Abstract:Objective To analyze the risk factors of early tricuspid regurgitation after heart transplantation, and to summarize the experience of donor and recipient evaluation and perioperative management of heart transplantation, so as to increase the survival rate and decrease the incidence of early right ventricular dysfunction in patients after heart transplantation. Methods A total of 74 patients who underwent orthotopic heart transplantation in our hospital from Mar. 2017 to Nov. 2019 were selected and divided into 2 groups according to the ratio of tricuspid regurgitation bundle area to right atrial area (group 1[15 cases, with the ratio<20%] and group 2[59 cases, with the ratio ≥ 20%]). The hearts were obtained according to the donor heart standards. The pulmonary artery systolic pressure (PAPs) and other indicators were monitored preoperatively by Swan-Ganz catheter, and the degree of tricuspid regurgitation within 30 days after surgery was evaluated by echocardiography. Multiple logistic regression model was used to analyze the influencing factors of early tricuspid regurgitation after heart transplantation. Results There were significant differences in primary graft failure (PGF), acute rejection, donor-to-recipient body weight ratio and preoperative PAPs between the two groups (all P<0.01). There were no significant differences in donor age, recipient age, donor and recipient gender match, preoperative New York Heart Association (NYHA) heart function classification, primary diseases, donor-to-recipient height ratio, preoperative total bilirubin level or preoperative right ventricular anteroposterior diameter between the two groups (all P>0.05). Multiple logistic regression analysis showed that PGF (odds ratio[OR]=1.892, 95% confidence interval[CI]1.150-1.972), acute rejection (OR=1.625, 95% CI 1.190-1.885), donor-to-recipient body weight ratio (OR=0.001, 95% CI 0.000-0.873) and preoperative PAPs (OR=1.274, 95% CI 1.099-1.498) were the influencing factors for early tricuspid regurgitation after heart transplantation (all P<0.05). Conclusion Matching the body weight of donor and recipient, preventing perioperative pulmonary hypertension, applying immunosuppressant strictly and preventing PGF are beneficial to reduce early tricuspid regurgitation and right heart failure after heart transplantation.

Abstract:Objective To investigate the clinicopathological features and prognosis of perimenopausal patients with estrogen receptor (ER) and/or progesterone receptor (PR) positive and human epidermal growth factor receptor 2 (HER2) negative (ER/PR⁺HER2^-) invasive breast cancer. Methods A total of 335 patients with ER/PR⁺HER2^- invasive breast cancer who were admitted to the Huangpu Branch of Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from Jan. to Dec. 2009 were included and divided into premenopausal group (<40 years, 23 cases), perimenopausal group (40-60 years, 228 cases) and postmenopausal group (>60 years, 84 cases) according to the menopausal statuses. The clinicopathological features and prognosis of the patients in the 3 groups were compared, and the prognostic risk factors for the patients were investigated using univariate and multivariate Cox regression analyses. Results There were no significant differences in tumor T stage, N stage, TNM stage, histological grade, histological classification, lymphovascular invasion or PR expression level of the ER/PR⁺HER2^- invasive breast cancer patients with different menopausal statuses (all P>0.05). There were significant differences in the expression of Ki-67, ER, and P53 among the 3 groups (all P<0.01). The proportions of patients with Ki-67 positive cells ≥ 60% and ≥ 20% were higher in the perimenopausal and premenopausal groups than in the postmenopausal group. The expression levels of ER in the premenopausal, perimenopausal and postmenopausal groups were increased in turn. The expression levels of P53 in the perimenopausal and premenopausal groups were higher than that in the postmenopausal group. The survival rates of the premenopausal, perimenopausal and postmenopausal patients were 87.0% (20/23), 92.1% (210/228) and 91.7% (77/84), respectively. The Kaplan-Meier survival curve analysis showed that there was no significant difference among the 3 groups (P>0.05). The multivariate Cox regression analysis showed that lymph node metastasis, Ki-67 positive cells ≥ 60% and low PR expression were independent prognostic factors for perimenopausal patients with ER/PR⁺HER2^- invasive breast cancer (hazard ratio=2.43, 3.45, 0.27, all P<0.05). Conclusion Perimenopausal ER/PR⁺HER2^- invasive breast cancer has its unique clinicopathological features, but there is no significant difference in the prognosis of ER/PR⁺HER2^- invasive breast cancer patients with different menopausal statuses. Lymph node metastasis, Ki-67 positive cells ≥ 60%, and low PR expression are independent prognostic factors for perimenopausal patients with ER/PR⁺HER2^- invasive breast cancer.

