Objective To observe the influence of congenital heart disease(atrial septal defect,ASD)to intervene closure on the right structure of children(<1 5 years)and adults(1 5-65 years)and to make the safety assessment.Methods Totally 1 1 1 un-derwent interventional treatment of complications in patients with ASD in our hospital from 2010 to 2013 were retrospective ana-lyzed.Closure on changing of right heart structure of child and adult were measured by ultrasonic cardiogram.Closure falls off,shut valve insufficiency,arrhythmia,residual shunt were recorded by ultrasonic cardiogram and electrocardiogram.making statistical a-nalysis.Results The inner diameter of the right atrium(RAD),right ventricle diameter(RVD),pulmonary artery diameter(PA) and right ventricular outflow tract(RVOT)were decreased compared with pre-operation(P < 0.05 ),during the follow-up 1,3,6 month,they was continue decreased in the aged between1 5-65 group(P <0.05),but was stable in less than 1 5 years old age group (P >0.05 ).The complication rate of children and adults were 25.0% and 21.3% respectively,and there were no significantly difference(P >0.05),and was no serious complications.Conclusion Congenital heart disease intervention of atria septal defects can improve heart right structure,which can benefit both children and adult,there is no difference in complication rates.All of these have less serious complications,high safety,curative effect affirmation.

Objective To select an ideal Parkinson ’ s disease ( PD) animal model with metabolic abnormalities for subsequent experimental studies .Methods A total of 62 Sprague-Dawley male rats were randomly divided into four groups:damaged medial forebrain bundle ( MFB) model group, damaged medial forebrain bundle ( MFB) sham group, damaged Striatum model group and damaged Striatum sham group .After detecting the rotation experiment , successful model rats of two groups were selected to detect the changes of food intake , body weight , blood glucose and intra-abdominal adipose tissue.Results It was easier to produce a PD model by destroying MFB than striatum .Compared with sham-operated rats, MFB model rats showed significant abnormality both in reduction of body weight [(218.1 ±13.99) g vs (252.7 ±10.1)g, P<0.05] and high blood glucose appeared at 15min and 30min after introperitoneal glucose tolerance test ( IPGTT) .Their perirenal white adipose tissue was significantly reduced ( both left and right side ) .Striatum model rats only appeared decreased food intake [(13.95 ±0.25)g vs (20.23 ±0.86)g, P<0.001] and impaired glucose regulation at 15min, 30min and 60min after IPGTT.Their body weight and adipose tissue did not change significantly .Conclusion No matter in the success rate or metabolism-related indicators , MFB damaged rat model of PD is more suitable to study PD patients with abnormal lipid metabolism compared with Striatum rat model .

Objective To summraize the safety and efifcacy of modiifed transcatheter closure of atrial septal defect. Methods From Dec. 2012 to Dec. 2013, 100 cases performed modiifed transcatheter closure of atrial septal defect in our center (72 were famale and 28 were male) with average age (37±16) years. The diagnosis was conifrmed by transthoracic echocardiography. All the atrial septal defect closures were completed in the modiifed way by direct delivery of the closure devices without the need of guidence wire. Results One hundred and one defects were identiifed in 100 patients, with 1 patient had 2 defects. The mean diameter of the defect was (20.3±6.6) mm. 100 devices were implanted successfully. Complete closure was revealed in all the patients after the procedure. One patient developed atrial ifbrillation during the procedure. No other serious complication occurred till the last follow-up. Conclusions The modiifed transcatheter closure of atrial septal defect is an effective procedure with high successful rate and low rate of complications.

