Effects of quality nursing on the surgical site wound infections in patients undergoing cardiothoracic surgery: A meta-analysis.

The aim of this study is to systematically evaluate the effects of quality nursing on wound infections and postoperative complications in patients undergoing cardiothoracic surgery. Computerised searches of the PubMed, Web of Science, Cochrane Library, Embase, China Biomedical Literature Database, China National Knowledge Infrastructure and Wanfang databases were conducted from database inception to October 2023 for randomised controlled trials (RCTs) on the application of quality nursing to patients undergoing cardiothoracic surgery. The studies were screened and evaluated by two researchers based on the inclusion and exclusion criteria, and data were extracted from the included studies. Stata software (version 17.0) was used for all analyses performed. A total of 18 RCTs and 1742 patients were included, including 972 in the quality nursing group and 870 in the routine nursing group. The analysis revealed that compared with routine nursing, patients undergoing cardiothoracic surgery who received quality nursing care were significantly less likely to experience postoperative wound infections (OR = 0.31, 95% CI: 0.19-0.51, p < 0.001) and complications (OR = 0.24. 95% CI: 0.17-0.33, p < 0.001). The implementation of quality nursing in clinical care after cardiothoracic surgery can effectively reduce the incidence of wound infections and postoperative complications, and is worthy of promotion and clinical application.

Progress of Muscle Chain Theory in Shoulder Pain Rehabilitation: Potential Ideas for Pulmonary Rehabilitation.

Pulmonary dysfunction is very common in stroke patients. A study has shown that acute stroke patients often cause a series of pulmonary dysfunction due to primary damage to the respiratory center, which is an important reason for hindering disease treatment and recovery. American Thoracic Society (ATS) and the European Respiratory Society (ERS) pointed out that pulmonary rehabilitation (PR) can be applied to the rehabilitation of stroke patients to improve their lung function. PR can improve the respiratory muscle strength of stroke patients, which is beneficial to improving the respiratory function of patients. At the same time, it can also significantly increase the maximum oxygen intake of patients, effectively improve the cardiopulmonary function of stroke patients, and reduce respiratory complications such as aspiration pneumonia. However, the common dysfunction of joints and muscles such as shoulder pain after stroke will affect the process of pulmonary rehabilitation. This is mainly because the changes in the position of the shoulder girdle, the decrease in the range of motion of the cervical and thoracic spine, and the changes in the cervical spondylolisthesis position caused by the elevation of the upper limbs will directly affect the breathing movement during the pulmonary rehabilitation process. The instability of the spine will weaken the deep abdominal muscles and reduce the function of the diaphragm; moreover, changes in the alignment and stability of the cervical and thoracic spine will also lead to wrong breathing methods. Therefore, it is of practical clinical significance to evaluate the functional rehabilitation of shoulder joint muscles and evaluate the efficacy of stroke patients to improve their respiratory function. This article through an extensive review of domestic and foreign literature in recent years, combined with clinical practice experience, summarizes the practical application of chain structure theory in the fields of rehabilitation training, postural adjustment, pain relief, etc., and further studies the functional exercise method based on muscle chain theory. The research on the muscle chain of shoulder pain rehabilitation as a model illustrates the positive effect of reconstructing neuroarticular muscle function on the respiratory system, hoping to provide new ideas for the treatment of respiratory diseases in stroke patients.

Identification of a 6-RBP gene signature for a comprehensive analysis of glioma and ischemic stroke: Cognitive impairment and aging-related hypoxic stress.