Abstract:Objective To evaluate the development of white matter in preterm infants without brain injury by T2 weighted-fluid attenuated inversion recovery (T2WI-FLAIR) sequence. Methods The magnetic resonance imaging (MRI) and clinical data of 157 preterm infants without brain injury admitted to the neonatal intensive care unit of Qilu Children's Hospital of Shandong University from Jul. 2015 to Jul. 2018 and the corresponding data of 33 full-term newborns were collected. The preterm infants were divided into 5 groups according to the gestational age at birth:28-29, 30-31, 32-33, 34-35 and 36-37 weeks. Brain MRI with T2WI-FLAIR sequence was performed in preterm infants of each group within 1 to 3 days after birth and at 40 weeks of corrected gestational age, as well as in full-term newborns at 40 weeks of gestational age, measuring the maximum cross-sectional area and signal intensity ratio of low signal region in white matter. The differences of the maximum cross-sectional area and signal intensity ratio of low signal region in white matter were analyzed between the different gestational age groups and between preterm infants at 40 weeks of corrected gestational age in each group and full-term newborns at 40 weeks of gestational age. The differences of signal intensity ratios in the central, peripheral and adjacent ventricular regions of white matter in different gestational age groups were analyzed. Results The maximum cross-sectional areas of low signal region in white matter in preterm infants of 28-29, 30-31, 32-33, 34-35 and 36-37 week groups were decreased with the increase of the gestational age, the signal intensity ratios were increased with the increase of the gestational age (all P<0.01), and the signal intensity ratios were decreased in the order of occipital, parietal, frontal and temporal lobes (all P<0.01). The signal intensity ratios of low signal region in white matter with preterm infants in the groups of 32-33, 34-35 and 36-37 weeks were decreased in the order of central, peripheral and adjacent ventricular regions (all P<0.01). The maximum cross-sectional area of low signal region in white matter in preterm infants at 40 weeks of corrected gestational age was decreased significantly with the increase of the gestational age, and the signal intensity ratio was increased significantly with the increase of the gestational age (all P<0.01). The maximum cross-sectional area of low signal region in white matter of preterm infants in different gestational age groups at 40 weeks of corrected gestational age was significantly larger than that of the full-term newborns at 40 weeks, and the signal intensity ratio was significantly lower than that of the full-term newborns at 40 weeks (all P<0.01). Conclusion MRI with T2WI-FLAIR sequence can quantitatively evaluate the degree of myelination in preterm infants without brain injury, and it is an important non-invasive examination for the development of brain white matter in preterm infants.

Abstract:Objective To investigate the efficacy and experience of oral mucosa (lower lip mucosa and tongue mucosa) and penile skin flap in repairing complex anterior urethral stricture. Methods The data of 33 patients with complex anterior urethral stricture caused by various reasons undergoing oral mucosa graft urethroplasty or penile skin flap urethroplasty in our hospital from Aug. 2012 to May 2018 were retrospectively analyzed. Oral mucosa graft urethroplasty was suitable to patients with insufficient prepuce, multiple urethral stricture, or a history of urethral surgery. Penile skin flap urethroplasty was suitable to patients with sufficient prepuce and without a history of urethral surgery. The preoperative information and postoperative follow-up data were collected, and the differences of maximum urinary flow rate and international index of erectile function 5 (ⅡEF-5) were compared and analyzed before and after operation. Results The 33 patients were 12-80 years old, with an average of (43.5±19.3) years old. Twenty-three patients underwent oral mucosa graft urethroplasty, and the length of the urethral stricture was 5.0 (3.0-12.0) cm. Ten patients underwent penile skin flap urethroplasty, and the length of the urethral stricture was 4.0 (3.0-7.0) cm. The postoperative follow-up period was 20 (12-36) months. Two patients in the oral mucosa graft urethroplasty group developed urethral stricture recurrence and 1 patient in the penile skin flap urethroplasty group developed urinary fistula during the follow-up. In the oral mucosa graft urethroplasty group, 21 patients voided well, and the maximum urinary flow rates were 5.0 (0.0-8.2) mL/s and 19.6 (12.2-21.7) mL/s before and 1 year after operation, respectively, showing significant difference (P<0.01); the ⅡEF-5 scores were 14.0 (5.0-18.0) and 16.0 (4.0-21.0) before and 1 year after operation, respectively, showing no significant difference (P>0.05). In the penile skin flap urethroplasty group, 9 patients voided well, and the maximum urinary flow rates were 6.1 (0.0-12.0) mL/s and 20.4 (13.6-23.6) mL/s before and 1 year after operation, respectively, showing significant difference (P<0.01); the ⅡEF-5 scores were 15.0 (7.0-19.0) and 17.5 (3.0-23.0) before and 1 year after the operation, respectively, showing no significant difference (P>0.05). Conclusion Oral mucosa and penile skin flap are promising substitutes for urethroplasty, and they can be selected for urethroplasty according to patient's physical condition.

