Objective: To evaluate the long-term efifciency of percutaneous transluminal septal myocardial ablation (PTSMA) for treating the patients with hypertrophic obstructive cardiomyopathy (HOCM).
Methods: A total of 66/94 (70.2%) HOCM patients received PTSMA in Shenyang PLA general hospital from 2001-10 to 2012-10 were retrospectively studied. The left ventricular out lfow gradient (LVOFG) was measured at before and after the operation, ECG and echocardiography were examined at 1 month, 6 months and 1 year after operation, and then examined once per year for (63.8±28.5) months.
Results: There were 26 patients lost contact during follow-up period, 40 returned to routine clinical check-up and 2 patients died thereafter, 1 because of sudden death and 1 because of cerebral bleeding. The pre-operative average LVOTG was (102.7 ± 47.5) mmHg, compared with the values at 6 months post-operation and long term (>6 months) after operation (33.9 ± 30.2) mmHg and (29.7 ± 25.4) mmHg,P<0.001. The pre-operative average inter ventricular septal (IVS) was (20.1 ± 3.6) mm, compared with the values at 6 months post-operation and long term after operation (17.5 ± 2.9) mm and (16.4 ± 3.6) mm, P=0.028 andP<0.001. There were 7 patients with NYHA class at II-III and having occasional chest suppression and short of breath. There were no heart transplantation, frequent premature ventricular contraction, tachycardia and other malignant arrhythmia occurred in 38 survivors.
Conclusion: PTSMA may reduce LVOTG, IVS thickness and improve the clinical symptoms in HOCM patients, the long-term efifcacy is reliable.

Objective:To investigate the application of 3.0T multiparametric magnetic resonance imaging (Mp-MRI) prostate imaging-reporting and data system (PI-RADS) V2.1 score combined with prostate-specific antigen density (PSAD) in the diagnosis of prostate cancer (PCa).Methods:The clinical data of 82 patients with suspected PCa who were admitted to Nantong Second People's Hospital from May 2017 to Octorber 2021 were retrospectively analyzed. The 3.0T Mp-MRI PI-RADS V2.1 score, serum PSAD level and pathological diagnosis were obtained from all patients. The 3.0T Mp-MRI PI-RADS V2.1 score and its distribution as well as serum PSAD level between patients with pathologically diagnosed PCa and patients with prostatic hyperplasia (BPH) were compared. The diagnostic efficiency of 3.0T Mp-MRI PI-RADS V2.1 score and serum PSAD level alone and in combination for PCa was analyzed using receiver operating characteristic (ROC) curve, with pathological results as the gold standard.Results:Pathological diagnosis showed that there were 43 cases (52.44%) of PCa and 39 cases (47.56%) of BPH. There was a statistical difference in the distribution of 3.0T Mp-MRI PI-RADS V2.1 score between PCa and BPH patients ( Z = 32.25, P<0.001). The 3.0T Mp-MRI PI-RADS V2.1 score of PCa patients was higher than that of BPH patients [(4.29±0.25) points vs. (2.24±0.11) points, P < 0.001], the serum PSAD level was higher than that of BPH patients [(0.49±0.15) ng·ml -1·cm -3 vs. (0.27±0.08) ng·ml -1·cm -3, P < 0.001]. The ROC curve analysis showed that area under the curve of 3.0T Mp-MRI PI-RADS V2.1 score, serum PSAD level alone and both together for the diagnosis of PCa were 0.766 (95% CI 0.659-0.852, P < 0.001), 0.793 (95% CI 0.689- 0.874, P < 0.001) and 0.816 (95% CI 0.715-0.893, P < 0.001). Conclusions:3.0T Mp-MRI PI-RADS V2.1 score and serum PSAD level are both elevated in PCa patients. They have certain values in the diagnosis of PCa, and the combination of the two has higher diagnostic efficiency.

Objective To understand the cognition status of high-alert medications among medical staffs in Chongming District of Shanghai,and to explore its influencing factors and improvement countermeasures,so as to provide references for safe clinical use and effective control of such drugs.Methods Convenient sampling method was used to investigate among medical staffs in 9 hospitals in Chongming District from March to May 2022,the survey content included general information of medical staff and their awareness of high-alert medications.The orderly multi-classification logistic regression was used to analyze the influencing factors of the cognition of high-alert medications among medical staffs.Results A total of 605 valid questionnaires were collected,including 263 from doctors and 342 from nurses.The results of univariate analysis showed that there were significant differences in the grade distribution of high-alert medications management knowledge scores among doctors of different gender,education background and whether to partcipate in in-hospital training(P＜0.05).There were significant differences in the grade distribution of high-alert medications management knowledge scores among nurses with different education background,hospital level and whether to partcipate in in-hospital training(P＜0.05).There was significant differences in the grade distribution of high-alert medications pharmacy knowledge scores whether doctors participated in in-hospital training(P＜0.05).There were significant differences in the grade distribution of high-alert medications pharmacy knowledge scores among nurses with different education background,professional title,working years and whether to partcipate in in-hospital training(P＜0.05).The results of multi-factor Logistic analysis showed that whether doctors had participated in in-hospital training was an influential factor for and high-alert medications management knowledge score level(OR=0.003,95％CI 0.000 to 0.023,P＜0.001),high-alert medications pharmacy knowledge score level(OR=0.252,95％CI 0.147 to 0.431,P＜0.001).Whether nurses participated in in-hospital training(OR=0.022,95％CI 0.010 to 0.048,P＜0.001)and hospital level(OR=3.353,95％CI 1.639 to 6.855,P=0.001)were the influencing factors of nurses'high-alert medications management knowledge score level,and education background(OR=4.933,95％CI 1.452 to 16.760,P=0.011)and whether nurses participated in in-hospital training(OR=0.414,95％CI 0.239 to 0.717,P=0.002)were the influencing factors of nurses'high-alert medications pharmacy knowledge score level.Conclusion The cognition of high-alert medications among medical staffs in Chongming District is at a medium level on the whole.It is suggested to improve their cognitive ability and risk prevention awareness by improving their education,strengthening the knowledge education and training of high-alert medications,and homogenizing management,so as to ensure the safety of clinical drugs.

Objective To research the prohibitin2 (PHB2) expression and cellular localization in the rat brain cortex after traumatic brain injury (TBI),and explore its relationship with astrocyte proliferation and neuron apoptosis.Methods TBI rat models were established by knife injurying the brain.Western blotting was used to detect the PHB2 expression variation trend in the brain cortex.Immunohistochemical method was used to detect the distribution of PHB2 in damaged cerebral cortex,and immunofluorescence was applied to research the PHB2 expression changes and cellular localization in the rat brain cortex after TBI,and explore its relationship with astrocyte proliferation and neuron apoptosis.Results (1) The TBI models were established successfully;12 h after TBI,the PHB2 expression started to increase obviously,and PHB2 expression reached to its peak level 5 d after TBI.(2)The PHB2 expression in the cortex of TBI rats was significantly increased as compared with that in the sham-operated group,control group and contralateral side of TBI rats.(3) PHB2 mainly located at the astrocytes and neurons of the cerebral cortex after TBI.(4) Co-localization was noted in astrocytes and cell proliferation marker PCNA,and in PHB2 and PCNA,which indicated that proliferation of astrocytes existed and PHB2 involved in the proliferation.(5) Co-localization was noted in astrocytes and cell apoptosis marker A-caspase-3,and in PHB2 and A-caspase-3,which indicated that TBI induced cell apoptosis,and PHB2 involved in the apoptosis.Conclusion PHB2 has a high expression in the cerebral cortex of rats after TBI,and these changes are related to astrocyte proliferation and neuronal apoptosis.

Objective:To investigate the effects of breast milk to total milk intake ratio during hospitalization on the duration of antibiotic therapy in preterm infants less than 34 weeks of gestation.Methods:Clinical data of preterm infants ( n=1 792) less than 34 gestational weeks were retrospectively collected in 16 hospitals of Jiangsu Province Neonatal-Perinatal Cooperation Network from January 1, 2019, to December 31, 2021. The days of therapy (DOT) were used to evaluate the duration of antibiotic administration. The median DOT was 15.0 d (7.0-27.0 d). The patients were divided into four groups based on the quartiles of DOT: Q 1 (DOT≤7.0 d), Q 2 (7.0 d27.0 d) groups. According to the breast milk intake ratio (breast milk intake to total milk intake during hospitalization×100%), they were also divided into four groups: very-low-ratio breastfeeding group (breast milk intake ratio≤25%), low-ratio breastfeeding group (25%75%). Univariate analysis ( Chi-square test and Kruskal-Wallis rank-sum test) was used to analyze the factors influencing DOT. Spearman correlation analysis and trend Chi-square test were used to explore the relationship between breast milk intake ratio and DOT. After using multiple imputations to address missing data, two models were constructed after adjusting for different factors, and multinomial logistic regression model was applied to evaluate the effects of the breast milk intake ratio on DOT. Finally, sensitivity analysis was conducted to assess the stability of the models. Results:(1) Of the 1 792 preterm infants, there were 507 (28.3%) in the Q 1 group, 422 (23.5%) in the Q 2 group, 438 (24.4%) in the Q 3 group and 425 (23.7%) in the Q 4 group. (2) The median values of DOT in the very-low-ratio, low-ratio, medium-ratio and high-ratio breastfeeding groups were 20.0 d (11.0-31.0 d), 20.0 d (11.0-32.0 d), 13.0 d (6.0-25.8 d) and 10.0 d (4.0-21.0 d), respectively. Compared with the very-low-ratio and low-ratio breastfeeding groups, the medium-ratio and high-ratio breastfeeding groups had shorter DOT (all P<0.05). (3) After adjusting for factors with P<0.1 (prenatal glucocorticoid exposure, antimicrobial use within 24 h before delivery, gestational age at delivery, birth weight, Apgar score≤7 at 1 min, neonatal respiratory distress syndrome, infectious pneumonia and early-onset neonatal sepsis) between the DOT quartile groups, it showed that medium-ratio and high-ratio breastfeeding were protective factors in contrast to very-low-ratio breastfeeding in the Q 2, Q 3 and Q 4 groups as compared with the Q 1 group [Q 2 group: OR=0.50 (95% CI: 0.30-0.85) and OR=0.36 (95% CI: 0.26-0.51); Q 3 group: OR=0.31 (95% CI: 0.18-0.55) and OR=0.20 (95% CI: 0.14-0.29); Q 4 group: OR=0.22 (95% CI: 0.12-0.42) and OR=0.17 (95% CI: 0.12-0.26)]. Conclusion:Breast milk intake accounting for over 50% of total milk intake has a positive impact on reducing DOT in premature infants requiring antibiotics, which suggests that breastfeeding should be actively encouraged.

OBJECTIVETo observe the prognostic value of Medical Image Three-dimensional (3D) Visualization System (MI-3DVS) in evaluation of the distribution and blood supply of gastroesophageal varices (EGV).

METHODS3D reconstruction was played by MI-3DVS and CT-maximum intensity projection (CT-MIP) respectively on multi slice computed tomography (MSCT) date of 51 patients with EGV from February 2010 to October 2012. The demonstration rate of collateral vessels in spleen and stomach area, EGV typing and the blood supply between the two methods were observed and compared.

RESULTSThe demonstration rates of LGV, gastro-renal shunt, splenorenal shunt and PGV showed a high coincidence between the MI-3DVS and CT-MIP (κ = 0.882-1.000), and moderate agreements in SGV and paraesophageal varices (κ = 0.646 and 0.757). The outcome of EGV classification (MI-3DVS vs. CT-MIP) were typeIfor 31 vs. 28 cases, type II for 6 vs. 4 cases, type III for 4 vs. 4 cases and type IV for 6 vs.10 cases, the 2 methods show high agreements (weighted Kappa value of 0.848 and P < 0.01).Significant differences were found in the blood supply distribution among the four types of EGV (χ(2) = 36.647, P < 0.01); and the blood supply of the EGV tended to be a strong correlation with EGV classification (C = 0.769 and 0.744, P = 0.000). There were 12 patients with gastro-renal shunt and 5 patients with Spleno-renal shunt.

CONCLUSIONSMI-3DVS can explicitly determine the location, blood vessel diameter and blood supply of the EGV, which is helpful for us to grab the formation of collateral circulation completely. The 3D reconstruction of MI-3DVS has guidance and current significance in optimizing therapeutic schedule or preoperative planning.

Adult ; Aged ; Esophageal and Gastric Varices ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Tomography, X-Ray Computed

Cognitive impairment is the most common non-motor symptom of Parkinson's disease (PD), which may associate with the disorders of transmitters, cortical atrophy, proteinosis, etc., and seriously influence the motor function, ability of daily life of the patients. Transcranial direct current stimulation (tDCS), which may adjust the cerebral excitability, regional blood flow, plasticity of synapses, etc., has been used for PD cognitive impairment.

SOCS3, a feedback inhibitor of the JAK/STAT signal pathway, negatively regulates axonal regrowth and inflammation in the central nervous system (CNS). Here, we demonstrated a distinct role of SOCS3 in the injured spinal cord of the gecko following tail amputation. Severing the gecko spinal cord did not evoke an inflammatory cascade except for an injury-stimulated elevation of the granulocyte/macrophage colony-stimulating factor (GM-CSF) and interferon gamma (IFN-γ) cytokines. Simultaneously, the expression of SOCS3 was upregulated in microglia, and unexpectedly not in neurons. Enforced expression of SOCS3 was sufficient to suppress the GM-CSF/IFN-γ-driven inflammatory responses through its KIR domain by attenuating the activities of JAK1 and JAK2. SOCS3 was also linked to GM-CSF/IFN-γ-induced cross-tolerance. Transfection of adenovirus overexpressing SOCS3 in the injured cord resulted in a significant decrease of inflammatory cytokines. These results reveal a distinct role of SOCS3 in the regenerating spinal cord, and provide new hints for CNS repair in mammals.