Mechanism of anterior cingulate cortex in modulating pain and anxiety-like behavior in chronic non-specific low back pain model rats / 中华行为医学与脑科学杂志

Objective:To explore the potential mechanisms of anterior cingulate cortex (ACC) in modulating pain behavior and anxiety-like behavior of rats with chronic non-specific low back pain induced by nerve growth factor (NGF).Methods:Ninety-six male SPF grade SD rats aged 8 weeks were randomly divided into four groups according the random number table method: control group, model group, control+ D-2-amino-5-phosphonopentanoate (D-AP5) group (control+ D-AP5 group) and model+ D-AP5 group, with 24 rats in each group.Low back pain model of rat was established by injection of NGF into multifidus muscle (left side) of the low backs of rats(two times with a five-day interval). Five days after modeling, rats in model+ D-AP5 group and control+ D-AP5 group were injected with the N-methyl-D-aspartate (NMDA) receptor antagonist D-AP5(2 μg, 0.3 μL) at the right side of the ACC once a day for consecutive 3 days, and rats in control group and model group were injected with the same amount of 0.9% sodium chloride solution. Seven days after modeling, the pain threshold of rats was evaluated by mechanical stimulation test and hot and cold plate test.The anxiety-like behavior was tested by open field test.The density of glial fibrillary acidic protein (GFAP) positive cells and c-Fos(a kind of immediate early gene) positive cells of the spinal cord were observed by immunofluorescence. The expression of GFAP, c-Fos, phosphorylated-c-Jun N-terminal kinases (p-JNK), monocyte chemoattractant protein-1 (MCP-1), and chemokine (C-X-C motif) ligand 1 (CXCL-1) proteins in the L2 segment of the spinal cord were detected by Western blot. SPSS 23.0 software was used for statistical analysis. One-way ANOVA was used to analyze normal distribution measurement data for comparison among multiple groups, and Tukey test was used for further pairwise comparisons. The Kruakal-Wallis H test was used for non-normal distribution measurement data, and Mann-Whitney U test was used for further pairwise comparisons with Bonferroni-corrected P-values. Results:In the experiments measuring pressure pain threshold (PPT) and paw withdrawal threshold (PWT), there were statistically significant differences in the PPT and PWT of rats among the four groups ( F=53.498, 41.939, both P<0.001). Seven days after modeling, PPT ((418.5±46.9) g) and PWT ( (55.6±7.1) g) in the ipsilateral side of the rats in model+ D-AP5 group were higher than those in model group ((290.0±32.0) g, (30.5±7.5) g) (both P<0.001). In the open field test, there were statistically significant differences in percentage of the inner zone distance ( H=11.922, P<0.01) and the percentage of inner zone time ( H=21.614, P<0.001) of rats among the four groups. The percentage of inner zone time in model+ D-AP5 group was higher than that in model group (5.6(4.3, 7.9) %, 3.1(2.1, 3.8) %) ( P<0.01). The results of immunofluorescence showed that there were statistically significant differences in the density of GFAP positive cells and c-Fos positive cells at the ipsilateral side of the superficial laminae of rats among the four groups ( H=49.085, F=18.120, both P<0.001). The density of GFAP positive cells (34.3(21.1, 47.5) cells/mm 2) and c-Fos positive cells ((52.7±39.4) cells/mm 2) at the ipsilateral side of the superficial laminae in model+ D-AP5 group were less than those in model group (76.5(68.6, 94.9) cells/mm 2, (112.4±63.7) cells/mm 2) (both P<0.001). The Western blot results showed that there were statistically significant differences in the protein expression of GFAP, c-Fos, p-JNK, MCP-1 and CXCL-1 in the L2 segment of rats among the four groups ( F=49.413, 38.437, 41.867, 36.735, 130.951, all P<0.001). The protein expression of GFAP (1.7±0.5), c-Fos (1.1±0.1), p-JNK (1.7±0.3), MCP-1 (1.0±0.4) and CXCL-1 (0.8±0.1) in the L2 segment in model+ D-AP5 group were lower than those in model group ((4.3±0.7), (2.6±0.5), (2.8±0.4), (2.9±0.4), (3.5±0.4)) (all P<0.01). Conclusion:ACC modulates mechanical hyperalgesia and anxiety-like behavior in chronic non-specific low back pain rats, which might be associated with the involvement of spinal astrocytes, p-JNK signal pathway and chemokines such as MCP-1 and CXCL-1.