Objective:To investigate the effect of the Ilizarov technique in the treatment of post-traumatic lower extremity shortening with talipes equinovarus.Methods:Clinical data of patients with post-traumatic lower extremity shortening and talipes equinovarus treated by the Ilizarov technique in the Department of Orthopaedics of Xuzhou Renci Hospital from January 2013 to April 2020 were retrospectively analyzed. The annular external fixator was installed on the affected limb according to the Ilizarov principle of external fixation. 3 days after the operation, the internal and lateral screw rods were adjusted at the speed of 2 mm/d to gradually correct the talipes equinovarus. 7 days after surgery, the lower leg was lengthened at a speed of 1 mm/d. After the foot was corrected, the foot external fixator was continued to be worn for 4 to 6 weeks, and then the fixator was removed and the foot was immobilized with a brace for 6 to 8 weeks. The lower leg fixator was removed after the lower extremity length was restored and the bone mineralization at the extension site was good. The length of both lower extremities, angle of talonavicular joint, angle of plantar flexion and dorsal extension of the ankle, and range of motion of ankle were compared before surgery and at the last follow-up. At the last follow-up, the affected feet were scored and rated using the International Clubfoot Study Group (ICFSG) scoring system, which was divided into four grades: excellent, good, medium, and poor. SPSS 25.0 software was used for statistical analysis, and each measurement index and ICFSG score were expressed in Mean±SD. Paired t-test was used to compare the preoperative and last follow-up data, and P<0.05 was considered statistically significant. Results:A total of 31 patients were enrolled, including 17 males and 14 females. The age was 15-18 years old, with an average of 16.5 years old. There were 16 cases on the right side and 15 cases on the left side. The lower extremity shortening was 45-75 mm, with an average of 65 mm. The fixation time of the external fixator was 4.5-6 months after surgery, with an average of 5 months, and the follow-up time was 22-28 months, with an average of 25.5 months. The length of the affected lower extremity recovered, the shape was basically satisfactory, and the plantar gait was restored. At the last follow-up, compared with the preoperative period, the anteroposterior talocalcaneal angle of the foot (23.0°±2.1° vs. 8.5°±2.6°), from lateral talocalcaneal angle the foot (27.0°±4.3° vs. 11.2°±4.4°), ankle plantar flexion angle (24.5°±6.8° vs. 51.1°±6.5°), ankle dorsiflexion angle (5.8°±3.5° vs. -46.8°±7.0°) and ankle range of motion (30.3°±8.2° vs. 4.2°±1.6°) were statistically significant ( P <0.01). ICFSG score: The points at the last follow-up (8.0 ± 4.2) were significantly lower than that before the operation (41.9 ± 5.3) ( P<0.01), of which 18 were excellent, 9 were good, and 4 were medium. Two cases had recurrent deformities in the later stage, and the results were satisfactory after the fusion of the talonavicular joint and calcaneocuboid joint and the anteposition of the posterior tibial tendon in the second stage. There were 4 cases of toe contracture deformity, which did not recur after the release of the flexor digitorum longus tendon at the toe. Anterior ankle impingement was observed in 5 cases and improved after the arthroscopic osteophyte removal. After the lower extremity extension was in place, the external fixator was replaced by the intramedullary nail for walking in 6 patients. The infection of the nail path occurred in 7 cases, which improved after replacement of fixing pins and dressing change of the nail path. Conclusion:The application of the Ilizarov technique in the treatment of post-traumatic lower extremity shortening with talipes equinovarus has the advantages of small trauma and dynamic control of deformity correction, which can achieve good result.

The glucose metabolism is crucial for sustained brain activity as it provides energy and is a carbon source for multiple biomacromolecules; glucose metabolism decreases dramatically in Alzheimer’s disease (AD) and may be a fundamental cause for its development. Recent studies reveal that the alternative splicing events of certain genes effectively regulate several processes in glucose metabolism including insulin receptor, insulin-degrading enzyme, pyruvate kinase M, receptor for advanced glycation endproducts, and others, thereby, influencing glucose uptake, glycolysis, and advanced glycation end-products-mediated signaling pathways. Indeed, the discovery of aberrant alternative splicing that changes the proteomic diversity and protein activity in glucose metabolism has been pivotal in our understanding of AD development. In this review, we summarize the alternative splicing events of the glucose metabolism-related genes in AD pathology and highlight the crucial regulatory roles of splicing factors in the alternative splicing process. We also discuss the emerging therapeutic approaches for targeting splicing factors for AD treatment.

