Objective To investigate the risk factors for postpartum cardiac events in pregnant women with heart diseases and to provide prenatal counseling for them.Methods A retrospective analysis was made in cases of pregnant women with heart diseases admitted to the surgical intensive care unit (SICU) of Anzhen Hospital from May 2004 to May 2012.Data were used to identify univariate and multivariate predictors for postpartum cardiac events.Results A total of 190 patients (≥ 20 weeks gestation) were enrolled in the study with 134 (70.5％) of congenital heart disease,30 (15.8％) of rheumatic heart disease,10 (5.3％) of cardiomyopathy,2 (1.1％) of peripartum cardiomyopathy and 14(7.4％) of hypertensive heart disease.Postpartum cardiac events were observed in 42 cases with the incidence of 22.1％.A total of 7 cases resulted in death with the mortality rate of 3.7％.Among them,5 cases were dead of circulatory collapse and pulmonary hypertensive crisis postpartum,while the other 2 cases with secondary pulmonary infection were died of respiratory and circulatory collapse.The baseline parameters of New York Heart Academy(NYHA) ＞ 1,left ventricular ejection fraction (LVEF) ＜ 50％,use of cardiac drugs and pulmonary artery hypertension(PAH) ＞ 80 mm Hg(1 mm Hg =0.133 kPa) were the independent predictors for postpartum cardiac events by univariate and multivariate logistic regression analysis.Conclusions The incidence of postpartum cardiac events is high in pregnant women with heart diseases.Pulmonary artery hypertension and heart failure are the main causes of death.

Oligodendrocyte progenitor cells are distributed throughout the central nervous system and can proliferate, migrate and differentiate into oligodendrocytes. The core function of oligodendrocytes is to produce myelin, form a myelin sheath, wrap the axons, and increase the conduction rate of neurons. Recent studies have shown that large numbers of oligodendrocyte progenitor cells exist in the lesions of neurodegenerative diseases such as multiple sclerosis and Alzheimer's disease, and these cells play an important role in the repair of neurological damage. The physiological functions of oligodendrocyte progenitor cells and their roles in neurodegenerative diseases such as multiple sclerosis and Alzheimer's disease are reviewed in order to provide a new idea and direction for the research and treatment of neurodegenerative diseases.

Objective:To observe the clinical efficacy of a new type of "firebreak" drainage with skin preservation in the treatment of Fournier's gangrene.Methods:This technique is suitable for patients with perianal necrotizing fasciitis who can tolerate surgery without large area of skin blackness and necrosis. Procedure and key points: (1) The dividing line between inflammatory tissue and normal tissue was determined according to imaging examination and intraoperative exploration; (2) The abscess cavity was cut along the most obvious part of the abscess fluctuation, with a long diameter of 3~4 cm and a short diameter of 1~2 cm; (3) Necrotic tissue was discreetly separated and removed from the main incision to the outer edge of the infection. A fusiform incision was made every 3 to 5 cm, with a long diameter of 2 to 3 cm and a short diameter of 1 cm, and discreetly separated until the normal tissue, and a hose was hung between the adjacent incisions for drainage. (4) Each adjacent edge cut between the stealth separation and hanging hose drainage, forming a "firebreak"; (5) Rinse the wound repeatedly; (6) If the infection invades the rectum, colostomy is performed as required. The case data of 11 patients with perianal necrotizing fasciitis admitted to the Second Affiliated Hospital of Nanjing University of Chinese Medicine from July 2019 to February 2023 were retrospectively analyzed. All patients were treated with emergency surgical debridement by "firebreak" drainage with skin preservation.Results:All 11 cases were cured with 100%. One case underwent multiple operations. The hospitalization time was 11-46 days, with an average of 22 days. The wound healing time was 28-75 days, with an average of 43 days. Except for 1 patient with trauma, all the other patients had no significant anal function injury after surgery. All the 11 patients recovered and were discharged from hospital with a median follow-up of 136 (115-413) days.Conclusions:The "firebreak" drainage based on skin preservation has the advantages of less trauma and faster recovery, and do not cause obvious anal function damage.

