Abstract:With the wide application of internal fixation technology, the quantity and quality of posterior lumbar fusion surgery are growing year by year. However, revision surgery may be needed for recurrence of symptoms due to selection of improper surgical protocols, surgical errors, complications related to internal fixation, degeneration of adjacent segments, and other factors. The main purpose of revision surgery for posterior lumbar internal fixation is to relieve nerve compression and reconstruct the stability of lumbar spine. Exploring the causes for revision of lumbar internal fixation, and then formulating corresponding surgical treatment strategies and correctly dealing with surgical related complications will help to improve the surgical efficacy.

Abstract:Objective To study the culture characteristics of tick-borne encephalitis virus (TBEV) in susceptible cells and identify the RNA replication, protein expression and infectivity.Methods The TBEV was cultured using African green monkey kidney cells (Vero cells). The RNA replication of TBEV was detected by quantitative polymerase chain reaction, the expression of flavivirus envelope protein was detected by Western blotting, and the titer of TBEV was detected by plaque assay. The human lung adenocarcinoma cells (A549 cells) was infected with TBEV, and the cytopathic effect of A549 cells infected with TBEV was observed under microscope. The expression of flavivirus envelope protein in A549 and Vero cells infected with TBEV was detected by immunofluorescence staining.Results The levels of TBEV RNA were increased in Vero cells at 72 h incubation compared with those at 48 h incubation, and the expression of flavivirus envelope protein was detectable. The results of plaque assay showed that the TBEV titer in the supernatant of Vero cells was (2.0±1.4)×10⁶ plaque-forming unit (PFU)/mL after culturing for 72 h. There was obvious cytopathic effect in A549 cells with TBEV infection. The positive rate of flavivirus envelope protein expression in A549 cells (61.0%) was higher than that in Vero cells (9.3%) after infection with 1∶1 000-diluted TBEV. Compared with Vero cells, the titer in the supernatant of A549 cells infected with TBEV for 48 h was significantly higher ([2.0±0.4]×10⁷ PFU/mL vs [8.5±2.1]×10³ PFU/mL, P < 0.05).Conclusion Vero cells can be used to culture TBEV, and A549 cells are more susceptible to TBEV.

Abstract:Objective To explore the anti-inflammatory effect of alginate dressing combined with vacuum sealing drainage on seawater immersion wounds in rats.Methods Ten healthy female SD rats were randomly divided into 2 groups, with 5 rats in each group. The wounds in the experimental group were covered with alginate dressing combined with vacuum sealing drainage, and the wounds in the control group were covered with conventional first aid dressing. Blood samples were taken for routine blood test on the 5^th day after modeling. On the 7^th day after modeling, total RNA was extracted from the wound tissues, and the mRNA expression of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) was analyzed by quantitative polymerase chain reaction (qPCR). Meanwhile, the wound tissues were taken for hematoxylin-eosin (H-E) staining and immunohistochemical staining to observe the histological change and the expression of vascular endothelial growth factor (VEGF).Results The results of routine blood test showed that the white blood cell count in the experimental group was significantly lower than that in the control group (P < 0.05). The results of qPCR showed that the mRNA expression levels of IL-6 and TNF-α in the experimental group were significantly lower than those in the control group (both P < 0.01). The results of H-E staining showed that the collagen fibers were arranged neatly, the neovascularization grew vertically, and the epithelialization was obvious in the wound tissues of rats in the experimental group; while the epithelialization was insufficient, and more inflammatory cells could be seen in the granulation tissues in the control group. The results of immunohistochemical staining showed that the average optical density of VEGF in the experimental group was significantly higher than that in the control group (P < 0.05).Conclusion For seawater immersion wounds, alginate dressing combined with vacuum sealing drainage can significantly reduce inflammatory reaction, promote proliferation of fibroblasts and angiogenesis, so as to promote wound healing.