Zygomaticotemporal suture maturation evaluation in Chinese population using cone-beam computed tomography images / 대한치과교정학회지

Objective@#This study aimed to evaluate the zygomaticotemporal suture (ZTS) maturation, analyze the age distribution patterns of ZTS maturation stages, and investigate the relationship between ZTS and cervical vertebral maturation (CVM). @*Methods@#A total of 261 patients who underwent cone-beam computed tomography (112 males, mean age, 13.1 ± 3.3 years; 149 females, mean age, 13.7 ± 3.1 years) were examined to evaluate the ZTS stages. The ZTS stages were defined based on a modified method from previous studies on zygomaticomaxillary sutures. Differences between groups and correlations between indicators were analyzed using the Spearman correlation test, intraclass coefficient of correlation (ICC), one-way analysis of variance and rank sum test.Statistical significance was set at p 10 were found for several cervical stages (CSs), including CS1 and CS2 for the diagnosis of stage B, CS1 to CS3 for the diagnosis of stages B and C, and CS6 for the diagnosis of stages D and E. @*Conclusions@#The ZTS maturation stage may be more relevant to the CVM stage than to the chronological age. The CVM stages can be good indicators for clinical decisions regarding maxillary protraction, except for CS4 and CS5.

Advances in the study of the correlation between urolithiasis and non-alcoholic fatty liver disease / 中华泌尿外科杂志

In recent years, researchers have found that patients with nonalcoholic fatty liver disease (NAFLD) often have urolithiasis, and the incidence of urolithiasis increases gradually with the severity of NAFLD. Meanwhile, the detection rate of NAFLD was higher in patients with urolithiasis than in normal controls. In this paper, we reviewed the domestic and international studies on the correlation between urolithiasis and NAFLD and described the related pathogenesis, such as insulin resistance, oxidative stress, abnormal lipid metabolism and impaired glyoxalate detoxification. Meanwhile, this paper proposed preventive measures to reduce the risk of development and recurrence of NAFLD-associated urolithiasis by addressing the common risk factors of both diseases, including metabolism-related diseases, lifestyle and diet.

Research progress of PD-1 and PD-L1 in the immune of sepsis / 国际生物医学工程杂志

Sepsis is currently the leading cause of death in the intensive care unit, and its survivors also experience long-term immunosuppression and high rates of recurrent infections. At present, the clinical treatment of sepsis is still based on antibiotics, intravenous rehydration, and vasopressors, and there is no targeted drug treatment. However, as the rate of antibiotic resistance continues to increase, immunotherapy is highly anticipated as a new treatment. Patients with sepsis are often accompanied by acute leukocyte immune dysfunction and immunosuppression, which may be an important risk factor for the increasing morbidity and mortality of patients. Targeted inhibition of specific cell surface inhibitory immune checkpoint receptors and ligands, such as programmed death receptor-1 (PD-1), programmed death-ligand 1 (PD-L1), and other targets, can improve the host’s resistance to infection. In this paper, the research progress of PD-1 and PD-L1 in the immune response to sepsis was summarized to provide a theoretical basis for their further application in the treatment of sepsis in the future.

Efficacy of Dupilumab in the treatment of severe atopic dermatitis in children / 中华实用儿科临床杂志

This clinical data of 3 cases of severe atopic dermatitis (AD) who had no remission after taking to-pical glucocorticoids and antihistamines were collected retrospectively.The patients were treated with Dupilumab in the Department of Pediatrics, the Second Hospital of Tianjin Medical University from April to October 2021.All 3 cases developed eczema-like rashes with strong itching and sleep disturbance within the first year after their birth.The children′ quality of life was seriously impaired.All the cases were combined with allergic rhinitis, 2 cases of whom were simultaneously complicated with bronchial asthma.After 14-18 weeks of treatment, the rash, pruritic symptoms and quality of life were significantly improved.Meanwhile, rhinitis symptoms were reduced, asthma control scores and lung function were improved to varying degrees.No serious adverse reactions occurred during the injection period.

