Objective To investigate the effect of ropivacaine on biological behavior of gastric cancer BGC-823 cells and AMP activated protein kinase(AMPK)/nuclear factor E2-related factor 2(Nrf2)signaling path-way.Methods Gastric cancer BGC-823 cells were cultured in vitro.When BGC-823 cells were cultured to log-arithmic growth phase,they were divided into control group(routine culture),cisplatin group(medium con-taining 5 mg/L cisplatin),and low-level(medium containing 25 mg/L ropivacaine),medium-level(medium containing 50 mg/L ropivacaine),and high-level(medium containing 100 mg/L ropivacaine)ropivacaine groups.The cells were cultured for 48 h.Cell counting kit-8(CCK-8)was used to detect the survival rate of BGC-823 cells.Transwell chamber assay was used to detect the invasion ability of BGC-823 cells.The apopto-sis rate of BGC-823 cells was detected by flow cytometry.The mRNA levels of AMPK and Nrf2 in BGC-823 cells were detected by real-time fluorescence quantitative PCR(qPCR).The protein levels of AMPK and Nrf2 in BGC-823 cells were detected by Western blot.Results Compared with the control group,the survival rate,invasion number,AMPK and Nrf2 mRNA and protein levels of BGC-823 cells in the cisplatin group and the low-level,medium-level and high-level ropivacaine groups were decreased(P＜0.05),while the apoptosis rate was increased(P＜0.05).Compared with the cisplatin group,the survival rate,invasion number,AMPK and Nrf2 mRNA and protein levels of BGC-823 cells in the low-level,medium-level and high-level ropivacaine groups were increased(P＜0.05),while the apoptosis rate was decreased(P＜0.05).Compared with the low-level ropivacaine group,the survival rate,invasion number,AMPK,Nrf2 mRNA and protein levels of BGC-823 cells in the medium-level and high-level ropivacaine groups were decreased in oder(P＜0.05),while the apop-tosis rate was increased in oder(P＜0.05).Conclusion Ropivacaine could inhibit the survival and invasion of BGC-823 cells and promote the apoptosis of BGC-823 cells,which may be related to the inhibition of AMPK/Nrf2 signaling pathway.

Objective:To explore the clinical phenotype and genetic basis of a child with Neutral lipid storage disease with myopathy (NLSDM).Methods:A child who was admitted to the First Affiliated Hospital of Zhengzhou University in February 2021 for a history of elevated creatine kinase (CK) for over 2 months was selected as the study subject. Clinical and laboratory examinations were carried out, and the child was subjected to whole exome sequencing. Candidate variants were validated by Sanger sequencing of her family members.Results:The patient, a 9-year-old female, had exhibited weakness in the lower limbs, elevated CK level, and refractory cardiomyotrophy. Genetic testing revealed that she has harbored c. 32C>G (p.S11W) and c. 516C>G (p.N172K) compound heterozygous variants of the PNPLA2 gene, which were respectively inherited from her mother and father. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), both variants were rated as likely pathogenic (PM1+ PM2_Supporting+ PP3+ PP4). Conclusion:The c. 32C>G (p.S11W) and c. 516C>G (p.N172K) compound heterozygous variants of the PNPLA2 gene probably underlay the myasthenia gravis and elevated creatine kinase in this child.

Objective:To explore the genetic etiology of fetuses with congenital heart disease (CHD) through whole exome sequencing (WES).Methods:Thirty seven fetuses identified with CHD by prenatal ultrasonography but with negative results by chromosomal microarray analysis (CMA) at Jinhua Maternal and Child Health Care Hospital from January 2020 to June 2022 were selected as the study subjects, for whom WES was carried out.Results:WES and Sanger sequencing had detected 6 pathogenic or likely pathogenic variants, and 6 variants with unknown clinical significance. The variants had involved 15 loci within 11 genes, in addition with one copy number variation.Conclusion:WES can increase the detection rate for genetic abnormalities among fetuses with CHD, which can facilitate the prenatal diagnosis, evaluation of prognosis and genetic counseling for the couples.