Abstract:Objective To explore the effects of advanced glycation end product (AGE) on proliferation and differentiation of mouse embryonic osteoblast line MC3T3-E1 cells and its mechanisms.Methods MC3T3-E1 cells were treated with different mass concentrations of AGE (100, 200, and 300 mg/L). Cell proliferation activity and apoptosis rate were detected by cell counting kit 8 and flow cytometry, respectively. Osteogenic ability was detected by alkaline phosphatase (ALP) staining, and the mRNA expression of osteogenesis-related genes (osteocalcin, ALP, and Runx2), Yes-associated protein (YAP), and β-catenin was detected by quantitative polymerase chain reaction. The protein expression of YAP and β-catenin was detected by Western blotting, and the nuclear contents of YAP and β-catenin and the expression of cytoskeleton protein filamentous actin (F-actin) were observed by immunofluorescence assay.Results The proliferation activity of MC3T3-E1 cells was significantly decreased and the apoptosis rates were significantly increased after treatment with 200 or 300 mg/L AGE (all P < 0.05), and 100 mg/L AGE had no significant effect on cell proliferation or apoptosis and was selected for the experiment. Under osteogenic induction culture condition, compared with the control group, the ALP staining was shallow in MC3T3-E1 cells after treatment with 100 mg/L AGE, and the mRNA expression levels of osteocalcin, ALP and Runx2 were significantly lower (all P < 0.05). Under conventional culture condition, compared with the control group, the morphology and distribution of F-actin were significantly changed in MC3T3-E1 cells after treatment with 100 mg/L AGE; there were no significant changes in the mRNA or protein expression of YAP, but the nuclear contents were decreased; and the mRNA and protein expression levels of β-catenin were significantly decreased (both P < 0.05), but the nuclear contents had no significant change.Conclusion AGE can inhibit proliferation activity, induce apoptosis, and inhibit osteogenic differentiation ability of MC3T3-E1 cells. F-actin, YAP, and β-catenin participate in the regulation process.

Abstract:Objective To examine the monocyte to high density lipoprotein ratio (MHR) in patients with acute cerebral infarction, analyze the plaque characteristics of culprit arteries, and explore the correlation between MHR and plaque stability.Methods A total of 147 consecutive patients with acute cerebral infarction who were hospitalized in Neurovascular Center of The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2019 to Jul. 2020 and underwent intracranial high resolution magnetic resonance (HRMR) vessel wall imaging were retrospectively enrolled, with 27 cases in non-plaque group, 72 cases in mono-diseased artery group, and 48 cases in multi-diseased artery group. The intracranial artery stenosis and plaque stability were evaluated by intracranial HMHR vessel wall imaging. The correlation between MHR and plaque enhancement was explored by Spearman correlation analysis. With plaque enhancement grade used for reflecting plaque stability (grade 0 enhancement was stable, and grade 1 and 2 enhancement was unstable), the influencing factors of intracranial arterial plaque stability were evaluated by binary logistic regression analysis. The evaluation value of MHR on plaque stability was analyzed by receiver operating characteristic (ROC) curve, and the optimal cut-off value and corresponding sensitivity and specificity were calculated according to Youden index. The patients with plaques were divided into high MHR group and low MHR group according to the optimal cut-off value of MHR. The data change of plaque enhancement was obtained during 12.00-month (median) follow-up, and Cox regression equation was constructed to explore the role of MHR in predicting the stability of intracranial arterial plaques.Results The MHR was significantly higher in the mono-diseased artery group and multi-diseased artery group than that in the non-plaque group (P＝0.003, P < 0.001), and was significantly higher in the multi-diseased artery group than that in the mono-diseased artery group (P＝0.003). Spearman correlation analysis showed that MHR was positively correlated with the plaque enhancement (r＝0.469, P＝0.001). Binary logistic regression analysis showed that after adjustment for age, hypertension, stenosis degree of culprit artery, vascular remodeling, and plaque burden, MHR was an influencing factor of intracranial arterial plaque stability in patients with acute cerebral infarction (odds ratio＝2.13, 95% confidence interval [CI] 1.45-3.14, P < 0.001). ROC curve analysis showed that the area under curve (AUC) value of MHR in evaluating the stability of intracranial arterial plaques of patients with acute cerebral infarction was 0.821 (95% CI 0.726-0.915, P < 0.001), with an optimal cut-off value of 0.52×10⁹/mmol, a sensitivity of 0.75, and a specificity of 0.80. There were 44 patients in the high MHR (MHR≥0.52×10⁹/mmol) group and 76 patients in the low MHR (MHR < 0.52×10⁹/mmol) group. The plaque enhancement in the high MHR group was significantly higher than that in the low MHR group (P＝0.009). Cox regression analysis showed that low MHR was associated with the stability of culprit artery plaques (hazard ratio＝3.21, 95% CI 1.92-5.36, P < 0.001).Conclusion MHR is correlated with the stability of intracranial arterial plaques of patients with acute cerebral infarction, and it has a predictive value for the plaque stability, and probably is a marker of the stability of intracranial arterial plaques.