Efficacy of Dupilumab in the treatment of severe atopic dermatitis in children / 中华实用儿科临床杂志

This clinical data of 3 cases of severe atopic dermatitis (AD) who had no remission after taking to-pical glucocorticoids and antihistamines were collected retrospectively.The patients were treated with Dupilumab in the Department of Pediatrics, the Second Hospital of Tianjin Medical University from April to October 2021.All 3 cases developed eczema-like rashes with strong itching and sleep disturbance within the first year after their birth.The children′ quality of life was seriously impaired.All the cases were combined with allergic rhinitis, 2 cases of whom were simultaneously complicated with bronchial asthma.After 14-18 weeks of treatment, the rash, pruritic symptoms and quality of life were significantly improved.Meanwhile, rhinitis symptoms were reduced, asthma control scores and lung function were improved to varying degrees.No serious adverse reactions occurred during the injection period.

The gut microbial metabolite, 3,4-dihydroxyphenylpropionic acid, alleviates hepatic ischemia/reperfusion injury via mitigation of macrophage pro-inflammatory activity in mice

Hepatic ischemia/reperfusion injury (HIRI) is a serious complication that occurs following shock and/or liver surgery. Gut microbiota and their metabolites are key upstream modulators of development of liver injury. Herein, we investigated the potential contribution of gut microbes to HIRI. Ischemia/reperfusion surgery was performed to establish a murine model of HIRI. 16S rRNA gene sequencing and metabolomics were used for microbial analysis. Transcriptomics and proteomics analysis were employed to study the host cell responses. Our results establish HIRI was significantly increased when surgery occurred in the evening (ZT12, 20:00) when compared with the morning (ZT0, 08:00); however, antibiotic pretreatment reduced this diurnal variation. The abundance of a microbial metabolite 3,4-dihydroxyphenylpropionic acid was significantly higher in ZT0 when compared with ZT12 in the gut and this compound significantly protected mice against HIRI. Furthermore, 3,4-dihydroxyphenylpropionic acid suppressed the macrophage pro-inflammatory response in vivo and in vitro. This metabolite inhibits histone deacetylase activity by reducing its phosphorylation. Histone deacetylase inhibition suppressed macrophage pro-inflammatory activation and diminished the diurnal variation of HIRI. Our findings revealed a novel protective microbial metabolite against HIRI in mice. The potential underlying mechanism was at least in part, via 3,4-dihydroxyphenylpropionic acid-dependent immune regulation and histone deacetylase (HDAC) inhibition in macrophages.

Research progress on healthcare-associated infection in patients with extracorporeal membrane oxygenation / 中华危重病急救医学

Extracorporeal membrane oxygenation (ECMO), as an effecitive life support technique, is widely used in patients with respiratory and/or cardiac failure. Infection, with a prevalence of approximately 21% in adult patients with ECMO, is one of the most common complications and has a significant impact on mortality. Early identification of infections, and accurate prevention and anti-infective therapies for ECMO patients can improve their survival, but there is a lack of standardized protocols for recognition, diagnosis, management, prevention and treatment of the infections. By analyzing a series of literatures on healthcare-associated infections in patients with ECMO, the epidemiology, pathogens, risk factors, diagnosis, prevention and treatment were summarized to provide a theoretical background for the early identification, diagnosis and patient management of nosocomial infections.

