Objective To explore the value of MRI in diagnosis of fetal meconium peritonitis.Methods Seven meconium peritonitis fetuses proved by surgery and pathology were enrolled.The prenatal MRI findings and clinical data were analyzed retrospectively.Results Six fetuses showed a large amount of ascites,intestinal tube floating in the abdomen,small intestine gathered together.One fetus showed a giant abdominal cystic mass,with bowel compressed,displaced and uneven dilated.Four fetuses showed small colon and rectum,or without meconium signal.Two fetuses were accompanied by bilateral hydrocele.Amniotic fluid increased in 3 cases.After the neonates were born,1 case of them died from sudden heart rate decline during operation,1 case died from severe pulmonary edema after operation,and 5 cases survived after operation.Conclusion MRI has some features in the prenatal diagnosis of meconium peritonitis,which can provide an important basis for postpartum treatment and evaluation of prognosis.

Objective:To evaluate the value of MRI in the diagnosis of jejunal and ileal atresia in fetus.Methods:This study included thirteen neonates with surgically and pathologically confirmed jejunal or ileal atresia without other gastrointestinal diseases treated in our institution between January 1, 2010 and December 31, 2018. MRI was performed on all fetuses subsequent to routine prenatal sonographic examinations indicated bowel dilation or ascites. MR images were analyzed by two radiologists,and MRI diagnosis was compared with surgical and pathological results.Results:On prenatal MRI, eight fetuses exhibited single or multiple dilated small bowel loops, one of them exhibited a cystic mass in the abdomen; five fetuses exhibited massive ascites, and collected bowels. On final surgical and pathological diagnosis, nine fetuses had ileal atresia, five of them had intestinal perforation; four fetuses had jejunal atresia, one of them had intestinal perforation and a meconium pseudocyst. Among the 7 cases without intestinal perforation, the atresia location was diagnosed correctly in 5 cases. The 6 fetuses with intestinal perforation were diagnosed as intestinal atresia and meconium peritonitis by prenatal MRI, but the location of atresia could not be determined.Conclusions:Jejunal and ileal atresia have their characteristic manifestations on prenatal MRI. The location of atresia can be inferred from the distribution of amniotic fluid and meconium in the intestine. Prenatal MRI has a complementary role in the assessment of fetal bowel abnormalities after standard obstetric ultrasound.

A 3-year-old girl was hospitalized for cough and asthma for 2 days, and fever and anuria for 1 day in Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in January 2019.Retrospective analysis was used.She developed end-stage renal disease and received peritoneal dialysis 6 months ago.After admission, she was diagnosed as acute-on-chronic renal failure, respiratory failure, heart failure, severe influenza A (H1N1). The patient was rapidly recovered by the management of high-volume peritoneal dialysis, mechanical ventilation, and medications of Peramivir and Methylprednisolone.Through literature review, case report or cohort study about the treatment of acute kidney disease by high-volume peritoneal dialysis has not been previously reported.This case report suggested that high-volume peritoneal dialysis is able to effectively remove solutes and control volume without causing severe hypoproteinemia and hyperglycemia, which may become an effective renal replacement therapy for children with multi-organ dysfunction syndrome.

Objective To investigate the effects of aluminum lactate exposure on learning and memory and the transportation of amyloid-beta peptides (Aβ) in cerebrospinal fluid in rats.Methods A total of 80 male Sprague-Dawley rats were randomly divided into solvent control (distilled water) group and low-,medium-,and high-dose aluminum poisoning groups (10,30,and 90 mg/kg aluminum lactate),with 20 rats in each group,and the poisoning procedure was performed by gavage for 2 months.The Morris water maze test was used to test the rats' learning and memory,Western blot was used to measure the expression level of low-density lipoprotein receptor protein-1 (LRP-1) in rats' choroid plexus,and enzyme-linked immunosorbent assay (ELISA) was used to measure the content of Aβ in the cerebrospinal fluid and plasma.Results The Morris water maze test showed that in the place navigation test,with the increasing training time,the escape latency was significantly shortened in each group and showed significant differences between any two groups (P＜0.05).In the spatial probe test,the time spent in target quadrant in the medium-and high-dose groups was 11.52±1.56 s and 10.43 ±5.27 s,respectively,which was significantly shorter than that in the control group and the low-dose group (15.81±3.01 s and 13.91±2.17 s)(P＜0.05).The numbers of platform crossings in the medium-and high-dose groups were 2.64± 1.39 and 1.50±0.76,respectively,which were significantly lower than those in the control group and the low-dose group (4.29±0.914 and 3.56±1.38)(P＜0.05).The results of ELISA showed that the medium-and high-dose groups had significant increases in the content of Aβ1-42 in cerebrospinal fluid (320.35±84.82 pg/ml and 327.68±67.51 pg/ml),which was significantlyhigher than that in the control group(203.46±74.36 pg/ml) (P＜0.05).The content of Aβ1-42 in plasma showed no significant difference between any two groups (P＞0.05),and that of Aβ1-40 in cerebrospinal fluid and plasma also showed no significant difference between any two groups (P＞0.05).The results of Western blot showed that the high-dose group had significantly lower protein expression of LRP-1 than the control group and the low-and medium-dose groups(0.57±0.21 vs 1.00±0.00/0.79±0.15/0.95±0.24,P＜0.05).Conclusion Subchronic aluminum exposure may reduce learning and memory in rats,and the accumulation of Aβ in cerebrospinal fluid may be related to the reduced protein expression of LRP-1 in the choroid plexus,suggesting that aluminum affects learning and memory in rats through reducing the protein expression of LRP-1,influencing the transportation of Aβ,and leading to the accumulation of Aβ.