Abstract:Objective To investigate the relationship between soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and atherosclerotic plaque formation in patients with type 2 diabetes mellitus (T2DM).Methods A total of 73 T2DM patients hospitalized in Department of Endocrinology of The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jun. to Dec. 2017 were enrolled, and were divided into plaque group (46 cases) and non-plaque group (27 cases). General data, blood biochemical indexes and serum sTWEAK levels of the 2 groups were compared. The correlation between sTWEAK and each clinical index was evaluated using Spearman correlation analysis. Influencing factors of atherosclerotic plaque formation were evaluated using logistic regression analysis.Results Compared with non-plaque group, the age and serum sTWEAK level were significantly higher in the plaque group ([55.87±10.65] years old vs [44.04±11.96] years old, P＝0.001; 79.53 [26.87, 113.03] pg/mL vs 47.70 [18.62, 78.15] pg/mL, P＝0.018). Spearman correlation analysis showed that serum sTWEAK level was positively correlated with age (r＝0.247, P＝0.035) and number of plaques (r＝0.270, P＝0.021). Logistic regression analysis showed that age was an independent risk factor of atherosclerotic plaque formation in T2DM patients (odds ratio [OR]＝1.091, 95% confidence interval [CI] 1.036-1.148, P＝0.001), while serum sTWEAK was not an independent risk factor (OR＝1.012, 95% CI 0.999-1.025, P＝0.063).Conclusion T2DM patients with atherosclerotic plaques have higher serum sTWEAK levels, and the increase of serum sTWEAK levels may be related to age.

Abstract:Objective To analyze the plaque characteristics of patients with recurrent or stable ischemic stroke caused by non-stenotic intracranial atherosclerosis using three dimensional high resolution vessel wall magnetic resonance imaging (3D hr-VW-MRI).Methods A total of 42 patients with ischemic stroke caused by non-stenotic intracranial atherosclerosis in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2019 to Aug. 2021 were prospectively enrolled. The patients were examined by 3D hr-VW-MRI within 4 weeks of onset and after 3-month follow-up. Imaging features of plaques, including luminal area, maximum wall thickness and minimum wall thickness at the most stenotic site, stenosis rate, plaque burden, remodeling index, eccentricity index, enhancement ratio at the most stenotic site, enhancement ratio of the whole plaque, plaque volume, and intraplaque hemorrhage, were measured based on plain and contrast-enhanced T1 weighted imaging (T1WI). With regular medical treatment, the patients were divided into recurrent group and stable group according to whether they had transient ischemic attack or cerebral infarction (hyperintensity on cranial magnetic resonance diffusion weighted imaging images with corresponding ischemic stroke symptoms) on the ipsilateral side of the original ischemic stroke. The differences in imaging features of plaques between recurrent group and stable group were analyzed.Results There were 11 patients in the recurrent group and 31 patients in the stable group. The eccentricity index, enhancement ratio at the most stenotic site, enhancement ratio of the whole plaque, plaque volume and intraplaque hemorrhage incidence in the recurrent group were significantly higher than those in the stable group (all P < 0.05). There were no significant differences in the luminal area, maximum wall thickness or minimum wall thickness at the most stenotic site, stenosis rate, plaque burden, or remodeling index between the 2 groups (all P > 0.05).Conclusion 3D hr-VW-MRI can effectively evaluate the plaque characteristics of patients with recurrent ischemic stroke caused by non-stenotic intracranial atherosclerosis, providing reference for clinical prevention of ischemic stroke recurrence.

