The surface morphology and histogenesis of small intestine of human embryos (from 6 to 36 weeks) were studied by scanning electron microscopy and light microscopy. The results indicated that some low prominences began to form at 6 weeks of gestation and then transformed to round tuberculum, after that to polygonal column. The finger-like intestinal villi were formed finally at the end of 3 months. There was a apparent proximodistal gradient of the morphological maturation of villi and the histogenesis of intestine from duodenum, jejunum to ileum. Splitted and branched villi were found. From 18 weeks onward, the respective characteristics of villi in the three segments of small intestine appeared. Neutral mucus and sialomucus were mainly secreted by the goblet cells, while sulphomucus was secreted by the goblet cells of ileum during the late gestation. By 6-12 weeks the microvilli of duodenum were shorter than that of jejunum and ileum but they increased in height to 1.4?m at 18 weeks. The height of microvill at jejunum and ileum were 0.8-1.0?m from 14 weeks to 32 weeks. Tufts of thick and long microvilli among short microvilli were found. The formation of villi, secretion of goblet cells and microvilli was discussed.

Objective To explore the action mechanism of shenxiong glucose injection in treatment of acute spinal cord injury(SCI) through observing its effects on the recovery of motor function and the expression of aquaporin-4(AQP-4) in SCI rats.Methods Totally 90 healthy,aduh,Sprague-Dawley rats were randomly divided into a sham operation group (n=30),aSCI group (n=30) and a drug group (n=30).The SCI rat models in both the SCI group and the drup group were established aecording to the modified Allen's method,while the sham operation group was only given laminectomy.After the operation,the drug group was given intraperitoneal shenxiong glucose injection of 30 rnl/kg a day,while the other two groups were injected in the same way with normal saline.The neural function recovery,the pathological changes after SCI and the expressions of AQP-4 were observed 1,3,7,14 and 21 d after the operation using the Tarlov score,the hematoxylin and eosin staining,as well as immunofluorescence techniques and Western blotting.And the correlation of Tarlov scores with AQP-4 expressions was analyzed.Results No significant changes in Tarlov scores were observed in the sham operation group (P ＞ 0.05),while in the SCI group and the drug group,postoperative Tarlov scores decreased significantly.The hindlimb nerve function recovered to some degree with time in the SCI group and drug group.At 3,7,14 and 21 days after the operation,the Tarlov scores in the drug group were significantly higher than the SCI group (P ＜ 0.05).The drug group showed less severe pathological changes,with more residual neurons still visible of nucleoli than the SCI group 21 days after the operation.Compared with the sham operation group,the expression levels of AQP-4 were significantly higher in the SCI group and drug group at all the time points (P ＜ 0.05).However,the expression levels of AQP-4 in the drug group were significantly lower than the SCI group accordingly (P ＜ 0.05).The Tarlov scores were found to be significantly and negatively related to the AQP-4 protein expression levels 3 days(r =-0.523,P =0.003),7 days(r =-0.437,P=0.016),14 days(r=-0.417,P=0.022) and 21 days(r=-0.377,P=0.040)after the operation.Conclusion Injecting shenxiong with glucose can effectively promote the recovery of motor function after SCI,at least in rats.And its mechanism may be that the development of spinal cord edema is prevented and the secondary spinal cord injury alleviated by restraining the expressions of AQ P-4 in the injured areas.

