Objective To improve the theoretical basis for the typical hemodynamic changes in subclavian steal syndrome (SSS) patients underwent transcranial doppler (TCD) by detailed hemodynamic analysis.Methods Patients with SSS were examined by transcranial doppler and some patients performed tourniquet test.Flow spectrum,flow velocity and pulsatility index (PI) of vertebral artery,basilar artery and middle cerebral artery (MCA) were recorded.Results The flow spectrum of steal side vertebral artery showed that there were 14 cases with systolic notch,18 cases with systolic reverse flow and 3 cases with flow completely reversed.The flow spectrum showed high resistance spectrum in vertebral artery and basilar artery and ipsilateral basilar artery vortex or turbulence in 32 cases.The PI value was higher in contralateral vertebral artery and basilar artery than in anterior circulation (q =9.56,9.98,both P ＜ 0.01),and there was no difference between contralateral vertebral artery and basilar artery (q=0.416,P＞0.05).The tourniquet test were positive in all 22 patients.Conclusions TCD is a convenient,fast,accurate and non-invasive method for hemodynamic examination,which is the first choice for the diagnosis of SSS.

Objective To observe the therapeutically effect of kangnao liquid on Pi3k mRNA and Aktm RNA ex-pressions in rats with focal cerebral ischemia-reperfusion (I/R) injury. Methods 180 male SD rats were randomly divided into 6 groups:sham operated group, model group, three kangnao liquid groups (high-dose, medium-dose and low-dose) and nimodipine group. Rats in kangnao liquid groups were administrated with kangnao liquid of 24 g/(kg · d), 12 g/(kg · d) and 6 g/(kg · d), orally once a day. Rats in nimodipine group were given nimodipine 1 mg/(kg · d). Rats in model group and sham group were treated with the same volume of distilled water for 7 days. The animal model of middle cerebral artery occlusion (MCAO) was established by a monofilament method from right internal carotid artery. The neurological evaluation was per-formed 24 h after reperfusion. The in situ hybridization was used to investigate the expression levels of Pi3k mRNA and Akt mRNA in rats on 12 h, 24 h, 48 h, 72 h and 168 h after ischemia for 2 h. Results Compared with model group, neurological functions were improved significantly in kangnao liquid groups. The expression levels of Pi3k mRNA and Akt mRNA were al-so significantly higher in kangnao liquid groups than those of model group. The expression levels of Pi3k mRNA and Akt mRNA were significantly higher in nimodipine group than those of model group, but which were lower compared with those of high-dose and medium-dose kangnao liquid groups. Conclusion Kangnao liquid can protect nerve cells by enhancing the expressions of Pi3k mRNA and Akt mRNA in rats with cerebral ischemia-reprefusion injury.

A sensitive colorimetric method for the detection of copper ions (Cu2+) was developed based on the surface modification of silver/platinum nanoclusters (Ag/Pt NCs) and regulation of peroxidase-like activity. It was found that 3-mercaptopropionic acid (MPA) could inhibit the catalytic ability of Ag/Pt NCs; however, it lost the inhibition toward catalytic ability of Ag/Pt NCs after oxidized by oxygen through the catalysis of Cu2+. On the basis of this, a colorimetric method was developed for the detection of Cu2+ through measuring the colorimetric signal variation of the TMB-H2O2 reaction. This method exhibited high sensitivity and selectivity toward Cu2+ over a panel of other metal ions. The linear range was 10-100 nmol/L and the detection limit was 5.0 nmol/L (3σ). The above method was also applied to detect real water samples and spiked samples, and the results demonstrated that this method was simple with low cost.

Objective To investigate the contrast enhanced ultrasound(CEUS)features of ovarian tumor torsion(OTT).Methods Seventeen cases with OTT were evaluated using CEUS.CEUS was performed with low mechanical index and the contrast agent of Sono Vue.Results Thirteen cases with total torsion of ovarian tumor appeared as no enhancement.Four cases with partial torsion showecl hyperechoic enhancement in the early phase and hypoechogenicity in the late phase.Conclusions The enhancement of OTT has characteristic,which would be helpful for the diagnosis and differential diagnosis of OTT.

