Objective To evaluate prenatal diagnosis value of echocardiography in pathological types,differential diagnosis and accompanied malformations of fetal persistent truncus arteriosus(PTA).MethodsTwenty-four cases of PTA selected from 1 392 cases were analysed,who were definitely diagnosed to be suffered from cardiovascular malformation by fetal echocardiography.The ultrasound findings,pathological results and followed up were analysed.According to Van Praagh classification,the type IV PTA was excluded in this study which was classified into pulmonary artery atresia.Results The total PTA were 24 cases,in which 10 cases of A1 type,3 cases of A2 type,9 cases of A3 type,and 2 cases of A4 type.Nine cases of PTA accompanied other cardiac anomalies,and 1 case of PTA accompanied both cardiac anomalies and extracardial malformations.Two PTA cases were born,one was A1 type underwent surgical intervention,and the other was died due to multiple organ-failure.Fourteen PTA cases were termination and 7 cases were confirmed by pathology.Seven women pregnant again,of which 5 cases were born while only one was diagnosed atrial septal defect after birth,2 pregnant women were still during follow-up.Eight PTA cases follow-up were lost.Conclusions A1 type and A3 type of PTA have high incidence in fetus.Accompanied cardiac anomalies is certainly related to different types.Combination of multiple ultrosund techniques can diagnose PTA prenatally,make accurate classification and detect accompanying malformations,which is of great significance to offer proper pregnancy counselling and postpartum treatment.

BACKGROUNDSevoflurane preconditioning (SP) has been shown to invoke potent myocardial protection in animal studies and clinical trials. However, the mechanisms underlying SP are complex and not yet well understood. We investigated the hypothesis that the cardioprotection afforded by SP is mediated via the Wnt/glycogen synthase kinase 3β (GSK3β)/β-catenin signaling pathway.

METHODSTwo models were established: a Langendorff perfused rat heart model and the H9C2 cell hypoxia/reoxygenation model. Both rats and H9C2 cells were randomly divided into 6 groups as follows: S group, ischemia-reperfusion (I/R) group, DMSO group, IWP group, SP group, and SP + IWP group. Hemodynamic parameters, lactate dehydrogenase (LDH) activity in coronary effluent and cell culture supernatant, and the infarct size were measured to evaluate myocardial ischemia-reperfusion injuries. To determine the activity of Wnt/GSK3β/β-catenin signaling pathway, the expressions of Wnt3a, phospho-GSK3β, and β-catenin were measured by Western blotting.

RESULTSSP improved cardiac function recovery, reduced infarct size (18 ± 2% in the SP group compared with 35 ± 4% in the I/R group; P < 0.05), decreased LDH activity in coronary effluent, and culture supernatant. IWP-2, an inhibitor of Wnt, abolished the cardioprotection by SP. In addition, Western blotting analysis demonstrated that the expressions of Wnt3a, phospho-GSK3β, and β-catenin significantly (P < 0.05) increased in the I/R group, compared with the S group; and compared to I/R group, SP significantly (P < 0.05) increased Wnt3a, phospho-GSK3β, and β-catenin expressions. Pretreatment with IWP-2 significantly (P < 0.05) abolished SP-induced Wnt/GSK3β/β-catenin signaling activation.

CONCLUSIONSThe results showed for thefirst time that cardioprotection afforded by SP may be mediated partly via the Wnt/GSK3β/β-catenin signaling pathway.

Animals ; Cell Hypoxia ; drug effects ; Cell Line ; Glycogen Synthase Kinase 3 ; genetics ; metabolism ; Glycogen Synthase Kinase 3 beta ; Hemodynamics ; drug effects ; Male ; Methyl Ethers ; therapeutic use ; Myocardial Reperfusion Injury ; drug therapy ; prevention & control ; Rats ; Rats, Wistar ; Wnt Signaling Pathway ; drug effects ; genetics ; beta Catenin ; genetics ; metabolism

OBJECTIVETo evaluate the effect of titrated target-controlled infusion with propofol and remifentanil on anesthetics consumption and anesthesia depth in patients undergoing elective laparoscopic colorectal surgery.

METHODSSixty ASA I-III patients for elective laparoscopic colorectal surgery were enrolled. Titrated target-controlled infusion (TCI) with propofol and remifentanil was performed. Plasma concentration of the drugs was administered by titrated method to maintain bispectral index (BIS) in the range of 40-60 with systolic blood pressure (SBP) fluctuation within 20% of the basic value. BIS, SBP, plasma concentration of propofol and remifentanil were recorded at different time points. Awareness during operation was inquired postoperatively.

RESULTSDuring the entire anesthesia period, the blood pressure was stable and BIS was maintained less than 60. There was no awareness during operation. The plasma concentrations (95% confidence interval) for TCI of propofol and remifentanil were 2.55-2.65 mg/L and 4.09-4.26 μg/L respectively when existing surgical stimulation during anesthesia, and the plasma target concentration of propofol was lower than the recommended dosages.

