Objective To investigate the clinical characteristics,diagnosis,and treatment of gastric duplication(GD)in children.Methods A retrospective analysis was conducted on the clinical data of 46 pediatric patients with GD treated at our hospital from January 2008 to January 2025.The evaluated parameters included age,gender,symptoms,comorbidities,imaging data,surgical process,postoperative treatment and follow-up situation.Analyze the clinical characteristics of GD.Results Forty-four cases were cystic structures,and 2 cases were sinus tracts or tubular structures respectively.The most common site was the cardia/fundus area(20 cases).Seventeen cases were asymptomatic(7 detected during prenatal screening and 10 identified incidentally).The most common associated anomalies were inguinal hernia(4 cases),pulmonary airway malformation(3 cases),pulmonary sequestration(3 cases),and hiatal hernia(3 cases).All 46 patients underwent ultrasound examination,with an accuracy of 97.8％.Upper gastrointestinal contrast studies were performed in 16 cases and computed tomography(CT)was conducted in 34 patients.Perforation occurred in 7 cases.Surgical approaches included laparoscopy(35 cases,with 5 conversions to open surgery),open surgery(9 cases),robotic surgery(1 case),transthoracic surgery(1 case).Operative time ranged from 50 to 250 minutes(median:105 minutes).Postoperative pathology identified pancreatic heterotopia in 6 cases.Time to resume oral intake ranged from 1 to 17 days(median:4 days),and postoperative hospital stay lasted 3-21 days(median:7 days).During follow-up,one patient was readmitted for adhesive intestinal obstruction and managed conservatively,with no other significant complications reported.Conclusion Pediatric GD is a rare congenital anomaly,typically presenting as non-communicating cystic lesions with nonspecific clinical manifestations.Ultrasonography is the primary diagnostic tool,with upper GI series,CT/MRI,and endoscopy as adjuncts.While prompt surgical intervention is indicated for symptomatic cases,those complicated by perforation/infection should undergo delayed elective resection ≥ 3 months following complete inflammatory resolution.Laparoscopic approach is the treatment of choice,while endoscopic intraoperative localization or endoscopic therapy may be considered for small intraluminal lesions.

Objective To investigate the clinical characteristics,diagnosis,and treatment of gastric duplication(GD)in children.Methods A retrospective analysis was conducted on the clinical data of 46 pediatric patients with GD treated at our hospital from January 2008 to January 2025.The evaluated parameters included age,gender,symptoms,comorbidities,imaging data,surgical process,postoperative treatment and follow-up situation.Analyze the clinical characteristics of GD.Results Forty-four cases were cystic structures,and 2 cases were sinus tracts or tubular structures respectively.The most common site was the cardia/fundus area(20 cases).Seventeen cases were asymptomatic(7 detected during prenatal screening and 10 identified incidentally).The most common associated anomalies were inguinal hernia(4 cases),pulmonary airway malformation(3 cases),pulmonary sequestration(3 cases),and hiatal hernia(3 cases).All 46 patients underwent ultrasound examination,with an accuracy of 97.8％.Upper gastrointestinal contrast studies were performed in 16 cases and computed tomography(CT)was conducted in 34 patients.Perforation occurred in 7 cases.Surgical approaches included laparoscopy(35 cases,with 5 conversions to open surgery),open surgery(9 cases),robotic surgery(1 case),transthoracic surgery(1 case).Operative time ranged from 50 to 250 minutes(median:105 minutes).Postoperative pathology identified pancreatic heterotopia in 6 cases.Time to resume oral intake ranged from 1 to 17 days(median:4 days),and postoperative hospital stay lasted 3-21 days(median:7 days).During follow-up,one patient was readmitted for adhesive intestinal obstruction and managed conservatively,with no other significant complications reported.Conclusion Pediatric GD is a rare congenital anomaly,typically presenting as non-communicating cystic lesions with nonspecific clinical manifestations.Ultrasonography is the primary diagnostic tool,with upper GI series,CT/MRI,and endoscopy as adjuncts.While prompt surgical intervention is indicated for symptomatic cases,those complicated by perforation/infection should undergo delayed elective resection ≥ 3 months following complete inflammatory resolution.Laparoscopic approach is the treatment of choice,while endoscopic intraoperative localization or endoscopic therapy may be considered for small intraluminal lesions.

