived with an appearance similar to the contralateral sides. The patients were followed up for 10 months on average (range, 4 to 18 months). The result of two-point discrimination test was 10.1 mm on average (range, 9.2-12.0 mm). The preserved joints possessed partial function. The average range of motion of the metacarpophalangeal joint was 69.6° (range, 20° to 90°). The range of motion of interphalangeal joint was 15° and 20° in 2 patients, respectively. No infection or bone resorption occurred. The injury was healed successfully in 4 patients, and delayed union occurred in one patient. Conclusion Complete bone and tendon from the nonreplantable amputated part combined with wrap-around flap can be used for emergency thumb reconstruction and it can achieve good clinical results.

Abstract:Objective To evaluate the surgical treatment for congenital heart disease plus pulmonary artery hypertension (CHD-PAH) in children weighing less than 5 kg. Methods The clinical data of 29 CHD-PAH children with body weight ≤ 5 kg who were treated surgically between Aug. 2016 and Aug. 2018 were collected and retrospectively analyzed. Surgical complications and death causes were analyzed. Pulmonary artery pressure (PAP), the ratio of main pulmonary artery to ascending aorta diameter (MPA/AAO), the ratio of ventricular pre-ejection period to acceleration time (PEP/AT), arterial oxygen partial pressure (PaO₂), pulse oxygen saturation (SpO₂), the ratio of height to normal children, the ratio of weight to normal children, and functional classification of pulmonary arterial hypertension were evaluated in 26 survival children before surgery, before discharge and at 6 months after surgery. Results The procedures were finished successfully in all the 29 children. Postoperative complications were as follows:low cardiac output syndrome (LCOS, 2 cases), pulmonary hypertension crisis (1 case), residual shunt or recanalization (2 cases), arrhythmia (1 case), hepatic insufficiency (1 case), and delayed wound healing (2 cases). Three children (10.3%) died; of them 2 died of LCOS and one died of pulmonary hypertensive crisis. The above-mentioned indexes were significantly improved before discharge and at 6 months after surgery (P<0.05). The growth and development of 24 children reached the normal level 6 months after surgery. Conclusion Surgical treatment is safe and effective for CHD-PAH children with body weight ≤ 5 kg, which can restore normal growth and development of the children.

Abstract:Objective To explore the pathogenesis and syndrome differentiation of Pi-deficiency syndrome (PDS) from microRNA (miRNA) levels through screening and bioinformatic analysis of serum miRNA expression in PDS patients. Methods Four hyperlipemia patients with PDS, 4 hyperlipemia patients with Pi-Wei damp-heat syndrome (PWDS) and 5 healthy volunteers were recruited. Their serum RNA was used in miRNA quantitative PCR array experiment. Serum miRNA expression profiles in PDS patients were screened to perform bioinformatic analysis. Results Nine candidate miRNAs (6 upregulated and 3 downregulated) were screened from PDS patients. These miRNAs were able to clearly distinguish among PDS patients, PWDS patients and healthy volunteers. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed 83 target genes controlled by 6 up-regulated miRNAs were significantly enriched in 7 pathways, which were mainly involved in cytokine-cytokine receptor interaction, pathogens of infectious diseases, immune/inflammatory-related signaling pathway and pancreatic cancer; and 365 target genes controlled by 3 down-regulated miRNAs were significantly enriched in 5 pathways, which were mainly involved in signaling pathways of neurotrophin and phosphatidylinositol, RNA transport, and metabolisms of inositol phosphate and amino acid. Conclusion Our findings provide potential miRNA biomarkers for clinical syndrome differentiation of PDS patients, as well as information for understanding and studying the pathogenesis of PDS patients.