Targeted inhibition of GRK2 kinase domain by CP-25 to reverse fibroblast-like synoviocytes dysfunction and improve collagen-induced arthritis in rats

Rheumatoid arthritis (RA) is an autoimmune disease and is mainly characterized by abnormal proliferation of fibroblast-like synoviocytes (FLS). The up-regulated cellular membrane expression of G protein coupled receptor kinase 2 (GRK2) of FLS plays a critical role in RA progression, the increase of GRK2 translocation activity promotes dysfunctional prostaglandin E4 receptor (EP4) signaling and FLS abnormal proliferation. Recently, although our group found that paeoniflorin-6'-

Modified single-patch technique for children with complete atrioventricular septal defect in a single center / 中国胸心血管外科临床杂志

@#Objective    To sum up the experience of the primary modified single-patch (MSP) technique applied in our hospital for children with complete atrioventricular septal defect (CAVSD). Methods    The clinical data of 141 children who underwent primary MSP technique for CAVSD between June 2009 and December 2017 were retrospectively analyzed, including 62 males and 79 females with a median age of 6 (3, 11) months and a median weight of 5.8 (4.5, 7.0) kg. According to Rastelli classification, there were 116 patients in type A, 14 in type B and 11 in type C. Among them, 15 patients were diagnosed with Down’s syndrome. Cardiopulmonary bypass time, aortic cross clamp time, atrioventricular valve regurgitation and other clinical data were recorded during and after operation. Results    Postoperatively, 17 patients suffered from severe left atrioventricular valve regurgitation (LAVVR) and 6 patients severe right atrioventricular valve regurgitation (RAVVR). In the follow-up period, 5 patients suffered from severe LAVVR and 1 patient severe RAVVR. Left ventricular outflow tract obstruction (LVOTO) appeared in 1 patient during follow-up period and none at the end of follow-up. There were 5 early deaths and 2 late deaths. Twelve patients underwent reoperation with a median interval time of 268 (8, 1 270) days. Conclusion    MSP technique is a wise surgical strategy for CAVSD children with good outcomes, improved postoperative mortality and decreased atrioventricular valve regurgitation.

Clinical characteristics and risk factors of adverse reactions to blood transfusion in Chinese adults based on evidence-based medicine / 中国输血杂志

【Objective】 To evaluate the clinical characteristics and risk factors of adverse transfusion reactions (ATR) in Chinese adults, and to provide evidence-based medical evidence for early prevention. 【Methods】 The controlled trial (CT) of risk factors for ATR in Chinese adults were collected through PubMed, Embase, Cochrane Library, CNKI, CMB, VIP and Wanfang database, and the retrieval time was from the establishment of those databases to January 31, 2021 Literature was selected and extracted by 2 researchers according to inclusion and exclusion criteria. Meta-analysis was performed by RevMan5.3 software. 【Results】 A total of 28 049 patients in 12 literature were included, 1 190 patients were included into the ART group and 26 859 into the non-ART group. Meta-analysis results showed that the incidence of ART was 1.63% (410/24 361), mainly allergic reaction (43.90%, 188/410) and non-hemolytic fever (40%, 164/410). Primary hematologic disease (OR=27.11, 95%CI=21.64~33.96, P 2 (OR=7.06, 95% CI=5.64~8.84, P30 min interval between blood issuing and transfusion (OR=3.40, 95% CI=2.88~4.00, P2, >30 min interval between blood issuing and transfusion, transfusion of plasma and cryoprecipitates, while transfusion of red blood cells/white blood cells/platelets was the protective factor.

Treatment and effect of cardiovascular surgery in patients with Williams syndrome / 中国胸心血管外科临床杂志

@#Objective    To analyze the effects of cardiovascular surgery on Williams syndrome (WS). Methods    The clinical data of 68 WS patients undergoing cardiovascular surgery in the Department of Cardiac Surgery, Guangdong Provincial People's Hospital from January 2010 to January 2020 were retrospectively analyzed. There were 48 males and 20 females with a median age of 2.8 years ranging from 3 months to 33 years. Except one patient undergoing the coarctation repair, the rest 67 patients underwent surgical interventions to correct supravalvular aortic stenosis (SAVS) and pulmonary artery stenosis with hypothermic cardiopulmonary bypass, concommitant with 3 patients of relief of left ventricular outflow tract obstruction, 2 patients of relief of right ventricular outflow tract obstruction, 2 patients of mitral valvuloplasty, 3 patients of ventricular septal defect repair and 1 patient of arterial catheter ligation. Results    Two (2.9%) patients died of sudden cardiac arrest on the next day after surgery. One (1.5%) patient died of cardiac insufficiency due to severe aortic arch stenosis 3 years after surgery. The effect of SAVS was satisfactory. Two (2.9%) patients progressed to moderate aortic valvular regurgitation during postoperative follow-up. A total of 5 (7.4%) patients were re-intervened after operation for arch stenosis or pulmonary stenosis. Conclusion    WS patients should be diagnosed early, followed up and  assessed for cardiovascular system diseases, and timely surgical treatment has a good clinical effect.