There is mounting evidence that ischemic cerebral infarction contributes to vascular cognitive impairment and dementia in elderly. Ischemic stroke and glioma are two majorly fatal diseases worldwide, which promote each other's development based on some common underlying mechanisms. As a post-transcriptional regulatory protein, RNA-binding protein is important in the development of a tumor and ischemic stroke (IS). The purpose of this study was to search for a group of RNA-binding protein (RBP) gene markers related to the prognosis of glioma and the occurrence of IS, and elucidate their underlying mechanisms in glioma and IS. First, a 6-RBP (POLR2F, DYNC1H1, SMAD9, TRIM21, BRCA1, and ERI1) gene signature (RBPS) showing an independent overall survival prognostic prediction was identified using the transcriptome data from TCGA-glioma cohort (n = 677); following which, it was independently verified in the CGGA-glioma cohort (n = 970). A nomogram, including RBPS, 1p19q codeletion, radiotherapy, chemotherapy, grade, and age, was established to predict the overall survival of patients with glioma, convenient for further clinical transformation. In addition, an automatic machine learning classification model based on radiomics features from MRI was developed to stratify according to the RBPS risk. The RBPS was associated with immunosuppression, energy metabolism, and tumor growth of gliomas. Subsequently, the six RBP genes from blood samples showed good classification performance for IS diagnosis (AUC = 0.95, 95% CI: 0.902-0.997). The RBPS was associated with hypoxic responses, angiogenesis, and increased coagulation in IS. Upregulation of SMAD9 was associated with dementia, while downregulation of POLR2F was associated with aging-related hypoxic stress. Irf5/Trim21 in microglia and Taf7/Trim21 in pericytes from the mouse cerebral cortex were identified as RBPS-related molecules in each cell type under hypoxic conditions. The RBPS is expected to serve as a novel biomarker for studying the common mechanisms underlying glioma and IS.

Modulation of 1 MeV electron irradiation on ultraviolet response in MoS2FET.

The material, electrical and ultraviolet optoelectronic properties of few layers bottom molybdenum disulfide (MoS2) field effect transistors (FETs) device was investigated before and after 1 MeV electron irradiation. Due to the participation of SiO2in conduction, we discovered novel photoelectric properties and a relatively long photogenerated carrier lifetime (several tens of seconds). Electron irradiation causes lattice distortion, the decrease of carrier mobility, and the increase of interface state. It leads to the degradation of output characteristics, transfer characteristics and photocurrent of the MoS2FET.

Effects of Vortioxetine on depression model rats and expression of BDNF and Trk B in hippocampus.

Effects of Vortioxetine on the expression of brain-derived neurotrophic factor (BDNF) and tyrosine kinase B (Trk B) in hippocampus of depressive rats were investigated. Forty-five SD rats were randomly divided into three groups: model control, Vortioxetine and normal control group, with 15 rats in each group. The changes of body mass were recorded within 5 weeks, and the open field test, sugar water preference test and Morris water maze test were performed to evaluate the behavior and mental status of the rats. The expression of BDNF and Trk B in rat hippocampus was detected by enzyme-linked immuno sorbent assay. Compared with the model control group, the body mass, horizontal and vertical movement, sugar and water preference rate of the vortioxetine group in the 5th week were significantly higher than those of the model control group (P<0.05), and significantly lower than those of the normal control group (P<0.05). The escape latency of the Vortioxetine group within 4 days was significantly lower than that of model control group (P<0.05), but higher than that of normal control group (P<0.05). The target quadrant residence time of the Vortioxetine group was significantly lower than that of the model control group (P<0.05), but higher than that of the normal control group (P<0.05). Expression of BDNF and Trk B in the Vortioxetine group was significantly higher than that in the model control group (P<0.05), but lower than that of the normal control group (P<0.05). Collectively, Vortioxetine can effectively alleviate the symptoms of autonomous and exploratory behavior, and reduce the decrease of learning and memory in depressive rats. Vortioxetine can increase the expression of BDNF and Trk B in depressive rats and alleviate their depressive behavior.

Detection of microbial aerosols in hospital wards and molecular identification and dissemination of drug resistance of Escherichia coli.