Objective To explore the value of contrast-enhanced ultrasound(CEUS)in the differential diagnosis of endometrial carcinoma and endometrial hyperplasia.Methods Forty-five patients with endometrial carcinoma and 21 patients with hyperplasia were studied by CEUS.Twenty-four normal women were enrolled as contrast group.Results In normal uterus, myometrium exhibited earlier enhancement later washout than the endometrium.Similar phenomenon was observed in patients with hyperplasia.In patients with endometrial carcinoma,the lesion showed wash-in and washout earlier, at least not later than the myometrium.Conclusions Endometrial carcinoma and hyperplasia showed different enhancement patterns,which may be helpful for the diagnosis of the two diseases.

Chronic atrophic gastritis (CAG) is a common and refractory disease of the digestive system in clinic.Apoptosis is the important reason which relates CAG pathological changes.As one of the important means of clinical prevention and treatment of digestive diseases, traditional Chinese medicine (TCM) in the role and mechanism of CAG related research has become an important direction in recent years.Based on the collection of related literatures and data, the paper analyzed the possible mechanism of CAG pathogenesis grasped the key aspect of apoptosis and clarified the research status of TCM on the regulation of gastric mucosal cell apoptosis in CAG in recent years through focusing on the specific signaling pathways in mitochondrial pathway, death receptor pathway, endoplasmic reticulum pathway.Through the above analysis, the paper provided some ideas for further systematic and in-depth research and explored CAG effective TCM program.

Objective:To investigate the clinical features of children with kidney diseases who developed posterior reversible encephalopathy syndrome (PRES), explore the risk factors of PRES in these children, improve the understanding of the diseases, and help early diagnosis and effective treatment of the diseases.Methods:The clinical manifestations, laboratory inspection results, magnetic resonance imaging(MRI) material as well as the prognosis of 10 children with kidney diseases complicated by PRES who were admitted to the Department of Nephrology, Xi′an Children′s Hospital from November 2016 to August 2018 were analyzed retrospectively.Results:A total of 10 children were recruited, including 1 boy and 9 girls, with the onset age ranging from 4 years and 3 months to 13 years [(8.53±3.09) years]. The diagnosed kidney diseases in these patients were primary nephritic syndrome (6 cases), lupus nephritis (1 case), Hepatitis B-related nephritis (1 case), polyarteritis (1 case) and hemorrhagic fever with renal syndrome (1 case). Eight children received corticosteroids and 4 of them received other immunosuppressants simultaneously.Nine children suffered from the infections.All of them had acute onset, and the main symptoms were hypertension (10/10 cases, 100.0%), headache and dizziness (5/10 cases, 50.0%), nausea and vomiting (5/10 cases, 50.0%), visual disturbance (3/10 cases, 30.0%) and convulsions by the ways of seizures definitely (9/10 cases, 90.0%). There was nothing positive in the examinations of the nervous system and fundus.Computer tomography examinations of 9 cases showed nonspecific low-density foci.The cranial MRI scan showed abnormal signals on the cerebral cortex of frontal lobe, parietal lobe and occipital lobe in all these 10 cases.The hyperintensities were observed on the fluid-attenuated inversion recovery sequences of all the 10 cases.Slight hyperintensities on diffusion-weighted images of 4 cases indicated that PRES progressed from reversible angiogenic edema to irreversible cytotoxic edema, meaning a poor prognosis.After blood purification treatment and reducing intracranial pressure, these 4 cases recovered.After timely treatment upon PRES diagnosis, patients had no recurrence and showed a good outcome.Conclusions:Children with kidney diseases and PRES also suffer from hypertension, and the treatment with immunosuppressive agents may precede the occurrence of PRES.Cranial MRI is important for the diagnosis of PRES.

