Objective To report 49 cases of adult interatrial septal defect with pulmonary hypertension operated and to evaluate their results.Method Most of those cases were repaired with conventional operative procedures,but 2 cases among them with severe pulmonary hypertension were repaired with one-way valvular patch.Those with mitral or tricuspid remarkable regurgitation,were repaired with annuloplastic procedure at the same time.Results There were no operative death,and followed up for one to five months,the heart size,ECG and the data of blood gas analysis were retuned into normal value.Heart function of 47 case was raised to Ⅰ class(NYHA),and 2 case to Ⅱ class.Conclusions Operation for adult interatrial septal defect especially with pulmonary hyperteasion is highly indicated.Treatment of mitral or tricuspid regurgitation remarkably at the same time is important for recovery of cardiac function.One-way valvular patch used to repair ASD with severe pulmonary hypertension could reduce complication and mortality,so it is an effective procedure adapted.

BACKGROUND: Wnt signaling pathways can stimulate the proliferation and differentiation of neural stem cel s, and promote the repair of spinal cord injury. The electrical field stimulation can change the protein expression of Wnt signaling pathways.
QBJECTIVE: To explore the influence of oscil ating electric field on motor function recovery and the expression of Wnt-3a protein in rats with spinal cord injury.
METHODS: A total of 36 Sprague-Dawley rats models with spinal cord injury were induced by the Al en’s method. Al rats were randomly divided into oscil ating electric field stimulation group and spinal cord injury group. The stimulating electrodes were added in both groups. The oscil ating electric field stimulation group received oscil ating electric field intervention.
RESULTS AND CONCLUSION: At 3 days after model establishment, Basso, Beattie, and Bresnahan (BBB) locomotor rating scale scores and Wnt-3a expression were similar between the oscil ating electric field stimulation group and spinal cord injury group. At 7 and 14 days, significant differences in BBB scores and Wnt-3a expression were detected. These results indicate that oscil ating electric field stimulation can activate Wnt signaling protein in the early stage of spinal cord injury, which may be associated with the promoting effect of oscil ating electric field stimulation on spinal cord injury.

In recent years, there have been increasing studies on the role of microorganisms in pancreatic cancer which show that bacteria and fungi are closely associated with pancreatic cancer. In the past, the pancreas has usually been considered as a sterile organ. Recent studies, however, show that microbiome exists in the pancreas. Bacteria can migrate from the intestine to the pancreas. Changing the composition of the microbiome may have positive effects on treatment of pancreatic cancer. This article reviews the relationship between gastrointestinal microbiome and pancreatic cancer.

Objective To investigate the effect of supine regulating on maternal fetal occiput posterior position during the delivery after epidural analgesia. Methods Totally600 cases of parturient with intravaginal posterior occipital position with 3cm voluntary labor analgesia were selected,who were born in Dalian maternity hospital from October 2015 to October 2016.The(Visual Analogue Scale/Score) VAS pain score at 15min after epidural labor analgesia was as effective as less than 3 points.They were randomly divided into the control group and the observation group by random number table method,with 300 cases in each group.The control group monitored parturient respiration, pulse, blood pressure, heart rate and fetal heart rate according to routine treatment.The control group monitored parturient respiration, pulse, blood pressure, heart rate and fetal heart rate according to routine treatment.In the observation group,except for routine treatment according to the labor process,after the opening of 5cm,the pregnant women were instructed to take the lateral prone position,so that the maternal side and the fetal side of the spinal column should be the same side. To observe the difference between the two groups in the rate of spontaneous vaginal delivery, delivery rate, cesarean section rate, fetal cardioversion rate, time of birth process and neonatal Apgar score. Results Totally 283 cases delivery through vagina and 17 cases of cesarean section in observation group,while 257 cases of vaginal delivery and 43 cases of cesarean section in the control group.The successful rate of fetal position transfer in the observation group was 74.6%(211/283) which was significantly higher than 45.9% (118/257) of the control group (Χ2=62.782, P<0.01), natural labor rate was also 87.3% (262/300) which increased significantly according to 64.7% (194/300) (Χ2=42.251, P<0.01),the rate of midwifery (7.0%, 21/300) and cesarean section (5.7%, 17/300) were significantly lower than 21.0% (63/300)and 14.3% (43/300) of the control group (Χ2=24.419, 12.519,P<0.01),the second stage of labor was(1.60±0.56)h which was significantly shortened than(2.19±0.53)h also(t=-12.589,P<0.01).In the observation group, the ratio of the posterior occipital position to the occipital transverse position after the opening of 8-10 cm and the complete dilation of the cervical were 7.4%(21/283)and 13.1%(37/283),which were also significantly increased than 3.4%(9/264),6.8%(18/264) of the control group (Χ2=4.240, 5.911, P<0.05). Conclusions Supine adjustment after the cervix dilatation larger than 5cm is more conducive to fetal rotation and to avoid the adverse complications, reduce the rate of vaginal delivery and cesarean section rate,improve the rate of natural childbirth,shorten delivery time,improve the quality of delivery.

