AIM:To observe the effects and mechanisms of hydroxyethylstarch (HES) 130/0.4 on no-reflow phenomenon after myocardial ischemia-reperfusion in rats.METHODS: SD rats were randomly divided into 4 groups:sham operation group , ischemia-reperfusion ( IR, treated with normal saline ) group, normal saline ischemia-reperfusion (NS-IR, treated with NS) group and HES ischemia-reperfusion (HES-IR, treated with HES) group.Myocardial infarct size and no-reflow range were determined by staining methods , and the activities of myocardial enzymes ( CK-MB, cTnI and MPO) were measured .Meanwhile , cardiac microvascular endothelial cells of the rat were cultured and divided into 4 groups:control group, hypoxia/reoxygenation (H/R) group, NS-H/R group and HES-H/R group.Acute ischemia reper-fusion models were simulated , and the concentration of calcium ions was measured .The relative cell activity was evaluated by CCK-8 assay, and the apoptotic rate was detected by flow cytometry .RESULTS:In HES-IR group, the myocardial in-farct size, the no-reflow zone, CK-MB, cTnI and MPO activity were all significantly lower than those in IR group ( P<0.05).In microvascular endothelial cells , the concentration of calcium ions and the apoptotic rate in HES-H/R group were significantly decreased, while the relative cell activity increased compared with H/R group (P<0.05).CONCLUSION:HES reduces no-reflow in acute myocardial ischemia-reperfusion .The mechanism may be involved in the inhibition of both the infiltration of neutrophils and the calcium overload of endothelial cells .

Objective To investigate the clinical efficacy of conjoint fascial sheath (CFS) of the levator and superior rectus attached to the conjunctival fornix suspension surgery and the modified frontails muscle suspension in the treatment of severe blepharoptosis.Methods There were 15 eyes of 11 patients in the group with CFS suspension and 12 eyes of 10 patients in the other group with frontails muscle suspension.Follow-up was conducted for 1 week to 6 months.The surgical results were compared with statistical analysis.Results Among the patients 2 cases of palpebral fissure was closed poorly,1 cases of upper eyelid had poor shape,4 cases of upper lid was lag,2 cases of recurrence in group with modified frontails muscle suspension,and compared with 1 case of less straightening phenomenon in the group with CFS suspension.All the others,palpebral fissures were completely closed,the appearance of double eyelid was good,with no exposure keratitis.In terms of postoperative curative effect in 6 months observation,group with CFS suspension had less complications and was of advantages in the symmetry of upper eyelid fissure.The effect of correction post operation and upper eyelid back amount in the group with CFS suspension were better than those with the frontails muscle suspension in 6 months.There was significantly statistical difference.Conclusions The surgery with CFS suspension is of advantages of aesthetic appearance,high security,natural look,high satisfaction from patients,less complications and more in line with the physiology,which is worthy of clinical reference.

A 3-year-6-month-old boy presented with multiple asymptomatic banded white macules at birth, which expanded in proportion to his body, and deformity of his right thumb with slight dyskinesia. The patient showed difficulty in communication and concentration compared with children of the same age. The family history was unremarkable. The child had clear consciousness, passable spirits, and poor language ability. Physical examination revealed a special face and slight macrodactyly of the right thumb joints, and the heart, lung, and abdominal examination was otherwise normal. Skin examination showed multiple banded or confluent irregular white macules of varying sizes and slightly elevated plaques distributed along the Blaschko′s lines on the right chest, the flexor aspect of the right upper limb, the median line of the lower abdomen, and the right lower limbs, and banded brown macules on the palmar side of the right hand and radial aspect of the right thumb. Histopathological findings of the while macule on the lower limb were consistent with basaloid follicular hamartoma. Cranial magnetic resonance imaging revealed agenesis of the corpus callosum. Whole-exome sequencing of the lesional tissue showed a mutation c.1234C>T (p.L412F) in the SMO gene, which was not found in his parents. A diagnosis of Curry-Jones syndrome was made based on the skin lesions, and pathological and genetic findings. The mutation c.1234C>T (p.L412F) in the SMO gene may contribute to the disease. The patient continued functional exercises to improve the mobility of his right thumb, and underwent a close follow-up.

OBJECTIVETo study the extensibility and retractility of the surgical margins in digestive system neoplasms.

METHODSThe length difference of the digestive tract was measured in vivo and in vitro under different conditions. Five cm of the stomach, small intestine and large bowel and 2 cm of the esophagus were measured as standard control length in vivo just before resection. The length was measured with a ruler under pull of 500 g and 1 000 g in vivo, in fresh status in vitro, and 10% formaldehyde fixed for 6 - 8 h, 12 - 24 h and 48 - 72 h. The extension or retraction ratio was calculated. The length difference was divided by the natural length in vivo.

RESULTSSeventeen cases of the esophagus, 18 cases of the stomach, 15 cases of the small intestine and 25 cases of the large bowel were measured under pull of 500 g and 1 000 g. The esophagus extended 16.5% and 30.5%, stomach 15.0% and 22.6%, small intestine 66.4% and 120.0%, large bowel 36.0% and 56.0% respectively. In natural status ex vivo, the esophagus retracted 44.5%, stomach 13.6%, small intestine 11.4% and large bowel 15.6% respectively; they continue to retract after 10% formaldehyde fixation until 12 - 24 h later. If the length of surgical margin of the fresh specimen ex vivo was x, the natural length of margin in vivo of the esophagus would be 1.80 x, stomach 1.16 x, small intestine 1.13 x, and large bowel 1.18 x. If formaldehyde fixation for 6 - 8 h, the natural length of surgical margin in vivo of the esophagus would be 1.82 x, stomach 1.41 x, small intestine 1.22 x, large bowel 1.55 x. If formaldehyde fixation for 12 - 24 h, the surgical margin length in vivo of the esophagus would be 2.22 x, stomach 1.43 x, small intestine 1.28 x, and large bowel 1.57 x.