Abstract:Objective To explore the role of myocardial strain parameters in predicting left ventricular remodeling (LVR) in patients with acute ST segment elevation myocardial infarction (STEMI).Methods A total of 81 patients who were diagnosed with STEMI and successfully treated with primary percutaneous coronary intervention (PPCI) in Cardiovascular Clinic of Shanghai Jiao Tong University Affiliated Sixth People's Hospital from Jan. 1, 2018 to Jan. 31, 2019 were sequentially enrolled. Cardiac magnetic resonance at 3.0 Tesla was performed at the acute stage of STEMI (< 7 d) and after 6 months of onset. According to whether LVR (increase of left ventricular end-diastolic volume [LVEDV] measured by the second cardiac magnetic resonance examination ≥20% from baseline) occurred after 6 months of onset, the patients were divided into LVR group (33 cases) and non-LVR group (48 cases). Myocardial strain parameters were evaluated to predict LVR of STEMI patients after PPCI.Results Compared with the non-LVR group, the level of peak hypersensitive serum cardiac troponin I (peak hs-cTnI) at the acute stage of myocardial infarction was significantly higher, the global longitudinal strain (GLS) was significantly lower, and the time to peak longitudinal strain in infarct zone was significantly shorter in the LVR group (all P < 0.01). Multivariate logistic regression analysis showed that peak hs-cTnI (odds ratio [OR]＝1.026, 95% confidence interval [CI] 1.006-1.046, P＝0.012) and time to peak longitudinal strain in infarct zone (OR＝0.967, 95% CI 0.950-0.983, P < 0.001) were independent influencing factors of LVR after 6 months of onset in STEMI patients. ROC curve analysis showed that when the peak hs-cTnI was 85.54 μg/L, the sensitivity and specificity of predicting LVR in STEMI patients after 6 months of onset were 60.60% and 97.90%, respectively (area under curve [AUC] value was 0.795, P < 0.001); when the GLS was －10.56%, the sensitivity and specificity were 81.80% and 70.80%, respectively (AUC value was 0.761, P < 0.001); when the time to peak longitudinal strain in infarct zone was 309.12 ms, the sensitivity and specificity were 87.90% and 87.50%, respectively (AUC value was 0.926, P < 0.001).Conclusion Peak hs-cTnI at acute stage, GLS and time to peak longitudinal strain in infarct zone were valuable in predicting LVR in STEMI patients receiving PPCI treatment after 6 months of onset, and peak hs-cTnI and time to peak longitudinal strain in the infarct zone are independent influencing factors for LVR.

Abstract:Objective To evaluate the role of contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) in the malignant risk assessment of focal liver lesions in patients with chronic liver disease.Methods The clinical and imaging data of 197 nodules in 151 patients with focal liver lesions with high-risk factors of hepatocellular carcinoma (HCC) who underwent liver CEUS in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from Jan. 2018 to Oct. 2020 were analyzed retrospectively. The nodules were graded by CEUS LI-RADS according to the American College of Radiology (ACR) LI-RADS (2017). The diagnosis of target lesions was confirmed by histopathology or contrast-enhanced computed tomography/magnetic resonance imaging combined with follow-up. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS LI-RADS classification standard in the diagnosis of liver malignant lesions were calculated by diagnostic test formula.Results Among the 197 lesions, 126 were malignant and 71 were benign. CEUS LI-RADS showed that there were 12 lesions for LR-1, 24 lesions for LR-2, 39 lesions for LR-3, 14 lesions for LR-4, 90 lesions for LR-5, and 18 lesions for LR-M. When LR-5 was recognized as HCC, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 77.57% (83/107), 92.22% (83/90), 92.22% (83/90), 77.57% (83/107), and 84.26% (166/197), respectively; when LR-4+5 was recognized as HCC, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 86.92% (93/107), 87.78% (79/90), 89.42% (93/104), 84.95% (79/93), and 87.31% (172/197), respectively; there was no significant difference in the diagnostic value between the 2 criteria (P > 0.05). In addition, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of LR-M in diagnosing non-HCC malignant lesions were 73.68% (14/19), 97.75% (174/178), 77.78% (14/18), 97.21% (174/179), and 95. 43% (188/197), respectively.Conclusion CEUS LI-RADS provides a standardized evaluation for focal liver lesions in patients with chronic liver diseases. It shows good diagnostic efficiency for HCC and high diagnostic specificity and accuracy for non-HCC malignant lesions.

