Objective To discuss the value of volume helical shuttle(VHS) of high-definition CT(HDCT) in diagnosis and clinical path of tetralogy of Fallot(TOF).Methods 88 preschool children with TOF were examined with VHS of HDCT and echocardiography(ECHO).60 children were received surgery.Based on surgical data,the results of VHS of HDCT were compared with that of ECHO,assessing the display ability of basic deformity of TOF,the intra-cardiac lesion,extra-cardiac lesion and hemodynamics.The radiation dose(mSy) were calculated.Results The diagnostic accuracy of HDCT was 95.0％ and the ECHO was 90.0％ on the positional display.The results of HDCT were slightly smaller than ECHO on the measure of size of VSD,P ＜ 0.05,the difference was significant between the two methods.The display on right-to-left shunt of VSD using HDCT were all coincided with ECHO.One quarter of the cases showed the left-to-right shunt simultaneously.Whereas all the cases were showed slow bi-directional shunt by ECHO.There are 99 deformity in pulmonary artery stenosis,including right ventricular hypertrophy,outflow tract stenosis,pulmonary stenosis.The results of HDCT,ECHO and the operation showed no difference.All the McGoon ratio of HDCT were obviously higher than ECHO,P ＜0.01.Statistical difference was significant.The coincidence rates in aortic straddles by HDCT and ECHO both were 98.3％.Each has one case misdiagnosed.37 other intra-cardiac lesions,for example,foramen ovale and atrial septal defect.VAS has 25 misdiagnosed places and ECHO has 8.88 other extra-cardiac lesions,such as one side of pulmonary artery stenosis or atresia,collateral circulation between systemic and pulmonary circulation,coronary artery abnormal,patent ductus arteriosus(PDA) and so on.The diagnostic accuracy of HDCT was 98.8％ and the ECHO was 59.1％.Average effective dose with HDCT was(1.58 ± 0.43) mSv.Conclusion VHS of HDCT scan has obvious advantages in the diagnosis of TOF.Multiple data can reflect intra-cardiac lesion,extra-cardiac lesion accurately and intuitively.The radiation dose was in the acceptable range.Combining the HDCT VHS and the ECHO will become the clinical path of preoperative diagnosis,differential diagnosis and making the operation scheme in children with TOF.

Objective To assess the effect of snapshot freeze (SSF) motion correction algorithm on the image quality of coronary CT angiography (CCTA).Methods Thirty-one consecutive patients underwent coronary CTA without heart rate control.All of the CCTA images were reconstructed by the means of both standard (STD) and SSF motion correction.Image quality and interpretability of STD and SSF reconstructions were compared.CCTA images were interpreted with Likert 4-points score system by two experienced radiologists.The image qualities were assessed on per-artery and per-segment level,and interpretability was performed on per-segment,per-artery,and per-patient levels.Comparisons of variables were performed with paired Wilcoxon rank sum test and paired Chi-square test.Results SSF reconstructions showed higher interpretability than STD reconstructions on per-patient [100.0％ (31/31) vs 64.5％ (20/31),x2 =9.09,P =0.002] and per-artery [100.0％ (124/124) v s 83.9％ (104/124),x2 =18.05,P =0.001] and per-segment level [99.0％ (413/417) vs 89.2％ (372/417),x2 =35.56,P =0.001].Image qualities were higher with the use of SSF than STD reconstructions on LAD [3.3 ± 0.7 vs 2.9 ± 1.0,Z =2.70,P=0.007],LCX [3.1 ±0.8 vs 2.5 ± 1.1,Z =3.23,P =0.001] and RCA [3.3 ±0.6 vs 2.1 ±0.9,Z =4.60,P =0.001],but they were similar on LM [3.9 ± 0.4 vs 3.7 ± 0.6,Z =1.89,P =0.059].Image quality was higher with the use of SSF versus STD reconstructions on per-segment [3.5 ± 0.7 vs 3.0 ± 1.0,Z =10.31,P =0.001] level.Conclusions The use of SSF motion correction algorithm improves image quality and interpretability of coronary CTA without heart rate control.