Abstract:Objective To analyze the expression of complement C3a receptor 1 (C3AR1) in low-grade glioma (LGG) tissues and the association with the prognosis and immune cell infiltration in LGG based on The Cancer Genome Atlas (TCGA) database. Methods The gene expression profile data and clinical information of 514 LGG patients were downloaded from TCGA database. The expression levels of C3AR1 in LGG and normal tissues were compared. The expression levels of C3AR1 in different World Health Organization (WHO) grades of LGG tissues and their relationship with prognosis were analyzed. The influence of clinical features and C3AR1 expression level on prognosis of LGG patients was analyzed. The correlation between C3AR1 expression in LGG tissues and tumor immune cell infiltration, and the influence of immune cell infiltration level on prognosis were analyzed, and gene groups positively correlated with the expression of C3AR1 were further analyzed by Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. Results The expression of C3AR1 in LGG tissues was significantly higher than that in normal tissues (P<0.05). The expression of C3AR1 was higher in WHO gradeⅢ LGG tissues than in WHO gradeⅡ tissues (P<0.05). The prognosis of C3AR1 low-expression group was significantly better than that of the high-expression group (hazard ratio=1.7, 95% confidence interval 1.1-2.4, P=0.003 6). Patient age, LGG grade and expression level of C3AR1 were independent prognostic factors of LGG (all P<0.01). The expression level of C3AR1 was positively correlated with the immune cell infiltration level of LGG (all P<0.01), and the latter was related to the prognosis of LGG patients. Gene groups positively related to C3AR1 regulated several LGG-related key pathways:interferon γ-mediated signaling pathway, conserved immunoglobulin (Ig)/major histocompatibility complex (MHC) site, Ig-like Cl type domains, MHC class Ⅰ/Ⅱ-like antigen recognition protein, specific regions of junctional peptide, and Toll-like receptor signaling pathways. Conclusion C3AR1 is associated with the prognosis and immune cell infiltration of LGG, and it can be a biomarker for grading diagnosis, immunotherapy and prognosis of LGG.

Abstract:Objective To identify the core genes of clear cell sarcoma of the kidney (CCSK) based on the Gene Expression Omnibus (GEO) database, and to analyze the immune cell infiltration between tumor and normal tissues, so as to provide a new direction for the diagnosis and treatment of CCSK. Methods Combined analysis of GSE49972 and GSE2712 datasets from GEO database was performed to screen the differentially expressed genes between CCSK and normal embryonic kidney tissues. The Gene Ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway enrichment analyses of the differentially expressed genes were performed and the protein-protein interaction network was constructed to identify the core genes of CCSK. Meanwhile, the immune cell infiltration of CCSK and normal embryonic kidney tissues was analyzed. Results A total of 740 differentially expressed genes were screened out, and the GO function analysis showed that these genes were enriched in the extracellular structure organization, collagen-containing extracellular matrix, cell adhesion molecule binding and so on. The KEGG signaling pathway analysis showed that the major signaling pathways involved in differentially expressed genes mainly included in phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway, trancriptional misregulation in cancer, focal adhesion, calcium signaling pathway and proteoglycans in cancer. The protein-protein interaction network analysis showed that claudin family and cadherin family had large weighted values in the core modules. The immunity cell infiltration analysis showed that the infiltration of most immune cells was low in CCSK tissues, but the infiltration of CD4 T cells was relatively high. Conclusion Claudin and cadherin pathways and core genes play an important role in CCSK and can be potential therapeutic targets. The combination of immune checkpoints and specific kinase inhibitors may improve the immunotherapeutic effect of CCSK.

