Objective To investigate the origin of α-SMA positive cells in the outflow tract ridge of the embyonic mouse heart and to explore the ultrastructure change of the mesenchymal cells during the ridges fusion. Methods Sections of embryonic day 10(E10d) to E14d mouse embryonic hearts were stained by immunohistochemistry assay with monoclonal antibodies against α-smooth muscle actin (α-SMA), α-sarcomeric actin(α-SCA) and in situ hybridization method with PlexinA2 probe. The outflow tract ridges fusion was observed by transmission electron microscopy at E12.5d. Results From E10d to E11d, PlexinA2 positive cells were seen in the neural tube with mesenchymes around it, the aortic sac and aortic arch. These cells also migrated into the outflow tract ridge along the aortic sac wall and part of them expressed α-SMA. At E12d, PlexinA2 was expressed in the spinal ganglia, the pharyngeal mesenchyme, the aorto-pulmonary septum and the ascending aorta and pulmonary trunk. The septum showed α-SMA strongly positive. But only a few of α-SMA positive cells were observed in the ascending aorta and pulmonary trunk. At E12.5d, two clusters of condensed mesenchymal cells in the outflow tract ridges formed and began to express PlexinA2 weakly and α-SMA strongly. When the ridges began to fuse, the endothelial cells formed a cellular seam, which rapidly broke into pieces and disappeared and were replaced by the sparsed mesenchymal cells containing a few of microfilaments. Two clusters of condensed mesenchymal cells gradully moved to merge. It was noted that some mesenchymal cells contained plenty of microfilament bundles, mitochondria and focal contacts between them. Some mesenchymal cells only had a few of microfilaments and plasma membrane fusion was seen between them. Conclusionα-SMA positive cells in the outflow tract cushion may be derived from cardiac neural crest. The endothelial cells might participate in the fusion of the outflow tract ridges by endothelial-mesenchymal transformation. Mesenchymal cells of the condensed cell mass contain plenty of microfilament bundles and focal contacts or membrane fusion, which contribute to the ridges fusion.

Objective:To investigate the difference in efficacy between transsylvian-transinsular approach and transcortical-transtemporal approach for hematoma evacuation in the treatment of severe basal ganglia intracerebral hemorrhage in young adults.Methods:Young adult patients with severe intracerebral hemorrhage in the basal ganglia region underwent craniotomy hematoma removal in Ankang Central Hospital from February 2012 to February 2021 were retrospectively enrolled. The Glasgow Outcome Scale score was used to evaluate the outcome at 6 months after onset. 4-5 were defined as good outcome and 1-3 were defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of the poor outcomes. Results:A total of 51 patients were enrolled. Their median age was 41 (interquartile range 39-43) years, and 29 were men (56.8%). The median Glasgow Coma Scale score at admission was 6.0 (interquartile range 5.5-7.0), and the median baseline hematoma volume was 38.0 ml (34.5-47.5 ml). Twenty-one patients (41.2%) were in the transsylvian-transinsular approach group and 30 (58.8%) were in the transcortical-transtemporal approach group. There were no significant differences in demographics, vascular risk factors and baseline clinical data between the transsylvian-transinsular approach group and the transcortical-transtemporal approach group. Compared with the transcortical-transtemporal approach group, the amount of intraoperative bleeding and hematoma residue in the transsylvian-transinsular approach group were less, the proportion of patients requiring decompressive craniectomy was lower (33.3% vs. 63.3%; χ2=4.449, P=0.035), and the duration of dehydration medication and hospital stay were shorter (all P<0.05). However, there was no significant difference in the good outcome rate between the two groups (66.7% vs. 56.7%; χ2=0.518, P=0.472). Multivariate logistic regression analysis showed that lower scores of Glasgow Coma Scale at admission (odds ratio 0.128, 95% confidence interval 0.017-0.977; P=0.047) and longer hospital stay (odds ratio 1.402, 95% confidence interval 1.065-1.844; P=0.016) were independently associated with the poor outcomes. Conclusion:For young adult patients with severe basal ganglia intracerebral hemorrhage who underwent hematoma removal, although there was no significant difference between the outcomes of patients with transsylvian-transinsular approach and transcortical-transtemporal approach, the former had more advantages.

Objective To explore and analyze the signals of pneumonia-related adverse events(ADEs)caused by endothelin receptor antagonists(ERAs)and provide reference for clinical safe medication.Methods Based on the the U.S.Food and Drug Administration(FDA)adverse event reporting system(FAERS)database,the data from the first quarter of 2015 to the first quarter of 2023 was extracted,and reporting odds ratio,pro-portional reporting ratio,Bayesian confidence propagation neural network and multi-item gamma poisson shrinker were used for mining.Results 7 279 reports of pneumonia-related ADEs with ERAs as the main suspects were extracted,including 3 705 reports of ambrisentan,1 028 reports of bosentan and 2 546 reports of macitentan.There were 68 pneumonia ADEs related to ERAs,including 21 ambrisentan,25 bosentan and 22 macitentan.According to the criteria for judging the signal of ADEs,there were 14 kinds of ADEs that formed signals,and all the systems involved in system organ classification were infections and infectious diseases.Infectious pneumonia accounted for the highest proportion of adverse reactions(93.61％)and caused the most deaths.Conclusion In the real world,ERAs can lead to pneumonia related ADEs.Female,elderly,and high-dose are important factors in the occurrence of pneumonia-related ADEs,which suggests that medical personnel need to individualized use drugs based on the patient's physiological status and drug characteristics when using ERAs to ensure medication safety.

Pulmonary hypertension （PH） is a severe and rare chronic cardiopulmonary disorder for which existing vasodilator therapies can only alleviate symptoms， rather than target or fundamentally reverse the disease. Additionally， the long-term prognosis remains poor. Recent studies have found that some novel anti-tumor drugs （NADs） can relieve PH， such as imatinib， gefitinib， sorafenib， olaparib， piperacillin， everolimus， rituximab， etc. However， some NADs can induce PH or exacerbate its symptoms， including dasatinib， lorlatinib， carfilzomib， bevacizumab， trastuzumab， nivolumab， etc. The effects of lapatinib， ruxolitinib， and bortezomib on PAH are controversial. Individualized medication should be adopted in clinical practice when using NADs for treatment， with close monitoring being essential.