Objective:To investigate the effect of the Ilizarov technique in the treatment of post-traumatic lower extremity shortening with talipes equinovarus.Methods:Clinical data of patients with post-traumatic lower extremity shortening and talipes equinovarus treated by the Ilizarov technique in the Department of Orthopaedics of Xuzhou Renci Hospital from January 2013 to April 2020 were retrospectively analyzed. The annular external fixator was installed on the affected limb according to the Ilizarov principle of external fixation. 3 days after the operation, the internal and lateral screw rods were adjusted at the speed of 2 mm/d to gradually correct the talipes equinovarus. 7 days after surgery, the lower leg was lengthened at a speed of 1 mm/d. After the foot was corrected, the foot external fixator was continued to be worn for 4 to 6 weeks, and then the fixator was removed and the foot was immobilized with a brace for 6 to 8 weeks. The lower leg fixator was removed after the lower extremity length was restored and the bone mineralization at the extension site was good. The length of both lower extremities, angle of talonavicular joint, angle of plantar flexion and dorsal extension of the ankle, and range of motion of ankle were compared before surgery and at the last follow-up. At the last follow-up, the affected feet were scored and rated using the International Clubfoot Study Group (ICFSG) scoring system, which was divided into four grades: excellent, good, medium, and poor. SPSS 25.0 software was used for statistical analysis, and each measurement index and ICFSG score were expressed in Mean±SD. Paired t-test was used to compare the preoperative and last follow-up data, and P<0.05 was considered statistically significant. Results:A total of 31 patients were enrolled, including 17 males and 14 females. The age was 15-18 years old, with an average of 16.5 years old. There were 16 cases on the right side and 15 cases on the left side. The lower extremity shortening was 45-75 mm, with an average of 65 mm. The fixation time of the external fixator was 4.5-6 months after surgery, with an average of 5 months, and the follow-up time was 22-28 months, with an average of 25.5 months. The length of the affected lower extremity recovered, the shape was basically satisfactory, and the plantar gait was restored. At the last follow-up, compared with the preoperative period, the anteroposterior talocalcaneal angle of the foot (23.0°±2.1° vs. 8.5°±2.6°), from lateral talocalcaneal angle the foot (27.0°±4.3° vs. 11.2°±4.4°), ankle plantar flexion angle (24.5°±6.8° vs. 51.1°±6.5°), ankle dorsiflexion angle (5.8°±3.5° vs. -46.8°±7.0°) and ankle range of motion (30.3°±8.2° vs. 4.2°±1.6°) were statistically significant ( P <0.01). ICFSG score: The points at the last follow-up (8.0 ± 4.2) were significantly lower than that before the operation (41.9 ± 5.3) ( P<0.01), of which 18 were excellent, 9 were good, and 4 were medium. Two cases had recurrent deformities in the later stage, and the results were satisfactory after the fusion of the talonavicular joint and calcaneocuboid joint and the anteposition of the posterior tibial tendon in the second stage. There were 4 cases of toe contracture deformity, which did not recur after the release of the flexor digitorum longus tendon at the toe. Anterior ankle impingement was observed in 5 cases and improved after the arthroscopic osteophyte removal. After the lower extremity extension was in place, the external fixator was replaced by the intramedullary nail for walking in 6 patients. The infection of the nail path occurred in 7 cases, which improved after replacement of fixing pins and dressing change of the nail path. Conclusion:The application of the Ilizarov technique in the treatment of post-traumatic lower extremity shortening with talipes equinovarus has the advantages of small trauma and dynamic control of deformity correction, which can achieve good result.

Objective:To summarize the experience of 15 cases of balloon endovascular occlusion assisted aortic replacement.Methods:15 patients who needed reoperation after aortic surgery underwent endovascular balloon occlusion assisted aortic replacement by DSA guidance in the hybrid OR. Main inclusion criteria: The target vessel to be blocked cannot be directly blocked. Based on the last CTA before the operation, the diameter of the target vessel was measured, and the appropriate diameter balloon and the appropriate diameter balloon and the amount of contrast agent were selected. The vascular approach was selected according to the CTA.During the operation, the balloon was filled and fixed well, the distal invasive blood pressure waveform showed advection, and the pressure close to hydrostatic pressure as the complete blocking standard.Results:All 15 cases of balloon endovascular occlusion assisted aortic surgery were successful. After the operation, 14 target vessels normally without damage, and there was no vascular complication. One case after surgical three-branch stent surgery underwent the second thoracoabdominal aortic replacement operation. After the stent was blocked by the balloon, the new tissue in the stent fell off, and the celiac trunk and superior mesenteric artery were embolized for reoperation.Conclusion:Balloon endovascular occlusion technology expands the indications of aortic surgery and simplifies the operation, that is a safe and effective occlusion method. Whether the target vessel is suitable for balloon occlusion should be judged before the operation to avoid related complications.

OBJECTIVETo determine whether smoking increases the risk for developing metabolic syndrome (MetS) in Chinese men.