Abstract:Objective To analyze the differences in sagittal spino-pelvic parameters among adolescent idiopathic scoliosis (AIS) patients who underwent posterior spinal osteotomy orthopedic implant fusion and internal fixation with different distal fixed vertebrae.Methods The general data and imaging parameters of 49 AIS patients who underwent posterior spinal osteotomy orthopedic implant fusion and internal fixation in our hospital between Jan. 2010, and Nov. 2019 were analyzed retrospectively. The imaging parameters were measured preoperatively and at the last follow-up (at least 24 months after operation), including thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and the Cobb angles of proximal thoracic curve, main thoracic curve and thoracolumbar/lumbar curve, and PI－LL was calculated. According to the distal fixed vertebrae, the patients were divided into T₁₂-L₂ group and L₃-L₅ group. The general data and imaging parameters were compared between the 2 groups.Results There were 31 AIS patients in the T₁₂-L₂ group and 18 AIS patients in the L₃-L₅ group. There were no significant differences in age, gender, follow-up duration, Risser sign, or number of fused vertebrae between the 2 groups (all P > 0.05). There were no significant differences in SVA, PI, PT, SS, TK, LL, or PI－LL between the 2 groups before operation (all P > 0.05). Compared with those before operation, at the last follow-up, the LL was significantly increased in the L₃-L₅ group (P＝0.001) while significantly decreased in the T₁₂-L₂ group (P＝0.027), and the PI－LL was significantly increased in the T₁₂-L₂ and L₃-L₅ groups (1.8°[－4.0°, 8.7°] vs 0.3°[－4.7°, 5.7°]and －10.1°[－14.4°, －8.8°] vs 1.7°[－7.3°, 5.6°], P＝0.016 and 0.002). At the last follow-up, the change of PI－LL in the L₃-L₅ group was significantly greater than that in the T₁₂-L₂ group (P < 0.001).Conclusion For AIS patients, postoperative LL may increase when distal fixation is at L₃-L₅ during posterior spinal osteotomy orthopedic implant fusion and internal fixation, resulting in the mismatch between PI and LL, which may affect the sagittal spino-pelvic balance. The appropriate LL should be predicted according to PI before operation to avoid excessive bending of the rod during operation.

Abstract:Objective To explore the characteristics of automatic cognitive processing of identity information as self-related information using eye tracking technology.Methods A total of 95 students from Air Force Medical University were recruited from Jul. to Oct. 2020, including 62 males and 33 females, aged 18-24 years old, with an average age of (20.71±1.53) years old, all right-handed. Through Go/NoGo visual search task combined with eye tracking technology, a single-factor general linear model was used to compare the differences of eye movement characteristics (gaze points and gaze duration) between highly self-related information and lowly self-related information after relevance evaluation of identity words.Results The relevance evaluation results of identity words showed that, for the recruited students, the identity words of students (experiment, student, and internship) were highly self-related information, and the identity words of soldiers (sentry, soldier, and sentinel) were lowly self-related information. Univariate general linear model analysis showed that the eye movement characteristics of self-related information had a significant marginal main effect. The gaze points and gaze duration of highly self-related information were marginally smaller than those of lowly self-related information (1.80±0.67 vs 1.87±0.68 and [499.36±269.70] ms vs [525.58±278.17] ms, F＝3.83 and 3.55, P＝0.052 and 0.059). The main effect analysis showed that the gaze points and gaze duration in the upper left quadrant (P1) were the highest compared with the other 3 areas (all P < 0.01); the gaze points and gaze duration in the upper right quadrant (P2) were higher than those in the lower left quadrant (P4) (both P < 0.01); the gaze points in the P2 were more than those in the lower right quadrant (P3) (P < 0.01); and the gaze duration in the P3 was significantly longer than that in the P4 (P < 0.05).Conclusion Individual identity information, as highly self-related information, may have cognitive characteristics of automated processing. At the same time, in an overall gaze space, there is a phenomenon that information processing decreases sequentially from left to right and from top to bottom.

Abstract:The incidence of adolescent idiopathic scoliosis (AIS) is higher in females than in males. Whether AIS and its clinical treatment will affect pregnancy and delivery has become a concern of female AIS patients and clinicians. Based on the literature on the fertility status of female AIS patients after treatment, this paper summarizes the indicators that can be used to evaluate the fertility status of female AIS patients after treatment, including low back pain, spinal anesthesia rate, delivery mode/cesarean section rate, sexual function, and postpartum depression, and lists the measurement methods used to evaluate different indicators.