ObjectiveTo investigate the correlation between recent cardiac events and the score of myocardial infarction by delayed-enhancement MRI (DE-MRI).Methods DE-MRI was performed in 40 subjects with coronary artery disease.The score of myocardial infarction by DE-MRI,the ejection fraction (EF) by echocardiography,recent cardiac events (the number of weekly nitroglycerin,the number of weekly angina episodes and the onset number of heart failure in the last year),6-minute walking distance,as well as the Seattle angina questionnaire (SAQ) score were assessed.The Spearman correlation test and Kruskal-Wallis test,Mann-Whitney test were used for the statistics.ResultsThere were negative correlation between the myocardial infarction score by DE-MRI (median 12,inter-quartile range:6.0-19.8) and the 6-minute walking distance(378.93 ± 100.53 ),SAQ score (74.55 ± 11.40 ) (r was 0.66 and 0.54,P ＜0.05).The myocardial infarction score by DE-MRI was strongly correlated with the number of weekly nitroglycerin ( median 1 ; inter-quartile range:0-2.8),the number of weekly angina episodes ( median 3,inter-quartile range:1-6.5 ) and the onset number of heart failure in the last year ( median 0,inter-quartile range:0-2) (r was 0.87,0.85 and 0.89,P ＜0.05).EF [(49.2 ± 13.72)％] was negative correlation with the number of weekly nitroglycerin,the number of weekly angina episodes and the onset number of heart failure in the last year (r were 0.67,0.73 and 0.73,P ＜0.05).ConclusionDE-MRI can be used for evaluation and prediction of future cardiac events.

Objective To investigate the clinical value of evaluation of fetal cardiac function in congenital heart disease by brain natriuretic peptide (BNP) and velocity vector imaging (VVI). Methods Fetuses who came from Shenzhen Maternity & Child healthcare Hospital were divided into the congenital heart disease group and the control group. At the same time we collected amniotic fluid and assayed BNP concentration. Using the VVI software, the velocity, strain and strain rate of the global and segmental of the left ventricle were measured. Comparison and correlation were made between the two groups. Results There was significantly difference of BNP concentrations in amniotic fluid between two groups. The gestational age had significant positive correlation with BNP concentrations in disease group. The comparison of global velocity, strain and strain rate of left ventricle between the two groups showed significant differences. All of the left ventricular dynamic parameters in disease group were lower than those of the control group. Conclusions Compared with the control group, the disease group had a high level of BNP in amniotic fluid and a lower level of dynamic parameters of left ventricular. There was a positive correlation between BNP concentration and gestational age in disease group. So we can conclude that theBNP concentration can be a biological parameter for evaluating the latent impairments of fetal cardiac function.

Objective To determine sonographic features and outcome of fetal lung abnormal lesions. Methods Blood supply of the lesion, fetus hydrops and other extra-lung anomalies should be evaluated by color Doppler flow image(CDFI) when abnormal lesion was detected in fetus lung during routine scanning. The fetus with lung abnormal lesion without hydrops at the first time scanning should be monitored by ultrasound in every four to six weeks. Results Forty cases fetus presented lung abnormal lesions, which included 21 cases with hyperechogenic solid masses,15 cases with cystic-solid mixture masses,4 cases with cystic masses. Lesions of 8 cases were demonstrated systemic arterial blood supply arising from the aorta on CDFI and the diagnosis of pulmonary sequestration (PS) were suggested. Seventeen cases lesion that had small size or decreased or disappeared or remained stable in size with gestational age developing had normal neonate. Conclusions CDFI is very useful in detecting abnormal lesion of the fetal lung and differentiating pathology and evaluating the prognosis. The outcome of isolated lung lesion without hydrops and mediastinal shift that decreased or disappeared or remained stable in size had a good prognosis.

Objective To determine the prevalence of metabolic syndrome ( MS) in women who had gone through natural menopause, and to provide basic data for developing effective prevention and intervention of metabolic syndrome in Taixing area Jiangsu province. Methods A cluster sample of natural postmenopausal women aged 45 to 64 years were sampled and assessed by questionnaires, physical measurements, and biochemical tests; and analyzed according to the International Diabetes Federation ( IDF, 2005) diagnostic criteria for MS. Results The crude prevalence of metabolic syndrome was 35. 25% and the standardized prevalence rate was 31. 47% after age being adjusted. The prevalence of metabolic syndrome was increased with age ( P < 0. 01). The constituent ratio of the combinations of 3, 4, and 5 components in MS was 21. 45% , 10. 73% , and 3. 07% , respectively. Conclusion The prevalence of the metabolic syndrome among older women after menopause is high and increasing with aging. Public education should be strengthened to improve the quality of life in postmenopausal women and prevention and intervention should be adopted earlier as well.

