Objective:To investigate the diagnosis and treatment for incarceration of retroverted uterus in pregnant women.Methods:This study retrospectively recruited four gravidas with incarcerated retroverted uterus indicated by prenatal ultrasonography in Hunan Provincial Maternal and Child Health Care Hospital from August 2016 to February 2020. Clinical features, diagnosis, and treatment of these cases were described.Results:Vaginal bleeding or discharge were the main symptoms of the four cases and prenatal ultrasound suggested incarcerated retroverted uterus. Obstetric examination was performed for all cases, except one due to small gestational age, and bulging posterior fornix was found in one case. Three cases were diagnosed in the third trimester and one at 14 gestational weeks. In light of gestations, symptoms, and anterior uterine muscle thickness, three patients underwent planned cesarean sections with a median abdominal incision and a superior transverse uterine incision after fetal lung maturation acceleration. Uterus involution was good, and the incisions healed well in these three cases, with all neonates in good condition. Following a two-week knee-chest position treatment, the position of her uterus and bladder turned normal in case 4.Conclusions:Considering the atypical clinical presentations, clinicians should be aware of incarceration of retroverted uterus when related symptoms or signs were presented. Placenta previa might be the comorbidity and should be differentially diagnosed. The timing of a cesarean section is supposed to be determined based on multiple factors. Moreover, a median abdominal incision and a superior transverse uterine incision are recommended, and an anatomic landmark is often required for the latter's accurate position.

The chemical structures of mequindox related metabolites in chicken plasma had been investigated using high performance liquid chromatography combined with linear ion trap quadrupole(LC-ESI/LTQ) and high performance liquid chromatography combined with ion trap-time of flight-mass spectrometry (LC-ESI/IT-TOF).Samples were separated by Hypersil BDS C_(18) and symmetry Shield columns, respectively, and 0.01% formic acid aqueous(A) and methanol(B) were used as mobile phase with gradient elution.Electros pray ionization mass spectrometric(ESI) source was used and operated in positive ion mode.When chickens were orally administered with mequindox at dosage of 20 mg/kg, blood samples were collected from the brachi al vein.Mequindox and its metabolites were extracted by the mixture of acetonitrile and acetoacetate (3:2, V/V).After solvent evaporated, the residue was dissolved in 30% methanol aqueous and the solution was detected by LC/IT-TOF MS and LC-ESI/LTQ.The molecule weight from LC-ESI/IT-TOF was analyzed by software Shimadzu's Composition and the mass chromatogram from LC-ESI/LTQ was analyzed by software Xcalibur 2.0.7.According to the molecular weight and MS~n data, referring the metabolic reaction rules, five chemical structures of mequindox related metabolites in chicken plasma were identified.Metabolites (M1-M4) were synthesized to verify the structure of metabolites.The metabolites are 3-methyl-2-(1-hydroxy) ethyl-qui-noxaline-N~1,N~4-dioxide(Ml), 3-methyl-2-(1-hydroxy) ethyl-quinoxaline-N~4-oxide(M2), 3-methyl-2-acetyl-quinoxaline-N~4-oxide, 3-methyl-2-acetyl-quinoxaline (M4), 3-hydroxymethyl-2-(1-hydroxy) ethyl-quinoxa-line-N~1,N~4-dioxide (M5).

SIRT3, SIRT4 and SIRT5 are located in mitochondria and also known as mitochondrial sirtuins. They play important roles in regulating many cellular functions including cell survival, cell cycle or apoptosis, DNA repair and metabolism. Mitochondrial sirtuins are involved in the protection of mitochondrial integrity and energy metabolism under stress regulating the expression of neurotransmitter receptors, neurotrophins, extracellular matrix proteins and various transcription factors, thus involved in epileptogenesis triggered by both genetic or acquired factors. Here we review research progress on the actions of mitochondrial sirtuin in epilepsy; and discuss the challenges and perspectives of mitochondrial sirtuin as a potential therapeutic target for epilepsy.
Apoptosis ; Epilepsy/genetics* ; Humans ; Mitochondria/genetics* ; Sirtuin 3 ; Sirtuins

To explore the correlation between the cognitive functions and syndromes of traditional Chinese medicine (TCM) in amnestic mild cognitive impairment (aMCI), and to provide evidence for clinical syndrome differentiation treatment.