Abstract:Depression is a kind of mental illness that endangers the quality of life among human beings all over the world. It has the characteristics of high morbidity, high disease burden, and high disability rate. Despite the availability of several antidepressants targeting monoamine transmitters, nearly a third of patients fail to respond to treatment after adequate treatment based on multiple monoamine therapies. The condition is clinically known as treatment-resistant depression. At present, the specific pathophysiological mechanism of the disease is not clear, but with the increasing recognition of the inflammatory mechanism of depression, the neuroinflammation of treatment-resistant depression has attracted much attention. This paper reviews the pathogenesis of treatment-resistant depression from the perspective of inflammation, so as to provide ideas and directions for further research.

Abstract:During diving, the change in ambient pressure may cause inner ear barotrauma, which is closely related to the repeated Valsalva maneuver for equilibration of middle ear pressure. Valsalva maneuver may increase the cerebrospinal fluid pressure and inner ear pressure, and therefore the pressure gradient between inner ear lymph and middle ear increases, which may cause the rupture of the round or oval window and the perilymph leakage from the inner ear, leading to inner ear barotrauma. Although the incidence of inner ear barotrauma is low, it is an important factor affecting the fitness to dive in divers. Divers with inner ear barotrauma usually experience non-specific symptoms such as dizziness, tinnitus, and hearing loss. The vestibular involvement may even cause nausea and vomiting. The inner ear barotrauma is mainly distinguished from inner ear decompression sickness. Treatments for inner ear barotrauma include compression therapy, conservative treatment, and surgical repair. This paper briefly introduces the current knowledge about diving-related inner ear barotrauma.

Abstract:Objective To explore the early warning role of high-frequency ultrasonography on knee joint military training injury (MTI).Methods A total of 80 newly recruited soldiers from an armed police force were enrolled. All of them received standardized recruit training, and underwent high-frequency ultrasonography of both knee joints, clinical inquiry and physical examination before and after 3-month recruit training.Results All the 80 recruits were male, with an average age of (20.4±1.4) years old, in good physical condition, and there was no chief complaint of knee discomfort before recruit training. Ultrasonography of both knee joints before recruit training showed osteochondrosis of the tibial tuberosity in 4 cases (4 knee joints, including 1 case complicated with old injury of patellar tendon), patellar tendinopathy in 2 cases (2 knee joints), old tendinopathy at the end of iliotibial tract in 2 cases (2 knee joints), old injury at the end of lateral collateral ligament in 1 case (1 knee joint), and suprapatellar bursa effusion in 2 cases (2 knee joints). After 3-month recruit training, 3 of the 4 recruits with osteochondrosis of the tibial tuberosity developed knee joint pain, and 2 of them had significant pain (1 case complicated with old injury of patellar tendon), which affected normal training. Knee joint pain was found in the 2 cases with patellar tendinopathy, of which 1 case had significant pain affecting normal training. No complaints of discomfort were reported in the 2 cases with old tendinopathy at the end of iliotibial tract, 1 case with old injury at the end of lateral collateral ligament, or 2 cases with suprapatellar bursa effusion.Conclusion High-frequency ultrasonography can find the knee joint MTI of asymptomatic soldiers, which is helpful for early development of prevention and control strategies, and is of great significance for maintaining the health of soldiers and improving the combat effectiveness of troops.

Abstract:Objective To compare the efficacy of a new precision surgical system and traditional surgical instruments in the treatment of hypertrophic obstructive cardiomyopathy (HOCM).Methods Eight 4-month-old male Guangxi Bama miniature pigs were used to prepare HOCM models, and were randomly divided into control group (n＝4) and experimental group (n＝4). The pigs in both groups underwent modified extended Morrow procedure by the same team. The ventricular septal hypertrophy tissues were removed in the control group with traditional surgical instruments such as sickle blade, while in the experimental group with a new precision surgical system. Echocardiography was performed by the same physician 24 h before and 72 h after surgery. Anteroposterior diameter of the left atrium, interventricular septal thickness, left ventricular end-diastolic diameter, mean pressure difference of left ventricular outflow tract (LVOT), left ventricular ejection fraction, systolic anterior motion (SAM) of the mitral valve, and mitral valve regurgitation were measured. Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level was detected by chemiluminescence method.Results The extracorporeal circulation time and aortic occlusion time in the experimental group were significantly shorter than those in the control group (both P < 0.05). The postoperative interventricular septal thickness, mean pressure difference of LVOT, anteroposterior diameter of left atrium, left ventricular ejection fraction, mitral valve regurgitation, and serum NT-proBNP level were significantly lower than preoperative ones in both groups (all P < 0.05). The postoperative interventricular septal thickness, mean pressure difference of LVOT and serum NT-proBNP level of the experimental group were significantly lower than those of the control group (all P < 0.05). All HOCM pigs survived 72 h after surgery, aortic valve injury was detected in 1 HOCM pig in each group, and there were no left bundle branch block or iatrogenic ventricular septal perforation.Conclusion Compared with the traditional surgical instruments, the new HOCM precision surgical system can accurately remove the ventricular septal hypertrophy tissues, significantly shorten the operative time and improve the short-term treatment outcome without increasing the early postoperative complications or mortality.