PURPOSE: The purpose of this study was to develop and preliminarily evaluate the reliability and validity of the Symptom-Management Self-Efficacy ScaleeBreast Cancer (SMSES-BC) related to chemotherapy. METHODS: The study included three stages. This paper presents the results of stage 2 and stage 3. In total, 34 items in the SMSES-BC were found during stage 1 from qualitative findings, a literature review, and expert suggestions; the 34 items were used for the psychometric properties test. Test-retest reliability and Cronbach alpha were assessed in the first sample, which included 45 participants for the pilot test (stage 2). The second sample, which included 152 patients, was used to assess the construct validity and concurrent validity (stage 3). RESULTS: The pilot test results revealed a test-retest reliability of .73 (p < .001) and Cronbach alpha coefficient of .96 for the total scale. Three factors (managing chemotherapy-related symptoms, acquiring problem solving, and managing emotional and interpersonal disturbances) were identified from exploratory factor analysis. Correlation coefficient r was .40 (p < .001), which supported the association between SMSES-BC and the General Self-Efficacy Scale for concurrent validity. CONCLUSIONS: The study results demonstrate acceptable reliability and validity for the SMSES-BC that was developed for measuring symptom-management self-efficacy related to chemotherapy for patients with breast cancer. This study suggests further research to validate the construct of the SMSES-BC.
Adult ; Aged ; Antineoplastic Agents/*therapeutic use ; Breast Neoplasms/*drug therapy/*psychology ; Drug Therapy/*psychology ; Factor Analysis, Statistical ; Female ; Humans ; Middle Aged ; Patients/*psychology ; Pilot Projects ; Psychometrics ; Reproducibility of Results ; Self Care/*psychology ; Self Efficacy ; Surveys and Questionnaires ; Taiwan

Objective To explore the genetic characteristics of fetuses with congenital heart diseases(CHD)diagnosed by prenatal ultrasound.Methods Data of 613 singletons with prenatal ultrasonic diagnosed CHD were retrospectively analyzed.The cardiac structural abnormalities were classified into 8 types.Whole-exome sequencing(WES)was performed for 40 fetuses since chromosomal karyotyping analysis and/or chromosomal microarray analysis(CMA)showed benign copy number variations(CNV)or variants of uncertain significance(VUS).Results Among 613 fetuses,479 fetuses underwent both chromosomal karyotyping analysis and CMA,genomic abnormalities were detected in 60 fetuses(60/479,12.53％).Among 134 fetuses underwent only CMA,genomic abnormalities were found in 4 fetuses(4/134,2.99％).According to results of chromosomal karyotyping analysis and/or CMA,abnormalities were noticed in 40 fetuses(40/568,7.04％)among 568 fetuses with isolated CHD,while in 15 fetuses(15/45,33.33％)among 45 fetuses with non-isolated CHD,respectively.Abnormality detection rate of chromosomal karyotyping analysis and/or CMA in fetuses with complex CHD(10/41,24.39％)was higher than that in fetuses with non-complex CHD(54/572,9.44％).Among complex CHD fetuses,abnormality detection rate was the highest in fetuses with conotruncal defect(CTD)combined with malformation of venous system(4/13,30.77％),while among fetuses with non-complex CHD,situs inversus viscerum had the highest detection rate(1/4,25.00％).Among 40 fetuses chromosomal karyotyping analysis and/or CMA showed benign CNV or VUS,WES indicated pathogenic CNV/likely pathogenic CNV(P/LP)in 3 fetuses,VUS in 3 fetuses and benign CNV in 34 fetuses.Conclusion Fetuses with CHD,especially extracardiac malformations had possibilities of genomic abnormalities.Fetuses with CTD combined with malformation of venous system had higher possibilities of genomic abnormalities.Compared with CMA alone,chromosomal karyotyping analysis combined with CMA was helpful for detecting genomic abnormalities.

