Objective: To establish the aortic regurgitation model in Chinese miniature pigs under echocardiography guidance. Methods: The animal models were established by following steps: general anesthesia, measuring body weight and then receiving echocardiography examination to exclude aortic valve lesions; carotid artery was exposured by surgery, catheter was sent to aortic sinus with stiff guide wire penetrates and the position of catheter was adjusted to obtain aortic valve damage. The aortic valve injury and regurgitation were evaluated by ultrasound; then the pigs were killed and the heart was taken to observe aortic valve damage. Results: A total of 7 pigs were used including 4 male and 3 female with the mean body weight of (24.7 ± 3.6) kg. Aortic regurgitation model was successfully established in 5 pigs including 1 mild, 1 mild-moderate, 2 moderate, 1 severe aortic valve regurgitation, and 4 were with valve lealfets perforation and 1 with lealfets tearing. Conclusion:①Echocardiography can smoothly guide wire go through aortic valve and make valve damage at different degrees, it is reliable to establish aortic valve regurgitation model in experimental pigs.②Echocardiography may clearly identify the position and degree for aortic valve injury.

Objective:To improve the understanding of chronic lymphoblastic leukemia (CLL) with t(14;18)(q32;q21).Methods:The clinical data of 3 cases diagnosed as CLL with t(14;18)(q32;q21) in the Tianjin KingMed Medical Laboratory from January 2020 to January 2021 were retrospectively analyzed. The clinicopathological data, morphological examination, immunophenotype, cytogenetics and somatic mutation of immunoglobulin heavy chain variable region genes of patients were comprehensively analyzed, and the literature was reviewed.Results:All the 3 patients showed lymphatic proliferative diseases, and their morphological characteristics and immunophenotype were typical characteristics of CLL.Conclusions:The diagnosis of CLL is mainly based on the typical morphology and immunophenotype of tumor cells. The presence of t(14;18) should not be used to exclude the diagnosis of CLL.

Objective:To investigate the impact on image quality of a new deep learning image reconstruction (DLIR) algorithm in dynamic CT myocardial perfusion imaging (CTP) and to explore whether the algorithm affects the quantification of myocardial blood flow (MBF) in swine.Methods:Dynamic CTP imaging was performed in five anesthetized domestic swine [body weight (58.6±1.9) kg], at both rest and stress state. The tube voltages were fixed at 100 kV, and the low-dose and high-dose scanning tube currents were set as 150 mA and 300 mA, respectively. The low-dose (LD) scan data were reconstructed with filtered back projection (FBP) and three different DLIR strengths (low, medium, and high). High-dose (HD) scan data were reconstructed with filtered back projection (FBP) only. Subjective (5-point scale) image quality was evaluated, and objective evaluations included image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) was performed. Linear regression was used to test the linear trend between DLIR algorithm strength and image quality. Data sets normality was determined by the Shapiro-Wilk test. Comparisons between groups were performed using Student′s t test for normally distributed data or the Wilcoxon rank-sum test for non-normally distributed data. Results:The mean effective radiation dose was 7.2 and 3.8 mSv for the HD protocol and the LD protocol, respectively, with statistically significant difference found between two protocols ( t=282.50, P<0.001). The image noise of the images obtained at LD protocol gradually decreased and the image SNR and CNR gradually increased with DLIR algorithm strength increased ( F=60.10,35.87,41.41; P for trend were all<0.001). As for DLIR-high strength (LD) and FBP (HD) images, the image noise values were (31.7±3.1) and (38.2±1.2) HU; SNR were 16.6±2.0 and 13.8±0.8; CNR were 14.5±1.7, 11.6±0.9, respectively, with significant differences found between two groups ( t=5.70, 4.15, 5.68; all P<0.05). The subjective scores of DLIR-high strength (LD) and FBP (HD) images were significantly different (4.8±0.4 and 4.2±0.6, Z=2.12, P<0.05). No significant differences were found between the MBF calculated from FBP (LD) and from DLIR-high strength (LD), with the values as (81.3±17.3) ml·100 ml -1·min -1 vs. (79.9±18.3)ml·100 ml -1·min -1 at rest state; and (99.4±24.9)ml·100 ml -1·min -1 vs. (100.7±27.3) ml·100 ml -1·min -1 at stress state ( t=1.10, 0.89; P>0.05). Conclusion:DLIR-high strength can improve image quality of myocardial CTP in swine, and can reduce radiation dose without influencing the MBF calculation.

This study reported a family of mitochondrial diabetes mellitus complicated with chronic hereditary pancreatitis. A 18-year-old woman presented with self-reported hyperglycemia and chronic epigastric pain was admitted to our hospital. Clinical data and family history were collected. Mitochondrial gene sequencing and whole exon gene sequencing showed that the proband carried mutation of mt.3243A>G and heterozygous mutation of SPINK1 c. 194+ 2T>C, which was considered as mitochondrial diabetes mellitus with chronic pancreatitis.

Objective    To investigate the effect of simvastatin and mechanical pretreatment on intimal hyperplasia of venous graft and its mechanism. Methods    Twelve New Zealand rabbits were selected and randomly divided into 4 groups: a blank control group, a simvastatin topical treatment group, a mechanical precondition group and a combined group (n=3 in each group). Ultrasound was used to evaluate the changes of graft wall and blood flow velocity in the graft, and pathological section was used to evaluate the intimal hyperplasia. Human umbilical cord endodermal cells were cultured in vitro. A simvastatin group and a solvent control group were set to detect YAP phosphorylation, downstream target gene expression and cell proliferation. Results    Vascular ultrasound showed that except the simvastatin topical treatment group, the flow velocity in vein grafts in the other three groups significantly increased 21 days after surgery compared with 7 days after surgery (P<0.01). Pathological sections showed that the thickness of new intima in the simvastatin topical treatment group, mechanical precondition group, combined group and blank control group were 45.56±4.11 μm, 201.28±16.71 μm, 143.57±7.82 μm, 249.45±13.33 μm, respectively, and there were statistical differences compared with the blank control group (P<0.05). In vitro results showed that compared with the solvent control group, cell death was observed in high concentration simvastatin (5 mmol/L) group, cell proliferation was inhibited in low concentration simvastatin (2.5 mmol/L) group (P<0.05), the expression of YAP protein in the simvastatin group was unchanged, but the expression of phosphorylated YAP protein significantly increased (P<0.05), and the expression of downstream target gene ccn1 was down-regulated (P<0.001). Conclusion    Intravascular local application of simvastatin and mechanical preconditioning alone or in combination can inhibit intimal hyperplasia of venous graft. High concentration of simvastatin has cytotoxicity, while low concentration of simvastatin has inhibitory effect on cell proliferation. Simvastatin can inhibit the formation of new intima by inhibiting the entry of YAP into the nucleus and reducing the transcription of cell proliferation-related target gene ccn1.