Combined application of anti-IgE therapy and subcutaneous immunotherapy in children with allergic asthma / 中华实用儿科临床杂志

Objective:To analyze the effects of the combined applications of Omalizumab and subcutaneous immunotherapy (SCIT) in improving clinical symptoms and immunotherapy tolerance in children with allergic asthma.Methods:A total of 9 children with asthma who received Omalizumab combined with SCIT in the Pediatrics Asthma Clinic of the Second Hospital of Tianjin Medical University from July 2018 to August 2020 were retrospectively analyzed.The symptoms of asthma, lung function, exhaled nitric oxide(FeNO), life quality scores, inhaled corticosteroids (ICS) dosage, comorbidities improvement, and adverse reactions during SCIT were analyzed and compared before and after the combined treatment.Results:After treatment, both the scores of children asthma control test/asthma control test (C-ACT/ACT) and pediatric asthma quality of life questionnaire (PAQLQ) improved in 9 patients with reduced or maintained doses of ICS.After treatment, comorbidities, including rhinitis and eczema, the scores of visual analogue scale (VAS) for rhinitis, pediatric rhinoconjunctivitis quality of life questionnaire(PRQLQ) and scoring atopic dermatitis (SCORAD) were all improved.During SCIT, all children didn′t have systemic adverse reactions, and 4 children had 1 (2 cases), 3 (1 case), and 8 (1 case) local adverse reactions, respectively.The number of rapid local adverse reactions accounts for only 2.6% (3/116 times), and the number of delayed local adverse reactions occupies 8.6% (10/116 times). Among them, the number of local adverse reactions accounts for only 2.6 % (3/116 times), and the dia-meters of swelling or induration were more than 4 cm.Conclusions:The combined applications of anti-IgE therapy and SCIT can effectively improve the symptoms and quality of life, and reduce asthma exacerbations and dosage of ICS in children with asthma.It also has certain effects on the improvement of comorbidities.At the same time, the addition of anti-IgE therapy can enhance the tolerance and compliance of SCIT.

Construction and application of the information system for preview and triage during novel coronavirus pneumonia epidemic time in stomatological hospitals / 西安交通大学学报(医学版)

Objective: To construct an information system for preview and triage during novel coronavirus pneumonia (NCP) epidemic time in stomatological hospitals and put it to clinical use. Methods: To sort out and formulate the preview and triage process of stomatological hospitals during the epidemic, we constructed B/S development platform with Jeesite open source framework, sort outed and developed relevant input and query functions. ActiveX widget was used to connect the hardware part with the ID card reader through the browser. At the initial stage of the system put online, the parallel mode of manual registration and system registration was used to verify the actual effect of the system. Results: After the system went online, the triage data of 35 patients were analyzed. The average triage time was shortened from (90.82±31.85) seconds to (38.97±12.14) seconds, with an efficiency increase of about 125%. Results: The system's performance can meet the actual business requirements, reduce the risk of cross infection, improve the preview and triage efficiency, and improve patients' medical experience. Meanwhile it ensures the accuracy and safety of the information record of people seeking medical service.