Based on single-cell sequencing of the hippocampi of 5x familiar Alzheimer's disease(5x FAD)and wild type mice at 2-,12-,and 24-month of age,we found an increased percentage of microglia in aging and Alzheimer's disease(AD)mice.Blood brain barrier injury may also have contributed to this increase.Immune regulation by microglia plays a major role in the progression of aging and AD,according to the functions of 41 intersecting differentially expressed genes in microglia.Signaling crosstalk between C-C motif chemokine ligand(CCL)and major histocompatibility complex-1 bridges intercellular communi-cation in the hippocampus during aging and AD.The amyloid precursor protein(APP)and colony stimulating factor(CSF)signals drive 5x FAD to deviate from aging track to AD occurrence among intercellular communication in hippocampus.Microglia are involved in the progression of aging and AD can be divided into 10 functional types.The strength of the interaction among microglial subtypes weakened with aging,and the CCL and CSF signaling pathways were the fundamental bridge of communication among microglial subtypes.

Objective:To observe the clinical efficacy of a new type of "firebreak" drainage with skin preservation in the treatment of Fournier's gangrene.Methods:This technique is suitable for patients with perianal necrotizing fasciitis who can tolerate surgery without large area of skin blackness and necrosis. Procedure and key points: (1) The dividing line between inflammatory tissue and normal tissue was determined according to imaging examination and intraoperative exploration; (2) The abscess cavity was cut along the most obvious part of the abscess fluctuation, with a long diameter of 3~4 cm and a short diameter of 1~2 cm; (3) Necrotic tissue was discreetly separated and removed from the main incision to the outer edge of the infection. A fusiform incision was made every 3 to 5 cm, with a long diameter of 2 to 3 cm and a short diameter of 1 cm, and discreetly separated until the normal tissue, and a hose was hung between the adjacent incisions for drainage. (4) Each adjacent edge cut between the stealth separation and hanging hose drainage, forming a "firebreak"; (5) Rinse the wound repeatedly; (6) If the infection invades the rectum, colostomy is performed as required. The case data of 11 patients with perianal necrotizing fasciitis admitted to the Second Affiliated Hospital of Nanjing University of Chinese Medicine from July 2019 to February 2023 were retrospectively analyzed. All patients were treated with emergency surgical debridement by "firebreak" drainage with skin preservation.Results:All 11 cases were cured with 100%. One case underwent multiple operations. The hospitalization time was 11-46 days, with an average of 22 days. The wound healing time was 28-75 days, with an average of 43 days. Except for 1 patient with trauma, all the other patients had no significant anal function injury after surgery. All the 11 patients recovered and were discharged from hospital with a median follow-up of 136 (115-413) days.Conclusions:The "firebreak" drainage based on skin preservation has the advantages of less trauma and faster recovery, and do not cause obvious anal function damage.

OBJECTIVETo investigate the relationship between serum/follicular fluid fetuin B levels and outcome offertilization (IVF).

METHODSInfertility women (28 with low fertilization rates, 44 with normal fertilization rates) receiving IVF in Women's Hospital of Zhejiang University School of Medicine during June and December 2016 were enrolled in the study. Serum/follicular fluid fetuin B levels were measured with ELISA method. Correlations of serum and follicular fetuin B level with fertilization outcome of IVF were analyzed with Pearson correlation coefficient and receiver operating characteristic (ROC) curve.

RESULTSA positive correlation between serum fetuin B and follicular fluid fetuin B levels was observed (=0.675,<0.01). Both serum and follicular fluid fetuin B levels in women with low fertilization rates of IVF were lower than those in women with normal fertilization rates[(6.09±1.31) μg/mL vs. (7.13±1.47) μg/mL,=3.050,<0.05; (5.13±0.96)μg/mL vs. (6.22±1.33) μg/mL,=3.755,<0.01]. ROC analysis showed that the area under curve (AUC) of serum fetuin B level in predicting fertilization rate was 0.832 (95%:0.729-0.934,<0.01), and 6.08 μg/mL could be used as cut-off value.

CONCLUSIONSSerum fetuin B level is correlated with follicular fluid fetuin B level, and it may be used for predicting the fertilization outcome of IVF.