Objective To investigate the protective effect of NDUFA13 protein against acute liver injury and liver fibrosis in mice and explore the possible mechanisms.Methods BALB/C mice(7 to 8 weeks old)were divided into normal group,CCl4 group,CCl4+AAV-NC group and CCl4+AAV-NDU13 group(n=18).Mouse models of liver fibrosis were established by intraperitoneal injection of CCl4 twice a week for 3,5 or 7 weeks,and the recombinant virus AAV8-TBG-NC or AAV8-TBG-NDUFA13 was injected via the tail vein 7-10 days prior to CCl4 injection.After the treatments,pathological changes in the liver of the mice were observed using HE and Masson staining.Hepatic expression levels of NDUFA13 and α-SMA were detected with Western blotting,and the coexpression of NDUFA13 and NLRP3,TNF-α and IL-1β,and α-SMA and collagen Ⅲ was analyzed with immunofluorescence assay.Results HE and Masson staining showed deranged liver architecture,necrotic hepatocytes and obvious inflammatory infiltration and collagen fiber deposition in mice with CCl4 injection(P<0.001).NDUFA13 expression markedly decreased in CCl4-treated mice(P<0.001),while a significant reduction in inflammatory aggregation and fibrosis was observed in mice with AAV-mediated NDUFA13 overexpression(P<0.001).In CCl4+AAV-NDU13 group,immunofluorescence assay revealed markedly weakened activation of NLRP3 inflammasomes(P<0.001),significantly decreased TNF-α and IL-1β secretion(P<0.001),and inhibited hepatic stellate cell activation(P<0.05)and collagen formation in the liver(P<0.001).Conclusion Mitochondrial NDUFA13 overexpression in hepatocytes protects against CCl4-induced liver fibrosis in mice by inhibiting activation of NLRP3 signaling.

Objective To investigate the protective effect of NDUFA13 protein against acute liver injury and liver fibrosis in mice and explore the possible mechanisms.Methods BALB/C mice(7 to 8 weeks old)were divided into normal group,CCl4 group,CCl4+AAV-NC group and CCl4+AAV-NDU13 group(n=18).Mouse models of liver fibrosis were established by intraperitoneal injection of CCl4 twice a week for 3,5 or 7 weeks,and the recombinant virus AAV8-TBG-NC or AAV8-TBG-NDUFA13 was injected via the tail vein 7-10 days prior to CCl4 injection.After the treatments,pathological changes in the liver of the mice were observed using HE and Masson staining.Hepatic expression levels of NDUFA13 and α-SMA were detected with Western blotting,and the coexpression of NDUFA13 and NLRP3,TNF-α and IL-1β,and α-SMA and collagen Ⅲ was analyzed with immunofluorescence assay.Results HE and Masson staining showed deranged liver architecture,necrotic hepatocytes and obvious inflammatory infiltration and collagen fiber deposition in mice with CCl4 injection(P<0.001).NDUFA13 expression markedly decreased in CCl4-treated mice(P<0.001),while a significant reduction in inflammatory aggregation and fibrosis was observed in mice with AAV-mediated NDUFA13 overexpression(P<0.001).In CCl4+AAV-NDU13 group,immunofluorescence assay revealed markedly weakened activation of NLRP3 inflammasomes(P<0.001),significantly decreased TNF-α and IL-1β secretion(P<0.001),and inhibited hepatic stellate cell activation(P<0.05)and collagen formation in the liver(P<0.001).Conclusion Mitochondrial NDUFA13 overexpression in hepatocytes protects against CCl4-induced liver fibrosis in mice by inhibiting activation of NLRP3 signaling.

Objective:To evaluate the safety and efficacy of 3D printing-assisted pre-fenestration and branch stent endovascular repair (F/b EVAR) in the treatment of thoracoabdominal aortic aneurysms.Methods:The clinical data of 26 patients treated with 3D printing-assisted F/b EVAR for complicated thoracic and abdominal aortic diseases at the Department of Vascular Surgery, the Ninth People's Hospital,Shanghai Jiaotong University School of Medicine from May 2019 to Sep 2022 were retrospectively analyzed.Results:The success rate in these 26 cases of TAAA with 3D printing combined with F/b EVAR was 97.89%, and the mean follow-up time was (8.03±4.15) months. Four cases had Ⅲc internal leakage and disappeared during the follow-up. One case of type Ⅲ leakage were narrowed during follow-up. Ic type internal leakage occurred in 1 patient and disappeared after the addition of a stent at the distal end. During the follow-up period, aortic CTA indicated that 1 patient had renal artery stent occlusion and smooth blood in other visceral branches. No complications such as organ ischemia, lower limb ischemia and all-cause death occurred during follow-up.Conclusion:3D printing-assisted F/b EVAR minimally invasive repair of TAAA is a feasible, effective and safe technique, with high success rate and low complication rate of visceral branch artery reconstruction.