Spectrum change of rheumatic diseases in hospitalized children: a 12-year single-center experience of Shanghai / 中华风湿病学杂志

Objective:To gain insight into the constitution of juvenile rheumatic diseases, treatment outcome and trends of rheumatic inpatients in past 12 years, and to improve awareness of juvenile rheumatic diseases.Methods:The clinical data of 5 950 patients in rheumatology department of the affiliated pediatric hospital of Fudan University (from 2005 to 2016) were analyzed retrospectively, and the chi-square test was used to compare and analyze the incidence.Results:Disease changes: ① The top three rheumatic diseases were Kawasaki disease (KD) (44.3%), Henoch-schoniein purpura (HSP) (35.4%), juvenile idiopathic arthritis (JIA)(9.6%). ② The number of all constitution of juvenile rheumatic diseases in hospital increased other than HSP. ③ The rheumatic diseases were increased from 17 to 37 kinds in the past 6 years. ④ The number of systemic lupus erythematosus (SLE) increased year by year (112/2 348 vs 197/3 602, χ2=1.41, P=0.235), as well as the severe SLE (35/112 vs 55/197, χ2=0.38, P=0.536). ⑤ The rate of rheumatic diseases complicated with macrophage activation (MAS) was 7.2‰(43/5 950). 12.9%(26/201) of systemic juvenile idiopathic arthritis(sJIA) were complicated with MAS, which was accounted for 60.5%(26/43) of total number of MAS in rheumatic diseases. In the last 6 years, there was a significant increase in the number of patients with MAS in patients with rheumatic diseases ( χ2=14.1, P<0.01) and sJIA( χ2=11.2, P<0.01). ⑥ 1.1%(64/5 950) of rheumatic diseases patients had lung lesions, juvenile dermatomyositis (JDM) accounted for 24.4%(20/82). In the last 6 years, the number of patients with lung lesions associated with rheumatic diseases increased significantly ( χ2=5.66, P=0.017). ⑦ The mortality rate of juvenile rheumatic diseases was only 3.7‰(22/5 950), and 45.5% occurred in SLE (10/22). The mortality rate of SLE decreased in last 6 years (5/112 vs 5/197, χ2=0.34, P=0.558). Conclusion:The constitution of juvenile rheumatic diseases in our center is decreasing for systemic vasculitis (KD, HSP), JIA, SLE, JDM in last 6 years. The annual total number of patients is relatively stable. But rare, difficult and critically illed cases increase year by year. Although SLE is still the primary cause of death in juvenile rheumatic diseases in recent 6 years, the mortality rate has decreased year by year.

Application of flow cytometry analyzing basophil activation test in allergy disease / 国际儿科学杂志

Allergic disease is the common disease that affects human health and life quality.With the development of flow cytometry, basophil activation test(BAT), as an ex vivo challenge test, has become a new method in the diagnosis of allergic disease that IgE mediates.An important step is to establish a standardized BAT method in order to make it available in clinical applications and to explore the mechanisms of allergy in laboratory.This review focuses on the main principles, clinical utility in the diagnosis and management of allergic disease.

Cognitive impairment in patients with cerebral small vessel disease: comparison of MRI total burden and diffusion tensor tract-based spatial statistics / 国际脑血管病杂志

Objective To compare the value of MRI total burden and diffusion tensor tract-based spatial statistics (TBSS) for identifying cognitive impairment in patients with cerebral small vascular disease (CSVD).Methods Consecutive patients with CSVD diagnosed in Suzhou Hospital Affiliated to Nanjing Medical University from January 2018 to June 2019 were enrolled.They were divided into cognitive impairment group and cognitive normal group.The MRI overall burden was evaluated,and TBSS analysis was performed to obtain regions with differences in diffusion parameters between the two groups.Multivariatelogistic regression analysis was used to determine the independent risk factors for cognitive impairment.The receiver operating characteristic (ROC) curve was used to identify the recognition ability of the MRI overall burden and TBSS analysis for cognitive impairment in patients with CSVD.Results A total of 71 patients with CSVD were enrolled,including 41 (57.75％) in the cognitive impairment group and 30 (42.25％) in the cognitive normal group.There was a statistically significant difference in the proportion of patients with white matter hyperintensities between the two groups,but the MRI overall burden was not statistically significant difference.After adjusting for the confounding factors such as age and gender,multivariatelogistic regression analysis showed that white matter hyperintensities was an independent risk factor for cognitive impairment inpatients with CSVD (odds ratio 3.459,95％ confidence interval 1.196-10.007;P=0.022).Diffuse parameters of the white matter area,such as the genu of corpus callosum,anterior thalamic radiation,fasciculus longitudinalis superior,and frontal-occipital fasciculus in the cognitive impairment group were significantly different from those in the cognitive normal group (all P ＜0.05).The fractional anisotropy of left anterior thalamic radiation (r =0.252,P =0.036) and the radial diffusivity of the genu of corpus callosum (r =-0.246,P =0.042) were significantly correlated with cognitive scores.ROC analysis showed that the areas under the curve of the MRI total burden,the fractional anisotropy of left anterior thalamic radiation,and the radial diffusivity of the genu of corpus callosum for identifying cognitive impairment were 0.61,0.56 and 0.57,respectively.Conclusion White matter hyperintensities is an independent risk factor for cognitive impairment in patients with CSVD.TBSS analysis may be superior to MRI overall burden assessment in the specific recognition of cognitive impairment in patients with CSVD.Some diffuse parameters have a certain correlation with the overall cognitive status,and may be used as early imaging markers for cognitive impairment in patients with CSVD.

