Objective To investigate the longitudinal systolic ventricular function of children with single ventricle, and to appraise the feasibility and clinical value of velocity vector imaging (VVI) on assessing it. Methods The study group consisted of 30 patients with functional single ventricle. The control group consisted of 30 age- and gender-matched normal children. Using Sequoia C512 echocardiography machine,the peak velocity(V),peak displacement(D) ,strain(S) ,and strain rate(SR) were measured. Results Basel and median velocities,as well as basel and median displacements of rudimentary chamber side(RCS), were lower than those of septum[Basel velocity (1. 93 ± 0. 71)cm/s vs (3. 53 ± 1. 07)cm/s;Median velocity (1.19±0. 57)cm/s vs (2. 03 ± 0. 90) cm/s; Basel displacement (2. 53 ± 1.65) mm vs (6.21 ± 2. 12)mm;Median displacement(1. 26 ± 1. 06)mm vs (3. 21 ± 1.37)mm]. The values of strain of all the six segments of single ventricle were significantly lower than Corresponding segments of the control group [ basel nonrudimentary chamber side(NRCS) ( - 16. 17 ± 4. 37) % vs ( - 19. 66 ± 3. 47) % ; Median NRCS ( - 15. 23 +4.36)% vs (-19.64± 4. 75)%; Apical NRCS (-13.84 ± 5.79)% vs ( - 16. 7 ± 4. 15)%; Basel RCS(-10. 54±5.35)% vs (-19.49±3. 74)%;Median RCS ( - 10. 16 ± 5. 26)% vs ( -20. 83 ± 3. 82)% ;Apical RCS ( - 10. 97 ± 5. 22) % vs C - 18. 11 ± 4.43) %]. Aside from basel strain rates of NRCS, strain rates of all the other five segments of single ventricle were significantly lower than Corresponding segments of the control group [Median NRCS ( - 1. 21 ± 0. 42)s-1 vs (- 1.49 ± 0. 24)s-1 ;Apical NRCS ( - 1.10 ±0.41)s-1 vs (-1.47 ± 0.24)s-1;Basel RCS ( - 1.07 ± 0. 35) s-1 vs (- 1. 49 ± 0. 22) s-1; Median RCS (-0.97± 0.34)s-1 vs ( -1.48 ± 0. 20)s-1 (Apical RCS ( - 0. 93 ± 0. 39)s-1 vs ( - 1. 48 ± 0. 22)s-1]. Conclusions Longitudinal systolic ventricular function is impaired in children with functionally single ventricle. VVI can be used to asses ventricular systolic performance in children with functionally single ventricular.

Objective To investigate the short axis systolic function of children with single-left ventricle(LV),and to appraise the clinical value of velocity vector imaging(VVI) on assessing it.Methods The study group consisted of 14 patients with single-LV.The control group consisited of 14 age-matched normal children.VVI was used to analyse the circumferential and radial strain and strain rate of regional single-LV at the level of papillary muscle.Results Compared with values in control group,single-LV circumferential strain values were significantly lower in anterior septum,posterior septum,anterior wall,lateral wall and inferior wall(all P ＜0.05).Single-LV circumferential strain rate values were significantly lower in anterior septum,posterior septum,anterior wall,lateral wall and posterior wall compared with controls(all P ＜0.05). In control group,circumferential strain and strain rate were higher in inferior septum and anterior septum compared with other segments( P ＜0.05).Single-LV radial strain values were significantly lower in all segments compared with values in control (P ＜ 0.05).In control group,radial strain and strain rate of papillary muscle level showed no significantly difference( P ＞0.05).Conclusions Circumferential and radial systolic ventricular function are impaired in children with single-LV.VVI can beused as a quantitative tool in evaluating the short axis systolic function of single-LV.

