Humans ; Aortic Valve/surgery* ; Retrospective Studies ; Transcatheter Aortic Valve Replacement ; Sex Factors ; Heart Valve Prosthesis Implantation ; Treatment Outcome ; China ; Aortic Valve Stenosis/surgery* ; Risk Factors ; Risk Assessment

Humans ; Retrospective Studies ; Transcatheter Aortic Valve Replacement/adverse effects* ; Risk Assessment ; China ; Prognosis ; Aortic Valve Stenosis/surgery* ; Treatment Outcome ; Risk Factors ; Aortic Valve

The regulation of spermatogonial proliferation and apoptosis is of great significance for maintaining spermatogenesis. The single-cell RNA sequencing (scRNA-seq) analysis of the testis was performed to identify genes upregulated in spermatogonia. Using scRNA-seq analysis, we identified the spermatogonia upregulated gene origin recognition complex subunit 6 (Orc6), which is involved in DNA replication and cell cycle regulation; its protein expression in the human and mouse testis was detected by western blot and immunofluorescence. To explore the potential function of Orc6 in spermatogonia, the C18-4 cell line was transfected with control or Orc6 siRNA. Subsequently, 5-ethynyl-2-deoxyuridine (EdU) and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assays, flow cytometry, and western blot were used to evaluate its effects on proliferation and apoptosis. It was revealed that ORC6 could promote proliferation and inhibit apoptosis of C18-4 cells. Bulk RNA sequencing and bioinformatics analysis indicated that Orc6 was involved in the activation of wingless/integrated (Wnt)/ β-catenin signaling. Western blot revealed that the expression of β-catenin protein and its phosphorylation (Ser675) were significantly decreased when silencing the expression of ORC6. Our findings indicated that Orc6 was upregulated in spermatogonia, whereby it regulated proliferation and apoptosis by activating Wnt/β-catenin signaling.

OBJECTIVE To prepare cinnamaldehyde （CA） loaded liposomes bilayer-modified by bovine serum albumin （BSA）/chitosan （CTS）（BSA/CTS-Lip-CA） in order to improve the sustained-release effect and storage stability of the nanoparticles. METHODS Firstly，cinnamaldehyde loaded liposomes （Lip-CA）and blank liposomes （Lip-Blank）were prepared by thin film dispersion method. Then chitosan modified cinnamaldehyde loaded liposome （CTS-Lip-CA）and BSA/CTS-Lip-CA were obtained by electrostatic adsorption. Finally ， the prepared liposomes were characterized ， and their in vitro release characteristics and storage stability were investigated. RESULTS The particle size of BSA/CTS-Lip-CA was （177.8±4.0）nm and the Zeta potential was （－15.6±1.5）mV；they were in spherical shape ；FTIR analysis showed that the modification of BSA and CTS had no effect on the internal structure of liposomes. The results of in vitro drug release characteristics showed that the cumulative release of Lip-CA ，CTS-Lip-CA and BSA/CTS-Lip-CA within 10 hours were 82.9％，74.1％ and 72.9％ respectively. The results of storage stability showed that after 30 days of storage ，the particle sizes of Lip-CA ，CTS-Lip-CA and BSA/ CTS-Lip-CA were （134.2±2.1），（151.7±0.4），（164.8±1.5）nm；the retention rates of model drug CA were 65.4％，82.5％ and 90.2％ respectively. CONCLUSIONS BSA/CTS-Lip-CA is successfully prepared. It has a certain sustained-release effect and can improve the storage stability of the drug to a certain extent.

OBJECTIVES: To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China. METHODS: A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined. RESULTS: The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05). CONCLUSIONS It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
Female ; Fetal Growth Retardation ; Gestational Age ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Prospective Studies ; Risk Factors

Objective:To explore the effects of non-suicidal self-injury on suicidal ideation in adolescents with depressive disorder, and the mediating role of rumination and depression between them.Methods:A sample of 397 depressive disorder adolescents were recruited to complete the adolescent non-suicidal self-injury behaviour questionnaire, ruminative responses scale (RRS), self-rating depression scale (SDS), and Beck scale for suicide ideation-Chinese version(BSI-CV). All data processing and analysis were performed using SPSS 23.0.The mediating effect was tested by correlation analysis and Bootstrap analysis.Results:The non-suicidal self-injury score was (29.192±11.281), the rumination score was (65.036±12.284), the depression score was (75.770±11.278), and the suicidal ideation score was (40.681±11.626). Non-suicidal self-injury was significantly and positively correlated with suicidal ideation( r=0.403, P<0.01), rumination and depression( r=0.332, 0.470, both P<0.01). Rumination was significantly and positively correlated with depression and suicidal ideation( r=0.549, 0.181, both P<0.05). Depression was significantly and positively correlated with suicidal ideation( r=0.313, P<0.01). The direct effect value of non-suicidal self-injury on suicidal ideation was 0.341(95% CI=0.238-0.444), the indirect effect of non-suicidal self-injury on suicidal ideation through two pathways, the separate mediating effect value of depression was 0.057(95% CI=0.077-0.114), and the chain mediating effect value of rumination and depression was 0.026(95% CI=0.004-0.057). Conclusion:Non-suicidal self-injury can directly affect suicidal ideation of depressive disorder adolescents and indirectly through rumination and depression.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Objective:To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology.Methods:This was a retrospectively study. Newborn screening data ( n=5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data ( n=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns ' screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. Results:A total of 3 665 697 newborns ' screening data were collected including 3 019 cases ' positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment ( n=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. Conclusion:An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.