Outcome and follow-up analysis of transcatheter or surgical therapy for neonates with pulmonary atresia with intact ventricular septum and critical pulmonary stenosis / 中华实用儿科临床杂志

Objective@#To evaluate the safety and effectiveness of transcatheter or surgical procedure for neonates diagnosed with pulmonary atresia with intact ventricular septum (PA/IVS) or critical pulmonary stenosis (CPS) by retrospectively analyzina the clinical data, thus to discuss the clinical strategy decision.@*Methods@#From November 2006 to August 2018, 105 neonates (PA/IVS 51 cases, CPS 54 cases) went through transcatheter or surgical procedure in Guangdong Provincial Cardiovascular Institute (transcatheter procedure 43 cases, surgery 62 cases). All cases manifested mild to moderate right ventricular dysplasia.Transcatheter procedure included pulmonary radio frequency perforation and percutaneous balloon pulmonary valvuloplasty (PBPV). Surgical procedure included reconstruction of right ventricular outflow tract (transannular patch), pulmonary valvotomy and closed transventricular pulmonary valvuloplasty, while Aortic-Pulmonary shunt was performed in certain cases.Average follow-up period was (40.1±36.9) months.Hospitalization and follow-up data were analyzed to evaluate the safety and efficacy of transcatheter and surgical procedure.@*Results@#Operative time, hospital stay, complication rate were lower in transcatheter procedure group than those of surgery group[(107.8±61.6) min vs.(183.3±36.8) min, (18.6±7.9) d vs.(31.1±13.4) d, 30.2% vs.80.6%], and the differences were significant(all P=0.000). In transcatheter procedure group, 2 cases (4.7%) died and biventricular circulation is obtained in all survival cases.In surgery group, 5 cases (8.1%) died.Of the survival cases from surgery group, 39 cases (69.6%) obtained biventricular circulation, 3 cases (5.4%) obtained one and a half ventricular circulation while other 14 cases (25.0%) were candidates for biventricular repair.@*Conclusions@#Biventricular circulation can be achieved in most PA/IVS or CPS neonates with mild-moderate right ventricular dysplasia.PBPV turns out to be a safe and effective therapy for neonates with CPS while perforation of right ventricular outflow tract remains a nonnegligible complication in transcatheter therapy for PA/IVS.

Cognitive impairment in patients with cerebral small vessel disease: comparison of MRI total burden and diffusion tensor tract-based spatial statistics / 国际脑血管病杂志