Antibiotic-resistant bacteria (ARB) present a global public health problem. Microorganisms are the main cause of hospital-acquired infections, and the biological contamination of hospital environments can cause the outbreak of a series of infectious diseases. Therefore, it is very important to understand the spread of antibiotic-resistant bacteria in hospital environments. This study examines the concentrations of aerobic bacteria and E. coli in ward environments and the airborne transmission of bacterial drug resistance. The results show that the three wards examined have an average aerobic bacterial concentration of 132 CFU∙m-3 and an average inhalable aerobic bacterial concentration of 73 CFU∙m-3, with no significant difference (P > 0.05) among the three wards. All isolated E. coli showed multi-drug resistance to not only third-generation cephalosporin antibiotics, but also quinolones, aminoglycosides, and sulfonamides. Furthermore, 51 airborne E. coli strains isolated from the air in the three wards and the corridor were screened for ESBLs, and 12 (23.53%) were ESBL-positive. The drug-resistance gene of the 12 ESBL-positive strains was mainly TEM gene, and the detection rate was 66.67% (8/12). According to a homology analysis with PFGE, 100% homologous E. coli from the ward at 5 m and 10 m outside the ward in the corridor shared the same drug-resistance spectrum, which further proves that airborne E. coli carrying a drug-resistance gene spreads out of the ward through gas exchange. This leads to biological pollution inside, outside, and around the ward, which poses a direct threat to the health of patients, healthcare workers, and surrounding residents. It is also the main reason for the antibiotic resistance in the hospital environment. More attention should be paid to comprehensive hygiene management in the surrounding environment of hospitals.

Association study of serum soluble TREM2 with vascular dementia in Chinese Han population.

Objective: Recent extensive evidence suggests that the triggering receptor expressed on myeloid cells 2 (TREM2) is closely implicated in the pathogenesis of Alzheimer's disease (AD). However, no relative data exist regarding vascular dementia (VD). This study aimed to investigate the association between serum soluble TREM2 (sTREM2) and vascular dementia in Chinese Han population.Methods: A total of 120 VD patients and 120 cognitively normal controls matched for age and gender were enrolled for this study. Demographic and clinical characteristics were recorded at admission. Cognitive functions were assessed by the Mini-Mental State Examination (MMSE) and serum sTREM2 levels were detected using sandwich ELISA method.Results: Demographic and clinical characteristics did not differ dramatically between groups. Serum sTREM2 levels in VD patients are significantly decreased compared with normal controls. In VD patients, the serum sTREM2 levels were positively correlated with MMSE scores (r = 0.387, p = 0.008), and the association was independent of demographic and clinical characteristics (ß = 0.396, p < 0.001).Conclusion: VD patients have significantly lower serum sTREM2 levels in comparison to normal controls. Serum sTREM2 levels may be used as a potential predictive biomarker of cognitive decline in VD.

Electron radiation effects on the structural and electrical properties of MoS2 field effect transistors.

The effects of space radiation on the structural and electrical properties of MoS2 field effect transistors (FETs) were investigated. The 1 MeV electronically equivalent International Space Station (ISS) track was used to apply fluence equivalent to the orbital for 10 (1.0 × 1012 cm-2) and 30 years (3.0 × 1012 cm-2) using the AP8 and AE8 models. X-ray photoelectron spectroscopy (XPS), Raman and photoluminescence (PL) spectra were recorded before and after irradiation. Electron irradiation produced strong desulfurization effects in MoS2 FETs. The PL spectra before and after irradiation did not change significantly, while the [Formula: see text] and A1g Raman modes were red- and blue-shifted, respectively. The XPS results demonstrated a strong desulfurization effect of the electron beam on MoS2. This reduction indicates a much higher amount of irradiation-induced S vacancies compared to Mo vacancies. The electrical characteristics of the device were measured before and after irradiation. The increase in the channel leakage current after irradiation was attributed to the oxide trapping positive charges. MoS2 FETs irradiated by the electron-beam demonstrated a decreased current. This phenomenon can be attributed to the combination of the states at the SiO2/MoS2 interfaces and Coulomb scattering. Our study provides a deeper understanding of the influence of 1 MeV electron-beam irradiation on MoS2-based nano-electronic devices for future space applications.

Modulation of electronic and optical properties by surface vacancies in low-dimensional ß-Ga2O3.

