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Objective:To investigate the feasibility of echocardiography-guided transcatheter closure of atrial septal defect (ASD) during pregnancy and summarize the multidisciplinary treatment experience for such women.Methods:A retrospective analysis was performed on three women receiving echocardiography-guided secondum ASD closure during pregnancy in Guangdong Provincial People's Hospital from January 2018 to October 2021. Perioperative and perinatal multidisciplinary treatment and prognosis were described.Results:All three patients underwent cardiac ultrasonography due to abnormal electrocardiogram during routine prenatal examination and were diagnosed with secondum ASD. Progressive cardiac dysfunction was found during close follow-ups and all cases met the criteria for ASD closure during pregnancy after multidisciplinary evaluation. Echocardiography-guided ASD closure was successfully performed in all patients. Pulmonary arterial pressure was significantly reduced and the cardiac function was stable after the operation. All patients delivered vaginally at term without complications such as miscarriage, premature birth, postpartum hemorrhage or fetal growth restriction and had their cardiac function recovered during postpartum follow-up.Conclusions:Echocardiography-guided ASD closure during pregnancy is technically feasible. Good maternal and fetal outcomes can be obtained through multidisciplinary and close monitoring and treatment during perioperative and perinatal periods.
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Objective To assess the effect of repetitive transcranial magnetic stimulation (rTMS) at different frequencies on behavioral and psychological symptoms and cognitive function in patients with Alzheimer's disease.Methods Seventy-two patients were randomly divided into a high frequency group,a low frequency group and a control group (n =24 for each),and given 10 Hz,1 Hz or sham rTMS over the left and right dorsolateral prefrontal cortex at an intensity was 80％ of each patient's movement threshold.The stimulation was for 30 min a day,five days a week.During the 4 weeks of treatment,risperidone was used at a fixed dose of 1 mg per day for all patients.Before and after the treatment,all 3 groups were assessed using the behavioral pathology in Alzheimer's disease rating scale (BEHAVE-AD) and the mini-mental state examination (MMSE).Results Two weeks after the treatment,the average BEHAVE-AD score of the high frequency group had decreased significantly from (16.75±6.26) to (13.84± 6.10),significantly lower than the low frequency and the control groups' averages.Two weeks later,the average BEHAVE-AD scores of the 3 groups were significantly lower than before the treatment,but the decrease of the high frequency group was of significantly greater compared to the other 2 groups.Four weeks after the treatment the average MMSE score of the high frequency group was significantly better than before the treatment (P＜0.01),and better than the low frequency and the control group's averages.The effectiveness rates of the high frequency group,the low frequency group and the control group were 88％,58％ and 54％ respectively,all significantly different.Conclusion High frequency (10 Hz) rTMS combined with risperidone can improve the behavioral and psychological symptoms and cognitive function of AD patients,while low frequency (1Hz) rTMS does not have obvious effects.
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Objective The risk of ovarian/pelvic serous cancer can be reduced by prophylactic bilateral salpingectomy ( PBS) at the time of hysterectomy .This study was to evaluate the short-term influence of PBS plus hysterectomy on ovarian reserve in premenopausal women . Methods We retrospectively analyzed the clinical data about 60 premenopausal women treated by total lapa-roscopic hysterectomy ( TLH) for benign indications , 30 undergoing PBS at the same time ( the experimental group ) while the other 30 with the ovary preserved ( the control group ) .We compared the levels of FSH, LH, E2, and anti-Müllerian hormone ( AMH) and the inci-dence of peri-menopausal symptoms between the two groups of patients before and at 1 and 3 months after operation . Results Statistically significant differences were not observed between the two groups in the such baseline clinical characteristics as age , gravidity, parity, men-strual cycle, comorbidity, diagnosis, comorbidities, and history of abdominal surgery (P>0.05), nor in the AMH level at the baseline ([1.08±0.08] vs [1.04±0.10] ng/mL) or at 1 month ([0.86± 0.44] vs [0.81±0.48] ng/mL) or 3 months postoperatively ([0.84±0.94] vs [0.68±0.42] ng/mL) (F=0.247, P=0.746).Howev-er, the mean level of AMH was markedly reduced at 1 and 3 months after operation as compared with the baseline ( P0.05) .There were not any statistically significant differences in the levels FSH, LH, and E2 between the two groups before or at 1 and 3 months after surgery (P>0.05), nor in the incidence rates of peri-menopausal symptoms at 1 month (6.7%vs 3.3%, P>0.05) or 3 months postoperatively (10.0%vs 6.7%, P>0.05). Conclusion PBS at the time of total hysterectomy in premenopausal women does not affect ovarian reserve in the short term .The level of AMH has a higher sensitivity than those of FSH , LH and E2 in the assessment of postoperative ovarian function .