Objective To construct the Hut78 cell line with EZH2 gene knocked into by CRISPR/Cas9 system. Methods The EZH2 expression vector pMD-18T-EZH2 with homologous arm and the sgRNA expression vector pSpCas9 (BB)-2A-Puro-sgRNA, which could cut the double stranded genomic DNA, were constructed, and the two vectors were co-transfected into Hut78 cells. Then the expression of EZH2 mRNA was detected by qPCR, and the expressions of EZH2 and H3K27me3 proteins were detected by Western blot assay. Results The pMD-18T-EZH2 and pSpCas9(BB)-2A-Puro-sgRNA recombinant vectors were confirmed by DNA sequencing. When Hut78 cells were transfected with the two recombinant plasmid, qPCR results showed that the expression of EZH2 mRNA was significantly increased, and Western blot analysis showed that the expressions of EZH2 and H3K27me3 proteins were significantly increased. Conclusion EZH2 gene is successfully knocked into Hut78 cells by CRISPR/Cas9 system.

Gastric schwannoma is a tumor originating from mesenchymal tissue. The clinical incidence is relatively rare, accounting for 6.3% of all gastric stromal tumors. The tumor is more likely to occur in the body of the stomach and usually originates from the gastric submucosal nerve. Most gastric schwannomas do not have any clinical symptoms. Imaging examination can play a diagnostic role, but the diagnosis still requires pathological examination, especially S-100 protein which is the gold standard for the diagnosis of gastric schwannomas. Gastric schwannoma usually needs to be distinguished from gastrointestinal stromal tumors and gastrointestinal autonomic nerve tumors. In terms of treatment, complete surgical resection is the first choice.

Objective:To analyze the clinical effect of real-time virtual sonography (RVS) surgical navigation combined with indocyanine green fluorescence imaging technology in the anatomical liver segmentectomy for hepatocellular carcinoma (HCC).Methods:The clinical data of 35 patients who underwent anatomical liver segmentectomy using RVS surgical navigation combined with indocyanine green fluorescence imaging technology in the Department of Hepatobiliary Surgery of Peking University International Hospital from January 2020 to January 2022 were retrospectively analyzed. There were 22 males and 13 females, aged (60.0±10.0) years. RVS is real-time virtual sonography, which fuses real-time intraoperative ultrasound images with corresponding preoperative CT or MRI images to guide the surgical plane. Methods of operation, time of operation, intraoperative blood loss, operative margin, hospital stay and postoperative complications were analyzed. Postoperative complications were graded by Clavien-Dindo system. The 1-year overall survival and tumor-free survival rates of patients were followed up by outpatient or telephone review.Results:Anatomical liver segmentectomy was performed on 36 patients, including 1 patient (2.9%) of segment Ⅱ, 1 patient (2.9%) of segment Ⅲ, 5 patients (14.3%) of segment Ⅳ, 6 patients (17.1%) of segment Ⅴ, 10 patients (28.6%) of segment Ⅵ, 7 patients (20.0%) of segment Ⅶ, 4 patients (11.4%) of segment Ⅷ, and 1 patient (2.9%) of segments Ⅴ+ Ⅷ. The operation time of 35 patients was (310.2±81.6) min, with an intraoperative blood loss of [ M( Q1, Q3)] 390.0(250.0, 500.0) ml. The hospital stay was (11.6±2.1) d. There was no postoperative death. Postoperative complications occurred in 3 cases (8.6%), of which 2 cases (5.7%) were ascites, Clavien-Dindo grade Ⅰ; Postoperative hemorrhage occurred in 1 case (2.9%), Clavien-Dindo grade Ⅱ. HCC was confirmed by pathology in all cases, and the operative margins were negative. The median follow-up time was 14 months (12 to 20 months). The 1-year overall survival rate after surgery was 100.0%(35/35), three patients (8.6%) had tumor recurrence, and the 1-year tumor-free survival rate was 91.4% (32/35). Conclusion:RVS surgical navigation combined with indocyanine green fluorescence imaging technology could be feasible in anatomical segmental hepatectomy for HCC.

Colorectal cancer (CRC), a malignant tumor worldwide consists of microsatellite instability (MSI) and stable (MSS) phenotypes. Although SHP2 is a hopeful target for cancer therapy, its relationship with innate immunosuppression remains elusive. To address that, single-cell RNA sequencing was performed to explore the role of SHP2 in all cell types of tumor microenvironment (TME) from murine MC38 xenografts. Intratumoral cells were found to be functionally heterogeneous and responded significantly to SHP099, a SHP2 allosteric inhibitor. The malignant evolution of tumor cells was remarkably arrested by SHP099. Mechanistically, STING-TBK1-IRF3-mediated type I interferon signaling was highly activated by SHP099 in infiltrated myeloid cells. Notably, CRC patients with MSS phenotype exhibited greater macrophage infiltration and more potent SHP2 phosphorylation in CD68⁺ macrophages than MSI-high phenotypes, suggesting the potential role of macrophagic SHP2 in TME. Collectively, our data reveals a mechanism of innate immunosuppression mediated by SHP2, suggesting that SHP2 is a promising target for colon cancer immunotherapy.