Abstract:Objective To study the expression of transient receptor potential cation channel subfamily C member 6 (TRPC6) in endometrial carcinoma tissues and their role in regulating cell cycle of endometrial carcinoma cells. Methods Quantitative real-time PCR and Western blotting were used to examine the expression of TRPC6 in 30 normal endometrial specimens, 30 atypical hyperplasia specimens and 32 endometrial carcinoma specimens. SKF96365 (an inhibitor of TRPC6 channel) and RNA interference (RNAi) targeting TRPC6 by small interference RNA (siRNA) were used to block TRPC6 so as to explore the role of TRPC6 in regulating the cell cycle of endometrial carcinoma cells HEC-1A. Results The expression levels of TRPC6 mRNA and protein in endometrial carcinoma were significantly higher than those in the atypical hyperplasia endometria and normal endometrial tissues (P<0.01). SKF96365 retarded cell cycle at G₂/M phase in a dose-dependent manner and reduced HEC-1A cells of G₀/G₁ phase. Transfection with target-TRPC6 siRNA retarded cell cycle of HEC-1A cells at G₂/M phase, and reduced HEC-1A cells of G₀/G₁ phase compared with negative control siRNA. Meanwhile, transfection with target-TRPC6 siRNA increased phosphorylated cell division cycle 2 (pCDC2) protein expression in HEC-1A cells. Conclusion The expression of TRPC6 is elevated in endometrial carcinoma tissues. TRPC6 may influence cell cycle through regulating pCDC2.

Abstract:Objective To investigate the in vitro and in vivo relative recovery rates of levofloxacin from microdialysis probes. Methods High-performance liquid chromatography (HPLC) was established for determination of levofloxacin concentrations. Column was Kromasil C₁₈ (150 mm×4.6 mm, 5 μm), the mobile phase consisted of acetonitrile and 10 mmol/L of potassium dihydrogen phosphate solution (15:85), with column temperature being 30℃, detection wavelength being 294 nm, and injection volume being 10 μL. The relative recovery rates of vascular microdialysis probes in vitro were measured by dialysis and reverse dialysis. The effects of drug concentration and flow rate on probe deliveries were investigated. The in vivo recovery rates of the probe in the jugular vein and prostate were measured by reverse dialysis, and the stability of 12 h recovery rate in vivo was investigated. Results When the concentration of levofloxacin was 0.1-50.0 μg/mL, the linear relationship was good in the HPLC analysis (r=0.998 7), and its specificity was good. The precision and accuracy of high-, medium-, low-concentration quality control samples, and lower limit of quantitation all met the analysis requirements. In the in vitro relative recovery experiments, there was no statistical difference between the recovery rate and reverse recovery rate of the vascular microdialysis probes (P>0.05). Drug concentrations did not affect in vitro recovery rate. The recovery rate decreased with the increase of flow rate. In vivo, the relative recovery rate of the probe was (48.46±1.94)% in the jugular vein and (13.23±1.44)% in the prostate. The relative recovery rates were stable during 12 h. Conclusion The established HPLC can be used for the determination of levofloxacin microdialysis probe. Reverse dialysis can be used to detect the relative recovery rate of levofloxacin microdialysis probe in vivo.

Abstract:Objective To investigate the clinical characteristics and treatment of asymmetric syndesmosis. Methods The clinical data of 2 cases of asymmetric syndesmosis admitted to our hospital in recent 10 years were introduced, and the relevant literature was analyzed and summarized. Results The diagnosis of asymmetric syndesmosis was clear in 2 cases. After multidisciplinary consultation, a detailed surgical plan was drawn up. All patients underwent asymmetric syndesmosis under general anesthesia, and multidisciplinary treatment was continued after operation. Follow-up after discharge showed that the patients grew well without obvious complications and adverse signs. Conclusion Asymmetric syndesmosis is rare in clinic. At present, the only treatment is surgical excision. Before operation, the local anatomy of the children"s syndesmosis can be fully assessed by imaging related examinations, and a perfect surgical plan can be drawn up. The operation should be careful during the operation, and the treatment plan can be worked out by multi-disciplinary cooperation after the operation. Long-term follow-up is needed after discharge.