CONCLUSIONTitrated target-controlled infusions with propofol and remifentanil for elective laparoscopic colorectal surgery can maintain proper anesthesia depth and reduce the drug consumption.

Adult ; Aged ; Aged, 80 and over ; Anesthesia, Intravenous ; methods ; Anesthetics, Intravenous ; administration & dosage ; Blood Pressure ; drug effects ; Colorectal Surgery ; Electroencephalography ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Piperidines ; administration & dosage ; Propofol ; administration & dosage

Objective To compare the dosimetric characteristics of preoperative volumetric modulated arc therapy ( VMAT) and fixed-field intensity-modulated radiotherapy ( FF-IMRT) for rectal cancer .Methods The CT images of 15 patients with rectal cancer were transferred into Eclipse planning system .FF-IMRT and VMAT plans were optimized on an Eclipse treatment planning system using beam data generated for Varian Trilogy linear accelerator .Same institutional dose-volume constraints for rectal cancer were used in both techniques .Targets and organs at risk were evaluated .Results The target volume coverage could meet the requirement of described dosage in both VMAT plan group and FF-IMRT plan group .Compared with the FF-IMRT plan group , the plan-ning target volume ( PTV) 105% ( PTV105%) coverage, Dmean, and Dmax significantly increased in the VMAT plan group ( P=0.011, P=0.017, and P=0.006, respectively), the radiation conformity index (CI) significantly decreased ( P=0.008 ) , and the homogeneity index showed no significant difference ( P=0.193 ) . Compared with the FF-IMRT plan group , the V50 of the bladder in the VMAT plan group was increased by about 15%( P=0.009 ) , and the Dmax increased by 0.7 Gy ( P=0.003 );the V30 of the small intestine decreased by 10% (P=0.004), and the Dmax was increased by 0.9 Gy (P=0.000); the V10, V30, and V40 of the bone marrow reduced by 2%, 10%, and 10%( P=0.000 , P=0.000 , and P=0.000 ) , and the Dmean re-duced by 1.7 Gy ( P=0.000 );the D5 of the left and right femoral heads reduced by 3.2 Gy and 2.4 Gy ( P=0.000 , P=0.000 ); the V10 , V20 , V30 , and V40 of the body also significantly decreased ( P=0.003 , P=0.000 , P=0.000 , and P=0.004 ) .The VMAT group also had significantly lower number of monitor units ( MU) when compared with the FF-IMRT plan group ( P=0.000 ) .Conclusions In patients with rectal canc-er, preoperative VMAT can achieve equivalent or superior dose distribution compared with the FF -IMRT.In addi-tion, VMAT can increase the number of patients treated per hour and reduce waiting time by shortening treatment time and reducing treatment MU .

Objective To summarize the relationship between the transverse dimension of the target volume and the most optimized X jaw size in volumetric modulated arc therapy ( VMAT) plan for cervical cancer radiother-apy.Methods The VMAT plans were made by modifying X jaw size on CT images in 12 postoperative patients with cervical cancer .On each image , the best X jaw size was identified .The relationship between the best X jaw size and the transverse width of planning target volume ( PTV) was determined .Results The change in the trans-verse dimension of the target volume was accompanied with the changes of the optimized X jaw size .The relation-ship between X jaw size (y) and the PTV's transverse width (x) could be expressed as the following equation: y=-0.0033x2 +0.7132x+3.6322.Conclusions There is a relationship between X jaw size and PTV's transverse width, which can be used for the postoperative VMAT plan design in patients with cervical cancer .

Objective To analyze the dosimetric differences between fixed-field intensity-modulated ra-diotherapy ( FF-IMRT) and volumetric modulated arc therapy ( VMAT) in treating pancreatic carcinoma , aiming to facilitate the clinical decision upon appropriate radiation technique .Methods From June to December 2011 , 10 postoperative patients of pancreatic carcinoma who received radiotherapy in Peking Union Medical College Hos -pital were selected for this comparison .FF-IMRT and VMAT plans were developed based on the same CT simula-tion image for each patient .The prescription dose was 50 Gy in 25 fractions.The doses distributions in planning target volume (PTV), organs at risk (OARs), and normal tissue were evaluated based on dose-volume histo-grams ( DVH) .The two plans were also compared in terms of monitor unit ( MU ) and length of treatment . Results The dose distributions in PTV showed no significant difference between FF-IMRT and VMAT plans (P>0.05).Compared with FF-IMRT plan, VMAT plan significantly increased V 5 of the liver, stomach, small intestine, and whole body (all P<0.05), while reduced V10 and V20 of the liver, V10 of the stomach, V10, V20 , and V50 of the small intestine , V20 of the left kidney , V20 , V30 , Dmean , Dmax of the right kidney , and V10 , V20 of the whole body (all P<0.05).The Dmax of the spinal cord decreased by 1.85 Gy in VMAT plan (P=0.04 ) .MU of VMAT plan was significantly lower than that of FF-IMRT plan ( 492.70 ±51.56 vs.619 ± 117.18 , t=3.18 , P=0.01 ) , with a 20.48%reduction from the MU level of the latter one .Conclusion For patients with pancreatic carcinoma , VMAT plan could reduce MU and shorten length of treatment while maintai-ning the dosimetric parameters at levels similar to or even better than those of FF -IMRT plan.

