Clinical analysis of children with cardiac syncope caused by anomalous origin of the left coronary artery from the right sinus / 中华心血管病杂志

Objective: To analysis the clinical characteristics and to summarize therapy experience of pediatric patients with cardiac syncope caused by anomalous origin of the left coronary artery from the right sinus (ALCA-R). Methods: We retrospectively analyzed the clinical data including clinical manifestations, myocardial injury biomarkers, radiological features, treatments and prognoses of pediatric patients with ALCA-R who were admitted to Beijing Children's Hospital from November 2015 to June 2018. Results: Four female patients were included in this analysis, age of onset was 7 to 14 years. All the patients presented with exercise-induced syncope and acute myocardial infarction. During the course, three patients presented with acute left heart failure, and one patient had history of sudden cardiac arrest. Laboratory data showed significant elevation of both the creatine kinase and troponin levels in four patients. All electrocardiogram (ECG) showed left main coronary artery occlusion, echocardiography suggested the possible anomalous origin of the left coronary artery in one child. Coronary CT angiography (CTA) revealed there was no coronary ostium in the left coronary sinus, and the left coronary artery had an anomalous origin from the right sinus. The left main coronary artery passed between the ascending artery and the root of the main pulmonary artery, which was compressed by these two large vessels. Two patients underwent cardiac magnetic resonance examination, which detected late gadolinium enhancement in ALCA-R with an interarterial course. Unroofing of the left coronary ostium (cut-back procedure) was performed in two patients, and the other two patients who were not operated were recommended to restrict their physical activities. During a regular follow-up period of 12-43 months, all the children survived without recurrent cardiovascular event. Conclusion: If an adolescent presents with exercise-induced syncope, acute myocardial infarction and even sudden death, and ECG shows left main coronary artery occlusion characteristics, we should consider the possibility of developmental abnormality of coronary artery, particularly the ALCA-R. Once diagnosed as ALCA-R, patients should be recommended to avoid strenuous activities，early recognition and surgical treatment are imperative for these patients.

Innovation and exploration in medical immunology experiment lessons that aiming on clinical practice / 中国免疫学杂志

As a frontal subject of life science, the medical immunology lessons are verification and complementary to theory lessons, and students need it to train their scientific ability and spirit. Therefore, some adjustments and explorations is needed in the experiments, for example, the data analysis of ELISA has been imported to the lessons to make them more closer to the practice. It' s shown that our lessons got welcomed by almost all students and is more helpful to them. The results playing an important role in improving our teaching effects in future.

Histomorphological changes of the fungiform papillae and taste buds as well as the expression of Shh during the tongue development in mice / 中国组织工程研究

BACKGROUND:Fungiform and circumvallate papillas on the surface of the mammal tongue mucosa are mainly associated with taste.Taste abnormalities seriously affect patients' quality of life,so it is of significance to understand the developmental processes of fungiform papilla and taste buds,for hypogeusia treatment.OBJECTIVE:To observe the morphological changes of mouse tongue fungiform papilla and taste buds during their developmental processes.METHODS:The tongues of C57BL/6J mice were observed by scanning electron microscope and hematoxylin eosin staining at embryonic days 13.5-18.5 (E13.5-E 18.5),postnatal (PN) days 0.5,4.5,7.5,14.5,21.5,90.5,and postnatal 1.5 years (PN1.5Y),and Shh antibody was used for immunohistochemical staining.Immunohistochemical staining of S-100 was performed on the tongue specimens of the mice at E16.5 and E18.5.RESULTS AND CONCLUSION:The number of fungiform papilla was mainly determined at E13.5-E14.5.From E15.5,the papilla gradually matured in morphology.Taste bud development began at E16.5,and the taste pore began to form at PN7.5.In adult and old age,taste bud cells and intercellular substances were reduced,and keratosis surrounding the fungiform papillae was visible.Shh was expressed in the epithelial cells of fungiform papilla at E14.5,in the epithelial cells at the tip of the fungiform papilla at E16.5 and E18.5,and in adult and elderly taste bud cells.These results suggest that Shh plays an important role in the development,maturation and maintenance of fungiform papillae and taste buds.S-100 is expressed in the connective tissue beneath the fungiform papillae at E18.5,indicating that the nerve extension may be involved in the development and maturation of taste buds.