Objective To investigate the morbidity of anomalous coronary origin from the opposite coronary sinus, which may cause sudden death of young athletes in Chinese population.And to identify the imaging characteristics of this anomaly and its clinical significance combined with literature review.Methods The computed tomographic coronary angiography (CTCA) database at TEDA International Cardiovascular Hospital was reviewed.All of the patients diagnosed with isolated anomalous origin of a coronary artery from the opposite sinus of valsalva (anomalous origin of coronary artery, AOCA) and subsequent coursing between the pulmonary artery and the aorta were collected from 14 343 Chinese individuals.The location of anomalous coronary origin, the shape and course of the proximal ectopic arterial segments were identified.The nonatherosclerostic stenotic caliber of the segments and the angle between the ectopic coronary artery and the adjacent aortic wall were assessed.Results Seventy-four patients of AOCA (including the left or right single coronary artery) were diagnosed using CTCA.Among the 74 cases, the potentially serious course of the ectopic coronary artery between the pulmonary artery and the aorta were identified in 59 individuals.Fifty-six cases of ectopic right coronary with interarterial course (anomalous origin of right coronary artery, AORCA) and three patients with anomalous origin of the left coronary artery (AOLCA) were found, including two cases judged as potentially serious origin of either single left coronary artery (n=1) or single right coronary artery (n=1).The morbidity of the potentially serious anomalous origin of coronary artery in Chinese population was established as 4.1‰ (59/14 343).In the subgroup of AORCA, the lumen of initial ectopic segment was frequently compressed and stenotic.In 29 cases (52.7%) the stenosis of the lumen were more than 50%, and in 3 cases (5.4%) the stenosis of the ectopic coronary artery were more than 70%.The incidence of AORCA was 17.7 times higher (56/3) than that of AOLCA in Chinese population.Conclusions Nowadays CTCA is considered the most useful imaging technique in identifying the origin, shape and course of ectopic initial segment of the coronary artery.The significance of these anatomic characteristics, that may induce sudden death in Chinese young athletes, need to be investigated further.

ObjectiveTo explore the state of misdiagnosis, missed diagnosis and excesseive diagnosis related to cerebral palsy(CP).Methods389 cases were retrospectively analyzed who were misdiagnosed, missed or escessively diagnosed related to CP as the first diagnosis in the inpatient and outpatient department from July 1999 to March 2010.ResultsAmong 389 cases, 156 cases were missed or misdiagnosed as nutritional disease, and 118 cases of other diseases were misdiagnosed as CP, while 115 cases who were normal children was excessively diagnosed as CP. The false diagnosis had relativity with children's age: doctors are more prone to make misdiagonsis when the children's age are smaller, while 293 cases were misdiagnosed before 12 months old (75.3%); 102 cases (65.4%) were misdiagnosed or missed as other diseases before September, 2004, while 87 cases (75.7%) were excessively diagnosed as CP after September, 2004. Frequency of misdiagnosis as CP reduced from 2004, and the proportion dropped from 55.9% to 44.1%.ConclusionIt is very important to master the diagnostic standard of CP. Both sides of the question are important, one side is to make early diagnosis and early treatment in order to achieve the best effect of rehabilitation, and the other side is to prevent misdiagnosis and excessive diagnosis which woud delay illness, or waste medical resources, increase the financial and psychological burden.

OBJECTIVETo study mRNA expression of receptor activator nuclear factor kappa B ligand (RANKL) and its decoy receptor, osteoprotegerin (OPG) in peri-implant tissue during unloading period.

METHODSAn animal model of dental implant was established in 6 male Beagle dogs of 1-2 years old. Bone remodeling was tested at 3, 7, 15, 30, 60 and 90 days since the placement of implants. RANKL and OPG mRNA expression were quantified by real-time polymerase chain reaction (PCR). Then mandibular bones were taken out and the morphological changes were observed by X-ray, bone tissue was tested by immunohistochemistry stain.

RESULTSThe most prominent period of bone remodeling occurred at 7th day after the placement of implants. The expression of RANKL and OPG increased in a time-dependent manner in both soft and hard tissue. After 7 days they gradually decreased.