Objective:To systematically compare the prognosis in non-compressible torso hemorrhage（NCTH）treated by resuscitative endovascular balloon occlusion of the aorta（REBOA）and resuscitation thoracotomy（RT）.Methods:Data were searched form MEDLINE, EMBASE, PubMed, WanFang, CNKI and VIP databases to collect studies on the prognosis of patients with NCTH undergone REBOA and RT from inception to December 2020. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. The Meta-analysis was performed using Revman 5.3. The patients were divided into REBOA group and RT group according to the different surgical treatment methods on admission, and the prognosis of each group was evaluated. The difference of mortality rate, reoperation rate of laparotomy after operation, reoperation rate of embolization after operation and mortality rate in different operating room area were compared between the two groups. Publication bias was assessed using the Egger test.Results:A total of 2 prospective studies and 4 retrospective studies involving 2, 588 subjects were included. There were 1, 591 patients in REBOA group and 997 patients in RT group. Significant differences were observed in the mortality rate（ I2=68%, OR=0.33, 95% CI 0.26-0.42, P<0.01）, reoperation rate of laparotomy after operation（ I2=76%, OR=1.41, 95% CI 1.11-1.77, P<0.01）and reoperation rate of embolization after operation（ I2=84%, OR=0.76, 95% CI 0.59-0.99, P<0.05）between REBOA group and RT group. Subgroup analysis showed that the mortality rate in the ICU were not statistically different between the two groups（ I2=83%, OR=0.69, 95% CI 0.45-1.05, P>0.05）, but the mortality rate in the emergency room was lower in REBOA group than that in RT group（ I2=94%, OR=0.52, 95% CI 0.38-0.70, P<0.01）. Egger test showed that publication bias had little effect on the results. Conclusions:For patients with NCTH, REBOA can reduce the mortality rate and reoperation rate of embolization after operation, but increase the reoperation rate of laparotomy after operation when compared with RT. In addition, the emergency room may be a more suitable operationg room area for REBOA.

In this paper, a new surface electromyography (sEMG) signal decomposition method based on spatial location is proposed for the high-density sEMG signals in dynamic muscle contraction. Firstly, according to the waveform correlation of each muscle motor units (MU) in each channel, the firing times are extracted, and then the firing times are classified by the spatial location of MU. The MU firing trains are finally obtained. The simulation results show that the accuracy rate of a single MU firing train after classification is more than 91.67%. For real sEMG signals, the accuracy rate to find a same MU by the "two source" method is over (88.3 ± 2.1)%. This paper provides a new idea for dynamic sEMG signal decomposition.
Action Potentials ; Computer Simulation ; Electromyography ; Muscle Contraction ; Muscle, Skeletal

Objective: To investigate the correlation between the stenosis degree of superior mesenteric artery (SMA) and each artery within the scope of aorto-iliac artery in patients with lower extremity atherosclerotic occlusive disease (LEAOD). Methods: Images of 70 patients who had undergone the aorta-iliac-femoral arteries CT angiography (CTA) examination and had a definite diagnosis of LEAOD due to intermittent claudication or resting pain admitted to Tianjin Hospital from January to December in 2017 were enrolled. The arteries in the aorta as well as iliac were surface-reconstructed, which were analyzed by advanced vascular analysis (AVA) combined with the original images, including SMA trunk, abdominal aorta (AA), left and right common iliac artery (LCIA, RCIA), left and right internal iliac artery (LIIA, RIIA), left and right external iliac artery (LEIA, REIA). The normal reference plane and the maximal stenosis plane were selected, and the stenosis rate of each artery in the reconstruction range was automatically calculated with software. The patient's imaging data were divided into groups with two methods: ① according to the degree of SMA stenosis, the patients were divided into group Ⅰ (stenosis degree ≤70%) and groupⅡ (stenosis degree > 70%); ② LEAOD patients with different gender were respectively divided into three groups: middle-aged group (45-59 years old), pre-elderly group (60-74 years old) and elderly group (75-89 years old). The comparison between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery was analyzed with Pearson simple correlation analysis. Results: The incidence of SMA stenosis in all LEAOD patients was 100%. Correlation analysis showed that there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in group Ⅰ (n = 64) and group Ⅱ (n = 6), respectively (r value was -0.021, 0.023, 0.023, -0.137, 0.182, -0.113, 0.141, respectively, in group Ⅰ, and it was 0.020, -0.560, 0.010, 0.306, -0.204, -0.381, 0.393, respectively, in group Ⅱ, all P > 0.05). In 52 male patients, there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in middle-aged group (n = 16), pre-elderly group (n = 27) and elderly group (n = 9), respectively (r value was -0.032, 0.024, 0.324, 0.146, 0.312, 0.008, 0.344, respectively, in middle-aged group, it was -0.108, -0.116, -0.040, -0.249, -0.082, -0.052, 0.096, respectively, in pre-elderly group, and it was 0.182, 0.311, 0.400, 0.360, 0.688, 0.498, 0.406, respectively, in elderly group, all P > 0.05). In 18 female patients, there was also no correlation between the stenosis degree of SMA and above each artery within the scope of aorto-iliac artery in pre-elderly group (n = 11) and elderly group (n = 6), respectively (the r value was -0.170, 0.040, -0.019, 0.152, 0.508, 0.042, 0.456, respectively, in pre-elderly group, and it was -0.660, 0.008, -0.055, -0.056, -0.213, 0.344, 0.011, respectively, in elderly group, all P > 0.05). The correlation in middle-aged group was not analyzed because there was only 1 patient. Conclusions Although the atherosclerotic changes in LEAOD patients can affect SMA and aorto-iliac artery at the same time, there was no correlation between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery which may due to the differences in the histological structure and hemodynamics among different arteries. SMA atherosclerotic stenosis and occlusion is a relatively independent disease process for LEAOD.