Objective To investigate the diagnostic value of High-Sensitive Troponin T(hs-TnT)in acute myocardial infarction(AMI). Methods One hundred and sixty nine patients with serum hs-TnT concentration≥0.014 μg/L in early hospitalization were enrolled in this study.The ROC curve was used to compare the concentra-tion of hs-TnT with four heart enzyme(CK,CK-MB,LDH,AST)on the diagnostic efficacy to AMI. The differ-ence of hs-TnT in different clinical data groups were investigated using Mann-Whitney U rank test.Then the correla-tion between hs-TnT and Gensini score of Coronary angiography was investigated using the Spearman rank correla-tion test.Results The concentration of hs-TnT in patients with chest pain was significantly higher than that in non-AMI group(P<0.05).The AUC of each ROC curve was hs-TnT(0.806)>CK-MB(0.792)>CK(0.780)>AST (0.704)> LDH(0.684). The optimal diagnostic point of hs-TnT was 0.152 ug/L(sensitivity 0.659,specificity 0.894,Yuden index 0.553).There was a positive correlation between hs-TnT and Gensini scores in men,age>65 years old and the chest tightness group(P < 0.05). Conclusion The hs-TnT is better than four heart enzyme in early diagnosis of AMI and benefit early treatment of AMI.

Objective:To assess the ultrasonographic features and potential diseases of fetal abnormal sylvian fissure(SF), and to explore the value of whole-genome sequencing (WGS) in prenatal detection.Methods:A total of 28 fetuses with a sonographic diagnosis of abnormal SF in Shenzhen Maternal and Child Health Hospital Affiliated to Southern Medical University between October 2018 and October 2020 were prospectively included. The fetal brain was evaluated by neuroultrasound and intrauterine MRI in detail. Amniotic fluid/cord blood obtained by amniocentesis or tissue samples from umbilical cord after birth were collected for WGS. Pregnancy outcomes and postnatal MRI were recorded, and neurodevelopment of live-born infants was followed up for more than 24 months after delivery.Results:During the study period, 28 fetuses with abnormal SF were identified, with a gestational age of 21.3-30.0 (24.8±2.0) weeks. Abnormal SF presented in MCD ( n=15, 53.6%), chromosomal anomalies ( n=3, 10.7%) or single-gene genetic syndromes ( n=3, 10.7%) with the affected fetuses showing developmental delay, hydrocephalus or leukomalacia ( n=4, 14.2%), corpus callosal agenesis with large interhemispheric cysts ( n=1, 3.6%), benign subarachnoid space enlargement with arachnoid cysts ( n=1, 3.6%), and multiple malformations ( n=1, 3.6%). Among the 15 cases with MCD, the most common pathology was lissencephaly/pachygyria, followed by schizencephaly, severe microcephaly, hemimegalencephaly with paraventricular heterotopia, and polymicrogyria. Abnormal SF presented bilaterally in 23 fetuses and unilaterally in 5. All cases were categorized into six types depending on SF morphology in the transthalamic section: no plateau-like or a small insula, linear type, irregular corrugated SF, Z-shaped, and cyst occupying type. In addition to abnormal SF, associated anomalies or mild variations were identified in all fetuses. There were 17 cases underwent intrauterine MRI, and 13 cases underwent postnatal MRI examination.And 25 pregnancies were terminated; 3 were born alive, and 2 had typical syndromic changes with poor neurodevelopmental prognosis. A related pathogenic genetic variant was detected in 57.1% (16/28) fetus, and the incidence of single nucleotide variants(SNVs) was 42.9% (12/28), among which de novo SNVs accounted for 91.7% (11/12). Conclusions:Fetal abnormal SF could be classified based on the ultrasonographic features of transthalamic section. Fetal abnormal SF may indicate MCD, some chromosomal abnormalities or single-gene genetic syndromes that may lead to poor neurodevelopmental outcomes, and may be affected by extra-cortical factors. It is suggested to carry out targeted prenatal genetic diagnosis for fetuses with abnormal SF.