Objective To observe and assess the clinicopathological significance of smooth muscle differentiation in breast cancer stromal fibroblasts. Methods A monoclonal antibody recognizing ? smooth muscle actin was used to determine the smooth muscle differentiation of fibroblasts in 69 breast cancer(BC) tissues, compared with 8 breast tissues which were removed more than 5cm from the cancer margin comfirmed without cancer cells. The relationship between the smooth muscle differentiation and clinicopathological parameters including age, tumor size, lymph node metastatic status, histological grade and ER receptor status in invasive BC were analyzed. Results Stromal fibroblasts smooth muscle differentiation was defined in 55.0% of the invasive breast cancer tissues,whereas no immunostain was demonstrated in histological normal samples. Twenty eight of the 41 cases(68.3%) with matastatic lymph nodes showed stromal fibroblasts smooth muscle differentiation,which more than that of without lymphatic metastasis group (26.3%,P

Objective To investigate the merit and feasibility of vasoactive drugs by the double atrial infusion in children with congenital heart disease combined with pulmonary hypertension.Methods Ninety cases of congenital heart disease combined with pulmonary hypertension were randomly selected.One group(45 cases) was infused by double atrialadministration,which left atrium for catecholamines,and right atrial infusion for highly targeted expansion of pulmonary vascular drugs,such as prostaglandin E1.Another group(45 cases) was infused through the right atrium by a central venous to catecholamines and pulmonary vascular dilatation drugs.Cardiac output(CO) and cardiac index were measured by thermal dilution method and systemic vascular resistance and pulmonary vascular resistance(PVR) were calculated.Results Three cases were dead in early postoperative period(1 week),which were central intravenous group.2 cases with total anomalous pulmonary venous drainage had low co after operation,include 1 case through the left atrium,and the other case through central venous administration,and were recovered.There was no long-term mortality.There was no significant difference in CPB time,blocking time,the amount and timing of vasoactive drugs in two groups (P ＞ 0.05).Conclusion Double atrial infusion of vasoactive drugs can significantly reduce the mean pulmonary artery pressure and pulmonary vascular resistance,and increase CO,which is better than the traditional central intravenous methods.The treatment method is of very important significance.Thus double atrial infusion is safe and feasible.

Objective:To study the clinical manifestations and genetic characteristics of neonatal-onset primary mitochondrial disease (PMD) caused by nuclear gene mutations.Methods:From May 2020 to March 2022, the clinical data, genetic results and follow-up information of neonates with PMD admitted to the Department of Neonatology of our two hospitals were retrospectively analyzed.Results:A total of 4 patients were enrolled, all with hyperlactatemia and metabolic acidosis. In case 1, the fetal cranial MRI showed agenesis of corpus callosum. In case 2, echocardiography after birth indicated hypertrophic cardiomyopathy. Whole exome sequencing found the following mutations: EARS2 nuclear gene c.1294C>T and c.971G>T variants, COA6 nuclear gene c.411_412insAAAG variant, ACAD9 nuclear gene c.1278+1G>A and c.895A>T variants, FOXRED1 nuclear gene c.1054C>T and c.3dup variants. Mitochondrial second-generation sequencing and multiplex ligation-dependent probe amplification showed no abnormalities. Cases 1 and 3 died during the neonatal period. Case 2 died at 2-year-and-2-month of age. Case 4 was followed up to 1 year of age with developmental delay.Conclusions:The main phenotypes of neonatal-onset PMD caused by nuclear gene mutations are hyperlactatemia, refractory metabolic acidosis and cardiomyopathy, which have a poor prognosis. Proactive genetic tests are helpful for early diagnosis.

Objective To investigate the protective effect of artesunate on hypoxic-ischemic brain damage (HIBD) and its mechanism in neonatal rats. Methods 7-day-old neonatal SD rats were randomly divided into sham operation group, model group, artesunate 5 mg/kg group, artesunate 10 mg/kg group, artesunate 20 mg/kg group and dexamethasone 6 mg/kg group, with 18 rats in each group. HIBD models were established in groups except for the sham operation group. The sham operation group only needed to separate the left common carotid artery without ligation and nitrogen-oxygen mixed gas ventilation. Each group was injected with drug intraperitoneally right after surgery and the rats in the sham operation group and the model group were injected with an equal volume of normal saline (once a day for a total of 5 times). One hour after the last injection, the rats in each group were scored for neurological defects. After the rats were sacrificed, the brain water content was measured and the pathological changes of the brain tissues of rats were observed. Terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) was used to detect the neuronal cell apoptosis, and ELISA was applied to detect the levels of IL-1β, IL-6 and TNF-α in brain tissues and peripheral blood of each group of rats. Western blot analysis was adopted to detect the protein expression levels of NLR family pyrin domain containing 3 (NLRP3), apoptosis-associated speck-like protein containing CARD (ASC) and caspase-1 in the rats brain tissues of each group. Results Compared with the model group, the neurological deficit score was decreased; the pathological damage of brain tissues was relieved; the brain water content was significantly reduced; the apoptosis number of hippocampal neurons was decreased significantly; the levels of IL-1β, IL-6 and TNF-α in brain tissues and peripheral blood were significantly reduced; the protein expression levels of NLRP3, ASC and caspase-1 were significantly lowered in the middle-dose and high-dose artesunate groups and the dexamethasone group. Conclusion Artesunate can improve the neurological function, relieve the brain damage, and alleviate the brain edema in neonatal rats with HIBD. It can protect the HIBD, which may be related to the inhibition of NLRP3 inflammasome activation and reduction of inflammatory cytokine secretion.
Animals ; Rats ; Animals, Newborn ; Artesunate/pharmacology* ; Brain/metabolism* ; Caspases/metabolism* ; Dexamethasone ; Hypoxia-Ischemia, Brain/pathology* ; Inflammasomes ; Interleukin-6/metabolism* ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha/metabolism* ; Water/metabolism*