Objective To evaluate regional right ventricular function by ultrasonic strain rate imaging in postoperative children with conotruncal defects(CTD). Methods All 27 postoperative CTD children had magnetic resonance imaging evaluation of right ventricular end-diastolic volume and end-systolic volume to calculate right ventricular ejection fraction (RVEF). The ultrasonic parameters of peak systolic strain rate (SRs), peak early diastolic strain rate (SRe), peak late diastolic strain rate(SRa) and strain (S) were obtained at the basal,middle and apical segment in curve of right ventricular anterior wall in 27 postoperative CTD children and 27 normal children. The correlation between SRs,S and RVEF were evaluated. Results Compared with healthy children,SRs,S,SRe,SRa were significantly reduced in postoperative CTD children (P ＜ 0.01 ), there were different distribution rules between postoperative CTD children and normal children,and all indexes had no statistical descrepancy among the basal, middle and apical segment ( P ＞0.05). SRs in basal segment of the right ventricular anterior wall correlated well with RVEF ( r = 0.89,P ＜ 0. 01 ). Conclusions Regional right ventricular function still was reduced in postoperative CTD children, and could be accurately evaluated by ultrasonic strain rate imaging.

Objective To analyze the level of cardiac troponin I (cTnI) in children with left-to-right shunt congenital heart disease (CHD). Methods In this study, 146 children with secundum atrial septal (ASD) defect, 132 children with ventricular septal defect (VSD) and 300 healthy children were recruited. The levels of cTnI and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured and their correlation with clinical data was analyzed. Results The serum cTnI and NT-proBNP levels in both ASD and VSD patients were signiifcantly higher than those in normal children (H=3.89 and 5.27, P<0.01). The serum cTnI and NT-proBNP levels in VSD patients were signiifcantly higher than those in ASD patients (P<0.05). The ratio of pulmonary to systemic arterial pressure (Pp/Ps), pulmonary vascular resistance index (PVRI) and standardized left ventricular end diastolic volume in VSD patients were signiifcantly higher than those in ASD patients (P<0.05). Multiple regression analysis showed that Pp/Ps was signiifcantly correlated with cTnI in VSD patients. (β=0.81, SE=0.03, P=0.000). Conclusions Signiifcant volume and pressure overload due to a left-to-right shunt induce myocardial injury and could lead to irreversible myocardial remodeling in children with CHD. The serum cTnI level is a sensitive biomarker for myocardial damage in VSD patients.

Objective To prepare an in situ gel system for nasal delivery of menthol and to evaluate the safety of this formulation.Methods Menthol in situ gel was prepared with deacetylatedgellan gum.The nasal mucocilia toxicities of this formulation was evaluated using in situ toad palate model.Guinea pig skin sensitization test and the rabbit skin irritation test were conducted.Skin allergy and irritation reaction were monitored and scored.Results No significant effect on nasal mucosa ciliary movement and the morphology of rat nasal mucosa were observed.The formulation did not induce any dermal irritation in rabbits.Skin allergic reaction was not found in guinea pigs.Conclusion The preparation of menthol in situ nasal gel with low ciliary toxicity was easily achieved.This gel has good physiological flexibility.The further investigation was warranted for this formulation as an intranasal drug delivery system.

Objective To systematically evaluate the effect of intranasal dexmedetomidine on agita-tion during emergence from general anesthesia with sevoflurane in pediatric patients. Methods Pubmed, Embase, The Cochrane Library, China National Knowledge Infrastructure, VIP, Wan-Fang databases were searched for randomized controlled trials involving the effect of intranasal dexmedetomidine on agitation during emergence from general anesthesia with sevoflurane in pediatric patients from the start of their data-base until June 2017, and the reference lists of all included studies were checked manually. Data were ex-tracted independently by two reviewers, and primary evaluation indexes included the incidence of emergence agitation and sedation score. Secondary evaluation indexes included emergence time, extubation time, du-ration of post-anesthesia care unit stay, postoperative consumption of analgesics, incidence of adverse reac-tions ( such as bradycardia, nausea and vomiting, pruritus, laryngeal spasm) during recovery from anes-thesia. The quality of methodology of included studies was assessed. Meta-analysis was conducted with Rev-Man 5. 3 software. Results Eight randomized controlled trials involving 520 pediatric patients were includ-ed in this meta-analysis. Compared with placebo group, the incidence of emergence agitation was signifi-cantly decreased, sedation score was increased, extubation time was prolonged ( P<0. 05) , no significant change was found in the duration of post-anesthesia care unit stay or incidence of postoperative nausea and vomiting in intranasal dexmedetomidine group ( P>0. 05) . The emergence time was prolonged in intranasal 0. 3-1. 0 μg∕kg dexmedetomidine group ( P<0. 05 ) , and no significant change was found in emergence time in intranasal dexmedetomidine 1. 0-2. 0μg∕kg group ( P>0. 05) . Conclusion Intranasal dexmedeto-midine can decrease the occurrence of agitation during emergence from general anesthesia with sevoflurane and raise the quality of emergence in pediatric patients.