CONCLUSIONRANKL and OPG can express in soft tissue, and the changing tendency is consistent with the change of bone remodeling, it indicates that RANKL and OPG play an important role in the bone remodeling.

Animals ; Bone Remodeling ; Bone and Bones ; Carrier Proteins ; Dogs ; Male ; NF-kappa B ; Osteoprotegerin ; RANK Ligand ; Receptor Activator of Nuclear Factor-kappa B

Objective To investigate the effects of chronic starvation stress on the proliferation and migration of colorectal cancer cells, as well as the underlying mechanisms. Methods By using prolonged serum starvation to simulate chronic starvation stress in tumor cells, we established enduring serum-deprived models of SW480 and DLD-1 cells and observed cellular morphological change. Effects of prolonged serum starvation on SW480 and DLD-1 proliferative and migratory capabilities were assessed using CCK-8 and Transwell assays. Differential gene-expression analysis on SW480 cultured with 1% FBS or 10% FBS medium was followed by GO and KEGG pathway assessments. Migration-related protein interactions were explored using String database and Metascape software, leading to 16 genes being selected for RT-qPCR validation. Protein levels of ITGB1 and key molecules in the relevant pathways were measured. Mobility changes in SW480 were observed through Transwell assay after ITGB1 knockdown or STAT3 inhibition. Results Prolonged serum starvation significantly inhibited the proliferation of SW480 and DLD-1 cells, and DLD-1 mobility, while enhanced SW480 migration. Transcriptome analysis revealed that prolonged serum deprivation caused the upregulation of 3016 genes, among which 283 were involved in cell migration. Metascape analysis identified the correlations among potential core genes ITGB1, CD44, TNS1, STAT3, etc. Prolonged serum deprivation increased the mRNA levels of VTN, TNS1, VEGFA, STAT3, and ITGB1 while also increasing the protein levels of ITGB1 and MMP2 and the phosphorylation levels of JAK2 and STAT3. Mobility reduction in prolonged serum-starved SW480 cells was achieved through ITGB1 knockdown or a STAT3 inhibitor. Conclusion Colorectal cancer cells can endure chronic starvation stress which enhances migration capability by upregulating ITGB1 expression.

Objective:To observe the clinical efficacy and side effects of injecting different doses of botulinum toxin type A (BTX-A) into children with spastic cerebral palsy (CP) and tiptoe deformity.Methods:A total of 107 children with tiptoe deformity resulting from CP were divided into group A ( n=35), group B ( n=36) and group C ( n=36) using a random number table. Group A received 3u/kg injections of BTX-A, group B received 4u/kg injections and group C received 5u/kg. The injections were guided by color Doppler ultrasound and followed by 4 courses of rehabilitation therapy. Before and 1, 3 and 6 months after the treatment, the modified Tardieu scale (MTS) was used to assess gastrocnemius spasms, while sections D and E of gross motor function scale 88 (GMFM-88) and the pediatric balance scale (PBS) were used to evaluate motor functioning and balance. Any side effects were also observed. Results:After the treatment, improvement was observed in all of the measurements, though there were no significant differences in the degree of improvement nor in the incidence of side effects among the three groups.Conclusions:There is no significant difference in clinical efficacy or side effects involved in using different doses of BTX-A to treat tiptoe deformity in children with spastic cerebral palsy. The recommended dosage is therefore 3u/kg.