Abstract:Objective To explore an effective method for culturing perineurial cells in vitro, and to preliminarily study the role of hair follicle neural crest stem cells (hfNCSCs) in activating perineurial cells. Methods Perineurial cells from rat sciatic nerve were cultured and purified by the method of "limited digestion-differential adherence-chemical drug", hfNCSCs from rat vibrissa were cultured, and the cells were identified by immunocytochemistry staining. hfNCSCs and perineurial cells were co-cultured in Transwell plates, where perineurial cells were seeded in the upper chamber, and hfNCSCs (hfNCSC co-culture group) or acellular grids (control group) were seeded in the bottom chamber. Crystal violet staining was performed after co-culture for 6, 12 and 18 h to observe the migration of perineurial cells. The perineurial cells were treated with hfNCSCs conditioned medium (hfNCSC conditioned medium group) and 2% FBS DMEM medium (control group), respectively, and the proliferation of perineurial cells was detected by cell counting kit 8 (CCK-8) after 24, 48 and 72 h. Results Perineurial cells with purity up to (97.66±2.08)% were obtained within 2 weeks by this method. The migration number of perineurial cells was significantly higher in the hfNCSC co-culture group than in the control group after 6, 12 and 18 h of co-culture (P<0.05, P<0.01). The cell viability of perineurial cells in the hfNCSC conditioned medium group and control group was similar after treated with hfNCSCs conditioned medium for 24 and 48 h (both P>0.05); however, the cell viability of perineurial cells was significantly higher in the hfNCSC conditioned medium group than in the control group after 72 h (P<0.01). Conclusion Perineurial cells can be successfully cultured and purified by the method of "limited digestion-differential adherence-chemical drug"; hfNCSCs can activate perineurial cells and promote their migration and proliferation.

Abstract:Objective To investigate the effect of hyperbaric oxygen (HBO) combined with basic fibroblast growth factor (bFGF) on bone defect repair with natural calcined bovine bone (CBB), and to explore its relationship with the expression of osteoprotegerin (OPG) and CD34. Methods A total of 32 SD rats were randomly divided into two groups:HBO and non-HBO (NHBO) groups (n=16 in each group). Bone defects were made on the left and right sides of the top of the skull. CBB (CBB group) or CBB combined with bFGF (CBBbF group) were implanted on one side and non-implanted on the other side (control[Con] group). HBO group received HBO exposure for 2 weeks, and the rats were sacrificed at 4, 8 and 12 weeks after operation. The healing of bone defect was observed by radiographic and histological observation, and the expression of OPG and CD34 was evaluated by immunohistochemistry. Results The bone densities (BDs) of bone defect areas of the rats were significantly higher in the HBO-CBB, HBO-CBBbF, NHBO-CBB and NHBO-CBBbF groups than in the HBO-Con and NHBO-Con groups at 12 weeks after operation, and the HBO-CBBbF group has the highest BD (all P<0.01). The percentages of new bone formation areas were significantly higher in the HBO-CBB, HBO-CBBbF, NHBO-CBB and NHBO-CBBbF groups than in the HBO-Con and NHBO-Con groups (all P<0.01), and the blood vessel numbers were significantly larger in the HBO-CBBbF, HBO-CBB, NHBO-CBB and NHBO-CBBbF groups than in the HBO-Con and NHBO-Con groups at 12 weeks after operation. The blood vessel numbers were significantly larger in the HBO-CBBbF, HBO-CBB and NHBO-CBBbF groups than in the NHBO-CBB group at each time point after operation. The expression of OPG and CD34 was significantly higher in the HBO-CBBbF, HBO-CBB and NHBO-CBBbF groups than in the NHBO-CBB, HBO-Con and NHBO-Con groups (P<0.05, P<0.01). Conclusion CBB can promote bone defect repair and bFGF can increase bone regeneration and blood vessel number. HBO has synergistic effect on bFGF combined with CBB in repairing bone defects, and the effect is closely related to the promotion of OPG and CD34 expression.