OBJECTIVE: To investigate the correlation between the stenosis degree of superior mesenteric artery (SMA) and each artery within the scope of aorto-iliac artery in patients with lower extremity atherosclerotic occlusive disease (LEAOD). METHODS: Images of 70 patients who had undergone the aorta-iliac-femoral arteries CT angiography (CTA) examination and had a definite diagnosis of LEAOD due to intermittent claudication or resting pain admitted to Tianjin Hospital from January to December in 2017 were enrolled. The arteries in the aorta as well as iliac were surface-reconstructed, which were analyzed by advanced vascular analysis (AVA) combined with the original images, including SMA trunk, abdominal aorta (AA), left and right common iliac artery (LCIA, RCIA), left and right internal iliac artery (LIIA, RIIA), left and right external iliac artery (LEIA, REIA). The normal reference plane and the maximal stenosis plane were selected, and the stenosis rate of each artery in the reconstruction range was automatically calculated with software. The patient's imaging data were divided into groups with two methods: (1) according to the degree of SMA stenosis, the patients were divided into group I (stenosis degree ≤70%) and group II (stenosis degree > 70%); (2) LEAOD patients with different gender were respectively divided into three groups: middle-aged group (45-59 years old), pre-elderly group (60-74 years old) and elderly group (75-89 years old). The comparison between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery was analyzed with Pearson simple correlation analysis. RESULTS: The incidence of SMA stenosis in all LEAOD patients was 100%. Correlation analysis showed that there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in group I (n = 64) and group II (n = 6), respectively (r value was -0.021, 0.023, 0.023, -0.137, 0.182, -0.113, 0.141, respectively, in group I, and it was 0.020, -0.560, 0.010, 0.306, -0.204, -0.381, 0.393, respectively, in group II, all P > 0.05). In 52 male patients, there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in middle-aged group (n = 16), pre-elderly group (n = 27) and elderly group (n = 9), respectively (r value was -0.032, 0.024, 0.324, 0.146, 0.312, 0.008, 0.344, respectively, in middle-aged group, it was -0.108, -0.116, -0.040, -0.249, -0.082, -0.052, 0.096, respectively, in pre-elderly group, and it was 0.182, 0.311, 0.400, 0.360, 0.688, 0.498, 0.406, respectively, in elderly group, all P > 0.05). In 18 female patients, there was also no correlation between the stenosis degree of SMA and above each artery within the scope of aorto-iliac artery in pre-elderly group (n = 11) and elderly group (n = 6), respectively (the r value was -0.170, 0.040, -0.019, 0.152, 0.508, 0.042, 0.456, respectively, in pre-elderly group, and it was -0.660, 0.008, -0.055, -0.056, -0.213, 0.344, 0.011, respectively, in elderly group, all P > 0.05). The correlation in middle-aged group was not analyzed because there was only 1 patient. CONCLUSIONS Although the atherosclerotic changes in LEAOD patients can affect SMA and aorto-iliac artery at the same time, there was no correlation between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery which may due to the differences in the histological structure and hemodynamics among different arteries. SMA atherosclerotic stenosis and occlusion is a relatively independent disease process for LEAOD.
Aged ; Aged, 80 and over ; Computed Tomography Angiography ; Constriction, Pathologic ; Female ; Humans ; Iliac Artery ; Lower Extremity ; Male ; Mesenteric Artery, Superior ; Middle Aged

Objective:To compare the content of total saponins in Paridis Rhizome from Wudang mountain area to explore the cor-relation between the quality of medicinal materials and the production areas and species. Methods: The content of total saponins in Paridis Rhizome was determined by an ultraviolet-visible spectrophotometer at 406nm with perchloric acid as the chromogenic reagent. Results:The saponins content in Paridis Rhizome from Wudang mountain area had obvious differences:the minimum was 1. 29%, and the maximum was up to 10. 22%. The content of total saponins had no obvious correlation with species, production area and altitude. Conclusion:The quality of Paridis Rhizome is unstable in Wudang mountain area, and that will affect the effectiveness and safety of the clinical medication. Only by promoting the standardized planting of Chinese medicine materials, the stable quality of Paridis Rhizo-me can be ensured.