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is the fourth-leading cause of cancer-related deaths worldwide. HCC is refractory to many standard cancer treatments and the prognosis is often poor, highlighting a pressing need to identify biomarkers of aggressiveness and potential targets for future treatments. Kinesin family member 2C (KIF2C) is reported to be highly expressed in several human tumors. Nevertheless, the molecular mechanisms underlying the role of KIF2C in tumor development and progression have not been investigated. In this study, we found that KIF2C expression was significantly upregulated in HCC, and that KIF2C up-regulation was associated with a poor prognosis. Utilizing both gain and loss of function assays, we showed that KIF2C promoted HCC cell proliferation, migration, invasion, and metastasis both in vitro and in vivo. Mechanistically, we identified TBC1D7 as a binding partner of KIF2C, and this interaction disrupts the formation of the TSC complex, resulting in the enhancement of mammalian target of rapamycin complex1 (mTORC1) signal transduction. Additionally, we found that KIF2C is a direct target of the Wnt/β-catenin pathway, and acts as a key factor in mediating the crosstalk between Wnt/β-catenin and mTORC1 signaling. Thus, the results of our study establish a link between Wnt/β-catenin and mTORC1 signaling, which highlights the potential of KIF2C as a therapeutic target for the treatment of HCC.
Adult ; Aged ; Animals ; Carcinoma, Hepatocellular/pathology* ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Epithelial-Mesenchymal Transition/genetics* ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Intracellular Signaling Peptides and Proteins/metabolism* ; Kinesins/metabolism* ; Liver Neoplasms/pathology* ; Male ; Mice ; Mice, Inbred BALB C ; Middle Aged ; Neoplasm Staging ; Prognosis ; Protein Binding ; RNA, Small Interfering/metabolism* ; Survival Analysis ; Tumor Burden ; Wnt Signaling Pathway ; Xenograft Model Antitumor Assays ; beta Catenin/metabolism*

Objective: To analyze the effect and adverse reactions of radiotherapy in patients with primary orbital lymphoma. Methods: A total of 28 patients with primary orbital lymphoma from Tianjin Union Medical Center, the First Central Hospital of Tianjin and Tianjin Dagang Oil Company Hospital between March 2006 and August 2012 were retrospectively analyzed. All the patients received orbital tumor dissection or biopsy, then received radiation therapy. Three patients received chemotherapy with CHOP protocol before radiotherapy. Radiotherapy was delivered routinely with 3D-conformal radiation therapy (CRT) technique with daily 2-2.5 Gy for 5 times per week and 3-5 fields. Total dosage was 20-50 Gy. There were 18 cases of 30 Gy, 1 case of 22 Gy, 1 case of 25 Gy, 1 case of 20 Gy, 1 case of 28.8 Gy, 3 cases of 40 Gy, 1 case of 42 Gy, 1 case of 46 Gy and 1 case of 50 Gy. Results: All the patients had complete remission (CR) after radiotherapy during follow-up. One patient recurred after radiotherapy of 4 months and received CR with radiotherapy again. One patient died of lung infiltration. Acute complications during radiotherapy were conjunctivitis (28 cases, 100.0%) and keratitis (1 case, 3.6%), long-term complications with ophthalmoxerosis (10 cases, 35.7%) and decreased visual acuity (1 case, 3.6%). Conclusion Radiotherapy is an effective method for primary orbital lymphoma, and the adverse reactions can be tolerated for most patients.

Nonpharmaceutical interventions (NPIs) have been commonly deployed to prevent and control the spread of the coronavirus disease 2019 (COVID-19), resulting in a worldwide decline in influenza prevalence. However, the influenza risk in China warrants cautious assessment. We conducted a cross-sectional, seroepidemiological study in Shandong Province, Northern China in mid-2021. Hemagglutination inhibition was performed to test antibodies against four influenza vaccine strains. A combination of descriptive and meta-analyses was adopted to compare the seroprevalence of influenza antibodies before and during the COVID-19 pandemic. The overall seroprevalence values against A/H1N1pdm09, A/H3N2, B/Victoria, and B/Yamagata were 17.8% (95% CI 16.2%-19.5%), 23.5% (95% CI 21.7%-25.4%), 7.6% (95% CI 6.6%-8.7%), and 15.0 (95% CI 13.5%-16.5%), respectively, in the study period. The overall vaccination rate was extremely low (2.6%). Our results revealed that antibody titers in vaccinated participants were significantly higher than those in unvaccinated individuals (P < 0.001). Notably, the meta-analysis showed that antibodies against A/H1N1pdm09 and A/H3N2 were significantly low in adults after the COVID-19 pandemic (P < 0.01). Increasing vaccination rates and maintaining NPIs are recommended to prevent an elevated influenza risk in China.