OBJECTIVETo construct a lectin-like oxidized low-density lipoprotein receptor (LOX-1) RNA interference (RNAi) lentivirus and explore the role of LOX-1 in H(2)O(2)-induced apoptosis of rat myocardial cells.

METHODSLOX-1 shRNA sequence was synthesized and cloned into pLentiLox3.7 (pLL3.7) lentiviral vector to construct the lentiviral vector pLL3.7-LOX1. The lentiviral vectors (pLL3.7 and pLL3.7-LOX1) and the packaging vectors dR8.9 and VSVG were co-transfected into 293FT cells for packaging the lentivirus. H9C2 myocardial cells were infected by the lentiviruses to observe the inhibitory rate of LOX-1 on H(2)O(2)-induced apoptosis of H9C2 cells by RT-PCR, CCK-8, and Hochest33258 staining.

RESULTSDouble restriction enzyme digestion and DNA sequencing confirmed correct insertion of the sequence. Suppression of LOX-1 by the lentivirus attenuated H(2)O(2)-induced cell viability reduction and apoptosis in the myocardial cells (P<0.01).

CONCLUSIONLOX-1 activation may play an important role in H(2)O(2)-induced apoptosis of rat myocardial cells.

Animals ; Apoptosis ; physiology ; Cells, Cultured ; Genetic Vectors ; genetics ; Hydrogen Peroxide ; Lentivirus ; genetics ; Myocytes, Cardiac ; cytology ; Oxidative Stress ; RNA Interference ; RNA, Small Interfering ; genetics ; Rats ; Scavenger Receptors, Class E ; genetics

Objective:The study was planned to evaluate the clinical utility of microcytic anemia factor (MAF) and low hemoglobin density (LHD%) in the screening of iron deficiency in blood donors.Methods:A total of 400 blood donors, 200 male and 200 female, were randomly admitted to Fujian Blood Center from January1, 2022 to February 28, 2022 by the way of stratified sampling. According to the fourth edition of Diagnostic and therapeutic criteria for hematological diseases, the patients were divided into three groups: normal group (N=299), iron depletion group (ID, n=54) and iron deficient erythropoiesis group (IDE, n=47), Blood routine indexes including hemoglobin (HGB), mean corpuscular volume hemoglobin (MCV), mean corpuscular hemoglobin content (MCH), mean corpuscular hemoglobin concentration (MCHC) and iron metabolism indexes including serum ferritin (SF), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TS) and unsaturated iron binding capacity (UIBC) were measured, MAF and LHD% were calculated by formula.One-way ANOVA or Kruskal-Wallis H tests were used to analyze the differences among three groups. Spearman correlation analysis was used to analyze the correlation between MAF and LHD% and iron metabolism indexes.The Receiver Operating Characteristic (ROC) curve was used to evaluated the diagnostic value of MCH, MCHC, MAF and LHD% for iron deficiency in blood donors. Results:MAF in ID group which was 11.81±0.81 were higher than the IDE group which was 10.69±0.95 and lower than the healthy group which was 13.17±1.24, the total difference among the three groups was statistically significant ( F=110.784, P<0.001), the difference between two groups was statistically significant ( P<0.01); LHD% in ID group which was 2.61 (1.87, 3.91)% were lower than the IDE group which was5.60(2.99, 8.02)% and higher than the healthy group which was1.74 (1.22, 2.73)%, the total difference among the three groups was statistically significant ( H=62.166, P<0.001), the difference between two groups was statistically significant ( P<0.01).In 101 iron deficiency blood donors, Spearman correlation analysis showed that MAF was positively correlated with SF, SI and TS ( r=0.426, P<0.01; r=0.547, P<0.01; r=0.566, P<0.01);contrarily, LHD% was negatively correlated with SF, SI and TS ( r=-0.397, P<0.01; r=-0.400, P<0.01; r=-0.479, P<0.01).The areas under the ROC curve of MCH, MCHC, MAF and LHD% diagnostic ID were 0.745, 0.646, 0.819 and 0.646, respectively;the cut-off value of MAF was 12.56, with a sensitivity of 67.90% and a specificity of 83.30%.While the areas under the ROC curve of MCH, MCHC, MAF and LHD% diagnostic IDE were 0.901, 0.834, 0.941 and 0.834, respectively; the cut-off value of MAF was 11.73, with a sensitivity of 87.60% and a specificity of 87.20%. Conclusions:MAF performed a high diagnostic value of iron deficiency, especially IDE, and can be used as a marker in the diagnosis of iron deficiency in blood donors.