Objective:To analyze the significance and factors influencing of CT scan under the modified Valsalva maneuver. Methods:Clinical data of 52 patients with hypopharyngeal carcinoma diagnosed from August 2021 to December 2022 were collected, all patients had calm breathing CT scan and modified Valsalva maneuver CT scan. Compare the exposure effect of the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall, and glottis with each CT scanning method. The effects of age, neck circumference, neck length, BMI, tumor site, and T stage on the exposure effect were analyzed. Results:In 52 patients, 50 patients（96.15%） completed CT scan at once time. The exposure effect of the CT scan under modified Valsalva maneuver in the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall was significantly better than CT scan under calm breathing（Z=-4.002, -8.026, -8.349, -7.781, -8.608, all P<0.01）, while CT scan under modified Valsalva maneuver was significantly worse in glottis than CT scan under calm breathing（Z=-3.625, P<0.01）. In the modified Valsalva CT scan, age had no obvious effect on the exposure effect. The exposure effect was better with long neck length, smaller neck circumference, smaller BMI and smaller T stage. The exposure of postcricoid carcinoma was better than pyriform sinus carcinoma and posterior hypopharyngeal wall carcinoma. But differences were not all statistically significant. Conclusion:The anatomical structure of the hypopharynx was clearly under CT scan with modified Valsalva maneuver, which clinical application is simple, but the effect of glottis was worse. The influence of age, neck circumference, neck length, BMI, and tumor T stage on the exposure effect still needs further investigation.
Humans ; Hypopharynx/diagnostic imaging* ; Valsalva Maneuver ; Hypopharyngeal Neoplasms/surgery* ; Tomography, X-Ray Computed ; Carcinoma

Objective:To explore the correlation between parents′ posttraumatic growth, mental resilience and family functioning in children with autism spectrum disorder.Methods:Using the convenience sampling method, 169 parents of children with autism spectrum disorders were selected. General data questionnaire, Posttraumatic Growth Inventory (PTGI), Conner-Davidson Resilience Scale (CD - RISC) and Family Assessment Device (FAD) were investigated.Results:The total PTGI score of parents of children with autism spectrum disorder was 58.79±18.92. The scores of appreciation of life, new possibilities, personal strength, relating to others and spiritual change were 19.49±6.15, 10.46±4.59, 9.05±3.32, 7.79±3.65, 12.01±3.83. The PTGI score of 37.3% parents was lower than 52, which was at a low level. Parents in the high score (> 74) group and the low score (< 52) group had statistically significant differences ( P<0.05) in the total score of CD - RISC and scores in all dimensions, as well as the differences in the scores of the four dimensions of FAD, namely problem solving, communication, role and behavior control. The total score of PTGI of parents was positively correlated with the total score of CD - RISC and the scores of its all dimensions ( r values were 0.201-0.317, P<0.05), and negatively correlated with the scores of Problem Solving, Communication and Behavioral Control of FAD ( r values were -0.233 - -0.196, P<0.05). Conclusions:The parents of children with autism spectrum disorder have an average level of posttraumatic growth. People with better mental resilience and healthier family functions have higher post-traumatic growth level.

Histology teaching requires a combination of theory and experiment for a better understanding of microstructure and related functions of body.On the basis of the comparison and summary of the advantages and limitations of traditional light microscopy tissue slices and the emerging digital slicing,we combined them in the teaching of micromorphology experiments to achieve a better teaching results.Each experimental course (about 3 to 4 hours) was divided into four parts:teaching videos,observation of light microscopy tissue slices and digital slicing,discussion on course content and random quizzes.This teaching method contributed to the improvement of the students' interest and motivation in learning,the teachers' teaching efficiency and the overall teaching quality.

OBJECTIVE:To systematically review the efficacy and safety of intrathecal injection of vancomycin combined with dexamethasone in the treatment of intracranial infection,and to provide evidence-based reference in the clinic. METHODS:Re-trieved from PubMed,Medline,CJFD,VIP,Wanfang databases,randomized controlled trials(RCTs)about intrathecal injection of vancomycin combined with dexamethasone in the treatment of intracranial infection were collected. Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies according to Cochrane system review manual 5.0.1. Then Meta-analysis was conducted by Rev Man 5.2 statistical software. RESULTS:Total of 8 RCTs were included,involv-ing 543 patients. Meta-analysis showed that,compared with intravenous dripping of ceftriaxone or vancomycin,intrathecal injec-tion of vancomycin combined with dexamethasone could significantly increase response rate [RR=1.18,95%CI(1.11,1.26),P<0.001] and bacterial clearance rate of CSF[RR=1.13,95%CI(1.01,1.27),P<0.001] of intracranial infection patients,shortened treatment time [SMD=-1.60,95%CI(-1.89,-1.30),P<0.001],reduce the incidence of ADR [RR=0.48,95%CI(0.32,0.73), P<0.001]. At the same time,it also could improve changes of intracranial pressure[SMD=-1.78,95% CI(-2.10,-1.47),P<0.001],changes of protein quantitation of CSF[SMD=-0.18,95%CI(-0.25,-0.11),P<0.001] and changes of glucose quantita-tion of CSF[SMD=1.77,95%CI(0.91,2.63),P<0.001],with statistical significance. CONCLUSIONS:Intrathecal injection of van-comycin combined with dexamethasone shows good clinical efficacy for intracranial infection,improves bacterial clearance rate, shortens treatment duration,significantly lowers intracranial pressure and protein quantitation,improves glucose quantitation of cere-brospinal fluid,with good safety.