Dopamine is the precursor of biosynthesis of norepinephrine.Low-dose dopamine mainly excites dopamine receptors,which may dilate renal and mesenteric vessels,increase renal blood flow and improve the microcirculation.In recent years,low-dose dopamine has been widely applied in the field of kidney transplantation due to its vasoactive effect.However,with the development of evidence-based medicine,the role of dopamine in protecting the perfusion function of renal allograft in kidney transplantation has been questioned.Multiple studies have shown that dopamine brings no significant benefit to renal and cardiac function in kidney transplantation,exerts low pressor effect,and may even increase the risk of perioperative complications.Norepinephrine may be used as a safe substitute.In this article,recent progress in the effect of dopamine upon renal and cardiac function and hemodynamics during kidney transplantation was reviewed,aiming to provide reference for clinical application of dopamine in kidney transplantation.

Objective:To discuss outcomes of emergency repairing for Gustilo III B and III C fractures of forearm with complicated tissue defects and the related influence factors.Methods:From January 2014 to Feburary 2022, data of 98 cases of Gustilo III B and III C fractures with large compound defects of soft tissue, blood vessel, bone, tendon or muscle from elbow to wrist were collected. Primary debridement, bone fixation, wound coverage by free flap, bone transfer(or bone cement filling) or dynamic reconstruction of muscle were completed with emergency surgery in Department of Hand and Foot Microsurgery, Xi'an Fengcheng Hospital. Postoperative follow-ups were conducted through outpatient clinic visits, telephone and WeChat reviews. Video clips, questionnaires and the latest information of patients were also analysed. Rank sum test and Chi-square test were used to examine the relationship between independent variables such as general condition, disease condition and surgical procedures of chimeric tissue transfer group and simple flap transfer group, together with dependent variables such as limb salvage, number of surgery, wound healing, function scores, and complications. P<0.05 were further included in the regression equation to discover the relationship between multiple independent variables and dependent variables. Results:Follow-up lasted for 6-96 months, with an average of 71.1 months. In the chimeric group, the limb salvage rate was at 95.1%, with an infection rate of 8.50% and an average number of surgery was 2.13±0.89. In the simple flap transfer group, the limb salvage rate was at 87.5%, with an infection rate of 15.38% and an average number of surgery was 2.62±0.64. The good rate of Anderson score was 65.3% and the average score of Disability of the Arm, Shoulder and Hand(DASH) was 32.9(0-60) points for all the patients. There were significant differences in dependent variables of limb salvage and infection rate between the 2 groups ( P<0.05). Ischemia time and method of bone fixation led to significant differences in number of surgery ( P<0.05). Methods of bone fixation and the types of flap made significant differences in wound healing ( P<0.05). Underlying disease, bonedefect, Gustilo classification and method of bone fixation all contributed to the significant differences in function score ( P<0.05 or P<0.01) . Conclusion:Emergency surgery for repair of serious injury of forearm has a relatively high limb salvage rate and good functional effects. The limb salvage rate is not correlated with independent variables such as severity of injury, Mangledextremity Severity Score (MESS) and ischemia time, while transfer of a simple flap or a chimeric flap is significantly correlated with the limb salvage rate, infection and wound healing. The severity of injury, ischemia time and bone defect are correlated with functional assessment, number of surgery and bone healing.