Objective To investigate the impairment in primary cultured rat choroid plexus epithelial cells (CPECs) induced by aluminum.Methods The choroid plexus isolated from Sprague-Dawley rats 14 days old was cut into pieces and digested by trypsin in the sterile area.The obtained single cells were cultured in DMEM with 1％ epidermal growth factor and 20％ fetal calf serum.Five days later,immunohistochemistry with anti-transthyretin antibody was used to identify the purity of cultured cells.The well-grown cells were treated with aluminum lactate at different concentrations (0,100,400,and 1 600 μmol/L for control,low-dose,medium-dose,and high-dose groups).Forty-eight hours later,the cell viability,apoptotic rate,level of reactive oxygen species (ROS),and activity of superoxide dismutase (SOD) were measured in each group to evaluate the impairment in primary cultured rat CPECs by aluminum.Results More than 95％ of the cultured cells were identified as CPECs.The medium-and high-dose groups had significantly lower cell viability than the control group (86.74％±4.03％ vs 100％,P＜0.01;81.90％±9.17％ vs 100％,P＜0.01).The high-dose group had significantly lower cell viability than the low-dose group (81.90％±9.17％ vs 92.92％±8.81％,P＜0.01).The medium-and high-dose groups had significantly higher apoptotic rates than the control group (7.26％±0.99％ vs 1.29％±0.03％,P＜0.01;22.25％±1.55％ vs 1.29％±0.03％,P＜0.01) and the low-dose group (7.26％±0.99％ vs 1.68％±0.27％,P＜0.01;22.25％±1.55％ vs 1.68％±0.27％,P＜0.01).The high-dose group had a significantly higher apoptotic rate than the medium-dose group(22.25％±1.55％ vs 7.26％±0.99％,P＜0.01).The medium-and high-dose groups had significantly higher fluorescence intensity of ROS than the control group (22.23％±0.41％ vs 17.24％±0.09％,P＜0.05;25.10％±1.13％ vs 17.24％±0.09％,P＜0.05) and the low-dose group (22.23％± 0.41％ vs 18.31％±0.21％,P＜0.05;25.10％±1.13％ vs 18.31％±0.21％,P＜0.05).The high-dose group had significantly higher fluorescence intensity of ROS than the medium-dose group (25.10％±1.13％ vs 22.23％± 0.41％,P＜0.05).The low-,medium-and high-dose groups had significantly lower SOD activity than the control group[(28.65±0.74) U/g Hb vs (37.35±1.05) U/g Hb,P＜0.05;(22.75±1.94) U/g Hb vs (37.35±1.05) U/g Hb,P＜0.05;(13.29 ±0.64) U/g Hb vs (37.35 ± 1.05) U/g Hb,P＜0.05].The medium-and high-dose groups had significantly lower SOD activity than the low-dose group [(22.75±1.94) U/g Hb vs (28.65±0.74) U/g Hb,P＜ 0.05;(13.29±0.64) U/g Hb vs (28.65±0.74) U/g Hb,P＜0.05],while the high-dose group had had significantly lower SOD activity than the medium-dose group[(13.29±0.64) U/g Hb vs (22.75±1.94) U/g Hb,P＜0.05].There were no significant differences in cell viability,apoptotic rate,level of ROS,or activity of SOD between any other two groups (P＞0.05).Conclusion Aluminum lactate may induce impairment in primary cultured rat CPECs.It reduces the cell viability,elevates the apoptotic rate,and causes oxidative stress.