Objective:To study therapeutic effect of Guanxintongluo (GXTL ) capsule combined dual antiplatelet drugs on prevention and treatment of in -stent restenosis after percutaneous coronary intervention (PCI) .Methods :A total of 82 patients with coronary heart disease undergoing stent implantation treated in our hospital were select‐ed .All patients were numbered ,and they were divided into dual antiplatelet group (n=40) and combined treatment group (n=42 ,received GXTL capsule based on dual antiplatelet group ) according to odd and even number method . Therapeutic effect was compared between two groups .Results:Compared with dual antiplatelet group after treat‐ment ,there were significant rise in total effective rates of in -stent restenosis (77.5% vs .95.2% ) ,angina pectoris (80.0% vs .95.2% ) ,ECG (77.5% vs .92.9% ) and syndrome of traditional Chinese medicine (72.5% vs .90.5% ) in combined treatment group , P< 0.05 all . There were no significant difference in liver function between two groups before and after treatment , P>0.05. Conclusion:Guanxintongluo capsule combined dual antiplatelet drugs can effectively reduce incidence rate of restenosis , improve syndrome of traditional Chinese medicine ,ECG chan‐ges ,reduce pain degree of angina pectoris in patients with coronary heart disease after PCI , which is worth extending .

Objective:To investigate the optimal time of coronary computed tomography angiography (CCTA) after taking nitroglycerine,and to provide basis for improving the image quantity of CCTA .Methods:43 patients underwent CCTA were scanned with coronary artery calcium score (CACS)after taking nitroglycerin 0,3,5 and 10 min.Then the diameters of the same coronary artery from the same anatomic location and the expanding rates were measured,and the change regular was analyzed with single factor analysis of variance of SPSS 17.0 software. Results:The average coronary artery expanding rate was 8% 3 min after taking nitroglycerin, and the difference was significant compared with 0 min (P<0.05);but there were 5 patients whose coronary artery didn’t expand. The coronary artery expanded obviously 5 and 10 min after taking nitroglycerin compared with 0 and 3 min (P<0.05);the maximum expanding rates at 5 and 10 min were both 38%.There were 13 and 28 patients whose coronary artery reached the maximum expanding rates (17% and 19%)5 and 10 min after taking nitroglycerin, respectively;the coronary artery of 2 patients expanded at a same level at 5 and 10 min.The average expanding rates of coronary artery had no significant differences between 5 and 10 min (P>0.05 ).Conclusion:Taking nitroglycerin can significantly expand the diameter of coronary arteries.It is necessary to perform CCTA during 5-1 0 min after taking nitroglycerine.

Objective To evaluate and compare the applicability and accuracy of POSSUM , P-POSSUM and Thora-coscore in predicting the postoperative mortality of thoracic surgery patients .Methods We collected the clinical data of 1 450 thoracic surgery patients during March 2012 to August 2013 in the Second Xiangya Hospital.We used the 3 kinds of risk sco-ring system to calculate the predicted postoperative mortality in these patients .Then we used H-L test and the area under the ROC curve to evaluate and compare their degrees of compliance and validities of identification independently .Results Within 1 450 cases,20 patients (1.4%) died in 30 days after surgery, POSSUM overestimated the mortality (3.84%,P<0.001), while the P-POSSUM (1.05%/1.10%) and Thoracoscore (0.90%) underestimated the mortality, P>0.05.The area under the ROC curve of POSSUM, P-POSSUM ( two kinds of death prediction formula ) and Thoracoscore to predict postoperative mortality in all thoracic surgery patients was 0.774,0.777,0.777 and 0.831 independently, P <0.05; the area under the ROC curve to predict postoperative mortality in patients after lung surgery was 0.755,0.771,0.771,0.849 independently, P<0.05; the area under the ROC curve to predict postoperative mortality of patients with esophageal surgery was 0.640,0.650,0. 650,0.764 independently, only Thoracoscore P<0.05;the area under the ROC curve to predict postoperative mortality of pa-tients with mediastinal and other surgical was 1.000,1.000,1.000,0.854 independently, only Thoracoscore P<0.05.Con-clusion Thoracoscore scoring system is the most suitable risk scoring system to predict postoperative mortality in thoracic sur-gery patients with high predictive accuracy and good identification validity .