Objective@#To compare the value of MRI total burden and diffusion tensor tract-based spatial statistics (TBSS) for identifying cognitive impairment in patients with cerebral small vascular disease (CSVD).@*Methods@#Consecutive patients with CSVD diagnosed in Suzhou Hospital Affiliated to Nanjing Medical University from January 2018 to June 2019 were enrolled. They were divided into cognitive impairment group and cognitive normal group. The MRI overall burden was evaluated, and TBSS analysis was performed to obtain regions with differences in diffusion parameters between the two groups. Multivariate logistic regression analysis was used to determine the independent risk factors for cognitive impairment. The receiver operating characteristic (ROC) curve was used to identify the recognition ability of the MRI overall burden and TBSS analysis for cognitive impairment in patients with CSVD.@*Results@#A total of 71 patients with CSVD were enrolled, including 41 (57.75%) in the cognitive impairment group and 30 (42.25%) in the cognitive normal group. There was a statistically significant difference in the proportion of patients with white matter hyperintensities between the two groups, but the MRI overall burden was not statistically significant difference. After adjusting for the confounding factors such as age and gender, multivariate logistic regression analysis showed that white matter hyperintensities was an independent risk factor for cognitive impairment in patients with CSVD (odds ratio 3.459, 95% confidence interval 1.196-10.007; P=0.022). Diffuse parameters of the white matter area, such as the genu of corpus callosum, anterior thalamic radiation, fasciculus longitudinalis superior, and frontal-occipital fasciculus in the cognitive impairment group were significantly different from those in the cognitive normal group (all P<0.05). The fractional anisotropy of left anterior thalamic radiation (r=0.252, P=0.036) and the radial diffusivity of the genu of corpus callosum (r=-0.246, P=0.042) were significantly correlated with cognitive scores. ROC analysis showed that the areas under the curve of the MRI total burden, the fractional anisotropy of left anterior thalamic radiation, and the radial diffusivity of the genu of corpus callosum for identifying cognitive impairment were 0.61, 0.56 and 0.57, respectively.@*Conclusion@#White matter hyperintensities is an independent risk factor for cognitive impairment in patients with CSVD. TBSS analysis may be superior to MRI overall burden assessment in the specific recognition of cognitive impairment in patients with CSVD. Some diffuse parameters have a certain correlation with the overall cognitive status, and may be used as early imaging markers for cognitive impairment in patients with CSVD.

Analysis of serum markers for the prognosis of primary Sj?gren's syndrome with interstitial pneu-monitis / 中华风湿病学杂志

Objective To analyze the relationship between ferritin, carbohydrate antigen (CA)125, CA153, lactic dehydrogenase (LDH), albumin and progression and prognosis of Sj?gren's syndrome with inter-stitial pneumonitis (pSS-IP). Methods Five hundred and twenty-seven primary pSS patients from 2011 to 2017 were analyzed retro-spectively. According to the lung imaging and clinical features, they were divided into groups. The differences of ferritin, CA125, CA153, LDH and albumin (ALB) levels in each group were analyzed by Mann-Whitney U test. Logistic regression was used to analyze the risk factors of pSS complicated with interstitial pneumonitis. Results ① Among the 527 pSS patients, 206 (39.1％) were diagnosed with IP. Compared with 321 patients without interstitial pneumonitis (pSS-N-IP), ferritin, CA125, CA153 and LDH in pSS-IP were relatively higher [189(116, 380) ng/ml vs 138(75, 258) ng/ml, Z=-3.777, P<0.05;19(12, 36) U/ml vs 12(9, 19) U/ml, Z=-5.974, P<0.05;22(12, 34) U/ml vs 9(6, 14) U/ml, Z=-4.582, P<0.05;206(165, 258) U/L vs 161(139, 195) U/L, Z=-8.770, P<0.05], while albumin was lower [34(31, 37) g/L vs 36(34, 39) g/L, Z=5.210, P<0.05]. ② pSS-IP were divided into pSS-IP progression group (46 cases) and pSS-IP stable group (60 cases) according to their lung imaging characteristics. Compared with pSS-IP stabilization group, pSS-IP progression group had higher ferritin [254(129, 693) ng/ml vs 161(104, 259) ng/ml, Z=-2.437, P<0.05]. ③ Logistic regres-sion analysis showed that there was correlation between ferritin and the progress of pSS-IP (OR=1.002). Conclusion Ferritin, CA125, CA153, LDH, albumin are related to pSS-IP. Ferritin isrelated to the progress of pSS-IP, and is a risk factor for the progress of pSS-IP.