Objective To explore MRI manifestations of extrapleural solitary fibrous tumor(SFT)and to analyze the reasons of misdiagnosis.Methods MRI data of 9 cases with extrapleural SFT proved by pathology were analyzed retrospectively.Lesions location, size,shape,intensity,degrees and patterns of enhancement were assessed,and the imaging features and causes of misdiagnosis were also analyzed.Results Among 9 lesions,1 was located in the right cerebellopontine angle region,2 were in subdural-extramedullary region,4 were in the abdominal cavity and 2 were in the pelvic cavity.7 cases were misdiagnosed before operation including 1 as meningioma, 2 as schwannoma,2 as mesenchymal stem cell tumor,1 as pancreatic carcinoma and 1 as Castleman disease.8 lesions were isointense and 1 was mixed iso-or slightly hyperintense on T1WI.3 lesions were isointense,4 were mixed iso-or slightly hyperintense and 2 were mixed slightly hyperintense,iso-or hypointense on T2WI.3 lesions showed significant homogeneous enhancement after the administration of contrast agent,1 lesion showed varying degrees of enhancement and the enhancement was more remarkable in isointense area on T2WI than peripheral hyperintense area.4 lesions showed heterogeneous peripherial enhancement in the early phase,progressive filling in the late phase and finally remarkable homogeneous enhancement.1 lesion showed predominant peripheral striped enhancement in the early phase,and progressive filling and mildly inhomogeneous enhancement with patchy unenhanced area in the center of the lesion in the late phase.Conclusion The MRI features of extrapleural SFT have certain characteristics.It needs to be carefully diagnosed to improve the diagnostic accuracy.

Objective:To explore the efficacy of tracheotomy and nasal intubation in airways management in treatment of patients with respiratory failure caused by severe tetanus.Methods:A respective case series study was conducted to analyze the data of 92 patients with respiratory failure caused by severe tetanus admitted to Jiangxi Chest Hospital from January 2012 to December 2019. There were 60 males and 32 females, aged 23-81 years [(47.5±14.1)years]. Overall 43 patients underwent tracheotomy (tracheotomy group), and 49 patients underwent nasal intubation (nasal intubation group). The blood gas related indexes (PaO 2, PaCO 2), catheter retention time, incidence of complications such as airway bleeding, nasosinusitis, catheter blockage and ventilator-associated pneumonia (VAP), and clinical outcome were compared between the two groups. Results:After mechanical ventilation, the PaO 2 and PaCO 2 in both groups were significantly improved ( P<0.01), with no significant difference between groups ( P>0.05). Both groups were similar regarding the catheter indwelling time, catheter blockage, airway bleeding and nasosinusitis ( P>0.05). The incidences of VAP and catheter blockage after extubation in tracheotomy group [12%(5/43), 12%(5/43)] were significantly different from those in nasal intubation group [0%(0/49), 31%(15/49)] ( P<0.05). There were 3 deaths in each group, with the mortality rate of 7% (3/43) in tracheotomy group and of 6% (3/49) in nasal intubation group ( P>0.05). Both groups of live tetanus patients were cured. After 3-month follow-up, the tetanus was cured in the two groups. Conclusions:The tracheotomy and transnasal tracheal intubation are optional for severe tetanus patients with respiratory failure. The former has airway and tissue trauma, but it is convenient for mechanical ventilation management, especially indicated for patients with severe convulsions, angular arch reflexes, poor sedation, and continuous application of muscle relaxants. Nasal intubation is relatively non-invasive, simple and fast method, but the prevention and monitoring of VAP requires higher requirements.