Abstract:Objective To quantitatively evaluate the changes of right ventricular function and myocardial strain in patients with coronary artery chronic total occlusion (CTO) during long-term follow-up after treatment by cardiac magnetic resonance (CMR).Methods A total of 13 patients who were diagnosed as coronary artery CTO in The First Affiliated Hospital of Dalian Medical University from Jan. 2015 to Dec. 2019 and completed CMR scanning before and after treatment were enrolled. The left and right ventricular structural and functional parameters as well as right ventricular myocardial strain parameters were measured by CVI42 5.10 software, and the differences of these parameters were analyzed before and after treatment.Results The interval between 2 CMR examinations was 259 to 1 168 d in the patients, with an average of (500.08±228.34) d. In terms of left ventricular parameters, left ventricular end-diastolic volume and left ventricular end-systolic volume were significantly increased after treatment, while left ventricular mass was significantly decreased (148.35 [141.70, 181.66] mL vs 140.08 [116.42, 170.90] mL, 77.78 [52.41, 100.24] mL vs 56.07 [47.59, 89.93] mL, [113.67±16.81] g vs [127.14±22.99] g, all P < 0.05); and there were no significant differences in other left ventricular structural or functional parameters before and after treatment (all P > 0.05). In terms of right ventricular parameters, right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), and right ventricular mass (RVM) were significantly increased after treatment ([144.52±25.14] mL vs [118.46±28.08] mL, [71.51±14.59] mL vs [55.62±15.93]mL, [35.05±7.31] g vs [30.43±5.95] g, all P < 0.05); and there were no significant differences in right ventricular function parameters such as right ventricular ejection fractionConclusion During long-term follow-up after treatment, the right ventricular functional parameter RVEF and myocardial strain of coronary artery CTO patients are stable, while the structural parameters RVEDV, RVESV and RVM are increased.

Abstract:Objective To investigate the expression and significance of microRNA-21 (miRNA-21) and its target gene Pellino-1 (Peli1) in mouse model of autoimmune premature ovarian insufficiency (POI).Methods Twenty-four female BALB/c mice were randomly divided into POI group and control group (12 in each group), with zona pellucida 3 (ZP3) polypeptide and the same dose of normal saline subcutaneously injected, respectively. Ovarian function was evaluated by counting follicles, observing estrus cycle and detecting the levels of serum estradiol, follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH). The levels of interferon-γ and interleukin (IL)-10 were detected by enzyme-linked immunosorbent assay, the ratio of regulatory T cells (Tregs) of the spleen was detected by flow cytometry, the target gene of miRNA-21 was predicted by bioinformatics, and the expression of miRNA-21 in peripheral blood mononuclear cells (PBMCs) and ovarian tissues and the mRNA expression of Peli1 in PBMCs and Tregs of the spleen were detected by quantitative polymerase chain reaction.Results Six weeks after the second immunization, the mice in the POI group basically had no estrus, while the estrus cycle was normal in the control group. The number of follicles of each grade in the ovaries, the levels of serum estradiol, AMH and IL-10, ratio of Tregs in the spleen, and the expression levels of miRNA-21 in PBMCs and ovarian tissues were significantly lower in the POI group than those in the control group (all P < 0.05), while the levels of serum FSH and interferon-γ were significantly higher than those in the control group (both P < 0.01). Bioinformatics prediction revealed that Peli1 was a target gene of miRNA-21. The mRNA expression levels of Peli1 in PBMCs and splenic Tregs in the POI group were significantly lower than those in the control group (all P < 0.05).Conclusion The expression of miRNA-21 and its target gene Peli1 is significantly decreased in autoimmune POI mouse model, suggesting that miRNA-21 and Peli1 may be involved in the pathogenesis of autoimmune POI.

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