Abstract:Objective To investigate the insomnia status and the related influencing factors of clinical nurses fighting against coronavirus disease 2019 (COVID-19) in Wuhan, so as to provide references for targeted psychological intervention during the prevention and control of the COVID-19 epidemic. Methods Convenience sampling method was conducted among clinical nurses fighting against COVID-19 in the Zhongnan Hospital of Wuhan University from Mar. 3 to 7, 2020. General information questionnaire, Athens insomnia scale (AIS) and patient health questionnaire (PHQ-9) were used, and multivariate linear regression analysis was conducted to analyze the influencing factors of insomnia in clinical nurses fighting against COVID-19. Results A total of 521 questionnaires were collected, including 504 valid ones, with an effective rate of 96.74%. The AIS score was 6 (3, 9), of which 352 (69.84%) had sleep disorder; the PHQ-9 score was 6 (2, 9), of which 292 (57.94%) had different degrees of depression. Professional title, total working time at epidemic frontline, whether the direct relatives diagnosed as COVID-19 or not, fear of the COVID-19 epidemic and depression level were included in the regression equation (all P<0.05), which explained 56.2% of the total variation of insomnia in clinical nurses fighting against COVID-19. Conclusion Insomnia is common among clinical nurses fighting against COVID-19 in Wuhan, and the related influencing factors are complex. Nursing administrators should pay attention to the insomnia status of clinical nurses fighting against COVID-19, and all-round and effective interventions should be carried out in time, so as to improve the sleep quality of nurses.

Abstract:Vacuum-assisted breast biopsy (VABB) is widely used in the excision of benign breast lesions in China. It is also safe, accurate and convenient in the diagnoses of malignant tumors. For management of breast imaging reporting and data system (BI-RADS) 3 lesions, such as flat epithelial atypia (FEA), classical lobular neoplasia (LN), papillary lesion (PL) and radial scar (RS) diagnosed by core-needle biopsy (CNB) or VABB, excision by VABB is recommended in preference to open surgery. Image-guided VABB is a safe diagnostic method for microcalcification and is progressing toward complete resection. Special attention after VABB should be paid to intraductal papilloma patients who are elderly, with residual lesions, atypical hyperplasia and peripheral type. There is still a certain residual tumor rate after VABB in early-stage breast cancer with small tumor focus. Nowadays, it is recommended to further expand the resection of malignant tumors. The era of VABB combined with sentinel lymph node biopsy as local treatment for breast cancer has not come yet; VABB evaluation after neoadjuvant chemotherapy is also in exploration. This article reviews the research progress of VABB in the treatment of suspected malignant breast lesions.

Abstract:The continuous production of oxidative stress by reactive oxygen species (ROS) is related to the pathogenesis of cardiovascular diseases. The major enzymatic sources of ROS in the cardiovascular system are reduced nicotinamide adenine dinucleotide phosphate oxidase (NOX), uncoupled endothelial nitric oxide synthase, mitochondria, and xanthine oxidases. This article reviews the role of the relationship between these oxidases in cardiovascular diseases, focusing on the core role of specific subtypes of NOX that are activated in different cardiovascular diseases. An improved understanding of these mechanisms can facilitate the development of novel therapeutic agents targeting these oxidase stress-related enzyme systems and their interactions, which will be effective in the prevention and treatment of cardiovascular diseases.

Abstract:Histone deacetylase (HDAC) is an important target in cancer treatment, and several HDAC inhibitors have been approved for clinical treatment. Compared with single-target drugs, multi-target drugs have better drug efficacy and specificity, can effectively improve the efficacy and reduce the drug resistance, and have great prospects for the treatment of Alzheimer's disease, mycosis, tumor and other diseases. This article mainly introduces the research progress of HDAC dual-target inhibitors in anti-Alzheimer's disease, anti-fungi and anti-tumor fields, so as to provide reference for the development and application of the drugs.