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BACKGROUND:Previous studies discovered that pRST98, original y isolated from Salmonel a enterica serovar typhimurium (S.typhimurium) could promote bacterial biofilm formation. In addition, bacterial harboring pRST98 can promote the secretion and expression of interleukin-10 after infection in cells and animals. OBJECTIVE:In vitro studies have discovered the effects of interleukin-10 at varying concentrations and conjugative plasmid pRST98 on the biofilm formation of S.typhimurium. METHODS:S.typhimurium wild-type strainχ3306, virulence plasmid-deletion S.typhimurium strainχ3337 and pRST98-transconjugant S.typhimuriumχ3337/pRST98 were established in vitro and cultured for biofilm formation. 1, 10, 100 μg/L interleukin-10 were added during the biofilm formation. 0 μg/L interleukin-10 was set as a control. Crystal violet staining method, semi-quantitative method, confocal laser scanning microscopy and scanning electron microscopy were used to determine the effects of interleukin-10 on the biofilm formation and compare the effects of S.typhimurium with or without pRST98. RESULTS AND CONCLUSION:Intra-group comparison showed that, compared with the control group, S.typhimurium gathered together and formed thicker biofilm in concentration of 1 and 10 μg/L of interleukin-10. The promotion effects of S.typhimurium on biofilm formation were greatly improved in 10 μg/L. Interleukin-10 in 100 μg/L inhibited S.typhimurium biofilm formation. Inter-group comparison showed that, A570 inχ3337/pRST98 was greatly higher than that inχ3306 andχ3337 under the same concentration of interleukin-10. The results indicate that both 1 and 10 μg/L of interleukin-10 promote biofilm formation, especial y bacteria harboring pRST98.
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BACKGROUND: Denddtic cells (DCs) constitute the dominant population of antigen presenting cells (APCs) by possessing potent ability to initiate T cell immunity. The ultrastructure study of DCs is less reported. OBJECTIVE: To investigate the ultrastructure of DCs from mice bone marrow at different maturation stages, and the morphology of DCs between CD40 ligation and tumor necrosis factor-alpha (TNF-α) stimulation in vitro. METHODS: Mice myeloid DCs were generated from bone marrow in vitro using granulocyte-macrophage colony-stimulating factor (GM-CSF)and interleukin-4 (IL-4). Immature DCs were loaded with apoptotic tumor cells (AP-DC), and AP-DC was then stimulated with CD40L-CHO cells and TNF-α for 48 hours, respectively. DCs were routinely sectioned, and ultrastructure was observed under transmission electron microscope. RESULTS AND CONCLUSION: Immature DCs showed a few short and blunt cytoplasmic processes, there were specific morphology lysosomes that liked earphone in some cells; DCs engulfing the apoptotic bodies were observed; sub-cellular structures between CD40 ligation and TNF-α stimulated DCs were different, the former had typical morphology of mature DCs which exhibited many dendritic protrusions, however, some DCs displayed apoptosis and autophagy after TNF-α stimulation. In a conclusion, CD40 ligation plays an essential role in myeloid DCs differentiation and maturation, TNF-α can mediate apoptosis and autophaqy of DCs.
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Objective To explore the possibility of R plasmid (pRST98) encoding resistance to antimicrobial agents in S. typhi mediate virulence to its host bacteria. Methods pRST98 was transferred into a less virulent strain of S. typhimurium RIA for creating a transconjugant pRST98/RIA. The standard S. typhimurium virulence strain SR-11 which carries a 100kb virulence plasmid was used as a positive control, and RIA as a negative one. Infection with S. typhimurium was employed to assess the effect of pRST98 on the virulence of host bacteria by LD50 of peroral (p.o.) and intraperitoneal (i.p.) infection of BALB/c mice. After oral inoculation of the bacteria into BALB/c mice, mesenteric lymph nodes, spleen and liver were examined for quantity of bacteria and for the histopathological changes. The three strains were also studied for their in vitro adhesion and invasion of HEp-2, CHO and HeLa cells. Three chromosomally isogenic strains, i.e., plasmid-containing wild-type S. typhi strain, plasmid artificially cured strain and plasmid-reintroduced into the cured strain were compared for their resistance to the bactericidal activity present in human, rabbit and guinea pig sera. Results The p.o. and i.p. LD50 of pRST98/RIA was 700 and 75 folds less than that of RIA. The bacteria counting in mesenteric lymph nodes, spleen and liver were more (P<0.05) and more severe histopathological changes were observed in pRST98 harboring S. typhimurium. However, pRST98 did not affect the adhesion and invasion of S. typhimurium to the cells. Experiments showed that pRST98 mediated resistance to serum bactericidal effect in host bacteria (P<0.05). Conclusion This is the first report about a plasmid carrying genes coding for drug resistance and virulence in S. typhi. The data presented here suggested that novel virulence gene or related sequences, which are important in the pathogenesis of Salmonella infection could exist on pRST98.