The magnetic anchoring lung nodule positioning device is composed of a target magnet, an anchor magnet, a coaxial puncture needle and a puncture navigation template, through these, a new type of accurate positioning technology for small pulmonary nodules is derived. The device inserts the target magnet into the both sides nearby the lung nodule under the guidance of CT. Helped by the mutual attraction of the two target magnets, they can be fixed in the lung tissue, avoiding the movement in the lung, and accurately positioning the target lung nodule before surgery. In thoracoscopic surgery, the anchor magnet and the target magnet attract each other to achieve the purpose of positioning the target nodule. The device uses the characteristics of non-contact suction of magnetic materials biomedical engineering technology, eliminating the previous procedure of direct interaction with the positioning marks, finally achieves the target of precise positioning of lung nodules and rapid surgical removal.
Humans ; Lung ; Lung Neoplasms ; Magnetic Phenomena ; Magnets ; Solitary Pulmonary Nodule ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed

Objective: To analyze the clinical effect of right subaxillary small incision approach on children with congenital heart disease (CHD). Methods: Eighty-six patients with CHD admitted to Henan Children′s Hospital from January 2015 to September 2017 were enrolled in this study.The patients were randomly divided into the control group and the observation group with 43 cases each group.The control group underwent sternal median incision, and the observation group underwent right subaxillary small incision.The total effective rate, incision satisfaction, general conditions of surgery (cardiopulmonary bypass time, operation time, aortic occlusion time, intraoperative blood loss), postoperative related conditions (thoracic drainage volume, postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, hospitalization expenses), Wong-Baker facial expression scale (FPS-R) score, as well as the respiratory function index including the levels of peak inspiratory pressure (PIP) and alveolar-arterial oxygen pressure difference [p_(A-a) (O₂)]after anesthesia (T₁), after operation (T₂), at admission to intensive care unit (T₃) and before extubation (T₄) and complication rate between 2 groups were compared. Results: (1)The incision satisfaction in the observation group [90.70% (39/43 cases)] was higher than that in the control group [62.79% (27/43 cases)], and the difference was statistically significant (χ²=9.382, P=0.002). (2)There was no significant difference in the the extracorporeal circulation time, operation time and aortic block time between the two groups [observation group: (68.94±8.26) min, (2.33±0.21) h, (28.79±7.32) min; control group: (67.11±9.11) min, (2.25±0.31) h, (30.02±6.88) min] (P>0.05). (3)The intraoperative blood loss [(89.87±11.25) mL] in the observation group was less than that in the control group [(105.91±31.01) mL], which difference was statistically significant (t=3.189, P=0.002). (4)Also there was significant difference in postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, thoracic drainage volume and hospitalization expenses between the two groups (the observation group: postoperative monitoring time (30.55±10.39) h, postoperative assisted ventilation time [(9.68±2.19) h, hospitalization time (9.61±2.17) d, thoracic drainage volume (90.36±26.14) mL, hospitalization expenses (36 956.15±1 097.84) yuan; the control group: (41.39±9.93) h, (12.72±3.81) h, (12.33±3.15) d, (163.24±29.36) mL and (45 271.97±1 134.55) yuan] (t=4.946, 4.536, 4.663, 12.157, 34.540, all P<0.01). (5)FPS-R scores at 1, 2, 3, 4 d postoperatively in the observation group were (4.02±0.41), (3.41±0.15), (2.55 ±0.20) and (1.16±0.27) points, while those in the control group were respectively (5.21±0.89), (5.02±0.63), (4.12±0.67) and (3.05±0.39) points, which differences were statistically significant (t=7.963, 16.302, 14.724, 26.128, all P<0.01). (6)There was no significant difference in p_(A-a) (O₂) and PIP between the two groups at T1, T2, T3 and T4 (all P>0.05). There was no significant difference in the complication rate between the observation group [6.98% (3/43 cases)] and the control group [4.65% (2/43 cases)] (χ²=0.000, P>0.05). Conclusions Right subaxillary small incision approach does not affect the respiratory function of children with CHD, which can improve the satisfaction of incision, reduce the amount of blood loss, accelerate postoperative recovery of children, relieve postoperative pain, and reduce the financial burden of parents.Besides, intra-operative proficient and accurate operations can reduce or avoid the occurrence of related complications and ensure the safety of surgery.