Abstract:Objective To explore the changes of heart rate (HR) and heart rate variability (HRV) of trainees in the process of fast buoyancy ascent escape training, and to analyze the characteristics of individual stress caused by training, so as to provide scientific basis for effective psychological protection. Methods The electrocardiogram data of 128 officers and soldiers who participated in 3, 5 and 10 m fast buoyancy ascent escape training depths were recorded during the whole process, and the influences of different training phases (before training, during training[cabin entry, cover closing, water injection, cover opening, cabin exit] and after training) and different training depths (3, 5, 10 m) on time domain (standard deviation of normal to normal intervals[SDNN]) and frequency domain (total power[TP], low frequency[LF], high frequency[HF], LF/HF) indexes of HRV and HR were compared. Results The tension of the trainees in the 3 m training depth was significantly higher than that in the 5 m and 10 m training depths (both P<0.01), the tension in the water injection phase was significantly higher than that in the other phases (all P<0.01), and the tension in the cabin exit phase was significantly lower than that in the other phases (all P<0.05). The HR of the trainees increased significantly in the cabin entry phase in the 3 m training depth compared with the 5 m training depth (P<0.05); the HR of the trainees increased gradually after training with the increase of the training depth (P<0.05); and the HR of the trainees in the 3 phases (water injection, cover opening or cabin exit) had no significant difference at each training depth (P>0.05). The indexes of the HRV showed a significant downward trend before, during and after training at each training depth (all P<0.001). Conclusion HR and HRV can reflect the physiological and psychological state of the trainees in the process of fast buoyancy ascent escape training, which provides the basis for stress intervention in the future.

Abstract:The accomplishment of infrastructure construction on islands and reefs in the South China Sea, the normalization of combat readiness and garrison, and the increase of civil activities in adjacent waters have higher demands for medical services of islands and reefs. Joint medical services can be provided through refined management of medical processes, optimal allocation of medical staff and sharing of medical materials and consumables based on the current 3 reef hospitals. With a joint system, the medical efficiency and treatment capability will be greatly improved, while casualty evacuation and related medical risks as well as expenditures will be markedly reduced. The authors elaborated the proposal of this joint medical service system in this article.

Abstract:Objective To investigate the relationship between negative cognitive bias and social anxiety in serviceman, and to understand the mediating role of fear of evaluation. Methods A total of 878 officers and soldiers were randomly selected from a naval force. The fear of positive evaluation (FPE), fear of negative evaluation (FNE), negative cognitive bias and social anxiety levels were measured by fear of positive evaluation scale (FPES), brief fear of negative evaluation scale (BFNES), negative cognitive processing bias questionnaire and interaction anxiousness scale (IAS). Structural equation model was used to test the mediating role of fear of evaluation. Results The correlation analysis showed that the scores of 4 dimensions (negative attention bias, negative memory bias, negative interpretation bias and negative rumination bias) and total scores of negative cognitive processing bias questionnaire were positively associated with the scores of FPES, BFNES and IAS (all P<0.01). The mediating effect tested by structural equation model showed that the fear of evaluation played a partial mediating role, the indirect effect was 0.31, 95% confidence interval (CI) 0.26-0.35, and FPE and FNE were independent of each other. Conclusion Soldiers' fear of evaluation plays a mediating role in the relationship between cognitive bias and social anxiety, and soldiers should correctly treat others' comments.

Abstract:Objective To evaluate the clinical efficacy and prognosis of children with obstructive sleep apnea hypopnea syndrome (OSAHS) after surgical treatment. Methods Clinical data of 106 children with OSAHS were retrospectively analyzed, including 16 cases (15.1%) aged <3 years, 64 cases (60.4%) aged 3-6 years, and 26 cases (24.5%) aged >6 years. Among them, 83 cases (78.3%) underwent adenoidectomy combined with tonsillectomy and 23 cases (21.7%) underwent adenoidectomy alone. They were followed up in outpatients after operation, and children with complications were treated with pediatrics. Results All patients were operated smoothly, and their sleep at night was significantly better than that before operation. Fever occurred in 3 cases 1 day after operation (1 case with repeated high fever), and their body temperature returned to normal after pediatric anti-infection and antipyretic treatment. All patients were followed up for 12-20 months, with an average of (16.0±1.4) months. At 12 months after operation, 88 cases (83.0%) were cured, 13 cases (12.3%) were improved, and 5 cases (4.7%) were ineffective. Within 6 months after operation, 1 recurrence was found in children aged <3 years; at 12 months after operation, 5 recurrence cases (31.2%, 5/16) were found in children aged <3 years, while no recurrence occurred in children aged 3-6 years or >6 years, showing significant difference (both P<0.05). Seven cases of children aged <3 years with recurrent respiratory tract infections within 12 months after operation were cured after combining the follow-up of pediatrics (anti-infection and immunoregulation treatment). Conclusion Surgical resection is still the main treatment for children with OSAHS, and appropriate operation should be selected according to different obstruction causes; children aged <3 years should be operated cautiously after the assessment of risk and prognosis; meanwhile, follow-up after operation and treatment of related complications should be jointly done with professional pediatricians to reduce long-term poor prognosis.