Objective To investigate the effects of aluminum lactate exposure on learning and memory and the transportation of amyloid-beta peptides (Aβ) in cerebrospinal fluid in rats.Methods A total of 80 male Sprague-Dawley rats were randomly divided into solvent control (distilled water) group and low-,medium-,and high-dose aluminum poisoning groups (10,30,and 90 mg/kg aluminum lactate),with 20 rats in each group,and the poisoning procedure was performed by gavage for 2 months.The Morris water maze test was used to test the rats' learning and memory,Western blot was used to measure the expression level of low-density lipoprotein receptor protein-1 (LRP-1) in rats' choroid plexus,and enzyme-linked immunosorbent assay (ELISA) was used to measure the content of Aβ in the cerebrospinal fluid and plasma.Results The Morris water maze test showed that in the place navigation test,with the increasing training time,the escape latency was significantly shortened in each group and showed significant differences between any two groups (P＜0.05).In the spatial probe test,the time spent in target quadrant in the medium-and high-dose groups was 11.52±1.56 s and 10.43 ±5.27 s,respectively,which was significantly shorter than that in the control group and the low-dose group (15.81±3.01 s and 13.91±2.17 s)(P＜0.05).The numbers of platform crossings in the medium-and high-dose groups were 2.64± 1.39 and 1.50±0.76,respectively,which were significantly lower than those in the control group and the low-dose group (4.29±0.914 and 3.56±1.38)(P＜0.05).The results of ELISA showed that the medium-and high-dose groups had significant increases in the content of Aβ1-42 in cerebrospinal fluid (320.35±84.82 pg/ml and 327.68±67.51 pg/ml),which was significantlyhigher than that in the control group(203.46±74.36 pg/ml) (P＜0.05).The content of Aβ1-42 in plasma showed no significant difference between any two groups (P＞0.05),and that of Aβ1-40 in cerebrospinal fluid and plasma also showed no significant difference between any two groups (P＞0.05).The results of Western blot showed that the high-dose group had significantly lower protein expression of LRP-1 than the control group and the low-and medium-dose groups(0.57±0.21 vs 1.00±0.00/0.79±0.15/0.95±0.24,P＜0.05).Conclusion Subchronic aluminum exposure may reduce learning and memory in rats,and the accumulation of Aβ in cerebrospinal fluid may be related to the reduced protein expression of LRP-1 in the choroid plexus,suggesting that aluminum affects learning and memory in rats through reducing the protein expression of LRP-1,influencing the transportation of Aβ,and leading to the accumulation of Aβ.

Objective To investigate the impairment in primary cultured rat choroid plexus epithelial cells (CPECs) induced by aluminum.Methods The choroid plexus isolated from Sprague-Dawley rats 14 days old was cut into pieces and digested by trypsin in the sterile area.The obtained single cells were cultured in DMEM with 1％ epidermal growth factor and 20％ fetal calf serum.Five days later,immunohistochemistry with anti-transthyretin antibody was used to identify the purity of cultured cells.The well-grown cells were treated with aluminum lactate at different concentrations (0,100,400,and 1 600 μmol/L for control,low-dose,medium-dose,and high-dose groups).Forty-eight hours later,the cell viability,apoptotic rate,level of reactive oxygen species (ROS),and activity of superoxide dismutase (SOD) were measured in each group to evaluate the impairment in primary cultured rat CPECs by aluminum.Results More than 95％ of the cultured cells were identified as CPECs.The medium-and high-dose groups had significantly lower cell viability than the control group (86.74％±4.03％ vs 100％,P＜0.01;81.90％±9.17％ vs 100％,P＜0.01).The high-dose group had significantly lower cell viability than the low-dose group (81.90％±9.17％ vs 92.92％±8.81％,P＜0.01).The medium-and high-dose groups had significantly higher apoptotic rates than the control group (7.26％±0.99％ vs 1.29％±0.03％,P＜0.01;22.25％±1.55％ vs 1.29％±0.03％,P＜0.01) and the low-dose group (7.26％±0.99％ vs 1.68％±0.27％,P＜0.01;22.25％±1.55％ vs 1.68％±0.27％,P＜0.01).The high-dose group had a significantly higher apoptotic rate than the medium-dose group(22.25％±1.55％ vs 7.26％±0.99％,P＜0.01).The medium-and high-dose groups had significantly higher fluorescence intensity of ROS than the control group (22.23％±0.41％ vs 17.24％±0.09％,P＜0.05;25.10％±1.13％ vs 17.24％±0.09％,P＜0.05) and the low-dose group (22.23％± 0.41％ vs 18.31％±0.21％,P＜0.05;25.10％±1.13％ vs 18.31％±0.21％,P＜0.05).The high-dose group had significantly higher fluorescence intensity of ROS than the medium-dose group (25.10％±1.13％ vs 22.23％± 0.41％,P＜0.05).The low-,medium-and high-dose groups had significantly lower SOD activity than the control group[(28.65±0.74) U/g Hb vs (37.35±1.05) U/g Hb,P＜0.05;(22.75±1.94) U/g Hb vs (37.35±1.05) U/g Hb,P＜0.05;(13.29 ±0.64) U/g Hb vs (37.35 ± 1.05) U/g Hb,P＜0.05].The medium-and high-dose groups had significantly lower SOD activity than the low-dose group [(22.75±1.94) U/g Hb vs (28.65±0.74) U/g Hb,P＜ 0.05;(13.29±0.64) U/g Hb vs (28.65±0.74) U/g Hb,P＜0.05],while the high-dose group had had significantly lower SOD activity than the medium-dose group[(13.29±0.64) U/g Hb vs (22.75±1.94) U/g Hb,P＜0.05].There were no significant differences in cell viability,apoptotic rate,level of ROS,or activity of SOD between any other two groups (P＞0.05).Conclusion Aluminum lactate may induce impairment in primary cultured rat CPECs.It reduces the cell viability,elevates the apoptotic rate,and causes oxidative stress.