Objective:To explore the mechanism of balance control after stroke by plantar pressure analysis. Methods:From July to December, 2019, twelve stroke subjects (stroke group) and 30 normal subjects (control group) were recruited in the rehabilitation department of our hospital. Both groups were measured plantar pressure in eyes open and closed conditions. The kinematic parameters, dynamic parameters, plantar pressure center (CoP), symmetry index (SI), symmetry angle (SA) and Romberg quotient (RQ) were calculated. Results:Compared with eyes open condition, the average Y and maximum swing of the control group increased significantly in eyes closed condition (P < 0.01); moreover, the ball length, average speed and maximum swing increased significantly in the stroke group (P <0.05). Compared with the control group, the area of the ellipse (|t| > 3.509, P < 0.001) and the average X (|Z|> 2.311, P < 0.05) significantly increased both in eyes open and closed condition, whereas the maximum swing (Z = -3.118, P < 0.01) increased significantly in eyes closed condition in the stroke group. The RQ of ball length was significantly more in the stroke group than in the control group (t = -3.570, P < 0.01). There was no significant difference in SI and SA of all parameters between the eyes open and closed condition in two groups (P > 0.05). Compared with the control group, load SI, overall load SI, forefoot load SI, area SI and forefoot area SI increased in both the eyes open and closed conditions in the stroke group (t > 2.344, P < 0.05), whereas load SA, overall load SA, forefoot load SA, area SA, forefoot area SA increased (|t|> 2.297, P < 0.05), hindfoot load SA increased only in eyes open condition (t = -2.485, P < 0.05), and hindfoot area SA increased only in eyes closed condition (t = -2.132, P < 0.05). In the control group, CoP was mainly distributed in the negative direction of Y axis when the eyes were open and closed, while CoP in the stroke group was relatively discrete, and the distribution on X axis was more obvious than that of the control group. Conclusion:The balance control of stroke patients might depend on visual compensation, and the plantar pressure analysis system could be used to evaluate the balance function in stroke patients.

We report one case of estimated glomerular filtration rate (eGFR) decline after taking unilateral adrenalectomy due to aldosterone adenoma. A 60-year-old male with 23-year history of hypertension was reported to the endocrinologist due to hypokalemia (serum potassium 3.01 mmol/L). Urine microalbumin/creatinine (ALB/CR) was 70.15 mg/g, serum creatinine was 82 μmol/L and eGFR was 89.79 mL/(min·1.73 m²). Random serum aldosterone was 172.2-203.5 ng/L, and random plasma rennin activity was 0-0.17 μg/(L·h). His captopril challenge test suggested that his aldosterone le-vels were suppressed by 8% (< 30%) and the adrenal enhanced computed tomography scan revealed a left adrenal tumor. The patient was diagnosed with primary hyperaldosteronism (PA), aldosterone adenoma and underwent left laparoscopic adrenalectomy. Histological examination confirmed adrenal cortical adenoma. One week after the operation, his serum creatinine was increased to 127 μmol/L compared with preoperative level; eGFR was 32.34 mL/(min·1.73 m²). His systolic blood pressure (SBP) was 110 mmHg and diastolic blood pressure (DBP) was 60 mmHg (hypotensive drugs discontinued), and serum potassium level was 5.22 mmol/L. At the end of the 2-year follow up, the serum creatinine of this patient remained at 109-158 μmol/L and eGFR fluctuated from 63.28-40.12 mL/(min·1.73 m²). PA is one of the most common causes of secondary hypertension. Several studies have reported renal function deterioration of PA patients after unilateral adrenalectomy, like the patient in this article. Age, preoperative plasma aldosterone concentration, albuminuria and preoperative potassium level might be significant predictors of a decrease in the eGFR. Growing evidence suggests that aldosterone could contribute to structural kidney damage, arterial injury and hemodynamic disorder. At the same time, patients with PA exhibit glomerular hyperfiltration and glomerular vascular hypertension, leading to the misinterpretation of renal function in PA patients as subtle kidney damage may be masked by the glomerular hyperfiltration before treatment. After a unilateral adrenalectomy, glomerular hyperfiltration by aldosterone excess is resolved and renal damage can be unmasked. In conclusion, kidney function deterioration after adrenalectomy can be detected in some patients with PA. Thus, accurate evaluation of kidney function in patients with PA may be essential, especially for those with preoperative risk factors for postoperative renal impairment. After unilateral adrenalectomy, close monitoring of renal function and adequate management are required for PA patients.
Adrenal Gland Neoplasms/surgery* ; Adrenalectomy ; Glomerular Filtration Rate ; Humans ; Hyperaldosteronism/surgery* ; Male ; Middle Aged ; Renal Insufficiency, Chronic