Objective:To analyze the effect of percutaneous transluminal angioplasty (PTA) in the treatment of autogenous arteriovenous fistula (AVF) stenosis and influcing factors of restenosis/loss of function after PTA.Methods:The medical records of 104 patients with AVF stenosis treated by PTA in People′s Hospital of Huadu District from March 2019 to July 2020 and the 1-year follow-up were retrospectively analyzed. Kaplan-meier curves were used to analyze the primary patency rates at 3 months, 6 months and 1 year. COX regression was used to analyze the influencing factors of restenosis/loss of function after PTA.Results:The primary patency rates of AVF at 3, 6 and 12 months after PTA were 86.2%, 83.2% and 64.7%, respectively. Guide wire entry into the distal end of radial artery, the use of two balloons in stepwise mode, postoperative dilatation diameter, and dialysis blood flow after PTA were independent risk factors for restenosis/loss of fuction after PTA for AVF stenosis (all P<0.05). Conclusions:The guide wire into the distal end of the artery and passive use of more than two balloons are important factors affecting AVF restenosis/loss of function after PTA .

To investigate the prenatal sonographic feature in the early diagnosis of amniotic band syndrome at 11 －14 weeks′ gestation . Methods A retrospective study was conducted to analysis and summarize the ultrasonographic features of 4 fetuses without band‐like echoes in amniotic cavity at 11－14 weeks′gestation ,but verified as amniotic band syndrome in Peking Union M edical College Hospital . Results T wo cases ( cases 1 ,2) showed the fixed head position with skull defect and intracranial structure disorders . Cases 3 and 4 showed one upper limb in a fixed position ,and the hand seemed to adhere to the umbilical cord isolatedly . In addition ,case 1 showed complete chorioamniotic membrane separation . T here were multiple band‐like echoes adhered to body of 3 fetals during the follow‐up scan at 14 －18 weeks . T he parents of cases 1 and 2 chose to terminate the pregnancy after counseling ,the other 2 cases also induced labor due to intrauterine fetal death at 15+2 weeks and 19+2 weeks respectively . All 4 cases were confirmed as amniotic band syndrome by pathology . Conclusions When the fetal sonographic images showed fixed head position ,disordered intracranial structure ,or adhesion between umbilical cord and hand with limited movement at 11 －14 weeks′ gestation ,it should be paid attention to observing the band‐like echoes and followed up closely to prevent missed diagnosis of amniotic band syndrome .

Objective:To evaluate the placental micro-vascular circulation by microvascular flowing imaging (MVFI) method, and to explore the clinical value of microvascular index (MVI) for the diagnosis of fetal growth restriction (FGR).Methods:A total of 21 fetuses at 24-34 weeks of gestation at the Peking Union Medical College Hospital from October to November 2019 were enrolled in this study, including 7 fetal growth restriction (FGR) fetuses, and 14 normal fetuses as control group. The fetuses of the two groups were matched according to the gestational weeks at the ratio of 1∶2. Fetal biometry parameters were measured and the placenta was observed by two-dimensional ultrasound.Uterine artery pulse index (UtA-PI), middle cerebral artery pulse index (MCA-PI), and umbilical artery S/D ratio were evaluated by color and pulse-wave Doppler. The placenta mico-circulation was displayed by the MVFI method and MVI was measured.Results:The study included 14 normal fetuses and 7 FGR fetuses. Compared with the control group, more placenta in the FGR group manifested as thickened and heterogeneous with decreased MVI and increased UtA-PI. There was statistically significant difference in placental mean MVI between two groups ( P=0.044). Besides, a trend towards significant negative correlation was observed between MVI and placenta thickness, although this was not statistically significant ( rs=-0.35, P=0.065). MVI had a higher specificity (100%) in the prediction of FGR. Conclusions:MVFI can display the micro-circulation of the placenta, and provide a direct and quantitative assessment method for placental perfusion.

Objective: The research was aimed at exploring the effects of mandelic acid on the proliferation , apoptosis and migration of H1299 lung adenocarcinoma (LUAD) cells and the related molecular mechanisms. Methods: CCK⁃8 was used to detect changes in the proliferation ability of H1299 cells;Hoechst 33258/PI double⁃staining assay was used to analyze the apoptosis of H1299 cells;Transwell and migration assays were used to analyze changes in the invasive and migration ability of H1299 cells;Western blot was used to detect the expression of proliferation ,apoptosis and migration⁃related pathway proteins. Results : Different concentrations of mandelic acid inhibited the proliferation viability and invasion and migration ability of H1299 cells (P < 0. 05) . Mandelic acid induced high expression of bax and cl⁃caspase⁃3 and low expression of p ⁃stat3 in proliferation and apoptosis pathways (P < 0. 05) .In addition , it inhibited the expression of MMP⁃9 and Vimentin proteins ,which were related to invasion and migration (P < 0. 01) . Conclusion Mandelic acid inhibited the proliferation of H1299 LUAD cells and elevated the level of apoptosis , and molecular biological mechanism might be closely related to the decreased activation of stat3 and activation of bax/caspase⁃3 signaling axis. The inhibition of invasive and migrational ability of H1299 cells induced by mandelic acid was associated with the decreased expression of MMP⁃9 and Vimentin proteins.

BACKGROUND: Early fluid resuscitation is one of the fundamental treatments for acute pancreatitis (AP), but there is no consensus on the optimal fluid rate. This systematic review and meta-analysis aimed to compare the efficacy and safety of aggressive vs. controlled fluid resuscitation (CFR) in AP. METHODS: The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and Web of Science databases were searched up to September 30, 2022, for randomized controlled trials (RCTs) comparing aggressive with controlled rates of early fluid resuscitation in AP patients without organ failure on admission. The following keywords were used in the search strategy: "pancreatitis," "fluid therapy,""fluid resuscitation,"and "randomized controlled trial." There was no language restriction. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to assess the certainty of evidence. Trial sequential analysis (TSA) was used to control the risk of random errors and assess the conclusions. RESULTS: A total of five RCTs, involving 481 participants, were included in this study. For primary outcomes, there was no significant difference in the development of severe AP (relative risk [RR]: 1.87, 95% confidence interval [CI] 0.95-3.68; P = 0.07; n = 437; moderate quality of evidence) or hypovolemia (RR: 0.98, 95% CI: 0.32-2.97; P = 0.97; n = 437; moderate quality of evidence) between the aggressive and CFR groups. A significantly higher risk of fluid overload (RR: 3.25, 95% CI: 1.53-6.93; P <0.01; n = 249; low quality of evidence) was observed in the aggressive fluid resuscitation (AFR) group than the controlled group. Additionally, the risk of intensive care unit admission ( P = 0.02) and the length of hospital stay ( P <0.01) as partial secondary outcomes were higher in the AFR group. TSA suggested that more studies were required to draw precise conclusions. CONCLUSION: For AP patients without organ failure on admission, CFR may be superior to AFR with respect to both efficacy and safety outcomes. REGISTRATION PROSPERO; https://www.crd.york.ac.uk/PROSPERO/ ; CRD 42022363945.
Humans ; Randomized Controlled Trials as Topic ; Fluid Therapy ; Hypovolemia ; Pancreatitis/therapy*