Calculations using the Heyd-Scuseria-Ernzerhof screened hybrid functional reveal the detailed influence that surface vacancies have on the electronic and optical properties of low-dimensional (LD) ß-Ga2O3. Vacancies manifest subtle changes to the electronic characteristics as oxygen states predominate the valence band at the surface. Dielectric functions at the surface are found to increase with vacancies and defects. A broad impact on optical properties, such as absorption coefficients, reflectivity, refractive indices, and electron loss, is seen with increased vacancy defects. Both visible and infrared regions show direct correlation with vacancies while there is a marked decrease in the deep ultraviolet (UV) region. These calculations on the ß-Ga2O3 model system may guide the rational design of two-dimensional optical devices with minimized van der Waals forces.

Metaplastic carcinoma of the breast: Imaging and pathological features.

Metaplastic carcinoma of the breast is a rare form of breast cancer. The aim of the present study was to investigate the imaging and pathological features of metaplastic carcinoma. The features identified on mammography and sonography were retrospectively reviewed in 13 women with metaplastic carcinoma of the breast. The results from the mammographs and sonographs were additionally evaluated using immunohistochemical staining for the expression of the estrogen receptor (ER) and progesterone receptor (PR), receptor tyrosine-protein kinase erbB-2 (CerbB-2) and P53. The most common features observed in the mammographs were as follows: Irregular and oval shaped masses, 53.8 and 46.2%, respectively; spiculated and circumscribed margins, each 30.8%; and high and marginally high density masses, 69.2 and 30.8%, respectively. The most common sonography features observed were as follows: Hypoechoic masses, 84.6%; complex echogenicity, 76.9%; irregular, round and oval shaped masses, 69.2, 30.8 and 30.8%, respectively; indistinct and circumscribed margins, 53.8 and 46.2%, respectively; an abundant blood flow, 53.8%; and posterior acoustic enhancement, 61.5%. The immunohistochemical (IHC) profile for 13 patients demonstrated that ER was not expressed in 100% of patients, PR and CerbB-2 were not present in 92.3% of patients, and P53 was present in 63.6% of patients. Therefore, metaplastic carcinoma of the breast exhibits more benign IHC features compared with invasive ductal carcinoma. In addition, it may be challenging to diagnose patients that do not possess posterior acoustic enhancement or express hormone receptors from other types of breast cancer.

Digital Breast Tomosynthesis: A New Diagnostic Method for Mass-Like Lesions in Dense Breasts.

To compare the rates and accuracy of digital breast tomosynthesis (DBT) and 2D digital mammography (DM) for detecting and diagnosing mass-like lesions in dense breasts. Mediolateral and craniocaudal images taken with DBT (affected breast) and DM (both breasts) of the dense breasts of 631 women were assessed independently using Breast Imaging Reporting and Data System (BI-RADS) scores. Images were compared for detection and diagnostic accuracy for masses; sensitivity and specificity of diagnosis; false-negative and recall rates; and clarity of display, particularly of margins and spicules. Histopathology was conducted via surgical biopsies of all patients. The detection and diagnostic accuracy rates of DBT images (84.3% and 82.3%, respectively) were significantly higher than that of DM (77.3% and 73.4%; p < 0.01, both). The sensitivity and specificity of DBT (68.1% and 95.2%) were higher than that of DM (58.8% and 86.7%), whereas the recall rate of DBT was lower (3.6% cf. 9.8%). The number of cases of benign circumscribed masses and malignant spiculated masses detected by DBT (172 and 182) was significantly higher than the number detected through DM (75 and 115; p < 0.01, both). Radiologists assigned higher BI-RADS scores for probability of malignancy to DBT images than DM, to lesions proved malignant (p = 0.025); for benign cases, the methods were comparable (p = 0.065). Compared with DM, DBT yielded significantly higher rates of detection and diagnostic accuracy for benign and malignant masses, with greater sensitivity and specificity and lower recall rates. In addition, DBT images facilitated analysis of margins, and the rate of accuracy for judgments of malignancy probability was higher, as proved on biopsy.

The immune adjuvant response of polysaccharides from Atractylodis macrocephalae Koidz in chickens vaccinated against Newcastle disease (ND).

Build on our previous research, polysaccharides from the rhizome of Atractylodis macrocephalae Koidz (RAMPS), RAMPStp and RAMPS60c were prepared and the structural characterization and immune response of ND vaccine in chicken were investigated. Immune organ index, Lymphocyte proliferation, antibody titers, cell cycle distribution, and percentages of CD4(+) and CD8(+) cells were determined. GPC analysis showed that the Mn of RAMPS with two peaks were 1.29×10(5) and 1.74×10(3), respectively. GC-MS analysis revealed that RAMPS was composed of glucose, mannose, arabinose, galactose, xylose, d-Ribose and rhamnose, with mass percentages of 66.39%, 21.24%, 5.64%, 2.65%, 2.30%, 1.15% and 0.64%, respectively. NMR spectroscopic analysis demonstrated that a preliminary structure of RAMPS was proposed as 1,3-linked ß-d-Galp and 1,6-linked ß-d-Galpresidues. In vivo test showed that RAMPStp and RAMPS60c could promote peripheral lymphocytes proliferation and entering into S and G2/M phases, enhance serum HI antibody titer and effectively improve the percentages of CD4(+) and CD8(+) T cells in chickens vaccinated with ND vaccine at most time points. The actions of RAMPStp and RAMPS60c were stronger than that of Lev, and RAMPStp presented the best efficacy. These results indicated that RAMPStp and RAMPS60c characterize of the immune-enhancing activity and RAMPStp possessed the strongest activity. It would be anticipated as a component of new-type immunopotentiator.

Immune-enhancing activity of polysaccharides isolated from Atractylodis macrocephalae Koidz.

This study evaluated the immune-enhancing activity of polysaccharides from the rhizoma of Atractylodis macrocephalae Koidz (RAMPS) in vitro. Lymphocyte proliferation, cell cycle distribution, and percentages of CD4(+) and CD8(+) cells were determined. Different concentrations of RAMPS were added to peripheral blood T lymphocytes. Results showed that RAMPStp and RAMPS60c could significantly enhance T lymphocyte proliferation individually or synergistically with phytohemagglutinin at most concentrations. The active sites of RAMPStp and RAMPS60c were then selected. Lymphocyte cell cycle distribution and percentages of CD4(+) and CD8(+) cells were determined by flow cytometry. At most time points, RAMPS60c and RAMPStp could promote lymphocytes enter into S and G2/M phases. RAMPStp and RAMPS60c effectively improved the percentages of CD4(+) and CD8(+) T cells. RAMPStp produced optimal effects. Therefore, RAMPStp could be used as a component of novel immunopotentiators.

The comet-like composition of a protoplanetary disk as revealed by complex cyanides.

Observations of comets and asteroids show that the solar nebula that spawned our planetary system was rich in water and organic molecules. Bombardment brought these organics to the young Earth's surface. Unlike asteroids, comets preserve a nearly pristine record of the solar nebula composition. The presence of cyanides in comets, including 0.01 per cent of methyl cyanide (CH3CN) with respect to water, is of special interest because of the importance of C-N bonds for abiotic amino acid synthesis. Comet-like compositions of simple and complex volatiles are found in protostars, and can readily be explained by a combination of gas-phase chemistry (to form, for example, HCN) and an active ice-phase chemistry on grain surfaces that advances complexity. Simple volatiles, including water and HCN, have been detected previously in solar nebula analogues, indicating that they survive disk formation or are re-formed in situ. It has hitherto been unclear whether the same holds for more complex organic molecules outside the solar nebula, given that recent observations show a marked change in the chemistry at the boundary between nascent envelopes and young disks due to accretion shocks. Here we report the detection of the complex cyanides CH3CN and HC3N (and HCN) in the protoplanetary disk around the young star MWC 480. We find that the abundance ratios of these nitrogen-bearing organics in the gas phase are similar to those in comets, which suggests an even higher relative abundance of complex cyanides in the disk ice. This implies that complex organics accompany simpler volatiles in protoplanetary disks, and that the rich organic chemistry of our solar nebula was not unique.

Percutaneous balloon angioplasty for severe native aortic coarctation in young infants less than 6 months: medium- to long-term follow-up.

BACKGROUND: Although balloon angioplasty (BA) has been performed for more than 20 years, its use as a treatment for native coarctation of the aorta (CoA) during childhood, especially in young infants, remains controversial. This study aimed to assess the effects and potential role of percutaneous transcatheter BA for native CoA as an alternative therapy to surgical repair in young infants. METHODS: The 37 patients aged from 6 days to 6 months with severe CoA in congestive heart failure or circulatory shock were admitted for BA. Patient's weight ranged from 2.4 to 6.1 kg. All 37 patients were experiencing cardiac dysfunction, and eight patients were in cardiac shock with severe metabolic acidosis. Eleven patients had an isolated CoA, whereas the others had a CoA associated with other cardiac malformations. Cardiac catheterization and aortic angiography were performed under general anesthesia with intubation. Transfemoral arterial approaches were used for the BA. The size of the balloon ranged from 3 mm × 20 mm to 8 mm × 20 mm, and a coronary artery balloon catheter was preferred over a regular peripheral vascular balloon catheter. RESULTS: The femoral artery was successfully punctured in all but one patient, with that patient undergoing a carotid artery puncture . The systolic peak pressure gradient (PG) across the coarctation was 41.0 ± 16.0 mmHg (range 13-76 mmHg). The mean diameter of the narrowest coarctation site was 1.7 ± 0.6 mm (range 0.5-2.8 mm). All patients had successful dilation; the PG significantly decreased to 13.0 ± 11.0 mmHg (range 0-40 mmHg), and the diameter of coarctation significantly improved to 3.8 ± 0.9 mm (range 2.5-5.3 mm). No intraoperative complications occurred for any patients. However, in one case that underwent a carotid artery puncture, a giant aneurysm formed at the puncture site and required surgical repair. The following observations were made during the follow-up period from 6-month to 7-year: (1) The PG across the coarctation measured by echocardiography further decreased or remained stable in 31 cases. The remaining six patients, whose PGs gradually increased, required a second dilation. No patient required further surgery because of a CoA; (2) in two cases, an aortic aneurysm was found with an angiogram performed immediately postdilatation and disappeared at 18 and 12 months of age, respectively; (3) tricuspid regurgitation and pulmonary hypertension improved in all patients; (4) all patients were doing well and were asymptomatic. CONCLUSIONS: Percutaneous BA is a relatively safe and effective treatment for severe native CoA in young infants, and should be considered a valid alternative to surgery because of its good outcome and less trauma and fewer complications than surgery.

[Balloon valvuloplasty for congenital aortic valve stenosis in children].