METHODSA total of 693 men with no MetS at baseline were followed for 2.9-5.5 years. Subjects were divided into nonsmokers, ex-smokers, and current smokers according to baseline smoking status.

RESULTSAfter adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR index, and BMI at baseline and weight change, current smokers were dose-dependently associated with increased risk for developing new MetS compared with nonsmokers. The odds ratio (OR) was 2.131 (95% CI, 1.264, 3.592; P<0.01) for the NCEPIII definition or 3.083 (95% CI, 1.807, 5.295; P<0.01) for the JCDCG definition of MetS. Ex-smokers who had quit for ≥13 years significantly decreased the risk for developing new MetS defined by the JCDCG definition. Compared with nonsmokers, current smokers were significantly associated with increased incidence of hypertriglyceridemia and low HDL-C.

CONCLUSIONSmoking is a risk factor for developing MetS in Chinese men after adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR, BMI, and weight change. This could be due to an increased incidence of dyslipidemia. Smoking cessation for >13 years decreased the risk for developing MetS defined by the JCDCG definition.

Adult ; Aged ; Aged, 80 and over ; Blood Glucose ; metabolism ; Body Mass Index ; China ; epidemiology ; Cholesterol, HDL ; blood ; Diabetes Mellitus ; blood ; epidemiology ; Follow-Up Studies ; Humans ; Hypertriglyceridemia ; blood ; epidemiology ; Male ; Metabolic Syndrome ; blood ; epidemiology ; etiology ; Middle Aged ; Odds Ratio ; Risk Factors ; Smoking ; adverse effects ; blood ; epidemiology ; Waist Circumference

The long-term efficacy and complications of implantable diaphragm pacer (IDP) in a child with cervical spinal cord injury (CSCI) in the Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center in September 2022 were retrospective analyzed.A male child had quadriplegia without an obvious cause at the age of 12 years, and he was then lived completely with the assistance of mechanical ventilation.At the age of 14 years, he could wean off the ventilator in unilateral diaphragmatic pacing mode.However, mechanical ventilation was re-given for months after 5 years due to pneumonia, and then the IDP was re-given with the self-felt decreased pacing effect.After hospitalization, the patient was examined with mild diaphragmatic atrophy, secondary flat chest, and mild scoliosis.After optimization of the transdiaphragmatic pacing threshold and rehabilitation, his respiratory function improved.IDP can be used in CSCI for long time, while flat chest and scoliosis that limited the expansion of the lungs should be considered.At the meantime, the increased abdominal spasm affected the abdominal compliance, leading to the decrease in the efficiency of the diaphragm.

Objective: To investigate the interventional effect of bicyclol on isoniazid-induced liver injury in rats and the expression of endoplasmic reticulum stress (ERS) protein, glucose regulatory protein 78 (GRP78), and growth arrest and DNA-damage-inducible gene 153(CHOP). Methods: Eighty Wistar rats were randomly divided into control group (8 rats) and model group (72 rats). After 10 days of intragastric administration of isoniazid, the model group rats were randomly divided into treatment group (A), natural recovery group (B), etiological persistence group (C) and etiological persistence plus treatment group (D). Sixteen rats from each group were sacrificed after 1 and 2 weeks of intervention with different methods. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected. Liver pathological morphology was observed. Apoptotic cells were detected by TUNEL assay. ERS protein expression was detected by Western blot. A t-test or randomized block analysis of variance, K-S test and Levene’s test were used to analyze the normality and homogeneity of variance. Kruskal-Wallis rank sum test was used for data that did not suit the conditions of t-test and variance analysis. Results: ALT and AST were elevated in the model group, and liver pathological examination showed liver tissue damage. Apoptotic index was higher than control group (7.13% ± 1.55% vs. 0.75% ± 0.71%, Z = -3.411, P < 0.01), and the expression value of ERS protein in model group was significantly higher than control group (GRP78: 1.16 ± 0.30 vs. 0.23 ± 0.05, t = -6.008, P < 0.01; CHOP: 0.98±0.23 vs. 0.20 ± 0.10, t = -6.378, P < 0.01). Serum enzymes, apoptotic index and ERS protein expressions of rats were decreased after treatment with bicyclol, and the pathological damage was eased. Rats in natural recovery group recovered less than the treatment group. Conclusion Isoniazid-induced liver injury is associated to ERS-related excessive apoptosis and the therapeutic effect of bicyclol on drug-induced liver injury may minimize ERS-induced apoptosis.