CONCLUSIONThe length of surgical margin of digestive system cancers varied under different conditions, and the evaluation of surgical margin during surgery should be performed under natural status in vivo.

Adult ; Aged ; Digestive System Neoplasms ; surgery ; Digestive System Surgical Procedures ; Female ; Humans ; Male ; Middle Aged

OBJECTIVE: To assess the association of apolipoprotein (apo) C1 (APOC1) gene rs4420638A/G and -317H1/H2 polymorphisms with the risk of pre-eclampsia (PE) and the influence of their genotypes on the clinical and metabolic indexes among Chinese women. METHODS: In total 289 PE patients and 824 women with uncomplicated pregnancies were included. The rs4420638A/G genotype was determined by a Taqman real-time PCR allelic discrimination assay. The -317H1/H2 genotype was measured through PCR and restriction fragment length polymorphism analysis. Serum lipid and apo levels were measured by an enzymatic kit and a PEG-enhanced immunoturbidimetric assay. RESULTS: Allelic and genotypic frequencies of the APOC1 gene rs4420638A/G and -317H1/H2 were not significantly different between the two groups (all P> 0.05). However, patients carrying the G allele of the rs4420638A/G locus had higher serum levels of triglyceride, non-HDL-C and apoB, and a higher apoB/apoA1 ratio compared with those with an AA genotype (all P< 0.05). Patients carrying the H2 allele of the -317H1/H2 polymorphism had smaller delivery gestational weeks compared with those with the H1H1 genotype (P< 0.05). CONCLUSION Polymorphisms of the APOC1 gene rs4420638 and -317H1/H2 sites may be associated with abnormal lipoprotein metabolism among Chinese patients with PE, though no association was found between variants of the APOC1 gene and the risk of PE among them.

OBJECTIVE: To explore the clinical and genetic characteristics of eight children with Primary hypertrophic cardiomyopathy (HCM). METHODS: Eight children with HCM admitted to the Department of Cardiology of Henan Children's Hospital from January 2018 to December 2021 were selected as the study subjects. Clinical data of the children were collected. Whole exome sequencing was carried out on two children, and trio whole exome sequencing was carried out on the remainder 6 children. Sanger sequencing was used to verify the candidate variants in the children and their parents, and the pathogenicity of the variants was evaluated based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). RESULTS: The patients had included 5 males and 3 females, with their ages ranging from 5 to 13 years old. The average age of diagnosis was (7.87 ± 4.8) years old, and the cardiac phenotype showed non-obstructive HCM in all of the patients. WES has identified variants of the MYH7 gene in 4 children, including c.2155C>T (p.Arg719Trp), c.1208G>A (p.Arg403Gln), c.1358G>A (p.Arg453His), and c.1498G>A (p.Glu500Lys). Based on the guidelines from the ACMG, the first 3 variants were classified as pathogenic, while c.1498G>A (p.Glu500Lys) was classified as likely pathogenic (PM1+PM2_Supporting+PM6+PP3), which was also unreported previously. The remaining four children had all harbored maternal variants, including MYL2: c.173G>A (p.Arg58Gln; classified as pathogenic), TPM1: c.574G>A (p.Glu192Lys) and ACTC1: c.301G>A (p.Glu101Lys)(both were classified as likely pathogenic), and MYBPC3: c.146T>G (p.Ile49Ser; classified as variant of uncertain significance). Seven children were treated with 0.5 ~ 3 mg/(kg·d) propranolol, and their symptoms had improved significantly. They were followed up until September 30, 2022 without further cardiac event. CONCLUSION Genetic testing can clarify the molecular basis for unexplained cardiomyopathy and provide a basis for clinical diagnosis and genetic counseling. Discovery of the c.1498G>A (p.Glu500Lys) variant has also expanded the spectrum of MYH7 gene mutations underlying HCM.
Female ; Male ; Humans ; Child ; Child, Preschool ; Adolescent ; Cytoskeletal Proteins ; Family ; Genetic Counseling ; Genetic Testing ; Cardiomyopathy, Hypertrophic/genetics*

Stroke flaccid paralysis is stroke patients with abnormal physical movement function and muscle tone decline as the main performance and is a kind of common pathological state after apoplectic stroke. The longer the flaccid paralysis is, the worse the prognosis. The theory of TCM holds that stroke is mainly due to "deficiency, wind, fire, phlegm, stasis, qi", and when the pathogenic factor accumulate and block the meridians, which would cause blood stagnation, muscle and tendon damage and flaccidity, resulting in stroke paralysis. Therefore, it is necessary to set up the "Tongjing Roujin" (stimulating the muscle and nourishing the tendon) as its main treatment. Fire-needling has the effect of stimulating muscle, warming yang, nourishing tendon, and relieving pain in the treatment of stroke flaccid paralysis. It can warm yang and dissipate cold, replenish and nourish meridian qi, release muscle nodules, promote the circulation of qi and blood, and nourish all limbs and bones. Fire-needling therapy can promote the recovery of neural pathway, strengthen local metabolism, improve local muscle tension, and thus restore limb function. The high-quality clinical research, acupoint selection rules, and standardized operating techniques of fire-needling treatment for stroke flaccid paralysis need to be further deepened.