Abstract:Objective To investigate the preliminary application of the da Vinci Si robotic surgery system for gynecological single-port laparoscopic surgery. Methods Five patients who were hospitalized for elective gynecological surgery in the Department of Obstetrics and Gynecology of Changzheng Hospital, Naval Medical University (Second Military Medical University) from May 27 to June 20, 2018 were enrolled. The single-port laparoscopic surgeries were performed with the third-generation da Vinci Si robotic surgery system and Lagiport^TM multi-channel single-port laparoscopic puncture device. One patient with high-grade cervical intraepithelial neoplasia (microinfiltration cannot be excluded after cervical conization) underwent total hysterectomy+sentinel lymphadenectomy; one patient with stageⅠa1 invasive cervical carcinoma underwent total hysterectomy+bilateral adnexectomy+sentinel lymphadenectomy; one patient with stageⅠa1 endometrial carcinoma underwent total hysterectomy+bilateral adnexectomy+sentinel lymphadenectomy; one patient with stage Ⅳ endometriosis underwent extensive enterolysis+unilateral adnexectomy; and one patient with stageⅡa1 invasive cervical carcinoma underwent extensive hysterectomy+bilateral adnexectomy+pelvic lymph node dissection. Results The operation of the 5 patients was successfully completed without additional auxiliary port. The operative duration of the 5 patients were 174, 110, 90, 125 and 300 min, and the volumes of the intraoperative blood loss were about 110, 80, 100, 210 and 150 mL. None of the 5 patients had perioperative complications. Conclusion The third-generation da Vinci Si robotic surgery system has promising feasibility for gynecological single-port laparoscopic surgery.

Abstract:Objective To investigate whether the embryo cleavage rate on day 3 of fertilization can predict the blastocyst development potential and clinical outcome of assisted reproduction. Methods The embryo implantation data of 366 fresh blastocysts and the clinical data of 150 infertility patients undergoing in vitro fertilization or intracytoplasmic single sperm injection-embryo transfer (IVF/ICSI-ET) in our center from Jan. 1, 2016 to Dec. 31, 2018 were retrospectively analyzed. According to the cell number of the blastomere on the third day of fertilization, embryos were divided into slow development group (≤ 6 cells, n=78), normal development group (7-9 cells, n=230) and fast development group (≥ 10 cells, n=58). The blastocyst formation rate, high quality blastocyst formation rate, embryo implantation rate, clinical pregnancy rate and live birth rate of the 3 groups were compared. Results The blastocyst formation rates of the slow, normal and fast development groups were 7.7% (6/78), 55.7% (128/230) and 29.3% (17/58), respectively, and the normal development group had the top rate, with significant difference when comparing with those in the other two groups (both P<0.01); the high quality blastocyst formation rates of the 3 groups were 0 (0/6), 7.0% (9/128) and 11.8% (2/17), respectively, and the highest rate was found in the fast development group, with significant difference when comparing with that in the normal development group (P<0.05); the embryo implantation rates of the 3 groups were 0 (0/18), 50.6% (80/158) and 63.3% (19/30), respectively, and the highest rate was found in the fast development group, with significant difference when comparing with that in the normal development group (P<0.05); the clinical pregnancy rate and live birth rate were 53.7% (58/108) and 41.4% (24/58) in the normal development group, and were 63.0% (17/27) and 47.1% (8/17) in the fast development group, respectively; there were significant differences in clinical pregnancy rate and live birth rate between the normal and fast development groups (both P<0.05). Conclusion The cleavage embryos with 7-9 cells on day 3 of fertilization have the highest blastocyst formation rate, and cleavage embryos with ≥ 10 cells on day 3 have much higher rates of high quality blastocyst formation, embryo implantation, clinical pregnancy and live birth, suggesting that fast development embryos have normal development potential.

Abstract: