Objective To investigate the value of echocardiography in the diagnosis of interrupted aortic arch (IAA). Methods Forty-three children that diagnosed as IAA by transthoracic echocardiography (TTE) were reviewed. The results of CTA (CT Angiography) and operation also were compared. Results Among the 43 children, 41 was admitted as IAA by operation and 2 were diagnosed as coarctation of aorta. According to the type of IAA, 25 cases were diagnosed as type A, 13 cases were diagnosed as type B, 3 cases were diagnosed as type C. Thirty-ifve cases were diagnosed by TTE correctly, 3 cases were misdiagnosed by TTE, 4 cases were suspected as IAA by TTE and ifnally conifrmed by operation. The accuracy rate was 81%(35/43). Among the 35 deifnite diagnosed cases, corrected typing cases were 30, the accuracy rate was 86%(30/35). The accuracy rate of type A, B, C were 96%(23/24), 64%(7/11) and 0. According to the results of CTA, 40 cases were diagnosed correctly, 1 case was misdiagnosed. The accuracy rate was 98%(40/41). Among the deifnite diagnosed cases, corrected typing rate was the same with operation result. Conclusions TTE is the ifrst choice for the detection of IAA. During TTE, in case the indistinct display of aortic arch, CTA should be used to improve the accuracy rate of IAA.

This article interprets the " Screening for and Managing the Person with Frailty in Primary Care: Guidelines " developed in 2020 by the International Conference on Frailty and Sarcopenia Research (ICFSR) . This article also analyzes the characteristics of frailty assessment tools and management strategies for frail elderly in order to provide new ideas for the assessment and management of frail elderly in China, and achieve healthy aging of the elderly.

Based on domestic and foreign literature, this article systematically elaborates the frailty assessment tools for the aged, and summarizes effective intervention measures to prevent and improve frailty, such as exercise, nutrition and social support, so as to provide a reference for clinical nurses or researchers to compile a frailty assessment scale suitable for the aged in my country and to formulate a comprehensive frailty intervention model.

Pregnane X receptor (PXR, NR1I2) is a prototypical member of the nuclear receptor superfamily. PXR can be activated by both endobiotics and xenobiotics. As a key xenobiotic receptor, the cellular function of PXR is mostly exerted by its binding to the regulatory gene sequences in a ligand-dependent manner. Classical downstream target genes of PXR participate in xenobiotic responses, such as detoxification, metabolism and inflammation. Emerging evidence also implicates PXR signaling in the processes of apoptosis, cell cycle arrest, proliferation, angiogenesis and oxidative stress, which are closely related to cancer. Here, we discussed, in addition to the characterization of PXR , the biological function and regulatory mechanism of PXR signaling in cancer, and its potential for the targeted prevention and therapeutics.

Objective To investigate the clinical efficacy and application value of submucosal tunneling endoscopic resection(STER)for upper gastrointestinal submucosal tumors(SMTs). Methods A retrospective analysis was performed on the endoscopic and clinical data of 44 cases with SMTs who received STER from January 2015 to June 2016 in Chinese PLA General Hospital. Results The rate of complete resection was 88.6%(39/44). The operating time was 60.1±30.6 min. The hospitalization time was 10.1± 3.3 days. The rate of complications was 6.8%(3/44). The diagnosis of SMTs by pathology and endoscopic ultrasonography(EUS),the size of SMTs measured by EUS and ruler after STER,and the growing direction judged by EUS and CT were consistent. Conclusion STER for SMTs has a higher complete resection rate, shorter operating time and hospitalization time, and fewer complications. EUS combined with CT is an effective method for preoperative evaluation.

Objective To explore the joint contact force, ligament tensile force and force transmission mode of foot internal structure in Down’s syndrome child (DSC) during standing. Methods The finite element models of foot were constructed based on CT image data from one DSC and one typically developing child (TDC). The models were validated by plantar pressure measurement during static standing. To simulate foot force during standing, the ground reaction force and the triceps surae force were applied as the loading condition. Contact pressure of the tibiotalar, talonavicular and calcaneocuboid joints, tensile force of the spring and plantar calcaneocuboid ligaments, and force transmission mode in transverse tarsal joints were calculated and analyzed. Results The finite element models of foot were validated to be reliable. Compared with the TDC, the DSC showed higher contact pressure at the tibiotalar joint and lower contact pressure at the talonavicular joint. The tensile force of spring and plantar calcaneocuboid ligaments of DSC was 10 times and 58 times of TDC, respectively. The forces transmitted through both mediate and lateral columns in DSC were lower than those in TDC. Conclusions Abnormal contact pressure of the tibiotalar joint, larger tensile force of midfoot ligaments and smaller force of the transverse tarsal joint were found in DSC during standing. The abnormal alteration of stress patterns in foot internal structure of DSC should be fully considered in clinical rehabilitation, so as to provide theoretical references for screening and making intervention plans for early rehabilitation, as well as designing individualized orthopedic insoles.