Objective:To explore the mechanism of Honghua Xiaoyao Tablets in the treatment of premature ovarian failure (POF) using network pharmacology and molecular docking technology; To conduct further experimental verification.Methods:The active components and related targets of Honghua Xiaoyao Tablets were obtained using TCMSP and PubChem databases, and the related targets of POF were obtained by using GeneCards database. The Venn online tool was used to screen the intersection genes, and the STRING database was used to construct the PPI network. Then, GO function enrichment analysis and KEGG pathway enrichment analysis were performed on the intersecting genes through the Metescape database, and Cytoscape 3.7.1 software was used to construct the "active component-target" network and "Chinese materia medica-active component-target-key pathway-disease" network. Finally, molecular docking verification was carried out. Mice were divided into blank group, model group, and Honghua Xiaoyao Tablets group using a random number table method, with 8 mice in each group. Except for the blank group, mice in each group were treated with zona pellucida polypeptide 3 (ZP3) and Freund's Complete Adjuvant (FCA) to establish a mouse model of immune POF. Mice in the Honghua Xiaoyao Tablets group received Honghua Xiaoyao Tablets solution 0.56 g/kg for gavage, and the blank control group and the model group received saline for gavage for consecutive 4 weeks. The histopathological changes of the mouse ovary were observed by HE staining. Immunohistochemical staining was used to observe the expression of ESR1, and Western blot was used to detect the expressions of Akt and p-Akt.Results:A total of 80 intersection targets between Honghua Xiaoyao Tablets and POF were obtained, and the PPI network contained 44 core targets. The top 5 compounds in the topological analysis were formononetin, quercetin, Betulinic acid, Hydroxysafflor Yellow A and Baicalin, and the top 5 targets were PPARG, ESR1, AR, AKT1 and IL6. The molecular function of core genes was mainly receptor ligand activity, and its biological process mainly involved the positive regulation of cell migration. The cellular components mainly included membrane rafts, which were involved in signaling pathways such as cancer signaling pathway, proteoglycans in cancer, PI3K-Akt signaling pathway, and HIF-1 signaling pathway. "Chinese materia medica-component-target-pathway-disease" network showed that 8 kinds of Chinese materia medica in the Honghua Xiaoyao Tablets had important core components, among which Glycyrrhizae Radix et Rhizoma and Carthami Flos involved the most important core components. Molecular docking results showed that the active components had a good affinity with the core target. The experimental verification confirmed that Honghua Xiaoyao Tablets promoted follicular development, increased the expression of ESR1 in ovarian tissues and up-regulated the expression level of the key factor of Akt phosphorylation in the PI3K-Akt signaling pathway.Conclusions:The various active components of Honghua Xiaoyao Tablets may act on PPARG, ESR1 and other targets through multiple signaling pathways such as PI3K-Akt and HIF-1 to treat POF. The potential active components are mainly formononetin, quercetin, etc.

Objective To analyze the detection efficiency of p16INK4a protein combined with human papillomavirus and liquid-based cytology(LCT)in the screening of cervical precancerous lesions,and to provide a basis for cervical cancer preven-tion and treatment.Methods The results of p16INK4a staining of cervical epithelial cells,human papillomavirus testing and cer-vical cytology were analyzed in 139 inpatients at Guangzhou Women's and Children's Medical Center between January 2019 and December 2020.Of them,there were 111 patients with cervical intraepithelial neoplasia(CIN)and 28 cases of cervical inflam-matory disease.The efficacy of the three methods alone and in combination to screen for CIN lesions was compared.Results In the detection of CIN patients,the sensitivity of p16INK4a,microfluidic microarray and cervical cytology for detecting CIN and a-bove lesions was 91.89% ,94.59% and82.88% ,with specificity of 57.14% ,17.86% and46.43% ,and AUC of 0.75,0.56 and 0.65,respectively;while the sensitivity of"p16INK4a+LCT","p16INK4a+hrHPV","LCT+hrHPV"and their sen-sitivity were 96.40% ,97.30% ,94.59% and 99.10% ,their specificity was 85.71% ,92.86% ,89.29% and 92.86% ,and the AUC was 0.91,0.95,0.92 and 0.96,respectively.Conclusion The combined p16INK4a and hrHPV test helps to improve diagnostic accuracy and early detection,thus allowing for earlier intervention or treatment.This combined application allows for more accurate identification of low-grade and high-grade cervical intraepithelial neoplasia,providing more information for indi-vidualized patient management.