The chemical compositions of Anemone raddeana Rhizome, a kind of traditional Chinese medicine, were reviewed, along with its bioactivity and pharmacological properties and method improvements of extracting and detecting triterpenoid saponins. A. raddeana Rhizome is used to treat neuralgia and rheumatism, and is rich in triterpenoid saponins, most of which are pentacyclic, with oleanane as the nucleus. So far, 37 triterpenoid saponins have been determined from the herb. Its reported bioactivity and pharmacological properties have been described as anticancerous, antimicrobial, anti-inflammatory, analgesic, antipyretic, anticonvulsive, antihistaminic, and sedative. It has also been used for the induction of the humoral immune response and treatment of liver fibrosis in chronic hepatitis. However, the herb also has hemolytic effects and can be toxic, which limits its clinical application. Further studies are needed on the pharmaceutical functions, mechanisms, and immunological responses to contribute to the herb's clinical applications.

ObjectivecircRNAs play an important role in tumor development, but the relationship between circRNAs and hepatocellular carcinoma remains to be further explored. The present study aimed to bioinformatically analyze the target gene of microRNA-1. Another aim was to screen circRNAs that are associated with target genes and differentially expressed in hepatocellular carcinoma cells, as well as provide theoretical basis for clinical screening of molecular markers and targeted therapies related to hepatocellular carcinoma.MethodsThe miRNA related database used for the prediction of microRNA-1 target genes, and the bioinformatic analysis of the target genes of microRNA-1 involved functional enrichment analysis and signal transduction pathway enrichment. Then, the circRNAs, which are related to the downstream target genes of microRNA-1, are screened through the circRNA database.ResultsThe number of microRNA-1 target genes was 230 in miRNA related database. Through GO analysis, it was found that the target genes of microRNA-1 had a strong tendency in regulation, and were mainly enriched in three aspects: biological function, biological process and cell localization.The target genes of microRNA-1 are involved in the function of proteins, regulation of biosynthesis, cofactor binding, enzyme regulation and other biological processes. Predicted target genes of miRNA-1 were significantly enriched in cancer signaling pathways, hepatitis B occurrence, endocytosis and splicing pathways. Further, 21 circRNAs related to the target gene of microRNA-1 were found in three circRNA databases, wherein hsa_circ_0004651 was highly expressed in hepatocellular carcinoma cell line HepG2 and its pavent gene was hnRNPD.ConclusionMicroRNA-1 influence the occurrence of hepatocellular carcinoma development through the regulation of protein and enzyme. Hsa_circ_0004651 may affect the development of hepatocellular carcinoma with microRNA-1 and its parental gene hnRNPD.

Chemical constituents from the fruits of Vitex negundo var. cannabifolia and their nitric oxide (NO) inhibitory and cytotoxic activities were investigated. The compounds were isolated and purified by various column chromatography, and their structures were identified by physiochemical properties and spectroscopic data. Thirteen lignans and six phenolic compounds were isolated from the CH2Cl2 extract of the fruits of V. negundo var. cannabifolia, respectively. Their structures were elucidated as 6-hydroxy-4-(4-hydroxy-3-methoxyphenyl)-3-hydroxymethyl-7-methoxy-3,4-dihydro-2-naphthaldehyde (1), vitedoin A (2), vitexdoin F (3), detetrahydroconidendrin (4), vitexdoin E (5), 4-oxosesamin (6), L-sesamin (7), (+)-beechenol (8), ligballinol (9), 2-(4-hydroxyphenyl)-6-(3-methoxy-4-hydroxyphenyl)-3,7-dioxabicyclo[3.3.0]octane (10), (-)-pinoresinol (11), balanophonin (12), thero-guaiacylglycerol-β-coniferyl aldehyde ether (13), trans-p-coumaryl aldehyde (14), coniferyl aldehyde (15), 5,7-dihydroxychromone (16), trans-3,5-dimethoxy-4-hydroxy-cinnamic aldehyde (17), frambinone (18), and alternariol 4-methyl ether (19). Compounds 8-10,14,18,19 were firstly isolated from Verbenaceae family, compound 13 was obtained from Vitex species, and 6,7,12,15-17 from V. negundo var. cannabifolia for the first time, respectively. The isolated compounds were evaluated for their anti-inflammatory and cytotoxic effects in vitro. Eight compounds (3,5,7,10,11,14,15,17) showed inhibition against NO production in LPS-stimulated RAW 267.4 cells (IC₅₀ in the range of 7.8-81.1 μmol•L⁻¹) and four compounds (1-4) showed cytotoxicity on HepG-2 cells (IC₅₀ in the range of 5.2-24.2 μmol•L⁻¹).

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]