OBJECTIVE: To evaluate the efficacy and safety of percutaneous balloon aortic valvuloplasty (PBAV) for congenital aortic valve stenosis in children. METHOD: This is a retrospective clinical study including 14 children treated with PBAV for congenital aortic valve stenosis from October 2006 to December 2012 in our institute. During clinical follow-up, aortic residual stenosis and restenosis, left ventricular function and the procedure-related complications, including the approach artery injury, and aortic regurgitation were particularly assessed. RESULT: A total of 14 patients consisting of 12 boys and 2 girls underwent the procedure, with mean age (17.1 ± 10.5) months (range from 8 days to 6 years) and the mean body weight (8.9 ± 5.5) kg (range from 1.9 kg to 23.0 kg). The indication for PBAV was a Doppler-derived peak instaneous gradient of ≥ 75 mmHg(1 mmHg = 0.133 kPa) or a smaller gradient with signs of severe left ventricular dysfunction or left ventricular strain on the ECG. The mean ratio of balloon-annulus was 0.92 ± 0.09 (range from 0.75 to 1.09). The catheter-measured peak systolic valve gradient was successfully relieved in all the patients, decreasing from (69 ± 26) mmHg to (29 ± 13) mmHg immediately after balloon valvuloplasty (t = 7.628, P = 0.000). The Doppler-derived peak and mean gradient decreased from (95 ± 21) mmHg and (50 ± 7) mmHg to (49 ± 16) mmHg and (24 ± 11) mmHg, respectively (t = 7.630, 10.401; P = 0.000, 0.000) . The mean follow-up period was 1 day to 61 months. At follow-up, 2 patients (2/14, 14%) underwent the second balloon valvuloplasty for the significant restenosis, and both showed successful relief of restenosis, however 1 patient required surgical Ross procedure due to significant recurrent systolic pressure gradient and moderate aortic regurgitation 4 years after the second balloon valvuloplasty. Among the 3 young infants who presented with congestive heart failure before intervention, 1 died 1 day after the procedure, the other 2 patients had improved left ventricular systolic function significantly during post-procedural follow-up. Only 1 patient (1/14, 7%) developed moderate aortic regurgitation. There was no other procedure-related complication. CONCLUSION: PBAV for congenital aortic valve stenosis is effective and safe in children. It is a very feasible palliative intervention for children with severe aortic valve stenosis to postpone the aortic valve surgery.

[Balloon angioplasty for native coarctation in children: one year follow-up results].

OBJECTIVE: Balloon angioplasty is an alternative to surgical repair for coarctation of the aorta in children. However, its role in the treatment of neonates and infants younger than 3 months old remains controversial. The purpose of this study was to evaluate the efficacy and safety of balloon angioplasty for native coarctation by comparing children in different age groups. METHOD: This is a retrospective clinical study including 37 children treated with balloon angioplasty for native coarctation from January 2006 to December 2012. A total of 37 patients consisting of 26 boys and 11 girls underwent the procedure, with median age 10 months (range from 7 days to 6 years) and the mean body weight was 6.3 (2.5-17.0) kg. The indication of the procedure includes discrete native coarctation without aortic arch hypoplasia and a peak-to-peak systolic pressure gradient > 20 mmHg (1 mmHg = 0.133 kPa) across aortic coarctation. During one year follow-up, the approach artery injury, recoarctation and aneurysm formation were particularly assessed. RESULT: We classified these patients into two groups according to their age. Group A consisted of 25 patients younger than 3 months and Group B of 12 patients older than 3 months. There was no significant difference between the two groups in systolic pressure gradient before balloon angioplasty (P > 0.05). The mean peak systolic gradient decreased from (38 ± 18) mmHg to (12 ± 11) mmHg immediately after angioplasty in group A and from (47 ± 18) to (17 ± 12) mmHg in group B (P = 0.000 for both). Meanwhile, the mean diameter of the coarctation segment increased from (1.8 ± 0.7) to (3.7 ± 1.1) mm after angioplasty in group A and from (2.6 ± 1.5) to (5.5 ± 1.8) mm in group B (both P = 0). The initial successful balloon angioplasty (immediate postangioplasty peak pressure gradient < 20 mmHg) was achieved in all the 37 patients; 32 patients (86.5%) have been followed up for one year. Approach arterial complications occurred in 3 patients (9.4%), all of whom were in Group A (P = 0.537). Two patients had decreased femoral artery pulse and one required surgical repair for a postoperative pseudoaneurysm at left carotid artery. At follow-up, 8 patients (25.0%) developed recoarctation, with 6 cases in Group A and 2 in Group B. There was no significant difference between groups A and B in the recoarctation rate (P = 1.000). Among them, 7 patients underwent repeat balloon angioplasty, and all showed successful relief of coarctation, and one patient required surgical repair. Two patients (2/37, 5.4%) had small aneurysms of the descending aorta immediately after balloon angioplasty, with one patient in each group (12/25 vs.1/12, P = 0.755).Late aneurysm development has not been observed in the 17 patients who have had a follow-up CTA or MRA study. CONCLUSION: Balloon angioplasty of discrete native coarctation is effective and safe in children both younger and older than 3 months with similar incidence of approach arterial complication, recoarctation and aneurysm formation.