Objective:To evaluate the teaching effectiveness of independent experimental design from students' active learning behavior, and further provide the basis for advancing the reform of functional experimental teaching and teaching quality.Methods:In June 2019, 186 undergraduates (5-year-programme and 8-year-programme) of Xiangya School of Medicine were included in the teaching research. Self-administered questionnaires were applied to characterize students' active learning behavior in independent experimental design education. Spearman rank correlation analysis and Logistic regression analysis were used in the study. SPSS 23.0 was used for descriptive analysis of the data.Results:During the independent experimental design, 85.0%(158/186) of the students thought it was necessary and important to conduct independent experimental design education; 72.6%(135/186) of the students tentatively raised new scientific questions; 97.8%(182/186) of the students actively searched literature; 77.4%(144/186) of the students participated in reply positively. The value of correlation coefficient of actively learning behavior "tentatively raising new science questions" and teaching effectiveness "improving the ability of scientific thinking" was 0.81. And only 42.5%(79/186) of the students agreed that students needed to summarize after reporting.Conclusion:Independent experimental design education is welcomed and widely accepted by students, which has effectively improved the capacity for scientific research and innovation spirit of students. Whether students' active learning behavior can be fully mobilized in the education practice is closely related to the teaching effect. And the cultivation of leadership and leading consciousness still need to be improved.

Nonalcoholic fatty liver disease is a common chronic liver disease with the risk of progression to nonalcoholic hepatitis, liver fibrosis, and hepatocellular carcinoma. Nonalcoholic fatty liver disease has various pathogeneses, among which abnormal metabolism of branched-chain amino acids can induce oxidative stress, autophagy, and mitochondrial dysfunction in hepatocytes and is the most important mechanism in the development and progression of nonalcoholic fatty liver disease. This article reviews related research advances and analyzes the possible role of abnormal metabolism of branched-chain amino acids in the development and progression of nonalcoholic fatty liver disease, in order to improve clinical awareness and diagnosis.

OBJECTIVE: To investigate the effect of working time on the prognosis of patients with ischemic stroke undergoing intravenous thrombolysis. METHODS: Clinical data of 3050 patients with ischemic stroke received intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and September 2018 were retrospective analyzed. Whole day of Saturday and Sunday were defined as weekend; whole day of Monday to Friday were defined as weekdays; Monday to Friday 8:00-17:00 were defined as daytime of weekdays; Monday to Friday 17:01-07:59 on next day were defined as nights of weekdays; unconventional working time were defined as weekend and nights of weekdays. Good outcome was defined as mRS 0-2 at 3 months. Univariate analyses of baseline and prognostic variables in group of weekend and weekdays, nights of weekdays and daytime of weekdays, unconventional working time and daytime of weekdays were performed. Binary logistic regression was used to investigate whether weekend, nights of weekdays and unconventional working time were independent predicting factors of outcome after intravenous thrombolysis, respectively. RESULTS: There was no difference in 7-day mortality, 3-month mortality and good outcome at 3-month between weekend group and weekdays group, nights of weekdays group and daytime of weekdays group, unconventional working time group and daytime of weekdays group (all >0.05). Binary logistic regression results showed that weekends, nights of weekdays and unconventional working time were not independent predicting factors for outcome after intravenous thrombolysis (all >0.05). CONCLUSIONS The working time has not affected the outcomes of patients with ischemic stroke undergoing intravenous thrombolysis in studied hospitals of Zhejiang province.
Brain Ischemia ; drug therapy ; Humans ; Prognosis ; Retrospective Studies ; Stroke ; drug therapy ; Thrombolytic Therapy ; Time Factors