Objective:To analyze the gene mutation, clinical manifestations and prognosis of children with steroid resistant nephrotic syndrome (SRNS), and to provide reference for the treatment of hereditary SRNS in children.Methods:The clinical data of 29 patients with SRNS and whole exon sequencing (WES) diagnosed in Xi′an Children′s Hospital from January 1, 2018 to December 31, 2020 were retrospectively analyzed.Results:In 29 cases of SRNS with genetic testing, 10 cases (34.5%) were gene mutations, including 2 cases of congenital nephrotic syndrome. The onset age of the patients with gene mutation ranged from 0.1 to 10.7(4.06±3.73)years, and the median age of onset was 3.3 years. The clinical type was mainly nephritis (8/10), and the pathological type was mainly focal segmental glomerulosclerosis (FSGS) (5/7). The main mutant genes were NPHS1 (2 cases), NPHS2 (2 cases), WT1 (2 cases), SMARCAL1 (1 case), COQ8B (1 case), TRPC6 (1 case) and COL4A3 gene (1 case). The main types of genetic variation were missense mutations, and 6 (60%) cases were new mutations that had never been reported in the database containing human pathogenic mutations before. Compared with the non-gene mutation group, 24 hour urinary protein was higher [(177.92±164.59)mg/(kg·24 h) vs (84.99±40.79)mg/(kg·24 h)] in gene mutation group, with statistically significant difference ( P<0.05). In the gene mutation group, there were 2 cases of complete remission, including 1 case of complete remission treated with coenzyme Q10, 1 case of partial remission, and 8 cases of immunosuppression treatment, with an effective rate of 2/8, while in the non-gene mutation group, the effective rate of immunosuppression treatment was 17/19, with statistically significant difference in prognosis between the two groups ( P<0.05). Conclusions:The pathological type of children with hereditary SRNS is mainly FSGS, which are often ineffective to immunosuppressive therapy, poor prognosis and easy to progress to end-stage renal disease. Gene detection is of great significance for etiological diagnosis, treatment and prognosis evaluation in children with SRNS.

OBJECTIVETo detect potential mutation in a pedigree affected with congenital nephrogenic diabetes insipidus (NDI).

METHODSClinical data of a male patient affected with NDI was collected. Genomic DNA was extracted from peripheral blood samples from the patient and five family members. The whole coding region of the arginine vasopressin receptor 2 (AVPR2) gene was amplified by PCR and directly sequenced.

RESULTSThe patient presented polyuria and polydipsia postnatally. Computerized tomography revealed bilateral hydronephrosis and hydroureter. The patient was responsive to hydrochlorothiazide but not to desmopressin. DNA analysis identified a hemizygous missence mutation c.295 T>C in exon 2 of the AVPR2 gene in the proband. His mother and grandmother were both heterozygous for the same mutation.

CONCLUSIONThe congenital NDI in the patient was probably due to mutation of the AVPR2 gene.

Adolescent ; Base Sequence ; DNA Mutational Analysis ; Diabetes Insipidus, Nephrogenic ; congenital ; genetics ; Exons ; genetics ; Family Health ; Female ; Genetic Predisposition to Disease ; genetics ; Humans ; Male ; Mutation ; Pedigree ; Receptors, Vasopressin ; genetics

Objective: To understand the current situation of academic burnout among primary and middle school students and to explore its associated factors, so as to provide a scientific guidance and preventing and amelioration academic burnout among primary and middle school students. Methods: Between September and October 2023, a total of 10 474 primary and middle school students residing in Wuxi City participated in a questionnaire survey and physical examination conducted through stratified cluster random sampling. Latent profile analysis was used to classify academic burnout among primary and middle school students. Furthermore, differences in the types of academic burnout among children and adolescents with varying characteristics were examined using the Chi square test. Additionally, multinomial Logistic regression analysis was utilized to identify the associated factors for academic burnout. Results: The academic burnout of primary and middle school students was divided into 4 categories:no/light academic burnout group(43.6%),physical and mental exhaustion group (32.9%), low achievement group(15.0%), high physical and mental exhaustion/high academic burnout group(8.5%). Middle and high school students, boys, not living with parents, smoking, daily screen time ≥2 hours, suffering from campus bullying, sometimes/often subjected to cyber attacks, abused by parents were more likely to have high physical and mental exhaustion/high academic alienation among primary and middle school students ( OR=1.70, 1.42, 1.56, 1.56, 2.31, 1.48, 2.94, 3.03, 5.94, 2.08, P <0.01). Conclusions The phenomenon of academic burnout among primary and middle school students is prominent. And targeted intervention measures shoould be actively taken to prevent and reduce the occurrence of academic burnout among primary and middle school students.