Liposomes containing recombinant gp85 protein vaccine against ALV-J in chickens.

To study the potential of liposome vaccines in the clinical prevention of ALV-J, the effect of recombinant gp85 protein of subgroup J avian leukosis virus (ALV-J) entrapped by liposomes in chickens against ALV-J infection was investigated in this paper. A recombinant plasmid (PET28a-gp85) containing the PET28a vector and gp85 gene was constructed and then expressed in Rosetta (DE3) cells with 0.5mM IPTG to produce recombinant gp85 proteins that could be entrapped by liposomes through reverse-phase evaporation. The chickens were inoculated intramuscularly either once or twice with the liposomes or with Freund's adjuvant emulsion containing recombinant gp85 protein. Sixty chickens were raised to one week old for the first inoculation and to three weeks old for the second inoculation. Chickens raised to five weeks old were challenged with a 10(2.4) 50% tissue culture infective dose (TCID50) of ALV-J. Blood samples were collected from each chicken at weekly intervals for serum antibody and viremia analyses. Changes in serum antibodies showed that positive serum antibodies (S/P value >0.6) could be induced in all groups regardless of the frequency of inoculation but improved significantly in the twice-inoculated groups. As well, high levels of antibodies emerged earlier in the Freund's adjuvant groups but persisted longer in the liposome groups. Detection of viremia indicated that the liposomes provide better protection against ALV-J than Freund's adjuvant emulsion and that this protection is directly influenced by serum antibody levels. Overall, this study reveals the potential of liposome vaccines containing recombinant gp85 protein in the clinical prevention of ALV-J.

[Clinical characteristics and imaging evaluation in children with renovascular hypertension].

OBJECTIVE: To characterize the clinical and angiographic features in children with renovascular hypertension. METHOD: Clinical data of 14 children (7 male, 7 female; age 0.8-14 years, mean 8.7 years), who were diagnosed with renovascular hypertension by renal angiography in our institute from January 2005 to December 2012 were collected and retrospectively analyzed. RESULT: The mean blood pressure at the diagnosis was 187/127 mm Hg. Chief complaints of symptomatic patients were headache (29%, 4/14), hypertensive encephalopathy (36%, 5/14), signs of congestive heart failure (14%, 2/14) and hematemesis (7%, 1/14). Renovascular hypertension was found incidentally in 14% (2/14) of patients who were asymptomatic. Conventional renal angiography elucidated the anatomical distribution of lesions in the renal arterial system. It was found that 14% (2/14) of patients had bilateral disease, 50% (7/14) had single stenosis at main or accessory renal artery, while multiple stenoses was seen in 43% (6/14) of children, with involvement of segmental renal artery and small interlobar or arcuate vessels. Compared with catheter angiography, 50% (7/14) of patients with renovascular hypertension, especially intrarenal arterial disease, were missed on computed tomography angiography or magnetic resonance angiography. CONCLUSION: It is mandatory to emphasize blood pressure measurement in pediatric clinical practice for early recognition of renovascular hypertension. As children with renovascular hypertension display involvement of multiple arteries, including in smaller intrarenal arteries, digital subtraction angiography is the only method that can reliably diagnose pediatric renovascular hypertension.

Imaging of the CO snow line in a solar nebula analog.

Planets form in the disks around young stars. Their formation efficiency and composition are intimately linked to the protoplanetary disk locations of "snow lines" of abundant volatiles. We present chemical imaging of the carbon monoxide (CO) snow line in the disk around TW Hya, an analog of the solar nebula, using high spatial and spectral resolution Atacama Large Millimeter/Submillimeter Array observations of diazenylium (N2H(+)), a reactive ion present in large abundance only where CO is frozen out. The N2H(+) emission is distributed in a large ring, with an inner radius that matches CO snow line model predictions. The extracted CO snow line radius of ~30 astronomical units helps to assess models of the formation dynamics of the solar system, when combined with measurements of the bulk composition of planets and comets.