【Objective】 To investigate the variation of hematological parameters in male plateletpheresis donors. 【Methods】 A total of 194 male plateletpheresis donors from Fujian Blood Center were divided into two groups according to the frequency of blood donation: Group 1 (n=107), with the number of plateletpheresis donation less than or equal to 12 per year; Group 2 (n=87), with the number of plateletpheresis donation more than 12 per year. Serum ferritin (SF) and related iron metabolism indexes, red blood cell count (RBC), hemoglobin (Hb), hematocrit(Hct), platelet count (Plt) and other blood routine indexes, as well as percentage of reticulocyte counts (RET%), immature reticulocyte fraction(IRF) and other reticulocyte indexes were measured before blood donation and analyzed by statistical methods. 【Results】 Compared with Group 2, the RBC, Hb, Hct, SF in Group 1 were significantly higher, while Plt, RET%and IRF were significantly lower(P<0.05), and the probability of ferritin decrease in Group 1 was lower, with significant difference(P<0.05). 【Conclusion】 As the number of donation increased, male plateletpheresis donors were prone to iron deficiency, and the bone marrow hematopoiesis were obviously enhanced. We should be more concerned about male plateletpheresis donors who donated more than 12 times per year, further more, SF monitoring should be conducted and the blood donation interval should be appropriately extended.

Objective To investigate distribution and antimicrobial resistance among nosocomial pathogens from 13 teaching hospitals in China in 2009. Methods Non-repetitive pathogens from nosocomial BSI, HAP and IAI were collected and sent to the central lab for MIC determination by agar dilution method.WHONET5.6 software was used to analyze the data. Results A total of 2 502 clinical isolates were collected. The top three pathogens of BSI were Escherichia coli [27. 1% (285/1 052 )] , coagulase-negutive staphylococcus [12. 6% ( 133/1 052)] and Klebsiella pneumoniae [10. 8% ( 114/1 052)]. The top three pathogens of HAP were Acinetobacter baumannii [28. 8% (226/785)], Pseudomonas aeruginosa [16. 1% (126/785)] and Klebsiella pneumoniae [14.6% (115/785 )] . The top three pathogens of IAI were Escherichia coli[31.0% ( 206/665 )], Klebsiella pneumonia [11.3% ( 75/665 )] and Enterococcus faecium [10. 8% (72/665)]. Against Escherichia coil and Klebsiella spp. , the antimicrobial agents with higher than 80% susceptibility rate included imipenem and meropenem (98. 1%-100% ), tigecycline (95.3%-100% ), piperacillin-tazobactam ( 88.6% -97. 1% ) and amikacin ( 88. 3% -92. 5% ). Against Enterobacter spp. , Citrobacter spp. and Serratia spp. , the susceptibility rates of tigecycline were 93.5% -100% whereas the value of imipenem and meropenem were 92.9% -100%. Other antimicrobial agents with high activity included amikacin ( 85.2% -96. 7% ), pipcracillin-tazobactam ( 82.4% -96.4% ), cefepime ( 79. 6% -96. 7% ) and cefoperazonc-sulbactam (78. 7%-90. 0% ). Polymyxin B showed the highest susceptibility rateagainst Pseudomonas aeruginosa ( 100% ), followed by amikacin ( 81.9% ) and piperacillin-tazobactam (80.1% ). Polymyxin B also showed the highest susceptibility rate against Acinetobacter baumannii (98. 8% ), followed by tigecycline (90. 1% ) and minocycline (72. 0% ). The incidence of carbapenemresistant Acinetobacter baumannii was 60. 1%. The MRSA rate was 60. 2% and the MRSCoN rate was 84. 2%. All Staphylococcus strains were susceptible to tigecycline, vancomycin, teicoplanin and linezolid except for one isolate of Staphylococcus haemolysis with intermediate to teicoplanin. Two Enterococcus faecalis isolates which were intermediate to linezolid and one Enterococcus faecium isolate which was resistant to vancomycin and teicoplanin was found in this surveillance, while the MICs of tigecycline against these three isolates were 0. 032-0. 064 μg/ml. Conclusions Tigecycline, carbapenems, piperacillin-tazobactam,amikacin and cefepime remain relatively high activity against nosocomial Enterobacteriaceae. Pseudomonas aeruginosa exhibite high susceptibility to polymyxin B, while Acinetobacter baumanni shows high susceptibility to polymyxin B and tigecycline. Tigecycline, vancomycin, teicoplanin and linezolid remain high activity against nosocomial gram-positive cocci.